Depression, subjectivity, and the embodiment of suffering in urban reform China

Depression was once a rare psychiatric disorder in China. However, over the past twenty years the disease-category has come to proliferate at an astounding rate in Chinese psychiatric discourse and everyday clinical practice. For Chinese psychiatry, the importance of instating depression as a legitimate disease-category is part of a larger movement aimed at reshaping the profession largely in line with the norms and practices of the DSM-influenced global psychiatric model.;If depression is to be constituted as a legitimate disease, however, Chinese psychiatry above all requires patients. Building on previous work on the medical anthropology of psychiatric disorders in China, in this dissertation I examine the extent to which urban Chinese sufferers integrate depression as a meaningful category within their local lives and daily health practices.;Through an ethnographic analysis of everyday bodily emotional language, symptom presentations, and help-seeking behaviors, in the first part of this dissertation I show that, whether conceived as a mood/emotion, symptom, or disorder, and despite massive efforts at raising popular awareness, depression does not possess much cultural relevance for urban Chinese. Yet when personal suffering passes a certain threshold, and often when most other options for medical consultation and treatment have been exhausted, Chinese patients find themselves seeking care at a psychiatric clinic. Given culturally-informed interpretations of suffering that resonate little with the category of depression, in the context of inpatient and outpatient clinical interactions, patients nevertheless permit the establishment of an "ad hoc contract" with psychiatrists that allows for the temporary contextual legitimacy of depression -- usually only for the purposes of treatment.;Critical to an understanding of Chinese individuals' experiences of suffering is the lived embodied process of shenti, or "body-person." In Chinese, the word shenti denotes not simply the "body" or "body-object" as conceived in English and other western European languages. Shenti rather encompasses the life of a body-person situated within active and dynamic subjective, interpersonal, moral, and social and natural worlds. Drawing on more than two years' ethnographic research, throughout this dissertation the concept of shenti informs my examination of Chinese interpretations of suffering and lived ontologies of emotional life and personal bodily disorder.;In the second half of the dissertation, my analysis moves away from the clinical context to analyze the ways in which individuals narrate their suffering. Reading these narratives, I use the language of Lacan to demonstrate the disordered life of sufferers, whose experience frequently takes the form of an incessant dismembering of their own lived subjectivities. Dividing ethnographic materials by "generations" or "cohorts" -- namely, "youth" and "middle-age" -- I show how the contingencies of historical bodily, social, and economic life in contemporary urban China shape and influence subjectivities of suffering. All too often sufferers are denied any cause for hope or belief that they will ever enjoy what in Chinese cultural terms is defined as "the good life" (xingfu). Instead, embodied "crises of value" lead sufferers to focus only upon the likelihood of irremediable subjective failures and deep social isolation, and even -- in some cases -- contemplations of outright death.