This qualitative exploratory study based on therapy observations and interviews with psychological experts and family therapists in Beijing, China, and Delhi, India, compares and contrasts families’ psychotherapeutic experiences in India and China. Analysis suggests that the economic growth enjoyed by middle- and upper-class, urban families has also brought with it substantial anxiety and guilt. Therapists in India and China report some similar family dynamics, such as a belief in and striving for a special mother–son bond, alongside differences, such as the greater participation of men in therapy in India. This article argues this striking difference in the gender composition of clients in India compared to China is best understood in relation to the greater political and social context of each country. Elite families in India and China are differently positioned in ways that significantly impact their respective concerns about their children and their family’s future class reproduction.