community therapy: a participatory response to psychic misery · 2018-10-15 · a participatory...

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The International Journal of Narrative Therapy and Community Work2010 No. 4 www.dulwichcentre.com.au


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adalberto Barreto & marilene grandesso (with reflections from David Denborough and Cheryl white)

AdalbertoBarretoisaProfessorofCommunityHealthintheSchoolofMedicineatthe

UniversityFederalofCearaBrazil.Heisapsychiatristandananthropologist,andisthe

originatoroftheCommunityTherapyIntegrativeapproach.Hecanbecontactedc/-email:

[email protected],seealsowebpagewww.projeto4varas.com.br

Thiscollectionintroduces‘communitytherapy’whichhasbeendeveloped

inBraziltorespondtovariousformsofsocialsufferingand‘psychic

misery’.Thecollectionincludesanintroductiontothehistory,keytasks,

andstagesofacommunitytherapygathering;adescriptionofoneexample

ofacommunitytherapymeeting;andabriefexplorationofhowideasfrom

narrativetherapyhavebeenintroducedintocommunitytherapypractices.

Keywords:communitytherapy,localknowledge,outsiderwitnesses,Brazil,externalising,communitas,narrativetherapy

Community therapy: A participatory response to psychic misery

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34 The International Journal of Narrative Therapy and Community Work2010 No. 4 www.dulwichcentre.com.au

INTRODUCINg COmmUNITy TheRaPy

Adalberto BarretoCommunitytherapyinvolvesrespectingtwo

differentformsofknowledge:academicknowledgeandlocalknowledge.Ibelievethattheexclusionanddiminishmentofpeople’slocalknowledgeisakeycontributortopsychicmisery.Whenpeople’slocalknowledgeisdevalued,thisleadstoaninteriorisationofmisery:miserybecomesaninternalexperience.Insomeways,psychicmiserybecomesaproblemoffaith.Whenpeoplenolongerhaveabeliefinthemselves,orafaithintheirownknowledge,thisbringspsychicmisery.Andthesituationismadeworseiftheyseekassistancefrompeoplewhoonlyvalueacademicknowledgeanddonotvaluelocalknowledge.Oneofthekeytasksinrespondingtopsychicmiseryistoenablepeopletobelieveinthemselves–toassistotherstohavefaithintheirownknowledge.

a BRIef hISTORy Of COmmUNITy TheRaPy

MybrotherisalawyerwhowasoftenconsultingpeoplefrompoorcommunitiesinFortalezainthenortheastofBrazilaboutlegalmatters.Wheretherewerepsychicrepercussions,psychologicaldifficulties,relatedtotheselegalmatters,hewouldreferthemtomeasIwasworkingasapsychiatristinauniversityhospital.Oneday,attheuniversityhospital,eightpeoplesentbymybrotherturneduptoseemeandmystudentsofpsychiatry.IrealisedonthisdaythatIwasn’tgoingtobeabletokeepupwiththenumbersofpeoplewhowantedtospeakwithmesoIdecidedthatnexttimeIwouldtakemystudentsofpsychiatryandwewouldgotothefavelas(shantytowns).Wewouldseethepeopleintheirowncontext.Thenexttime,however,whenIarrivedinthefavelaswiththestudents,33peopleturnedupfortheconsultationandIdidn’tknowwhattodo.Ididn’thaveanymedicinestogivethemandsothissituationmeantIhadtostartspeakinginadifferentway.

Isaid,‘Look,Ican’tcomeheretocureanydiseasethatyouhave.Instead,I’vecomeheretocuremyowndisease’.ThepeoplelookedatmeinaveryfunnywayandthenIsaid,‘Areyouhappywiththedoctorsthatyousee,thedoctorswhoseeyou?’Andtheysaid,‘No.Theydon’tlookatus.Theydon’ttouchusandtheydon’tstaywithus’.

Ireplied:‘Well,look,Iamtheirteacher.IteachthesedoctorsandthesepeoplewhocometoyourcommunityandsoIwantyoutoteachmehowIcanmakethemmoreeffective.I’mheretocuremydisease.I’mheretocuremyuniversityalienation.I’mheretocuremyselffromtheideaofthatIshouldknoweverything.Becausewhenwecomeherewerealisewedon’thavethemedicinestogive.Wealsorealisethateachoneofushasknowledges:thereareAfricanknowledges,Indigenousknowledgesandexperience.I’dliketofindawaythatwecouldshareourknowledgeinthiscontext.I’mnolongercomingheretosolveyourproblem,buttosolvemine.Perhapseachoneofuscansolveourownproblems,andperhapstheonlywaywecandothisisthroughacommunityrelationship’.

Atthispoint,westartedhavingabroaderpublicconversationorpublicconsultation.Peoplestartedtospeakabouttheparticulardifficultiesthattheywerecurrentlyexperiencing.Onewomansaidthatshewasunabletosleepbecauseshewashavingvisionsofkillingherhusband.Atfirst,Itriedtoprescribehersomesleepingpills,butthewomansaid,‘Look,you’vegivenmethispaper,thisprescription,butit’sactuallynogoodforus.Idon’thavethemoneytobuythemedicationthatyou’veprescribed.Theonlygoodthatthisprescriptioncouldpossiblydo,wouldbeifImadesometeaoutofthepaperitiswrittenon.That’showusefulthisprescriptionisforme’.

AtthispointIsaid,‘Okay,that’snotsogood’,andthenIaskedthegroup,‘Well,howmanyofyouherehavehaddifficultieswithsleeping?’,andmanydifferentpeopleinthefavellaatthattimesaidthattheyhadhaddifficultysleeping.Istartedaskingthem,‘Well,whatdidyoudo?’.Onepersonsaid,‘Look,IhadtroublesleepingwhenmysonleftthefavellaandwenttoSaoPaulobutIusedthiscertainteatocalmmedown’.Anotheronesaid,‘Iusedmassage’.Anotheronesaid,‘IspokewithmyfriendeachnightbeforeItriedtosleep’.Thereweremanydifferentideas,manydifferentexpressionsoflocalknowledge,thatwereshared.Iwastakingnotesandwasveryimpressed.

ThiswasthemomentwhenIrealisedthatsolutionscouldbefoundwithinthecommunities.ThiswasthemomentIrealisedthattherewasanalternativetoimposingmysolutions.WhydidIhavetoprescribe?Thiswasthestartingpointoftryingto

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thinkaboutasystemicformof‘communitytherapy’–onethatwouldintegratetheknowledgesdevelopedbycommunitymembersthroughtheirlivedexperiences.Thisiswhereitbegan.Westartedtoholdregularmeetingsinthefavela.Afterfiveyearsofdoingso,wethenanalysedwhatwe’dbeendoingandtriedtofindatheorytoexplainwhathadbeentakingplaceinthesemeetings.

key TaSkS

Whenweanalysedwhatwehadbeendoing,werealisedthereareanumberofkeytasksthatwearetryingtoachieve:

(i) Tomovefromnurturingdependencetocreatingautonomy.

(ii) Tobreakfromaprofessionaltraditioninwhichinformationisconcentratedandheldbythetechnicianortheprofessionalandinsteadtocreateacontextinwhichinformationabouthealingcirculatesamongthepeople.

(iii) TorescueandhonourknowledgefromAfricanandIndigenousIndianancestorsratherthantodomesticateandcolonisetheknowledgefromthesetraditions.WewishtobreakfromwesternpsychoanalyticmetaphorsandtoinsteadbaseourworkonmetaphorsthatareindigenoustoBrazilandtoAfrica.Forinstance,theprimarymetaphorforcommunitytherapyisthatofthespiderweb.

(iv) Todevelopaveryefficientapproachthatcanreachmany,manypeople.

(v) Torespondtoandpreventsuffering.Thisisacitizen’stask.Westernpsychologyandpsychiatryhasdevelopedasaresponsetopathology.Itisthereforebasedonconceptsofdisease,treatment,andhygiene.Treatmentisseentobedonebyprofessionalsinaprivatespacewithfixedchairsandaconcernabouthygiene.Whileprofessionalsaretrainedtorespondtodiseaseandtopathology,torespondtosufferingisataskbeyondprofessionals.Torespondtosufferingandtopreventsufferinginvolvesrespondingtothesoul.Itinvolvescomfortandacommunalspace.Thisisacitizens’task.WhenWesternpathologicalmodelsareusedtorespondto

suffering,thismedicalisessuffering.Wearerefusingtomedicalisesocialproblems.Wereturntheroleofrespondingtoandpreventingsufferingtocitizens.

(vi) Toupholdmutualrespectbetweenpopularknowledgeandscientificknowledge.Thesedifferentformsofknowledgecancomplementeachother.WerespectWesternmedicalknowledgeinrelationtorespondingtopathologyandwerespectlocalknowledgeinrelationtosuffering.Thisincludeslinkingwithtraditionalhealers.

(vii) Tocreateaparticipatorymodelforrespondingtosocialsuffering.Sustainingmentalhealthisapluraldynamicprocess.Weareinterestedinmovingmentalhealthoutofaprivatespaceintoapubliccitizens’spacewhereeachpersoncanbecomealeadactorincommunalandcollectivehealth.Withincommunitytherapyweareinterestedingivingrenewedvaluetosocialparticipationandtocontextsofbelonging.Wearelookingtoparticipatorysolutionswhichenhancesolidaritynetworks.

(viii) Tomovebeyondprofessionalism.Wearemovingtoendthemaniaoftryingtocurepeopleandwe’redeterminedtocreateanapproachinwhichthere’snoneedforfacilitatorstohaveauniversitybackground.Communitytherapistsareperformingcitizentasksandsothereisnoneedforthistobeprofessionalised.

The STageS Of COmmUNITy TheRaPy

Communitytherapyisorganisedthroughapublicritualwhichconsistsofeightstages.Thesecommunitytherapyritualsormeetingsoccurinpublicspacessuchasschools,churches,andlocalcommunitycentres.Thelargermeetingscaninvolvehundredsofpeople.Howevermanypeopleareinvolved,theprocesslastsapproximatelyone-and-a-halfhours.

STage ONe: weLCOmINg aND waRmINg UP

Thewelcominglastsforaboutsevenminutesandevokesvariousritualstobuildacollectiveethos.Wemightcelebratethosepeoplewhohavehadarecentbirthday,oracknowledgethe

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significanceofarecentpublicholidaythatrepresentsaparticularhistoryinthelifeofthenation.ThewelcomingofteninvolvessomeactivityinwhichpeoplemakephysicalcontactwitheachotherbecausethisfitswithBrazilianculturewhichisverytactileculture.Thewelcomeoftenalsoinvolvesasongandaclappingandjoiningofhands.Thiswelcomingprocessbuildsacollectiveethos.

Thefacilitatorwillthenintroducethefollowingrules:

• Nocounselling,judgement,oradviceistobegiven.

• Peoplewillbesilentwhenothersarespeaking.

• Nointerpretationsoranalysisofwhatpeoplesaywillbeoffered.Itisonlypossibletoaskotherparticipantsquestions.

• Whenpeoplearespeaking,theywilltalkusingthe‘I’.Theywillspeakfromtheirownexperience,thingsthattheyhavelivedalready.

• Atanytimeduringthemeeting,it’sokaytoproposeasong,astory,apoem,ajoke,oraproverbifwhathasbeenspokenhassuddenlybroughtthistoyourmind.Theseofferingsaretobeshort,butifyousuddenlyrememberasongoraproverborapoemthatislinkedtowhatsomeoneissaying,thenyoucansharethesefolkculturalpropositions.

STage TwO: SeLeCTINg a Theme

Thisstageinvolveschoosingthesubjectofwhatthiscommunitytherapysessionwillfocuson.Whenworkingwithacommunityofpeopleit’simportanttoacknowledgethatdifferentpeoplewillrelatetolifethroughdifferentmediumsofcommunication.Thefacilitatorwilloftenbeginthisstagebysayingsomethinglike:‘Nowweregoingtotalkwithourmouthsbutlaterwe’llcommunicateinotherways’.Thefacilitatorthendescribesthatinordertochoosethesubjectforthismeeting,weneedtohearsomeexamplesofdifficultiesthatpeoplearecurrentlyexperiencing.Variousparticipantswillvolunteertoshareashortexampleofadifficulty,aformofsuffering,thattheyaregoingthrough.Thefacilitatorisveryclearthatthisisnotaforumtodisclosesecrets.Theysaysomethinglike:‘Thisisabout

routineproblems.Ifyouhavesecrets,wellkeepthemsecret.Don’tsharetheseatcommunitytherapy’.Oneoftheotherphrasesthatfacilitator’smightuseis,‘Doyouhaveanyconcerns?Istheresomethingthatismakingyousleeplessatthemoment?’

Afterfourtosixpeoplehavegivenanexampleofaproblemthey’refacing,thefacilitatorwillthensetupavote.Everyonewillvoteonwhichthemethathasbeenmentionedtheywouldliketoseethemeetingaddress.Participantsalsohavetojustifywhytheychoosethisparticulartheme.Eachpossiblethemeisvotedonandeveryonejustifieswhytheyhavemadeaparticularchoice.Peoplecanvotefortheirowntheme.

STage ThRee: CONTexTUaLISINg The Theme – LINkINg SUffeRINg

Whoever’sthemereceivedthemostvotesisthenaskedtospeakforabouttenminutestodescribeinmoredetailwhatthey’vebeengoingthrough.Duringthisprocessofcontextualisation,anyoneinthegroupcanaskthispersonquestions.Participants’questionsenquireabouttheperson’sfeelingsandresponsestocertainsituationsinwaysthatmakelinkswithotherpeople’sexperiences(seestagesix).

Afterthethemehasbeencontextualised,itisthefacilitator’sroletonegotiatethethemeintoaformthatwillberesonantforothers.Thethemeisturnedintoaquestionforthegrouptorespondto.Thisisakeypartoftheprocesses.Instagefive,aparticipantwillhavedescribedinsomedetailapersonaldifficultythatthey’regoingthrough.Nowit’sthefacilitator’sroletonegotiatewiththispersonanamefortheproblemthatwillberesonantforothers.Forinstance,iftheproblemwasinitiallycalled‘sexualabuse’thenthismightbere-namedasa‘violationofrights’.Thequestionforthegroupmightbecome,‘Whoamongstushasexperiencedakindofviolenceinwhichourrightshavebeenviolated?Andhowhaveyouenduredthis?’Alternatively,ifsomeoneinitiallysaid,‘IhaveAIDS’,theninthecontextualisationstagetheywouldbeaskedquestionsincluding,‘Whatdoyoufeelorfearinrelationtothisexperience?’Whentheyanswer,‘Ihaveafearofdiscrimination’,thethememaybeproblematisedas,‘Whichofushasbeendiscriminatedagainstforwhateverreason?Andhowhaveyoudealtwiththis?’Or,ifthepersonaltheme

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thathasbeencontextualisedisaboutloss,thefacilitatormightsay,‘Whohashadabigloss?Whohaslostlovelypeopleintheirlives?Andhowdoyourememberthem?’Thisstageinvolvesnegotiatingadefinitionofparticularsufferinginwaysthatotherswillbeabletojoinwith.Thethemeforthemeetingisderivedfromindividual,personalexperience,butiscarefullynamedinwaysthatotherscanthenjoinaround.

STage fOUR: ShaRINg Of LOCaL kNOwLeDge

Oncetheproblemhasbeennamedinawaythatwillberesonanttoothers,thefacilitatorputsthisouttothegroupwithquestionslike:‘Whoelsehaslivedasimilarsituation?’,‘Whathaveyoudonetorespondorresolvethis?’,‘Throughoutyourdealingwiththissituation,whathasnotbeendestroyed?’Participantssharestories,localknowledge,andmemoriesforthenext45minutes.

Withinthispartoftheprocess,thefacilitatorhasanumberofresponsibilities.Ifthissharingeverseemstobefocusingonthenegatives,thenitisthefacilitator’sresponsibilitytoshiftthesharingfromthenegativetothepositive.Forinstance,ifthegroupissharingstoriesaboutsignificantlossestheyhaveexperienced,thenhalfwaythroughthe45minutesthefacilitatormightswapthewaytheyareaskingquestions.Theymightstarttoenquire:‘What’sthebeststoryyouknowaboutthepersonwhohasdied?Whatdidthedeathnotdestroyinyourlife?Whathasnotbeendestroyedbythisdeath?Whathascarriedon?’Inthisway,thedeadareresurrected.

Similarly,ifthethemeisjealousy,thequestionposedtothegroupmaybe,‘Whoelsehaslivedwithfeelingsofjealousyandhowhavetheyresolvedthis?’Ifthefirst20minutesofsharinghasbeenaroundexperiencesofjealousy,thenthefacilitatormayask‘Whathavepeopledoneintheirrelationshipswithfriendsthathavetakentheplaceofjealousy?Orpeoplewhohavenoproblemwithjealousy,canyousharewithuswhatyoudoinyourrelationships?’Andthenpeoplemightstarttosharedifferentsortsofstories.Inthesesortsofways,halfwaythroughthisstage,thefacilitatortakessomeresponsibilitytomovethesharingfrommorenegativeaspectsofthethemetomorepositiveaspects.Balancingthenegativeandthepositivewithinthesessionisoneofthefacilitator’sresponsibilities.

Facilitatorsalsotakecaretoensurethatskillsorstrategiesofovercomingarenotlocatedinanindividualoranexpert.Instead,theseskillsandstrategiesarelocatedinthecollective.Facilitatorsalsospeakabouthowovercomingobstaclesismoreabout‘perspirationthaninspiration’.

STage fIve: CLOSINg RITUaL

Themeetingendswithsomesortofculturalritualofconclusionwhichemphasisessolidarity,therhythms/cyclesoflife,oracertainsustainingthemethathasemergedduringthemeeting.Participantsareaskedtospeakaboutwhattheywillbetakingawaywiththemfromthisparticularmeeting.

RefLeCTIONS

Thisprocessisn’tgrouppsychotherapy.We’renottryingtocomeupwithanswersforparticipants.Infact,throughthesecollectiveconversations,we’retryingtomakeitpossibletodoubtcertainties.Weoftenhavemorequestionsthananswersattheend.Andthesemeetingsarenotlookingforconsensus.Anysearchforconsensuswilldestroywhatwearetryingtobuild.Instead,thisisaboutasharedspaceofsuffering.Wearequestioningtheideaoftheenlightenedindividualandareworkinginsteadfromcollectiveinspirationandperspiration.Thisisaprocessofofferingandsharingstrategiesofdealingwithsuffering,soit’snotaboutconfidentiality.It’sapublicspaceapproachwhichenablesparticipantstobecomethedoctorsoftheirownexperience.Thisisalsoaprocessofawakeningmemory.Wearetryingtoawakenmemories,toassistpeopletorememberwhattheyhaveforgotten.

aN examPLe Of COmmUNITy TheRaPy

Described by David Denborough & Cheryl White

Theexampleofcommunitytherapywewitnessedoccurredoneevening.WeweregatheredtogetherinachurchinSalvador,Brazil,andaboutonehundredpeopleweresittinginlargecircles.Asthewelcomingtookplaceinsongandritual,specialmentionwasmadeofthetwoAustralians!Recentbirthdaysofparticipantswerecelebratedandwewereinvitedtojoinhandsasasongwassung.

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Asmallbandwasonhandtoprovidetheaccompaniment.Itwasobviouslyawell-knownsongaseveryonejoinedinwithstrongvoices.

Aftertheruleswereshared,participantswereinvitedtovoicethetopicstheywouldliketospeakabout.Anumberofcurrentsufferingswereshared.Onepersonsaid,‘Ihaveaconcernthatmydreamisnotgoingtobecometrue.BecauseIcannotfindwork,Iamconcernedthatmydreamsformylifewillnotcometrue’.Asecondpersonspokeaboutfightsandconflictinthefamilywithhersister.Whenthefacilitatorasked,‘Howdoyoufeelaboutthis?’,shesaid,‘Depressed.I’vedoneeverythingIcanandthemisunderstandingscontinue’.Thefacilitator(DrAdalbertoBarreto)thenasked,‘Sothisisaboutnotbeingunderstood?’,andthewomansaid,‘Yes,notbeingunderstoodbymysister’.Thesefirsttwothemesendedupbeingnamedas:‘Nottohavemydreamcometrue’and‘Notbeingunderstoodbymysister’.Athirdpersonthenspokeof‘Feelingrejectedandnotlovedbymymother’.Thesewerethethreethemesofferedbyparticipants.

Beforethevotewastaken,thefacilitatorsaid,‘Look,we’regoingtovotenowtodecidewhichthemewe’regoingtofocuson.Whicheverthemegetsthemostvotesdoesn’tmeanit’sthemostimportant.Itjustmeansit’stheonemostofuscanrelatetotonight’.Asitturnedout,thefirstthemereceived24votes,thesecondthemesixvotesandthethirdone,‘feelingrejectedandnotloved’received46votes.Thiswasthethemethatthemeetingthenfocusedon.Thefacilitatortookcaretosay,‘Forthetwoofyouwhodidn’tgetthevotes,Iwillbeavailableforconversationafterwards’.Fromwhatwecouldgather,however,neitherofthepeopletookupthisoffer.

Wenowmovedinto‘contextualising’thetheme.Someofthequestionsthatthepersonwasaskedincluded:

• Isthisfeelingofrejectionoldornew?

• Isitasoldasyourlife,likefromwhenyouwereborn?

• Whathaveyoudonetokeepgoing?

• Throughoutthistime,whatdidyoufeelandwhatdidyouthink?

Atonepointinthisprocess,aparticipantmentionedthatsomethingintheconversationhadremindedthemofaparticularstrongwomen’ssong.Andso,thefacilitatorproposedthatthissongbesung.Thebandstartedupandeveryonelaunchedintosong.Thiswasapowerfulmoment.Itwasclearthatthissongandthecollectivesingingbroughtsolace.Butitalsoprovidedapowerfulwayofmovingfromtheindividualvoicetoacollectiveexpression.Throughouttheevening,atkeymoments,thesharingofproverbs,song,jokes,andsongs,wouldtransformthemeeting.Theseformsofculturalexpressionwouldmovetheritualbeyondthesharingofindividualexperienceandintoanexperienceofcommunitas(Turner,1969,p.96).Asenseof‘unityindiversity’wouldbeinvitedinthesemoments(Freire,1994,p.157).

Whenthemeetingmovedintostageseven,participantswereaskedtosharetheirexperiencesofnotbeingunderstoodorbeingrejectedbyothers,andhowtheyhavedealtwiththis.Onemanspokeaboutbeingrejectedbyhisbrothers.Hewasthenaskedquestionsbyotherparticipantsandbythefacilitator:

• Whatdidyoudofirst?

• Didthishelp?

• Whathelpedyoutostrengthenyourself?

• Wasthereasentenceorathoughtthatyoutoldyourself?

Atthispointhesaid,‘WhenIwasfeelingmostrejected,Iwouldsingtomychildthesong“Iwillnotletyoubehurtagain”’.Andatthispoint,everybodystartedtosingthissongaboutchildren.Thisisaninspiringsonganditliftedthegroup’sspiritsaloft.Towardstheendofstageseven,afunnymomentoccurredwhensomeonesaid,‘DearLord,asIcannotloseweight,pleaseletmyfriendsgainweight!’Everybodyburstintolaughter.

Whenthemeetingclosedinritualandinsong,theatmospherewasoneofgoodwillandconnectedness.AsDrAdalbertoBarretodescribes,itwasasifapublicspaceofsharedsufferinghadbeencreated,localknowledgehadindeedbeenrespectedandrescued,andmemoriesofsustenancehadbeenawakenedandcirculated.

Whatwillwebetakingawaywithusfromwitnessingthiscommunitytherapyevent?Asense



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ofexcitementandhopefulnessaboutwhatcommunitytherapycouldcontributeinothercontexts,othercountries.Andasenseofintrigueaboutwhatelementsmayneedtobeadapted,changed,improvisedsothattheprocessisresonantinotherlocalcultures.

The INTRODUCTION Of NaRRaTIve IDeaS TO COmmUNITy TheRaPy

Marilene Grandesso

Marilene Grandesso is a Brazilian therapist and community therapy facilitator. The largest community therapy event she has facilitated was for 1400 members of the police force. There are many ways in which Marilene is now using ideas and practices from the field of narrative therapy and collective narrative practice as she facilitates community therapy meetings. Here Marilene describes some of these explorations. She can be contacted c/o [email protected]

exPLORINg The effeCTS Of aN exTeRNaLISeD PROBLem

Asfacilitators,whenwe’recontextualisingthethemethatistobefocusedon,wewillaskquestionsthatexternalisetheproblemandthatexploretheeffectsthatthisproblemhashadontheperson’sexperience.Weaskquestionsthattracetheeffectsoftheexternalisedproblemontheperson,ontheirrelationships,andontheirsenseofthefuture.Forinstance,wecanaskquestionssuchas,‘Howhasthisproblemaffectedyourlife?Howhasitaffectedyourrelationships?Whataretheeffectsofthisproblemonyoursenseofyourfuture,onyourdreams,andyourgoals?Howdoesthisproblemaffectyourwaysoflookingatyourselfasawoman?’Throughthesesortsofquestions,peoplecanpaintadetailedpictureoftheeffectsofexternalisedproblemsontheirlivesandrelationships.

NOT LOCaTINg The PROBLem IN PeOPLe

Duringstagesix(problematising)wenegotiateasharedunderstandingoftheproblem,orformofsuffering,andposeareflexivequestionthatislikelytoberesonantformanypeoplewithinthemeeting.Howthethemeorproblemisnamedinstagestwo(selectingthetheme)andthree(contextualisation)

isaveryimportantpartoftheprocess.Itisherethatwemusttakecareinrelationtothepoliticsofexperience.Wemustalsoensurethatproblemsarenotlocatedwithinpeople.Forinstance,ifsomeonehasnamedthatthey‘don’tfeellovedbytheirmother’,wemusttakecarethatthesessiondoesn’tgettakenupwithmother-blame.Similarly,ifsomeonesays,‘Iwouldliketotalkaboutaproblemwithmyhusband’,thenwehavetoaskafewquestionsinordertotrytonegotiateadescription:

(i) thatismoreneartoherexperience,thatismoreparticular,

(ii) thatisgoingtoberesonantforothers,and

(iii) thatisnottotalisingofthehusband,ormother,orofanyotherperson.

Thequestionthatisputtothegroupinstagesixisaninvitationthatwillopenparticularhorizons.Wemustconsiderwhathorizonsareopenedbythequestionweask.Thedefinitionoftheproblemneedstobeco-constructedinsuchawaythatitwillnotleadtonegativetalkaboutothers.Thisistheresponsibilityofthefacilitator.Ifapersonstartsblamingtheirmother,andothersjoininawaythatcouldescalatethis,thenthefacilitatormusttakeresponsibilitytoaskquestionsthatopenhorizonsawayfrommother-blame.

Generatingthesharedthemeislikepreparingtheearthbeforeputtinginaseed.Thisprocessinvolvescreatingasenseofconnectionthroughfeelingandmeaning.Asapartofthis,thefacilitatortakescaretoconstructthethemeandthequestionintermsofhowpeoplehaverespondedtotheparticularproblembeingdiscussed,andwhatskillstheyhaveusedtodoso.

geNeRaTINg RICheR DeSCRIPTIONS Of PeOPLe’S SkILLS aND vaLUeS

Asparticipantsthensharestoriesandstrategiesaboutwaysofrespondingtothethemethatisbeingconsidered(stageseven),weaskre-authoringquestionstogeneratericherdescriptionsofpeople’sskillsandknowledge.Originally,communitytherapywouldproposethatthefacilitatorwritedownthelistofstrategiesthatisgeneratedbythegroupconversationandthiswasthenhandedtothepersonwhosethemewasbeingdiscussed.Butthislistcouldsometimesappearasifitwascontainingadviceorsuggestions.Weareusingnarrative

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practicestoimprovethisprocessandtoremovethehazardofadvice-giving.Allofthestrategiesthatpeoplespeakaboutconsistofimplicitskillsandvalues.Asfacilitators,wecanaskquestionstoplacethesestrategiesincontext.Wecanenquireaboutthesocialhistoriesoftheseskills,values,andknowledges.Bytracingtheseskillsandvaluesthroughtimeandspacetheprocesscangeneratericherstories.Andhavingdoneso,wearenowcreatingcollectivenarrativedocuments(Denborough,2008)thatcollatetheskillsandknowledgesfromthegrouponanyparticularthemeinthehopethattheymaybeofassistancetoothers,indifferentplaces,whoaregoingthroughsimilarsuffering.Generatingricherdescriptionsoftheskills,valuesandknowledgesthatareimplicitwithinstrategiesthatpeoplehaveusedcanenrichthecommunitytherapyprocess.

QUeSTIONS ThaT evOke mOvemeNT

Asafacilitator,Iamconsciousofaskingquestionsthatevokemovement.Forinstance,duringacommunitytherapysessioninwhichamotherwasspeakingabouthersonwhohadattemptedsuicide,Iaskedquestionssuchas:

• ‘Canyoutellmewhathappened?’

• ‘Howwasthisforyoupassingthroughthesituation?’

• ‘Whatwastheprocessofmovingthroughthissituation?’

Thesearedeliberatequestionsthatevokemovement.Wearealwaysaskingquestionssuchas,‘Howdidyoupassthroughthis?’

a PeRSONaL aND COLLeCTIve LISTeNINg

Communitytherapycreatesaparticularlisteningcontextandthepowerofthewordisunpredictable.Aspeoplelistentotheexperiencesofothers,momentsofresonanceoccur.Goodmemoriesareevoked,memoriesofsituationsinwhichtheydidsomethingspecial,oracquiredsomeability.Theseexperiencesofresonanceandthememoriesthattheyspark,opendoorstopeople’svaluesandbeliefs.Inthisway,whenpeoplearelisteningwithincommunitytherapy,they’reputinconnectionwiththemselves.Peopledon’tspeakoftheother,andsowe’relisteningtoourselveswhenothersspeak.As

theconversationsweaveinandoutbetweenindividualandcollectiveconsiderations,wearelisteningtoothersandourselves.

OUTSIDeR-wITNeSS PROCeSSeS

Theritualsofcommunitytherapyinvolvemanydifferentformsofoutsider-witnesspractice.People’stestimoniesaretoldinfrontofanaudienceofpeerswhorespondandjoininvariousways.Asnarrativecommunitytherapists,atcertainpointsinthesessionweinvitesomepeopletocomeintothecentreofthegrouptospeakaboutwhatwords,expressionsanddescriptionshavecapturedtheirattention;whatimagesormetaphorsthesewordsorexpressionshaveevokedforthem;whattheseimagesormetaphorssayaboutwhatisimportanttothiscommunity;andwherethesewordsandexpressionshavetakenthem(White,2007).

Atthesametime,musicandsongisoneofthemostpowerfulformsofoutsider-witnesspracticeincommunitytherapy.Wealwayshavesingersplayakeypart.Everytimesomeoneinthegroupdescribesanevocativeexperience,wethinkofasongthatrelatestothis,andwesingittogether.Thiscreatesconnectionsbetweenpeople’sstoriesandstorylines.

SPeakINg IN The ‘I’ IN a COLLeCTIve CONTexT

Thereareanumberofreasonswhyweaskpeopletospeakinthe‘I’,inthefirstperson,duringcommunitytherapymeetings.It’saparadoxinaway,becauseattheverymomentthatapersonspeaksinthe‘I’withinthesecommunitytherapymeetings,theyareactuallyapartofcreatingcollectiveconnectionaroundsharedthemes.Thisdoubleexperienceistakingplace:peoplearespeakinginthe‘I’inrelationtotheirjointexperienceofaproblem,soit’sdifferentthanspeakinginthe‘I’inothermoreindividualisticcircumstances.

Wefindthataskingpeopletospeakinthefirstpersoncreatesadifferentrelationshiptofatalism.Peoplehereoften‘accepttheirfate’andinvitingpeopletospeakinthe‘I’createsdifferentpossibilitiesinrelationtothisfatalism.Havingtheopportunitytospeakinthe‘I’canbeanempoweringprocesswhendoneinthiscollectivecontext.

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Whatismore,peopleinBrazilliketotalkalot.Afurtherreasonwhyitisgoodtogetpeopletospeakinthe‘I’isthatifsomeonestandsupandstartspontificatingaboutlifeandtheuniverse,thefacilitatorcansay,‘Oh,isthistrueinyourlifepersonally?Canyouspeakaboutthat?’,andthismeansthatthepersondoesnotcontinuetospeakforhours!

Havingsaidthis,thereisgreatdiversitywithinBrazilandsoweneedtohaveconsiderablesensibilitytoculturalmeanings.Forinstance,speakinginthe‘I’willhaveverydifferentculturalmeaningsinafavelaintheNorthEastofBrazilcomparedtothecontexthereinSãoPaulo,whichisahugecityinwhichmanypeoplehavelostconnectiontoculturaltraditionsandarelivingmuchmoreisolatedlives.Considerationsofclassandstatusalsomakeabigdifferenceinhowpeoplespeakabouttheirlives.Respondingtotheseculturalnuancesresultsindifferencesinhowwefacilitatecommunitytherapymeetings.

CReaTINg a SeNSe Of SOLIDaRITy

Withincommunitytherapy,we’reinterestedincreatingasenseofsolidarity,asenseofcompassion,asenseof‘myproblemisnottheworst’,or‘Iamnottheonlyonewiththisproblem’.We’realsotryingtocreateapublicspaceinwhichthere’snoconformistagenda,there’snoonewaytolivelife.Significantly,we’retryingtocreateacontextinwhichthereisnopositionofsubmissiontosuffering.Wewishinsteadtocontributetoasenseof‘Icando…’,ofnotacceptingthestatusquo.Thisrenewedsenseofpersonalagency,asenseofbeingabletobeaprotagonistinone’sownlife,iswhatwehopeparticipantswillcarrywiththemafteracommunitytherapymeeting.

RefeReNCeSDenborough,D.(2008)Collective narrative practice:

Responding to individuals, groups and communities who have experienced trauma.Adelaide,Australia:DulwichCentrePublications.

Freire,P.(1994).Pedagogy of hope: Reliving Pedagogy of the oppressed.NewYork,NY:Continuum.

Turner,V.(1969).The ritual process: Structure and anti-structure.NewYork,NY:AldinedeGruyter.

White,M.(2007).Maps of narrative practice.NewYork,NY:W.W.Norton.

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community therapy: a participatory response to psychic misery · 2018-10-15 · a participatory...

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