Are high expectations in life bad for you?

[Laura Corin]

I was just listening to a psychologist on the radio comparing mental health problems in China and the US. An American is five times more likely to be mentally ill.

 

Some of that is, I'm sure, due to different diagnostic habits. He suggested, however, that Chinese people didn't expect very much of their lives, and therefore experienced less stress from encountering reality. Americans have high expectations, and the gap between the dream and the reality leads to unmanageable distress.

 

(I have a private theory that a lot can be explained by different rates of exercise in the two countries - exercise produces happy brain chemicals which many people in the West miss out on).

 

What do you think?

 

Laura

[lionfamily1999]

I would say different rates of diagnosis has a LOT to do with their findings. Also, different governments and cultures have different views on mental illness. Perhaps, less Chinese are diagnosed, because their families would respond in a different way.

 

One more thing, many of the things Americans stress about are not high expectations, they are requirements. In many counties and under some hoas, you cannot go without utilities, you can't live in a house that's falling down, you can't leave the grass long, etc. Our standard of living is higher, and in some cases enforced, iykwIm. Of course, we're going to be more stressed, when losing your job could mean you lose your home, even if you're paying the mortgage.

[Renee in NC]

I think that several factors are at play (and I am speaking of depression only):

 

1. Less exercise - as you said. The Amish believe that if someone is depressed, one thing they need to do is to go outside and do hard physical labor in the sun.

 

2. Different Diagnosis (as you said.) When I went to my postpartum checkup, the doctor wanted me evaluated for postpartum depression because I was "depressed." OF COURSE I was depressed - we had just lost our business, our home, our livelihood, we had no jobs, and no good prospects of jobs! What would a "normal" person feel?

 

3. (I think this one kind of dovetails with expectations.) Americans expect to be happy all the time. If they aren't happy, they must be depressed, and must need a pill to make them happy.

 

Clinical depression is very real and very debilitating for some people. However, the high rates of "depression" are not clinical depression in the strictest sense. I think that the medical community needs to spend more time determining whether depression is clinical or situational and for medication to be a last resort, not a first line of attack.

 

What's really unfortunate is that many times clinical depression goes untreated and situational depression gets overtreated.

[hillfarm]

I think there is a vast difference between realistic, high expectations and unrealistic ones.

 

IMO, the American media pumps young people full of ridiculous hopes that they will be able to grow up to be rich and famous for doing practically nothing. Then the educational system comes along and fosters those unfounded dreams with a lot of self-esteem drivel. And then the child ends up graduating with very high expectations to become something for which they have no training, skills, or aptitude, and to be rich and live the easy life while doing it. I watched my neighbor's son grow up believing he would become a rich skateboarding moviestar who lived in a mansion. He could barely skate and never acted at all. Not surprisingly he still lives at home as a twentysomething, working at menial jobs and spending most of his free time either blowing all his money or vegging out on Mama's couch in front of the television. I recently heard the Drs. think he may be bipolar. I believe that the disparity between what he was taught to expect and the reality in which he lives may well have contributed to this diagnosis. (Not saying that all bipolar patients have the same causation, just commenting that this poor kid was encouraged to live in la la land and that it is not IMO outside the realm of possibility that the stress when he crash landed in reality could have been a significant cause of the problem.)

 

I think that as the media becomes more prevalent in other cultures, those who become more aware of the differences between the haves and the have nots will begin to experience more stress and that may well show up in the area of mental illness. If your life is not perfect, but you have been raised to believe that everyone is in the same boat and that nothing will ever change, then resignation to that will not produce so much stress. However, if you see that everyone is not experiencing the same and that but for (fill in the blank), you, too, would be living the good life, that creates tons of stress.

 

I also think that the breakdown of the American family may be a contributor. IMO, children need to be in a stable family unit where they know they are loved. American culture in the last 30 years or so has done an increasingly poor job of this. (Witness every Disney movie I can think of, all of which feature a dead, missing, or incompetent parent who is unable or too stupid to protect the child.) In my understanding, several mental illnesses can get a foothold during a person's youth when the pressures of life become literally too much for them to bear, and they have a psychotic break of some sort. Children who don't have the support of family are much more prone to this type of problem. (This was the topic of dh's college psych internship...)

 

I also think it is possible that the American diet may well be a contributing factor to the problem. Many of our children grow up on a diet of french fry grease and refined sugar. I suspect that does not fuel their brains with the nutrients needed for optimal or even normal function.

 

Regarding activity levels and "happy brain chemicals", it may play a role, but despair also creates its own set of sad brain chemicals (cortisols, etc.) which can affect brain and body function. I don't think activity level is the main controlling factor.

Edited June 4, 2009 by hillfarm

[Tap]

I agree that all the aforementioned factors are all a part of the problem. I think another key is the breakdown between the generations in families here. There is no where near the familial support here, as there is in a lot of Asian cultures. Kids move out at 18 and typically live on their own from then on, unless the parent moves back in with the kids during their last years.

 

In the Asian families I know: (warning stereotype alert) the kids often live at home through college or if they go away to college they return in the summer and live at home until they find a job and get on their feet. These students come out of college with significantly less debt. I know some people who stayed at home until their mid-late 20's to save money for buying a house. This is almost unheard of in America.

 

The parents often move in with the adult child's family once they start having their own children. This not only impacts family togetherness, but puts the grandparents into the care role for the grand kids. Several generations will all live together, everyone taking care of each other. I know there is some of this in American culture, but it is not the norm here. A grandparent babysitting for a parent while they are at work is seen as a luxury here. A great-grandparent will most likely be cared for by a family member in an Asian family, not as likely in America.

 

By the grandparents taking care of the grandchildren, and the adult child providing housing and care for the grandparents, the family assets are kept closer to home and are passed from generation to generation, instead of spent on extra homes, cars and living expenses. The financial load and emotional burden due to economic woes seems to be less on our Asian friends. And the way of spending is definitely different!

[Guest Virginia Dawn]

This is a very complex issue and I agree with most of what everyone has said already.

 

However, I do think that it is true to a certain extent that Americans expect too much out of life *without having to invest time and energy.* I think, generally speaking, we are not teaching our children to expect to work hard no matter what their profession. When we find that life is hard work, no matter how much education or how many labor saving devices, we feel cheated and put upon. We chase after a dream of freedom from the mundane tasks of life, and it never comes.

 

I think that is a big difference from other cultures that teach an ethic of hard work from a young age.

[KidsHappen]

I agree with everyone else. This is a very complex issue that involves huge cultural differences. But to answer your basic question, I think that it is important to have expectations that are just challenging enough that you have to stretch a little to reach your goals but not so high that they are completely unrealistic. And we need to do a better job preparing kids to work hard to achieve their goals and to have realistic expectations. But yeah, as a whole culture I think that we would be better served if we had a better work ethic and lower expectations.

[Carol in Cal.]

China is a place that is kind of on the way up. So even though expectations might not be very high, certainly the observed truth is that kids are likely to be better off than their parents were. That creates a lot of optimism and a path to rising above your circumstances.

 

I would not exactly say that the US is on the way down, but certainly it is difficult to picture continued huge progress here comparable to that of the last 50 years or so, and so there is a certain amount of angst over waning expectations. I would argue that it's not the circumstances but the direction of the circumstances that lends itself to optimism and pessimism.

 

Also, our cultural heroes are pop culture ones. No one knows anyone like them. Kids generally don't aspire to be like their parents or even like anyone else they know--they aspire to be like people they see on TV. So we have, without meaning to, set up sort of fake expectations and hopes.

 

I don't believe that Miley Cyrus's life is a reasonable hope for most kids, yet it's the main one for a ton of tweener girls especially.

 

We don't really have much of a cultural consensus anymore--even my generation largely does not, let alone the generation of our kids. That couldn't be more different than China. Even in Europe, everyone has a certain 'home' country and 'home' culture, and it's very clear and distinct and can be utterly taken for granted. Here that is mostly not the case. Although those assumed cultures can be oppressive and frustrating at times, there is also a certain security in them. I was raised in a family that was more culturally distinct than that of most of my peers, and found as I grew up that most of my friends in high school and college were from foreign countries. No one who wasn't could understand why I would care what my parents thought as late as age (gasp) 15, for instance. No one else would understand that I really did have to go to church every Sunday, because that is just what you do. I think that culture makes you crazy in some ways, but that it also offers a certain set of assumptions that you can always fall back on, in a way that is perhaps helpful if you're moving toward mental illness, especially depression.

[Garga]

The East and West are so different we might as well be from different planets in some regards.

 

We are apples and oranges. We can't compare ourselves to each other.

[Karen sn]

I agree with the others on the exercise. We all meed more.

 

I also wish I had not grown up believing that hard work and honesty is all that is needed to get "established" - you know, a house, a car, a bit of money in the bank. Nothing fancy mind you, just the basics. I started working in a restaurant at the age of 13. Minimum wage was $3.35 an hour and I worked 4 nights a week. I enjoyed my work and got a raise of 40 cents an hour in 3 months' time and I was put on the cash register (big promotion).

 

I have worked my entire life (minus a year off with each kid).

 

I do not lie, I work hard, I am proud of the job I do no matter what that job is. I have always taken pride in my work, whether it be waiting tables or registered nursing. I am good at what I do and have awesome people skills. I can get the meanest, most awful patient to love me.

 

I am a million miles away from being secure in any way, shape, or form.

Some of that is due to bad luck and some is believing that everyone is a person of their word. I have been lied to, stolen from, and screwed by many people I trusted. Last year was the epitome of that.

 

Had I known that hard work is not the only factor for success I would not feel this awful pain of dissillusionment. But I have FINALLY learned from my mistakes. I trust NO ONE - if you won't put it in writing, I know you are a liar; and I will not put myself in a position to be taken advantage of EVER AGAIN.

 

I didn't know that at almost 40 I would be worse off than I was at 20.

Had I not had these grand expectations - I would be ok. No expectations means no failure in a way.

[melissel]

I think there is a vast difference between realistic, high expectations and unrealistic ones.

 

IMO, the American media pumps young people full of ridiculous hopes that they will be able to grow up to be rich and famous for doing practically nothing. Then the educational system comes along and fosters those unfounded dreams with a lot of self-esteem drivel. And then the child ends up graduating with very high expectations to become something for which they have no training, skills, or aptitude, and to be rich and live the easy life while doing it. I watched my neighbor's son grow up believing he would become a rich skateboarding moviestar who lived in a mansion. He could barely skate and never acted at all. Not surprisingly he still lives at home as a twentysomething, working at menial jobs and spending most of his free time either blowing all his money or vegging out on Mama's couch in front of the television. I recently heard the Drs. think he may be bipolar. I believe that the disparity between what he was taught to expect and the reality in which he lives may well have contributed to this diagnosis. (Not saying that all bipolar patients have the same causation, just commenting that this poor kid was encouraged to live in la la land and that it is not IMO outside the realm of possibility that the stress when he crash landed in reality could have been a significant cause of the problem.)

 

I think that as the media becomes more prevalent in other cultures, those who become more aware of the differences between the haves and the have nots will begin to experience more stress and that may well show up in the area of mental illness. If your life is not perfect, but you have been raised to believe that everyone is in the same boat and that nothing will ever change, then resignation to that will not produce so much stress. However, if you see that everyone is not experiencing the same and that but for (fill in the blank), you, too, would be living the good life, that creates tons of stress.

 

I also think that the breakdown of the American family may be a contributor. IMO, children need to be in a stable family unit where they know they are loved. American culture in the last 30 years or so has done an increasingly poor job of this. (Witness every Disney movie I can think of, all of which feature a dead, missing, or incompetent parent who is unable or too stupid to protect the child.) In my understanding, several mental illnesses can get a foothold during a person's youth when the pressures of life become literally too much for them to bear, and they have a psychotic break of some sort. Children who don't have the support of family are much more prone to this type of problem. (This was the topic of dh's college psych internship...)

 

I also think it is possible that the American diet may well be a contributing factor to the problem. Many of our children grow up on a diet of french fry grease and refined sugar. I suspect that does not fuel their brains with the nutrients needed for optimal or even normal function.

 

Regarding activity levels and "happy brain chemicals", it may play a role, but despair also creates its own set of sad brain chemicals (cortisols, etc.) which can affect brain and body function. I don't think activity level is the main controlling factor.

 

:iagree: with almost every word here. I've long considered the media to be a huge factor in this kind of thing. For years now, researchers have studied the overall happiness of the people in this country, and it keeps decreasing. I strongly believe the media to be one of the biggest factors, if not the biggest. And I don't just mean TV. Read a mainstream magazine and consider how you feel about yourself afterward!

[Karen sn]

This is a very complex issue and I agree with most of what everyone has said already.

 

However, I do think that it is true to a certain extent that Americans expect too much out of life *without having to invest time and energy.* I think, generally speaking, we are not teaching our children to expect to work hard no matter what their profession. When we find that life is hard work, no matter how much education or how many labor saving devices, we feel cheated and put upon. We chase after a dream of freedom from the mundane tasks of life, and it never comes.

 

I think that is a big difference from other cultures that teach an ethic of hard work from a young age.

 

But even if we invest time and energy, there are no guarantees.

I know that I will always be the one cleaning my toilet and and mopping my floors. I am ok with that. I just want MY OWN house to do it in. I am sick and tired of renting and moving and dealing with other people's messes. I can handle my own mess.....I just don't want to move into another rental house where no one ever really cared about the house.

[laughing lioness]

To answer the question. No. High expectations, if they are realistic and attainable are terrific. Why else are we all TWTM groupies and on this board?

However, the conversation has digressed. Perhaps China has less "mental illness" but their suicide rate is sky-high. Do we define this as mental illness or simply the outgrowth of a nihilistic world-view?

 

http://www.washingtonpost.com/wp-dyn/content/article/2007/05/14/AR2007051401506.html

 

Overall, the suicide rate in China is comparatively high. An estimated 287,000 Chinese kill themselves each year, a rate of 23 people per 100,000, more than double the U.S. rate, according to a study by the Beijing Suicide Research and Prevention Center, part of Huilongguan Hospital in the capital.

[Karen sn]

I think that as the media becomes more prevalent in other cultures, those who become more aware of the differences between the haves and the have nots will begin to experience more stress and that may well show up in the area of mental illness. If your life is not perfect, but you have been raised to believe that everyone is in the same boat and that nothing will ever change, then resignation to that will not produce so much stress. However, if you see that everyone is not experiencing the same and that but for (fill in the blank), you, too, would be living the good life, that creates tons of stress.

 

 

I agree with everything you said - this especially.

If you watch MTV Cribs (the modern day Lifestyles of the Rich and Famous), then you can not look around at what ya have and be happy. I don't watch these shows for that reason. And when I start to feel sorry for myself, I look at my National Geographic magazines and realize how lucky I am to have hot water from a tap.

[lionfamily1999]

To answer the question. No. High expectations, if they are realistic and attainable are terrific. Why else are we all TWTM groupies and on this board?

However, the conversation has digressed. Perhaps China has less "mental illness" but their suicide rate is sky-high. Do we define this as mental illness or simply the outgrowth of a nihilistic world-view?

 

http://www.washingtonpost.com/wp-dyn/content/article/2007/05/14/AR2007051401506.html

 

Overall, the suicide rate in China is comparatively high. An estimated 287,000 Chinese kill themselves each year, a rate of 23 people per 100,000, more than double the U.S. rate, according to a study by the Beijing Suicide Research and Prevention Center, part of Huilongguan Hospital in the capital.

Which goes right along with the number of undiagnosed mentally ill people in China being much higher.

 

I would imagine there is a greater stigma attached to mental illness there. As a previous poster said, comparing us with China is apples and oranges.

[BikeBookBread]

I think there is a vast difference between realistic, high expectations and unrealistic ones.

 

IMO, the American media pumps young people full of ridiculous hopes that they will be able to grow up to be rich and famous for doing practically nothing. Then the educational system comes along and fosters those unfounded dreams with a lot of self-esteem drivel. And then the child ends up graduating with very high expectations to become something for which they have no training, skills, or aptitude, and to be rich and live the easy life while doing it. I watched my neighbor's son grow up believing he would become a rich skateboarding moviestar who lived in a mansion. He could barely skate and never acted at all. Not surprisingly he still lives at home as a twentysomething, working at menial jobs and spending most of his free time either blowing all his money or vegging out on Mama's couch in front of the television. I recently heard the Drs. think he may be bipolar. I believe that the disparity between what he was taught to expect and the reality in which he lives may well have contributed to this diagnosis. (Not saying that all bipolar patients have the same causation, just commenting that this poor kid was encouraged to live in la la land and that it is not IMO outside the realm of possibility that the stress when he crash landed in reality could have been a significant cause of the problem.)

 

I think that as the media becomes more prevalent in other cultures, those who become more aware of the differences between the haves and the have nots will begin to experience more stress and that may well show up in the area of mental illness. If your life is not perfect, but you have been raised to believe that everyone is in the same boat and that nothing will ever change, then resignation to that will not produce so much stress. However, if you see that everyone is not experiencing the same and that but for (fill in the blank), you, too, would be living the good life, that creates tons of stress.

 

I also think that the breakdown of the American family may be a contributor. IMO, children need to be in a stable family unit where they know they are loved. American culture in the last 30 years or so has done an increasingly poor job of this. (Witness every Disney movie I can think of, all of which feature a dead, missing, or incompetent parent who is unable or too stupid to protect the child.) In my understanding, several mental illnesses can get a foothold during a person's youth when the pressures of life become literally too much for them to bear, and they have a psychotic break of some sort. Children who don't have the support of family are much more prone to this type of problem. (This was the topic of dh's college psych internship...)

 

I also think it is possible that the American diet may well be a contributing factor to the problem. Many of our children grow up on a diet of french fry grease and refined sugar. I suspect that does not fuel their brains with the nutrients needed for optimal or even normal function.

 

Regarding activity levels and "happy brain chemicals", it may play a role, but despair also creates its own set of sad brain chemicals (cortisols, etc.) which can affect brain and body function. I don't think activity level is the main controlling factor.

 

:iagree:

 

The other day we were in line at Target. DD5 (who has never watched Hannah Montana, nor WILL SHE in my home for THIS reason, not because of any other except for perhaps just being too grown up...she needs to be a child for as long as she's a child...) said, "Ooooh, Mommy, Hannah Montana! She's cool." The only place she has ever been to that she would learn that is in Sunday School or Pre-K. (And I hope that we weren't paying for her to be sitting watching HM!) Anyway, I said, "Ingrid, it's okay to NOT be famous." The 20-something checker chimed in, "I am going to be famous someday, blahdy blah blah blah blah..." I wanted to throttle him, but I just smiled and kept along with my merry brainwashing :lol: that average is good! She's only five and I know it went in one ear and out the other. I know that you WTMers understand what I'm saying -- because I think for the most part, we want excellence for our children, but excellence does NOT equal fame, fortune and popularity.

[Stacy in NJ]

I think the 5:1 ratio is related almost entirely to diagnosis and how one defines "mental illness". The Chinese cannot afford or socially tolerate mental illness. I imagine there would be a great deal more shame in being mentally ill in China than there is in the US. Also, many Americans suffer from marginal type mental illnesses (i.e. depression, bi-polar disorder) and, while very disruptive to their lives, these conditions go completely undiagnosed in China.

 

The suicide rate in most Asian countries is typical much higher than in the USA.

Edited June 4, 2009 by Stacy in NJ
sp

[Impish]

I think a good chunk of this also comes from this overwhelming attitude of entitlement that I find so incredibly pervasive in North American society. It stuns me the number of young adults that seem to think that once they're out of school they'll simply walk into a job making six figures because...well, they're THEM ya know. They DESERVE better than entry level.

 

I worked a few months as a grocery store cashier when we were first married, and it blew my mind. Two instances I'll share here to illustrate what I mean.

 

First story was two young women, early twenties in my line. The first was sporting a blinding engagement wedding set. I'm talking...whoa. I've seen a similar if not the same set advertised since for $10k :blink: She was complaining to her friend about the size of her apartment, and how her DAD, while still paying for her car, and spent THIRTY THOUSAND on her wedding, was refusing to buy them a house. :svengo: "I told him he didn't raise me to live in a condo! I hate the condo!" she was whining. I couldn't help thinking that the ring on her hand OR the wedding costs would have made a heck of a down payment on a house!

 

Second story: Mom and son were coming up the line. She was berating him over poor grades the entire time. After she finished paying, and was ready to leave, she turned to her son and said, "Do you want to end up a loser, working a dead end job at Safeway like this woman?!" and pointed at me. :eek: I honestly didn't have words, just stood there, dumbfounded. I could have defended myself, explained that I worked there because it was across the street from my house, flexible hours around my dh's travelling schedule, that I was a college graduate with a health care career that I was wanting to go back to once he was in a job that didn't have him travelling on the road more than he was home...but I stood there, gaping like the proverbial fish.

 

Its attitudes like that that are the problem, not high expectations. Its high expectations without a road map of how to get there, without work ethic.

[Crissy]

I think a good chunk of this also comes from this overwhelming attitude of entitlement that I find so incredibly pervasive in North American society. It stuns me the number of young adults that seem to think that once they're out of school they'll simply walk into a job making six figures because...well, they're THEM ya know. They DESERVE better than entry level.

 

 

 

 

I recently saw a television commercial that featured a young man behind the counter at a fast food restaurant. He was taking a customer's order while the narration was his internal thought process. It went something like this, "I can't believe I'm working here. I deserve so much better than this!"

 

I turned off the TV, and my boys and I had a great conversation about whether any of us deserve anything more than what we're willing to work for.

 

That mindset drives me up the wall!

[TravelingChris]

I am sure it is not diagnosed in China. But let me also say, some types of mental illness run in families and are more likely to be in some ethnic groups. The AMish, for example, have an inordinately high rate of manic-depression due to genetics and they intermarry families at a high rate.

 

That being said, anyone who has seen a person with true major depression or true mania could ever mistake it for normal. It is so far from normal. My son had a bout of major depression last year and my sister was bipolar. This is so different from being a little sad or a little hyper. Both my son and my sister (when she was on the depressed side) slept for 18 or more hours per day. They had absolutely no will, no motivation of any kind, their whole body had slowed down to almost zero. When my sister was manic, she didn't sleep, talked a mile a minute, drove like a crazy person, spent moanye she didn't have, went off on wild schemes, etc. Casual meeings with schizophrenics tell me you can't disguse that very well either.

[Stacy in NJ]

I am sure it is not diagnosed in China. But let me also say, some types of mental illness run in families and are more likely to be in some ethnic groups. The AMish, for example, have an inordinately high rate of manic-depression due to genetics and they intermarry families at a high rate.

 

That being said, anyone who has seen a person with true major depression or true mania could ever mistake it for normal. It is so far from normal. My son had a bout of major depression last year and my sister was bipolar. This is so different from being a little sad or a little hyper. Both my son and my sister (when she was on the depressed side) slept for 18 or more hours per day. They had absolutely no will, no motivation of any kind, their whole body had slowed down to almost zero. When my sister was manic, she didn't sleep, talked a mile a minute, drove like a crazy person, spent moanye she didn't have, went off on wild schemes, etc. Casual meeings with schizophrenics tell me you can't disguse that very well either.

 

I didn't mean to imply that depression or other mental illnesses are less than real. I do think that the availability of mental health services, less shame in diagnosis, and reasonably affordable drugs like Prozac and Zoloft have lead to a surge in diagnosis. This is a good thing for Americans for the most part.

 

I think it mirrors other health related issues in the U.S. We're told often via tv commercial that Autism is on the rise in the US and that 1 child in 133 will be diagnosed with Autims. But, really, Autism isn't on the rise. The diagnosis of Autism is on the rise.

 

So, I think Laura's radio show was trying to articulate an idea based on fallacy. Unrealistic expectations equal more mental illness seems like a pretty thin argument to me.

Edited June 4, 2009 by Stacy in NJ
sp

[Jean in Newcastle]

I agree with the posters who talked about undiagnosed mental illness. I haven't lived in China (like Laura Corin has!) but I know that the shame and stigma of acknowledging a mental illness in Japan (where I did live) is very high. Suicide rates are high in Japan too. And often these suicides are reported in the press and in the neighborhood as "coming out of the blue" which you know was probably not true.

 

Disability in Japan is often hidden. Even in this age, children with severe brain damage or disabilities are often dropped off at a hospital. Parents may (or may not) visit the surreptitiously but the neighbors and even other family are told that the child died. I know this because I worked at a hospital ward where these "children" (ranging from newborn to age 60) lived. Even children with a disability like muscular dystrophy live at the hospital where they attend school. There is no question of these kids being "mainstreamed" into regular school or society.

 

I know that many, many people in Japan are dissatisfied with their lives. They've told me so - even as they told me in the next breath that they would never ever admit it to a family member or a close friend. They told me because I was a foreigner and was thus "safe".

 

I don't know about more severe mental illnesses in Japan because I never ever saw it. I would suspect that it is hidden away in special hospitals. I would also suspect that some of the same might be true in China.