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To touch or not to touch

Adapting to a new reality away from your beloved ones is not easypeasy. The process can be uplifting and daunting. In this article I share some steps of my journey in Oulu, and what friends, Tinder, and a relationship taught me in the process.

When planning on coming to Oulu I took care of the money, winter clothes, and the paperwork, but little I did know about the challenges the cultural factors would pose on me. It was not the language, nor the food, but the touching. Yes, epidemic issues.

Unlike in Latin America people here do not feel prone to touch. As a joke once, a dear Finnish friend told me: “Are you trying to insult me?” when I was about to hug him. Although a joke, as we said in Peru: “de broma en broma la verdad asoma” (“Shaped like a joke, a truth is told”).

For several weeks after my arrival, I touched no one. I do not mean with a romantic or lusty interest. No, just touching. No one. A hug, a caress, a handshake. None. So, in pursuit of a solution, I joined a quest that took to unknown roads.

THE COMFORT ZONE: FRIENDS

The kind welcome of the Nordic winter gave me nocturnal insomnia and total daytime fatigue. So, I ended up going to the Finnish Student Health Services looking for some psychological support. In the process I realized what an issue depression is here, and that vitamin D is important to compensate for the lack of sunlight.

Although it helped to deal with insomnia and fatigue, it did not solve the deep problem. Who can I hug? Who? It also did not help when I came closer to a lecturer, and she stepped back. Would it be my breath? Did I forget to take a shower? But not, it was just that here people respect their personal space quite much.

Under those circumstances, I did what I thought was the best. If I could not go to Latin America, I will bring Latin America to me. So, I mingled more often with friends with a similar cultural background. “Pablo, there is this potluck…” Let’s go. “My party is…” Your address? Would you like to…? Of course. Becoming a regular of these events proved to be an effective way to deal with the problem, but a short-term one. Events occurred every now and then, while darkness and absence were a daily life routine. And even though parties took place often, I could not spend all the time touching people.

When facing a difficult problem some people drink, some eat, and others (like me) find the realm of sanity by working insane amounts of hours. As long as I had a deadline to reach, all my mind went into that impeding me to think about anything else.

Although I made a lot of friends and money, I was still yearning for human contact. So, too ashamed to ask for extra hugs or professional cuddlers services (yes, those exist!!!), I accepted a kind advice: “Use Tinder, Pablo”. And minutes after having heard her words, there was my friend: creating a “sexy” profile for me.

A CHRISTMAS PRESENT: TINDER

Even though I had heard about it, I had never used Tinder before. It took me a while to learn what is a ‘super like’, that profiles in Finnish more likely belong to people who want to speak only in local language, and that decency is not sending unrequested (nude) pictures. But then, I was finally able to date some girls.

Like work, Tinder also offered me a place to find distractions. Plus, it was also a place to find that human touch I was so hardly looking for. Many hugs, caresses, and kisses later, I found talks were (quite often) nice, and (sometimes) the sex as well. However, amid that abundance many times I found myself feeling deeply alone. People passing by, people talking, people laughing, people kissing… nothing.

It was not what you were looking for?

I came here without any expectation of finding the same food, music, or landscapes I was leaving behind. But I did not consider those deep connections with loved ones. No, it was not an epidemic issue, it was a cardiac one.

Tinder abundance showed me I was looking for that open and truthful connection that leads to long talks where you can share your feelings, fears, or hopes. Intimacy without nudity. Or a different kind. A nudity of heart.

That intimacy could be well expressed in a glance, a hug, or a kiss. But my beloved ones were far away, and I had no idea of when I would go back to meet them. And here among many like me, with doors open to possibilities (of a job, a new life, a new love), I was struggling to find people to build such bonds.

For that, time and patience are needed. But in pain, you have neither. Maybe that is how my friend saw me at that meeting before Christmas. Someone in so much pain that wanted to cry when smiling.

Were you aware of that?

No, I was not. Instead, I choose to cover my eyes with a tiny but dangerous veil. One that blurs reality, turning any minimal expression of care into love. And that spell guided me to a relationship that would show me a truly deep abyss.

CHOOSING NOT TO HUG

She lived in another city, so after matching we spent the first weeks chatting on Tinder. Messages to make her smile. Messages that made me smile. Then one short visit. Another. Then one for a weekend. Slowly she went underneath my skin, covering my whole self with her presence. I was no longer feeling alone.

For a while, I thought everything was going to be ok. If I knew little about my sorrow, even less about hers. “I am not good”, she began to say, and never stopped repeating it. I knew things were not easy for her. A difficult relationship with her parents and some ugly experiences with guys later made her tough to deal with. But my stubbornness was not going to let things go that easy.

I decided to stay. And I did. But after a few weeks, all the initial effervescence slowly vanished removing all beauty filters. There were only us: two fragile beings struggling to survive.

We had sex, care, and problems. Many problems. Like if drowning in the middle of the sea, we both were trying to help the other to keep afloat, while renouncing the oxygen for ourselves. And slowly I began to feel overwhelmed, having problems sleeping or focusing on simple tasks. Just like at the beginning of this story.

More likely I would have drowned if something different would not have happened. I never liked looking for help. Neither was I looking for it. That day I just saw an old friend connected on Facebook and called her. “Hey, how are you…?” , “It has been a while...”, “What are you up to now...?”. It was then, when I felt truly cared, that all the pieces I was fighting to keep together, abruptly broke apart. The tears came out. One after another. And there I was, me alone in my darkened room, connected with a friend 11 thousand kilometers away.

With patience she understood my mumbled words, and slowly helped me to realize what I was trying to hide: the relationship was not doing me any good. Instead, it was haunting me, breaking me down piece by piece. I always thought that with enough resolution, you could overcome any obstacle. But in this case, it was a dance of two. And my stubbornness was not helping. So, you must let it go…

I stayed in my apartment without seeing anyone. It took me a while to go deeper inside, not only to let that relationship go, but also to let go of that desperate need for connecting. It was not one or two, but several weeks until I could abandon the pain and the anger.

Finally, my inner voice emerged pure and calm again. You are doing good. Be patient. After all the pain, I could finally listen to it. The pain was still there, but now it was not that heavy. After all the suffering, I started to move slow again. With patience enough to build new (solid) bonds again.

Realizing that even wild storms end at some point, I choose to connect with my friends from here and there: the two places where I am living. And here I am, walking towards a horizon with beloved ones next to me to have deep open talks with.

This time with no rush. Slowly, step by step, one day at a time. •

The deranged, the distressed, and the detrimental – The stigma of the severely mentally ill is still strong

Petteri Pietikäinen, who has researched the history of madness for over 20 years, has always been interested in the fate of utopists, anarchists and other outcasts. How has our attitude towards madness changed over time?

“[...] And so the unfortunate sufferer is shackled to a corner or kept in the dark, being fed from a small hole in the wall. There they shall live in their loneliness day and night, in the most miserable condition, hungry and thirsty, sweating in hot weather and then shivering with cold, in the dirt, among parasites. They shall listen to insults and face contempt.”

“Treating the insane” (fin. Mielenvikaisen hoidosta), Savo newspaper, 7/1889

This was the fate of some mentally ill patients back when institutional care was not yet common in Finland. Usually the mentally ill were sold as paupers or they were moved from home to home as lepers – worst case scenario, the mentally infirm were isolated and cuffed.

The excerpt is from Professor of History of Sciences and Ideas at the University of Oulu, Petteri Pietikäinen’s work titled Kipeät sielut: hulluuden historia Suomessa (trans. “Unwell souls: history of madness in Finland”). “Unwell souls” sheds light on the history of mental health in Finland from the 1850s to the 1960s. The work is a sequel to Pietikäinen’s earlier book Hulluuden historia (trans. History of madness), published in 2013.

The semantic shift of hullu: who does it apply to?

In the 1800s, hullu (trans. mad) was still a general term for the mentally ill.

However, the word hullu has always carried other meanings in the Finnish language. According to Pietikäinen, for example, Juhani Aho’s work contains several mentions of the word in both adjective and noun form (i. e. hullu and hulluus). However, Aho refers to the foolishness and unpredictability of people’s actions, not to mentally ill individuals, for example in the statement “Mad is he, who splurges his money on girls” (from the short story Kello, Ensimmäiset novellit, 1883).

According to the dictionary of the Institute for Languages of Finland, another definition of hullu is “wickedly awesome, funny” in contemporary Finnish. This is the definition that, for example, the title Hullut päivät (trans. “crazy days”) carries, referring to the prices of Stockmann’s 5-day long sale.

As modern psychiatry developed in Central Europe in the 19th century, the term hullu was replaced with different diagnoses. Ever since antiquity, madness had been divided into three varieties: mania, melancholy, and frenzy. As the definition transformed into a medical mental illness during the century, the amount of diagnoses multiplied and new illnesses, such as neurosyphilis, schizophrenia, and bipolar disorder were identified. Nowadays, the terms mental health patient and mentally ill are used (The Finnish Blue Ribbon).

So, should the word crazy then be used when talking about the mentally ill? Pietikäinen emphasises that it is not appropriate, unless the mental health patient decides to call themselves crazy, as for example, author and theatre director Juha Hurme has done.

“Juha Hurme is civilised for knowing the original definition of the term hullu”.

”“I don’t know what it’s like being severely mentally ill, either – it is such a distant concept.”

From closed psychiatric hospitals to outpatient care with the aid of psychopharmaceutical drugs

As the focal point of psychiatry shifted from Europe to the United States in the 20th century, psychopharmaceutical drugs to treat mental disorders were developed. Especially the introduction of chlorpromazine in the United States in 1955 caused a significant turn in psychiatry.

Before the invention of psychopharmaceutical drugs in the 1950s, symptoms of mental health disorders, such as suffering from hallucinations and delirium, would be visible in patients as such. Patients could only be offered, for example, sleep-inducing drugs and narcotics such as chloral hydrate (sometimes referred to as knockout drops) and derivatives of opium, which were not very effective. Nowadays the mentally ill receive medication early on in their sickness, thus relieving their symptoms.

Researchers have estimated the introduction of psychopharmaceutical drugs to have led to the reduction of psychiatric beds. For example in the United States, the number of psychiatric beds has decreased to a tenth in 50 years. Whereas in the 19th century psychiatric institutions were often the final station for the mentally ill, few spend their whole lives in psychiatric hospitals in the 21st century.

According to Pietikäinen, the prescription of strong medication is justified because it enables shorter treatment periods as opposed to longer treatment, which is more costly to society. However, medications do not cure mental illnesses, and they should only be used short-term alongside therapy and social support.

“Of course psychopharmaceutical drugs help, and it is good that we have them, but the systems should not be built to rely on them”, Pietikäinen states.

It’s a social engineering skill: from crazy people to proper citizens

The definition of madness studied by Pietikäinen shall not be limited to people who have got a contemporary psychiatric diagnosis, but shall include all those deviants that society has shut out at some point.

Pietikäinen calls this (mis)treatment of individuals who deviate from the norm social engineering. The concept refers to socio-political planning, which aims to change the behaviour of a certain group of people in a desired way. The focal point of it has gradually shifted from prison management to child protective services, education and health care. The concept gained its prominence through philosopher of science Karl Popper’s work titled The Open Society and its Enemies (1945), and it has mostly been employed in Swedish study of history in the 20th century, especially in discussion about social design and in creating “the people’s home” (swe. folkhemmet); a political concept which played a significant role in the Swedish welfare state in the 20th century.

Political adaptation should always be investigated in its context. A hundred years ago, Finnish society designers had very different ideas as to what a proper citizen was like than contemporary social engineers do. The idea of moulding citizens to fit societal needs is still prevalent.

“The expectations of a proper citizen are imposed on students also by pushing you to graduate as soon as possible and enter the working life”, Pietikäinen points out. Utilitarianism is still prevalent: good taxpayers are desired.”.

According to Pietikäinen, the most important difference between former and present times is that instead of using discipline, the mentally ill aim to be helped using rather gentle means, such as social support and therapy.

Discussion nowadays is more accepting, but the severely ill remain invisible

Another clear difference is that mental health issues are nowadays discussed more openly. “If one uses social media at all, they will encounter discussions about mental health.” However, few talk openly about severe mental illnesses, such as schizophrenia. In the media, severe mental health issues are usually only mentioned in contexts of criminal sentences, which further reinforces the stigma.

“It is different to talk about issues that will pass and ease off than to talk about being in some way chained by that illness forever”, Pietikäinen says.

Pietikäinen finds one reason for this to be the fact that people have an easier time understanding minor mental illnesses, such as depression and anxiety. Each one of us has some sort of personal experience of these. It is difficult to treat people with severe mental illnesses naturally, not having any understanding of their disorders.

“I don’t know what it’s like being severely mentally ill, either – it is such a distant concept.”

On the other hand, experiences shared on social media often bring out the heroic and survival stories: people have recovered from depression or some other mental illness and enthuse over how they survived their illnesses, and what it taught them. The idea of the “proper citizen” is visible even behind this narrative. Can only the already-recovered mental health patients fit into modern society?

Improving the connection between the healthy and the ill – could we learn from the past?

Even before the invention of psychopharmaceutical drugs, we aimed to develop alternative treatments for institutional care – some of which could be used as an inspiration even today. A good example would be the family care, invented in a hospital in the village of Nikkilä, Sipoo in the early 20th century, which gained popularity especially in the time between the wars. Nowadays, the term family care refers to children in foster care being placed in a new family.

In family care, a patient would live in a farmhouse near the hospital and participate in the housework. The patient would be a part of the family’s everyday life just like the other family members, but the family would receive a subsidy from the government.

Although family care never became widespread in all of Finland, it has been proven to have had a positive impact on relieving prejudices. According to research, it seems as though people had a more open attitude toward mental health patients in municipalities where family care was practised.

“If family care was, for example, newly adopted somewhere where there had been a mental hospital for, let’s say, 10 years, people in those areas would have more prejudices against the mentally ill and fear them”, Pietikäinen clarifies. “It has been a big help as people have had the chance to see that mentally ill people are not scary or strange.”

The attitude toward mental health issues has changed during different time periods, and the severely mentally ill have by turns been feared, isolated, medicated and listened to. For example in the medieval times, hearing sounds was not necessarily deemed strange, but it was believed that people experiencing auditory hallucinations had a connection to God.

According to Pietikäinen, mental health problems are part of humanity and life – the line between healthy and ill is eventually quite fine. The surprising misfortunes and setbacks of life can lead to depression and anxiety. On the other hand, it has been indicated that in a state of sensory deprivation, a human becomes delirious, anxious, and begins hallucinating in a few hours.

“The mentally ill are, after all, pretty much the same as us so-called normal people. We also have our episodes at times – and there is nothing mysterious about it, nor is there a reason to fear it.” •