Estranged bodies, simulated harmony, & misplaced cultures: neurasthenia in contemporary Chinese society

OBJECTIVE: To study the sociocultural transformation of

neurasthenia (shenjing shuairuo, SJSR), as both disease and

illness, in Chinese society.

METHOD: This is based on a

critical review of evidence drawn from the psychiatric and

anthropological literature, and the use of a single case


RESULTS: SJSR remains a ubiquitous illness in socio-

politically different Chinese societies, but the

Americanization of Chinese psychiatry has paradoxically made

the “same” disease category languish rapidly in professional

practice. Although it engages bodily modes of attention, SJSR

is far from being a physical, somatoform, or chronic fatigue


CONCLUSIONS: Psychiatric disease and illness do not

run a “natural” course independent of social and historical

contexts. SJSR usefully muddles the Cartesian mind-body

dichotomy and is readily compatible with psychosocial

manifestations and explanatory models. From a sociosomatic

perspective, the embodied world of SJSR may arbitrate as well

as critique the conjunctures of large-scale political,

economic, and moral transformations in Chinese communities.

These macrosocial forces and their local manifestations need

to be considered in deriving a cross-culturally valid paradigm

of psychosomatic medicine.

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