Hospitalization, Risks, and Familial Commitments Available to Purchase

This chapter examines how everyday hospital practices produce a specific subjectivity and illness trajectory for patients while shaping families’ authority over and responsibility for them. It shows that people come to psychiatry in hopes of guan—that is, bringing order to their loved ones’ seemingly chaotic lives. Psychiatry reshapes this hope into a desire for biomedicine by framing the patient as a disordered being who lacks self-knowledge, authorizing families’ interventions as medical protection, and translating people’s diverse experiences of madness into symptoms of a mental disorder to be treated with drugs and institutional disciplines. Meanwhile, psychiatry projects mental disorder onto a trajectory of chronic risk, relapse, and remission. This trajectory entangles hope with fear, and it reconfigures guan as a lifelong task of risk reduction and prevention to be managed by caregivers. As such, families become quasi-psychiatric institutions that help sustain the discourse and institution of psychiatry.