International Health Humanities Network: Humanities Subject Area Blog Entries

I would like to share with the IHHN members some reflections upon a project which was created some time ago in the city of Macaé, in the state of Rio de Janeiro. It started as a small project I initiated (at the oupatient services for mental health in Macaé) and grew into a regular occurence, which now not only involves patients but all those composing the community. My thanks to David Reggio for contributing to this blog. 

The Aesthetic Encounters of Urban Heterogenesis

 

Within the shade of a mango tree, time is punctuated by life stories which have otherwise remained obscured from the person, from the health service, from the teams, from the professionals. There is a counterpoint with every word, affect and sensation, where ideas and images interlace amid life experiences. Here, beneath the mango tree are various mental health professionals and teachers, together with service users, their friends and families. Outside the walls of the mental health center, outside of the routines of diagnosis and prescription, social and professional barriers are removed by aesthetic, creative practices which facilitate sharing, community dynamics and meaningfulness. 

These professionals are touched by the experiences of those considered patients and service users, through an aesthetic and affective dimension: a psychiatrist, moved by the descriptions of a patient diagnosed with schizophrenia, spontaneously speaks of the uncertainty of life, and the limits which life has set upon him ; of feeling nothing more than a cog within a machine which produces prescriptions and diagnoses. At this very moment, the thirty people gathered beneath the mango tree, participating in this aesthetic and affective reality, understand that the psychiatrist is also a person.

Many of those present are touched by the psychiatrist’s words; many understand, possibly for the first time, that behind these weighty academic titles, there are sensitive people, with their own lives and dramas, with their own frustrations and hopes.  

 And thus, it is in this way, every week, beneath the mango tree, that the aesthetic encounters of urban Heterogenesis take place: a practice uniting scientific, philosophical, artistic and cultural knowledge, and most importantly, the knowledge of people. It is a project which emphasizes the possibility to develop understanding and the ability to relate to others. That is, to relate to the history and biographies of others, to learn to understand the paradoxes of life and its contradictions, and consequently, to see new paths emerge in a paradigm of sharing and creativity.

Urban Heterogenesis is evidence of how the arts are potential vectors for aesthetic sensitivity, facilitating and enriching the dimension of human contact, facilitating and giving that all important space to new existential meanings which can transform the directions composed by each and every one beneath the mango tree – giving rise to new sensibilities, sympathies and understanding. In this way, bit by bit, medication can be reduced and the prescription a less frequent habit, so that each person can be a self sustaining individual, regenerating and recomposing their existence through an increased capacity to relate and engage with others, with the world, and with themselves.  

The arts and philosophy play a crucial role in creative recuperation and the promotion of community. Music, for example, mobilizes affections and emotions which have otherwise remained contained and pent up within a psychological obscurity. Music, as we see with Urban Heterogenesis, frees up the images which otherwise remains paralyzed in negative histories, and gives new movement and new sensations to a history otherwise negatively represented and understood.  The existential emptiness which many patients feel and experience daily, thus begins to develop contours and begins to be filled by meaning. Indeed, it is the possibility for each person to be affected in a different way, touched by poetic words, spontaneous harmonies, a song or musical phrasing, which means that the void can gradually be filled with meaning.

Diagnoses are discussed and indeed re-evaluated, through the increase in expressivity and in the revelation of facts which had hitherto remained hidden to traditional therapies. Professionals begin to question, through this experience of sharing, contact and revelation, their academic certainties and begin to valorize the knowledge constructed through these encounters, rich in existential meaning. The health institution, or rather, the institution of health, enters into a new landscape when such encounters occur and the importance of community participation, sharing and the possibility of expression become crucial factors.

Here, beneath the Mango tree, we are far from the routine of scheduled consultations. We are in a different landscape where professionals and patients compose another story, of their lives and also of the institution.

 Urban Heterogenesis is thus a practice which makes the paradoxes of life visible. In an institution, with the chronometric regulation of hours and meetings, with the rapidity of prescriptions such experiences are not possible. Within this daily pattern of routine sessions and treatments, there is an opening which emerges, of a temporality which is more fluid, and of a space within which the people do not need to specify a time to be in the group. Friends of patients arrive to participate beneath the mango tree, and those who arrive late, just as those who arrive early, also participate, because it is human presence and the sympathies of sharing with others which are valued and facilitated by aesthetic practices and the creative parameters of Urban Heterogenesis.  

When Urban Heterogenesis occurs in the town square, children and school students participate – it is an open, aesthetic work which defines the true concrete possibility of mutual recovery, personal meaning and community. It has not been uncommon for numbers to reach two-hundred, three-hundred and even four-hundred. Mental health patients, mental health professionals, teachers, artists, workers, professors,  unite to compose life in the heart of the city. And it is within this creative space, where sympathy emerges as a lived reality, where a mutual understanding is aesthetically facilitated, where voices are heard, and where each once of these voices and the narratives it relates, is a fundamental aspect of the overall composition.

Thus the town square, becomes everyone’s space where people develop the capacity to express and speak on a theme they have chosen : some may decide to spontaneously recite poetry, others may dance, others may recount an episode marking their lives, others may play an instrument. At times, a child will speak about living in the solitude of a broken family. At times a school principal will speak of how students that were previously considered aggressive and « problematic », or had « learning problems », demonstrated a new sensibility and way of being after participating in the encounters of Urban Heterogenesis: they had more contact with what was being said in school ; they waited their turn to speak, not needing to use violence as a way to express their frustrations, and they learned to be more compassionate with their fellow students.

The homeless also participate in the Urban Heterogenesis encounter, bringing with them the difficult experiences of living rough.  Here, whether beneath the mango tree or in the town square, they have the possibility of expressing their sufferings, hopes and dreams. Those that were previously without the courage, space or possibility to speak in public are touched by the words and revelations of others, this producing a therapeutic, meaningful and affirmative effect in their lives: to be recognized as a human being and as a person, equal to others by virtue of the aesthetic community of sharing and mutual understanding.

Urban Heterogenesis, is evidence of how creative projects can give new meaning to lives and promote solidarity, sharing, mutuality and community, where the history of the present is built collectively, where there is the possibility for people of all walks of life to participate and share collectively, poetically, where the time and limits of the chronometer, time-sheets, waiting lists, prescriptions, production, competition, wealth, do not form the parameters of experiences and behaviors. Urban Heterogenesis is a project of many possibilities, creative recuperation, yes, but also of promoting solidarity, tolerance, self-worth, contentment, fulfillment and peace in the community through creative means. And this, evidenced in practice. What we see with a project such as Urban Heterogenesis is that health professionals, teachers, artists, children, adolescents and adults have the possibility of participating in a community building project which promotes mutuality and sharing, and where the complexity of human diversity gains its largest sense and value for all present.     

Patients with their diagnoses, children previously considered violent, agitated or aggressive, the homeless and many others, gain a new meaning in these aesthetic encounters, all contributing to a composition of moments where life can be lived without masks, without artificialities, without stereotypes. Teachers begin to udnerstand that knowledge can also be produced outside of the classroom ; health professionals understand that psychiatric diagnoses at times, if not at many times, simplify the experiences of complex human phenomena. The community learns to develop abilities and skills to be with others in acts of collective care, these human skills which are not taught on training programs, or at universities and institutions. Indeed as with musical composition and the initial stroke of the artist´s brush, Urban Heterogenesis is the possibility to live life in its singularity, where there is space for sponteneity and a poetic logic.

Urban Heterogenesis provides evidence. It is evidence that the space and time to think, reflect and feel is fundamental to our understanding, and to the lives of people whether they be school-children, patients, widowers, the homeless or health professionals - all those in fact who compose the diversity of the community. An aesthetic-participatory paradigm for the community, as well as for healthcare and education, can reposition the diminishing hallmarks of humanity within schools, hospitals and institutions. It is in this way that a transformative potential can be articulated at the level of health, education and society, and paths of sympathy, mutual understanding and learning be defined. Aesthetic-participatory projects such as Urban Heterogenesis evidence the inherent qualities of human beings to share their life experiences, to narrate, to listen – qualities which more often than not are either obscured or muted by « common practice » and  « routine ».  For many, going to the doctor, the school, the meeting, is an alienating and isolating experience where compassion, listening and mutual understanding struggle. The facilitation of aesthetic-participatory spaces can mean that people (whether patients, the homeless, the student, the professional health worker) have the possibility to express themselves in a creative and collective context, to learn, to listen, and contribute to a new understanding of themselves and others.

http://heterogeneseurbana.org/