The wealthy stockbroker was living the Chinese dream. He seemed to have it all: a high-powered job in the nation's richest city, millions of dollars a day in stock trades, parties and banquets every night, and underlings to cater to his every need.

There was only one problem. He was a workaholic for whom the stresses and anxieties of his life had become so intense that he couldn't sleep at night. He was cracking under the pressure.

Finally, he checked into a psychiatric hospital in Shanghai and tried to explain the burdens that had overwhelmed him. "Every day, $100-million passes through my hands," he told the doctors. It wasn't clear whether he was boasting or lamenting -- or both.

They found him a bed, gave him antidepressants and sleeping pills, and sent him to a therapist, who tried to nudge him toward a healthier lifestyle. Despite the counselling, he was soon on his cellphone again, calling his assistants and trying to supervise his business from the hospital.

"His staff were waiting for his decisions, and he was still insisting on taking all the responsibility," says Dr. Xiao Zeping, chief psychiatrist at the Shanghai Mental Health Centre. "He could never relax. He couldn't resist the seduction of power and money."

As China hurls itself headlong into the global economy, its people are discovering what Westerners have long known: Money and consumerism are dangerous pleasures. They can be as addictive, and destructive, as any drug.

For millions of Chinese, the frantic pace of change in recent years has been bewildering. The security of a lifelong position in the Communist welfare state -- the "iron rice bowl" -- has been replaced by the anxiety of competition for the best jobs, the most prestigious universities, the fanciest gadgets and most exclusive apartments.

The effect is often traumatic, and China is finally learning that it needs the help of two disciplines it has trashed and perverted for most of the past 50 years: psychiatry and psychotherapy.

Now, for the first time, China is recognizing psychological counselling as a genuine health profession that requires certification and financial support. It had little choice. Psychological disorders and suicide are the biggest single cause of premature death and disability in China. Measured by lost years of productive life, mental illness is the most serious health problem in the country, yet only a tiny fraction of the ill and the stressed get any help.

Until the recent unleashing of capitalism, psychiatry was more than simply not considered a legitimate profession. The venerated Mao Tsetung condemned it as "90 per cent useless," with the remaining 10 per cent dismissed as "distorted and bourgeois phony science."

Under the ideology of the Maoist totalitarian state, mental illness was seen as "wrong political thinking," and suicide was deemed a traitorous act of rebellion against the system. Only a counterrevolutionary would ever be unhappy -- so why would anyone need psychiatry?

The handful of psychiatrists who had been practising in China were driven underground or sent into the countryside to work as manual labourers. The Chinese Academy of Sciences had a psychology institute, but it functioned in secret, mainly performing propaganda tasks. When the Great Helmsman died in 1976, for example, psychiatrists were consulted on how best to decorate and light his mausoleum.

The Maoists scoffed at psychiatry, but were happy to exploit mental hospitals. They used them as a convenient dumping ground for anyone who dared to question Mao's edicts. By the early 1970s, the vast majority of criminal offenders committed to Shanghai's top mental-health centre as "dangerously mentally ill" were in fact political dissidents.

In a recent report, Human Rights Watch revealed that, in the 1980s, dissidents also made up between 10 and 15 per cent of the population of all police-run mental asylums. The Chinese figure was even higher than that of the Soviet Union, where psychiatric hospitals were routinely used to warehouse opponents of the regime.

The practice lives on. In the past three years, according to the rights watchdog, more than 300 members of the Falun Gong spiritual sect have been sent to psychiatric hospitals. Another dissident was forcibly treated for an ailment described as "political monomania."

In response, China denies that there have been psychiatric abuses; it insists that some Falun Gong members are mentally ill and need treatment. Why? Because they "cannot control their own behaviour" and have "disturbed the social order."

Psychiatry may be a handy way to silence political and religious unrest, but Beijing has been forced to accept that the "phony science" has some legitimate value for the masses. So, to avoid a crisis, mental-health care has been rescued from the ideological wilderness, and now psychiatrists and therapists make up a tiny band of healers on the front lines of the new China's economic wars.

In an attempt to reverse psychiatry's tortured history, Chinese governments are pouring millions into an expansion of the mental-health system, and in October, the nation marked Mental Health Day with an outpouring of earnest articles in the state media. This year, the Chinese Health Ministry set up the first national licensing system for psychotherapists, with the first certification exams held in October.

Clearly, Beijing now acknowledges therapists as true professionals entitled to be paid. "This is revolutionary stuff," says Zhao Xudong, a psychiatrist in the southern city of Kunming who co-ordinated the first psychotherapy training program. "It's historic progress in China. I never expected it to happen so quickly.

"Psychotherapy is a totally new thing in China and many people don't understand how it works. In the past, we never had any official status, and other professions looked down at us."

Shanghai is at the forefront of this revolution. A red banner over the entrance to the Shanghai Mental Health Centre proclaims: "Let more people know about mental health, and improve the level of psychological health."

The city government, one of the wealthiest in China, recently financed the construction of a spacious new Italian-styled headquarters that makes the centre the country's first freestanding facility for psychotherapy.

In addition to her administrative duties, Dr. Xiao counsels 30 to 40 patients a week. Sitting under a portrait of Sigmund Freud and a framed calligraphy of a 1,000-year-old poem from the Tang Dynasty, she listens to her clients talking about the stresses of economic insecurity in a city obsessed with money and status.

"In Shanghai, everyone focuses on their work and their salary," she says. "It determines whether you are successful or not. If someone loses his job, he feels that he is no good. It's very shameful."

Until the 1980s, the Chinese could be confident of support from their extended families and their work units. Their wages were low, but their jobs were secure for a lifetime, and there was always a co-worker or family member with time to talk and listen. People lived in densely populated alleys and courtyards, surrounded by relatives and friends.

But in the Darwinian capitalism of today's China, most of this support network has disappeared. Families are split up in high-rise apartments. Relationships are less permanent. Divorce rates are rising. Parents are limited to one child, creating huge pressure to find the best schools and universities. Business executives work long hours, often without a vacation, competing for career promotion and salaries to pay for the luxuries they see in television commercials or in their neighbour's home.

"We live in an ocean of people, but we are alone," says Dr. Zhao, the psychiatrist in Kunming. "People communicate so little with their neighbours now. Everyone is in charge of himself, everyone has to be independent, and it creates more inner pressure and anxiety.

"Because of the intensive work competition, everyone is uncertain about their future. All of the guarantees are gone. Our society is radically changing, and it's producing more and more stresses. It's a challenge to our traditional culture and values."

The rising number of factory layoffs and corporate job turmoil is adding to the stresses. "People are floating from one job to another," explains Dr. Xiao, the Shanghai psychiatrist. "Life is much quicker, and they don't have much spare time. There used to be 10 people sitting and chatting with you every weekend, and there was time to talk. Now you might meet your extended family only twice a year."

Many of her patients are simply burned out. "They work without a rest or a holiday, and they feel so tired that they lose almost all interest in life. They're rich, but they don't pay any attention to their health."

As for the younger generation, it has its own neuroses. Young urban Chinese are well-educated and intelligent, yet often poorly equipped to deal with frustration, she says. "They're a little self-centred and narcissistic."

But after so many years of state control, they also find that freedom can be overwhelming, especially when it comes to the huge range of choices they now have when deciding their futures. "They can go abroad, or they can start their own private business," says Liu Zhiying, a Beijing psychologist and therapist. "People are always comparing themselves to others. They see whose house is the biggest, whose spouse has the most money, whose child has the best school."

Under the weight of such pressures, China faces social problems rarely seen before. Alcoholism and drug addiction are increasing. New stresses -- traffic jams in the streets, gambling and Internet addiction, eating disorders such as anorexia -- are appearing here for the first time.

China is not a very relaxed society any more," observes Margarete Haass-Wiesegart, a German psychiatrist who helped to create China's first psychotherapy training program. "There's a lot of instability. Money is very important now. People have to pay for good schools and health care, and they have to work very hard."

Studies estimate that more than 60 million Chinese people suffer from mental disorders, with depression the most common problem. More than two million people attempt suicide every year. One-third of high-school students have suffered noticeable mental distress. Yet an estimated 95 per cent of depression cases and 70 per cent of schizophrenia cases in China are never treated.

Of those who attempted suicide, 63 per cent had a mental illness, but only 7 per cent had ever seen a mental-health professional, according to the biggest survey on suicide ever conducted here. Many who try to take their own lives are rushed to emergency wards, where they have their stomachs pumped and then are just sent home.

Of the 13,000 psychiatrists now practising in China, fewer than 300 have received the special training needed to make them therapists -- an absurdly tiny number for a country of 1.3 billion -- and their salaries remain far below those of other medical specialists.

A growing number of hospitals now offer "counselling" clinics, but their staff usually have little or no training in psychiatry. Few private clinics exist. Almost all counselling is provided through hospitals in big cities, and most people are reluctant to go to hospitals because of the shame they would feel. Often, they are too embarrassed to get permission from their bosses to visit a hospital during office hours.

The situation is even worse in rural areas, which usually lack any mental-health services at all. Many peasants are still convinced that people with mental problems have been possessed by a spirit or are being haunted by ghosts. They prefer to consult shamans, who prescribe remedies such as the ingestion of ground ashes from incense burned at temples. In the rural districts of Hubei province, 74 per cent of psychiatric patients had first consulted a shaman before going to hospital.

The vast majority of the mentally ill are kept hidden at home. When a family member needs treatment, most people keep it a closely guarded secret. And there is a stigma. In one survey, 60 per cent of Beijing residents said the severely mentally ill should not be allowed to marry or have children, and 40 per cent said they should not be allowed to work or live in the community.

Dr. Liu set up the country's first employee-assistance program at the China office of U.S. electronics giant Motorola. But she discovered that most people were unwilling to seek counselling on the job. "They believed that, if you see a psychotherapist, you have a very serious problem. They usually paid the cost from their own pockets because they didn't want to put anything on paper."

The shortage of public financing is a major obstacle. The government still places little value on a health professional who appears to be merely talking. Counselling services are rarely covered by insurance plans. Some provinces provide only 5 or 6 yuan (about $1) for an hour-long counselling session, and many provinces and hospitals authorize no payment at all.

Therapists in a few major cities earn 40 to 60 yuan ($7 to $10) an hour, which still won't cover the rent. "This amount isn't enough to support my colleagues, so we don't do it for the money," Dr. Zhao says.

In the wake of China's economic reforms, hospitals are forced to consider the profitability of each patient. Counselling services don't produce money for hospitals. Insurance rates are rarely more than one-fifth of the actual cost.

"If it is not drug-based, it doesn't generate enough revenue to make it viable," says Michael Phillips, a Canadian psychiatrist who has worked in China since 1985. "People want a drug to cure them, so they go to a place where they can get a drug, and the system can pay for that. China needs to get over the hump of accepting that a psychiatrist's time as as valuable as a drug."

The result is a severe shortage of therapists. At one psychiatric hospital in Beijing, patients must arrive as early as 6 a.m. to register for a counselling appointment. A clinic at Beijing University has a three-month waiting list, and when the university's psychology department tried to recruit a clinical psychologist, it couldn't find a single qualified candidate.

"Chinese people don't even want to become psychiatrists because it's stigmatized and there is a lot less potential for generating income," Dr. Phillips explains.

Dr. Zhao's hospital in Kunming is one of the few with enough trained staff to offer proper counselling. In a city of 4.6 million people, it provides therapy to about 70 clients per day, compared with 10 or fewer when the psychiatry department was revived in 1986.

Videotapes shot for classroom use offer a rare glimpse of what the counselling is like.

In a session held last July, a wealthy businesswoman and her lawyer husband begin by saying they have brought their teenage son to Dr. Zhao because they have heard he is one of China's most famous therapists. They wear expensive suits, and the woman's cellphone rings noisily.

She complains that the son is suffering from insomnia, bad temper and loss of appetite. She has already taken him to a general hospital, but no physical illness was found, so now she is trying a psychiatrist. She seems convinced that he needs to be repaired, preferably as quickly as possible.

With gentle questions and some quiet probing, Dr. Zhao soon finds there is a whole other side to the story.

"Does your mother say any good words to you?" he asks.

"No," the boy replies, as his mother fidgets nervously.

The father confirms this. "She has very high standards for him. Except for sleeping and resting, he is supposed to study all the time. She seldom says anything good about him, except when he reads books or does homework."

With a genial smile, Dr. Zhao ventures to suggest that the mother is a perfectionist. Then he delicately leads the parents into a discussion of their own relationship.

The father reveals that they have considered divorce -- and even discussed it with their son. "Our relationship may not be very close, and our son might sense that," he says.

Under questioning from Dr. Zhao, the boy confesses that he wishes his parents would stop quarrelling. The psychiatrist urges him to speak more freely to his parents in the future.

"Have they never held hands in front of you?" he asks.

"No," the boy replies.

At this point, Dr. Zhao notes that the father is in an armchair and the mother on a sofa with their son between them. "Do they always sit far apart like this?" he asks.

"Yes," the boy says.

Dr. Zhao persuades father and son to switch seats, which leaves both parents on the sofa. But they still avoid contact.

"What if you hold hands?" the psychiatrist asks.

They do so awkwardly for a brief moment. Then their hands drop and they turn away from each other.

It's clear that Dr. Zhao's work is just beginning, as is that of all the specialists trying to heal the Chinese psyche. They have a long march ahead of them.
Geoffrey York is The Globe and Mail's correspondent in China.
Medicine or politics?

More than 300 members of Falun Gong, the spiritual sect that so irritates the Chinese government, have been confined to mental-health centres. Authorities claim they need psychological assessment because many suffer from a "deviation syndrome" caused by failing to follow their traditional qigong breathing and exercise regimen properly.

Two examples of their psychiatric reports:

Female worker, 45
She started Falun Gong in 1996 because she had chronic colitis and hyperplasia of the lumbar vertebrae. She gradually became obsessed with Falun Gong, practising it all day long, rarely eating, unwilling to see a doctor or take medicine when she fell ill, growing ever more estranged from her family, her health declining markedly, and yet she flagrantly told everyone how much she was benefiting. Even after the government declared Falun Gong to be an evil cult, she refused to be dissuaded from her beliefs. Moreover, she went to Beijing to petition the authorities [about the suppression of the group] and was then placed under criminal detention, but still persisted . . . and she stopped sleeping.

Psychiatric examination: Markedly excited and loquacious; declared that since taking up Falun Gong she had been able to overcome all the tests and tribulations of life, said that she felt very energetic even after not eating for several days; and insisted that her original ailments had been cured without taking any medicine.

Furthermore, she said that she could see three suns in the sky and that the "Master" [leader Li Hongzhi] was protecting her at all times. And that her bloodstream was filled with constantly revolving tiny gems made up of high-energy cosmic matter, and that this caused her skin to shine with a special glow. Her emotional responses were also inappropriate.

Forensic finding: mental disorder caused by practising an evil cult; no capacity to bear legal responsibility; recommend medical treatment.

Male factory manager, 62
After suffering from insomnia for a long time, in 1995 he took up practising various kinds of qigong, and in 1997 became besotted with Falun Gong. He soon became solitary and untalkative, and began giving people valuable presents for no reason. He always ate less than other people and would buy the cheapest of foods, even taking home items that other people had turned down. He said he wanted to be a genuinely "truthful, compassionate and forbearing" person.

Psychiatric examination: Consciousness clear and alert; declared that since practising Falun Gong all his previous illnesses had been cured, and that if allowed to practise for just one more month his white hair would all turn black once again, his skin would become softer and clearer, and he would become "thoroughly rejuvenated."

Diagnosis: mental disorder caused by practising an evil cult; should bear partial legal responsibility for his crimes.

Source: Dangerous Minds: Political Psychiatry in China, Human Rights Watch, 2002.