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Psychoanalysis in Asia

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The world is looking East. Whilst in the West psychoanalysis is fighting to maintain its position among the other therapies in a society which has less time for introspection and self-reflective thought, in Asia a new frontier is opening up: we are witnessing a surge of interest for psychoanalysis among the mental health professionals and among the younger generations, interest which is articulated and nuanced differently in the different Asian countries. In Asia and particularly in India, Japan, South Korea, Taiwan and China, the development of psychoanalysis reflects separate socio-political historical contexts, each with a rich cultural texture and fuelled by the interest of a new generation of mental health professionals for psychoanalysis as a therapeutic method.

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Chapter One: Psychoanalysis and culture



Psychoanalysis and culture

Cláudio Laks Eizirik


Psychoanalysis is a branch of science developed by Sigmund Freud (1856–1939) and his followers, devoted to the study of human psychology. It is usually considered to have three areas of application: 1. A systematised body of knowledge about human behaviour (psychoanalytic theory); 2. A method of investigating the mind; 3. A modality of therapy for emotional illnesses or psychic suffering (psychoanalytic treatment).

Psychoanalysis has as basic principles the notion that our mind is predominantly unconscious and that all our current actions, feelings, and thoughts are associated with, or derive from, previous meaningful experiences, mainly the ones that happened during our childhood. (Moore & Fine, 1990).

The complex relationship between psychoanalysis and culture can be illustrated when we consider that it appeared in the end of XIX century, in Vienna, a cultural milieu in which the “intelligentsia” was developing innovations in many areas simultaneously. The Viennese cultural elite had a rare combination of provincialism and cosmopolitism, tradition, and modernity, which produced a sort of cohesion greater than in other cities at that time.


Chapter Two: Psychoanalysis and culture: Freud, Erikson, and beyond



Psychoanalysis and culture: Freud, Erikson, and beyond

Salman Akhtar

There is very little difference between one person and another, but what little difference there is, is very important.

—William James (1842–1910)

The interior dimension of human experience is the subject matter of psychoanalysis. It does pay attention to conscious thoughts and feelings, fantasies, daydreams, perceptions, values, and beliefs. Its heart and soul, however, are in the subterranean strata of psychic life. What lurks beneath awareness, beyond intellectual grasp, and beside our platitudes and rationalisations is of greatest interest to psychoanalysis. Puzzling obsessions, utterly unrealistic phobias, bizarre convictions, embarrassing parapraxes, incomprehensible dreams, and, yes, miraculous feats of resilience and creativity draw the attention of psychoanalysis with irresistible magnetism. To find meaning in the seemingly meaningless and to add an undiscovered layer of hermeneutics to the flatness of logical existence is what psychoanalysis is about. To put it bluntly, if one were forced to select the most outstanding contribution of the discipline's founder, Sigmund Freud, the three word answer would be: unconscious mental life.


Chapter Three: The Stranger and the Strange: Psychoanalytic Reflections on Meeting Otherness



The stranger and the strange: psychoanalytic reflections on meeting otherness

Sverre Varvin


All meetings of human beings imply a meeting with what we experience as strange, the stranger or what we may call the otherness of the other.

In this chapter I will discuss the developmental basis for our relation to otherness and how this becomes a problem in different pathological states of mind. Symbolising the other and our relations to the other requires an ability to endure ambivalence and to create psychic space that allows for the not already defined and/or known. In psychosis and in the traumatised mind the other tends to become one- or two-dimensional and frightening not allowing the “new” in otherness to take shape. In these states of mind foreclosure and denial of otherness dominates. In other conditions we see restrictions and narrowness in relation to otherness. A psychoanalytic process will potentially imply an increasing openness to otherness.

It will be argued that psychoanalysis as a treatment and a model for reflection may open the space for the ability to appreciate and endure the meeting with otherness, the strange and the “new” both on an individual and a group level.


Chapter Four: Psychoanalytic Psychotherapy in the Chinese Context: Developments and Challenges



Psychoanalytic psychotherapy in the Chinese context: developments and challenges

Yunping Yang *

As a discipline, psychoanalysis belongs to no one, to no state, to no country, to no institution. And while professional societies appear to wish to represent it exclusively, for the most part it overflows from the framework that attempts to constrain it. In a way, psychoanalysis belongs to humankind's legacy, as in fact do other disciplines born at the same time, such as sociology or anthropology. (Roudinesco 2004: p. 178)1


Erikson introduced the concept of identity into the field of psychoanalysis to explore the phenomenon of psychopathology. In one of his papers, Otto F. Kernberg summaries Erikson's ideas of identity: “He described identity as an overall synthesis of ego functions, on the one hand, and as the consolidation of a sense of solidarity with group ideals and group identity, on the other. Erikson stressed that ego identity has both conscious and unconscious aspects, and that it develops gradually, until a final consolidation of its structure occurs in adolescence. He stressing the importance of the conscious sense of individual identity, matched by unconscious strivings for continuity of the individual's self experience” (Kernberg, 2006: p. 2).


Chapter Five: Psychoanalysis on the China Road: Sense of Trust in Doubt



Psychoanalysis on the China Road* : sense of trust in doubt

Wang Qian


From the very beginning when psychoanalysis was introduced into China, the following questions were asked far and near.

Is psychoanalysis suitable for China?

Will Chinese believe in psychoanalysis and will they be able to manage it?

May psychoanalysis with its roots in the Judeo-Christian tradition understand and hold the thousand years of Confucianism?

To explore the above questions within the Chinese cultural context, one not only needs to focus on the phenomena of whether psychoanalysis is applicable for the Chinese or not, which has been extensively discussed, but also needs to ponder over the confrontation between psychoanalysis and China: how do the Chinese manage to locate their own cultural experience in a psychoanalytic frame, so as to contain their unique experience originated in Chinese culture, as well as to strengthen the bonding both to our living environment and to our immemorial wishes.


Chapter Six: Slow Psychoanalysis is Helpful for Fast Developing China



Slow psychoanalysis is helpful for fast developing China

Liu Yiling

Is psychoanalysis slow?

Internal changes do take time

External changes may be easier and quicker but internal changes do take time. Psychoanalysis can change the inner world of a person during the journey from A to B, but it is a long and hard process.

We take a small step in every session towards understanding the patient and in order to facilitate the progress of psychoanalysis.

In order for change to occur, patients need to feel trust and confidence in the psychoanalytic method, but there is so much anxiety and fear. We should let the psychoanalytic process evolve slowly and gradually. Gradually, as the patient accepts the feelings of dependence derived from his childhood experience, he will feel more and more secure in himself and have more respect for his feelings (Ursano, 2004).

Psychoanalysis brings internal changes

Psychoanalysis is a psychological treatment that provides containment and an environment which has been described close to the maternal environment. The most suitable environment for growth is the psycho-analytic setting. In this environment anxiety, fear to be criticised and insecurity are modulated. It is like being back in mother's arms: what Winnicott (1965) describes as the holding environment, what Kohut (1984) says about the mirroring self-object and what John Bowlby's (1958) attachment theory demonstrates: that the maternal environment is crucial for a healthy development and that love is effective in psychological treatment (Moo-Suk, 2007).


Chapter Seven: Havoc Comes from the Mouth—Working as a Psychoanalyst in China



Havoc comes from the mouth—working as a psychoanalyst in China

Irmgard Dettbarn

This title I borrowed from an old Chinese saying (Zhang, 2010: p. 352) to invite the reader to share my experience as a training analyst in China between 2007 and 2010. I wrote this article during my recent time in China. At that time, I had already been in China for almost three years working with nine Chinese psychotherapists, psychiatrists and counsellors in high frequent psychoanalysis. My aim in writing this paper was to get to know as much as possible about Chinese culture—whatever that may be, to learn more about the flip side of the coin in terms of my analysands' lives. In this way “culture” could act as a third party, enabling the analyst to be more objective in their analytical work and interpretations as mentioned by Filet with reference to Anzieu and his description of Freud's work concerning culture in particular. “To avoid being caught or trapped in our own professional language and thus running the risk of a folie à deux with our own original culture” (Filet, 2001: p. 17).


Chapter Eight: Working with Chinese Patients: Are there Conflicts between Chinese Culture and Psychoanalysis?



Working with Chinese patients: are there conflicts between Chinese culture and psychoanalysis?*

Jie Zhong


Despite differences between Chinese culture and Western culture (Sun, 2002, 2004), modern Chinese are gradually accepting psychoanalysis and psychodynamic therapy as options for dealing with psychological problems and inner conflicts (Gerlach, 1999). Through my own experience of being analysed and vignettes from my clinical practice as a Chinese analytic psychotherapist, I argue first, that although there are conflicts at philosophic and cultural levels between Chinese culture and psychoanalysis, modern Chinese may have varying experience in psychoanalytic and psychodynamic situations and second, such cultural conflicts can not be ignored or only regarded as defences in the psycho-analytic situation in China.


Chinese mainland society changed rapidly after 1976 at the end the Cultural Revolution. Since then, the Chinese have gradually regained aspects of their traditional culture. The beliefs that stem from Confucianism, Daoism and Buddhism are now much stronger in common Chinese families and individuals than before 1976. Psychoanalysis, as a general theory of personality and as a clinical theory came from the West, first introduced into China in the 1920s. But it was abandoned under the strong influence of the Chinese political system in the period from 1949 to 1976. It only returned to Mainland China after 1980s, at first mostly in academic settings. Beginning in the 1990s, psychodynamic clinical training programmes were established in Shanghai, Beijing, and Wuhan after 1990s by German and Norwegian psychoanalysts. Slowly, psychoanalysis or psychodynamic therapy has been gradually accepted by modern Chinese mental health professionals and patients as an option for dealing with psychic problems, and the relationship between Chinese traditional culture and psychoanalysis is now being discussed both inside China and by international psycho-analytic societies (e.g., Ng, 1985; Gerlach, 1999; Rascovsky, 2006).


Chapter Nine: Objectifying and De-Objectifying the Dead: The Use of Images in Chinese Ancestor Worship



Objectifying and de-objectifying the dead: the use of images in Chinese ancestor worship

Liza Ng


Ancestor worship is a practice that has been passed on from generations to generations since ancient times in the Chinese culture. While many cultural practices are changing rapidly, paying respect to the elders and collaterally to the ancestors is still customary. Chinese migrants continue to practice the ancestor rites, even though many have assimilated the culture of their newly adopted countries, such as Australia, America, and South East Asia.

This chapter applies psychoanalytic principles to promote an understanding of the psychic benefits of a traditional Chinese practice. In this exploration, I would like to discuss the relevance of the use of symbolic images in ancestor worship. Given that ancestor veneration through the use of images is associated with maintaining links with the deceased; I will therefore speculate on the psychic significance of such practices in instigating healthy links with the object. Through Winnicott's theory, I explore the idea that images and symbolic objects assist in objectifying and de-objectifying of the dead. Ogden (1992) described how the potential space is an expression of the capacity for symbolisation. I will demonstrate that the act of veneration, like playing, is an experience that resides in the potential space.


Chapter Ten: Psychoanalysis in a “Shame Culture”: A Drama-Based Viewpoint



Psychoanalysis in a “shame culture”: a drama-based viewpoint

Osamu Kitayama


In the first half of this paper, I will describe my drama-based view of psychoanalysis and discuss its background in terms of internal communication and external communication, quoting Japanese materials. I then will present a psychoanalytic theory and practice from the drama-based viewpoint of a culture in which people may feel deeply ashamed of their private self. These psychological phenomena can remain deep-seated in people's psychological inner world as they hide their shameful self underneath the surface, wearing a mask and playing a “respectable” role in public, as if acting on stage.

I will then refer to my own cultural study of “The Prohibition against Looking.” From the standpoint of dramatic psychology, I will not only discuss the significance of a drama's heroine in terms of shame, but also suggest the influence and power of the man playing the role opposite the protagonist. At the end of this chapter, I will quote a Japanese example of clinical dialogues, as analysed from a drama-based viewpoint, in order to show the importance of resistance analysis in psychoanalysis and psychoanalytic psychotherapy.


Chapter Eleven: Issues of Psychoanalysis in the Twenty-First Century: From Some Experiences in Japan



Issues of psychoanalysis in the twenty-first century: from some experiences in Japan

Masahisa Nishizono

Periodical and cultural backgrounds and the universality of psychoanalysis—from Freud to post-Freud

The discovery of psychoanalysis by Sigmund Freud is said to be one of the greatest cultural achievements of the twentieth century. Psychoanalysis began as a treatment for hysteria, which is a type of neurosis. It then developed as a treatment for all types of neurosis, such as phobias and obsessive-compulsive disorders. Followers of Freud developed psychoanalysis further and applied it to the treatment of mental illnesses such as schizophrenia and manic-depressive psychosis (currently diagnosed as “bipolar disorder”). In the course of developing these treatment methods, moreover, Freud evolved psychoanalysis from the study of treatment for mental disorders to a set of “psychological theories for understanding humans.” Psychoanalysis is regarded as one of the greatest cultural accomplishments of the twentieth century not only because of its value in therapeutics but also because of its advocacy of “psychological theories of understanding humans” which was a completely new concept.


Chapter Twelve: The Complications of the Perpetrator-Victim Relationship for Japanese Children During World War Two: What can Psychoanalysis Contribute toward Conciliation between China and Japan?



The complications of the perpetrator-victim relationship for Japanese children during World War Two: what can psychoanalysis contribute toward conciliation between China and Japan?

Shigeyuki Mori


China and Japan have suffered from a complicated perpetrator-victim relationship originating in acts perpetrated by the Japanese military during the Fifteen Year War (1931–45). The traumatic outcomes both for diplomatic issues and for individual citizens have not been worked through and still cast a shadow over both countries. Perhaps Japan owes the friendship and the economical cooperation brought into reality recently to Chinese kindness and the realistic judgment that traumatic memories are better avoided in order to establish economical cooperation. The memory of such brutal offences as the Nanking Massacre has not been forgotten and is often reawakened by Japanese politicians' words and behaviours, such as the Japanese prime minister's visit to Yasukuni Shrine. Economic cooperation may be interpreted, at least in part, as a manic defence with repression or dissociation of the traumatic memory. Therefore, it would be worthwhile to look into the China-Japan relationship as a process of repairing the trauma or as the result of that processes absence.


Chapter Thirteen: Korean Culture and Psychoanalysis



Korean culture and psychoanalysis

Moo-Suk Lee


Culture is demonstrated in clothing. English men wear suits, the Japanese wear kimonos, and Koreans, Han-Bok. They are all distinct but have one thing in common, they all wrap around the human body. Culturally, the unique manifestations of the human condition are like clothing in a psychoanalytic frame. Psychoanalysis, founded by Sigmund Freud (1915–1916), deals with the innate aspects (nature) of human beings. The distinctive biological features and instincts (sexual and aggressive instinctual drives) of human beings, the relationship between mother and child, the basic emotions of human beings, etc., are the main topics of psychoanalysis. There are no differences between the West and the East in terms of basic human biology, instinct, and emotions. Stories from the West, such as Les Miserables, cause great emotional stirring in those from the East. They also enjoy and appreciate music composed by western composers such as Mozart and Schubert. At the Congress of the International Psychoanalytical Association, I also observed that the western psychoanalysts were impressed by Japanese scholars, such as Professor Osmau Kitayama of Kyushu University, who discussed his studies on Ukieo (Kitayama, 2004).


Chapter Fourteen: Feeling and Thinking in English on the Couch



Feeling and thinking in English on the couch*

Do-Un Jeong


In this age of globalisation, the propagation of psychoanalytic training and therapy is no exception. Under the aegis of the International Psychoanalytical Association (IPA), we find shuttle and condensed analyses, though exceptionally applied, as well as traditional model of four to five times-per-week analysis. Outside the IPA, “analysis” using the telephone or internet, with each of the analytic dyad in their own country, is also being practiced despite opposition and controversies.

Psychoanalysis invented by Sigmund Freud in Austria used to be practiced in so-called western languages including German, English, French, Spanish, Italian, Hungarian, Russian, etc. Relatively speaking, westerners often share the linguistic root and communication amongst bilingual westerners is much easier, whilst communication between westerners and Asians sharing no linguistic root is naturally much more difficult.

Economic growth in East Asia has fostered interest in psychoanalysis among the general public as well as those who want to be trained as analysts. It is no longer surprising to find East Asian candidates at foreign psychoanalytic institutes. Moreover, analysts may travel abroad in order to provide training analysis for the foreign analysands.


Chapter Fifteen: The Formosa Model: An Emerging Tradition of Developing Psychoanalysis in Taiwan



The Formosa Model: an emerging tradition of developing psychoanalysis in Taiwan

Chia-Chang Liu

Taiwan is an island of 36,000 square kilometres with the current population of twenty-three million. The island is of a slender shape, 400 kilometres long, and it's quite mountainous, with the Central Mountain striding from north to south and the famous highest peak, Jade Mountain, nearly 4,000 meters high. The government has established six national parks and twelve national scenic areas to preserve Taiwan's best natural ecological environment and cultural sites. As for the cultural aspects, the blending of aboriginal, Hakka, Taiwanese, and mainland Chinese cultures has produced a glaring cultural and social scenery. Its religions, architecture, languages, living customs, and food show that Taiwan is a lively melting pot.

In 1542, Portuguese sailors on their way to Japan came across an island not identified on their maps. Amazed at the forest-cloaked land, they shouted, “Ilha Formosa”, meaning “Beautiful Island”. The island had thus come to be known as Formosa, which was to become what we know today as Taiwan. During the past 400 years, different political powers have ruled Taiwan. In 1624, the Dutch came to occupy and rule the island. Between 1661 and 1662, the Ming loyalist Cheng Ch'eng-kung expelled the Dutch and established on the island an independent kingdom. In 1683, the island was brought under the control of the Ch'ing dynasty until 1895, when it was ceded to Japan. Japan had occupied Taiwan for fifty years until it failed in the World War II in 1945.


Chapter Sixteen: Shame and Losing Face in Taiwanese Culture: A Clinical and Cultural Perspective



Shame and losing face in Taiwanese culture: a clinical and cultural perspective

Hsuan-Ying Huang and Ming-Min Yang

The understanding of shame has been entangled with that of guilt but taken a less unambiguous course. Both of them are members of the so-called “self-conscious emotions” (Tracy et al., 2007), which emerge in the later stage of childhood and require the capacity of self-awareness and self-representation. They seem to indicate the sense of obligation, duty, and responsibility, or less strongly, suggestion, and advice. By functioning as moral assignment they create an inner tension marked by “should” or “should not” and evoke a series of feelings, thoughts, and behaviours.

The juxtaposition of shame and guilt has a recent history. It was shaped by the heritages of “culture and personality school” which had once dominated American anthropology. Ruth Benedict (2005) makes a sharp contrast between shame and guilt as different kinds of moral sanctions in Chrysanthemum and Sword, a seminal academic work that also becomes a bestseller. In her formulation, while guilt takes place in the depths of the individual conscience, shame relies on the “external” existence of an audience, whether real or fantasied. She also explains why confession is unable to bring relief to Japanese people among whom ceremonies for good luck instead of atonement prevail, which is a characteristic shared by Chinese popular religions. E. R. Dodds (2004) makes a similar distinction in The Greek and the Irrational in which he sees the transition of Homeric period to Archaic Age in ancient Greece as the evolution from shame culture to guilt culture. Following the publication of these landmark works, the shame vs. guilt dichotomy is firmly established and the notions of “shame culture” and “guilt culture” also become popular designations in the descriptions and comparisons of Eastern and Western cultures.


Chapter Seventeen: A Personal Journey into Culture and Psychoanalysis



A personal journey into culture and psychoanalysis

Sudhir Kakar

After my psychoanalytic training in Germany, I returned to Delhi in 1975 and began my clinical practice in a ten by ten foot cubicle formed by plywood walls and a low wooden ceiling in a large commercial office on Barakhamba Road, just off Connaught Place. My house was far from the centre of the city and given the poor state of Delhi's transport system at the time, I felt I needed an office that was centrally located.

At the beginning of my practice, many of the patients who came to consult me had been diagnosed by their families and traditional healers as being possessed by evil spirits. They had made the rounds of neighbourhood exorcists, healing temples, Ayurvedic physicians and drug-dispensing psychiatrists. I was a new kind of “brain doctor”, with the prestige of Western medicine behind me, and for some I was their last hope for a cure.

My failure rate was around ninety per cent and my feelings of mortification were much greater than the disappointment of the patients' families. I was touched when a family member would try to console me, “It is not your fault, Doctor, this is an especially difficult case”. “Her possessing spirit—bhuta—is singularly strong”, another would add, not without a measure of pride. These consultations, however humiliating at the time, had an unintended benefit.


Chapter Eighteen: The Universal Truth of Myths Reflected in Psychoanalytic Theory and Practice



The universal truth of myths reflected in psychoanalytic theory and practice

Minnie K. Dastur


There is a commonality in the myths of all nations and cultures. As these myths are externalisations/projections of our own unconscious phantasies and desires, dreams and myths are interrelated; in that they both spring from the deep reservoir of the unconscious; one from the individual and the other part of a culture and race. The myths may differ in manifest content, but share a common latent content. The defence may be different, but the anxiety has a common root. These myths therefore are also part of our personal myths and they shape our idea of ourselves, our objects and therefore our object relations. Understanding the development and the psychical element in the myth, also leads to the understanding of the psychical development of the human mind from the time of birth to adulthood and that is the universal truth embodied in myths of all nations and cultures. I share my clinical work to show how patients use myths and fairy tales, which have become part of their psychic framework, to communicate, the communicative use of projective identification. The commonality of different myths and the psychical truth they contain in analytic theory makes psychoanalytic practice relevant in whichever corner of the world it is practiced in. It also forms the dialogue between analyst and analysand, irrespective of their different originating cultures.


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