Martti Siirala
On his eightieth birthday
Copyright © Ann-Helen Siirala 2002, 2020
Copyright © Anthony Stadlen 2002, 2020
[Existential Analysis 14.1 (January 2003): 162-178]
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| Martti Siirala |
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| Martti and Ann-Helen Siirala |
Anthony Stadlen writes:
Dr
Martti Siirala is one of the world’s great original existential
psychotherapists. He and his wife, Dr Ann-Helen Siirala, honoured us by coming
from Helsinki to conduct an Inner Circle Seminar
on his eightieth birthday, Sunday
24 November 2002 , from 10
a.m. to 5 p.m. ,
in the Tuke Common Room, Regent’s College, London
Thirty-nine
people attended. Many people, from a number of countries, sent greetings and
apologies.
The
Finnish Ambassador invited all participants to a concert and reception the
following evening at the Royal Festival Hall to celebrate eighty-five years of
Finnish independence. Sibelius’s Luonnotar,
among other works, was played.
Sibelius
was buried by Martti Siirala’s brother Aarne, a theologian and pastor. It has
been said that Martti writes as Sibelius composes. He himself says Sibelius’s
way of composing is like the Finnish language, approaching all beings with a
‘humble but passionate’ questioning: ‘Who are you? Could it be that you might
be …?’, while, according to Siirala, the German language tries to grasp and
dominate. In his 1980 paper, ‘On malignant violence: Where to look for hope in
reaching its roots?’, in From Transfer to
Transference[1]
(1983, Helsinki: Therapeia Foundation), he writes (p. 137) of the ‘violent
elements in the absolutist claims for “Daseinsanalysis” to a direct access to
the phenomena in an adequate, undistorted way’, but acknowledges that ‘it has
however essentially contributed to the defence of the unreducibility of human
bodily existing’.
Martti
Siirala’s presentation and the ensuing seminar discussion in London will be
reported elsewhere, as will the two-day Helsinki seminar to celebrate him,
organised by the Finnish psychotherapy society, Therapeia, in Finlandia Hall
later that week, on Friday 29 November (in Finnish) and Saturday 30 November
(in English). The speakers on the Saturday were Professor Gaetano Benedetti,
Professor Arno Gruen, and myself.
Participants
in the London and Helsinki
What
follows is the wonderful account Ann-Helen Siirala gave of her husband’s life
and work to the Inner Circle Seminar in London Finland
(in addition to the Siiralas); two of Finnish origin, resident in the United Kingdom ; and one from Sweden
MARTTI
SIIRALA BY ANN -HELEN SIIRALA
Dear Anthony and Naomi,
Ladies and Gentlemen,
dear Fellowmen,
tervetuloa Martin
suomalaiset ystävät,
och välkommen
också på svenska!
On behalf of Martti and myself, I will start expressing our gratitude to
Anthony Stadlen for arranging this inspiring event! – and to the nameless
something, that offers us a space for something like this event to take place.
Something that appears in itself as impossible … unrealisable.
As Martti would express it: … that here would
be a real, and not only seeming, presence to the wonders of life.
Martti’s views pertaining to
therapy have got their intense impact from the encounter with what he calls the
situation schizophrenia and with bodily illness.
Today,
eighty years ago, this Martti Olavi Siirala was born.
The
first time I congratulated him personally was twenty years ago, on his sixtieth
birthday – and since 1986 we have been a married couple.
Martti’s
father, having the same Christian name, proudly wrote in his diary, that his
fourth child and third son was born. He noted the son’s ‘long fingers and quite
an impressive nose’ (‘paljon nenävärkkiä’)!
After
Martti, a fourth son was born seven years after him.
Today
two of the five Siirala-siblings have passed away: the theologian-thinker
brother Aarne and the lawyer-brother Erkki.
Martti
became MD in 1947 and wrote his neurological thesis in 1949 – at the age of
twenty-six.
Three
years later, 1952, he and his musician wife and two little sons went to Switzerland
There
they stayed for five years, until 1957. A daughter had been born in Zürich,
1956.
Since
1952 Martti has been practising psychotherapy and since 1968 working also as a
senior lecturer in psychiatry at the University
of Helsinki
The
vision for founding Therapeia (the name is the Greek word for therapy) emerged
in Martti’s mind during his stay in Zürich. That course there was
centrally led by Medard Boss, who, inspired by the philosophy of Martin
Heidegger, had developed existential analysis. That signified a radical
renovation into a non-reductionist, phenomenological direction.
In
Martti’s vision the medical anthropology and social pathology also played an
essential role. These were founded by Viktor von Weizsäcker
(1886–1957). He was an internist and neurologist, who did pioneering studies in
sense-physiology, and above all he was a developer of deeply human
understanding of the sick man and that side of man‘s fate as man, experienced
by his physician in hospitals and private practice. His challenging views in
his large production were in their way systematic but did not form a system.
His friend and pupil Wilhelm Kütemeyer (1903–72), a bold anti-Nazi, developed
further both the medical anthropology and the social pathology, writing even a
book The Illness of Europe (Die Krankheit Europas, 1951).
In 1958 Martti
could get his vision provisionally realised, when the Therapeia Foundation and
Institute became founded. His vision was even explicitly contained in the
rules. The aim of Therapeia was stated to be the training and practice of
psychoanalytic therapy in the spirit of existential analysis and
anthropological medicine. In the practice of therapeutic training each
student’s own basic way of experiencing was respected, and the therapeutic
literature used in the process of training was meant to be treated in the
spirit of freedom. Such had been the constellation and spirit in Zürich.
Two of Martti’s Finnish colleagues got their training in the same circle a few
years later and joined him as ideators and instructors in the work during
Therapeia’s early years.
Participants
in the founding process in 1958 were also Martti’s theologian brother Aarne,
and from Basel, Switzerland, Martti’s companion in the psychoanalytic training
in Zürich,
Gaetano Benedetti, already then a pioneer in the psychotherapy of
schizophrenia. A Finnish firm had donated the legally demanded founding
capital.
Therapeia
happened that time to be the first established psychoanalytic institute in
Finland, one offering analytic psychotherapy to psychotic, neurotic and bodily
ill patients. Training in psychoanalysis by Therapeia took place in all these
clinical dimensions. A number of Finns had received their training with the
International Psychoanalytic Association (IPA) in different countries, but
their group had not yet received its acceptance as a membership organisation.
This constellation, IPA–non-IPA (since the 1970s, IFPS), created some problems,
but did not lead to any serious conflicts. An encounter of Martti with D. W.
Winnicott on his lecturing trip among the IPA people in Helsinki
Therapeia
as such spontaneously signified many-dimensional questioning, a
phenomenological research, opening itself up in an unorthodox and not
hierarchically controlled way, even in a spirit open to renovations concerning
theory, method and conception of knowledge. Martti came to write a most extensive
manuscript, Therapy and Conception of
Knowledge, an epistemological treatise, one from challenging,
generally-human perspectives. Not only he and the two colleagues mentioned
above, but also other members of Therapeia, finished works on psychopathology
and psychosomatics, some of them appearing as academic dissertations and others
as books and papers published in international journals.
The
Therapeia Institute became run by the Foundation. It offered professional
training programmes in psychoanalytic therapy, got such therapies approved by
the Finnish National Board of Health as competent to receive social funding by
the National Pension Institute – this, however, only after quite some efforts.
(I
myself, being a psychologist, got my own training in analysis there, and Martti
has been one among several teachers during the, at that time, six years
programme. Today it is five years. Since 1998, I’m also a training analyst.)
The
theory outline in Therapeia includes studies in classic and modern theory of psychoanalysis,
phenomenological philosophy and theory of Daseinsanalysis, social pathology and
developmental theories.
Martti’s
basic views did not appear just in one push or during just a short period of
his life, but have developed themselves during quite some period of his life,
and continue to do so. Sure, that process also has been centred around some
significant events, encounters, and coincidences.
From
his autobiographical, unpublished notes I quote:
‘Ideas
that engage a person’s thinking processes always have their genesis in a
struggle with problems that are personal and near, which is shown, e.g., by Erik Homburger Erikson, in his
work Young Man Luther. How widely
such a struggle can be spread depends on the significance of the ideas and on
the historical situation, its particular constellation. In a way, this
historical situation comes to serve as a midwife to the ideas becoming born.
Formation of ideas works in this way on all levels, so also in the case of my
own.’
The
contemporary academic philosophical views appeared to Martti rarely really
relevant in the encounter with man’s predicament in the actual historical
situation.
One
weighty reason for this lies in the domineering practice in our scientific
culture of dividing life into primarily separated domains and spheres, each one
obeying just its own laws – and thus their mutual interconnections remain
unobserved.
These
matters were the subject of his first major work – in German – the title of
which would be translated: The
Schizophrenia of the Individual and of All of Us (Die Schizophrenie des Einzelnen und der Allgemeinheit, 1961).
Martti’s
formation of ideas must also have to do with his own childhood family
situation. He sees it as a source of his interest in psychodynamics and for
developing the concept of collective delusion.
One
thing affecting his identity obviously was the particular constellation of
sibling rivalry in the family into which he was born.
For
the boy Martti it seemed that the brothers and the sister were those who made the
decisions in the group; he was an outsider. He felt a need of capturing an
ultimate correct image of what happened between him and his siblings – in order
to estimate what was right and what was unjust in the treatment he received
from the side of his elder siblings.
Another
kind of problematics has to do with his parents. On the mother’s side there was
an influence of the social pathology of the Swedish-speaking upper class, with
power both in matters of language and economics, though in this case no big
fortune. In addition, some of the ancestors of his mother had made a military
career in the service of the Russian tsar. The mother was a nurse, but did not
work professionally.
On
the father’s side there were priests in many generations, their language was
Finnish and they did not possess any significant fortunes. What kind of micro-
and macrosocial motivating agents drew these two to join into matrimony?
Martti
Siirala senior, a gynaecologist and obstetrician, was a pioneer in the field of
social medicine, an originator of maternal care and active in founding
different healthcare systems in the underdeveloped parts of Eastern Finland,
along the Finnish-Russian border. There wasn’t time and psychic space to devote
real attention to the being of this son. Besides, they had wanted a girl! Thus
his position as the very object of murderous hatred from the side of his
two-years-elder brother did not become noticed by either one of them.
At
the age of forty-four Martti’s father creepingly became severely ill. The
diagnosis was never set – not even today. It was some kind of neurological
illness, hinting at degeneration of nervous connections between the cerebellum
and the spinal cord. The symptoms were: difficulties in coordination,
difficulties to swallow, strongly varying moods, and at last apparent
arteriosclerosis.
At
the age of fifty he had to stop working. Martti has told that his father could
think about his illness as an incomprehensible punishment. For what? Between
the age of fifteen to twenty-five, four of the five years of the wartime
exempted, Martti read aloud ingenious anecdotes written by a physician in
Rauma-dialect. Both Marttis enjoyed this very much! Martti jr. was twenty-five
when his father died.
Afterwards
Martti has thought that his parents could not have been very much aware of the
burdens – in micro- as well as in macrosocial milieu – that were passed over to
the offspring. Such unidentified burdens, the nature of which Martti later came
to study, seemed to have obstructed many channels between the parents.
Since the early 1950s epistemological matters have occupied
Siirala’s mind.
The
texts about psychoanalysis that he came into contact with as a young physician
were average ones, but they and other readings gave him the insight that illnesses/diseases
are something very human – that there is
an appeal and a message in them. They can be met and understood differently
than what mostly happens in traditional medical practice.
So
he started to listen to the patients’ life-histories and found an actual and
historical network of misery in the family.
Not
only the studying of Sigmund Freud’s theories, but also studying Martin Luther
was decisive for Siirala’s thinking.
The
theologian brother Aarne made his academic dissertation on Luther – and the two
brothers then became engaged in discussions about the split between
scientific/philosophic and religious thinking. What are the consequences of such a split?, they asked. Man was not
any more aware of his responsibility for the oneness in life.
The rapid development in medicine had lost the
basic wisdom of the oneness of life – and so the split
continued.
Planning this presentation,
I happened to come across a seminar work, written by a student in Sweden
In the following, I will briefly present some
concepts, some in the form of a thesis, that have emerged to him and which refer
to something in our existence as men.
Such
concepts do not primarily mediate any command or control over human challenges.
Their central function is one of articulating our fundamental experience, to
help us to open ourselves to our life addressing itself to us, to accept to
listen to its messages.
Here
the formation of concepts does not so much promote doing and techniques, but rather our readiness to become more and
more open to receive insight and encouragement given by it.
Man’s
distress, also in the form of manifest illness, signifies a new chance to
receive a message.
I. The patient is really injured.
His/her
wounds and traumas are not only intrapsychic; there is not only question of an
‘intrapsychic reality’. The first ‘reception-world’ (family, society, culture)
has damaged him by its inhuman traditions and practices, restricted his rights
and chances for development. Such inhuman traditions and models figure without
exception on all levels of life.
II. Illness has a vicarious character.
The
damage takes place in a way that the challenges of life do not become met
responsibly within the person’s reference surroundings and instead become split
out. This leads to transformation into burdens, landing on vicarious
goal-persons or -groups. Those burdens (existential problems and challenges)
become more and more anonymous, ever more difficult to become identified, to
the extent the common responsibility concerning them becomes reduced. They just
continue their passage between individuals, generations and their society and
culture. Within the individual one meets his burden situated in his personality
structure and/or in his bodily and psychic functions and their regulation
systems. Finally the burden may get its expression as an identifiable particular
illness.
The
illness appeals for getting the burden recognised as something alien to the
character of the befallen person and alongside with this for getting it shared
through becoming taken into common responsibility in life. Life and the sick
man appeal for becoming again membered and remembered as forming organically
part in the common life. The anonymous burden contains hitherto not lived parts
of life, both individually and socially, as potentialities for development,
talents and creativity.
The
appealing from the side of the sick one for remembering again and for getting
insight is ambivalent. Life strives, in contrast to the ambivalence, for
development and for realised possibilities. These dimensions have not become
noticed enough within therapies and research.
However,
if the message does not become denied but becomes received, then therapy
becomes born, and there is possibility of recovery or improvement for the sick.
The process from transfer to transference[2]
can begin, because a readiness for sharing the burden meets the sick and the
illness. Old patterns start getting the character of interaction, of
reciprocity within a relation different from the one in the first
reception-world. This fact can remain unobservable for a long time. That
process may end so that the help-seeking one finally becomes responsible for
his liberated possibilities as well as for the cross which always comes to
belong to his personal life-history.
This
process always contains resistance. It appears within the therapeutic frame;
within the patient, and between him and the therapist. Besides, resistance
takes place in the final phase of therapy within the human surroundings. There
it lies far away from simply welcoming the change or improvement in the
patient. This occurs both in the close and in the more distant surroundings,
because people there prefer to see the patient continuing to carry his burden,
to be the vicarious one, since otherwise the unresponded challenges from earlier
in life would threaten again. Within family therapy this has been noticed, but
not enough in other forms of therapy.
IV. Sharing burdens and the responsibility is the true ground for therapy.
That
ground offers a better ‘second reception-world’, capable of correcting damages.
Empathy is a too narrow concept for sharing[3],
just as the uncovery of the unconscious material only represents a part within
the sharing. Both of those alone do not form a sufficient ground for a healing
therapy. Gaetano Benedetti says that the first step in the psychotherapy of
schizophrenia is constituted by the therapist identifying[4]
himself with his patient, and that the counteridentification of the patient
then can take place on that ground. This readiness for listening to the appealing
of the illness, and for recreating the sharing of the situation, is rare.
V. The healing process inescapably contains
suffering.
This
is because the damage which has encountered the patient is real. The suffering
is not an end in itself, but has the character of a crossing or a way through.
The
pain and discomfort under the burden represent an attempt to flee from pain and
threatening suffering. He must flee as long as there is not any sharing in
sight. Within a dialogical sharing the burden can become distinct and
communicative. The birth of hope is a precondition for true, meaningful
suffering, for a passage from darkness via a desert towards light. Therapy
contains suffering for both parties.
The
source of the patient’s pain contains three things:
(a) gradual re-creation of the childhood’s damaged
patterns for getting through some way possibility of experiencing them behind
all layers of defence;
(b) a painful encounter with the neglected
life-possibilities;
(c) last but not least, to relinquish the hopeless
security-system.
The ‘first reception-world’ exists as the
individual and his ‘first reception’, i.e.,
fertilisation, living in th womb, birth, the surroundings of childhood and
youth. Within this ‘first reception-world’ all the time through his life-history
a ‘reception-religion’, a system of trust and distrust, hope and hopelessness,
basic expectations, images of man and existence, time and eternity, etc., are being formed. The god of this
religion may become reflected in one or several faces, existing in different
religions. The relation to a confessional surrounding is just one of its
features. Even where that relation is consciously neutral or atheistic, it all
the same is a re-ligio, one
existentially given relation to each man’s individual and general roots. (Religio = rootedness!)
The ‘second reception-world’ becomes
realised in the ‘second reception’ by therapy, a dialogical reception,
containing overtaking of responsibility in a vicarious sense, contrary to the
first reception-world. The goal in the second reception is that the patient in
the future shall accept responsibility.
Something
on the patient’s side tries to get the therapeutic space identical with the
first reception-world and so prevent the possibility of the second reception
from becoming a living dialogue. Sometimes, not only during psychotic
outbreaks, the repeating compulsion of the patient, to re-create the first
reception-world, takes the expression of a religion, the idol of which must
become defended ragingly against the threat of becoming transformed to a living
God, who is the god of true reception and love. Harold Searles describes how
the contradictory expectations of the patient sometimes do not leave almost any
space for something new in his life. The therapist can then feel how the damage
produced by the parents to the patient engraves into himself.
Martti
has, time and again, come to try to articulate the basic human situation to
which therapy as a faithful sharing process within man’s illness predicament
takes place with the fellowman, in the form of dialogue as a second reception.
Taking
such exposure of us therapists to the illness predicaments of man within an
utter solitariness in our societies and cultures, even in the midst of its
health-care institutions, living with such a professional fate as being a
therapist represents the impossible becoming somehow possible. No wonder that
most of the psychoanalytic institutions with which Martti has been in touch
have undergone severe crises. ‘Thanks to our Creator’s mercy, something really
healing all the same takes place here and there,’ he is used to saying. One
dimension vitally needed, opening itself up more and more for us therapists,
seems to him to be the social pathology. Good through bad, hope through to
receiving light through humble and passionate therapeutic encounter: that takes
place, as we know, as wanderings in human solidarity through darknesses and
deserts. According to Dostoyevski the kernel of life is JOY.
[1] In Martti
Siirala’s terminology, ‘transfer’ means ‘alienation’ or ‘displacement’, which
he also calls ‘social pathology’ (see my introduction), while ‘transference’,
starting from but transcending Freud’s term, means a restoring of the wholeness
and holiness of human relatedness and ‘being-with’, a healing of ‘social
pathology’.
[2] See note 1.
[3] Ann-Helen
Siirala here indicates that Martti Siirala, too, is dissatisfied with the
notion of ‘empathy’, which in Helsinki
[4] See my
introduction.
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