In China, therapy is going mobile

When Zhen Li was a child growing up in Henan Province, China, in the 1980s, nobody had a therapist. Mental illness was widely perceived as a sign of weakness. Paying money to talk to a stranger about your personal life was unheard of. Chinese rhetoric around these issues was simple: Swallow your bitterness. Don’t air your dirty laundry. Keep your problems to yourself. This was partly rooted in recent history: After condemning psychology as a “bourgeois pseudoscience” during the Cultural Revolution, Mao Zedong went so far as to ban the practice entirely.

Only three decades later, it now seems like everybody wants a spot on the analyst’s couch. Private practices abound, self-help titles make up an estimated third of China’s book market, and a therapist can be summoned with a few taps on a smartphone screen. Today, Li is the founder and CEO of MyTherapist, one of several digital-psychology platforms in China popular among young urbanites concerned with their emotional well-being. For 100 to 1,200 yuan, a user can choose from hundreds of mental health professionals located anywhere from Beijing to Boston and book a consultation on such topics as #TrustIssues, #Self-Love, and #CareerPressure. Through the app’s educational platform, they can also join a Freud book club, sign up for an eight-day “Confidence-Boosting Camp,” or take a drama-therapy course based on the teachings of German clown Johannes Galli.

The groundwork for this shift was laid in the 1980s, as the state began to loosen its grip on culture. The market economy had just been introduced, and China was opening up to the world. By the millennium, the country’s fascination with psychology had blossomed into a full-fledged “psycho boom,” as some call it. In big cities such as Beijing and Shanghai, celebrity psychoanalysts delivered speeches to packed auditoriums. A popular television program called “Psychology Sessions” featured ordinary folk soliciting professional advice on problems like gambling addiction and extramarital affairs. In the wake of the devastating 2008 Sichuan earthquake, the state made mental health assistance a key part of its relief program. “They wanted to emphasize that they cared not only about the material but also the psychological needs of the people,” explained Huang Hsuan-Ying, a professor of anthropology at the Chinese University in Hong Kong.

Despite the public obsession with therapy, however, individual acceptance lagged. While 173 million people, or 12% of the population, live with a mental health disorder, the lingering stigma of treatment means that only one in 10 of them end up seeking it. The country also lacks a robust infrastructure for mental health services: China has four times fewer trained mental health professionals than the global average, and most are concentrated in major cities. But that’s not the full story. Therapy is very new in China, and there is also an appetite for more innovative approaches. And as some of the most dramatic social shifts in recent memory reshape how people think about themselves and the world, the domestic tech sector is taking notice.

After Li returned to Beijing from London with a master’s degree in cognitive neuropsychology, she started spending her free time writing about psychotherapy on the social media platform Douban, posting first under her English nickname, “Jane Whisperer,” before switching to her Chinese alias, “Jian Lili.” Her brand of yuppie self-empowerment couched in science jargon struck a chord — readers loved her chatty how-to guides about seeking psychological help and her lyrical essays on caring for the inner self. A handful of followers grew into hundreds of thousands, and her inbox filled with notes from curious readers: “Can the therapist answer my life questions?? Does he just sit on a couch, twiddle his spectacles, and solve all of my problems?” Eventually, she created a spreadsheet to keep track of daily requests for therapist referrals.

In 2014, as the government was pouring money into startups and tech incubators, Li decided to turn her spreadsheet into a “hospital in the air”: a virtual institution staffed by certified therapists. Over the course of eight weeks, she hashed out the idea at a startup training program in San Francisco, brought two investors on board, and set up an office in Zhongguancun, Beijing’s Silicon Valley. It quickly gained an impressive reputation: by 2015, it had raised more than $1 million in venture capital funding, and by 2016, it was widely praised by therapists for its efforts to professionalize the field. A woman with an idea and a spreadsheet had grown into a company of 40 employees, a network of 240 carefully vetted therapists, and an online education platform offering a robust array of courses.

Competing platforms such as Yixinli and KnowYourself have also emerged to cater to the tech-savvy Chinese millennial. Brought online, China’s psycho boom has taken on an aspect of clinician meets lifestyle brand. Yixinli’s podcast, “Psychology FM,” features a soft-spoken host addressing issues like workplace fatigue and romantic grievances. KnowYourself, whose corporate clients include Estée Lauder, Land Rover, and Tmall, leads offline meditation retreats and holds workshops on cultivating creativity. A mix of Marie Kondo and Chicken Soup for the Soul, the platform outlines its goal plainly: “At KnowYourself, we believe that happiness is a skill that can be acquired. Our mission is to help people in their pursuit of happiness.”

A crucial step to happiness, in this telling, is looking inward. “Do You Truly Understand Yourself?” asks one KnowYourself class, a 39-yuan, five-session Chinese interpretation of the work of American organizational psychologist Tasha Eurich. Other courses share this concern: “33 Lessons To Be a Better Me,” “Gaining Self-Confidence,” “Self-Care,” “Transcend Yourself.” These appeals to self-actualization are finding an audience. Having launched in 2016, KnowYourself now reports a user base of nearly 9 million, and in April, six-year-old MyTherapist averaged 300 calls per day. Meanwhile, Chinese internet giants Baidu, Alibaba, and Tencent have each launched their own online psychological services (respectively, Baidu Jiankang, Alibaba Health, and WeDoctor).

Arthur Kleinman, a professor of psychiatric anthropology at Harvard University, has linked the demand for therapy to a recent “cultivation of subjectivity” in the Chinese middle class and a growing fascination with the individual. During tumultuous times, people seek to explore, develop, and master the uncharted terrain of the inner self. Young Chinese, like young people everywhere, have a lot to be anxious about right now — skyrocketing housing prices, widening income gaps, soaring unemployment, and a global pandemic. And in the span of a generation, they’ve also witnessed the introduction of a market economy, the largest migration in human history, and the near-universal penetration of the mobile internet. That’s a lot to process. “In a society of unprecedented change [taking place] at breakneck speed,” writes Kleinman, “Chinese individuals simply have been unable to avoid the question: who am I?”

But how far will this go, and at what point does an inward turn move outward? Is examining one’s interiority simply a form of narcissism, navel-gazing wrapped in the language of self-improvement? And what can China expect from this generational shift? Will it train participants to observe the world in ways that are more discerning than those of previous generations? Can self-care transform an individual into a more conscientious member of a community? Will cultivating a more aware, more autonomous, and more expansive self produce a truer, freer, and more plural society?

At the moment, nobody knows. But the answers might be hidden in an online course — for 39 yuan.