Religious and spiritual motifs in the art of the patients of Nikkilä Hospital

This is a sel -a chi ed e sion o an o iginal a icle. This e sion may di e om he o iginal in pagina ion and ypog aphic de ails. Au ho (s): Ti le: Yea : Ve sion: Copy igh : Righ s: Righ s u l: Please ci e he o iginal e sion: CC BY 4.0 h ps://c ea i ecommons.o g/licenses/by/4.0/ Religious and spi i ual mo i s in he a o he pa ien s o Nikkilä Hospi al © 2021 he Au ho s Published e sion Kuu a, Sa i Kuu a, S. (2021). Religious and spi i ual mo i s in he a o he pa ien s o Nikkilä Hospi al. App oaching Religion, 11(1), 135-155. h ps://doi.o g/10.30664/a .98057 2021 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 135 A ibu ion 4.0 In e na ional (CC BY 4.0) SARI KUUVA Religious and spi i ual mo i s in he a o he pa ien s o Nikkilä Hospi al DOI: h ps://doi.o g/10.30664/a .98057 This a icle ocuses on eligiousness and spi i uali y in he a wo ks o psychia ic pa ien s o Nikkilä Hospi al, Finland. The pic u es analysed he e belong o a collec ion held a he Helsinki Ci y Museum and hey we e made du ing he wen ie h cen u y. The heo e ical ame o he s udy is a cul u al s udy o men al heal h. The collec ion is app oached as p esen ing a speci ic kind o image y which has connec ions no only o he pe sonal his o y and diagnoses o he pa ien s; hei cul u al con ex and hospi al en i onmen is also aken in o accoun . The eligiousness and spi i uali y o he Nikkilä collec ion a e also compa ed wi h ou side a and examples o a his o y in e - na ionally. In oduc ion The Vi gin Ma y wi h he child, he Ch is ca ying he c own o ho ns, angels and de ils, pic u es o chu ches, symbols o he e angelis s, c osses and ancho s, ships and boa s, spi i ual landscapes. In he collec ion o pic u es made by he psychia ic pa ien s o Nikkilä Hospi al he e a e nume ous mo i s and symbols which can be clea ly ca ego ized as eligious, bu he e a e also wo ks whose eligiousness and spi i uali y can be in e p e ed mo e widely. In his a icle, I will analyse he pic u es o he Nikkilä collec ion om he pe spec i es o eligiousness and spi i uali y. The Nikkilä Hospi al, a men al heal h acili y loca ed in Sipoo, was ounded in he 1910s o pa ien s om Helsinki. The i s pa ien s en e ed he hospi al in 1914 and he las le in 1999 when he hospi al was closed. In Nikkilä he use o a p ac ice as an elemen o ehabili a ion was begun as ea ly as in he 1930s, du ing he pe iod o chie physician S en Donne (1890–1970). Subsequen chie physicians o Nikkilä – Johan Runebe g (1903–61), E kki Leh o suo (1912–97) and Osca Pa land (1912–97), Helsinki Ci y Museum, NSM I121 – EiNo, 1984. 136 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 we e also deeply in e es ed in a and con- inued along he same lines a e he wa . Ini ially he pa ien s we e gi en he oppo - uni y o d aw, pain , and do po e y wi h he p o ision o a oom and ma e ials o a . The wo ks we e some imes e e ed o when e alua ing he e ec i eness o he pa ien s’ ea men (Tikka and Tukia o hcoming; Tuo inen 2009: 8, 188, 328– 33). The collec ion o pa ien s’ wo ks was ans e ed o he Helsinki Ci y Museum in 2000 when he Nikkilä Hospi al was closed. Nowadays he collec ion is physic- ally in he wa ehouse o he Helsinki Ci y Museum. Pa o he collec ion has been digi ized, and is a ailable o esea che s a he museum. The whole collec ion includes abou 5,000 wo ks – pain ings, d awings and o he handic a s such as ce amics (Tuo i nen and A onsson 2018: 71). Among he 2,000 digi ized wo ks he e a e abou 200 pic u es which I ound o be associa ed wi h eligiousness and spi i uali y – abou one- en h o all o he elec onically s o ed pic u es. The a is Ra ael Wa di (b. 1928) s a ed a Nikkilä Hospi al as an a club ins uc- o in 1959 and con inued wo king he e un il 1986. His wo k in Nikkilä was cha - i able. The hospi al p o ided equipmen and space o a is ic wo k and guided he pa ien s in o he a g oups. P e iously, Wa di had un an a club a Kellokoski Hospi al. Wa di’s mo o o wo king wi h he pa ien s was ‘Wha can be done!’ (Mi ä oidaan ehdä!). The s a ing poin was he indi idual wi h his/he pe sonal abil- i ies and in e es s. The aim was o de elop he sel -unde s anding o he pa ien s and o gi e hem some ools o exp ess hem- sel es. Pencils, c ayons, inge pain s, wa e colou s and pas els we e mos e- quen ly used. A exhibi ions o he club we e held annually in Nikkilä, and some- imes also ou side he hospi al. Some imes he pa ien s also isi ed he homes o a is s (Tikka and Tukia o hcoming; Tuo inen 2009: 189–90).1 In he Nikkilä collec ion he ea lies a wo ks a e om he 1940s, and mos o he wo ks we e done be ween he 1960s and 1980s. Al hough i isn’ possible o de ine he in en ions behind he wo ks, some keys o hei in e p e a ion can be ound h ough in e iews o he pe son nel o Nikkilä Hospi al. Fo ex ample, Wa di has desc ibed his expe iences o he wo k wi h he pa ien s and his wo king me hods in in e - iews (e.g. Anha a 2005; Tikka and Tukia o hcoming; Tuo inen 2009). Al hough indi idual schola s ha e desc ibed ce - ain aspec s o he a o Finnish psy- chia ic pa ien s, he subjec has no ye been widely s udied (e.g. Cadogan 2008; Elo i a 2005; Hämäläinen 2018; Hämä- läinen o hcoming; Ha e i 2010; Pa - land 1991; Tol anen 2006; Tuo inen 2009; Tuo inen and A onsson 2018). The e o e, in es iga ions o he a o he pa ien s om an in e na ional pe spec i e p o ide impo an poin s o compa ison. In in e - na ional s udies o he a o psy chia ic pa ien s he heme o eligiousness is e- quen ly discussed (e.g. P inzho n 1922/72; MacG ego 1989; Rhodes 2000; Beyme e al. 2019), bu how do he eligious mo i s in in e na ional examples ela e o he eli- gious mo i s o Finnish wo ks? Many hings complica e he in e p e - a ion o he eligious and spi i ual con- en o he pic u es. The pe sonal his o - ies and diagnoses o he pa ien a is s a e no known. The au ho ’s da e o bi h o 1 The selec ion o digi ized pic u es was made by wo isual a is s, Tommi Ma ikka and Leena Kaisa Palonen in 2020. In addi ion, some wo ks ha e been digi ized when being shown in exhibi ions (Elina Kallio’s email o Sa i Kuu a, 2.5.2019.) 137 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 gende is also no epo ed, and i he e ha e been signa u es on he pic u es, hey ha e been co e ed when possible. The e o o pseudo nymize pic u es is e hically jus i ied when discussing he a o psychi- a ic pa ien s, al hough some o he a is s amongs hem may ha e been indi idu- als who would ha e been happy ha hei names we e men ioned in ela ion o hei wo ks. Wa di men ioned in his in e iew ha i didn’ make sense ha he names o he pa ien s we e ne e men ioned in he exhibi ions (e.g. Tikka and Tukia o h- coming). In he digi ized po ion o he Nikkilä collec ion au ho ial codes ha e been applied o he a is s which helps wi h seeing which o he wo ks in he collec- ion ha e been made by he same pe son. Howe e , no all he digi ized images a e ma ked wi h such a code in he da abase, which indica es ha he au ho ’s iden- i y was no always known by he pe sons who ca alogued he wo ks. Some imes, he au ho code ‘XY’ has been used when he au ho is unknown, and o he imes he wo ds ‘au ho known’ indica e ha he au ho was a cul u ally well-known pe son. Some imes he yea he wo k was com- ple ed is known, bu in many cases ha in o ma ion is also missing. Religion and men al illness The ela ionship be ween men al illness and eligiousness has been widely discussed (e.g. Po e 1987: 82–102; Pie ikäinen 2013: 23–66; Pie ikäinen 2020: 65, 67–8, 85–6, 145–6, 217, 219, 231, 238–9, 261, 263). Acco ding o he his o ian o psychia y Pe e i Pie ikäinen, be ween he wo ld wa s – du ing he i s hal o he wen ie h cen u y – Finnish people we e clea ly mo e eligious han nowadays, and he majo i y o he popula ion we e membe s o he Lu he an o G eek O hodox Chu ch. Al - hough eligion has ce ainly b ough com- o o many pa ien s and gi en meaning o hei own expe iences, i has also been a sou ce o blame and shame. As s a ed by Pie ikäinen, he Chu ch o Finland was o en disciplina y and ec imina o y a he han ecep i e and kind, and his ha sh and some imes e en na ow-minded eligiosi y le i s ma k bo h on heal hy and men ally ill ci izens. A he beginning o he wen- ie h cen u y he Finnish Lu he an cle gy pe sis ed in i s endency o p each abou o iginal sin, Hell and a judgmen al God, and he he apeu ic u n in eligion came abou only a e he wa (Pie ikäinen 2020: 145, 217; see also Ki i uo i 1999: 26–30). In many con ex s men al illness has been associa ed wi h a p oblema ic ela- ion ship wi h eligion. Ka l Johan Lind (1832–1917) and Aino Manne (1885– 1975) we e among he i s Finnish pa ien s who published au obiog aphical desc ip- ions o men al illness and li e in a psy- chia ic hospi al. Ki si Tuohela (2015), a esea che o cul u al his o y, has analysed hese ex s whe e he heme o eligiousness is s ongly p esen . K. J. Lind was a heolo- gian who was ea ed a Lapinlah i Hospi al in 1872–4. Lind w o e his ex en i led ‘U en själasö ja es an eckninga l. angående sinne sjuka och de as å d’ as ea ly as 1874, bu i was no published un il 1911. Religious ca e was an essen ial pa o he ea men o he pa ien s o psychi- a ic hospi als in he nine een h cen u y, bu i s impo ance diminished as he cen- u y wen on. The e was a p ies wo king in Lapinlah i Hospi al, o example, in he la e nine een h cen u y. He p eached on Sundays and o e ed he com o o eli- gion h ough discussions wi h pa ien s who needed i . Howe e , as Thiodol Saelan (1834–1921), chie physician o Lapinlah i Hospi al, poin ed ou as ea ly as he 1870s, i was com mon knowledge among psychi- a is s ha he eligious e lec ions o some 138 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 men ally ill people could be unde s ood o be symp oms o an illness, and in hese cases eli gious in e ac ion wi h someone inadequa ely quali ied could e en exace - ba e he si ua ion o he pa ien . As a la e chie phys ician o Lapinlah i, Kalle Ach é (1928–2019) sugges ed, one o he diagno- ses used du ing Lind’s ime was Melancolia eligiosa, which is based on he idea ha men al illness can be caused by excessi e eligious p ac ice (Ach é 1982). Many psy- chia is s, hus, saw eligious pas o al ca e only as a ma ginal aid – o en as unneces- sa y and some imes e en ha m ul. P ies s disag eed wi h his and unde s ood he ea men o he deluded mind p ima ily o be a ask o eligious pas o al ca e. Thei opinion was ha he doc o s, who ocused on he body, did no unde s and spi i ual con adic ions well enough (Tuohela 2015: 199–200). Lind also s ongly emphasized he no ion, ypical o his pe iod, ha psy- chia ic diso de s ha e a spi i ual ounda- ion. In his iew, pa ien s would ha e been be e ea ed wi h he help o heology han h ough medicine. Acco ding o Lind, i would be pa icula ly impo an o be clea abou he passions ha ha e b ough pa ien s’ soul unc ions ou o balance, bu a he same ime i would be essen ial o y o es o e pa ien s’ minds and s eng hs in an app op ia e way – h ough selec ed wo ds om he Bible and sui able eligious pic u es (Lind 1982: 48–50). Lind, hus, opposed he idea ha men al illness was caused by excessi e eligiosi y and assumed ha anxious people in di icul y ended o ely on eligion. Tuohela has compa ed Lind’s memoi s om he la e nine een h cen u y o Aino Manne ’s memoi s o a psychia ic hospi al in he ea ly wen ie h cen u y. She has paid a en ion, o example, o he di e ences be ween he wo au ho s’ concep ions o he soul. Fo Manne , men al illness, like physical illness, is inhe i ed and biological in i s causes and o igins; no eligious o spi i ual. Manne also discussed he con- cep o he soul wi h he publishe o he memoi s and insis ed ha men al illness was a disease o he mind and no o he soul. Fo example, acco ding o Manne , a soul o a eligious seeke migh be sick – no his/he mind. When dis inguishing be ween mind and soul Manne hough di e en ly han Lind, who equa ed men al illness wi h sin and belie ed in eligious soul ca e. The dis inc ion be ween mind and soul was no always scien i ically clea in he ea ly wen ie h cen u y ei he . Fo example, psychology, ocusing on he mind, was also called he ‘science o he soul’ in Finland (Tuohela 2015: 221–3). In 1894, he pas o al ca e o Lapinlah i hospi al and gene al hospi al o Helsinki was managed in acco dance wi h he Impe ial P oclama ion and he p eache was hi ed on s a e unds. The i s pos o a p eache in municipal hospi als was es ablished in 1925. Howe e , in he hospi al a Nikkilä he p ies s and can o s o he pa ish o Sipoo pe o med he ecclesias ical du ies o he hospi al on a pa - ime basis. Se ices, hou s o de o ion and o he ecclesias ical e en s played an essen ial pa in hospi al li e. The i s hospi al heologian s a ed o wo k in Nikkilä in 1962 and la e he e we e also hospi al p ies s. Theologians o Nikkilä co-ope a ed wi h psychia is s and psychologis s and some imes he doc o s encou aged hei pa ien s o speak wi h a heologian (Tuo inen 2009: 246–51). Religion and spi i uali y Religious a has adi ionally been exam- ined wi hin a mul idisciplina y and he e o- geneous ield o esea ch called a and eligion (e.g. Kokkinen 2019a: 31–2). In his a icle, I will discuss wha eligiousness 139 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 and spi i uali y could mean in he con ex o he a o psychia ic pa ien s (see, e.g. Kokkinen 2019a; Kokkinen and Nylund 2020; Mahlamäki and Kokkinen 2020; Viho lainen e al. 2020). A e discussing hese concep s I will desc ibe wha kind o eli gious and spi i ual ea u es he e a e in he wo ks o he Nikkilä collec ion. The heo e ical ame o my s udy is a cul u al s udy o men al heal h (e.g. Jän i e al. 2019: 9–45; Kinnunen 2020: 9–15). The goal is o app oach he wo ks o he pa ien s om a di e en pe spec i e han is ypically done in he psychia ic, diagnos ic analysis o he wo ks o he pa ien s. When he wo ks o he pa ien s a e app oached h ough he ame o a cul u al s udy o men al heal h, he collec ion is app oached as a speci ic kind o image y which has connec ions no only o he pe sonal his o y and illness o he pa ien s, bu also he su ounding cul u al con ex and ea u es o he hospi al en i onmen a e aken in o accoun . A cul u al s udy o men al heal h can also open pe spec i es on o he ole o a and a -making in he well-being o he pa ien s. In his a icle eligiousness e e s o mo i s ha can be iden i ied as eligious h ough speci ic symbols associa ed wi h Ch is ian iconog aphy o he eligious image y o o he cul u es. When compa ed o eligiousness, spi i uali y is a mo e loose- ly de ined, less dogma ic, less au ho i a ian and less egula ed ca ego y. Acco ding o Nina Kokkinen, a schola o eligions, pa icula ly a he u n o he nine een h in o he wen ie h cen u y, spi i ually- o ien ed a aimed o each and depic e e nal uni e sal u hs and i ended o sepa a e om adi ional Ch is ian a by u ning owa ds mys icism whe e al e - na i e eligious mo emen s played an impo an ole. In his con ex he a is s c e a i ely combined di e en h eads o spi i uali y a he han commi ed o indi idual eligious o scien i ic dogmas (Kokkinen 2019b: 362–4, 374–5). In he con ex o he Nikkilä collec ion he wo ks I ha e ca ego ized as spi i ual somehow ela e o inne expe iences o he pa ien s. Fo example, he e a e wo ks which canno un ambiguously be unde s ood as pic u es o na u e as hey seem o depic he li e and si ua ion o human beings h ough he elemen s o na u e. These kinds o wo ks can be unde s ood as spi i ual. In some cases when he wo ks clea ly ha e con- nec ions wi h eso e ic ideas and sym bols, he concep o eso e ic spi i uali y is used (c . e.g. Kokkinen 2019a: 22–4). When s udying he pic u es, I ha e ex ensi ely e lec ed on he c i e ia o my analysis: on wha basis I ha e ca ego ized one wo k as eligious and ano he as non- eligious, one as eligious and ano he as spi i ual? My in e p e a ions a e no based on knowledge o he pa ien s’ pe sonal his- o ies o hei medical diagnoses; a he I ha e s udied he pic u es as pic u es, as a pa o Nikkilä Hospi al’s collec ion o he wo ks o he pa ien s, and e en as a pa o a b oade ca ego y o in e na ional a by pa ien s. I ha e aimed o cla i y wha is ypical and wha is a ypical in he a is ic exp ession o psychia ic pa ien s. The e o e I ha e s udied indi idual pic u es in ela ion o o he pic u es – bo h in ela ion o he a o he pa ien s and he wo ks known om a his o y. F om his pe spec i e, i is no a diagnos ic, bu a cul u ally con ex ualizing o m o in e p e a ion. I call my me hod isual analysis, wi h an emphasis on he s udy o he symbol- ism o he pic u es. By symbolism, I mean bo h isual signs con ained in he pic- u es, and he means o exp ession. When analysing he pic u es I ha e d awn a en- ion o he symbols which ha e been used, looked a how he symbols ha e combined 140 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 wi h o he isual elemen s a ound hem, and how he use o he symbols ela es o ways in which o he pa ien s o known a - is s use hem. The pa ien s’ o iginal ways o using symbols ha e also a ac ed he in e - es o many ea ly esea che s o he a o he pa ien s o psychia ic hospi als, such as Cesa e Lomb oso (1835–1909), Ma cel Réja, Hans P inzho n (1886–1933), and John MacG ego (MacG ego 1989: 99, 182, 188, 202). When classi ying he wo ks as eligious o spi i ual I ha e emained awa e ha I ha e no access o he in en ions o he au ho s and I canno be su e how he pa ien s ha e unde s ood he mo i s hey ha e wo ked wi h. Ann Ta es, a schola o eligion, has made a dis inc ion be ween he concep s o ‘ eligious expe ience’ and ‘expe ience e alua ed as eligious’ (see Salmes uo i 2020: 176). Recen s udies o eligions ha e shown ha oday an inc easing numbe o people classi y hemsel es as spi i ual a he han eligious. In his con ex , spi i uali y is seen as a concep wi h ee bounda ies han a mo e p ecisely unde s ood eligiousness. I is also impo an o no e ha he e is no clea line be ween eligiousness and spi i uali y, bu a some poin spi i uali y may app oach, o become, a s ic e , mo e dogma ic, mo e au ho i a ian eligiosi y (Mobe g e al. 2015: 65–6). Religious and spi i ual mo i s in he wo ks o pa ien s o Nikkilä Hospi al Du ing he ea ly wen ie h cen u y chu ch a and al a pain ings we e he mos equen ly seen a wo ks among mos Finn ish people (c . e.g. Takanen 2020: 17–18). The e o e, i is no su p ising ha he e a e nume ous pic u es wi h biblical hemes in he Nikkilä collec ion. Fo ex - ample, he e a e eligious mo i s, such as pic u es o Ch is , he Vi gin Ma y, de ils and angels, and symbols o he apos les. Some o he mo i s ha e a clea de i a ion in he his o y o a , while some o he au ho s ha e in e p e ed Ch is ian mo i s mo e eely. Religious igu es: he Vi gin Ma y and Ch is The mo i o a mo he and child can be unde s ood as eligious when he pe sons depic ed ha e a halo a ound hei heads. Howe e , he Nikkilä collec ion also con- ains wo ks whe e i is possible o see he mo he and child as secula igu es. Usually he Vi gin Ma y appea s in he pic u es alongside Ch is . Indi idual pic u es o he ha e connec ions wi h he depic ion con- en ions o G eek O hodox icons and one pain ing o he Vi gin Ma y in he Nikkilä collec ion also imi a es a mosaic su ace equen ly u ilized in ecclesias ical a . In he pic u es he Vi gin Ma y and he child a e some imes placed in an anonym- ous space, and o he imes hey s ay in a meadow o s able nex o an angelic Helsinki Ci y Museum, NSM I121 – 3412, 1982. 141 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 cha ac e , ox and donkey. Usually he child Ch is lies in he a ms o his mo he , bu in he pain ing con- aining he Pie à mo i he Vi gin Ma y holds an adul , wounded Ch is in he a ms. In e na ionally, many pa ien s o psy chia ic hospi als ha e depic ed hemes ela ed o he Vi gin Ma y. Fo example, he Vi gin Ma y is o en a key igu e in he wo ks o Pe e Moog, p esen ed in P inz- ho n’s s udy A is y o he Men ally Ill (P inzho n 1922/72: 144–58). The oles o he igu e o Ch is in he wo ks o pa ien s a e mo e nume ous han he oles o he Vi gin Ma y. Al hough he child Ch is is usually depic ed wi h his mo he , he e is one wo k in he Nikkilä collec ion whe e he child igu e wi h a halo is alone in a blue landscape, kneel- ing a he edge o he wa e wi h a whi e lowe in he backg ound. In o he wo ks om Nikkilä Ch is has been depic ed, o ex ample, as a shephe d, knocking on he doo , as a es ed, in his c own o ho ns, and ca ying he c oss. The poin ha he e a e many pic u es in he Nikkilä collec ion o a su e ing Ch is wi h a c own o ho ns on his head, as well as Ch is ca ying his c oss, can p obably be linked wi h su e - ings expe ienced by he pa ien s. Su e ing and he c uci ied Ch is is also a equen ly epea ing mo i in he a o he pa ien s o psychia ic hospi als in e na ionally. P inzho n has p esen ed hese mo i s o example, while discussing he heme o he inc eased signi icance in he wo ks o he pa ien s. In his con ex P inzho n desc ibes he challenges o in e p e ing he symbolism in he a o he pa ien s as ollows: Whe he we a e able o in e p e sym- bols – and allego ies no easily dis- inguish able om symbols – depends p ima ily on he ex en o which an a is uses con en ional symbols o , on he o he hand, unde akes o coin new ones. We mus u he dis- inguish magic, occul meanings when hey can ha dly be deduc ed om a pic u e bu a e supplied only by e bal explana ion. (P inzho n 1922/72: 84) In he Nikkilä collec ion eligious symbols a e usually qui e con en ionally used, bu he e a e also examples o non- con en ional uses o eligious symbols. Howe e , i he e a e no e bal desc ip ions which explain he meanings o symbols i can be qui e challenging, and e en p oblema ic, o de ine exac meanings o uncon en ionally used symbols in he wo ks o he pa ien s. In he Nikkilä collec ion eligious sym- bols a e used mos con en ionally in he wo ks which a e copies o well-known pieces o a , such as Wa ne Sallman’s (1892–1968) The Head o Ch is (1940) and Mihály Munkácsy’s (1844–1900) Ch is in Helsinki Ci y Museum, NSM I121 – 2721, 1976. 142 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 F on o Pila e (1881) (see, e.g. Mo gan 1998: 1–20). Howe e , he e a e also examples in which he symbolism is mo e ambiguous. Fo example in one wo k, a bea ded igu e wi h a cloak seems o loa in he space, su ounded by he s a s, and he pic u e is en i led Mas e o he Uni e se. In he con- ex o mo e o iginally ea ed mo i s such as his i is mo e di icul o de ine whe he he mo i is spi i ual o no , and wha has been he signi icance o he wo k o he au ho . The e a e indi idual wo ks in he Nik- kilä collec ion, in he con ex o which I e lec ed on he explana o y alue o he concep o eso e icism. Usually eso e ic knowledge has been unde s ood as hidden, po en ially e ealing, and eachable by ollowing a ce ain pa e n o pa h (Hane- g aa 2006: 336–40; Mahlamäki and Kokkinen 2020: 13–14). Some pic u es and ex s o he pa ien s o psychia ic hospi als con ain meanings ha a e no in ended o be unde s ood by ou side s. Howe e , i is no a ques ion o eso e icism in he same way as, o example, in he con ex o he wo ks o a is s belonging o ce ain eligious o spi i ual communi ies o sec e socie ies migh be, because he meanings a e no collec i ely sha ed in he case o he pa ien s. As Colin Rhodes has poin ed ou , ou side a is s o en ha e a p oblema ic ela ionship o eligiosi y which mani es s as a desi e o c ea e hei own uni e se and symbolic language (Rhodes 2004: 109). Like eso e icism, men al illness can some imes also be associa ed wi h speci ic kind o knowing – knowing o he wise o in a di e en way. Men al illness can b ing abou a need o hide o o p o ec one’s hough s om o he s. One can co e his/ he ideas by using symbols and sym bol combina ions associa ed wi h non-con en- ional meanings. Howe e , he use o sec e symbols can also be accompanied by he wish o someone o de ec he in ended message. Among he d awings and pain ings in he Nikkilä collec ion he e a e also some pic u es o people p aying. In one wo k depic ing wo adul s and a child, he adul cha ac e s a e placed s anding wi h hei backs owa ds each o he whils he p aying child igu e s ands be ween hem. The wo k gi es an imp ession ha he child is ying o ac as a media o be ween he adul s, p obably hoping o be able o build a connec ion be ween hem. Fu he mo e, one pic u e depic s a young gi l kneeling in p aye and ano he pic u e a male igu e kneeling and p aying beside a emale igu e wi h da k d ess and whi e headd ess. P aying can be seen as an a emp o c ea e a connec ion ou side onesel . Angels, de ils and he Fall In addi ion o pic u es o he Vi gin Ma y, Ch is and p aying people he e a e nume - ous angels in he Nikkilä collec ion. In one Helsinki Ci y Museum, NSM I121 – 974, no da e. 149 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 Symbolis a o he u n o he nine een h and wen ie h cen u ies. The wo k a ouses associa ions, o ex ample, wi h many o Ed a d Munch’s pic u es in which people s anding on a beach a e jux aposed wi h ees (see, e.g. B odskaia 2007: 30; Kuu a 2010: 85–9). In he Nikkilä collec ion he e a e also nume ous wo ks which seem o sug ges ha na u al symbols such as ees and plan s a e used as symbols o he au ho ’s own si u- a ion and also e lec his/he expe ience o he su ounding eal i y, including spi i ual and eligious expe i ences. In his s udies o alchemy Ca l Gus a Jung (1875–1961) equen ly dis cussed he symbolism o he ee and analysed he pic u es con aining he ee mo i p oduced by his pa ien s. As s a ed by Jung, he ee is an image which equen ly appea s among a che ypal con- igu a ions o he unconscious and in ee mo i s he sel is usually depic ed as being in a p ocess o g ow h. O cou se, he eli- gious symbolism o he T ee o Li e is also an essen ial ea u e in he con ex o ee mo i s (Jung 1967/78: 253, 272; Kuu a 2010: 137–43). Some imes he ela ionship be ween man and na u e has also been app oached h ough lowe symbolism. Fo example, in a wo k en i led Unde wa e Flowe Gi l (Vedenalainen kukkais y ö) he human body ep esen ed seems o g ow lowe s. The mode o desc ip ion has connec ions, o example, wi h he ways in which Sym- bol is w i e s and a is s ea ed he cycle o li e and dea h. I was hough ha dead ma e se es as a b eeding g ound o new li e – o lowe s, ees, and he human beings (e.g. Tøjne 2000: 92; Kuu a 2010: 141–3). The symbolism o na u e has been closely linked wi h spi i uali y in Finland and o he No dic coun ies, bo h in he con ex o Symbolis a and mo e ecen ly in he New Age cul u es (e.g. Kokkinen 2019a, 2019b; Thu jell 2020). Eso e ic spi i uali y In addi ion o Ch is ian symbolism, sym bol ism o o he eligions can also be ob se ed in he indi idual pic u es. Fo ex ample, some wo ks depic mina- e s and god igu es wi h he ea u es o In dian eligious igu es wi h hei ypi- cal a ibu es, such as nume ous hands wi h con en ional pos u es, mud as, s yl- ized acial ea u es, and ich jewelle y. One wo k in e es ingly combines he con en- ions o he Ch is ian mo i o he Vi gin Ma y and child wi h he con en ions o Indian eligious pic u es. The isual exp es sion o he wo k has connec ions, o ex ample, wi h he wo ks o Ilona Ha ima (1911–86) (see, e.g. Kokkinen 2020a: 91–9). The Nikkilä collec ion also con ains wo ks ha u ilize he symbols o dea h, such as skulls, skele al igu es and a co in. One a is has depic ed a dea h mask. She has also u ilized eligious symbolism in o he Helsinki Ci y Museum, NSM I121 – 2053, 1977. 150 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 ways in he con ex o he sel -po ai s. She has desc ibed he sel , o example, as a sain , wi h a halo abo e he head, wi h a c own o ho ns, wi h a c oss a ound neck, and in he clo hes o a nun. She has also made a wo k en i led Wi eless Elec ici y: An Anima ed Elec ici y (Langa on sähkö – ani maalinen sähkö) in which ed wi es pass be ween people.4 Towa ds he end o he nine een h cen- u y, new phenomena such as elec ici y and magne ism we e in es iga ed and used o de elop new echnology. Fo ex ample, an elec onic eleg aph enabling com - munica ion o e long dis ances was de el- oped. A he u n o he wen ie h cen u y, howe e , he new phenomena we e no ye 4 In e es ingly, he ed wi e be ween people has also been essen ial symbol in Michelle Williams Gamake ’s pe o mance en i led ‘The e ec i eness o symbols: psychogeo- g aphic explo a ions o he body’ whe e he a is deals wi h he ela ionship be ween co po eali y and men al su e ing (Wil- liams Gamake 2020: 282–95). ully unde s ood and hey also became he subjec o eso e ic e lec ion. In his con- ex he possibili ies o communica ion wi h he he ea e cap u ed he imagin- a ion o he a is s ( on Boguslawski 2020: 204). Fo example, Ed a d Munch e lec ed in his no es on he subjec o wi eless com- munica ion, s a ing ha he sough o depic his heme in his pic u es by means o wa y lines c ossing h ough and be ween people (e.g. Tøjne 2000: 110). As he au ho and doc o Lau a La ala (1921–86), who wo ked in a psychia ic hospi al, desc ibed in he book Tuulien alo (1964), he con- en s o he delusions o he pa ien s end o change o e ime (La ala 1964: 94). Also, Tanya Luh mann and he esea ch eam ha e shown cul u al di e ences be ween he delusions expe ienced by pa ien s (e.g. Luh mann e al. 2014: 1–18). Among he wo ks o he Nikkilä col- lec ion he e we e only indi idual pic- u es which clea ly seemed eso e ic o me. In hese wo ks connec ions wi h eso e ic ideas om he u n o he wen ie h cen- u y could be obse ed and he e we e also combina ions o Wes e n and Eas e n eligious symbolism wi h ideas o wi e- less communica ion. In addi ion o hese ew wo ks he e we e o he wo ks in he con ex o which I could no be su e how in en ional he symbolism o he wo ks was, o whe he he e was some message o he beholde o no . Some imes he in en ions behind he wo ks we e cla i ied h ough he ex s linked wi h he pic u es, such as in he con ex o he wo k con ain- ing he ex ‘Wi eless elec ici y’ (‘langa on sähkö’). Conclusion As seen in his a icle, among he eligious and spi i ual mo i s o he Nikkilä collec- ion he e a e pic u es o bo h consola ion and anxie y, and adi ional ecclesias ical Helsinki Ci y Museum, NSM I121 – 3554, 1978. 151 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 a has g ea ly in luenced on he image y used by he pa ien s. The e a e also clea con nec ions be ween eligious mo i s in he Nik kilä collec ion and he a o psychia ic pa ien s in e na ionally (c . e.g. P inzho n 1922/72; MacG ego 1989). The pic u es which I ha e in e p e ed as eligious o spi i ual o m a ai ly la ge po - ion o he Nikkilä collec ion. Wi h a o al o abou 2,000 digi ized wo ks, he e we e abou 200 pic u es in he con ex o which I ha e e lec ed on hei eligiousness and spi i uali y. The wo ks, such as pic u es o Ch is , he Vi gin Ma y, angels and de ils, a e based on he s o ies o he Bible and Ch is ian iconog aphy, and hey can clea ly be unde s ood as eligious. Howe e , in he con ex o spi i ual wo ks he si ua ion is al eady mo e complex and open o a ious in e p e a ions. Fo example, which kinds o landscapes o abs ac composi ions a e spi i ual and which a e no ? In he Nikkilä collec ion mos o he pic u es which I ha e in e p e ed as spi i ual con ain symbol- ism o na u e. While e lec ing on he spi - i ual i y in he con ex o he Nikkilä col- lec ion I ha e o en compa ed he wo ks o he pa ien s wi h wo ks known om he his o y o a – hus assuming ha he wo ks o he pa ien s may con ain he same kind o spi i uali y as, o example, he wo ks o Roman ic and Symbolis a is s. Du ing he p ocess o s udy I ha e con- inuously e lec ed wha we can eally in e abou he eligious and spi i ual ex pe i ences o he a is s on he basis o hei wo ks. I is possible ha making a pic u e is a de o- ional ac i i y and ha pic u es ha e been made, o example, o unc ion as ins u- men s in eligious i uals o he pa ien s. Wo king wi h eligious and spi i ual hemes h ough isual symbols can be posi- i e expe ience i he mo i is in ha mony wi h one’s own alues and iden i y. On he o he hand, i is possible ha making a in i sel is a p ocess ha p omo es well-being by eeing he pa ien om he e e yday li e o he psychia ic hospi al o a momen and by making his/he own handp in is- ible – wha e e he mo i . Du ing he esea ch p ocess I ha e also wonde ed how he pa ien s ha e chosen he amous wo ks om he his o y o a ha hey ha e decided o copy. A e he opics he ones o which a model has easily been ound, o example, om a p in in he pa ien ’s possession, o om he lib a y o Nikkilä Hospi al? Books o a his o y we e a ailable in he lib a y a Nikkilä Hospi al, and hey we e eage ly ead. As a o me lib a ian he e has said, he Bible, and he Old Tes amen in pa icula , was he mos equen ly loaned book in Nikkilä. I has also been s a ed ha he pa ien s ended o ead philosophical books when hey we e in be e condi ion and heological books when hey el wo se (Tuo inen 2009: 85). Can heological li e a u e gi e clea e answe s and guidance o su e ing people han philosophical ex s? Fo example, he mo i o he su e ing Ch is can be com- o ing o some pa ien s as i b ings an objec o iden i ica ion wi h one’s own pain Helsinki Ci y Museum, NSM I121 – 3381, 1940s. Tex in he pic u e: ‘Wi eless elec ici y’. 152 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 and anguish, and also he ela ed idea o a onemen can b ing hope o one’s own si ua ion. In e p e a ions in which Ch is is depic ed wea ing his c own o ho ns o ca ying his c oss a e popula mo i s in he pic u es o he Nikkilä collec ion. In addi- ion o he igu e o Ch is , he Vi gin Ma y also appea s qui e o en in hese wo ks, as in he in e na ional con ex o he a o psychia ic pa ien s. Un o una ely, i is no possible o asce ain h ough s udy o he digi ized ma e ial and he in o ma- ion included wi h he pic u es whe he he e a e some gende ed di e ences in he choices o mo i s in he Nikkilä collec ion. Because many o he clea ly eligious subjec s a e copies o exis ing wo ks, hey ep oduce Ch is ian iconog aphy e y ai h ully. In indi idual wo ks, howe e , an un con en ional combina ion o Wes e n and O ien al o ms o exp ession can be obse ed. In hese pic u es i is possible o see e lec ions o he eso e ic ideas whe e he h eads o di e en eligions ha e been combined. Pa ien s’ wo ks we e made by bo h p o essional a is s in psychia ic ca e and hose who did no ha e any a is- ic aining. Bo h g oups p obably made pic u es on he basis o hei own s a ing poin s and needs. The making o he pic u es was p ob- ably in luenced by p e ious expe iences o a and li e, including he si ua ion o a is ic wo k in he hospi al en i onmen , o he a endees o he a club, ins uc- ions o he wo k, as well as he a ailable ma e ials and possible models o he pic- u es. Pa icula ly in he ea ly wen ie h cen u y, he equipmen needed o a is- ic wo k in psychia ic hospi als was qui e sca ce. Pa ien s ha e p obably used pape and o he ma e ials qui e spa ingly. Fo ex ample, d awings ha e some imes been made on bo h sides o he pape . This phe- nomenon is also known in e na ionally and some pa ien a is s ha e used un usual ma e ials in hei wo ks. Fo example, one o he a is s in P inzho n’s a collec ion made sculp u es ou o he b ead he was chewing (P inzho n 1922/72: 106). The Nikkilä collec ion displays many connec ions wi h in e na ional collec ions o he wo ks o he pa ien s o psychia ic hospi als. In in e na ional collec ions eli- gious mo i s ha e also been cen al. How- e e , I was su p ised ha he e was a ela- i ely low numbe o highly enigma ic wo ks among he pic u es o Nikkilä. I wonde whe he i is a ques ion o Finnish pa ien s no making hese ypes o pic u es, o ha i has no been decided o s o e hese pic u es in he collec ion o he hos- pi al museum. In in e na ional s udy o he a o he pa ien s o psychia ic hospi als, mo e c yp ic wo ks ha e been equen ly p esen ed. Based on he digi ized ma e - ial o he Nikkilä collec ion, i seems ha he eligious image y o Finnish pa ien s is mo e es ained and con en ional han he a o he pa ien s in many o he collec- ions in e na ionally. An ex eme example o he use o eligious image y in he a o he pa ien s o psychia ic hospi als can be ound in he p oduc ion o a Swiss pa ien , Adol Wöl li (1864–1930) (e.g. MacG ego 1989: 206–21). The na u e o he pa ien s’ wo ks is likely o be a ec ed, o example, by he kind o pic u es and s o ies hey al eady knew. When compa ing, o example, he Ca holic image y o sou he n Eu ope wi h he pic u es in Finnish P o es an chu ches, he di e ences a e e iden . Colou ul s o - ies o sain s and hei illus a ions ha e no been as dominan ly p esen in Finnish Lu he an chu ches as in Ca holic chu ches o sou he n Eu ope. The e o e, his ype o image y has no ed he pic o ial imagin- a ion o Finnish pa ien s o he same ex en as in sou he n Eu ope. 153 App oaching Religion • Vol. 11, No. 1 • Ma ch 2021 Pic u es ha appea spi i ual a he han clea ly eligious o en ha e connec ions wi h, o example, he image y and o ms o exp ession o Roman ic and Symbolis a . In addi ion, some o he wo ks ha e a clea endency o abs ac exp ession, o which a ious poin s o compa ison can be ound in Finnish a o he wen ie h cen u y. Bo h Roman ic and Symbolis a ha e been well ep esen ed in Finnish a collec ions, o example in he Sineb ycho collec ion and a he A eneum, and some pa ien s ha e p obably been qui e amilia wi h a is ic adi ions and con empo a y a displayed in Helsinki.  PhD Sa i Kuu a’s (a his- o y, 2010 and cogni i e science, 2007) in es i- ga ions ha e ocused on he ela ion ship be ween a , isual cul u e and he mind. He disse a ion o a his o y Symbol, Munch and C ea i i y: Me a bolism o Visual Sym bols (2010) ocused on he con cep o symbol. Kuu a has also s udied he use o symbols in he con ex o eligious p o ces sions. In ecen yea s, she has wo ked in he mul i- disciplina y esea ch p ojec ‘En g a ed in he Body: Ways o Reading Finnish People’s Memo - ies o Men al Hospi als’ (Kone Founda ion, 2017–20) by s udying emo ional expe i ences and embodied knowledge ela ing o psy chia ic ins i u ions. She has published widely on he opic o men al illness and psychia ic hospi- als. 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