Article
Comment
Digital
Freedom
5 min read

Seen in Beijing: what’s it like in a surveillance society?

Cameras and controls remind a visitor to value freedom.
A guard stands behind a barrier across an entrance to a station escalator.
A Beijing station gate and guard.

The recent Archers’ storyline wouldn’t have worked in Beijing. Here, great gantries of traffic cameras see into cars and record who is driving, so a court case which hinged on who was behind the wheel would not play out in months of suspense. The British press periodically runs stories on how much tracking and surveilling we are subject to, while the success of the TV series Hunted showed just how hard it is it to evade detection, and how interested we are in the possibility—but how often do we stop to think about the tensions inherent in the freedoms we enjoy? 

It is difficult to explain just how free life in Britain is to someone in China, and how precious, and conducive to social good, that freedom is, to people at home. Take my recent experiences. Prior to entry at Beijing airport, I was randomly chosen for a health check and required to give a mouth swap. This may have been a benign Covid testing program, but it was impossible to tell from the questions on screen we had to answer—and a mouth swab certainly hands DNA to the authorities. At the university where I was studying, face scans are required for entry on every gate, and visitors must be registered with state ID in advance. Despite not having been in China since prior to Covid restrictions, my face had been pre-programmed into the system and an old photograph flashed up on screen as the barriers opened.  

The first time I used a rental bike to cycle back to campus (the local Boris-bikes come on a monthly scheme, linked to a registered phone number), a message flashed up on my phone telling me that I had gone the wrong way down a one-way bike lane. The banner appeared twice, and the system would not let me lock the bike until I had acknowledged my error. The fact that the GPS system tracks the bikes so closely it knew I had gone against the traffic flow for a couple of hundred metres to avoid cycling across a 4-lane street was a surprise. Since that phone is registered to a Chinese friend, such infractions are also potentially a problem for him. What was less surprising, is the systemic nature of China’s ability to track its people at all times. 

Walking through my university campus, where every junction has three or four cameras covering all directions, I occasionally wonder where students find space to have a quick snog. 

No one uses cash in cities in China; in many outlets and places cash isn’t even accepted. Everyone uses apps like WeChat or Alipay to pay for goods—even at food trucks and casual stalls the vendor has a machine to scan a phone QR code. WeChat is WhatsApp and Facebook and a bank debit card and a travel service and news outlet rolled into one; Alipay, its only effective rival, offers similar. To obtain either account, a phone number is needed, numbers which have to be registered. And to pay for anything, a bank account in the name of the individual must be linked to the account. In other words, the government can choose to know every purchase I make, and its exact time and place. A friend who works in a bank says he uses cash where possible because he doesn’t want his colleagues in the bank to see what he's been buying. 

Transport is also heavily regulated. To enter a train station, a national ID card is needed, which is scanned after bags are x-rayed. To purchase a high-speed train ticket, a national ID card—or passport for foreigners—is required. It might be possible to purchase a ticket anonymously in cash from a ticket window outside the station for an old-fashioned slow train, but one would still need an ID card corresponding to the face being scanned to make it to the platform—and the train station has, of course, cameras at every entrance and exit. 

Cameras are pervasive. Walking through my university campus, where every junction has three or four cameras covering all directions, I occasionally wonder where students find space to have a quick snog. The only place I have not yet noticed cameras is the swimming pool changing rooms, which are communal, and in which I am the only person not to shower naked. There are cameras in the church sanctuary, and cameras on street crossings.  

Imagine being constantly reminded by human overseers that your activity in person and online is both seen and heard.

Even when not being watched, out in the countryside, the state makes its presence felt. On a recent hike in the hills, our passage triggered a recording every few hundred metres: “Preventing forest fires is everyone’s responsibility.” Once or twice is common sense, ten or twenty times a stroll is social intrusion. One can, of course, learn to ignore the posters, the announcements, the security guards on trains playing their pre-recorded notices as they wander up the aisles and the loud speaker reminders that smoking in the toilets or boarding without a ticket would affect one’s social credit score and imperil future train travel, but white noise shapes perception.  

As a (mostly) upright citizen, there are many upsides to constant surveillance. People leave their laptops unattended on trains, since they will not be stolen. Delivery packages are left strewn by the roadside or by a doorway: anyone stealing them will be quickly found. There is almost no graffiti. I can walk around at night safe in the knowledge that I am exceedingly unlikely to be a victim of petty theft, let alone knife or gun crime. Many Chinese have horrified tales of pickpockets in European cities or crime rates in the UK, while young friends are so used to the state having access to phone data and camera logs that they barely notice. Most Chinese I know are very happy with the trade-off of surveillance for safety—and the longer I spend in Beijing, the more appealing that normality seems. 

To those who have lived outside, however, the restrictions make for a more Orwellian existence. Any church group wanting to hold an online service must apply for a permit. A friend was recently blocked from his WeChat account for a period after using a politically sensitive term in a family group-chat. Not being able to access certain foreign websites, search engines or media (no Google, no WhatsApp and no Guardian without an illegal virtual private network) might be an irritation for a foreign resident but means a lifetime of knowingly limited information for a citizen. Not being able to access information freely means, ultimately, not being able to think freely, a loss that cannot be quantified. The elite can skip over the firewall, but many cannot.  

We have seen the dangers recently in the UK of limited information flow, and of social media interference by hostile players. Imagine never being able to know whether the information you are receiving is trustworthy—or being constantly reminded by human overseers that your activity in person and online is both seen and heard. Christians may believe in the benevolent and watchful gaze of God—but are rightly wary of devolving that omniscience to fellow humans.

Review
Books
Care
Comment
Psychology
7 min read

We don’t have an over-diagnosis problem, we have a society problem

Suzanne O’Sullivan's question is timely
A visualised glass head shows a swirl of pink across the face.
Maxim Berg on Unsplash.

Rates of diagnoses for autism and ADHD are at an all-time high, whilst NHS funding remains in a perpetual state of squeeze. In this context, consultant neurologist Suzanne O’Sullivan, in her recent book The Age of Diagnosis, asks a timely question: can getting a diagnosis sometimes do more harm than good? Her concern is that many of these apparent “diagnoses” are not so much wrong as superfluous; in her view, they risk harming a person’s sense of wellbeing by encouraging self-imposed limitations or prompting them to pursue treatments that may not be justified. 

There are elements of O-Sullivan’s argument that I am not qualified to assess. For example, I cannot look at the research into preventative treatments for localised and non-metastatic cancers and tell you what proportion of those treatments is unnecessary. However, even from my lay-person’s perspective, it does seem that if the removal of a tumour brings peace of mind to a patient, however benign that tumour might be, then O’Sullivan may be oversimplifying the situation when she proposes that such surgery is an unnecessary medical intervention.  

But O’Sullivan devotes a large proportion of the book to the topics of autism and ADHD – and on this I am less of a lay person. She is one of many people who are proposing that these are being over diagnosed due to parental pressure and social contagion. Her particular concern is that a diagnosis might become a self-fulfilling prophecy, limiting one’s opportunities in life: “Some will take the diagnosis to mean that they can’t do certain things, so they won’t even try.” Notably, O’Sullivan persists with this argument even though the one autistic person whom she interviewed for the book actually told her the opposite: getting a diagnosis had helped her interviewee, Poppy, to re-frame a number of the difficulties that she was facing in life and realise they were not her fault.  

Poppy’s narrative is one with which we are very familiar at the Centre for Autism and Theology, where our team of neurodiverse researchers have conducted many, many interviews with people of all neurotypes across multiple research projects. Time and time again we hear the same thing: getting a diagnosis is what helps many neurodivergent people make sense of their lives and to ask for the help that they need. As theologian Grant Macaskill said in a recent podcast:  

“A label, potentially, is something that can help you to thrive rather than simply label the fact that you're not thriving in some way.” 

Perhaps it is helpful to remember how these diagnoses come about, because neurodivergence cannot be identified by any objective means such as by a blood test or CT scan. At present the only way to get a diagnosis is to have one’s lifestyle, behaviours and preferences analysed by clinicians during an intrusive and often patronising process of self-disclosure. 

Despite the invidious nature of this diagnostic process, more and more people are willing to subject themselves to it. Philosopher Robert Chapman looks to late-stage capitalism for the explanation. Having a diagnosis means that one can take on what is known as the “sick role” in our societal structures. When one is in the “sick role” in any kind of culture, society, or organisation, one is given social permission to take less personal responsibility for one’s own well-being. For example, if I have the flu at home, then caring family members might bring me hot drinks, chicken soup or whatever else I might need, so that I don’t have to get out of bed. This makes sense when I am sick, but if I expected my family to do things like that for me all the time, then I would be called lazy and demanding! When a person is in the “sick role” to whatever degree (it doesn’t always entail being consigned to one’s bed) then the expectations on that person change accordingly.  

Chapman points out that the dynamics of late-stage capitalism have pushed more and more people into the “sick role” because our lifestyles are bad for our health in ways that are mostly out of our own control. In his 2023 book, Empire of Normality, he observes,  

“In the scientific literature more generally, for instance, modern artificial lighting has been associated with depression and other health conditions; excessive exposure to screen time has been associated with chronic overstimulation, mental health conditions, and cognitive disablement; and noise annoyance has been associated with a twofold increase in depression and anxiety, especially relating to noise pollution from aircraft, traffic, and industrial work.” 

Most of this we cannot escape, and on top of it all we live life at a frenetic pace where workers are expected to function like machines, often subordinating the needs and demands of the body. Thus, more and more people begin to experience disablement, where they simply cannot keep working, and they start to reach for medical diagnoses to explain why they cannot keep pace in an environment that is constantly thwarting their efforts to stay fit and well. From this arises the phenomenon of “shadow diagnoses” – this is where “milder” versions of existing conditions, including autism and ADHD, start to be diagnosed more commonly, because more and more people are feeling that they are unsuited to the cognitive, sensory and emotional demands of daily working life.  

When I read in O’Sullivan’s book that a lot more people are asking for diagnoses, what I hear is that a lot more people are asking for help.

O’Sullivan rightly observes that some real problems arise from this phenomenon of “shadow diagnoses”. It does create a scenario, for example, where autistic people who experience significant disability (e.g., those who have no perception of danger and therefore require 24-hour supervision to keep them safe) are in the same “queue” for support as those from whom being autistic doesn’t preclude living independently. 

But this is not a diagnosis problem so much as a society problem – health and social care resources are never limitless, and a process of prioritisation must always take place. If I cut my hand on a piece of broken glass and need to go to A&E for stiches, I might find myself in the same “queue” as a 7-year-old child who has done exactly the same thing. Like anyone, I would expect the staff to treat the child first, knowing that the same injury is likely to be causing a younger person much more distress. Autistic individuals are just as capable of recognising that others within the autism community may have needs that should take priority over their own.   

What O’Sullivan overlooks is that there are some equally big positives to “shadow diagnoses” – especially as our society runs on such strongly capitalist lines. When a large proportion of the population starts to experience the same disablement, it becomes economically worthwhile for employers or other authorities to address the problem. To put it another way: If we get a rise in “shadow diagnoses” then we also get a rise in “shadow treatments” – accommodations made in the workplace/society that mean everybody can thrive. As Macaskill puts it:  

“Accommodations then are not about accommodating something intrinsically negative; they're about accommodating something intrinsically different so that it doesn't have to be negative.” 

This can be seen already in many primary schools: where once it was the exception (and highly stigmatised) for a child to wear noise cancelling headphones, they are now routinely made available to all students, regardless of neurotype. This means not only that stigma is reduced for the one or two students who may be highly dependent on headphones, but it also means that many more children can benefit from a break from the deleterious effects of constant noise. 

When I read in O’Sullivan’s book that a lot more people are asking for diagnoses, what I hear is that a lot more people are asking for help. I suspect the rise in people identifying as neurodivergent reflects a latent cry of “Stop the world, I want to get off!” This is not to say that those coming forward are not autistic or do not have ADHD (or other neurodivergence) but simply that if our societies were gentler and more cohesive, fewer people with these conditions would need to reach for the “sick role” in order to get by.  

Perhaps counter-intuitively, if we want the number of people asking for the “sick role” to decrease, we actually need to be diagnosing more people! In this way, we push our capitalist society towards adopting “shadow-treatments” – adopting certain accommodations in our schools and workplaces as part of the norm. When this happens, there are benefits not only for neurodivergent people, but for everybody.

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