Sin embodied: Priest-psychiatrist Asser Stenbäck and the psychosomatic approach to human problems

Introduction

The late medical historian Roy Porter argued that mind–body relations, and especially soul–body relations, pose problems within ethics and theology. Psychosomatic conditions such as hysteria and hypochondria illustrate that these questions are also central to historians of medicine, setting an agenda for further inquiry into the interconnections between mind, body, and soul (Porter, 1991: 223–4). That religion and medicine share interest in the mind–body question draws attention to the history of psychosomatic medicine. This article pursues the intellectual biography of the Finland-Swedish theologian turned psychiatrist Asser Stenbäck (1913–2006), who was a pioneer of Finnish psychosomatic studies. It asks how Stenbäck combined religion and medicine and how Christian values, judgements, and duties inched their way into his medical views, and speaks for the relevance of the soul–body perspective in the 20th-century history of health.

Stenbäck is an attractive figure for this kind of study for three interrelated reasons. First, reflection upon Stenbäck's psychosomatic ideas reveals a great deal about the dialogue between medicine and religion and points towards tensions and fractures in this communication. Stenbäck, who made a pioneering contribution to Finnish psychosomatics, worked in the large Finnish psychiatric hospital Hesperia from 1954 to 1965 (from 1957 onwards as the psychiatrist in charge) and was an associate professor of psychiatry at the University of Helsinki from 1967 until his retirement in 1976. He was educated in theology in the 1930s, and his interest in otherworldly matters did not wane after he gained his medical degree in 1947. ¹ The biographical focus on Stenbäck makes apparent the intellectual, social, and political forces that operate through historical agents, and which, in this case, contributed to the development of Finnish psychosomatic medicine (cf. Florin, 2014; Nasaw, 2009; Rotberg, 2010).

Second, studying Stenbäck's medical life enriches existing histories on the relationship between psychiatry and religion. When the role of faith in the history of psychosomatics has been examined, sentimental or emotional healing experiences have usually occupied centre stage (Harrington, 2005, 2009; Hart, 1996; Powell, 2001). However, more attention should be given to the normative aspects of religion, since religious doctrines are also intended to organise life and give it meaning in theologically nuanced ways. Recent scholarship has defined religion as a form of embodied behaviour, which connects the sensory, emotional, and social ramifications of faith – in other words, it draws a parallel between bodily practices and morality (Burns Coleman and White, 2010: 4–7). This article makes the claim that Stenbäck's psychosomatics represented such a holistic understanding of faith, as he stressed the significance of inner experience, existential security, and moral behaviour for both mental and physical health. The psychosomatic approach, so to speak, preserved the idea of ‘embodied sin’ in the secular age of medicine.

The third incentive to examine Stenbäck's story is that it ties in with debates on how individual pathologies can be taken as indices of broader social problems (see e.g. Hayward, 2012, and the related special issue) and how concepts of stress and psychosomatics can be harnessed to further social reconstruction (see Greco, 1998; Jackson, 2013; Rosenberg, 1998). In Stenbäck's case, this potential pertains to the changing social status of Christianity. As is well known, the processes of secularisation, psychologisation, and medicalisation called into question the social role of religion during the 20th century (see e.g. Kivivuori, 1999; Madsen, 2014; Rakow, 2013; Wood, 2020). In the Nordic countries, the shift to spiritual pluralism undermined the previously uniform Lutheran culture (Markkola, 2015). The breakdown of the traditional value structure motivated Stenbäck to advocate a happy and healthy Christian society, first as a private person and later as an MP for the Finnish Christian League (1979–83). In contrast to contemporary critiques of a ‘sick society’, Stenbäck's political design was deeply informed by his religious world view. In conclusion, I argue that Stenbäck's ideas defended the ‘irrational’ not only as a source of religious experience and psychosomatic health, but also as a legitimisation of political action (cf. Mannheim, 1986).

As the term intellectual biography implies, this article is based chiefly on published medical texts and research. ² Stenbäck's Christian writings have been collected from a variety of religious journals. ³ The article centres on the years 1930–83, which covers the period of Stenbäck's most active involvement in the public sphere. This published material is supplemented by the archival holdings of the Signe and Ane Gyllenberg Foundation, the major funder of psychosomatic research in Finland. This archive contains correspondence between the banker and philanthropist Ane Gyllenberg (1891–1977), the founder of the organisation, and various physicians, including Stenbäck. I have also made use of the Oral History Archive of the Finnish Parliament and the archive of Suomen kristillinen lääkäriseura (the Finnish Christian Medical Society, FCMS). ⁴

Scandinavian readers may be familiar with Stenbäck's propagation of conversion therapies, which received public attention in the 1980s and 1990s. Again, the issue is topical due to a recent citizens’ initiative to criminalise conversion therapy, taken up in the Finnish parliament in October 2021. Furthermore, the physician and Christian Democrat MP Päivi Räsänen was prosecuted in spring 2022 after publicly condemning homosexual acts. Given the ongoing relevance, Stenbäck's views on homosexuality warrant a more thorough handling than can be provided here. For now, I refer the reader to the sociologist Olli Ståhlström's dissertation (1997) and a recent article by the Finnish theologian Teemu Ratinen (2017) that discuss medical and theological views on homosexuality in Finland, with reference to Stenbäck's influential conceptions.

The formative years of a Christian doctor

This section describes the interwar revival theologies that influenced Stenbäck's world view and would come to inform his psychiatric and psychosomatic views. Since the 18th century, strong revival movements have coexisted within the Finnish Evangelical Lutheran Church, which is still the spiritual home of most Finns. Revivalism has greatly influenced the church's theological stances, to the extent that the role of revival movements in the shaping of Finnish religious life is sometimes said to be unparalleled in other countries. These movements (five different strands are commonly distinguished) have intermittently either criticised or supported the teachings of the main church. Revivalists have often formed tight-knit communities and distanced themselves from the ‘carefree’ secular world, but have also criticised deplorable social mores (Huotari, 1981: 174–9).

Stenbäck himself was descended from a long line of clergyman. His father was a priest, and his great-grandfather Johan Mikael Stenbäck (1809–61) was curate of the municipality of Paavola. Johan Mikael's brother, Lars Stenbäck (1811–70), is probably the most famous of the Stenbäcks, as he belonged to the pioneers of one influential revival movement, the Awakening (Herännäisyys in Finnish; Murtorinne, 2012[2001]). The defining doctrines of the movement – humanity's sinfulness, salvation through the grace of God, and the supreme authority of the Bible – clearly resonated with Asser's beliefs. The young Asser was always fascinated by his father's tales of the family's ancestors, but made the decision to enrol in the theological faculty (in 1931) only when he personally came to faith around 1930. There is no detailed record of the events that led to his religious awakening, though it may be that Stenbäck's severe coincidental pneumonia, mistaken for tuberculosis, was partly responsible. ⁵ In line with this interpretation, Stenbäck later referred to a ‘phase’ shortly before his enrolment in theological studies that had made him a ‘confessional Christian’ (Särs, 1997: 9). He would accordingly describe himself as a ‘Christian revivalist’. ⁶

Stenbäck's student days at the University of Helsinki had a powerful impact on his religious thinking. The Lutheran Student Christian Movement, the umbrella organisation for Finnish Christian students, was a hotspot for 1930s theological debates. Its nationalistic Finnish-speaking wing, particularly the Students’ Christian Association (SCA), emphasised the revivalist roots of Finnish Christianity. This orientation was also adopted within the Swedish-speaking Students’ Christian Society (SSCS), based in Helsinki, in which Stenbäck acted as the chair from 1940 to 1952. In a ‘pietistic’ student dormitory, Stenbäck became acquainted with well-known Finnish theologians Martti Simojoki and Osmo Tiililä, who belonged to the SCA. Both societies ‘felt connected’ to the low-church Norwegian Hallesbyan movement and the British Inter-varsity Fellowship of Evangelical Unions (IVF for short; Särs, 1997: 9–10). This theological cohesion is remarkable, as it overrode the language schism between Finnish- and Swedish-speakers that penetrated Finnish political, scientific, and cultural life in the first half of the 20th century. ⁷

In contrast to the ecumenical aspirations of some other Christian student organisations, the SCA and SSCS advocated exclusive conceptions of faith and redemption (Franzén, 1987; Pietikäinen, 1997). They followed the examples of the Hallesbyan movement and the IVF by adopting, as Ruth Franzén has called it, a ‘fundamentalist’ approach to Christianity. This approach rested on the idea that the Scriptures were divinely inspired and infallible in every detail, making the Bible the highest authority in questions of faith and moral conduct. Christ was a deity, whose crucifixion and resurrection after the fact had reconciled the sins of those who believed (Franzén, 1987: 179). Such views grounded evangelical goals. Stenbäck's work for the Finnish Seamen's Mission and the Finnish Missionary Society in the mid 1930s, as well as his wartime letters that hailed the spread of the gospel to the atheist Soviet Union, suggest that he shared an affinity for evangelisation (Stenbäck, 1941).

Ole Hallesby's grand persona made a lasting impression on many Christian students. Stenbäck too heard Hallesby speak at Nordic student meetings, and would later describe Hallesby's book Varför jag är en kristen (Why I Am a Christian) as a significant influence on his own Christian ponderings (Särs, 1997). These later statements also suggest that Stenbäck found a few Hallesbyan ideas particularly compelling. Among them was Hallesby's conviction that the truth of Christianity could not be overcome intellectually, but only through religious experience (theologia regenitorum). The road to conversion ran through Christian deeds that made one realise how difficult being ‘like Jesus' was in practice, which in turn helped one to appreciate Christ's extraordinary nature. While Hallesby held that coming to faith was analogical to ‘dying’ and then being reawakened by God's power, seeking God was a continuous task (Hallesby, 1933[1925]). Therefore, the Hallesbyan revival laid out a path of active engagement in the world that would generate faith through experience – a theology to guide one on life's way.

The Finnish priest Urho Muroma (1890–66, né Murén) was an influential local propagator of Hallesbyan ideas. Later, he would be called the originator of the neo-pietistic ‘fifth revival’, which sparked a wave of conversion among Christian students in the 1960s. Already in the interwar years, Muroma organised revival meetings and widely distributed a journal called Herää Valvomaan! (Awake!), for which Stenbäck also collected subscriptions in his student years (Mäkelä, 2006). ⁸ Muroma encouraged his audiences to fully surrender themselves to God, to follow a godly way of life and to help others to do the same. Like Hallesby, he called for personal conversion and Christian rebirth (Junkkaala, 1995). Muroma's strong conviction that personal revival was the prerequisite for salvation conflicted with the Lutheran conception that man was reborn already through infant baptism. As a priest, Muroma nevertheless sought to reconcile his views with Lutheranism and accepted infant baptism as an initial, though not adequate, step towards joining a congregation (Junkkaala, 1990: 34–9, 126–8). As will be explained later, Stenbäck also emphasised the importance of personal conversion.

The first half of the 20th century also saw the emergence of revivalist movements that diverged from Lutheran teachings to the extent that they could not exist within the church. The spread of these Free Churches was accelerated by the Freedom of Religion Act in 1923 (Seppo, 1983). For the history of psychosomatics, the Finnish Pentecostal Movement is particularly interesting, as ecstatic healing experiences were an integral part of its operation. ⁹ It is of interest to note that Stenbäck also held that Christ could fill hearts with the Holy Spirit like he did with his disciples at Pentecost. With Christ's grace of revival came sanctification, which, according to the Bible, ‘heal[ed] our deficiencies’ (Stenbäck, 1940). Furthermore, according to Raimo Mäkelä (b. 1940), the executive leader of the Finnish Bible Institute (adherent to Muroma's revivalism) and Stenbäck's friend, Stenbäck ‘believed, following the Bible, that bad spirits could possess a person’. The question of demonic possession had become topical in the mid 1970s, when the movie The Exorcist was first aired in Finland. When Stenbäck was then mockingly asked whether the University of Helsinki would now start performing exorcisms, he replied: ‘We remain positivists at the hospital’ (Mäkelä, 2006: 75). However, there is no direct evidence that Stenbäck would have been associated with Pentecostalists, which is perhaps not surprising given his strong ties to the Evangelical Lutheran Church. He also showed a certain aversion to exaltation, which he likened to the chaotic stages of psychosis (Kyntäjä, 1972). While Stenbäck believed in spiritual healing, benefits of this kind seemed to occupy only a secondary place in his theology. As we will see in the next section, Stenbäck's active conflation of priestly and medical creeds rested on other, still revivalist, foundations.

The making of psychosomatic morality

Stenbäck was ordained a priest in 1935 but quickly began to pursue his medical studies, acquiring a bachelor's degree in medicine in 1942 and a full licence to practise medicine in 1947. In his own words, the change of careers was not motivated by his having ‘grown tired of’ the church but by a desire to ‘be closer to ordinary people’. ¹⁰ The shift, however, required some epistemological clarifications. Stenbäck's reconciliation of faith with medical science, articulated in a Christian student journal in 1944, clearly echoed the Hallesbyan advice on overcoming religious doubt:

The contradiction between faith and knowledge exists only when the two are incomplete. Understanding [förståndet] surpasses both.… The very expression ‘Christian student’ shows that this [critical] intellectual orientation can be reconciled with Christian faith. We dare say even more; all thinking that does not lead to Christian faith is superficial and deficient [ytligt och bristfälligt]. (Stenbäck, 1944: 1, 10)

For Stenbäck, the conflict between faith and science was only apparent, since natural laws represented God's work in nature. The truth of Christianity had nothing to do with critical thinking, as it could never be proved, only experienced. In other words, knowing facts and believing in God concerned different aspects of human existence (ibid.: 15). One might read Stenbäck's statement as an assertion that fundamental truths of the world were accessible only to those touched by faith. In that case, religious conversion would be a precondition to complete understanding.

Nevertheless, the practical work of medicine sidelined deeper truths about humanity, which was not an unproblematic position for a future psychiatrist. At the end of the 1940s, new psychological approaches were making inroads into the traditional realm of religion and claiming to offer insight into human problems. Among the clergy, the attitude towards Freudian theories was ambivalent. Some regarded them as too animalistic and materialistic (apparently neglecting the more recent developments in psychoanalytical theory), whereas others deemed psychoanalysis valuable in describing people's inner lives (Kettunen, 1997: 68–77). Stenbäck, influenced by his 1948 degree in psychology and having started work as a junior psychiatrist in 1949, belonged to the latter group. He even likened psychoanalysts’ conversational therapy style to the power of God's word; as God's message could offer salvation, so could putting unconscious conflicts into words solve psychological problems (Stenbäck, 1949).

The Second World War has repeatedly been referred to as a watershed in the adoption of psychosomatic ideas, and Stenbäck's development does not challenge this view (Brown, 2014; Hyrkäs, 2021). However, the significance of religious groundwork for the ‘psychosomatic turn’ is less discussed, despite the views of contemporary theologians that psychosomatic medicine opened up new pathways to the care of the soul (Kettunen, 1997: 77). Anu Peltoniemi has also identified the Christian soul–body discussion as a precursor to psychosomatic medicine in a study on the emergence of psychodynamism in Finland (Peltoniemi, 1996: 169–75). In the late 1940s, psychosomatic medicine fittingly became a recurring topic at the meetings of the Finnish Christian Medical Society, where Stenbäck was an active lecturer for decades. A lecture held in 1948 by another member of the FCMS noted that the fact that ‘mental’ (sielullinen) factors could cause physical diseases ranging from infections to hypertension and peptic ulcers was even ‘reassuring’ from a Christian point of view. ¹¹

To delve deeper into the nature of this reassurance, assimilating the ‘soul’ within the ‘mind’ drew sickness closer to sin. The historian Heini Hakosalo has studied the thinking of the FCMS's founder, psychiatrist Helmi Heikinheimo (who, notably, also came from a revivalist Christian family) and has argued that psychiatry attracted religiously inclined doctors because it invited them to comment on the moral aspects of and non-physical pathogens in disease (Hakosalo, 2014: 93–4). Similarly, the psychosomatic approach could extend the realm of legitimate religious intervention to organic diseases. It remains uncertain to what extent Finnish Christian doctors applied these ideas in practice, but in principle, their views resembled the thinking of the US Emmanuel movement, which deemed psychiatric and somatic illnesses essentially moral problems. As the historian Rhodri Hayward notes, the Emmanuel movement transformed Christian faith into a resource that contributed to the development of American psychosomatic medicine pioneered by H. Flanders Dunbar (Hayward, 2017; see also McCarthy, 1984). However, it should be noted that contemporaries, Stenbäck included, were wary of assigning a mere instrumental value to faith. Psychological and physical restoration came second to faith, not vice versa.

Stenbäck's lecture titled ‘Psykologisk frigörelse och kristen frälsning’ (Psychological Emancipation and Christian Redemption), held in 1952, when he obtained a license to practise psychiatry, is a good resource, as it summarises many of these theological elements and explicitly places them in a medical setting. In the lecture, Stenbäck evoked ‘the old’ Christian idea of man being divided into spirit (divine connection), soul (synonymous with mind/self), and body to criticise the Lutheran Church, which had minimised the role of the ‘soul’ in pastoral care. Stenbäck decreed that the church had become alienated from the modern person because of this psychological neglect (Stenbäck, 1952a: 10). Stenbäck had earlier elaborated on the question of the human soul in relation to medical science and remarked that the Bible entailed two formulations of the soul–body relationship: a ‘dichotomous' division into body and soul and a ‘trichotomous’ division into body, soul, and spirit. Stenbäck preferred the latter option, as he thought that the spirit, or a longing for something absolute (God), separated humans from animals and the ‘relativist’ natural world. Moreover, Stenbäck associated the spirit with striving after moral perfection, which, unlike soul–body connections, could not be described in medical and psychological terms (Stenbäck, 1945).

As moral striving was built into the human constitution, Christ could send people ‘harmony’ to help them to live up to their ‘need for perfection’ (Stenbäck, 1945). Stenbäck also displayed an appreciation for individual contentment and the this-worldly throughout his 1952 lecture. Echoing the concept of ‘glad certainty of faith’ developed by the Awakening's founder, Paavo Ruotsalainen (1777–1852), whose theology Stenbäck's theology master's thesis (1934) had examined, Stenbäck contended that faith could bring about peace of mind and happiness. However, salvation meant something much more than a sense of psychological freedom:

We must never forget … that to be saved is to come to Heaven. The clear message of the Bible is that the one who believes shall be saved and when he comes to faith he receives the Holy Spirit, which creates new life in the soul.… This leads to psychological emancipation; fear and anxiety are replaced with freedom and a spirit of sonship of God [Rom. 8:15], in place of being bound by sin enters force to overcome it and live as a collaborator of God.… Without this rebirth and daily renewal we cannot reach Heaven and the eternal, final salvation. (Stenbäck, 1952a: 20)

In the above passage, Stenbäck conceives salvation as something that is achieved through religious conversion, continuous renewal, and joyful service to God. Importantly, one was not enslaved by divine laws but followed them gladly as the heir to God's kingdom. These tenets also made psychological and physical health important. The mind and the body appeared to be tools of God, and they could be treated to free the believer to work better in His service (ibid.: 4–7).

Stenbäck's theology also entailed a lawful and dogmatic perception of how Christianity could advance health. He used the Freudian distinction between the id, the ego, and the superego to describe how the self and the body were connected to God. As Teemu Ratinen has argued, Stenbäck's understanding of the superego differed from the Freudian concept in that while Freud regarded internalised norms as being imposed by culture, Stenbäck considered them innate to human existence (Ratinen, 2017: 646). Daily renewal meant striving after the demanding Christian ethical ideal: to be perfect (fullkomlig) like Jesus (Stenbäck, 1952a: 14). Falling short, as Stenbäck would suggest on multiple occasions, not only evidenced moral corruption but also led to a host of health problems: headaches could be caused by ‘wrong’ behaviour towards a husband; a hypochondriac fear of syphilis could follow infidelity; and in depression, or ‘moralistic pain’, the inability to make amends or receive forgiveness could dim one’s hopes for the future (see respectively Stenbäck, 1954: 84; 1962: 160; Stenbäck and Rimón, 1964: 379). As one might expect, Stenbäck did not advocate the lowering of moral standards, but instead warned that psychotherapy could offer people false relief (Stenbäck, 1952a: 13). The stance that guilt was often legitimate, even necessary, was common to other religiously inclined readings of psychoanalysis. Stenbäck's thinking was, for instance, akin to that of the Swedish theologian Arvid Runestam, who argued that a nagging conscience led to mental imbalance, and to that of the American psychologist O. Hobart Mowrer, who stated that suppressing a bad conscience lay behind many psychological disturbances (see respectively Page, 2017: 15–16; Pietikäinen, 2007: 210–11).

Salvaging stressed souls and bodies

Following Christian ethical guidelines served a twofold purpose in Stenbäck's world view. First, doing the right thing was conducive to genuine religious conversion, and second, it could directly improve health by assuaging legitimate guilt. The latter approach seemed to be more relevant to the practical work of psychiatry, and Stenbäck believed that the Ten Commandments provided incontestable rules for ethical behaviour. Psychosomatic illnesses, ranging from sexual disorders to cardiovascular disease, often resulted from the internal conflict that emerged from breaking these rules. This section examines the construction of Stenbäck’s psychosomatic theory in his medical writings and relates it to a Christian understanding of human problems.

In the 1950s and the 1960s, Stenbäck's work in psychosomatic medicine was consistently supported by the Gyllenberg Foundation. ¹² The foundation's first board consisted of representatives of the Swedish-speaking elite, including the professor of internal medicine Fredrik Saltzman. Another renowned internist and professor, Bertel von Bonsdorff, joined the ranks of the foundation in the early 1950s and served as its chair from 1962 to 1974. ¹³ Even though the grants were relatively small, the foundation's goal was extraordinarily focused: to advance psychosomatic – and from 1960 onwards also anthroposophical – medical research. Together with Saltzman, von Bonsdorff encouraged Stenbäck to apply for the first Gyllenberg grant, which was awarded to him in 1950 (Stenbäck, 1954: foreword).

However, Ane Gyllenberg's ultimate objective to develop anthroposophical medicine created discord within the foundation. Though anthroposophy and psychosomatics shared a holistic vision of health, their theoretical underpinnings differed considerably. While psychosomatic medicine was usually built on psychodynamism or stress theory, the groundwork of anthroposophy was Rudolf Steiner's esoteric philosophy. ¹⁴ Gyllenberg found anthroposophical medicine to complement his spiritual views, which drew from Freemasonry and his broad philosophical reading, and in 1926 he became a member of both Finnish and German anthroposophical societies. Later, in 1934, Gyllenberg visited Goetheanum, the headquarters of anthroposophy in Dornach, Switzerland, where he was introduced to experiments in spiritual science that convinced him of the practical value of anthroposophical research (Nylund, 2018: 77–83). Expanding the realm of science so that it could again perceive the spiritual realm and make it comprehensible to modern man became Gyllenberg's goal. However, the anthroposophical occult conception of human physiology and the precedence of spirit over matter stood in stark opposition to the hopes of medical experts, who felt that the foundation should support scientifically sound, somatically oriented psychosomatic medicine (ibid.: 92–4).

Efforts to reconcile anthroposophy with medical science put Stenbäck in a difficult situation on both scientific and religious fronts. In 1956, Stenbäck replied to Gyllenberg's inquiry on how to promote anthroposophical medicine in Finland and suggested that instead of funding it directly, the foundation should support research into how psychological illness was connected to ‘culture, religion, and the philosophy of life [livsåsskådning]’. That way, anthroposophical medicine would also move forward. As for anthroposophical research on organic disease, Stenbäck regretted that the medical experts at the foundation could not advance it ‘in good conscience’ and recommended that Gyllenberg instead undertake a ‘private initiative’ in this field. ¹⁵ Gyllenberg ‘did not rejoice in the contents' of Stenbäck's letter – in fact, a note in the archive, written in Gyllenberg's handwriting and containing quotes from Stenbäck's letter, reads: ‘Horrible. All dead wrong. Knows apparently nothing about anthroposophy.’ However Stenbäck later thanked Gyllenberg for his ‘personal kindness’, which had surpassed their ‘differences of opinion’. ¹⁶

Stenbäck's conciliatory tone and apparent ignorance of anthroposophical nuance suggest that he had his own reservations regarding Gyllenberg's agenda. Although Gyllenberg’s and Stenbäck's world views shared a Christian undercurrent, Gyllenberg's looser interpretation of faith, influenced by Freemasonry and Steiner's unconventional reading of the Bible, must have been a poor fit with Stenbäck's biblical revivalism. This reading can be supported by looking at the book-length critique of anthroposophy that Stenbäck's fellow revivalist Osmo Tiililä published in 1937. Its preface called anthroposophy ‘one of the most weak-based world views on both scientific and religious grounds'. According to Tiililä, Steiner preferred occult sensing to the word of the Bible and was overly intellectual to the detriment of religious experience. What was worse, his unbiblical Christ was a ‘scribe, occultist, and Mahatma’ but not the ‘messenger of God's grace’, which made the ethical authority of anthroposophy weak and salvation impossible (Tiililä, 1937: 6, 142–63).

Stenbäck's Gyllenberg-funded dissertation, entitled ‘Headache and Life Stress’ (1954), encompassed a fairly rigorous physiological approach to ‘life stress' that at first glance lacked any spiritual dimension. Stenbäck's ‘psychosomatic study’ criticised the Hungarian Canadian scientist Hans Selye (1907–82) for equating the cumulative strain of life stress with effects induced by powerful laboratory stimuli (such as cold, noises, or lights). ¹⁷ Stenbäck himself used the concepts of ergotrophy (neuromuscular and vegetative tension) and histotrophy (correspondent recovery) to better describe the stages of rest and activity in everyday life (Stenbäck, 1954: 87–97). Yet, upon closer inspection, the imbalance between work and rest that Stenbäck regarded as the principal cause of headaches had intriguing ethical implications. In Ad Lucem, he elaborated that not sanctifying the Sabbath, and therefore not getting enough rest, gave rise to psychosomatic symptoms (Stenbäck, 1952b). Some 20 years later, Stenbäck continued to argue that an excess drive to collect earthly possessions and not taking the time for quiet contemplation caused stress and, by extension, cardiovascular diseases (Finnish Christian Medical Society, 1973: 9). Both statements imply a literal interpretation of the Ten Commandments (to ‘keep the Sabbath holy’ and ‘not to covet’) and conflate health with virtue, just like the scholars Sander L. Gilman and William J. Hoverd have shown to be the case with the Catholic mortal sin of gluttony and obesity (Gilman, 2010: 32–4; Hoverd, 2010).

To stay with the arguments in Stenbäck's dissertation a little longer, Christian ethics was perhaps the most obviously significant in marital matters. Stenbäck stated that life stress transpired only in rare cases from strictly Christian uncertainty, but in marital and sexual conflicts, the ethical aspect was inextricable. Therefore, ‘many a life stress, which [was] not experienced by the patient as an ethical or religious matter, [was] nevertheless of that nature’ (Stenbäck, 1954: 83–4). Stenbäck's voluntary work as the head of the Swedish-language marital guidance centre in Helsinki from 1950 to 1961 must have reinforced this view, and he did state that psychosomatic symptoms such as back pain, palpitations, and amenorrhea often revealed problems in a marriage (Stenbäck, 1951: 12; 1961: 1053). The centre's establishment in 1950 was a response to the social instability of the post-war period, which gnawed at the foundations of the traditional family and allegedly caused marital dissolution (see e.g. Bergenheim, 2018; Malinen, 2018). The centre was a combined effort by Samfundet Folkhälsan (the Public Health Association of Swedish Finland; notably, Saltzman and von Bonsdorff headed Folkhälsan's board), the Family Federation of Swedish Finland, and the Finland-Swedish Parish Association (FPA). In particular, the FPA demanded that the person in charge of the centre had to be a Christian, which was probably the reason for Stenbäck's appointment (cf. Dahlberg, 2021: 230–1). Stenbäck also promoted Christian sexual ethics through the Family Affairs Committee of the Evangelical Lutheran Church from 1957 to 1970 (Yli-Perttula, 2020).

The connection between bodily health and philosophy of life was also revealed in the peptic ulcer studies Stenbäck conducted with Gyllenberg's support at the turn of the 1960s. Importantly, the concept of stress freed Stenbäck from a default assumption of psychopathology, since life stress could be unhealthy regardless of the patient's mental state. In 1957, Stenbäck argued that visceral ulceration did not always result from a neurotic process. Loss of income, disease, and death could induce anxiety and related physiological changes ‘regardless of one's religious standing’ (Stenbäck, 1957: 193). In 1960, Stenbäck elaborated on the issue further, and pointed out that earlier peptic ulcer studies had not realised that situations precipitating stress – fear of disablement, serious illness, and economic penury – threatened human existence, and were in that sense perennial. The patient's life depended on the positive solution of these ‘existential conflicts', which was why many patients were metaphorically fighting for their lives (Stenbäck, 1960: 286, 290–1; on peptic ulcer studies, see also Grob, 2003).

Stenbäck did not elaborate on the relationship between peptic ulcer studies and Christianity directly, but the notion that human existence itself was pathogenic fitted well with the Lutheran idea of man's inherent sinfulness. Although suffering and pain were part of human life, they were easier to bear by seeking divine connection (Kettunen, 1990: 55–64). As Stenbäck asserted in a speech marking the anniversary of the SSCS in 1964, Christ's life, death, and resurrection were the key to salvation and the solution to the ‘great human problems', which included problems of ‘physical existence’ and ‘living well with others'. Again, Stenbäck's conception of alleviating suffering had two levels. First, anxiety and inner conflicts were immediately helped by adhering to God's ‘simple yet often difficult-to-follow laws for mental and physical health and social coexistence’. Second, the Bible's answer to human suffering was eschatological and articulated in the description of New Earth and New Heaven in the Apocalypse of John: ‘He will wipe away every tear from their eyes, and death shall be no more, neither shall there be mourning, nor crying, nor pain anymore, for the former things have passed away’ (Stenbäck, 1964: 22–3). ¹⁸ It seems safe to conclude that by using the term ‘existential conflict’, Stenbäck was associating psychiatric and psychosomatic illnesses with human problems. Certainly, he did not deny the relevance or existence of neuroses (he was a psychiatrist, after all), but this was not the point he wished to make. Rather, he hinted that the ultimate answer to the existential problem of life stress was not psychological emancipation, but Christian salvation.

In 1967, Stenbäck's personal cooperation with the Gyllenberg Foundation ended abruptly, probably for practical reasons related to Stenbäck's mounting professional responsibilities. When Stenbäck had just started as an associate professor at the University of Helsinki, he wrote to the foundation with hopes of establishing a research institute that would result in ‘more and better psychosomatic research’, ¹⁹ but the request seems to have been graciously denied. ²⁰ That epistemological differences may also have been at play is indicated by the fact that the foundation also rejected a proposal, made by Stenbäck's close colleagues Ranan Rimón and Kalle Achté, for establishing a Gyllenberg professorship in psychosomatic medicine at the University of Helsinki in 1973. Gyllenberg's response on this occasion concluded that psychosomatic medicine was only one phase of the development whereby increased understanding of the spiritual created ‘real knowledge’ of humanity. ²¹

Interestingly, Stenbäck rarely included openly religious statements in his medical publications and acquired a reputation as a man with a ‘critical scientific pattern of thought’ (Achté, 1973: 11). His Christian morality, however, oozed through the cracks. Not unlike Selye, Stenbäck used stress theory to advocate a healthier philosophy of life. As Selye argued in his popular work The Stress of Life (1956), saving adaptive energy by leading an altruistic life was key to happiness and prosperity (Jackson, 2012). The principal difference between the two men was that Selye derived his code of conduct from natural laws, not from the supernatural being of God. What is more, by the end of the 1960s, Stenbäck had become acutely aware of the social ramifications of a holistic understanding of health that found legitimisation on the transcendental plane. The perceived moral turmoil and existential insecurity in the modern world then impelled Stenbäck to switch his focus from sickness to sin.

The tumultuous social body and the politics of healing

In Finland, as in other Western countries, the late 1960s were marked by cultural criticism and radical movements pointing out disagreements between the old and the new generations (Kolbe, 2008; Virtanen, 2001: 380–7). Social unrest was revealed at many levels of society, and the Lutheran Church was also targeted by the 1960s radicals. A blasphemy litigation against the Finnish author Hannu Salama in 1964 was one obvious occasion on which the church's attempts to uphold public respect for the sacred clashed with contemporary criticism of the institution's perceived dogmatism and cultural nihilism. Radical tendencies were also apparent within the Christian student movement, where leftist liberation theology raised concern about international social and economic problems. Radical Christians subordinated theological questions to social responsibility, which led to a reactionary rise of neo-pietism (Murtorinne, 1977: 22–5; Pietikäinen, 1997: 74–83). When Stenbäck was asked about Christian student radicalism in 1997, he stated that he had always felt alienated from its ‘loose social ideology’, which could not be called ‘exactly pious' (Särs, 1997: 11–12). It was therefore not a coincidence that Stenbäck's own political commentaries proliferated from 1968 onwards; his energies were directed into criticising forces that weakened the role of religion and piety in society at large. This last section examines how Stenbäck harnessed the idea of holistic health to find cultural cures for sin and sickness, and how he combined Christianity with politics.

The perceived state of moral dissolution resided at the core of Stenbäck's cultural criticism. Stenbäck's writings from the 1950s already contained the ingredients of this critique, as he asserted that ‘anomalous environmental factors' could dull people's capacity for moral action (Ratinen, 2017: 646). In the 1960s and the 1970s, the prevailing value pluralism defied the existential and normative roles of Christianity, leaving psychiatrists to struggle with ‘rootless' people unable to find meaning in life (Stenbäck, 1973: 95–8; see also Stenbäck, 1980). Many contemporary critics joined Stenbäck in this perception. For instance, the British psychiatrist George Carstairs held that without the ‘supra-personal system of values' people no longer felt life to be meaningful, which in turn led to a loss of social cohesion (Carstairs, 1962), while the Glaswegian physician James L. Halliday named the decline of religion as a ‘moral sheet anchor’ and a source of a ‘shared sense of purpose’ as a constituent of a ‘sick society’ (Hull, 2012: 82–3). Building on similar thoughts, Stenbäck openly advocated ‘common-sense’ psychotherapy, in which a righteous way of life was offered to solve psychological distress. Nevertheless, Christian faith could be conducive to successful therapy on a national level, since the Finnish mind had a ‘strong religious component’ (Stenbäck, 1974: 1725–7; see also Stenbäck, 1985).

Growing levels of ‘deviance’ were one manifestation of the adverse ethical development. This term referred to any miscellaneous group of people who diverged from society's normative expectations, including criminals, sexual minorities, and people with drug or alcohol addictions (see e.g. Parhi, 2018). Deviant behaviour exemplified how uncertainty about the meaning of life threatened people's psychological well-being and physical existence. In 1964, Stenbäck and the psychiatrist Max Blumenthal conducted a study on alcohol addiction and attempted suicide, concluding that these ‘bio-psycho-social behaviours' were characterised by reduced care for bodily integrity, and even, quoting Karl Menninger, ‘a wish to be killed’. Self-destructive tendencies were contrasted with the highly valued body of the hypochondriac, who feared the body's loss and deterioration (Stenbäck and Blumenthal, 1964: 134; on suicide, see Myllykangas, 2019). As seen in the discussion regarding peptic ulcers, to Stenbäck's mind attitudes towards physical existence had a clear Christian dimension. In a further reflection on suicide, he made an indirect reference to Christian ideas by saying that the value of the body came from its being both a ‘tool’ and ‘the prerequisite for life’ (Stenbäck, 1972b; original emphasis). Here, we come back to Stenbäck's conception of the converted individual as God's collaborator and the this-worldly importance of psychosomatic health. As Stenbäck argued in 1973, alcoholics and drug addicts needed the conviction that the body was created for service to God to break their pernicious habits (Finnish Christian Medical Society, 1973: 9).

Stenbäck's views on addiction are also instructive in clarifying his relationship to the concept of the ‘sick society’, which was employed in contemporary anti-psychiatric critiques of how oppressive social norms produced unhealthy forms of adaptation (see e.g. Crossley, 1998: 877–80). In Finland, the anti-psychiatry-influenced November Movement (NM for short, 1967–71) criticised the medicalisation of deviance, claiming that structural issues and rule breaking were systematically deemed problems of individuals. ²² In a commentary published in 1969, Stenbäck agreed that it was indeed modern culture (included, as he understood it, in the term sick society) that had caused the drug-use epidemic. Yet, notably, for Stenbäck, student radicals and the NM were part of the problem. They participated in creating the very forms of maladjustment they claimed to counterbalance by, for instance, propagating the use of milder drugs (Stenbäck, 1969). While Stenbäck usually abstained from employing the specific term sick society in his own cultural criticism due to its anti-psychiatric connotations, he was clearly concerned about the unhealthy social environment. When asked on one occasion, with a reference to the opinions of ‘some other psychiatrists', whether psychosis was a healthy reaction in a society that differed so much from the Christian ideal, Stenbäck replied that it was possible to see modern society as so alienating that ‘only an inhumane person’ could thrive there. However, he maintained that mental illness never brought a person closer to finding meaning in life, nor to the realisation that man was created in God's image (Kyntäjä, 1972).

But who were these ‘other psychiatrists’? The idea that psychosis would be a healthy reaction in a sick society brings us to the psychiatrist Martti Siirala's metaphysical understanding of disease, developed under the auspices of the Therapeia Foundation and applied by some anti-psychiatric thinkers. ²³ The Therapeian form of psychoanalysis built on existential philosophy and anthropological medicine, which both hoped to shed light on the hidden meanings of disease. In the first instance, Siirala was inspired by the ideas of Ludwig Binswanger, Martin Heidegger, and Medard Boss, which prompted him to focus on immediate experiences of illness and to deny the dualism between mind and matter (Dasein analysis). Second, he was keen on anthropological medicine, developed by the German psychosomatist Viktor von Weizsäcker, which postulated that disease was a materialised conflict created by one's life situation (Ihanus, 2000: 17–18). Siirala extended these meanings beyond individual lives with the concept of ‘social pathology’, according to which psychoses and psychosomatic diseases transpired when individual organs literally ailed instead of the social body (ibid.: 187–9). Diseases hence communicated unresolved individual, communal, and even national traumas. It is easy to see how Siirala's ideas could be fitted together with the anti-psychiatric critique of the sick society, and, in fact, an English translation of Therapeia's handbook was published in a series edited by R. D. Laing (Siirala, 1969). One of the leading figures of the NM, the Finland-Swedish psychiatrist and author Claes Andersson (1937–2019), attended Therapeia's psychoanalytical training and contended that the idea of disease as a message had a great impact on him (Andersson, 2009: 98–102).

The relationship between Stenbäck and Siirala always seemed tension-filled despite the fact that both were devoted Lutherans. ²⁴ This unease may date back to post-war theological schisms within the church, when Luther studies conducted in Lund, Sweden, were taken up by some Finnish theologians to question the compatibility of (neo-)pietism and its emphasis on the inner experience of faith with Luther's teachings. ²⁵ Siirala's theologian brother Aarne was notably one of the most ardent Lundensians (Ahola, 1996: 76–80). Furthermore, in the 1950s and 1960s, there was clear cross-fertilisation between Martti and Aarne's medical and theological conceptions. ²⁶ As articulated in Therapeia's handbook, Martti regarded the distinction between theological, philosophical, and medical ways of knowing as a mere human delusion (Siirala, 1969: 4). However, as noted above, Stenbäck drew a distinction between religious and scientific modes of perception and considered the mind-body to belong to a different ontological category than the spirit. When Stenbäck criticised Therapeia's views in a major Finnish medical journal in 1976, the act spoke of these fundamental epistemological disagreements. Stenbäck scolded Therapeian psychoanalysis for being ‘too speculative’ and ‘unscientific’ and denied that illnesses could generally be interpreted as ‘symbols' or ‘messages' (Stenbäck, 1976). Although Siirala and Stenbäck both paid attention to the social environment, they assigned it a different role in disease causation. While Siirala regarded the denial of ‘social responsibility’ as a direct cause of illness, Stenbäck accorded it secondary status, with some ability to either help or hinder religious conversion and ethical behaviour.

More so than theology, contemporary conceptions of a sickness-inducing society were entwined with political currents. The central role of socialism was a defining feature of the ‘long 1968’ in Scandinavia, and Finland's bloody history of class conflict and the country's proximity to the Soviet Union made the theme topical on many levels of culture (Ekman Jørgensen, 2008: 330–1). For instance, the NM was not openly political, but its radical Marxist members viewed the deviant population as a vanguard in the effort to overthrow the capitalist system (Parhi and Myllykangas, 2019: 202–3). Interestingly, socialism and Christianity were not entirely dissimilar; for instance, the Finnish historian Jukka Relander uses the lexicon of ‘cult’, ‘awakening’, and ‘conversion’ to describe the ideological turn of Finnish Leninists (Relander, 2008: 470–1). Stenbäck also admitted to some similarities between the two, and sympathised with ‘Marxist faith’ in a review of Claes Andersson's anti-psychiatric novel Bakom bilderna (Behind the Pictures). In his review, Stenbäck remarked that Marxism and Christianity shared a conviction that working for a hoped-for common future was one of the essential conditions for mental health (Stenbäck, 1972a). Of course, Stenbäck, whose conservative Christian views leaned to the right, still opposed the revolutionary tendencies that ‘had prevailed in the Soviet Union’ and were now spreading to Western countries. He fretted that including macrosocial factors in the biopsychosocial definition of health would ‘make psychiatry political’ (Stenbäck, 1970).

However, Stenbäck himself (not as a psychiatrist but as a politically aware citizen) hoped for a society built on Christian values. In an interview conducted in 1972, he expressed admiration for North American Anabaptist Hutterites, who followed a traditional Christian way of life. Hutterites had low levels of schizophrenia, alcoholism, suicide, neuroses, and criminality, allegedly because of their religious and charitable mindset. Stenbäck reportedly sighed in longing: ‘If only one could create such a society!’ (Kyntäjä, 1972).

Religion and politics had ‘softened’ boundaries in Stenbäck's own body of work (cf. Haapalainen, Opas, and Räsänen, 2019). What Stenbäck regarded as an ‘anti-Christian state’ in Finland inspired him to become a parliamentary election candidate for the Finnish Christian League in the early 1970s. In 1979, three years after retiring from the University of Helsinki, Stenbäck was finally elected to parliament and could begin to address the social and moral core of proliferating issues. ²⁷ The digitised parliamentary documents from 1979 to 1983 show that Stenbäck participated in a variety of initiatives with a clear Christian angle. He supported, for instance, the transfer of income to evangelical organisations and the improvement of religious education in Finnish schools. In addition, he advocated a doctor's right to refuse to perform abortions for ethical reasons and tried to improve the treatment of alcoholics and narcomaniacs, also in Christian facilities. In questions regarding the care of the elderly and people with chronic diseases or disabilities, Stenbäck maintained a holistic approach to health. ²⁸ In a pamphlet titled Miksi juuri kristillistä politiikkaa (Why Precisely Christian Politics), created for the 1983 elections, Stenbäck once again conjured up Christian doctrines to instigate a behavioural change in Finns. Arguing for, among other things, solidarity, abstinence, and diligence, the pamphlet concluded with an ominous warning: ‘If our nation forsakes the laws of God, we have no right to expect a happy future’ (Stenbäck, 1982: 42). Faith thus guided Stenbäck's politics, which inextricably combined happiness, health, and piety.

Stenbäck's political career was cut short by his first experience of brain damage, suffered at the age of 71. However, his single parliamentary term testified to the fact that Christianity was the fundamental structure that shaped Stenbäck's counter-reaction to the so-called sick society. Stenbäck always held that man was an ‘active creature’ (Särs, 1997: 12), but in the 1970s, this dimension of his revivalist conviction truly transformed into a resource for upholding Christian ethics at the societal level. In other words, the world view that encouraged one to subject the mind and the body to His service acquired new functions in the changing social context. As the historian John Carter Wood writes, influential Christians of the 20th century were compelled to find ways to navigate this transformed social reality (Wood, 2020). Stenbäck's unwavering condemnation of male homosexuality in the 1980s and the 1990s pointedly illustrates his pursuit of rigid strategies to confront the postmodern world (cf. Ståhlström, 1997). However, it is also difficult to see how Stenbäck's dogmatic beliefs would have allowed for a different form of integration without losing their Christian core identity. One thing is certain: instead of representing an ethical double standard, Stenbäck's public life gives the impression of a man who consistently practised what he preached across the religious, medical, and political arenas.

Conclusion

In a review on mind–body interactions in the history of psychiatry, the historian German Berrios recounts the popular myth of René Descartes's metaphysical dualism, which ‘freed the human body from religious control’ (Berrios, 2018: 8). Stenbäck's psychosomatic ideas, founded on Christian principles, aspired to reinstate this connection. He believed that Christian dogma could promote health directly through existential safety and indirectly through a good conscience and healthy habits. To paraphrase the historian Rhodri Hayward, the psychosomatic illness model entailed a moral imperative, whereby past sins could become apparent in the flesh (Hayward, 2014: preface). The joint histories of psychosomatics and religion have previously been discussed through a ‘positive thinking narrative’ (to use the historian Anne Harrington's terms), in which one attains good health through the power of belief itself (Harrington, 2009: Chapter 3). Another, largely separate strand of study has argued that the idea of stress can be used politically to call for social change (see e.g. Greco, 1998; Jackson, 2013; Rosenberg, 1998). Stenbäck's story ties these perspectives together and implies an alternative formulation of the sick society: the postmodern social environment was pathogenic in that it was not conducive to the kind of inner religious experience that would have led to conversion and supported moral behaviour and holistic health.

Revival Christianity formed the foundation of Stenbäck's theological, medical, and political lives. It thus served as a fundamental world-view design that guided his conservative political thought to defend an irrational substratum of the world against modern, disenchanted meaninglessness. Here, Stenbäck importantly returned to a pre-modern understanding of the body, in which the function of living things was determined by divine creation. The medical concepts of stress and psychosomatics were powerful tools for connecting pathogenic cultural progress to the Lutheran idea of man, since they could be applied beyond psychiatric clientele (cf. Rosenberg, 1998: 729). Furthermore, it is illustrative that Karl Mannheim foregrounds early Pietists in his analysis of rationalist modernity for preserving the irrational in their inner lives by retaining certain attitudes and continuing to learn from experience (Mannheim, 1986: 64). Stenbäck too endorsed inner experience as a source of true knowledge of God and ethics in a way that became both medically and politically purposive. Mythical transcendence became the principal legitimisation of political action that was aimed against both secularisation and liberal theologies, the latter of which seemed to abandon personal religious life as the true core of prosperity and salvation (cf. ibid.: 56).

Despite the deep connection between religion and health in Stenbäck's writings, one is left with the feeling that he did fail to fully reconcile the two in a manner that would have satisfied sceptical audiences – that is, to truly bring the irrational into knowledge. However, it would be unfair to judge him by this ‘failure’, as he never intended to build a ‘psychotheology’ (Mäkelä, 2006: 74–5). Instead, and similarly to what has been suggested about the role of Catholicism in the works of the cultural philosopher Marshall McLuhan (1911–80), I believe that faith was the often implicit backdrop to most of Stenbäck's actions (cf. Marchand, 1989: preface). Religious persuasion entered medical texts through passing remarks and loud silences that were elaborated in full in Christian forums. This observation raises questions about the extent to which unarticulated world views may pervade scientific conceptions. Moreover, the contingencies of individual lives often inform the development of medicine. As the historian Robert Powell concludes in a biographical article on Helen Flanders Dunbar, one must look at the non-medical background to fully grasp the meaning of scientific work (Powell, 1977: 148). This notion is relevant not only to the present biography, but to examining the history of psychosomatics in general.