Preliminary Programme

In this presentation, I will discuss the problem of psychosomatic pain in the late twentieth-century Finland. Nearing the end of the 1970s, Finnish authorities received a growing number of disability claims, in which the principal complaint was musculoskeletal pain. The phenomenon resembled the one in the US, where ‘low back losers’ became an epitome of swelling disability rolls, and invoked ardent medical discussion and research. The presentation looks at this development from the viewpoint of medical mind-body interaction, and argues that the pain symptom represented a borderland between mental suffering and physical distress. As the sociologist Monica Greco has pointed out, somatisation can represent a modern subject’s compromise to serve social adaptation. Disability caused by ‘lesionless’ pain was a product of the improving welfare and health care systems and marked a changing medical attitude towards pain itself. However, the process was not straightforward. As this paper shows, it stirred up antagonism between doctors, social insurance systems, and patients. Back pain began to reflect not only the prevalence of biological disease, but also the state of and attitude towards social welfare, societal conventions, individual characteristics, changes in the workplace, shifts in the economic cycle and especially worker’s motivation and mental state. Through this, I argue that the emergence of ‘lesionless’ pain was influenced not only by concrete social change, but also by the changing medical norms on the expression of emotional distress. Back pain became a medical metaphor for uneasy emotions that, importantly, entailed implications for treatment and compensation practices. (Show less)

In this presentation, I focus on the changes of emphasis between the bodily/psychological constitution and the environmental factors in the Finnish medical discourse and psychiatry, in particular between the 1950s and the 1970s. The stress theories based on the psychosomatic medicine and the endocrinological research of Hans Selye and others, were gradually introduced to the Finnish medical discussion from the 1950s onwards. During and after the Second World War, Finnish psychiatry had leaned heavily on the biological paradigm, in which external ’events’ or ’experiences’ were only seen as of secondary importance in the disease process. During the following two decades, psychodynamic theories and social psychiatry shifted the focus from biology to the external factors. External stressors, such as damaging family dynamics, exhausting pace at the work place, or unjust social conditions, began to be regarded as pathological agents by themselves. What could be called ’externalising the origin of diseases’ has given rise to ’health utopias’, in which every citizen leads a healthy life as long as the society manages and controls the pathological agents and the individual carries out the personal responsibility of abiding by the rules of the health guidance.

In my presentation, I analyse the ways in which the adoption of the paradigm of psychosocial stress altered the perception of personal responsibility on one’s own physical and mental health. Even though I focus on the psychiatric discourses and how they were altered by the introduction of the concept of stress, the aim of this presentation is to draw wider-ranging conclusions regarding the ideal of a well-adjusted and fully functional citizen in the emerging welfare society. (Show less)

Neurosis, an illness that had been a predominantly neurological disorder in the late 19th century, became an all-round manifestation of subjective distress and individual maladjustment in the western societies in the interwar years. By the 1950s, neurosis had become a protean disorder made up of medical, psychiatric, psychological, psychodynamic, religious and sociological components. As a diagnosis with diffuse diagnostic boundaries, neurosis was increasingly interpreted as a psychopathological or psychosomatic outcome of psychic conflict, which was caused or at least triggered by family dynamics and personal insecurities related to one’s performance as an employee, student, spouse or parent. Moreover, individuals who suffered from periodic or constant maladjustment were often diagnosed with neurosis, especially if such maladjustment was not linked with criminality or other gross violations of social rules and norms. Drawing on patient records and relevant literature, I will argue in my presentation that most people who were suffering from neurosis between the 1920s and the 1950s in Sweden and Finland were plagued both by tangible problems of everyday living, which as psychosocial stressors had deleterious effects on their mental and physical functioning, and on their sense of ‘ontological security’ as members of an increasingly complex, skills and knowledge based societies. I suggest that neurosis was not so much an illness as an aspect of the human condition that came to the fore at the time when the Nordic societies were characterized by science-based social planning, in which the ideology and practice of social adjustment of individuals and groups was of paramount importance to the policy makers and human science experts. Thus, as a cross-class health problem and a signal of maladjustment, neurosis was linked with the emerging welfare state. (Show less)