Renata Caruso MeccaI,i; Eliane Dias de CastroII
IOccupational Therapist. Psychosocial Care Center (Centro de Atenção Psicossocial), Prefeitura de Guarulhos. <email@example.com>
IIOccupational Therapist. Course of Occupational Therapy, Faculdade de Medicina, Universidade de São Paulo. <firstname.lastname@example.org>
The use of artistic activities as agents for mental healthcare practices is discussed in relation to the organization of daily life and institutional spaces, in substitutive services, such as at psychosocial care centers. The importance of the porosity of this daily routine to embrace the users' creations and articulate these with the other activities that structure daily life and occupy institutional spaces is discussed. It is advocated that institutional spaces need to reflect the intrinsic characteristics and needs of people who are treated there and for the institution to function as a backdrop for semantic linkage of the subjects' experiences and their possible dialogue with culture.
Keywords: Occupational therapy. Institutionalization. Mental health. Culture. Activities of daily living.
Discute-se o uso das atividades artísticas como agenciadoras de práticas de cuidado em saúde mental, vinculadas à organização do cotidiano e do espaço institucional em serviços substitutivos como os Centros de Atenção Psicossocial (CAPS). Discorre-se sobre a importância da porosidade desse cotidiano para o acolhimento da criação dos usuários e a articulação desta com as demais atividades que estruturam o cotidiano e habitam os espaços institucionais. Defende-se a necessidade de o espaço institucional refletir o estilo de ser e as necessidades das pessoas que lá se tratam, e de a instituição funcionar como pano de fundo para a articulação semântica das experiências dos sujeitos e seus possíveis diálogos com a cultura.
Palavras-chave: Terapia ocupacional. Institucionalização. Saúde mental. Cultura. Atividades cotidianas.
Se discute el uso de las actividades artísticas como promotoras de prácticas de cuidados en salud mental, vinculadas a la organización del cotidiano y del espacio institucional en servicios substitutivos como los Centros de Atención Psico-social. Se discurre sobre la importancia de la porosidad de dicho cotidiano para la acogida de la creación de los usuarios, su articulación con las demás actividades que forman la estructura del cotidiano y habitar los espacios institucionales. Se defiende la necesidad de que el espacio institucional refleje el estilo de ser y las necesidades de las personas que allí se tratan y de que la institución funcione como telón de fondo para la articulación semántica de las experiencias de los sujetos y sus posibles diálogos con la cultura.
Palabras-clave: Terapia ocupacional. Institucionalización. Salud mental. Cultura. Atividades cotidianas.
This article discusses the use of artistic activities in a Psychosocial Care Center (PSCC - Centro de Atenção Psicossocial) dedicated to the attendance of individuals with severe psychic disorders, their possible correlations with the construction of the institutional daily life and with the appropriation and personification of this routine by the service users. We begin with the experience of the group Oficina de Bricolagem (Do-It-Yourself Workshop) of the PSCC of Guarulhos City Hall and propose to evolve an understanding of the experiences developed in the group as facilitators of the embracing of diverse forms of existence and the grounding of these in a network of collective signification.
These experiences are agents of self-recognition in the culture and promoters of feelings of affiliation. The present work composes part of our Masters dissertation in which the group in question is field research.
Oficina de Bricolagem is a group open to users who are receiving intensive and semi-intensive treatment at the PSCC every week and aims to produce artistic works in group, such as: panels, sculptures, installations, among others, which are exhibited in the PSCC environment and occasionally in other spaces around the city. Their purpose consists in making it possible for the users to leave their mark on the composition of environment of the institute and, based on this, work on the bond between the users and the service, such that this becomes a care reference for the same. Fragments of the subjects' history begin to physically compose part of the history of the institution and this begins to reflect the style of being of the individuals who are treated there.
Our investigation followed the participation of 23 PSCC users in the Oficina de Bricolagem for 13 months, though certain passages reported here occurred prior to the collection period, aimed at recovering the group's history. The method used was research-action, which consists of the analysis and reflection of a project of intervention, proposed in the research field by the researcher in joint and interactive construction with the group, intervening in the process of collection, problem definition and data analysis. A process of emancipation and appropriation of the research by the subjects is presumed, since this focuses on the generation of solutions for practical problems and the development of abilities and capacities, making them engage in the research and in the development and implementation of the activities (Meyer, 2005).
Given the context, we considered choosing a method with a strict association with the practice of occupational therapy developed in the workshop, aimed at offering care and attendance to individuals who, due to acute psychic suffering, present fragilized potential for action, because they find themselves in a situation of rupture with social ties, paralysis in the course of their lives, destructuration in their daily lives and difficulty in involving themselves in activities, appropriating them and gaining social recognition through them.
We present a field of experimentation related to doing, contextualized in the therapeutic relationship and in the construction of personal narrative, which is initiated by listening and observation: of the potentials and difficulties of each person; of the desires, expectations, fragments of personal history; of the style of being of the subject impressed on the doing and the personal poetic. From this process, proposals for artistic activities emerge organized as a group project, discussed with the participants and connected with their needs, in a attempt to align the subjects in a common esthetic proposal that opens up space for a poetic event and potentializes the unfolding of this doing in the diverse spheres of life and daily living, making them actors in the process of performing the activities.
The workshop began in September of 2001, when the Guarulhos PSCC moved installations to the location where the Guarulhos Psychiatric Institute used to be, which had been deactivated for several years, the place of internment and traumatizing experiences for many of our users and their relatives. For a while after the move, we lived with the reform of the space, floor surfaces being changed, walls being broken, conversations with the architects to achieve solutions that would better attend the team's projects. During this, we perceived the need to involve the users in this process of transformation of a physical space that reflected the forms of thinking about the disciplines and practices of mental health care for this population.
The proposal was to follow creation processes that brought about the physical transformation of the space based on the users' contents, ideas, projects and desires. Making the PSCC a home for projects for personal development and propose to the users that, during their stay at the institution, they could contribute to the historic event, both on a microphysical level and on a macropolitical level, considering the transformations needed for mental healthcare in the municipality.
According to Saraceno (1999), the work of transforming the logic of attendance during the substitution of the asylum model has a lot to do with deinstitutionalization of the practices, with humanization and rights, with the subjectivation of the individuals, though always and in every moment, it has to do with the concrete spaces in which the individuals eat, sleep, walk and talk. To quote Goffman (1968) apud Saraceno (1999), institutional disassembly is, above all, a work of disassembling the special functions, of the reacquisition of the right to use the spaces, of subjectivation and resymbolization of the spaces in order to legitimize the "magnificent banality of daily living".
The participation of the users in the reform of the institution, both physical and ideological, suggested a name for the group - Oficina de Bricolagem - the DIY Workshop. In principal, we considered the term do-it-yourself in its most common usage sense: using diverse types of building materials to personally and creatively intervene in the reform of environments. Over time and based on the creative processes developed in the group, we perceived that DIY also suggested other meanings linked to the art of combining materials from distinct origins, histories and diverse significations in a joint production, an esthetic production of living with differences.
We believe that the work of concrete intervention in the living spaces encourages a culture of difference and promotes changes both in the way the subjects attended relate to the doing and how they are recognized in it, and in the modi operandi of the professionals of the service. However, for this to occur, it is necessary to move in the direction of potentializing the encounter between singularities, to embrace contact with strangeness and make the experiences collective.
Sennett (1997) warns of the relationship of individuals with the urban space of contemporary metropolises as the place of passage marked by velocity and the passivity of bodies, by individualism and fragmentation. Dislocations grow ever quicker in an environment whose references become secondary. Bodies move passively without obstruction through scenarios that come into view and onto fragmented and discontinuous destinies. Modern individualism has solidified the silence and passivity of citizens regarding difference in an order that signifies lack of contact. Thus, daily life is consumed by efforts that tend to minimize and avoid conflicts with that which is strange. The author points out that even in multicultural metropolises, the people do not embrace difference and, the majority of the time, the best expectation is for tolerance, since the velocity and fragmentation of the medium strengthen quick judgment of the behavior of those that do not belong to the place. The author continues, saying that we will never be capable of capturing the difference of another if we do not recognize our own fragility and strangeness and change the concept of our bodies as self-sufficient. For Sennett (1997), civic compassion should be motivated by this need and not by good-will or political correctness.
For a good while in the workshop, the interests in working with the spaces were directed towards the development of group art works that used materials leftover from the reform. Initially, the encounter with materials remaining from the old psychiatric hospital released memories and the need, both for the team and the users, to transform these creatively so as to mark a rite of passage, a new form of using the space and developing other practices within it. The door of the strong room found among the rubble was fastened to a cement support and gained an eye carved into the wood that, from the outside, watched everything. The old psychiatric hospital flooring was transformed into a mosaic that captured celestial bodies and explosions in outer space. Objects and materials for hospital use were imbued with new signification and their forms suggested other journeys: an old sterilization heater became a ship that carried photographs of relatives and future aspirations. Hospital sheets, kindly donated by the infirmary, turned into painting panels of scenes from the history of each of the users. Leftover patches from the sewing workshop were transformed into a patchwork banner that reiterated stories linked to experiences in the field of doing.
The experiences of artistic creation in the workshop united fragments of the history of mental healthcare and the subjects' personal history and attributed resignifications in order to negotiate transformation in states of being, solidified in the dependence on others, in the place of disease, in the not being able to desire, demand or give an opinion concerning the collective, towards a new shared historical event.
The marks of this process were manifest through the productions, which initiated with the transformation of the strong room destituted of power by means of an allegory of vigilance, up to the painting and sewing of experiences that indicated the desires, needs and life projects of the users. It was necessary to exhume the wreckage of attendance measured by the tutelage and control of bodies and discourses, in order to somehow liberate ourselves and enable ourselves to desire, meet the other and recover their projects.
We believe that this creative passage of the group also reflects the historical transformations in the context of mental health. Perhaps, in substitutive services, we no longer have to deal with the explicit violence of the asylum model, rather with vigilance networks that hidden within the depths of the institutional daily routine and in the use of its spaces. While reflecting on new forms of social control, Deleuze (1992) clarifies that these are exerted by the establishment of continuous and unlimited control, with the "progressive and dispersed implantation of a new regime of domination" (Deleuze, 1992, p.225).
Certeau (1998) developed research concerning daily creativity and the ways in which the subjects subvert the representations, laws and products imposed by the dominant economic order. In this thesis, he uses the term DIY to describe the way in which users consumers of a dominant economic culture operate metamorphoses of the norms that are imposed on them and make use of these according to their own interests and their own rules. Thus, he referred to Foucault to consider substitution of the analysis of localizable institutions as apparatus that exert power, through "devices that vampirize institutions and secretly reorganize the functioning of power: miniscule technical procedures, acting on the details, redistributing space to transform it into the operator of a generalized vigilance" (Certeau, 1998, p.41).
This makes us think about transformations in the logic of the exercise of power within the post-reform psychiatric institutions, which substituted the centralized model of hospital admittance. Daily exercise of self-evaluation of the teams and criticism of the practices is needed, which, within their details, channel the vigilance and tutelage and that, in the face to face relationships with the users, operate control of behaviors and the institution of ways of being and doing merely adapted to social norms. This type of practice tends to evoke constant emptying of human doing, which becomes mere execution of tasks and gradually looses social recognition. As we see it, this is a permanent risk in substitutive services.
Guatarri (2005) points out that in contemporary time, the exacerbation of the production of material and immaterial goods in detriment to the consistency of individual and group existential territories engender a void in subjectivity, which tends to present every fewer resources. According to the author, we are currently living through degradations in the three ecological domains in which subjectivity is established: the mental, social and environmental. He proposes the construction of a new ecosophical reference that indicate lines of recomposition of human praxes in the most varied of domains in that which concerns daily living. It involves examining the devices of the production of subjectivity, in the direction of the individual and/or collective resingularization. From a perspective of constant reinvention, in counterpoint to processes frozen in repetitions, the author uses the esthetic paradigm to reconfigure practices in the field of health, in which each concrete performance inaugurates prospective openings for the construction of existential territories, based on the praxis that makes it inhabitable for a human project.
Currently, the dominant culture uses daily living as the forefront of their strategy of action. Signs that were previously transmitted by normative authorities, such as the Church or State, today are propagated by the media of mass communication, which broadcast, with intensity and omnipresence greater than the former entities, normative standards and homogenizing values that end up being incorporated in to the lives of the consumers (Dias, 1998).
However, based on this, Certeau (1998) questioned: if it is true that a network of vigilance extends all over society, how is it that an entire society is not subdued by it? What popular procedures allow society's subjects to escape, play with and alter its mechanisms of discipline? Certeau (1998) develops the thesis that it is through the "ways of doing" of the subjects that consume the products and norms of the dominant culture that they reappropriate the space organized by the techniques of socio-industrial production, in a creative attitude which he names "bricolador", since it combines innumerous and infinite metamorphoses of the singularized norms and ways of relating to them.
His thesis puts questions analogous and contrary to those approached by Foucault:
Analogous, because it involves distinguishing the microbe-like operations that proliferate within technocratic structures and deflecting their functioning by means of a multitude of "tactics" articulated in the "details" of everyday life; contrary, because it no longer concerns how the violence of order is transmuted into a disciplinary technology, but to exhume the tactical and surreptitious forces that are assumed by the bricolador creativity of the groups and individuals trapped within networks of "vigilance". (Certeau, 1998, p.41)
We also remember diverse ways in which the PSCC users subvert and appropriate the logic of its functioning through the proposals of the artistic activities, placing themselves in the constitution of the spaces that compose the institution and in the structuration of their daily life. In terms of an institutional analysis, a reconstruction, who efficacy is of an esthetic-existential order, concerned less about laws or bureaucratic programs and more about the promotion of innovative practices through the dissemination of alternative experiences, centered in the respect of singularity and in the permanent work of the production of subjectivity, which gains autonomy at the same time that it articulates towards the social (Guatarri, 2005).
INSTITUTIONAL DAILY LIFE
The concept of quotidian, in the common sense, appears to be confused with the idea of routine, of facts linked in continuity, of a field of need and repetition, of an area reserved for consumption and the dominant culture. However, for many contemporary thinkers, this concept differs from routine, since it refers to change, the dissolution of cultures, possibilities of new ways of being. This points to a meaning linked to desire, to space, even to a possible cultural revolution, since it is always in the process of being reinvented by the practices of resistance to hegemony and survival strategies at the edge of domination, which implies intersubjective sociabilities and articulations, rather than discourses between conscious individuals (Dias, 1998).
We assumed as a reference that which Heller (1972) outlined as daily life, understood as the center of the historical event and of human life, because within it the individual participates in all of their individuality and personality. It is constructed in the social relationships and presents as an intersubjective world, a universe whose participation occurs with other individuals and that has human activities as its structural elements. The activities compose a structural network of the quotidian and for it to proceed, it requires a certain dose of pragmatism, generalization and imitation in the way that behaviors and conducts necessary for the realization of daily activities are assimilated or incorporated. We perform daily activities automatically, with little reflection regarding the actions that are processed, and establish generalizations or analogies of a situation with others so that we can react or decide in the quotidian in a way that maintains its continuous flow. However, if characteristics like pragmatism, imitation and generalization occur in daily life, this becomes routine and stops providing a margin of movement to the singularized form of understanding and development of activities and alienation from everyday life occurs. When we think about daily living that points towards health, it should be constructed based on each subject's choices and shared in a network of encounters capable of absorbing what the subject can express, the emergence of desire and meaning. Daily living that presents as porous to the appearance of the unusual, the strange, the diverse form of being and of being in the world, the possibilities of creation and of meeting of that which is itself with that which is shared.
We speak about health in the sense expressed by Winnicott (1996), as the subject's capacity to achieve a certain identification with society without losing many of their personal impulses. Health has a direct link to the possibility of social participation and with creativity of the subject in a relational field. Feeling like you live your own life, recognizing yourself in it and being recognized; being in the collective without losing that which is yours.
In the PSCC, daily living can be constituted by this network of meetings and interlacing trajectories that configure an ambience. The ambience is the broth, the surrounding environment that provides sustenance and consistency to the experiences lived by the subjects and their significations, which can be transformed based on their needs. It is the ambience that differentiates the daily life of the PSCC, in which participation can be experienced. Participation gains a recognized place in the environment and it is participation that will constitute this environment, differentiating it from an alienating routine of isolated and enclosed activities. The choices of activities and the meanings attributed to them provide the tone of this difference.
In institutions, this quotidian tends to be traversed by procedures committed to technical knowledge and disconnected from the emergence of the unusual, of desire, creativity or personal potentialities.
According to Maximino (2006), institutions are a series of relationships and it is impossible to escape them, since they organize collective efforts and achieve results that we cannot achieve alone. Generally they are born flexible and alert to the needs of their members; however, over time, they become more bureaucratized and removed from their initial objectives, often spending all of their energy maintaining their own survival. Under the judgment of the medical, legal or pedagogical discourse, the subject's needs and resources are silenced and these become cases. Life and the creative possibility so essentially human become poorer.
In this situation, a continuous effort of the teams in the appearance and recovery of each individual as a person and of the humane in the constitution of these environments is required. Where every single person, with their story, their way of being and doing can emerge and evolve, not in the Darwinian sense of less to more evolved, rather as a school of samba performs in the avenue. Evolve in the sense of constructing a personal trajectory, personified and recognized in its passage, leaving an esthetic mark in the ambience, gaining territories for its existence.
We believe that actions in mental health that are oriented towards the construction of environments that facilitate the construction of subjectivity and citizenship should examine the institutional quotidian, in its relational microstructures, as a network of multiple negotiations (Saraceno, 1999). This, in the sense that it is articulate and flexible, increases the subjects' participation and social contractuality. Through this network, it is possible to construct the spaces needed for the human dimension, the occurrence of oneself and the sharing of this event.
According to Saraceno (1999), one of the axes upon which the contractual capacity of mental health patients is constructed is inhabiting. The quality of life and the contractual power are represented by how much being anywhere becomes inhabiting in this place. Inhabiting refers to an appropriation of the space by the individual that demands a high degree of contractuality in relation to the material and symbolic organization of the spaces and objects and their emotional division with others. Inhabiting is differentiated from being, which refers to an anonymity of the individual in relation to the space that does not reflect their needs or power of decision.
APPROPRIATION OF THE QUOTIDIAN AND SUBJECTIVATION OF SPACES
By proposing that the users intervene creatively in this ambience by means of the artistic act, the Oficina de Bricolagem made it possible for an esthetic experience to permeate the relationship of the individuals with the institution, its daily life and the forms of attendance that it proposes. It also permitted them to resignify and reconstruct the network of activities and relationships that articulated the daily lives of each individual and everyone at the same time, residing in this territory significantly and in their own way.
Stories, desires, ideas, images, forms without previously associated meaning appeared and were articulated in a joint composition. The structure, materiality and time required for the realization of the artistic activities marked a narrative of the historic occurrence of the encounter of each member with themselves and with the others.
This quotidianity of doing in group favors the appropriation of this doing by the users and often this same experience proportions the articulation of other such actions between themselves in the daily exercise of numerous activities. The activities cease to be entertainment or mere tasks and begin to recover what is imminently human within them: the sense they make when doing them.
Artistic activities, when performed in a facilitating environment, permit the articulation of this doing with the remaining actions that compose the subjects' everyday lives, they proportion the construction of new networks of social bonding and rupture with rigid cultural representations that discriminate and stigmatize certain actions and ways of being, because they diverge from the imposed standard. This generates interest for new possibilities of activities, a desire for technical instrumentalization and poetic expression, i.e., other pathways and not just attendance based on the disease (Castro, 2000).
From painting emerged the desire for a group trip to art an exhibition and from that, new gestural forms for performing brushstrokes, of composing colors or of giving expression to human figures were considered. For the mosaic, we went to a joinery shop to mount a structure that could sustain it; for the composition with words, we went to the library to search for books on concrete poetry. Meetings and activities were engendered and began to offer sustenance to the subjects' living experience and grounded the productions in the world of things produced by humans. By transforming the daily life of the institution, this process modified not only the users, but the members of staff as well, who participated in the groups with their own productions and recognized, in the users' production, aspects of their individual history and creative potential.
In occupational therapy groups, it is not rare for people in the team to participate, instigated by the process of performing activities. Normally, the professionals give an opinion regarding the user's production or explain how things should be made, maintaining a relationship based on the technical discourse. In the workshop, this is ruptured the moment that diverse production is legitimized and it is also liberating for the team who are invited to enter into contact with their own production and let themselves be touched by the users' production.
Several nursing assistants, a nurse and a psychiatrist entered the group and made clay decorations for the group mosaic. Mobilized, they continued producing and made several pendants for necklaces based on the decorations, which they used and some gave away as gifts at the June festival. One of the psychiatrists used to enter the group and give opinions concerning the users' production, saying what he liked and did not like, what color he thought should have been used or the placing of certain elements in the compositions. One particular day, he entered the group and encountered the earth floor painted by a user who, during an entire session of work on mixing colors, had reproduced the color of the earth of the city where he was born. Coming face to face with that figure of a Labrador on a red earth floor, the psychiatrist exclaimed that it was the color of earth of his infancy and so the user and the psychiatrist began exchanging memories and recollections. At that moment, the hierarchy mentioned above was ruptured and human to human contact was set in motion by a shared esthetic experience.
In a bricoladora (DIY) operation, users and technicians found each other in the gestures and sensory forms created, in a work of semantic articulation of ways of being and ways of doing, which reconfigured the geography of practices and created other representations in relation to the patients, their creative capacities ad possibilities for social participation.
Artistic and spatial composition initiated a place change for everyone. We describe a process of action and creation in the world, in which ways of doing are forms or fields of experimentation and operate the inscription of humans into the world. In the artistic creative process, the individual creates imagetic and sensory forms that transmit sensations and visions of the world. When these sensations are actualized by the presence of a significant other they permit that the person constitutes aspects of the self, thus they can exist in the world (Safra, 1999).
Contact with the materiality of forms and the processuality of artistic creation intervenes in the space shared with the other, producing a semantic articulation of the unusual, the strange and the genuine, transforming routine and preestablished spaces and resignifying them using creative potency.
Those who enter the Guarulhos PSCC are faced with a tree peopled with human figures; those who walk through its corridors enter in contact with scenes of love and others of criticism, forms that remember aquatic animals; those who eat there, live among skeletons and everyday objects that adorn heads in the refectory. "Where do I get my medication? - There, at that balcony of plants and butterflies".
The workshop proposed that the subjects' creation experiences were topologically grounded in the architecture of the institution and processually grounded in its continuous flow of daily living.
According to Kujawski (1988), daily life includes the individual in the plan of life in community and the continuous succession of its events function as an irrefutable community grammar, which we fill up with our personal creativity.
The quotidian is constituted as a processuality that provides shape for our experiences and, when it remains in constant transformation, opens doors so that the subject can change this course. This continuity initiates the living process for these subjects whose lives appear stagnated in a succession of the same events.
With the experiences of group creation, what you live is no longer more of the same, but the same transformed by the thing that creates itself, a constant becoming.
While evaluating the process of concluding a painting panel in the workshop, the users manifested interest in remaining in a constant working process. When finishing the project, they said that after our dissertation had been written, that we would mount what they denominated as a new creation team to do another project together with new people. They also explained the requirement that this work occurred in another space that was not the PSCC, since it concerned a cultural work, which they had entitled: "artecultural"; therefore, it should be shared with a larger number of people. They showed concern about publicizing the production and the theoretical production of this process in a Masters dissertation.
One user compared the process of realizing the group activities with his experience of working in companies. "Makes you want to continue. One job inspires the next one and it don't ever stop" (sic). Obviously, for him, this flow stopped when he got ill and for many years, he did not see himself as ever being part of some shared process again.
The habitual erosion of the grammar of everyday life makes the realization of an individual life project unpractical, due to the lack of support in this social infrastructure that is an organized articulation of daily living (Kujawski, 1988).
It is the semantic and topological articulation of the subjects' experiences that grounds these in the human world. Daily life activities promote this grounding and sustenance, since despite or even because so many situations happen to us, everyday life remains like a backdrop that provides us with form and direction. It is the everyday that repeats itself and allows us the sensation of continuity in our existence; the river where our experiences navigate.
We believe that the process of realizing artistic activities by the service users must be articulated in the wider context in which they are inserted: the quotidian of the institution that permits that experience, the subjects' daily lives and the culture.
For the articulation of this cultural doing to occur and to engage the pursuit of the subject, the institution and the quality of the porosity of its daily life have a fundamental role. The institution and how it is organizes its daily structure can function as a bridge for the articulation process, as long as it supports it and cedes space for the subjects' genuine production and ways of doing. Remaining as a backdrop is necessary so that these experiences unfold, provoking dialogues with the outside.
Even so, it is important that the institution remains a home, so that the users can reside in it, truly have it as a reference for the construction of projects whenever necessary, making possible a point of departure for grounding in other territories, permitting the continuity of the existence and feeling of belonging.
Our current understanding of the experience of the Oficina de Bricolagem extends to the way it assists its participants in the semantic organization of their daily life experiences and facilitates recognition of themselves, so that their production can gain access to the outside and provide meaning for others. For the experience to really promote the feeling of affiliation for individuals who, frequently did not feel they were participants of humankind or of a culture, understand that work is not exhausted in the continuous creation of new ways of being, since these must gain collective signification, so that, articulated within a network of sustenance, they can create new territories of existence and affirm the differences that arise (Lima, 1997).
In this work, it was possible to perceive that this collective signification is already engendered in the institution due to the fact that the workshop, in its openness to the processes of individual creation and to forms of culture with which they dialogue, also engenders the seed of creation in the team. In many sessions, it was possible to observe technicians instigated by what was realized in the workshop, entering and doing their own works. If that which is done in the workshop is "artecultural", as the participants say, it is something that provokes changes in everyone and, at this point, the hierarchy between technicians and patients, common to health services, is ruptured. It is important that everyone creates, technicians and users, giving form to that which is genuine in themselves, constructing space for diversity.
According to Guatarri (2005), it is in the complex whole of heterogenous fronts that new ecological practices should be articulated, whose objective is to make isolated singularities processually active, spinning around themselves. Engaged in a process of heterogenesis, private cultures should be left to develop, at the same time as inventing other contacts of citizenship.
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i Address: Rua Bartira 878 Perdizes, 05009-000 SÃ£o Paulo-SP