Psychological Relief Work After the Earthquake Frustrated Her — and Changed the Course of Her Life | "Ten Years" ⑩

"One earthquake in Sichuan pushed the development of psychology forward by 20 years."

In 2008, Gong Jianfen was a senior studying psychology at Northwest Normal University in Lanzhou, and one of the few people who stayed in the disaster zone after the earthquake to do psychological crisis intervention.

Compared with the work she would do later, this job gave her almost no sense of accomplishment — nothing like the halo people tend to imagine around such work, and, to some degree, far below her own expectations. Partly that was because China's counseling industry was still barely developed and society knew little about it; partly it was because psychological work in a disaster zone is simply very hard.

The moment she graduated, Gong Jianfen headed for Sichuan. Over the next three years she volunteered on projects run by the Shifang field station of the Institute of Psychology at the Chinese Academy of Sciences, by West China Hospital of Sichuan University, and by others, doing crisis intervention after the earthquake.

Those three years were spent "adrift." As a volunteer she belonged to no fixed organization, yet crisis intervention needs exactly the opposite — a way of being present that amounts to sitting with people. A volunteer who floats in and out solves nothing.

If there was a payoff, it may be that through the frustration and the situations she actually walked into, Gong Jianfen came to understand the profession more clearly. In 2011 she left the disaster zone and became one of the first nine counselors hired at Foxconn's Chengdu campus. An explosion had just torn through a Chengdu workshop, and the first job she did was comfort the families of the injured.

She later moved to Chengdu Xinan Gynecology Hospital, which specializes in IVF. Her main work there is explaining the psychology of assisted conception and counseling couples under stress.

She calls putting down roots in Chengdu "unexpected." Because of the earthquake she made her way from Gansu to Chengdu, and here she has worked, married, and had a child.

Ten years on, asked what difference she had made to the disaster zone, she paused and said, "How should I put it? Honestly, helping them get better is very, very hard."

"After the earthquake we saw on TV that psychological workers were going down to Sichuan for the May 12 earthquake, and we started talking about how good it would be if we could go too.

I saw our teacher on May 14, and he began working his contacts to prepare for post-disaster psychological aid. I remember it took us three days to put together the materials on post-earthquake crisis intervention. He assembled the materials and lined up people at the same time.

We were fairly quick off the mark in Gansu. The earthquake was on May 12, and after a week or so of work we were already on our way to the disaster zone by the 20th-something of May. At first we were in the Gansu disaster zone — there's a place in Gansu called Wenxian County, close to Qingchuan and Jiuzhaigou, and it was hit too.

I was supposed to graduate in July 2008, and the earthquake came before I had even graduated. I spent more than half a month in Wenxian County and got back around June 10-something, just in time for the last day of graduation photos. That was how it ended.

I was a fresh graduate, right at the point of choosing a career, and I could see how many openings and possibilities there were in the disaster zone, so after graduating I joined the post-disaster psychological aid project.

Why did I end up in Sichuan? Because compared with the Gansu disaster zone, the gap in resources was enormous — Gansu had far fewer psychological resources, and I could feel that clearly at the time. It wasn't until around August that experts from Taiwan came to Gansu to teach the basics of psychological crisis intervention. Later our team invited very well-known experts from Sichuan to run a two-day training in Gansu, but that too went no further than crisis intervention.

In Sichuan I first joined a West China Hospital project surveying the mental health of 100,000 survivors in the temporary-housing areas of Dujiangyan. In 2009 I moved to Hongbai Town in Shifang, Sichuan, another badly hit area.

I had two roles then. One was at the Shifang field station of the Institute of Psychology, Chinese Academy of Sciences, where we were stationed doing psychological services for the community and its residents. The station regularly took in people who found their way there on their own, some of them people from up in the mountains carrying psychological trauma.

At the same time I was on a project run jointly by West China Hospital and the Hong Kong Youth Foundation, aimed mainly at families in the Hongbai mountains whose only child had died in the earthquake. I had real, direct contact with many families whose child was gone and who were preparing to conceive again. Each time we went up there were more than a dozen of us, making regular visits to those bereaved families in the mountains. Experts from West China Hospital supported and trained us from behind the scenes, and the volunteers we pulled together all had a background in psychology.

But everyone only went once every two weeks, and we were all doing it on our days off."

When Gong Jianfen reached the disaster zone she was surrounded by young volunteers like herself, all speaking Mandarin, all fired up. "It really was like family. Everyone's enthusiasm came from wanting to help the local people the way you'd help your own family," she said. They crowded into housing that locals gave them for free, and as she described those scenes there was a hint of her being moved by her own story.

Set aside the question of professional skill, and what these scenes reveal is a deeper problem: after the earthquake, volunteers poured in from outside, but most stayed only briefly before returning to their own lives.

Later on, the young people who stayed in the disaster zone and kept doing counseling, as Gong Jianfen did, could be counted on one hand.

"The biggest challenge then was that in Gansu and in Sichuan alike, the support system for post-disaster psychological services was incomplete.

I had just come out of school, my skills weren't mature, and I badly wanted to help but felt powerless. I wasn't stationed there long-term the way the Hong Kong Youth Foundation people were — we were more of a 'go wherever we're needed' arrangement.

I spent half a year in Gansu, but across different projects. That Gansu project ran in only two phases, half a month each. Later I joined a Shenzhen NGO called Good People, Good Deeds, and we applied for a project in Mianzhu. On paper that project lasted a year, but it wasn't a permanent posting either — we still went down once every two weeks, a week at a time.

Going at that rate, the support is nowhere near enough.

Because trauma after a disaster does enormous damage to a person's mind, and the biggest part of it is this: the moment an earthquake hits, whether or not you have lost property or family, your sense of safety is destroyed in an instant. With the ground shaking and the mountains moving like that, a person suddenly feels as small as an ant. One flood comes through and you're gone — it isn't something you can outrun or control, and at that moment people find themselves in a state of tense alertness they can't explain.

So every major disaster brings this kind of post-traumatic stress disorder. At first people are stunned; later they stay permanently on guard. In 2008, in those conditions, the whole country went through that shared memory — the nerves of the entire country took a hit.

Everyone's fear of aftershocks, and fear for their own lives, formed then.

If you're stationed there, you can give people early, continuous intervention for acute stress, staying in touch with them in that place, feeling the changes in their lives. That kind of support is invisible. The best support for trauma is simply being there with someone; the power of it lies precisely in the fact that you are there.

But if you only go once a week, all they know is who has left again."

For Gong Jianfen and her team, the hard part was that there was no way to know how many families needed psychological help.

No one could give them figures, and even the patients themselves often could not see their own trauma.

"You can't find psychological problems just by asking," Gong Jianfen said. She and her team could only go door to door, one household at a time, identifying the problem before offering the help that matched it.

"Japan had the Great Hanshin earthquake in 1995, and they have been accumulating experience since then. Because earthquakes happen more often in Japan, their emergency response and contingency plans are more systematic. We compared notes with Japanese experts — since that earthquake, every community there has a resident therapist doing counseling. Once a week, kept up for ten or twenty years.

That kind of help is something you cannot achieve by going once a week on a project.

But the resources for the Wenchuan earthquake were nowhere near enough, and what a few of us could do was limited. Normally, at a hospital clinic, a doctor tells you what's wrong with you, and we could also do some public education in the community — telling people, for instance, that this set of symptoms is a 'cold.'

In psychology we had to explain what 'post-traumatic stress disorder' is, what 'depression' is, what 'anxiety disorder' is — and that kind of education was very hard to deliver.

Take the West China project. All we knew was which families had lost a child and where they lived. With that much information we would go and visit, and only on making contact did we learn what the situation actually was.

Many people carried a great deal of psychological trauma after the earthquake, but they didn't know enough about it to know what was wrong with them.

So without a system, this work does not get done properly. A lot of people were suffering with no way out — they didn't know why, and they couldn't find the people or the places that could help.

In 2008, officials and the country as a whole understood post-traumatic stress disorder only in a limited way. It was only after the earthquake that the media began trying to avoid broadcasting graphic, disturbing footage, and that people started to realize such footage can leave viewers with secondhand trauma.

So after 2008 there was a saying among people in psychology: 'One earthquake in Sichuan pushed the development of psychology forward by 20 years.' Look at the Sichuan disaster zone now — people there are far more willing to accept counseling than people elsewhere.

I once visited a family whose son had died in the earthquake and whose husband had injured his leg. Before the earthquake he had been very capable. There was a coal industry locally, and many strong young men dug coal, which was a big part of a household's income. Once his leg was hurt he couldn't do that work, and he said of himself that he was finished.

People in the community all said, 'Before the earthquake this man was in good spirits, very outgoing.' But when I visited I found he avoided people, his eyes darting away. He was hard to reach.

By then all the heavy work in the family fell on his wife. The first time I went to their home she had just come back from being out, and he was cooking for her. I could see how evasive he was. Something wasn't right.

I did some work then to try to understand him, chatting with him, trying to reach him. I visited him twice, and afterwards I reported to the person running our team and learned that a psychiatrist was already watching his case and that he was on antidepressants.

But when I went back after the New Year, I heard that he had killed himself.

If we had been stationed there I think a lot would have been different, but going once every two weeks, there's no way to provide continuous help.

One of the most basic things in psychology is that you have to gather a lot of information through conversation before you can make an assessment, and that takes a professional team — but our country's psychological resources are nowhere near enough."

About 20 years earlier, a Chinese delegation visited Hamburg, Germany, to discuss cooperation in psychotherapy. In 1988 the German-Chinese Academy for Psychotherapy (DCAP) ran its first advanced training program in psychotherapy, in Kunming.

In 1997 came the China-Germany Continuous Training Program for Advanced Psychotherapists — the so-called first class of the "China-Germany Program," described as China's first professional body for psychotherapy and counseling. Zeng Qifeng, founder of the Wuhan China-Germany Psychological Hospital, and Xiao Zeping, then deputy director of the Shanghai Health Bureau, were both students in that first class.

"In the cities, for psychological aid to schools or to the general public, there are nowhere near enough trained people.

Take an ordinary community: for roughly every 20,000 people there should be one psychology professional, someone systematically trained. After that earthquake in Japan, their community staffing might not even reach one per 20,000, but they have two counselors for every 100,000 people. Their counselors live locally and run a psychological clinic right there, because some people with trauma will not come forward on their own — the resident counselor has to go out and visit them.

That is what we need to do too.

But our Sichuan earthquake really was too big, and psychology as a field in this country had only just started to develop. You have to understand that counseling in China began in 1989 at the earliest, with the first China-Germany class, when the country's psychiatrists first started training in counseling.

Count it up: by the 2008 earthquake that was only ten-odd, twenty years. Psychology experts here like Li Zixun all came out of the early China-Germany classes. So by 2008 we simply didn't have enough trained people to do this work.

What we had were doctors from the Chinese Academy of Sciences or West China Hospital, who had funding and kept local psychological aid going through projects like these.

But it's hard for doctors to stay stationed somewhere long term.

Hospitals in China don't formally recognize the role of counselor — the people in our hospitals are psychiatrists. And what do psychiatrists spend their time on? They have their own mentally ill patients, inpatients to manage, outpatients to manage. They already have plenty of work.

If a disaster zone wants full-time counselors, someone has to pay for it and someone has to back it.

But it takes at least ten years to shape a mature counselor, and after ten years that person has a job, a family, a circle of their own. Send them to the disaster zone — however much you pay them, how much can one person accomplish there alone?

It can't be done by one person, or by some simple project. What would a sound system look like? Take West China Hospital: say I'm willing to put aside some staff and resources and open a hospital in Mianzhu on a standing basis. Once it opens I also have to train up community doctors and do public education about psychology after a disaster. Once it's built I have to pay the doctors' salaries, and that means management. It becomes a huge undertaking.

On the personnel side, our current pool of mental-health practitioners, of trained professionals, is not enough. Nowhere near enough.

The only people who could go back then were people like me — just graduated, unmarried, right? And with plenty of youth to spend there.

Honestly, for families who have lost a child, helping them get better is hard, very hard. And along the way you run into every kind of difficulty.

Take the family I was following. The first several visits we got on well, and they would wait at home for me each time. Then one time I went and the wife wasn't there. The husband said, 'She's gone up the mountain to work.' I said, 'I've come all this way — if it isn't far, could I go and see her?'

So I followed him up. On the hillside she was weeding, and all she said was, 'Oh, you're here.' I said, 'Yes, how have things been lately?'

'Fine.'

That was it. Very awkward.

I watched her weeding and thought I'd join in — that's a kind of being there too. Seeing me hoeing, she handed me a glove. Halfway through she let out a long sigh and said, 'Teacher Gong, let me ask you something. Why do you come to see us?'

I thought about it and said, 'This is my work. I don't know what I can help with, but since I'm here, I really do want to try to do something.'

At that she said, 'You make it sound so nice. Were you sent by the government to keep an eye on us?'

Only later did I learn that before I ever met them, the village had already sent community cadres to tell them not to make trouble and to stay home, and a few people had even been called in for 'tea.' But the government's way of intervening was the wrong one for people carrying that kind of trauma.

After the earthquake, at the various places in Dujiangyan and Beichuan where I worked with parents who had lost children, the emotions were enormous, and they ran through the whole group. There's a mechanism to what happens psychologically, and part of it is anger — anger that can be turned outward or inward. Turned outward at what? At our hospital, for instance, some women who miscarry have one very strong feeling: 'That doctor is to blame. It's because of that doctor that I can't get pregnant. That hospital is a complete fraud!' That is anger, and it points squarely at the doctor and the hospital.

As an ordinary person, that's hard to take.

In the same way, families who have lost a child feel things fiercely and demand every kind of compensation. The government tends to be rather 'protective' toward them, and may not grasp what the emotion actually is. It sees only the confrontational side.

If you understood them better, you would know that after a child dies the family will inevitably go through furious anger. It isn't that they need you to do anything; they are looking to be understood.

When we were at the Shifang field station of the Institute of Psychology, psychology experts trained the village cadres in Shifang, and the confrontation eased a great deal. Because they came to see that behind these parents' emotions there wasn't much resentment toward the government at all. Their anger at that stage could not be helped. They had to feel it."

By Gong Jianfen's account, most families who lost their only child in the disaster ended up adopting through channels that were "not entirely proper." The proper channels didn't work for them.

She once helped some families search welfare homes and orphanages across Sichuan, but the children there usually had some degree of physical disability. For families who had lost their only child and were carrying their own physical and psychological wounds from the earthquake, raising such a child would be harder still.

So they leaned toward getting a healthy child through private channels.

"This family's trauma later became very severe. The husband had been mining too, and he developed pneumoconiosis, so he couldn't do heavy physical work anymore. Their life was oppressive, and they wanted a child, something to fill their life with life again.

They started IVF in 2009, and over more than a year they did it three times. The number of eggs retrieved was never good, and all three attempts failed.

By the time I found out, over the phone, I had already left Shifang: they had adopted an infant, and the baby died six months later. Because of psychological trauma, parents in the Hongbai mountains all ran into a lot of problems raising children. Psychologically, once you have lost something, the next time you have it you handle it more carefully, more anxiously, guarding against losing it again.

They were full of love for the child they had adopted, and the moment the child showed any discomfort they became over-concerned and over-helpful. Many adopted children were prone to diarrhea, constipation, poor digestion, stomach trouble. The parents assumed the child was physically weak, but it had to do with how they were raising the child and how much they worried.

Afraid the child wasn't getting enough to eat, they'd mix the formula too thick. Ordinary families run into that too, but once it's explained they can correct it. With these parents, even after it was explained they still worried too much and still did it — which made the child weaker and more fragile.

One problem with the psychological aid work I was doing in Sichuan was that the pay couldn't support my life. I made a thousand-odd yuan a month, and I had to borrow from friends or take side jobs to get by.

At the Chinese Academy of Sciences field station in Shifang the pay was better in the second year — 2,000-odd yuan a month — but I was still a volunteer, and that is not the same as a job. A job should at least come with social insurance and a housing fund. I had none of that.

I was young then, and being young I could afford to burn that time, but as a career it clearly wasn't going to work.

And during those three years in the disaster zone my parents weren't very supportive. They felt it wasn't a proper job. I came from the countryside, so my parents thought: look, other village kids finish college and become teachers with a steady salary, while my child seems to be drifting.

So around the three-year mark I was thinking about where to go next. I interviewed at some large organizations, and at organizations connected to disaster relief. There were a lot of social-work groups in the disaster zone at the time, ones from Taiwan or Hong Kong such as Oxfam, but social work is a long way from my psychology training.

If I had wanted to stay in the disaster zone, I could have become a school psychology teacher locally — I graduated from a teacher-training program, so I would have had to sit an exam — but it wasn't easy for me to get in, because they generally wanted fresh graduates, and I was no longer one.

I could also have gone to a hospital, but in 2008 every hospital was hiring psychiatrists, not psychology teachers. So no hospital was going to take on someone like me with a teacher-training degree in psychology.

So it was hard, then, to find a way to stay in the disaster zone.

Then Foxconn happened to be moving its operation to Chengdu. I sent in a resume, interviewed in June 2011, and to my surprise got the job. I went to Foxconn as a crisis-intervention counselor, and I never did earthquake-related work again."

From the first employee jump on January 23, 2010, to November 5 of that same year, Foxconn Technology Group saw 14 employees kill themselves by jumping from buildings.

On the night of May 20, 2011, an explosion in a Chengdu workshop killed 2 people and injured 16.

In Gong Jianfen's second year at the company, another employee at the Chengdu campus died in a fall.

"In those three years in the disaster zone, even though I was a volunteer, I switched organizations quite a lot, and there weren't many people my age at any of them. So when I got to Foxconn I felt I belonged to a profession, and that feeling matters a great deal to a person.

Foxconn badly needed crisis-intervention people like me then — I had crisis-intervention experience from the disaster zone, and they were dealing with a run of bad press. What made Foxconn notorious that year was the '13 consecutive jumps.' In fact, after those 13 jumps Foxconn had already set up a counseling system at its Shenzhen campus. They included the same setup when they were planning the Chengdu campus, so I caught that window and was hired. We took on nine counselors in all, and I think I was the fourth one hired.

When they moved to the Chengdu campus there was also an explosion, so the very first thing I did on the job was to be sent to the hospital to help injured Foxconn employees and their families through it psychologically.

At Foxconn I didn't only do crisis intervention. I also ran psychological assessments for new hires, counseled workers on the factory floor, and gave psychological training to frontline supervisors.

On one side, when an employee hit a crisis, the counselor had to be able to defuse an extreme reaction immediately. On the other, psychological problems needed to be spotted when employees were hired. Many of the workers Foxconn recruited came from remote mountain areas and were very young. In a young workforce, emotions swing harder, so our job was to catch signs of psychological trouble early and, having caught them, steer people toward recovering on their own or getting counseling.

I worked at Foxconn for nearly two years. Then a volunteer I'd known in the disaster zone told me this hospital needed a counselor, and I've been here ever since — from November 2012 until now."

For a long stretch, the only patients Gong Jianfen could reach were the ones who came to her themselves, and there were very few of those.

Gradually the hospital began offering free psychological assessments, testing how willing patients were to accept them and how much good the service did.

Today the hospital's counseling is priced by the standards of the Sichuan provincial medical pricing bureau: a registration fee plus a treatment fee of about 112 yuan an hour.

In recent years, besides adding psychological assessment to IVF programs, counseling has gradually been folded into other outpatient services. Beijing's China-Japan Friendship Hospital, for example, has opened a "dual-heart clinic," meaning patients seeing a cardiologist must also receive counseling.

"Our hospital specializes in IVF, and I'd say we've been ahead of the curve on psychological work. Couples doing IVF can't conceive normally, for one reason or another, and they will try everything they can think of before turning to a hospital as the last resort — so by the time they arrive they have already been through a great deal.

For a group like this, mental health matters even more. The better their psychological state, the greater the chance the IVF succeeds.

Our hospital director could see that many patients had psychological needs. In fact, before me they had brought in a psychiatrist, because at the time the hospital gave more weight to psychiatry and considered counseling to sit under it. But six months after that doctor arrived, they closed the department.

Then I came along.

At first I was the only person doing counseling in the hospital. I was quite young, and outside the other doctors' consulting rooms patients queued up for ages, more than could be seen in a whole afternoon. Outside my door? No one. They saw more than a hundred patients a day; I couldn't see that many in a month. That gap felt sharp.

Psychological assessment used to be overlooked here too. It wasn't until around the end of 2015 that our IVF patients started having one.

Every couple who comes to us for IVF has a full workup, and it covers both a physical assessment and a psychological one. The physical side covers genetics, immunity, endocrinology, breast health and so on.

For the psychological assessment I spend 20 to 40 minutes talking with her about her situation. I have no hard rule that says, 'If you're under psychological stress you can't do IVF.' It's more that if the stress is high, I'll tell you how to adjust, and which parts of it to watch, because those parts can affect the IVF.

If you can adjust on your own, fine; if you can't, I recommend counseling. Whether people take that advice varies. By my standard, every couple carries stress to some degree, and I'd say three or four couples out of ten need counseling — but in the end maybe only one actually accepts it.

Because professional counseling costs real money. Some people can accept counseling and come straight away; others can't, thinking, 'Counseling? I'll go have a meal and I'll be fine' — and then they go home, get divorced, find a new husband, and come back to do IVF again.

I'm quite satisfied with my life now. Over these ten years, the first three were spent drifting from place to place. After Foxconn I found a boyfriend from Sichuan, and by the time I reached this hospital we were married. My daughter is three and a half.

I never imagined I would stay in Chengdu. That was unexpected.

If there had been no earthquake, I would probably have gone straight back to my hometown and would now be a psychology teacher at some middle school. Most of my university classmates in Lanzhou became teachers or civil servants; some went to graduate school, some teach middle school. Of everyone who studied this field, in terms of actually working in it, I'm one of the few who has stuck with it for these ten years, and I feel lucky about that.

Looking back on the Wenchuan earthquake, it's quite something to think about. A disaster and a trauma that large changes a person. It also gave me a chance to live through myself again, and to improve the parts of me that weren't good enough."

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