Xudong Zhao

Xudong Zhao, MD, PhD

I was born in 1962 in Guiyang, a southwestern city in China, and grew up in Yunnan Province, where 25 minority nationalities live together with the Han Chinese majority population. My pathway toward becoming a psychiatrist has been full of unexpected turns and twists in a rapidly and radically changing society; but growing up in the ethnically diverse place I did might be the first pre-determining factor for my career as a psychiatrist who is interested in cultural issues.

I started as a medical student at Kunming Medical College in 1978, when I was 16, having passed the first national examination for universities after the end of the “Cultural Revolution”. At that time, most young people wanted to study the “hard sciences”. But the medical curriculum in the first two years was boring for me. The only exceptions were courses in English and the 2-hour introduction to medical psychology, taught by a philosophy teacher. I immediately became intrigued with the idea that I should become a “psychological doctor”. However, I found out, to my disappointment, that it was impossible to find literature in this field and that there was no such specialty at all in China, unless I became a physician specializing in psychiatry; an occupation that seemed frightening to most medical students at that time. Some of my classmates laughed at me because of my ‘crazy’ idea of wanting a career in psychiatry.

Fortunately for me, and my aspirations of becoming a psychiatrist, I met my first mentor, Prof Wenpeng Wan, the pioneer of cultural psychiatry in China. I answered his question about my motivation to become a psychiatrist by saying: “I’d like to learn about why the people struggle against each other and why they are so unhappy. I’d like to do something to make them happier.” Then he told me, to my surprise, that my major task should be to learn English, because we Chinese needed to use conceptual frameworks developed in other countries to observe and study ourselves. In 1983, when I was 21, I started my psychiatry training; as a resident in the Department of Neuropsychiatry at the 1st Affiliated Hospital of Kunming Medical College.

In 1985, I was enrolled as a post-graduate student for a master’s degree at the West China University in Chengdu, Sichuan Province. There, my second mentor, Prof Motao encouraged me, as the first post-graduate student to study cross-cultural psychiatry, in light of my upbringing in multiethnic Yunnan Province. I completed my first research project on life stress and its impact on the mental health status of the Yi-nationality in Liangshan District, Sichuan Province. It was one of the first surveys dealing with the mental health problems of Chinese ethnic groups in the context of socio-cultural changes in China. Such social changes had been exclusively defined as positive progress for the minority nationalities before. In my thesis, the adaptation problems and drinking behavior of the Yi people in newly formed urban centers were discussed as key issues.

My first face-to-face transcultural encounter with foreign colleagues took place in 1988 in Kunming, when two German professors, Helm Stierlin and Fritz Simon, introduced systemic family therapy to China for the first time, at a symposium. I was fascinated by their description of this approach. Although all the participants were confused by the innovative ideas and techniques at the beginning of the symposium, I was pleased to notice that this kind of Western psychotherapy was clearly applicable to Chinese cultures. For example, I automatically associated systemic thinking embodied in family therapy with Taoism and Zen Buddhism.

But again, language became a barrier to pursuing my intense interest in the German school of psychotherapy. After the symposium, I began to learn German as my second foreign language. Learning foreign languages has been an essential part of my growth process and my professional career. It still is.

From 1990 to 1993, I studied family therapy as a doctoral candidate of Prof Stierlin at Heidelberg University. I was also the first Chinese psychiatrist from ‘mainland’ China to be sent to Europe to study psychotherapy. The time I spent in Heidelberg has taught me a great deal. I experienced bitter “cultural shock” there and strived for better adaptation to a totally strange culture through my own efforts, although my German colleagues and my sponsor, the Hamburg Foundation for the Promotion of Culture and Sciences, treated me very well. I learned from my own acculturative stress experiences, that culture is something substantial and irreplaceable.

Due to my preference to study cultural issues, I chose to write my dissertation on “Introduction of systemic family therapy into China as a cultural project” ( in German ). My thesis was awarded the distinction “magna cum laude” by the examination committee in 1993, and published as a book, in Berlin, in 2002. In this dissertation, I compared German and Chinese families and tried to describe Chinese families within the framework of family dynamics. I concluded that there were many similarities between families in Germany and China, and that systemic family therapy could be applied in the Chinese clinical setting, even though there was need to modify it and develop it in practical ways. Since my return to China in 1993, I’ve been trying to practice systemic family therapy and German psychosomatics in a general hospital setting. It seems that they work very well for Chinese patients.

I’ve been working actively in cross-cultural training programs since the 1990s. Some German and Chinese colleagues organized the German-Chinese Academy for Psychotherapy in 1996, and I am the coordinator and chairman on the Chinese side. Through our efforts, psychotherapies, including psychodynamic psychotherapy, behavior therapy, family therapy and hypnotherapy, have taken root substantially and been recognized in China. It has become obvious that cultural awareness is really very important for the success of such transcultural projects.

In addition to my clinical practice and administrative responsibilities as president of a large general hospital in Yunnan, I still maintain my interest in the relationship between socio-cultural change and mental health. I have continued the longitudinal survey of one of the smallest ethnic group in China, the Jinuo nationality in Yunnan Province, which was initiated in 1979 by my mentor and teacher, Prof Wenpeng Wan.

My family moved from the more remote province of Yunnan to the booming metropolis of Shanghai in 2004, where people from many countries and provinces are confronted with coping with the rapid changes and challenges of urban competitiveness and the pressures of globalization. From the perspective of transcultural psychiatry, there are also many factors impacting on mental health status due to these radical changes. The “side-effects” of China’s booming economy have been reflected in the daily clinical encounters between professionals and their clients. Precisely because of the urgent need for a multi-cultural health care center, I was assigned to be the head of a task force for constructing the “Sino-German Friendship Hospital” which will be an affiliated hospital of Tongji University.

Frankly, I’m ambivalent concerning my conflicting roles as a psychiatrist and as an administrator. I’ve been trying to integrate them, since it’s very rare for Chinese psychiatrists to be leaders of medical institutions and organizations. I will continue to supervise my colleagues and doctoral candidates doing cross-cultural research, while I also continue to apply my transcultural expertise to managing this extensive joint-venture project. I consider it as an opportunity to spread transcultural consciousness in medicine and management in China.

Dear colleagues, I welcome you to visit us in Shanghai!

April 5, 2006