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APAXXX10.1177/0003065115590419Diego BusiolPsychoanalysis in Hong Kong, Mainland China, and Taiwan
ja Pa
DOI: 10.1177/0003065115590419
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Diego Busiol
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Psychoanalysis in Hong Kong, Mainland China, and Taiwan
P s yc h o a n a ly s i s i n t h e C h i n e s e C o n t e x t
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Diego Busiol
and interpretations that had been popular in the 1920s (Larson 2009).
Currently there is a new openness to psychoanalysis.
In Taiwan, for several years, psychoanalysis has been present in uni-
versity departments of literature and philosophy, as well as among thera-
pists and psychiatrists (Rascovsky 2006). According to Liu (2013), in the
last four decades psychoanalysis has been drawing increasing attention
from intellectuals in Taiwan, and some medical students and young psy-
chiatrists have translated some of the classic works of Freud into Chinese.
Hong Kong represents an unknown. Here the majority of Western
psychotherapies are known and practiced, while psychoanalysis still has
little resonance. Indeed, the word psychoanalysis means little to most
people, while the term counseling is far more common. Chan and Lee
(1995), studying psychologists in Hong Kong, reported that their most
commonly endorsed orientation was behavioral/cognitive, followed by
existential/humanistic. Two years later, Cheung (1997) confirmed that
psychoanalysis was not very popular in Hong Kong, although most pro-
fessionals did claim to have a general understanding of it, and some could
even make use of psychoanalytic concepts in their practice. However,
almost none had a strong foundation in psychoanalysis or operated purely
as psychoanalysts.
R e s e a r c h S t u dy: M e t h o d s a n d F i n d i n g s
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1Initial findings from this research were presented and discussed in 2012 at the Seventh
Annual Conference of the Asian Studies Association held in Hong Kong (Busiol 2012c) and at
the Chinese Psychoanalytic Congress held in Shanghai (Busiol 2012a). A book based on this
research will be published by Routledge in 2016 (Busiol in press).
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Psychoanalysis in Hong Kong, Mainland China, and Taiwan
P e n e t r at i o n o f P s yc h o a n a ly s i s Am o n g
C o u n s e l i n g P r o f e s s i o n a l s I n H o n g Ko n g
Psychoanalytic attitude. Results from the PACWS showed that most Hong
Kong professionals scored above the theoretical midpoint on floating
attention and transference, but below the theoretical midpoint on the sub-
scale unconscious. Because psychoanalytic theory and techniques were
not much used by this sample, low scores on the unconscious dimension
were not surprising; the concept of the unconscious is not native to
Chinese culture (Zhang 1992) and could be provided only by specific
training. Conversely, higher scores on floating attention and transference
suggested that these two important components of the psychoanalytic
attitude are already embedded in the Hong Kong Chinese culture.
Factors affecting the reception of psychoanalysis.Results from the
PUNU showed that psychoanalysis is not perceived among this sample as
less effective than other approaches: the majority of respondents reported
that they do not perceive psychoanalysis as an obsolete and inadequate
method. Apparently, if they have received only minimal or no training in
psychoanalysis it is not because they are unwilling, or have biases against
psychoanalysis; it is more likely due to the lack of training opportunities
locally. Indeed, if such training were made available in Hong Kong,
counselors would tend to be interested. However, psychologists, social
workers, and counselors alike reported that they consider psychoanalysis
a complex and long-term approach. Another factor weighing against the
reception of psychoanalysis is the professionals attitude toward eclecti-
cism. Indeed, subgroups analyses have confirmed that eclecticism is
common among all professionals, regardless of other variables, showing
that this is a culture-specific trait and not merely the result of lack of
training among counselors. This also confirmed findings by Chan and
Lee (1995) and Tsoi and Lam (1991) that therapeutic practice in psychol-
ogy in Hong Kong is best characterized as eclectic. An eclectic approach
is based on what works, that is, on pragmatic rather than theoretical
grounds. Only the latter would seek explanations for why or how
various techniques are efficacious.
Conflicts with Chinese culture. Results showed important subgroup dif-
ferences: for social workers the confidence interval lies completely above
the theoretical midpoint of the CCC (in the Agree range), meaning that
the great majority of social workers think psychoanalysis is in conflict
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Psychoanalysis in Hong Kong, Mainland China, and Taiwan
over the visible, the explicit, and the articulate (Chia 2003); thus, under-
standing greatly relies on the receiver. This is quite the opposite of what
generally happens in European and American societies, where speaking
is emphasized. Second, transference is predicted first by eclecticism, then
psychoanalytic training, and conflicts with Chinese culture. The Chinese
normally place more attention on relations between people than on the
content of the communication (Gao, Ting-Toomey, and Gudykunst 1996;
Gao and Ting-Toomey 1998), and this was thought to explain why the
variable transference ranked so high among this sample. However,
although this relational inclination might be embedded within the local
culture, results showed that specific psychoanalytic training is an essen-
tial component for an understanding of transference as theorized in psy-
choanalysis. Third, the variable unconscious is predicted only by
psychoanalytic training; this is a significant finding, because, although
the concept of the unconscious is not found in the local culture, it can be
accepted nevertheless.
Further subgroup differences. Professionals who had been in therapy
(regardless of therapeutic approach) had statistically significant lower
scores on (a) perceived ineffectiveness of psychoanalysis, (b) perceived
complexity of psychoanalysis, (c) solution-oriented approach, and
(d)conflicts with Chinese culture than did respondents who had not been
in therapy. Finally, social workers had significantly higher scores on
solution-oriented approach than did psychologists and counselors.
T h e Impa c t o f Cu lt u r e
Certainly the literature suggested that the impact of Chinese culture and
Chinese values contraindicating psychoanalysis would be perceived as
strong by local professionals. Surprisingly, however, results from the
CCC showed that this was true only for social workers; psychologists and
counselors held an opposite opinion. However, the CCC can directly
assess only what respondents think about culture (their opinion), and not
the effect culture really plays on their counseling style. Then, because the
CCC was correlated with the PUNU subscales solution-oriented approach,
perceived ineffectiveness of psychoanalysis, perceived complexity of
psychoanalysis, and eclecticism, this suggested that culture indirectly
influences counselors theoretical orientation and how they understand
psychoanalysis. Thus, the impact of culture is at least threefold: (a) it may
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Diego Busiol
I s T h e r e P s yc h o a n a ly s i s I n H o n g Ko n g ?
Simply considering data from the background information, one may think
that at least some psychoanalysis is being practiced in Hong Kong.
However, there are serious issues regarding the availability of effective
training, and how psychoanalysis is actually practiced: (1) several other
techniques are mentioned more frequently, and none of the respondents
report having adopted psychoanalysis as their sole modality; (2) at pres-
ent teaching about psychoanalysis is limited to some introductory courses
in local universities; and (3) a lack of psychoanalysts means that profes-
sionals cannot usually undergo a personal analysis or receive psychoana-
lytic supervision.
In addition, local professionals have been shown to be listening-
oriented and receptive to the relational dimension in counseling; how-
ever, because the concept of the unconscious in the Freudian sense is still
foreign to most of them, it may be that their listening means listening to
the other person rather than to the unconscious; this is very different from
psychoanalytic listening.
Today, several translations for the term unconscious exist in Chinese
and are being used indiscriminately (Plnkers 2013), but none of them is
satisfactory (sometimes it is translated as nonconscious , as
opposed to consciousness; at best, it is translated with or
, both meaning subconscious). Interestingly, according to the histo-
rian of psychoanalysis Hannah Decker (1977), even in Western contexts
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P s yc h o a n a ly t i c T r a i n i n g
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Diego Busiol
P s yc h o a n a ly t i c T r a i n i n g i n H o n g Ko n g ,
M a i n l a n d C h i n a , a n d Ta i wa n
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Hong Kong was for many years a British colony, and has developed
an inclination, an admiration, indeed almost a fascination, for the cultures
of English-speaking countries (Tsang 2004). Many professionals offering
and teaching counseling today in Hong Kong were trained abroad, in such
places as the United States, Canada, Europe, and Australia (Leung, Chan,
and Leahy 2007). These professionals have therefore imported to Hong
Kong the theories and knowledge they have acquired during their training
abroad. Since we are referring mainly to English-speaking countries, such
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China. Namely, this detail is informative not only of the transfer of psy-
choanalysis to China but, more important, of the transference of both
Western and Chinese psychoanalysts. Then, rather than considerations of
cultural differences, which could be biased by a Western perspective, it is
suggested that two other issues be considered that might help explain the
apparent passivity of the Chinese in this matter: (1) the reasons that psy-
choanalysis is appealing to the Chinese today are largely ignored, and
may be different from the reasons it appealed to Western psychoanalysts
in different contexts and periods; (2) the passive role assumed by the
Chinese might be a consequence of too much activism in their Western
counterparts.
On the one hand, the myth of the Chinese learner as passive has been
questioned (Mok et al. 2008; Watkins and Biggs 2001); rather than sig-
nifying a lack or deficiency in Chinese culture, this apparent passivity
may arise simply from the fact that Chinese professionals have different
reasons for becoming psychoanalysts (perhaps the desire for a better pro-
fessional career, or the belief that being a psychoanalyst is more presti-
gious), reasons that do not require the development and diffusion of
psychoanalysis. Or perhaps because they perceive psychoanalysis as a
Western theory, they might not yet feel ready to make their contributions
and instead expect the Western experts to give them direction. These
questions should be further investigated and are revealing of a surprising
gap in the literature.
On the other hand, probably the most significant questions for
Western psychoanalysts (also ignored in the literature) are the following:
Why is China fascinating to them? What has led Western psychoanalytic
organizations to Mainland China, but not to Hong Kong? Where is the
desire of the analyst? Snyder (in Osnos 2010) observes that there is much
enthusiasm about psychoanalysis in China, and that the Chinese have a
passion for psychoanalysis the way people were in love with it in New
York during the fties and sixties. She also reports that many Americans
conducting analyses in China are semi-retired, and the work with their
Chinese patients allows them to prolong their working lives (Snyder
2009). According to Osnos (2010), it is fascinating for Western psycho-
analysts to teach in China, where they are considered experts, even as
their profession is under attack at home (Nagel 2011; Scull 2011); in
China it is likely they will find more respectful and less critical students.
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