Reflections on the concept of delusional possession of reality in Martti Siirala's work

1. Introduction

The theme of common or shared delusion is not althogether new. At least Arthur Schopenhauer wrote once how people were mostly living in illusions, not seeing the real nature of the world. This nature was, argued Schopenhauer, one of pain and horror, life not worth of living. Short after Left Hegelians like Strauss or Feuerbach started to tearing down christians misbeliefs – work that Nietzsche carried on with his own, lunatic way. Not to forget Marx, who was interested in idea of ideology or false consciousness reflecting social relationships.

During the second half of 20^th century antipsychiatrists like R. D. Laing gave a new interpretation of this theme, arguing that people considered mentally ill were really the sane ones, while the mad ones ruling the world. The subject of this paper, Finnish psychiatrist Martti Siirala (1922-2008) gave statements close to this. It's not pure accident that Siirala's work Medicine in Metamorphosis (1969), not considered here, was published in series edited by Laing.

But there are differences also. If Laing argued that schizophrenia is not an illness, rejecting the concept of illness here, Siirala gave a different interpretation to concept, arguing that all illnesses can be understood, not only explained, as a result of problems of one's life situations, past and present. Like Viktor von Weizsäcker, the godfather of anthropological medicine, also Siirala argued that bodily illnesses for example cancer or arthitis can be expressions of twisted or distorted gestalt of one's life. Mental illnesses make here no difference.

I have dealt with this subject in my minor Finnish work (Harhaisuus yhteisöllisenä ilmiönä, 2010). Here I shall just summarize certain points from Siirala's thinking, adding some extra notes of my own.

2. Communal dimension of human existence

In psychiatry and psychology man is considered usually as individual. This is in a way quite sensible view. But when person is considered as isolated unit, whose illness or other problem has nothing to do with community surrounding him, something important is lost. As A. Schutz and other social phenomenologists have studied this from other points of view, Siirala takes it into leading principle of his psychiatry of social pathology. Siirala stresses that being a man is always being with others, both in health and illness. For an illness, wether bodily or mental, there's no cause but rather a chain or a network of causes. If the mother has failed to take care of his child in a good enough way, this not a origin of problems but rather one link in a very long chain.

I could add here that even if it can be steadily assumed that there's something wrong with one's brain, this doesn't mean that this supposed fault has nothing to do with social environment. Rather it looks that there can be no such thing as ”human brain” but rather "network of brains" connected together with forms of communication. When this dialogue starts to disturb or faints, individual brains start to dysfunction and, in the end, collapse in some way. This argument isn't Siirala's, but I think it can clear the situation somehow.

Traditional psychoanalysis has described human existence mostly as intrapsychic (exclusing object-relations theory etc). But these entities can in many cases be transferred to social field. H. S. Sullivan wrote earlier about importance of communication in psychiatry, defining anxiety not as intrapsychic but rather social phenomena, a kind of obstacle to block communication. Siirala's attitude is partly identical to this. For example what Freud called censorship in his dreambook, is for Siirala not part of one's mind but rather social phenomenon that is living primarily between men. Same way kind of collective projection can be assumed, as the whole community denies or censors certain facts and places them somewhere else. Family is important of course, but can't be understood without taking whole community in account.

From this point of view we come also very close not only to Harry Stack Sullivan, but also to statements made by Erich Fromm in books like escape from Freedom or Beyond the Chains of Illusion. There are found similiar ideas on social unconscious or other uncontrolled processes. On the other hand, Fromm seems to give more press to factors like economics or infrastucture, arguing social character just to reflect it. As Siirala recognizes the force of economic conditions and importance of marxist viewpoint, he doesn't think that all of our problems could be solved by some kind of revolution or reformation. Destiny of Soviet Union is a clear prove to this.

3. Delusional possession of reality

As Siirala's basic point of view is sociological, it's also epistemlogical. Siirala states community to be subject of knowledge. Single man can use, maybe make even great innovations, but the basic bearer of knowledge can be only community. But if knowledge is all about communication and sharing, it follows also that knowledge can't be really objective or neutral. Instead of empty formal information it turns out to be something very personal and therefore also emotionally charged. We can think here for example knowledge of sexual crimes. It can raise anxiety and rage, also activate defences like denying, repression or projection.

But there's also other problem. It namely looks that human understanding is a tiny and pitiful creature, of very limited nature not to worth to be trusted in. Reality is a mystery in the end, at least from the human point of view. Misconceptions and errors just happen all the time. But when man is capable of admit the limits of his understanding, he can change his view. Of course there is no final view but rather some kind of infinite series, a continuum of constant adaptation as an unpredictable process of change. From Siirala's point of view some kind of basic trust forms the basis of human existence, so when dangers and problems arise, they can be seen over.

On the other things doesn't get always well. Many things, among the always living and unpredictable nature of thing seen can be experienced not as a blessing but also as a threat or as a source of anxiety. The usual reaction to this is attitude called delusional possession of reality, a communal defensive procedure based on clinging on one's present attitudes and opinions. Consequences are all too familiar. We see men, all around the world, in anxious and rageous states for different reasons, rising up, making false claims, pointing out nonexistent enemies and getting rid of demography and heretics, while the threat grows with defensive procedures. Leading politicians are partly using this collective madness for their own purposes, partly blinded itself by it. As things get scary, defences takes place both levels, on shared cognitive processes and on shared praxis. Different opinions are seen as a threat and are to be get rid of.

But not even science is free from this. Siirala referred often to psychiatric tradition, seeing clearly dangers of forced isolation and treatment. A mad one is in a state of placelesness, ie. with no real place among his fellow men. This all has started in early family envinroment not capable of providing a child to good enough childhood situation. Later on, when the illness gets manifest, one is threated like a dirty or dangerous, locking him up and threating him in a cruel way, just making his isolation worse: language of medicine can be here also language of preventing new contact, of not giving a new social place to man doomed into unreal existence. Here Siirala comes close to Laing, but not giving up the concept of illness.

More examples can be found from economics, to mention one more field. Karl Marx once noted that if economics is considered as objective science, it really looks more like political or ideological propaganda just hidden in the outfit of science. This seems to hold true even today. Politicians and economists suppose the market some kind of autonomous force, like a force of nature, that can only be adapted to. But this is not true, as market is an interpersonal process that follows the laws and other rules made by men. So it's quite absurd to speak about natural or free competition, as there's in the end nothing natural here – the market is in the end communal or social phenomena, a trend as Karl Popper once put it. To think otherwise is a form of delusional possession itself. Clearly that helps to hide the political responsibility for economical depressions or third world poverty, just blame the market and wash your hand.

4. Concluding remarks

Life is dangerous, full of hazards, disappointments and losses – there is no way to deny this. But as far as basic trustful and hopeful attitude can be kept up, bad things met can be shared and communicated. This is not a way to painless living, but still way to social and psychological integrity. But when this basic mode fails, is replaced of un-dialogical state of not speaking, feeling and knowing – not changing or adopting. It follows that changing and surprising nature of life is rejected and replace by control and force. This way man turn from child of life into a delusional ruler, wrapped in his own misbeliefs. As a result, world is filled with witches, madmen, untermeschen and other creatures to be controlled, tortured and eliminated. So we are speaking here with some kind of totalitarism, described also by authors like Levinas.

Schizophrenics, we may still add, are in delusional state, but Siirala argues they're not the only one. There's also normal madness, shared by us others - and if we usually don't admit this, either does the mentally ill. The basic substance is in the end common in both cases, as schizophrenics dream is weaven of our everyday prejudices, dichotomies and misbelieves - his hopelesness and self-hartred is just a negation of our rigid and unquestioned morality.

I have suggested at least three sources of experienced terror can be named: 1) immediate threats like poverty or threat of war, 2) introjected terror from early childhood and 3) general existential factors like mortality or uncertain nature of human knowledge. I'm not going to argue which one is the most fundamental one, because this propably depend on person and historical situation. Lloyd deMause and Arno Gruen, latter inspired partly by Siirala's work, stresses factor 2) but I think this is oversimplication of very complex problem.

This may come close to many analyzes of structuralism or discourse analyze. But when Foucault just think that discourse is wrong and distorts reality, Siirala founds his analysis on basic anthropological analysis. Like assumpting that man can never know more than just a bit, his knowledge is poor in every case – or that the delusional attitude is mostly defensive reaction. I would also suppose that best immediate way to calm down delusional system is to prove some security. That's something very unlike global capitalism is doing just now. Not only babies but also adults needs some holding, not only to be left among hostile forces.

5. Literary references

Fromm, Erich: Beyond the Chains of Illusion. 1962

Gruen, Arno: The Insanity of Normality. 1988.

deMause, Lloyd: Emotional Life of the Nations. 2002.

Siirala, Martti: Die Schizophrenie des Einzelnen und die Allgemenheit. 1961.

Siirala, Martti: Medicine in Metamorphosis. 1969.

Siirala, Martti: From Transfer to Transference. 1983.

Sullivan, Harry Stack: The Interpersonal Theory of Psychiatry. 1953.