Watching the recent publicity for a qinlizhe research forum, I feel uneasy. It's all going too smoothly.
Have we had a history of fighting for rights? Have different parties negotiated, compromised, clashed, and argued with one another? Have existing injuries and fractures been acknowledged? We haven't even had reconciliation, yet somehow we've already arrived at harmony.
It feels like a finished product, made and neatly packaged somewhere else, has been shipped in. Look: Japan has tojisha-kenkyu, research by people concerned; the West has user-led research and survivor research; now we have qinlizhe research too. How perfectly natural it all sounds! But what gave that finished product meaning elsewhere was precisely the history of conflict trailing behind it: resistance to forced treatment, challenges to psychiatric hospitals, patients organizing to wrest back the right to name themselves, fierce arguments within psychiatry and psychology...
China has not gone through a period of radical psychiatric critique led by psychiatrists and intellectuals with broad social influence. Nor has it developed a sufficiently public, continuous, autonomous patient, ex-patient, or survivor movement. Nor has it experienced something like Mad Pride, with mad people reclaiming identity and public space.
Perhaps someone will ask: must there be arguments? Conflict? Resistance? We've taken a smoother path. What's wrong with that? But the conflicts that have historically formed around psychiatry aren't incidental. They aren't packaging. They are the most valuable thing inside.
Take the refusal to be called a "patient," and the choice to call oneself a "survivor." Skip the struggle behind that choice and what you get isn't people taking control of how they're named. What you get is people being granted a space to speak. What have survivors survived? Not just particular acts of violence, such as coercion, restraint, electroshock, or medication harms, but the establishment that strips people of self-determination.
Something shaped by conflict and something that hasn't been are fundamentally different things sharing a name. At the heart of one is a redistribution of power. At the heart of the other is "letting those we've accepted speak, without changing any power relations." Does acceptance equal empowerment? "You ordinarily have no right to sit at the table, but some generous people have allowed you a seat" and "you don't need their generosity; you have as much right to sit here as anyone" are two entirely different things.
Perhaps someone will say: even if it's bestowed, even if it's granted, even if it's mild, it has still let some qinlizhe speak. It has improved some people's lives. Why be so idealistic, using something unrealistic to dismiss real benefits in front of us?
Please notice: I'm not saying there's something wrong with a moderate approach. But if this becomes the only permitted form, particularly when its presence blocks space for other versions, and makes anyone who asks about that look like an ungrateful troublemaker, it becomes exclusionary.
I don't want to frame this as "China is at a less advanced stage and will eventually have to catch up." That's arrogant and inaccurate. The Western path has its own troubles. Anti-psychiatry's celebrated figures were mostly intellectuals and psychiatrists, not psychiatric patients. Language and practices painstakingly won through survivor movements were later absorbed, rewritten, and depoliticized on a large scale by mental-health systems.
My question isn't "why didn't China follow the Western sequence?" It's sharper, and more locally grounded: harms caused by psychiatry, grassroots mutual support, self-directed inquiry, and critiques of positivism already exist here. Why couldn't they become the starting point for today's "qinlizhe research"? Why all the talk of "inaugural" and "first"? Why are professionals still holding the powers to name and organize?
One possible answer I want to offer is this: qinlizhe research and practice in China are beginning not with qinlizhe claiming authority over knowledge, but with the professional system deciding how to admit them.
I'm not going to attack particular people or organizations here. I don't think individuals could have produced this result on their own. It's almost the inevitable shape left by a structure collapsing in two directions at once. One is vertical: a break across generations, through time. The other is horizontal: among qinlizhe here and now, we can't piece together a "we."
1. Vertically: resistance cannot settle into an inheritable history
First, the vertical dimension. It's wrong to say China has "no resistance." There have always been people taking action around involuntary admission, non-consensual treatment, diagnostic power, and psychiatric harm: legal advocates, qinlizhe, family members attempting to organize. The problem isn't that resistance never happened. It's that it can't accumulate. Some efforts are marginalized, some can't continue, some are forced to lower their voices, and some disappear altogether.
When every act of resistance is isolated, erased, disconnected from others, experience leaves no inheritance. It can only repeat. Younger qinlizhe can't reach those who came before them, or locate themselves in a continuing history. Each generation seems to begin again with "sharing my story," "reducing our stigma," "getting professionals to hear us," rather than carrying forward rights already demanded. Movements depend on inheritance. Here, memory isn't allowed to accumulate.
More subtly, the largest public energy around opposition to psychiatric coercion in China was drawn into a particular issue, and turned in the opposite direction: bei jingshenbing (被精神病), being forcibly labelled mentally ill. Around the passage of the Mental Health Law in 2012, the broadest public discussion of psychiatric coercion largely gathered around "normal people forcibly sent to psychiatric hospitals." On the surface, it opposed coercion. Underneath, it strengthened psychiatric legitimacy. Its demand was "I'm not ill; you've misdiagnosed me," rather than "ill or not, you have no right to treat a person this way." The issue became "misdiagnosis," not "can the diagnostic system legitimately operate like this?" The opening most likely to generate radical critique instead welded the medical model more firmly in place. It took for granted that treating "real patients" this way was acceptable. All that needed correcting was "don't mistake good people for patients."
This means that even on the side of resistance, the language ready to hand reinforces the system. Someone wanting to criticize psychiatry can discover that the most powerful public vocabulary available already presumes psychiatry's legitimacy.
2. Horizontally: a "we" that won't come together
But broken continuity through time doesn't explain everything. Set that dimension aside and look only at the present, at one generation, and something more troublesome appears: qinlizhe don't constitute a "we."
Some want reform; some want the system overturned. Some are deeply grateful for psychiatric medication: it really did pull them out of an abyss they couldn't describe. Others believe psychiatry itself destroyed their lives through overdiagnosis, coercion, adverse effects, and the loss of autonomy. These aren't differences of degree but of direction. You can't put both into one subject and have it say "we demand..." The "we" splits on the spot.
I keep wondering whether we can even say "within the qinlizhe community." Perhaps there is no such inside. Different qinlizhe may want entirely different things. Some differences can be bridged through dialogue; others fundamentally can't.
For example, in certain settings I'll use "patient" myself. In others, I'll insist on "qinlizhe" or "survivor." That's something I can negotiate. But if someone introduces me as "a schizophrenia patient" or "a bipolar disorder patient," I'll firmly refuse it. That reaches into how I understand distress at the most fundamental level.
Whether someone feels grateful, angry, or indifferent depends greatly on how they understand the source of their suffering, and on which face this system, or this thing called society, has shown them.
If suffering arrived "for no reason," with no particular event to point to and no explanation the person can give, then "it's a brain disease; it has nothing to do with your life" may bring enormous relief. It wipes away "am I too weak?" and "what did I do wrong?" and replaces them with "you're just ill; it's not your fault." For that person, psychiatry isn't oppression but absolution. It's hard to fight something that has absolved you.
For others, suffering has a clear social source. Whatever diagnosis someone receives after sexual assault, whether depression or bipolar disorder, the assault may remain the central event in their own understanding. Here, "it's a brain disease; it has nothing to do with your experiences" does exactly the opposite: it erases the crucial truth, almost a second denial. They may instinctively resist it and seek language elsewhere: gender, power, trauma, anti-oppression. They move towards feminist or anti-oppressive understandings not because they're inherently more enlightened, but because the medical account doesn't suffice, or even feels like a lie.
So here's something that may sound harsh. For some people, the only difficulty in life may be "X disorder": something beginning and ending within the self, closed off, something the medical account can hold in its entirety. For others, distress is open-ended, connected to sexual assault, poverty, violence, and a whole world of social suffering without end.
But please notice: I'm not ranking kinds of pain or levels of political awareness. I don't demand that everyone understand their suffering socially or structurally. If I did, I'd be exercising violence myself. What I'm saying is that people's different responses may turn on whether their suffering points outwards. That can shape whether someone stands with structural critique or gratitude towards the structure.
Writing this, I feel I'm making another binary, as if things must be one way or the other. To get my thoughts across in limited space, I've had to use fairly extreme examples. Of course some people move between the two, some experience both, some change over time. I believe many more inhabit complicated, layered feelings.
A name such as "survivor" can gather people around violence and harm they have experienced in common. What we now call "qinlizhe" is less clear. People may have no common demands, no shared object of critique.
What they have in common is that they've encountered psychiatry and received a diagnosis. This "we" hasn't united in opposition to psychiatry. It has been produced by psychiatry's system of classification.
3. And so a moderate professional framework fills the gap
A group cut off vertically and unable to come together horizontally can't readily develop unified political demands of its own. What can loosely gather such people together? The least common denominator, the thing least likely to offend anyone.
"Improving services," "person-centred care," "co-production," "bringing qinlizhe into the process": these moderate professional discourses occupy the centre precisely because they can accommodate both gratitude and anger. They tell the grateful: your good experiences can improve the system. They tell the angry: your suffering will be heard and used to make improvements. Nobody is offended. The cost is that, while taking anger in, this language dilutes what matters within it. The question "is this system itself legitimate?" becomes a list of "service improvement suggestions." The moderate framework doesn't resolve the fracture; it skirts it. It offers not solidarity, but a public surface where people needn't confront their fundamental differences. That's roughly what all this harmony amounts to.
And there's another filter on who can stand on that public surface. To be a visible, active qinlizhe in China, you must first survive, become relatively stable, and have something left over for speaking out. That means being able to afford ongoing treatment, or sustain your life through travel, socializing, interests; having family or friends who can catch you when you fall apart; not worrying about next month's survival; having enough cultural capital to read and use a whole language of "recovery," "reflexivity," "narrative research." Anyone who meets all these conditions is already fortunate.
More importantly, this filter of resources and the filter of experience tend in the same direction. People treated well by the system, whose pain has "no outward object," and who therefore lean towards gratitude, often also have more resources, greater security, and better access to the public stage. Those whose suffering is rooted in social suffering, with the strongest reasons to criticize the system, may have the least support, the fewest ways out, and the least ability to be heard.
Those most wanting to resist may be forced into silence, while those already treated well get the microphone.
This isn't about judging individual qinlizhe with comfortable backgrounds and resources. Their pain is real; being close to death is real. Resources don't mean someone hasn't suffered. The structure should be questioned: what kind of structure lets this happen?
At the top of this filter stand professionals, particularly psychiatrists. In the current environment, they're almost the only people holding several scarce things at once: legitimate standing inside institutions such as hospitals, universities, and official associations; credibility with foundations and government; the cultural authority of the white coat; the reassurance of being "a harmless doctor who listens to patients and improves services." They can broker legitimacy, translating qinlizhe experiences into "reducing stigma," "promoting recovery," "advancing person-centred research." Through that translation, qinlizhe become visible. But coercion, harm, refusal, and institutional responsibility are filtered out.
We have to acknowledge that, where distress is widely denied and social support desperately scarce, psychiatry plays a double role: oppressor and scarce refuge. For many people, a diagnosis is the only legitimate way to rest, take leave, be taken seriously by family, even be allowed to "be ill for a while." In this situation, criticizing psychiatry can readily be understood as opposing all help, as taking away the few resources qinlizhe possess. Many therefore rely on psychiatric authority not necessarily because they fully believe it, but because almost no other institutional language is available.
When qinlizhe may depend financially on family, disclosure may threaten work or intimate relationships, and criticizing a psychiatrist or counsellor may expose them to being pathologized again, whether to appear publicly or speak out isn't always a question of courage. Under these pressures, different survival strategies emerge. Some keep quiet for safety. Some reject psychiatry's language and logic but repeat professional accounts to retain their place. Some seek a share of professional authority because resources are concentrated there. And there are organizations and individuals shut down or disappeared, never entering public view at all. Quietly, like dust, they dissolve into the mist of history.
4. What this means
Put these things together and we get a deeply strange yet internally coherent combination.
Qinlizhe participation without a sufficiently public, continuous, autonomous movement able to negotiate; qinlizhe voices without collective bargaining power; recognized experiential knowledge without power to decide what counts as knowledge; talk of "co-production" without any redistribution of resources or control.
All of this points to a difference at the beginning. Elsewhere, some important traditions of lived-experience-led research have, at least in principle, grown from patients, ex-patients, and survivors fighting over the right to name themselves. The language and practices those movements won have since been extensively absorbed, rewritten, and depoliticized, but there were confrontational moments in that history. Here, the version currently enjoying the public spotlight has been set at the other end from the start: not qinlizhe claiming authority over knowledge, but the professional system deciding how to admit them. Being admitted, rather than fighting for it: that's the source of the distortion I feel.
What is research? When we say "qinlizhe research," what are we talking about? To me, it means letting things we've worked out take shape, and explaining them clearly. For an individual, it might be a sustained exploration using one's own life as a point of reference. For a community, it means living together over time, carrying things together, supporting one another. That includes arguments, even ruptures. Letting what we've learned through this take shape, saying it clearly: that's what I understand qinlizhe research to be. It emerges when practice has acquired some depth, from a need to theorize experience. It doesn't begin with a research format that then goes searching for practice. It isn't a framework into which we stuff things.
Look at our practice: it's so thin. Scattered, fragile organizations that may cease to function at any moment, with no stable place, no sustainable operations, no bargaining power with hospitals or businesses. No wonder we haven't grown a research flourishing of our own. Our practices keep dying young.
If we force research out of thin practice, might we distort the practice itself? Will we trim ourselves towards what can be researched? Will we still dare, still be able, to say what academic formats can't accommodate?
As in our previous pieces, we've argued about "qinlizhe" and the development of "qinlizhe research." We haven't received a response to those arguments, and there seem to be very few people making them. That makes me worry that the "models" being established, those WeChat articles, have no challengers. Will simplified histories and mistaken uses of language encounter other voices questioning them? Will they become self-evident common sense? That's another reason I keep writing these pieces: I want to put a different voice into circulation before one version hardens into place.
I'm writing this in a very difficult period of my life. In fact, I've barely slept for days. Hauling myself up from a sickbed to untangle my thoughts only makes things harder. Yet look: I can still write. I still have a chance to let you see what I'm thinking. I've also cut away much of my anger and contained my feelings here, precisely what survivor research and Mad Studies resist.
What would undistorted research look like? An undistorted beginning? Perhaps we should first discuss what counts as intellectual work, rather than leave the answer to the party that holds legitimacy on its own. Perhaps we should first have an environment where saying "psychiatry ruined my life" or "I never take medication" doesn't cost someone the right to be taken seriously.
I can't pretend we've already arrived at a flourishing world of qinlizhe research.
I wrote this very quickly, and many thoughts haven't made it in. That makes me uneasy. But I also remind myself: this is a blog, thoughts flowing at a particular moment. Perhaps I shouldn't tie myself in so many knots. Criticisms and corrections are welcome.