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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.)
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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
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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.
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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.
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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.
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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.

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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.
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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’.
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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.
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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. In 2020–1, Kuu a has s udied he a o he
pa ien s in Finnish psychia ic hospi al museums
and collec ions wi h he suppo o unding om
he Finnish Cul u al Founda ion and Ella and
Geo g Eh n oo h Founda ion.
Lis o e e ences
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