Drawing on 15 years of experience teaching psychoanalytic theory and therapy primarily from an object relations perspective to Chinese psychotherapists onsite and online, the authors present their learning about Chinese culture, social history, and philosophy, and the Chinese way of communicating about emotional experience. Their essay is imbued with the Chinese use of metaphor and psychosomatic symbolization, particularly involving the heart. They elaborate on the Chinese concept of Empty Heart Disease, comparing and contrasting it to Western concepts from literature, sociology and psychoanalysis, namely spleen, anomie, dead mother, and schizoid, empty, false, and narcissistic self-states. They expand upon and extend the empty heart concept to various age groups and symptom presentations in China, illustrated by a vignette from individual psychoanalysis with a woman and three vignettes from applied psychoanalysis of a couple with no intimacy, a child with an obsessive psychosomatic symptom, and an adolescent school dropout who was self-harming and suicidal in response to academic pressure. Having emphasized the connection between symptom presentations and social life and times, they discuss the impact of trauma, its transgenerational transmission in China, and the impact of unprecedented economic growth and social change on individuals, couples and families.

The author selects three Chinese families among those he has interviewed over 15 years to show how the families' histories have taught him about marriage and family in China. He shares what he has learned about the effects of the One Child Policy, the impact of Confucianism and Communism, trauma and resilience in China, and makes the case that teachers who are aware of these factors will feel more prepared for work with Chinese therapists and the families whom they treat.

This article examines the evolution of family and marital structure in modern China in the light of changes in China's culture, changing government policy and changes in the attitudes and situations of modern couples and families. The most dramatic changes involved the one-child policy, instituted in the late 1970s, that changed family structure from large male-preference families to single child families that enhanced the value of girls. Since sex was no longer mainly for procreation, it also revised the role of sexuality. The result was both to pamper the "only children" and increase the pressure on them both as children and as young adults, because this policy produced an ageing population without enough workers. The recent change in government policy to allow three children has not altered median family size as many young people do not want more children. There is also the lingering effect on families of China's history of trauma. Several clinical vignettes illustrate the complex mixture of forces at play in modern families.

Introduction: Most psychotherapists had no choice during the COVID-19 pandemic but to offer teletherapy in order to provide needed treatment. Several psychoanalytic theorists wondered if the very concept of treatment would change without an embodied relationship in an office setting. Methods: To attempt to understand the current concept of effective psychodynamic treatment in the new norm of teletherapy, we surveyed practitioners from 56 countries and regions who remotely treated patients psychodynamically during the beginning months of the pandemic. We asked the practitioners to rank six factors felt to be important to psychodynamic treatment: use of the couch during sessions, session in-office or via teletherapy, cultural similarity between therapist and patient, number of sessions a week, patient factors (motivation, insightfulness, and high functioning) and therapist factors (empathy, warmth, wisdom, and skillfulness). Results: We received 1,490 survey responses. As predicted, we found that the therapist and patient variables were considered much more important (both tied as highest rankings) to effective treatment than any of the other variables, including if the therapy was in-office or by teletherapy. Discussion: Psychodynamic practitioners worldwide confirmed that the empathy, warmth, wisdom, and skillfulness of the therapist and the motivation, insightfulness, and level of functioning of the patient are most important to treatment effectiveness regardless if the treatment is remote or embodied.

We conducted an international survey to better understand both the negative and positive reactions of distance treatment during the pandemic. We received 1,490 survey responses from practitioners from 56 regions and countries who remotely treated patients psychoanalytically during the beginning months of the Covid-19 pandemic. Eighty-nine percent of the practitioners agreed or strongly agreed that distance treatment is valuable when the patient is house-bound or when travel would be difficult or impractical.

The author summarises factors that have played on changing roles and configurations in Chinese marriages and families in the last seventy years, including the one-child policy, periods of national trauma, and the recent stresses on families as China becomes more urban, individualistic, and entrepreneurial. He gives two family vignettes, one a couple that faces the strain of different expectations for their marriage, and the other a family with a history of trauma, alcoholism, and a school refusing adolescent girl, illustrating how couples and families experience the strains on modern Chinese families.

En este libro que marcará todo un hito, David y Jill Scharff, ambos psicoanalistas, desarrollan una manera de pensar y trabajar con la pareja como un pequeño grupo de dos personas quienes se mantienen en un sistema estrechamente unido por un compromiso que es poderosamente reforzado por un lazo de placer mutuo.

Marriage and Family in Modern China is a groundbreaking psychoanalytic examination of how 70 years of widespread social change have transformed the intimacies of life in modern China. The book describes the evolution of marriage and family structure, from the ancient tradition of large families preferring sons, arranged marriages and devaluation of girls, to a contemporary dominance of free-choice marriages and families that now prefer to remain small even after the ending of the One Child Policy. David Scharff uses extensive reports of his psychoanalytic interventions to demonstrate how the residue of widespread trauma suffered by Chinese families during past centuries has interacted with the effects of rapid modernization to produce new patterns of individual identity, personal ambition and family structure. This wholly original book offers new insight into Chinese families for all those interested in psychoanalytic psychotherapy and in the intricacies of Chinese domestic life.