BOOK REVIEW

In search of the self: Turbulence in neoliberal Vietnam

Shema Abraham

Allen L Tran, A Life of Worry: Politics, Mental Health, and Vietnam’s Age of Anxiety. University of California Press; 2023.Pages:196, INR 2323 (paperback) ISBN: 9780520392168

Vietnam grappled with economic challenges under its centrally planned system until the advent of Đổi Mới, which ushered in economic liberalisation. Allen L Tran’s A Life of Worry: Politics, Mental Health, and Vietnam’s Age of Anxiety explores anxiety in post-war Ho Chi Minh City amid neoliberal reforms. Termed Đổi Mới, these reforms attempt to blend market principles with socialist ideals. Despite the subsequent economic progress, anxiety levels surged due to new insecurities from modernisation and Western influence. Youth in Vietnam are openly discussing mental health to destigmatise it, reflecting shifting perceptions of a “good life” and morality.

Tran’s book is divided into three parts, examining the forms of anxiety, its clinical aspects, and its link to love. In the first chapter titled “How to worry”, Tran discusses how transnational capitalism generates ambivalence, leading to precarious experiences shaped by gender roles, aspirations, and morality. Neoliberalism promises personal freedom and growth but fuels insecurity by demanding constant adaptation to market demands. The ideal neoliberal self clashes with collectivist Vietnamese values, leaving many struggling to reconcile the two. People feel responsible for their own happiness, but lack clear strategies, leading to anxiety-inducing uncertainty. Neoliberalism thrives on this precarity, turning self-realisation into a personal obligation where failure brings both social stigma and self-doubt. Anxiety thus becomes a means of shaping rational, autonomous subjects while also signifying failure to achieve this ideal, perpetuating neoliberal norms.

In the second chapter “Moral sentiments”, the author discusses how “worry” or “anxiety” functions as a social practice in the Vietnamese context. The way people express concern for each other reflects their concern and affection for one another. Viewing anxiety as a cultural or social practice highlights the fact that intense worry is a natural aspect of daily life, not a pathological deviation. According to the author, the Vietnamese moral economy of anxiety demonstrates how worry, involving thoughts, emotions, and behaviours, influences and sustains an individual’s self-perception. The development of moral identity is a multifaceted process that extends beyond individual endeavours or external pressures.

In the third chapter titled “Rich Sentiments”, the author challenges the idea that modernisation leads to an increased rationalisation of the self and a diminishing of emotional aspects. Instead, they argue that the emerging self is deeply emotional. Through ethnographic inquiry of the author, it was found that certain emotions play a crucial role in the transition to a market-oriented economy. Emotion is used as a means to shape one’s identity, resulting in a significant shift in everyday life and life’s purpose. This shift is reflected in the transition from the concept of interpersonal obligations (“tinh cam”) to internal reflection and authenticity (“cam xuc”). Emotions are seen as a valuable source of self-understanding, shifting away from Confucian and socialist ideals that prioritise communal and hierarchical values. The breakdown of the traditional institutions opens up new spaces for alternative sources of meaning in people’s lives. “Cam xuc” has become an abstract category that connects various physiological, psychological, and social phenomena under the umbrella of inner self.

Chapter four delves into the medicalisation of anxiety, where the Western biomedical perspective perceives a wide array of emotional issues, including anxiety, as health problems necessitating medical intervention. This approach imposes Western norms of behaviour globally, disregarding personal and cultural interpretations of suffering and often prioritising individual symptomatic treatment over addressing community and structural factors. In Vietnamese society, the author says, anxiety often presents somatically, with neuroasthenia frequently seen as the somatic manifestation of repressed emotional issues. Despite its association with American culture, neuroasthenia paradoxically confers social and moral legitimacy upon patients, symbolising their resilience for others. Moreover, focusing on physical symptoms enables patients to evade the stigma associated with mental illness. Although outpatient clinics advocate for a nuanced comprehension of patients’ experiences, individuals themselves frequently medicalise their condition, minimising the significance of their emotions.

The fifth chapter titled “The Psychologization of Worry” explores the growing trend of psychologisation in Vietnamese society. In the early stages of Đổi Mới, therapeutic interventions resembled life coaching or training rather than the psychotherapy commonly seen in the West. First-generation psychology professionals tended to offer advice rather than actively listen to their clients. Nowadays, psychotherapeutic processes aim to cultivate heightened emotional awareness while simultaneously teaching people to manage their emotions. These concepts and techniques are no longer confined to clinical or academic settings, as popular psychology and self-help books gain traction among the middle class in Ho Chi Minh City. Cognitive-behavioural therapy (CBT), which is the widespread therapeutic technique here, often instilled the belief that certain emotional states are superior to others. Psy-professionals are keen on promoting Western ideas of self that facilitate self-management within the global economy, framing emotions as teachable skill bundles. While CBT’s emphasis on individualism and an internal locus of control may clash with South Asian collectivist values, its focus on achieving quick results and symptom alleviation enhances its popularity. Cultural deviations from CBT’s idealised notions of personhood may be pathologised or deemed deviant. These discourses prioritise interiority and self-manifestation for the pursuit of life goals, rather than challenging existing power structures. Consequently, psychotherapy can be seen as a mechanism employed by the state to pacify individuals by diverting attention from structural inequalities.

The sixth chapter titled “Love, Anxiety” depicts the romantic journeys of Ho Chi Minh City residents whose romantic relationships adhere to “both the grammar of love and the grammar of the market”. Rejecting arranged marriages, they embrace love as a pathway to self-realisation and individual freedom, aiding them in achieving a “modern identity”. The book concludes by underscoring the significance of community in the healing process, highlighting how hyper-individualistic values leave individuals susceptible. While acknowledging the value of community, it is essential to recognise that within any community, outliers — individuals whose experiences or perspectives deviate significantly from the norm — may encounter challenges in finding their place or being fully accepted. Embracing and acknowledging diversity within communities can cultivate greater empathy and understanding for these outliers. The book provides an insightful analysis of how neoliberalism influences the psyche of societies in the global South, making it a valuable resource for academics and individuals interested in the social and cultural aspects of mental health.