ABSTRACT
Western academic psychiatry first seriously engaged shenjing shuairuo (SJSR; 神經衰弱 / 神经衰弱) after the Cultural Revolution. China developed the Chinese Classification of Mental Disorders in the 1950s and ultimately retained SJSR as a diagnostic category, but Taiwan officially employed the DSM and ICD. Arthur Kleinman’s work in the 1970s and 80s, and other works of new cross-cultural psychiatry, have framed a debate that has carried into the twenty-first century. Tracing developments of this debate requires focusing on the publications that have proven so influential. This chapter addresses the ideas behind and the consequences of using the DSM in China and Taiwan to re-diagnose SJSR patients as having somatized depression. Claims about Chinese culture and language were made to support this redefinition, including that SJSR resulted from Asian suppression and denial of affect (“inscrutable Asian”), linguistic incapacity for emotional description (“poverty of language”), and the need to avoid stigma through clinical categories that fail to delineate the underlying reasons for patient distress. Later developments in Kleinman’s thought regarding SJSR showed that, after 1985, his model of SJSR as somatized depression lost some of its original coherence but also became less derogatory.
