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Opinion ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychiatry | doi: 10.3389/fpsyt.2019.00613


 Gentian Vyshka1* and Ariel Çomo1
  • 1Faculty of Medicine, University of Medicine, Tirana, Albania


Albanian society suffered deep changes and restructuration following the immediate post WWII war, and if it were not enough, the societal trembling never stopped for decades thereafter. The population was forced to live under a constant psychosis of war, with an imaginary ‘enemy’ at the gate, apart from multiple everyday restrictions and an almost complete isolation from the neighboring countries [1, 2].
The second world war (WWII) in the form it affected Albania, with subsequent invasions of fascist Italians and Nazi Germans, was almost simultaneously tinged with the colors of a civil war. Border skirmishes in the northern areas with Yugoslav partisans, sometimes synchronizing and sometimes antagonizing with the crimes perpetrated from Albanians communist themselves; along with Italian-Greek war whose hostilities partly took place within Albanian soil, all these factors and other, will obviously render the theme of war, martyrs, heroes and survivors, a highly debated one and widely mentioned for decades thereafter [2, 3].
The moment when communists started ruling Albania might have seemed as coinciding historically with the WWII end; instead the war of obviously not over. The psychosis of the war kept on looming with ebbs and tides during more than forty years (1945-1990), but it has almost always been there: in the air, in the mind, forecasted and broadcasted from official mass media in an unrelenting form [4].
The psychiatric and mental consequences following war, post-war, chronic exposure to hostilities, ill-treatment and torture related to belligerencies, have been largely studied among Holocaust survivors [5]. Other authors have enlarged their scope of study, and even of the diagnostic notions generated from war-related settings [6, 7]. However, large-scale studies on the probable influence of an imaginary but impending war, fomenting continuous fear, avoidance behavior and maladaptive coping style in a large scale, thus potentially affecting generations of a post-war society, are generally limited to a PTSD model, even when there is overlapping symptomatology [8].


The communist propaganda took particular care into pressurizing the general population continuously with fear of an impending aggression. The case of Albania might be not the only one; however, the forms of influencing general opinion and fomenting feelings of incessant aggression have been documented widely during the cold war [9].
One of the most productive and efficient mediums into making Albanians believe that the war was not over, and if not yet exploded at least it was imminent, was the graphic representation of recalling war. That mission was performed through flooding the country with tombstones and headstones of the dead patriots, mainly of WWII. The extension of these graphic monsters inside the territory was immense, and the writings over these stony premises evoked the incessant presence of the heroes: these are and must be immortal, i.e. still alive and among the people.

Image 1: One of the innumerous stony monuments spread over the Albanian territory in the memory of WWII heroes. Some stony figures representing partisans at the left side of the image actually reflect the erosion that the time has played over the structure and its importance: heroes stand up close to a garbage pile.

The number of stony monuments (‘lapidar’ – from Latin lapis, lapid- ‘stone’) exceeded 500 all over the Albanian soil, and was clearly decreasing after 1990 due to degradation, removal or deliberate destruction [10]. Nevertheless, their massive presence for almost forty years (their construction started almost immediately after the end of WWII) should have played an important role into the general opinion approach toward the alleged immortality of heroes.
The stony structures were obviously not the only way that the official propaganda kept on imposing beliefs to the population. The idea of eternity or of immortality of heroes fighting against the enemy, timely restricted almost during WWII years alone, has been a predilection for movies, media and literature [11]. Working always under a very strict censorship, almost the entirety of authorship, papers, movies and pictures produced, highlighted much or less the official policy of the governing party: some free space could have been found solely in the interaction between the official doctrine and the individual contributions to public discourse [12].
The indoctrination and perseverance over the theme of war, mixed up with a sense of glorification towards the dead, was obviously spread all over fields of society. In an attempt to control incessantly the general opinion, war (mainly WWII) and its aftermath were immortalized in sculptures, pictures, movies and written media of all forms: from everyday journalism kitsch to serious literary works of hundreds of pages.

Image 2: Graphic art works from Albanian authors covering the war theme; left inset: a sculpture with a partisan defeating a Nazi soldier; right inset: a picture reproducing a guerilla act of bombing an enemy tank. The enemy was always there; defeated, but still alive and capable of doing evil things.


The novel “General of dead army” of Ismail Kadare has been published in Albanian in 1963, and thereafter translated in several languages and re-published, with the first translation in French some seven years after the launch. The plot is focused on the everyday miseries and passions of an Italian general, visiting Albania with the aim of exhuming and repatriating the remains of the soldiers, fallen during the lost battles of his country’s army that invaded Albanian soil during WWII.

Image 3: Cover of the French version of ‘The General of the dead army’, Ismail Kadare (Edited from Albin Michel, Collection: Les Grandes traductions, 1970).

A particular psychopathological condition is depicted, especially through identification and misidentification delusions that gradually occupy the psychic horizon of the general. Believing himself as immortal and identifying his own image with the image of a lost corpse, that of the colonel Z, the general ambivalently pursues in an unrelenting search the fate of the dead colonel, and still conceals the remains of the latter, through dispersing the bones immediately after uncovering the skeleton. This psychic drama of the delusional belief in immortality, the particular setting of a post war environment, and the figure of an army general collecting exhumed skeletons, are the composing parts of this tricky history of psychotic despair.
The history of exhuming soldiers’ corpses from Albanian soil has been a long one, and recently flared up again with the re-burial of Greek soldiers fallen during the Italian-Greek war of ‘40ies. Italian; British and German soldiers have had also their historical share and war cemeteries have been built up to honor respective sacrifices.

Image 4: Cemeteries of German (above inset) and British soldiers (below inset) in the hilly suburb of Tirana, Albania.

The novel General of dead army was an artistic mirroring not only of the repatriation of Italian soldiers remains, something that was organized and performed some ten years after the WWII was over. The person in charge of the real mission was a military chaplain or maybe a little bit higher in the ecclesiastic hierarchy; whereas the writer in the novel separates the man in charge into two characters: that of the General and of the Priest.
Uncovering skeletons and packing human remains is obviously not a simple and psychically neutral job. The General itself will endure the hardship of digging the past. The hostilities might have been really over, but the atmosphere encircling post-war life could not have been pacific. In a desperate attempt to uncover primarily the remains of a certain colonel Z, the General identifies himself with the lost colonel. He starts flirting with his beautiful widow, and through undergoing the delusive process of identification with the lost corpse of the colonel, the acting character (the General) goes through nightmares, flashbacks, insomnia and delusive thoughts about a war he never fought. After the serendipitous discovery of the remains of colonel Z, he decides to throw out the sack with his bones: at that point, the delusion was over. Unable to accept the wrongful and delusive identification, the General could not stand the idea, that after all, he was identifying himself with a person killed during the WWII at least a decade before. The belief in immortality stood strong for at least two hundred twenty pages of a novel composed from a total of two hundred sixty and so; the lines below describe the moments when the General gets rid of the remains with whom he identified himself a long deal, till the uncovering of the bones corroded his delusion:

“…The general stumbled form the second time over the sack.
It’s this sack, he thought suddenly. It’s this sack that’s the trouble. It’s almost done for us once tonight. Up until now everything had been going perfectly, but now this sinister sack has forced its way into our lives and everything is going wrong!
“It’s this sack that’s put a jinx on us,” he said out loud.
“What did you say?” the priest answered.
“I say that this sack is bringing us bad luck,” the general repeated.
And as he spoke he gave it a vindictive push with his foot. The sack tumbled down the slope and fell with a resounding thwack into the water flowing at the bottom…” [13].


It might seem that the novel General of Dead Army is a solitary reflection of the post WWII Albanian society vis-à-vis the recent past. Instead, partly reckoning the legacy of Italy’s fascism, the ravages of the Italian invasion and occupation, the writer deals a lot – although implicitly – into examining the Albanian present [14]. As if writing under socialism was not an easy job, however, the regime itself used and abused widely with the ability that possess arts and literature as media, in order to influence general opinion, modulate beliefs, and shape emotional products [12, 15].
The literature and arts in the post WWII Albania were state-sponsored and therefore, deeply mirroring the official ideology. The novel ‘General of the Dead Army’ (‘The General’) was one of the most successful and read; it was included in the study of literature at almost all school programs covering levels from the obligatory education to the Universities. All together, the bulk of written literature and graphic arts produced and sponsored, reflecting the war heroism and its aftermath, aimed at creating the subconscious feeling of immortal conquerors.
In order to complete the illusive immortality paradigm, the presence of the enemy needed to be kept uninterrupted and obviously, threatening. The General dealt with exhuming corpses of his nation’s army that was defeated in Albanian soil during WWII, but through a continuous work of emotions and psychic byproducts, the General itself underwent a delusional situation. While flirting with the widow of the dead Colonel Z. and vesting himself as his reincarnation, he was dealing right from the start with a hostile if not a very unusual environment: Table 1 reproduces some from the terms depicting where his job, and his delusion as well, had to be worked out.
The quotes and pages of the Tables 1-3 are picked up from the English Version translated by Derek Coltman (Vintage Books, 2008) quoted here below as reference no. 13.

Table 1: Describing the unusual setting
Page Quotes from the text [13]
3 Foreign soil
3 Menacing mountains
9 From graveyard to graveyard
9 His campaign against the mud
42 …slits were vertical then the little forts had a cruel, menacing expression
67 The circle of bystanders was gazing at them with popping eyes
203 Generals always inspire respect

The menacing mountains and the foreign soil were only the background of a very hard work (page 3) because the General was meant to run from a graveyard to the other, in his desperate campaign against the mud (page 9) [13]. His counterpart, the Priest that is accompanying this grizzly pilgrimage, will mirror some ambiguous feeling that probably are intrinsic to the main character – the General itself.
Some emotional play is carefully described through the gaze and the facial features of workers employed to perform exhuming work, or bystanders that curiously follow up the General incessantly during his journey: Table 2.
Table 2: The general & his counterpart: emotions and psyche
Page Quotes from the text [13]
4 Feeling of pride
5 …face devoid of all expression
6 …companion’s taciturnity
11 Expressionless features
11 Absent gaze
12 …felt alarm run through every fibre of his being
19 …severe profile and impassive, masklike features
43 Indecipherable expression in the villagers’ eyes
43 We remind them of the invasion…
53 Heavens! Anyone would think I’m having hallucinations…
125 “A nightmare,” the priest said. “Another night I saw Colonel Z. in a dream…”
137 …even a sort of evil spell, something sinister anyway, dogging this work of ours…
138 Sense of oppression
217 I must sleep, he thought. Sleep, sleep… I must sleep at all costs

The feeling of pride of the General (page 4) will be soon mutilated from the taciturnity of the Priest, his companion (page 6); but this is just the beginning of the flourishing of a delusional situation. The General himself speaks about hallucinations in the page 53; some seventy pages further he has a nightmare dreaming of the dead (yet immortal) Colonel Z. (page 125). The evil spell is pounding over the psyche of the main character, the oppression (page 138) is replaced from severe insomnia (page 217).
Not less interesting are the dilemmas and thoughts coming from the afterworld soldiers in form of short notices in between main chapters of the whole novel: Table 3.

Table 3: Words from the afterworld
Page Quotes from the text [13]
14 Don’t worry, your grave’s going to be deep, really deep
14 …not to leave any clues behind, for fear someone might just notice something and dig his body up again.
61 …I have crossed over into a kingdom of bones, of pure calcium
77 …you’ll die like a dog and no one will be able to recognize that carcass of yours
83 Such exaggerated attachment to a husband who’s been dead twenty years…
88 …any greater satisfaction for an old soldier than that of pulling his old enemies back up out their graves? It’s like a sort of extension of the war

The author himself will come to an end with the idea of the everlasting war: the exhumation – if not profanation of graves – is a sort of extension of the war (page 88).
All these written material; and other art works reproducing (even fictionally) the WWII and its aftermath, have been served to the Albanian public: hence the psychological effects of keeping the hostilities alive even when there was no war to fight [16]. The enemy was there: exhumed and therefore still able to fight and provoke damage; the immortality of heroes (partisans) could not stay erect if this page was closed. The never-ending war will deeply influence society and its generations; not occasionally an author suggested that the future of Albania even after the death of communist dictator would have been conditioned more from its past, rather than from international developments [17].


According to DSM-5 delusions are fixed beliefs, not amenable to change in light of conflicting evidence [18]. Cotard’s syndrome is a rare and uncommon syndrome, which is characterized by various symptoms such as nihilistic delusions, hypochondriacal delusions, delusions of immortality, depression, and anxiety [19]. Its coexistence with other forms of delusions might be quite well possible within the background of a florid psychopathology [20]. The fictional case of a psychotic General dealing with the hard work of exhuming and repatriating soldiers remains from a recently fought war is just an illustration of how the propaganda fomented delusions.
Assmann discusses the concept of pietas referring to religious rituals in the Ancient Greek literature, and the concept of fama defined as the glorious memento of individuals after death and the immortalizing of the name of deceased [21]. The communist regime in Albania tried hardly to suppress religious feelings but the virtual immortality it granted to the war heroes probably contributed exactly to the contrary. Other authors have also commented on the fact that humans intuitively believe that they survive death, although from a quite different perspective [22].
In fact, post-WWII Albanian society has been living under the burden of an unrelenting war psychosis: the enemy was at the gates, and if not ready to assault, it was just a question of time. The huge number of concrete bunkers (more than one hundred seventy thousands) scattered over the small territory of the Mediterranean country converged into the creation of the state of siege. Literature, graphic arts, movies and all mass media was serving at this idea: the war was not over. Hence the heroes were still alive; their immortality meant the same for the enemy too.

Keywords: Delusions, immortality, WWII, War psychosis, society

Received: 03 May 2019; Accepted: 01 Aug 2019.

Edited by:

Thomas Wenzel, Institut für Ethik und Recht in der Medizin, Medizinische Universität Wien, Austria

Reviewed by:

Türkan Akkaya-Kalayci, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Austria
Heinrich Graf Von Reventlow, Nexus Clinic Baden, Germany  

Copyright: © 2019 Vyshka and Çomo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Gentian Vyshka, Faculty of Medicine, University of Medicine, Tirana, Tirana, Tirana, Albania,