Image credit: Dr Matthias Ripp: CC BY 2.0
Psychoanalysis in the wider world
Across the world, after the impact of Covid and the intense isolation it brought, people’s mental health is deteriorating. And mental health provision in the aftermath has been less than sterling in most countries. As a result, we find that groups of young online people are engaging in self-diagnoses to alleviate suffering. Hence, there has been a growing international focus on exploring, analysing, and assessing mental health provision in Covid’s wake in recent years. However, this is not easy. Caring for the mind is not the same as caring for the body.
Moreover, treating the body benefits from a unified system of medicine and scientific methodology that underpins most treatments. For example, if I break my leg and go to most hospitals worldwide, there is a unified system of medicine that posits that I need to get my leg into a cast etc. However, when treating the mind and its myriad psychological symptoms, the scope and breadth of the treatments on offer are anxiety-inducing. And unlike medicine, they also come with their own models of the mind. Hence, what the subject’s internal world looks like for someone practising psychodynamic therapy – for instance – will be fundamentally different than what it would be for a Lacanian clinician.
Hence, we generally talk more about the value of mental health, and many therapies have now replaced psychoanalysis (although not in all countries). Indeed, we have CBT, psychodynamic therapy, counselling, and many others. But unfortunately, this therapeutic progress – a treatment predicated on leaving behind the Freudian field – dispenses with important therapeutic concepts that most accept in everyday conversation but fail to fit into neat scientific concepts or methodology. Indeed, the space for what we call ‘the unconscious’ seems to be closing down as we satisfy ourselves with DSM-5 categorisation, which has had some unfortunately societal side effects as we turn it into a field of moral judgement over cluster b personality types. Indeed, where in the past, the anti-psychiatry movement would have been deeply suspicious of psychiatric nosological categorisation, today, we grasp it fully as a liberatory discourse that is certainly not without its problems. To be sure, treatments like cognitive behavioural therapy essentially dispense with ideas like the Freudian unconscious altogether.
On the other hand, paradoxically, interest in psychoanalysis as an academic discourse has never really left us. On the contrary, it exists in film study and cultural theory courses and as an interdisciplinary hermeneutic device in most university discourses. Hence, we can speak about two forms of psychoanalysis, there is what we can call the post-Freudian Lacanian psychoanalysis associated with the humanities, and then there is the much-contested clinical field.
Psychoanalysis in Taiwan
However, even if there is a controversial status given to the Freudian field ranging from object relations theory to Lacanian analysis, the current crises we have undergone have made many realise that we cannot pretend that questions of mental health provision have to be reductive and scientistic in scope. Indeed, in a time of acute mental suffering, questions of how we deal with mental anguish need to be made more complex, layered and rich instead of shutting down and simplifying conversation. And psychoanalytic treatment, a contested subject, needs to have a voice in such a process. And this voice applies just as much to Taiwan as to other places.
Nevertheless, psychoanalysis in Taiwan is generally a small endeavour and its diminutive status – outside the halls of academia – has to be framed in the larger mental health crises that are playing out on the island. Indeed, a study from 1990 to 2010 utilised a questionnaire to examine the prevalence of common mental disorders. The results were startling; they showed mental health problems growing from 11.5% to 23.8%. Furthermore, a survey took place in 2017 that shows how 53.2 per cent of respondents thought mental illness has a stigma in Taiwan. This is not to mention that 65.3percent had no clue about available mental health services.
Things are improving, and since these surveys took place, the government has taken steps to provision for people’s mental health. To be sure, caring for people’s mental health was also an incentive during the covid crisis, something – as we know – Taiwan has shined in.
This special issue focuses on those psychoanalytic clinicians’ voices working in Taiwan. First, the articles will map out some of the problems these practitioners face at a cultural and institutional level. Next, they will address issues like intergenerational trauma stemming back from the white terror. Finally, they will look at how language plays an important role in the ‘talking cure,’ with specific reference to how Mandarin cannot be separated from the subject in treatment and the narrative of suffering that plays out in their life.
The larger subtext of these articles is about giving focus on mental health in Taiwan and making people aware of the treatments that are available to them. In this spirit, we at Taiwan Insight are very excited to introduce this special issue on Psychoanalysis and Mental Health in Taiwan.
In our first issue, Ping-Yuan Wu, a counselling psychologist who practices a psychoanalytic approach in Taiwan, asks questions relating to the challenge of teaching and transmission of psychoanalysis outside Taiwan’s university setting.
In our second issue, Po-Wei Hao, who is a counselling psychologist and the director of the Lacanian Practice and Promotion Society in Taiwan and has worked in the mental health field for the past ten years, looks at the psychological trauma of Taiwan’s authoritarian past and the challenges this creates for clinicians.
Finally, in our third issue Hsiang-Yuan Yu, a psychiatrist, working at the Mind Spa Clinic in Tainan, and chairman of The Lacanian Practice & Promotion Society in Taiwan, explores how psychoanalytic practice challenges many of the presumptions of evidence-based and market-orientated culture in Taiwan.
Dr Mark G. Murphy is an editor for the political journal and blog Taiwan Insight and a visiting lecturer at St Mary’s University, Twickenham. He is currently convening courses on Ethics, Theology, Philosophy and Psychology.