Ms. Tao, 42 years old, is the manager of Jiyinian Psychological Counseling Center in Nanjing. Although she majored in literature rather than psychology in university, she developed an interest in psychological analysis, especially the theory of psychodynamics. She became the student of a Norwegian psychologist to systematically study psychoanalysis in 2003 and started her counseling career in 2004.
Jiyinian Psychological Counseling Center was established by Ms. Tao and her friends, Ms. Yang and Mr. Chen, in 2006. In its infancy stage, it was rather difficult to run the center. Therefore, in the next year, both Yang and Chen left the center for better careers. Ms. Tao remained till now but did not enlarge the scale of the center. There are two full-time counselors in the center and several part-time psychologists who come at times for academic exchanges. She explained that she neither has ambition or time to manage a center on a larger scale.
According to Ms. Tao, the history of psychoanalysis in China is rather short; it can be traced to the years before the Cultural Revolution. At that time, some Western psychoanalytical theories were introduced. The development was suspended during the Cultural Revolution Period and slowly restored when medical colleges re-introduced Psychiatry as a subject. The first generation of students majoring in Psychiatry after the Cultural Revolution, have become the backbone of the psychoanalytical profession. Many of them, she says, are her teachers.
Ms. Tao tells that in China counselors mainly utilize Western approaches, such the psychodynamics of Freud or the TA methodology (Transactional Analysis) in their counseling. However, many of them are making endeavors to adjust these traditional Western methods to better serve Chinese people. Their major attempt is to introduce Chinese ancient philosophies into psychoanalysis, such as the thoughts of Zen, Confucius and Tao. In the last few years, she herself has pursued the wisdom in Zen and tries to practice her findings in counseling.
She believes this attempt is necessary in China. First, the disasters China has weathered in the past one and a half century, namely 150 years of war and 10 years of Cultural Revolution, have torn a huge trauma on people’s sub-consciousness. Second, Chinese people show little concern on children’s mental health both in the traditional and modern education. This ignorance distorts the personalities of many children. Therefore, Chinese people have their own psychic wounds that cannot be cured merely through imported psychoanalytical methods.
“In psychodynamic treatment, counselors take respecting their clients as the primary principle”, said Ms. Tao, “so we call clients ‘visitors’ or ‘cases’ instead of ‘patients’.” Ms. Tao cannot give an average age, education level or social background of her visitors, because they are from all walks of life. Yet she is sure that all her visitors can afford the consulting fees and young people at the age of 20 to 30 account for the majority. In the exam season, many adolescents who are going to take the entrance examination for college or high school come to her to relieve their pressures.
In the psychoanalytical theories, mental illnesses can be classified into three kinds based on the severity; namely schizophrenia, personality disorders and neurosis conflicts. In European countries such as France, psychological counseling centers provide psychotherapies to all the three illnesses, whereas those in China are currently lacking the conditions to treat schizophrenia. Therefore, visitors coming to Ms. Tao usually suffer from personality disorders or neurosis conflicts.
In most cases, visitors are unaware of their personality disorders or neurosis conflicts. Visitors come to Ms. Tao to solve various types of common problems, for example, their difficulty in dealing with colleagues, friends, lover or pressures from their job or study. These problems are in effect only the symptoms of certain mental illness. Ms. Tao needs to utilize complex techniques and skills in psychoanalysis, which are mainly based on Freud’s theory of defense mechanisms and Bowlby’s theory of attachment patterns, to trace the root causes beneath these symptoms.
It is crucial to distinguish whether the visitor suffers from personality disorders or merely neurosis conflicts. For an experienced counselor, it takes only one or two sessions of talking to resolve the neurosis conflicts. Nevertheless, the treatment called “personality integration process” can last up to several years if the visitor has been assessed to have personality disorders.
Ms. Tao told that both personality disorders and neurosis conflicts find their roots in the childhood experience of visitors. People with such illnesses did not have a good connection with their “mother”, a metaphor of guardians like parents, grandparents, other family members or nannies. Any hurt feelings related to their “mother” could be deeply embedded in the sub-consciousness of them. Personality disorders are more severe than neurosis conflicts because they originate from the early stages in life, when people did not know how to deal with them.
Personality disorders can be caused by a variety of psychic shocks occurring to the visitors before they were three years old. The psychic shocks include the early death of parents, early divorce, domestic violence, abandoning or disregarding girls. Ms. Tao added that parents with psychic traumas, for instance, thanatophobia (a specific fear of death) or fear of being abandoned, tend to transmit their illnesses to their children. For instance, during the “Three Years of Natural Disasters” (1958 to 1961), people had to face the death of many family members. In some families, only one or two children survived out of ten. These miseries were ascribed to the thanatophobia of that generation and exerted a far-reaching effect on their next generation.
Most of the people with neurosis conflicts have an Oedipus Complex, which means, they have failed to establish a healthy relationship between father, mother and themselves. They were exposed to severe external shocks at the age older than 6 years old.
Ms. Tao tells that the charges of the psychological counseling service in her center are 300 RMB for a 50-minute talk for regular visitors, while new visitors need to pay 400 RMB. Visitors’ medical insurance does not reimburse the counseling fees. She said it is lower than the average level in Nanjing. Some counselors with less experience of counseling, ask 500 RMB. Visitors with severe symptoms, come twice per week, whereas others come once every week.
In China, it is now easier to get a license to work as a psychological counselor. Ms. Tao has such a certificate for her qualification. In the opinion of Ms. Tao, having a license is not equivalent to having the certification to be a good counselor. Many people who memorize book knowledge to obtain the license are short of clinical knowledge, which is critical in the practice of counseling. She accumulated experience through a 3-year clinical study following her Norwegian teacher in Wuhan, Hubei Province.
She stresses the importance of experience. She developed a set of methodology in counseling by reflecting upon every case she ever took. However, she avoids applying her experience to her new visitors. “It is necessary for us to keep curiosity for a new visitor, even if he has symptoms I am already familiar with,” says Ms. Tao, “for individuals are distinct, and their psychology changes all the time.”