Plucking Heartstrings: Guqin, Aesthetic Attunement, and TCM Music Therapy

Abstract

In the Chinese cultural context, music is deeply intertwined with the human heart and plays a central role in both healing and governance. Guqin, an ancient Chinese zither, exemplifies holistic care throughout history, embodying heart-based empathy and resonance. This study draws on insights from traditional Chinese medicine (TCM), classic philosophy, literature, and aesthetics to trace a lineage of thinking that continues to inform contemporary music therapy. We examine the Chinese notion of xin/heart and the interdependent self, and how music facilitates individuals’ aesthetic attunement toward the natural and social orders. Our approach transcends limitations of Euro-American psychological paradigms centered on the psyche, by adopting a holistic perspective that emphasizes the interconnectedness of the heart, the body, and the cosmos. We argue for the necessity of moving beyond reductive biomedical treatment models to explore alternative ways of living and alternative care that highlight relational, moral, and aesthetic approaches to well-being.

Qin is the heart; qin is to recite, to recite one’s heart. ¹

Li Zhi (1527–1602)

Listen not with the ears, but with the heart; listen not with the heart, but with qi [vital energy].

Zhuangzi (369–286 BCE)

The most profound music is silence; the ancient path is difficult to retrace. Without approaching [qin] with a temperament of balance and harmony, but rather reducing it to a mere matter of skill and technique, the transmission of this art risks gradual dilution and eventual loss over time. ²

Xu Shangying (1582–1662)

On April 7, 2023, the serene ambiance of the Pine Garden in the city of Guangzhou witnessed Chinese President Xi Jinping welcoming French President Emmanuel Macron for an informal meeting. ³ Savoring tea, the two leaders celebrated mutual understanding and friendship while listening to a well-known traditional melody played on guqin, a Chinese musical instrument that enjoyed a privileged position among literati for thousands of years. One of the highlights of the ceremony was the guqin music called Liushui, “Flowing Streams,” inspired by the ancient tale of Gaoshan Liushui, “Lofty Mountains and Flowing Streams,” which cherishes the legendary friendship between qin player Bo Ya and woodcutter Zhong Ziqi. Bo Ya played qin with an aspiration for high mountains and flowing water; Zhong Ziqi understood and echoed, “Excellent indeed is your playing!” “Towering and majestic like high mountains.” “Rippling and surging like flowing water.” After Zhong Ziqi died, Bo Ya shattered his qin and never played again for the rest of his life, believing there would never be anyone in the world who appreciated his music as Zhong did. ⁴

The resonance between Bo Ya’s music and Zhong Ziqi’s appreciation mirrors the affectivity of qin’s melodies, which transcends language and touches the heart of the listener. This legendary encounter has given rise to the term zhiyin, literally translated as “knowing the tune,” which crystallizes mutual understanding and appreciation in Chinese culture. It signifies a unity of kindred souls that resonate through heart-based empathy (inspired by music).

Also known simply as qin, ⁵ the seven-stringed Chinese zither has written records dating back to the Shang dynasty (1600–1046 BCE). The guqin played during the Xi–Macron meeting, named “Jiu Xiao Huan Pei”, is one of the earliest surviving qin, crafted in 756 during the late Tang dynasty (CCTV, 2023). In 2003, UNESCO proclaimed guqin and its music a world heritage treasure, and later added it to the Representative List of the Intangible Cultural Heritage of Humanity. Since then, guqin has graced various significant events in China, including the opening ceremony of the 2008 Beijing Olympics, and has experienced a resurgence of popularity both domestically and internationally—a phenomenon some have termed “guqin fever.” This trend contributes to the national revitalization of traditional Chinese culture, especially since 2012, when President Xi began promoting the “China Dream” (of unlimited growth and cultural participation to rejuvenate Chinese civilization) (see also Yang, 2023). The “guqin fever” aligns with government efforts to enhance the soft power and influence of Chinese culture on the global stage.

The contemporary popularity of guqin also resonates with widespread mental health issues and the consequent “psychoboom” in China—an explosion of interest in therapeutic modalities and psychological offerings (see Yang, 2015). This is because the psychomoral and therapeutic functions of guqin as a traditional mode of self-cultivation and governing are intertwined with the Chinese notion of xin, or heart, and its capacity for empathy and ruling. ⁶ This ancient instrument is rooted in Chinese intellectual history and classic philosophy; it embodies principles of balance and harmony valued by Chinese society. Guqin plays an active role in rejuvenating classical traditions and exploring applications of music in traditional Chinese medicine and art therapy.

At the turn of the century, Ming-yue Liang (2001) predicted the rise in guqin’s popularity in the 21st century. From a neuropsychological perspective, the instrument’s diverse playing techniques help balance qi energy transmission and enhance subcortical synergy, making it a significant means of health preservation (ibid., p. 415). In recent years, as part of TCM music therapy, guqin music has been recognized for its soothing effects on the heart and body. Research on grassroots guqin organizations indicates that the values inherent in traditional Chinese culture remain crucial to contemporary guqin practitioners and their well-being (Deng, 2020). Guqin music therapy may involve listening to or playing the guqin, sometimes combined with practices such as acupressure, acupuncture, and calligraphy, to alleviate emotional disorders like anxiety, depression, and insomnia syndrome (Fung & Dai, 2022; Fung et al., 2019). Notably, guqin music therapy was used as a complementary treatment during major public health crises, including the outbreak of severe acute respiratory syndrome (SARS) in Beijing in 2003 and the COVID-19 pandemic in Wuhan in 2020 (Fung & Dai, 2022). In addition to in-person therapies, guqin music is also promoted through online platforms as a form of “music prescription” and “cyber wellness.” Within the broader context of China’s psychoboom, these new applications of guqin music contribute to a growing fascination with alternative forms of care and self-cultivation that draw upon aspects of traditional Chinese medicine, philosophy, and aesthetics.

In this article, we engage the heart-based empathetic resonance between human and the cosmos inspired by guqin in order to explore the role of music in holistic, relational, and aesthetic forms of care and healing. Drawing on sources in Chinese medicine, classic philosophy, literature, and aesthetics, we illuminate a lineage of thinking about healing that informs today’s music therapy practices. We adopt a methodology similar to Foucault’s genealogy—the history of the present. Genealogy views the process of descent as the outcome of power struggles and battles over domination, use, and meaning. The present-day has been shaped by complex power relations and struggles: “Genealogy . . . seeks to reestablish the various systems of subjection: not the anticipatory power of meaning, but the hazardous play of dominations” (Foucault, 1991, p. 83). Foucault’s genealogies are also concerned with the body, which is conceptualized as a material surface, as a flesh upon which the micro-physics of power leave their mark. However, rather than seeing the body as a site for power inscription, we treat the body as a vital force, governed and regulated by the heart and its ganying, or empathetic resonance with the cosmos. By taking a holistic perspective of health centered on the heart and its connection to the world through guqin music, our approach transcends limitations in prescriptive Euro-American psychiatric models of care. We provide a genealogical study of the connection, in Chinese culture, between music, health, and governance.

Drawing on historical records and contemporary cases, we analyze theoretical debates about, and clinical practices of, music therapy in China. First, we describe the holistic worldview expounded in ancient medical classics, which emphasizes the oneness of heaven and humanity, as well as the oneness of body and heart. We show that holistic care through music resists standardization and, by yielding benefits through long-term practice, steers care away from clinical treatment and quick-fix therapies toward healthful practices in daily life. Second, we examine philosophical texts to explore the role of music and the centrality of the xin in Chinese tradition concerning health and healing. We differentiate Daoist approaches from Confucian ones. While Daoist philosophy favors “silent” and serene music in order to achieve wangji—forgetting ulterior motives—and align people with the Dao (Way), Confucian teachings advocate for music that is zhonghe—balanced and moderate—to rectify the heart and its attunement to the surroundings. Indeed, Confucianism emphasizes the moral and political dimensions of health and healing, extending to ethical standards of society and governance of the world. This has implications for how governance functions in China and the political roles of music. Third, we shift to contemporary therapeutic economy and its influence on the heart. With the “guqin fever” and its commercialization, this musical instrument has been transformed into a fetishized commodity partially detached from its traditional cultural context (though President Xi still highlighted this cultural practice to welcome President Macron). We argue that, reshaped by technological advancements and market forces, even guqin can be disconnected from xin, creating new vulnerabilities for individuals. Finally, we use a case of technology-mediated music on Chinese social media to illustrate how the modern therapeutic industry strategically manipulates and instrumentalizes the heart. Mass-produced “music prescriptions,” “cyber wellness,” and “electronic traditional medicine” often overlook individual and contextual nuances, fostering reliance on quick, consumption-driven solutions. We suggest that, within the mainstream biomedical care framework that perpetuates mental health issues, it is unrealistic to expect more than temporary fixes. Therefore, it is imperative to move beyond reductive treatment models and explore alternative lifeways and views that promote holistic, relational, and aesthetic forms of care and well-being.

Music, Medicine, and Xin/Heart

Music therapy has historically adopted a Western biomedical perspective in conceptualizing the nature of health and disease, viewing individuals as bounded physical entities or clusters of mechanisms. Recognizing the limitations of this approach, the discipline of medical ethnomusicology grants the same level of importance and attention to medicine, music and culture. Benjamin Koen and colleagues (2008, p. 5) define the discipline as a field of research and practice that employs “collaborative, integrative, and holistic” approaches to explore the roles of music and sound phenomena in diverse cultural contexts of well-being. Medical ethnomusicology acknowledges the interconnected and affective nature of the mind, body, emotions, beliefs, behaviors, social support, and economic and political factors (Koen, 2018, pp. 261–2). To elucidate the effects of music on health and healing, the discipline focuses on “the five factors of one’s being,” namely, the physical, psychological, social, emotional, and spiritual aspects (ibid., p. 262, emphasis in original).

The Chinese notion of personhood diverges slightly from this conception. Less concerned with “being” and existence, Chinese personhood is focused on dynamic process of living and life itself, thereby transcending ontological debates. In his critique of Western “ontology” from the perspective of Chinese “life,” philosopher and sinologist François Jullien argues that ontology tends to limit life’s potentialities by reducing the dynamic interplay between life and the world to the static notion of “being,” an abstraction detached from lived experience (Li & Lash, 2023). This critique suggests that, culturally, Chinese selfhood demands a non-reductive, holistic, intersubjective, and contextual approach to conceptualizing the human body and well-being. Such conceptualization could benefit other cultural configurations of the self and personhood. Similarly, Sun Lung-kee (1991, p. 2) suggests that the Chinese perceive an individual primarily as a “body” to be made whole by the exchange of “hearts” between two such bodies. Far from being a distinct and separate entity, the Chinese individual is conceived largely within the continuum of “two persons” connected through the empathy shared between their hearts. Unlike Euro-American cultures, which typically consider the human body as a distinct biological system with clearly defined boundaries and an emotional component regulated by rationality, the Chinese view the human body as interdependent and interconnected with the natural and social world. As a result, what would be personal and emotional problems for Westerners are often either “somatized into physical ailments” or “externalized into interpersonal or moral issues” by the Chinese (ibid., p. 6).

This conceptualization of the human body and its wellness centers the heart. Jie Yang (2024) explains how, in the Chinese tradition, xin is both body and mind, embodying cognition, emotion, aspiration, virtue, and bodily sensation. It operates as an “affective” force, responding to intensities of feelings emanating from sensory inputs, and as an “aesthetic” agent that is artful and intuitive, attuning to the world and maintaining balance and harmony (ibid.). This aesthetic attunement of the heart is associated with the Confucian tradition (Hall & Ames, 1987); it transcends the binaries of “inner and outer, micro and macro, private and public” (Yang, 2024, p. 142). The heart thus acts both as an arousing agent, processing emotional stimuli and stirring bodily fluids, and as a stabilizing force, aligning with bodily organs and the external world to maintain dynamic equilibrium and harmony (ibid.). While excessive desires and intense emotions can harm the heart and lead to ailments, the heart’s balance and stillness serve as a source of wisdom, understanding, and healing. One can cultivate the heart and increase equanimity. Thus, the heart can be both the root cause and cure of illness and distress: it is both diagnostic and prescriptive (ibid., p. 143).

In this cultural context, music is viewed as directly connected to the heart and is central to health and healing. Music therapy has deep roots in Chinese history. Extensive historical records from the Warring States period (476–221 BCE) to the Qing dynasty (1644–1911) document theoretical debates and cases of healing through music, positioning China as one of the earliest origins of music therapy (Zhang & Tian, 2011). Notably, the very word for “music” in traditional Chinese, 樂 (yue), encompassed the concept of medicine in oracle bone script (Xu, 2006). In time, the character for “medicine,” 藥 (yao), was formed by incorporating “艸” (grass) atop, symbolizing its association with plant-based remedies. The character for “joy,” 樂 (le), shares the same linguistic root, reflecting the euphoria and healing power of music (ibid., p. 21).

In traditional Chinese culture, music connects individuals to the rhythms of the natural world and affects their inner states. Lüshi Chunqiu, a classic encyclopedia, indicates that all music derives from the harmony of nature:

The origin of music is ancient, arising from moderation and rooted in the great unity. The great unity gives rise to heaven and earth; heaven and earth give rise to yin and yang. With the changes of yin and yang, one above and one below, they unite to form harmony. . . All music is the harmony of heaven and earth, the blending of yin and yang. ⁷

The dynamic nature of music mirrors the perpetual ebb and flow of yin and yang, the interplay of complementary opposites. According to the Book of Rites: Record of Music, all sounds arise from the xin/heart:

Being affected by external objects, the heart moves, thus manifesting in sound. When sounds resonate, changes occur; these changes take on forms, which are known as tones. Organized tones become melodies, accompanied by instruments and ceremonial objects, collectively referred to as music. [. . .] Emotions stir within the heart and are expressed through the sound. ⁸

Music, therefore, is deeply intertwined with the heart, emotions, and experiences of the world. Bridging the correspondence between the microcosm of the human body and the macrocosm of the universe, music resonates with the natural order and reverberates within the human heart.

Such interconnectedness of music with the body and the natural and social orders is illustrated in the Huangdi Neijing, or the Inner Canon of Yellow Emperor, putatively the earliest Chinese medical classic. It depicts intricate connectivities of the five elements (五行), five tones (五音), five zang organs (五脏), five emotions (五志), five colors (五色), and five flavors (五味), forming the theoretical foundation of traditional Chinese medicine (see Chapter 5 of Su Wen). Seasonal dynamics and the natural order give rise to the five elements of wood (木), fire (火), earth (土), metal (金), and water (水), which in turn generate the five tones, jue (角), zhi (徵), gong (宫), shang (商), and yu (羽). They also correspond to the five zang organs, liver (肝), heart (心), spleen (脾), lungs (肺), and kidneys (肾), which generate the five emotions of anger (怒), joy (喜), thought (思), worry (忧), and fear (恐), respectively. Excessive emotions can damage their corresponding organs, and the five elements interact through processes of mutual generation and regulation. For instance, excessive anger can damage the liver, while sorrow regulates the effects of anger. Similarly, joy damages the heart, and fear overwhelms joy; overthinking damages the spleen, anger overwhelms overthinking; worry damages the lungs, joy overwhelms worry; fear damages the kidneys, and thought overwhelms fear. By properly adjusting the pitch, frequency, timbre, and volume, the five tones can stimulate emotional changes and harmonize psychological states, thereby providing feedback to regulate the functions of internal organs (Ma et al., 2014)—That is, music interacts with the body. This is also why TCM music therapy is often called “five-element” or “five-tone” music therapy.

The theoretical foundation of five-element music reflects the holistic principle of oneness of heaven and humanity and oneness of body and heart in classic Chinese philosophy. The concept of unity between heaven and humanity emphasizes the connection between health and the cosmos, while the integration of body and heart underscores inseparability of the physical and the psychological, suggesting the impact of social factors on well-being (Shi, 2000a). The human body is intricately interwoven with the natural and social order. Alignment with the cosmic order fosters well-being, whereas disharmony or excessiveness may lead to illness (Yang et al., 2015).

Music plays a crucial role in maintaining this harmony via xin. The five tones, emanating from the natural world, affect operations of the five zang organs and interact with the five emotions. According to the Huangdi Neijing, the heart assumes the central position among the internal organs. As the “monarch” of the body (君主之官), xin reigns over the five zang organs and six fu organs:

If the ruler (xin) is clear and unobstructed, its subordinates (other bodily organs) will be stable and at peace. Nurturing life in this way leads to longevity without encountering calamities throughout life. Governing the world in this way leads to prosperity and flourishing. ⁹

In this metaphorical system, the heart governs emotional, physical, and intellectual activities, akin to the supreme political power of a monarch. The other bodily organs are likened to “governmental officials,” each tasked with specific functions. The heart serves as the central hub for processing and retaining the information received from the sensorial organs and their interactions with the external environment (Yang, 2024).

Through its sensory resonance with the body, music has the power to affect xin and shape well-being. Zuo Zhuan, an ancient Chinese chronicle of the Spring and Autumn period (771–476 BCE), illustrates the story of King Jing of Zhou who prepared to forge a giant bell in two years, producing loud and coarse sounds. Ling Zhoujiu, a music official, remarks: “The King will probably die from heart ailment.” He elaborates that music is the duty of the Son of Heaven, who observes customs to create music, gathering it with instruments and expressing it with sound. When small sound is not faint and large sound is not harsh, the music will harmonize things, leading to joy and prosperity:

Harmonious sounds enter through the ears and find residence within the heart. When the heart is at peace, joy ensues. Conversely, dim sounds would fail to resonate; harsh sounds would find no solace. The heart thus becomes unsettled; this unrest breeds illness. Now that the sound of the bell is coarse and loud, the King’s heart finds it intolerable. How could it last for long? ¹⁰

King Jing died exactly two years later. This story demonstrates impacts of frequency, pitch, and intensity of sound on xin and wellness (Shi, 2000a; Ma et al., 2014). While harmonious music is believed to soothe the heart and promote well-being, extreme sounds can unsettle the heart and lead to illness.

The esteemed physician Zhang Congzheng (1156–1228) documented a case of music therapy in his medical manuscript where he used dance, flutes, and drums alongside acupuncture to treat a patient suffering from excessive sorrow and an aching heart. ¹¹ In addition, he advocated for instrumental music training to enhance a patient’s emotional balance and alleviate the pain of illness (Lin, 2006). Even today, TCM music therapy takes on various forms, including guided listening, rhythmic breathing exercises, and active participation in playing instruments or singing (Ma et al., 2014). Through these activities, people not only experience the aesthetic beauty of music but also balance their hearts, express their emotions, and regulate their flow of qi.

TCM music therapy also takes into consideration contextual factors, personal experiences, and the doctor-patient relationship. Practitioners begin by considering the interplay of the five tones, five emotions, and five zang organs when selecting therapeutic music. They also account for contextual factors such as seasonal fluctuations, regional environment, dietary patterns, and the individual’s emotional state to gain a holistic understanding of the patient’s condition. The choice of music is customized not only to the individual but also to the timing and environment (Yang et al., 2015). For example, physician Wan Quan (1495–1585) documented a case where a child suffered from convulsions, excessive sleepiness, and spiritual fatigue due to ingesting spoiled food. ¹² Wan employed music therapy alongside conventional medication, inviting the child’s playmates to bring their drums and cymbals to the bedside, where they sang and danced to uplift his spirits. Within half a day, the child’s eyes opened, and his condition stabilized. This individualized and contextual approach suggests that TCM music therapy resists standardization and is instead tailored to each situation. In contrast to Euro-American medicine, where healing is approached as work on an isolated case to be treated under controlled, objective clinical conditions, TCM music therapy views healing as a dynamic process embedded in everyday life.

Qin: Oneness of Heart and Body, Oneness of Heaven and Humanity

The qin embodies classic Chinese philosophical beliefs regarding the harmony between heaven and humanity. As the epitome of this holistic principle, it serves to connect human with the cosmos. Its design and symbolism reflect elements of the human body, the natural world, and societal order. In Qin Cao, one of the earliest surviving texts on qin compositions, we find a detailed elucidation of the instrument’s construction. ¹³ The qin is crafted not merely as a musical instrument, but as a vehicle for self-cultivation and refinement. It aims “to restrain deviations and safeguard the xin against excessive desires, thereby fostering moral fortitude and guiding individuals back to their innate purity”:

Qin is three chi, six cun, and six fen long, resembling the 360 days of the year; it is six cun wide, symbolizing the six directions. . . It is broad in the front and narrow in the back, symbolizing the distinction between superior and inferior. Its upper part is round and lower part is square, in accordance with the principles of heaven and earth. It has five strings representing the five elements. The larger string is the ruler, broad and mild. The smaller string is the minister, clean and orderly. King Wen and King Wu added two strings, symbolizing the benevolence between ruler and minister. The gong string is the ruler, the shang string the minister, the jue string the people, the zhi string the affairs, and the yu string the objects. ¹⁴

Playing qin is akin to mirroring the intricate workings of the cosmos. One can harness the interplay of yin and yang and the five elements to create harmony and promote well-being. This engagement is reflected in qin tablature, which uses abbreviated characters to guide hand movements and interaction with the seven strings (Deng, 2020). In traditional Chinese culture, qin holds a preeminent position among the four classic arts—qin, chess, calligraphy, and painting—due to its unique capacity to convey profound thoughts and subtle emotions that other art forms cannot (Gui, cited in Yan, 2011). This distinctive quality underscores qin’s significance not only as an art form, but also as a philosophical conduit and vehicle for self-cultivation in Chinese tradition.

This sense of connectedness with the cosmos finds vivid expression in a particular qin composition, Shanju Yin (山居吟), often translated as “Ode to Living in the Mountains.” It portrays the ideal of living poetically as a recluse among the mountains in perfect harmony with nature. According to an interpretation in a qin handbook, its aesthetics lie in “residing amidst pine trees among the hills, tranquil and detached from worldly affairs, no longer entangled in the dust of mundane life”:

Taking the mountains as a barricade and flowing water as a fence. Heaven and earth form the hut; grass and trees comprise the garments. Reclining by the rocks and rinsing in the streams, wandering freely within. As for the sensation of mountain moonlight and river breeze, and the sound of birds singing and flowers falling, all of these can be obtained without restraint and experienced without exhaustion. . . ¹⁵

This qin piece symbolizes the fusion of humans with the cosmos, evoking a sense of openness, expansiveness, and detachment in the inner realm (Wu, 2018). Situated within the selfless spontaneity of nature, playing this piece soothes the heart and fosters self-cultivation, offering a retreat from the complexities of worldly affairs and officialdom.

Historically, this reclusive lifestyle and sense of detachment required leisure and free time, and thus were more accessible to men from the literati class than to women. In other words, learning qin and engaging in self-cultivation were privileges reserved for certain gender and class in ancient times. By adopting a genealogical approach, we explore the broader context of how discourses of qin and self-cultivation have emerged and evolved, focusing on the historical settings and conditions that enabled their development (Foucault, 1991). In recent years, the “guqin fever” in China has transformed the instrument from an elite, exclusive art into a popular and accessible cultural phenomenon. This shift underscores the ongoing tension between viewing guqin as “a literati tradition of the past” and “a people’s art of the present” (Deng, 2020, p. 4).

In tradition, playing qin at its highest level would require the player to fully integrate their heart and body with the instrument itself. The Daoist text Liezi provides such an example. Shi Wen left home to learn to play qin from Master Shi Xiang. However, at the very beginning he had difficulty producing a single piece. His heart did not connect with the strings, and he could not articulate what was in his heart through the instrument. ¹⁶ Later when he harmonized the rhythms of the seasons, evoking the melting ice, gentle breezes, and flourishing forests, his playing became masterful, manifesting his deep understanding of the harmony of music and the cosmos through connecting his heart to the qin. Qin music is expressive and evocative, putatively capable of ushering in seasonal transformations and flourishing of nature. It also enables individuals to perceive the hearts of sages from ancient times, refining emotions and cultivating moral virtues.

The story emphasizes the importance of heart cultivation and attunement to the world in mastering the qin. Shi Wen’s initial inability to play stemmed not from a lack of technical skill, but from difficulty in expressing his heart through the instrument. This suggests that a holistic approach, rather than technical proficiency, is the necessary ingredient for understanding the heart, resonating with the instrument, and aligning with the Dao. Highlighting the connection between the xin and qin, philosopher Li Zhi argues that qin is the heart, ¹⁷ and playing qin serves to actively articulate inner perceptions and emotions, rather than merely experiencing them passively. This concept also serves as inspiration for proactive therapeutic approaches in modern music therapy (Shi, 2000b). Music not only influences people’s inner state, but also provides them with the opportunity to actively express their heart and release their emotions, thereby contributing to a balanced psychological state. Contemporary writers have also echoed this sentiment, describing guqin music as an art that “passes through the heart” (Liu, 2015), and likening its silken strings to melodic strings of the heart (Shanghai Daily, 2009).

In the Chinese classics, qin served as a medium for literati to balance their xin and express their inner states. Philosopher Huan Tan (23 BCE–AD 56) noted that the sages played qin to foster resilience and inner harmony amidst external challenges. ¹⁸ During times of disappointment and failure in officialdom, they turned to the qin for solace and self-cultivation. Conversely, in times of achievement and success, they used ritual and propriety to govern the state, employing qin to promote virtue (see also Cai, 2003). These insights suggest that health cultivation through qin music in ancient China involved balancing internal and external states, and integrating Confucian and Daoist philosophies (Wang, 2020). This holistic approach emphasizes the coordination of physical and psychological health, as well as the harmonization of human–nature relations, interpersonal dynamics, and societal norms. Yuh-Wen Wang (2010, p. 8) argues that guqin’s life-nurturing experience is highly contextualized, reflecting a “non-dichotomous mentality” that transcends Western “bi-polarity of mind and matter”. This underscores the contrast between TCM music therapy and modern medical paradigms, including biomedical treatment models.

Wangji, Holistic Listening, and a Relational Sense of Well-Being

According to Daoist philosophy, the health-preserving effects of music stem from its ability to release the heart from excessive emotions, intentions, and desires, allowing it to return to the state of rest and tranquility. For example, the Tang dynasty poet Bai Juyi (772–846) describes how music dispels distractions from the heart: “Upon hearing the music, worldly schemes dissolve into emptiness. One note enters the ears, all concerns depart from the heart.” ¹⁹ He emphasizes the soothing nature of qin music and its power to clear the heart, alleviate anxiety, and enhance well-being.

In his treatise on the aesthetics and therapeutics of the qin, musician Xu Shangying elaborates on the close relationship between music and the xin:

Stillness (jing) arises from within, sound emanates from the heart. If the heart is disturbed, the fingers are obstructed, how can one find stillness when playing qin? Only the cultivated person, who is detached and serene, whose heart is clear without dust and fingers are at leisure, can grasp the principle of silent sound (xisheng) effortlessly. [. . .] In seeking stillness in sound, one clears away the restless breath and releases the competitive heart. . . (Section 2, Xi Shan Qin Kuang) ²⁰

Here, Xu underscores a foundational principle of healing music: jing (静), literally silent, still, and serene. It describes a state of tranquil composure and inner peace, detached from worldly concerns, desires, and ambitions. When playing qin, this subtle and soothing sound emerges from a clear heart and is expressed through relaxed fingers. Xu defines the purpose of the qin as “to illuminate the heart and reveal one’s true nature (明心见性).” It is intended not for entertaining others, but as an instrument for personal introspection.

The notion of jing also aligns with the Daoist principle of xisheng (希声), “faint sound,” or “silent sound,” as exemplified in Laozi’s dayin xisheng, literally: “the most profound music is silence.” ²¹ This epitomizes the Daoist philosophy of valuing simplicity, stillness, and emptiness. Xu himself interpreted this notion of silence as a subtle state, “transcending the mundane, existing in emptiness, and wandering the spirit above the realm of the ancient kings.” ²² This state of jing exemplifies the Daoist philosophy of music, which seeks to guide individuals in retrieving their original heart, shedding worldly distractions, thus cultivating a natural state of inner peace (Mao, 2021). Xu’s insights continue to hold relevance in contemporary music therapy practices, where tranquil music is used as a remedy for tension, anxiety, and restlessness (Shi, 2000b). Furthermore, Xu’s elucidation of “wandering the spirit” suggests alignment with the Dao, wherein a person harmonizes with the natural order and the myriad things, which is essential to one’s well-being.

The state of stillness and alignment finds illustration in a qin piece known as Oulu Wangji (鸥鹭忘机), commonly translated as “Regarding Seabirds without Ulterior Motives.” The music evokes imagery of a person peacefully wandering over the sea, accompanied by seabirds that trust him intuitively, undisturbed by worldly concerns. The inspiration for this piece originates from the Liezi, which tells the story of a seaside dweller who loved seabirds. ²³ Every morning he would go down to the sea and roam with the seabirds, and countless birds would come to him and never leave. His father said to him: “I heard the seabirds all come roaming with you. Bring me some to play with.” The next day, when the seaside dweller went to the sea, the birds danced above him but would not come down.

The teaching behind this story revolves around the notion of wangji (忘机), which entails forgetting ulterior motives to release the heart from turmoil and competition, leading to calmness and detachment. Only with a heart free from schemes can a person dwell harmoniously with the surroundings, as expounded in a qin handbook:

When a person is able to forget schemes, the birds harbor no suspicion; when a person’s heart moves, the birds immediately distance themselves. The form may be deceptive, but the spirit cannot be deceived. When my spirit moves subtly, the spirit of others knows instantly. Thus the sage is as one with the dust of the myriad things, always accompanying them with a heart of no intention. ²⁴

There is intrinsic connection between an individual’s inner state and the natural order. Even the slightest calculating impulse in the human heart reverberates through the surrounding world. The cultivated person therefore nurtures a “heart of no intention,” to become one attuning with the surroundings.

Central to achieving this state of emptiness, which is also fundamental to the notion of wangji, is the Daoist practice of xinzhai (心斋), fasting the heart (see Matthyssen, 2024). This concept imparts a lesson on attuning oneself to harmonize with the surroundings and navigate complexities:

Unify your intention. Listen not with the ears, but with the heart; listen not with the heart, but with qi. The ears are limited to hearing sounds; the heart is limited to interaction with external things. As for qi, it accommodates things within emptiness. The Dao gathers in an unoccupied and peaceful emptiness. This state of emptiness is the fasting of the heart (xinzhai). (Chapter 4, Zhuangzi) ²⁵

Practicing xinzhai involves quieting the heart and attuning it to the rhythms of the surrounding world through holistic listening involving the xin and qi. In Chinese culture, listening is deeply connected with the heart and body. The traditional character for “listening,” 聽, incorporates the Chinese character for “heart,” 心. Indeed, Chinese people are culturally trained to “listen” within the body (Ots, 1990, p. 26). Listening to guqin requires attentiveness and openness, enabling one to perceive not only the nuanced musical expressions but also “the player’s inner qi and the state of mind [heart/xin]” (Deng, 2020, p. 38). This holistic listening involves the heart’s empathetic resonance across the boundaries between mind and body, and between the individual and the surrounding world (Wang, 2017). This implies a connection among the human heart, sensory perceptions, the flow of qi, and surrounding phenomena. Health is thus understood as mental tranquility, sensory awareness, smooth qi circulation, and harmony with one’s surroundings. Music serves as a bridge connecting the subjective and objective realms, dissolving boundaries between self and others, and between humanity and nature. This alignment with the Dao suggests a relational and contextualized understanding of well-being.

A compelling example of this heart-centered approach to peace and health is the Song dynasty poet Ouyang Xiu (1007–1072), who found solace and healing from depression and burnout through playing qin. ²⁶ Despite retreating into seclusion, he initially found no relief. It was only after he began learning to play qin that he discovered enduring joy. In a poem celebrating the qin, he highlighted how music attuned the heart and the body: “Played through the fingers, the sounds within are listened to, not with ears but with the heart; once the heartfelt intention is attained, the physical body is forgotten, and worldly concerns dissipate.” ²⁷ This verse resonates with the concept of xinzhai in the Zhuangzi, emphasizing holistic listening through the heart, which enables individuals to fully tap into the healing power of music.

Daoist philosophy of music has significant implications on health and healing. Returning to the notion of wangji, the term ji (机), meaning “motive,” is rooted in the Daoist notion of jixin (机心), which denotes a heart of intent, calculations, and schemes. This concept of jixin is intimately connected to health. Guqin scholar Yang Zongji (1864–1931) compares qin with chess (also one of the four classic arts), arguing that qin should be played without jixin, whereas the game of chess employs jixin. While qin embodies the Dao and nurtures well-being, chess experts often experience severe physical and emotional strain, to the extent of “draining their heart and blood” (cited in Wang, 2009, p. 8).

The concept of jixin is also translated as “machine heart,” reflecting its association with reliance on machinery. The Zhuangzi tells a story where Zigong, a disciple of Confucius, encountered an old man laboriously digging a tunnel to access a well and lift water for his field. Despite his considerable efforts, the old man achieved little progress. Zigong suggested that he use a device capable of watering a hundred plots in a day, “with minimal effort and great effect.” The old man’s face changed, appearing resentful. Then, he smiled and said:

I have heard it from my teacher: with the advent of machinery, there will inevitably arise contrivances; with the emergence of contrivances, there will be a heart for scheming (jixin). With a scheming heart, pure simplicity is no longer complete, the spirit becomes unsettled, and the Dao will not enrich the inner being. It is not that I am unaware of such contraptions; I feel ashamed to make use of them. (Chapter 12, Zhuangzi) ²⁸

The old man emphasizes the emergence of jixin, “scheming heart,” as an unavoidable outcome of the reliance on machinery and technological progress. The scheming mindset, characterized by manipulation and calculation, poses significant risks to both individual well-being and alignment with the Dao. To counteract these detrimental effects, one must transcend the allure of scheming intentions and embrace a path of pure simplicity. Here, “pure simplicity” is not a naive rejection of complexity or a romanticized state of ignorance; rather, it signifies a state of completeness and interconnectedness with the world, safeguarding the integrity of one’s spirit and physical form. Zhuangzi’s ideas remain relevant today as they caution against anthropocentrism and the instrumental imposition of human will onto natural processes. Instead, they advocate for the development of technologies that harmonize with the dynamics of nature (such as sailboats and wind turbines) (Parkes, 2013). On a personal level, this entails recognizing the inevitability of technological advancement, vigilance against the alienating potential of machines, and consciously adopting a holistic and relational way of life.

The Daoist concept of pure simplicity starkly contrasts with the alienation experienced in modern lifestyles. Characterized by industrialization, urbanization, and fierce competition, contemporary ways of living have led to an increased sense of detachment from the natural world. This notion appears to align with Karl Marx’s (1978 [1844]) analysis of “estranged labor.” Under capitalist systems driven by utilitarian objectives, individuals become estranged from one another, the natural environment, and their inherent humanity—what Marx refers to as “species-being” (ibid., p. 74). The Zhuangzi seems to be a prior articulation of this sentiment, but it says a lot more than illness proper. It suggests that such alienation unsettles the spirit and is the root cause of illness. In today’s commercial environments, the heart often endure oppression and distortion, posing threats to both physical and mental well-being. However, contemporary mental health treatment is increasingly becoming part of a profit-driven industry that cultivates vulnerability and dependence (Furedi, 2004). Rather than pausing to focus on personal introspection and connection with their surroundings, people tend to seek quick remedies and medication. We argue that there is a need to shift our focus towards alternative therapies rooted in different worldviews and ways of living. Studying Chinese classics, such as the role of music in healing, offers new perspectives on mental health. The current framework, which is inevitably linked to psychology based on Euro-American precepts, offers benefits but struggles to address non-clinical practices like music that can strengthen the heart and health. Within the very framework that perpetuates mental health issues, we can hardly expect to find more than temporary fixes. And we need to explore alternative approaches that address the root causes of mental health challenges and promote holistic well-being.

Extending beyond conventional Western psychiatric models, Daoist philosophy of music offers an alternative approach to mental well-being through its emphasis on simplicity and harmony with nature. TCM music therapy embodies the Daoist ideal of “oneness,” which involves transcending the limitations of the individual body and connecting with the myriad things through releasing one’s personhood (Chai, 2022). This perspective contrasts with alienation and isolation, emphasizing a relational sense of the self and well-being (Wu, 1992; Ivanhoe, 2017). Studies have highlighted the therapeutic potential of achieving a state of oneness, especially for psychological issues like depression and anxiety. Music serves as a bridge connecting humans and nature, helping restore the heart from its alienated state and nurturing overall well-being (Fung & Dai, 2022). Guqin can inspire deep sentiments, foster connection with nature, and potentially liberate listeners from the “self-interest, temptation, and competition” perpetuated by the capitalist system, which has produced massive destruction of our planet (Tan, 2023, p. 283). TCM music therapy thus provides a practice-based avenue to escape the relentless pursuit of material gain, reconnect with the self, and achieve greater well-being.

Zhonghe, Aesthetic Attunement, and the Moral Dimension of Healing

In line with Confucian teachings, the healing effect of music is achieved through its rectification of the human heart. According to the Records of the Grand Historian, music serves to stir the circulation of blood and facilitate the flow of vital energy, thus harmonizing and rectifying the xin. ²⁹ Music moves the heart, brings about emotional resonance and promotes the movement of bodily fluids. Through musical experiences, a person achieves emotional balance and becomes physically and psychologically attuned, which is considered a state of health (Zhang & Zhang, 2014; Wang, 2020).

Not all music is considered therapeutic, however. The proper healing music must be zhonghe (中和), or balanced and moderate, in its tone, pitch, volume, and rhythm. Neither too swift nor too slow, neither too weak nor too strong, balanced music soothes and nurtures the xin. Highlighting the therapeutic effect of music in ancient times, philosopher Zhou Dunyi (1017–1073) described ideal music as “gentle without being piercing, harmonious without being excessive”:

It enters the ears and moves the heart, leaving a sense of lightness and harmony. Lightness calms the heart with desires, while harmony relieves the heart of agitation. This gentle moderation is the pinnacle of virtue; this harmonization of the world is the ultimate form of governance. This is aligning with heaven and earth, the utmost of antiquity. (Section 17, Tongshu) ³⁰

When balanced and moderate music is played, the heart is dispelled of excessive desires and rendered at peace. This stillness of the heart is a resource for healing. According to Zhou, the healing power of music entails a moral dimension. Its influence extends beyond the human heart to encompass ethical standards and societal governance. The harmony of music not only promotes tranquility of the heart but also contributes to the cultivation of virtues. The concept of zhonghe is not merely a feature of balanced music; it is also a principle of morality and social order. It conveys ideas of correctness, moderation, and harmony, referring to the ideal equilibrium in the world. It requires people to maintain a balanced approach in all aspects of life and is at the heart of Confucian thought (Yang et al., 2015). In this sense, zhonghe is closely associated with the principle of zhongyong (中庸), “the doctrine of the mean,” which advocates avoiding extremes and finding a balanced middle path in thoughts and actions. It encourages the cultivation of propriety, the harmonization of desires and emotions, and self-restraint. Ultimately, it seeks alignment with heaven and earth, as mentioned in Zhou’s quotation above, thereby fostering personal well-being, moral integrity, and social harmony. As Yang (2024) suggests, achieving this balance involves an aesthetic—artful, affective, and non-linear—attunement of the heart to its surroundings. Music plays a central role in this process by directly affecting the heart, which is the ruler of the self and connects to the broader natural and social order.

In a collection of Confucius’s teachings, there is a story about Zilu, a disciple of Confucius, playing qin. When Confucius heard it, he expressed concern that Zilu was deviating from the path of virtue and jeopardizing his well-being:

In the music established by the ancient kings, balanced and moderate notes are played to set the standard rhythm. . . The music of a virtuous person should be gentle and moderate, nurturing the vital energy of life. It does not exert sorrowful affects to the xin or violent movements to the body. This is what is called the wind of peace and tranquility. The music of petty individuals, however, is different. It is grand and extravagant, resembling the spirit of aggression and warfare. [. . .] Zilu, now, as an ordinary person, having no regard for the rites of ancient kings, instead practices the music of a fallen state, how can he preserve his own physical existence? (Chapter 35, Kongzi Jiayu) ³¹

Confucius was concerned that Zilu was playing qin the wrong way. He believed that only by engaging with music that is zhonghe could a person follow the path of virtue and maintain good health.

Conversely, the kind of music that undermines a person’s well-being, as opposed to the principle of zhonghe, is the music that is yin (淫), or excessive. For example, during the Spring and Autumn period, Duke Ping of Jin sought medical treatment from Yi He, a doctor, who suggested that the Duke’s illness was caused by an obsession with women and advised him to regulate his conduct. He used music as a metaphor to argue that excessiveness is the root cause of various illnesses:

Elaborate techniques and excessive (yin) music confuse the heart, disturb the ears, and make one forget peace and harmony. A virtuous person does not listen to such things. ³²

Yi He is one of the earliest documented music therapists in Chinese history (Shi, 2000a). The excessive sound he described refers to complex music that involves elaborate techniques, with high pitch and intense rhythm, which was seen as undermining well-being and leading people astray from the path of virtue. Quieter, more measured music would represent a more healthful path.

This is also why Confucius once suggested discarding the music of Zheng, describing it as “excessive” and “dangerous,” comparable to deceitful and treacherous flatterers. ³³ With its fast-paced, intense rhythm and significant variations in melody, the music of Zheng is believed to stir unrestrained emotions and provoke selfish desires. Such effects are detrimental to one’s health and contradict Confucius’s aim of cultivating moral virtues centered on benevolence and propriety. This suggests a difference between Confucian and Daoist approaches to the therapeutic use of qin. While Daoist philosophers engage with qin to express emotions and release the heart, Confucian doctrine views qin as an instrument to “restrain”. It restrains excessiveness and rectifies the heart. ³⁴ Playing qin helps a person regulate emotions and desires, contributing to the moral cultivation of the xin. It mediates the artfulness required at all levels of individual and social life to maintain harmony.

Scholars have investigated the role of qin in imposing social norms, and its effects on the regulation of people’s behavior, especially during the Han dynasty (Mao, 2021; Li, 2009). Still today, guqin is praised as an instrument of great subtlety and refinement and is called the “instrument of the sages.” Contemporary players have described how the instrument is calming and “keeps one balanced and not distracted by either honors or adversities” (Shanghai Daily, 2009, para. 13).

In classic Chinese philosophy, health and healing extend beyond the individual body and encompass social relations and the cosmic order, carrying moral and political implications. Historically, the term zhi (治) used in “governing a state” (zhiguo 治国) is analogous to the zhi (治) in “treating an illness” (zhibing 治病), both reflecting a concept of care and management (Shi, 2000b, p. 178). This suggests that a person’s physical and mental health is inseparable from moral virtues and social harmony, pointing to a political dimension of health and healing. This interconnectedness of healing and governing, we argue, forms the philosophical foundation of therapeutic governance in the Chinese context, which is rooted in the heart (Yang, 2015). It presents an alternative to forms of governance in the Western context, for example, those captured in Michel Foucault’s (2012 [1975]) analysis of technologies of discipline and Gilles Deleuze’s (1992) analysis of free-floating control. Instead of relying on public executions, psychiatric hospitals, timetables, and computers, the ideal Chinese ruler employs music to affect and attune people’s hearts. It is important to acknowledge that this represents an idealized vision of governance that Chinese rulers have historically aspired to achieve, and that in practice rulers have also resorted to forceful measures. In the ideal scenario where music plays a central role, social order is achieved through “ethical governing,” employed by a virtuous or even saintly leader (Wang, 2017, p. 15). The ideal ruler accomplishes governance by guiding their subjects to a state of xin yue cheng fu (心悦诚服), literally “joyous heart and sincere submission,” as music nurtures a peaceful and joyful heart and cultivates obedience.

While the very notions of health and healing are inherently political, so are music and aesthetics. As documented in the Book of Rites, since music originates from the xin, the movement of which is influenced by external objects rather than inherent nature, the ancient kings have been cautious in what is capable of affecting people’s hearts. ³⁵ In other words, anything that touches and moves the heart, including music, is political. Thus, there have been the music of governance, the music of disorder, and the music of a fallen state: sound and music are intimately connected with politics. Throughout the Chinese history, feudal rulers have sought to monopolize and control musical activities, recognizing its power to move people’s hearts and shape cognition (Zhang & Zhang, 2014). It is worth mentioning here that the excessive and unhealthy sound abandoned by Confucius, the music of Zheng, was folk music practiced by minority groups in ancient times. Poet and statesman Su Shi (1037–1101) pointed out the one-sidedness of regarding qin as the elegant sound (Luo & Xiao, 2019). ³⁶ Qin’s reputation as an elegant, refined “instrument of the sages” is partly due to its historically dominant position in rectifying people’s heart, promoting moral education, and achieving universal governance.

Commercialization of Guqin and Erosion of the Heart

Today, guqin is regarded as a holistic healing alternative. However, over the past two decades, amidst the surge of “guqin fever,” and particularly following its recognition as a UNESCO Intangible Cultural Heritage of Humanity in 2003, the instrument has been increasingly commercialized. A guqin can easily be worth tens of thousands of yuan, and some prominently display the instrument in their homes, viewing it as just another means of showcasing their elegance. In such cases, guqin is no more than a luxury item and a symbol of refinement—like “hard currency” to be hung on walls (Jiang, 2015). According to guqin craftsman Wang Peng, an increasing number of buyers today are more interested in the visual appeal of the instrument than its musical tones (cited in Eyunni, 2012). In this context, guqin has become a fetishized commodity detached from its cultural roots.

As a musical instrument, guqin has also fallen prey to commercial interests. In a public lecture on Chinese classics, guqin master Cheng Gongliang (2014) criticized the negative impact of this trend: Some individuals, with limited knowledge and skill in guqin playing and cultural understanding, have established studios and training courses solely to turn a quick profit. These individuals dress in Hanfu attire, ³⁷ adorn their walls with elegant calligraphy, and masquerade as “cultural masters.” They audaciously claim, “There is philosophy within my playing” (ibid., p. 114). Cheng explains that because the rhythm of guqin is free-flowing and many pieces feature irregular beats, distinguishing between competent and unskilled players can be challenging for many listeners (ibid., p. 115). This trend has coincided with the exponential growth in the number of guqin enthusiasts in China, exceeding 200,000 by the year 2015 (Jiang, 2015). Some ironists have even referred to learning guqin as one of the “four most vulgar things” in modern society. ³⁸

Meanwhile, in professional guqin-playing circles, undue emphasis is placed on technical prowess. Even dedicated learners tend to prioritize elaborate formalities and technical mastery over cultivating the heart. Chen Leiji, a musician who played guqin at the opening ceremony of the Beijing Olympics, expressed his unease witnessing a guqin performance where, upon the stage, a large censer was placed alongside a thick incense stick. As the performer, clad in Hanfu attire, began to play, he could not help but question whether this was “playing or performing the guqin” (cited in Jiang, 2015, section 2, para. 2). In a national symposium on professional guqin education, Zhang Huaying (2020, p. 116), a professor at the Central Conservatory of Music, argues that the overemphasis on performance techniques neglects the instrument’s cultural significance, leading to the “standardization and mass production of aesthetic and playing styles”. Additionally, the influence of Western music on guqin education in recent decades has transformed the instrument from an integral component of literati life into a distinct professional pursuit (ibid.).

Focusing solely on the technical intricacies and advancements of guqin playing risks severing its connection to the heart and its cultural heritage. The loss of connection to guqin and empathy with music is symptomatic of the alienating effects of modernity. The increasing prevalence of mental health disorders such as anxiety and depression is closely linked to individuals’ detachment from the natural environment and their difficulties in attuning to societal pressures (Fung & Dai, 2022). As a force connecting human and nature, music serves as a “spiritual vitamin” aiding in the well-being of the heart, body, and spirit (ibid., p. 1977). However, clearing the heart and achieving inner focus is no easy task amidst the pressures of contemporary life. This partly explains the overemphasis on formality and performativity in guqin learning: it is a response to the challenge of maintaining concentration amidst distractions. The need for external formality and elaborate rituals may stem from the difficulty in stabilizing the heart to attain inner concentration necessary for connecting with guqin and commencing play. Even in ancient times, for qin master Shi Wen, as depicted in the Liezi, it took three years to establish connection and resonance in the heart. In our contemporary era, the proliferation of digital technologies has further intensified this challenge of concentration.

Perhaps distraction helps explain new forms of music therapy, such as those offered on the technology-mediated music platform, NetEase Cloud Music, a popular online streaming app among China’s younger generation. Since its establishment in 2013, the platform has crafted its business model around social networking and collective healing practices within virtual communities. Users are encouraged to share personal stories and express emotions through comments on the music they listen to. In an open letter issued when NetEase Cloud Music was listed on the stock market in December 2021, Ding Lei, the company’s Chairman and CEO, depicted the platform as a “village” united by people’s hearts and emotions:

The power of emotional resonance is precisely what music is all about. In the past, emotions evoked by that power could dissipate quickly like tears in the rain. But now, they are treasured like everlasting jewels in this community we built. (NetEase Cloud Music, 2022, p. 5)

Yet despite appearing to foster expanded empathy and compassion through digital technologies and the market economy, the platform paradoxically creates anxiety and depression. Due to their strong affective resonance, music and comments labeled as “healing” (zhiyu 治愈) often end up as “depressing” (zhiyu 致郁). And the platform’s recommendation algorithms frequently favor melancholic content that is more emotionally stimulating, leading to pervasive depressive posts. As a result, NetEase Cloud (wang yi yun 网易云) has been frequently ridiculed as “Net-Depression Cloud” (wang yi yun 网抑云).

While perpetuating collective feelings of depression, NetEase Cloud offers easy access to quick fixes such as online counseling and “music prescriptions”. These include millions of user-generated playlists designed for healing and promoting sleep, with hundreds featuring “guqin life-nurturing” and “five-tone music therapy”. Marketed as forms of “cyber wellness” (赛博养生) and “electronic traditional medicine” (电子中药), these music pieces promise health benefits and even claim to have positive effects on specific zang organs. However, these music prescriptions are often mass-produced and arbitrary, overlooking individual and environmental differences. They foster user dependence on superficial, consumption-based solutions. Instead of treating the heart as a stabilizing force, the platform uses music as a powerful stimulus and treats the heart as an arousing agent. In this sense, the nickname of “Net-Depression Cloud” exemplifies a partial, strategic, and profit-driven instrumentalization of the heart, creating new vulnerabilities for users. In contrast to the principle of emotional balance and abstinence, modern platforms employ promotional tactics to induce exaggerated and even artificial emotions, exacerbating widespread feelings of depression.

Conclusion

Zhou Dunyi, after elaborating on the therapeutic and political significance of music in ancient times, critiqued the decline of the role of ritual and music in everyday life and governing in later generations:

When rites and laws are neglected, governance becomes harsh and disorderly; indulgence leads to degeneration, and the people suffer. They claim that music of ancient times is no longer worth listening to, replacing it with new sounds that are excessive and sorrowful, inciting desires and exacerbating depression, leaving them unable to restrain themselves. [. . .] Sigh! Music once calmed the heart, but now it perpetuates desires; it once spread enlightenment and virtue, but now it prolongs resentment. Without restoring ancient rites and reforming contemporary music, yet still expecting to achieve governance—how distant it seems! (Section 17, Tongshu) ³⁹

Instead of serving to soothe and rectify the heart, and to promote moral values and governance, Zhou believed that the music of his time manipulated the heart as an arousing agent. He advocated for the restoration of gentle, balanced, and moderate ancient music, which embodied harmony and moral order. We see a parallel in the modern therapeutic industry, which is influenced by technological advancements and the market economy. This industry harnesses the affective power of music to exploit the human heart, exacerbating desires and anxiety, this time in the name of commercial gain. This approach, rather than fostering holistic well-being, decontextualizes the heart from its cultural roots, leading to a sense of disconnection and alienation. These dynamics contribute to heart erosion, resulting in new vulnerabilities and internal strife, ultimately leading to a loss of empathy and relational ethics.

It is in this context that we propose the restoration of holistic, heart-centered approaches to care and healing, and exploration of alternative templates grounded in traditional Chinese medicine and philosophy. Music, with its innate ability to touch the heart and foster empathy and resonance, holds great healing potential. It plays a central role in harmonizing the balance and attunement of the human body, particularly the heart, with both natural and social orders. Drawing from the rich traditions of Chinese medicine, classic philosophy, literature, and aesthetics, TCM music therapy addresses physical, psychological, relational, and moral dimensions of well-being, encompassing personal health, moral cultivation, and social harmony.

Amidst China’s psychoboom, heart-based templates of care represent a departure from imported Euro-American psychological paradigms, transcending the limitations of approaches that focus solely (or partly, in hybrid therapies) on the psyche. These models also differ from the partial, strategic appropriation of Chinese cultural tradition that serves economic and political ends. For example, we distinguish between classic guqin training, and the quick-fix music therapies offered online on platforms like NetEase or those commercialized, superficial guqin studios. By embracing holistic, relational, and aesthetic forms of healing, TCM music therapy fosters greater openness, connectedness, and resilience in individuals and communities.

ORCID iDs

Wenlei Huang https://orcid.org/0000-0003-1853-904X

Jie Yang https://orcid.org/0000-0003-4757-5998