Estranged Bodies, Simulated Harmony, and Misplaced Cultures

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 study. 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 disorder. 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.