Decolonial feminism and Occupational Therapy: an experience report of a curricular internship in the context of the COVID-19 pandemic

Abstract

This experience report is a theoretical deepening of the practices of remote internship in Occupational Therapy (OT) at the Social Assistance Reference Center (CRAS) of territory in the municipality of Pelotas, State of Rio Grande do Sul, Brazil. The practices are based on the Occupational Therapy of the South and decolonial feminist perspectives. During the internship, individual interventions, a virtual group with women users of the CRAS, and a training group focused on workers from the same institution were carried out. Through these interventions, we had access to life stories marked by gender oppression. Supported by Patricia Hill Collins’s theory, we understood how the images of control impacted those women’s daily activities, especially those related to care. The interventions found support in the Amerindian paradigm of translation, underlining misunderstanding as the foundation of care in OT. We proposed Cultural Translation Activities as a method of occupational-therapeutic intervention that foresees and uses the cultural difference in favor of new forms of experimentation, awareness, collectivization, and incitement to face oppression.

Keywords:
Occupational Therapy; Feminism; Knowledge; Colonialism; Culture

Resumo

Este relato é um aprofundamento teórico a partir das práticas de estágio remoto de terapia ocupacional junto ao Centro de Referência de Assistência Social (CRAS) de um território do município de Pelotas, Rio Grande do Sul, Brasil. As práticas estão referenciadas pelas terapias ocupacionais do sul e pelas perspectivas feministas decoloniais. Durante o estágio, foram realizados acompanhamentos singulares, um grupo virtual com usuárias do CRAS e um grupo formativo voltado para trabalhadoras dessa instituição. Por meio das intervenções, tivemos acesso às histórias de vida marcadas por opressões de gênero. Com o auxílio de Patrícia Hill Collins, entendemos como as imagens de controle operavam nas atividades cotidianas das mulheres, sobretudo atividades relacionadas ao cuidado. As intervenções encontraram suporte no paradigma ameríndio da tradução, sublinhando o equívoco como fundamento do cuidado em terapia ocupacional. Propusemos as Atividades de Tradução Cultural como método de intervenção terapêutico-ocupacional, que prevê e se utiliza da diferença cultural em prol de novas formas de experimentação, conscientização, coletivização e incitamento ao enfrentamento das opressões.

Palavra-chave:
Terapia Ocupacional; Feminismo; Epistemologia; Colonialismo; Cultura

Introduction

This experience report proposes a theoretical and methodological deepening from internship-outreach activities developed during the first semester of 2021, in the context of remote teaching, prioritizing the practices that took place at the Social Assistance Reference Center (CRAS- Centro de Referência de Assistência Social). The activities were based on the theoretical assumptions of southern occupational therapies and the decolonial feminist perspectives defined below. Such theoretical-methodological orientation is justified by the need to think about occupational therapy (OT) in its critical aspect, politicizing technical-professional knowledge to respond to the complexity of social problems. The National Social Assistance Policy is made by and for women (Cisne, 2007) and the activities reported here bring in common the centrality of female suffering, crossed by racialization and class oppression.

Theoretical Reference: Southern Occupational Therapies and Decolonial Feminist Perspectives

To speak of coloniality is to see the dark side of modernity (Mignolo, 2017). The conception of humanity consolidated by European domination from the 16th century onwards divided the world into two groups: inferior and superior, primitive and civilized, traditional and modern. Indeed, colonizing Europe was shown a universal image of progress and the unique destiny of rationality, causing other peoples to be racialized by the discourse of archaism (Lugones, 2020). Even after nations had administratively emancipated themselves, colonialism was updated by coloniality, replicating relations of domination based on gender, racial, epistemic, cultural, and territorial hierarchies, which sustain the capitalist world economy (Castro-Gómez & Grosfoguel, 2007; Quijano, 1999).

The emergence of geocultural (America, Africa, Europe) and, therefore, racial (Indian, African, European) identities come from colonization. These classifications were imposed on the world, which was configured as a new universe of intersubjective relations of domination under the Eurocentric hegemony called modernity (Quijano, 1999). Even the gender binarism that divides the world into “men-women”, marked by high-intensity patriarchy, was a system of interpretation originating from colonization (Lugones, 2020). Such classifications organize social relations through hierarchy and exclusion since the categories because they are understood homogeneously, always keeping a dominating as the norm. When talking about women, it means the white, heterosexual and bourgeois women . The dominant pattern of capitalism is patriarchal, heterosexual, and racist, and decolonial feminist perspectives emerge as a theory and practice of confronting this matrix of oppression (Lugones, 2020).

The translation is a linguistic and ontological paradigm capable of modifying power relations based on coloniality (Costa, 2020). The translation is approached here according to the Amerindian perspective put forward by Castro (2004) and later worked on by Costa (2020) and other scholars of Latin American decolonial feminism.

For the Amerindian peoples, human and non-human beings derive from the same soul. They originate from the same vital source, differing in the bodily constitution that varies according to species; the material conditions create different ways of seeing and acting in the world. If western anthropology was structured around the belief that there is a single nature and a plurality of cultures due to different perceptions, indigenous cosmology reverses this logic: there are different worlds and just one point of view as a result of the different material conditions that define being (ontology), (Castro, 2004). Thinking about the contact between cultures, Castro (2004) states that translating the experience of the other is not to find a synonym but to highlight the differences between languages since we never talk about the same things. To translate is always to betray, and it is to inhabit the space of misunderstanding, enhancing it. In this way, translating assumes the existence of a mistake and communicates through it since there is no unity in what is being said. This opens the possibility of a third world by indicating divergent externalities in otherness (Castro, 2004). Thus, translations involve falsifications, camouflages, displacements, ambivalences, appropriations, and any other disidentification strategies that open up possibilities of resistance to the subaltern (Venn as cited in Costa, 2020).

There is important proximity between this paradigm and the occupational therapies of the south. Santos et al. (2016, p. 16) say that the south “is a metaphor for the human suffering caused by capitalism, colonialism and patriarchy, and the resistance to these forms of oppression”. It is the world “on the other side of the line” where the side effects of modernity are most strongly expressed, where sacrifice, exploitation, fetish, and infantilization operate naturalized under the justification of an inevitable and glorious destiny. Thus, southern occupational therapies take a critical stance toward history, seeing the root of suffering in the capitalist/colonial system, regulating occupations/activities in the dimensions of autonomy, participation, and inclusion (Acevedo, 2021; Almeida et al., 2020; Correia & Akemi, 2017; Córdoba et al., 2015).

Referencing the occupational therapies of the south requires legitimizing the plural, recognizing the diversity of epistemes, especially those erased by the discourse of absences (Tolvett, 2016). An important step in this direction is to overcome the field of health as the only field of knowledge and practice (Barros et al., 2002; Munguba et al., 2018; Núñez, 2019). This implies seeing human occupations/activities from other categories, such as justice, dignity, recognition, social protection, oppression, struggle, aesthetics, and freedom, among others.

Southern occupational therapies presuppose epistemic disobedience (Pino & Ulloa, 2016) by creating routes, abandoning unique stories, or even anthropophagically consuming knowledge from other latitudes (Acevedo, 2021; Correia & Akemi, 2017; Costa & Alves, 2017; Córdoba et al., 2015; Huff et al., 2018). An example of this is the work of Ramugondo & Kronenberg (2013), who theorizes about engagement in occupations based on the notion of 'intentionality' present in ubuntu ethics - “interactive African ethics to demonstrate how collective occupations manifest themselves in a continuum between oppressive and liberating relationships [...] reinforcing the interconnection between the individual and the collective” (Ramugondo & Kronenberg, 2013, p. 3. Our translation). Córdoba (2016) shows the panorama of OT in Latin America and the influences of colonization on professional practice. Anglo-Saxon countries tend to use positivist models aligned with neoliberal ideology, which transform violence, discrimination, and poverty into individual problems, supporting the therapeutics of social issues (Hammell, 2019; Iwama & Algado, 2008). Furthermore, we should highlight the problem of alterity inherent to care work, when a zone of cultural contact is created between occupational and assisted therapists (Acevedo, 2021).

Córdoba (2016) and other voices summon us to Another Occupational Therapy that requires a critical and decolonial stance in constant dialogue with the history of Latin America. Another Occupational Therapy that promotes democracy based on human rights, that produces new ways of life and the common good, recognizing plurality through practices and assuming that neutrality is impossible in a profession that works with human activity (Acevedo, 2021; Córdoba, 2016; Córdoba et al., 2015; Tolvett, 2016; Silva et al., 2019).

Contextualization, Materials, and Method

The practices of the mandatory supervised internship were directed to a given territory in the municipality of Pelotas, Rio Grande do Sul. Currently, the neighborhood is composed of about 20,000 residents and is below the average development of the rest of the municipality because it does not have basic urban conditions for living.

With the COVID-19 pandemic and the preventive measures adopted, the internship was adapted to the remote format. The actions took place together with CRAS, which highlights an online training process aimed at the workers of this institution on the theme of the reception, a group of women, and unique services with the users of the same service.

The training process consisted of four 1-hour weekly meetings through the Google Meet platform, with the participation of four social educators from CRAS. The women's group took place fortnightly, with synchronous participation of 1 hour through WhatsApp, totaling six meetings in the semester. All proposed activities took place directly from audio and text messages.

Eleven users participated in the group, including a social worker and three interns. During the meetings, we discussed the role of women in society, thinking about their history in domestic life. We stress the similarities between the participants of the group involving the care of children and the house through songs, vignettes, and a podcast.

The actions involve a complexity of references and practices. However, for theorization, we selected some situations that allowed a more evident dialogue with Latin American feminisms. Furthermore, we highlight the proposition of Cultural Translation Activities (CTA) as an intervention method capable of considering the ethical, ontological, and political problems inherent to the contact zone between cultures - a relational space where activities emphasize the asymmetries between languages, perspectives, and hierarchies of power inspired by the indigenous cosmovision worked by Eduardo Viveiros de Castro.

Given the specificities of an academic production that is spontaneously from a field of practice, the ethical care followed resolution 510/2016 (Brasil, 2016). This resolution says that investigations that start from spontaneous situations linked to professional or teaching practice and that aim at theoretical deepening are not evaluated by the CEP/CONEP system, as long as they do not reveal data that can identify the participating subjects. Even so, we count on the consent of CRAS for integrated outreach-research-teaching activities. When the present report addresses unique aspects of the lives of users and workers, we opted for more generic writing and fictitious names not to harm the anonymity of the participants.

Results and Discussion

The female body under control

One of the activities of the internship was a training process on reception for CRAS workers. During the meetings, when approaching the topic, the participants made evident the aesthetic criterion used in the screening of the demands presented by the users: those who seemed most in need were better assisted, and this “opinion” controlled the levels and quality of access to the service. Some “types of women” were placed under suspicion, being questioned about their rights based on criteria of dress and behavior. It is as if there were an ideal profile of the woman deserving of social protection: the humble, resigned, kind, optimistic, visibly poor, and suffering woman.

Based on black feminism, Collins (2019) discusses how black women's bodies are controlled by specific gender representations from white western culture. Control images act through the ideological dimension of racism and sexism, controlling the ways of life, the exercise of autonomy, and the citizenship of black women. Bueno (2019) cites some control images worked by Hill-Collins, such as the mule, a woman who works like an animal, compulsorily and without complaining; the jezebel, a hypersexualized woman seen as a sex machine; mammy, a maid loyal to her employers who dedicates her life to employment and providing care and comfort to white people, among others.

Particularly in the training on reception, the images of the mule and the mammy operated in the way the workers judged the needs. Would the idealized image of the woman of bolsa família¹ be an image of control nurtured in Brazil? Throughout the process, we invested in the meanings attributed to reception and in the criteria used in reception in an attempt to tense the images of control involving CRAS users. Diverging from the sentimentalist view, we defend that reception is an ethical posture that demands alterity.

Acevedo (2021, p. 224), when proposing an Andean Occupational Therapy, says that:

[...] alterity is a right that goes beyond the rights of the east, beyond the equality of the bourgeois revolution, more than the fight for the recognition of the other as another. The other becomes the source of all possible discourse and of the relationships from which the irruption of the other, of the poor, of the excluded, of the dominated woman, is valued.

The author argues that in any dialogue, even before the exercise of argumentation, the face of the Other who is prevented from living questions us about the responsibility we have in maintaining a world system that victimizes him (Acevedo, 2021). Given this, welcoming from the perspective of alterity reaffirms the ethics of translation: when we legitimize the existence of the other by recognizing that we inhabit different (referential) worlds. This creates an in-between time that demands tolerance and responsibility.

Due to the reduced number of meetings, we could not carry out the depth we wanted but our experience already suggests the need to look at some actions and services from decolonial feminist theories. By disregarding them, we would fall into an idealized and instrumental training on reception without entering key points, such as the stereotypes attributed to women users of CRAS, the problem of coloniality, and the ethics required in truly emancipatory social protection.

In the individual and group assistance, we understand that care is an axial element in the lives of women monitored at CRAS. They take care of others and take care of many. Indeed, it was up to us to problematize this place of care (mammy) which, historically, is constitutive of female performances. As an example, in one of the virtual meetings of the women's group, the dynamic “(re)knowing oneself” was created. In pairs, participants should talk and try to identify similarities and differences in their lives. The similarities found and shared with the group were “being a mother” and “being a housewife”, even when there were other facts in common, such as education. To stimulate the debate on gender identifications and roles, we used the song Desconstruindo - Amélia, by singer Pitty, which portrays a woman who takes care of everyone and often forgets about herself. Through music, it was possible to measure the importance of mothering in the organization of the participants' daily lives. Lugones (2020) warns about the imposition of the gender system and the consequent subordination of females in all dimensions of life. Thus, women recognize themselves as mothers and housewives, but they do not see the roots of patriarchy, justifying their roles based on personal choice or gifts.

Both in the group and the individual follow-ups, it was common to observe that care was marked by sacrifice, which was expressed in the extensive journey of caring for children, husband, and home, in addition to the current imperative of dealing with the pandemic crisis. Even situations of violence, such as verbal aggression, betrayal, and abandonment, were commonly reported, but rarely named as such. We also came across stories of extramarital relationships, in which the partner was exposed to sexually transmitted infections (STIs), with a focus on syphilis, infecting the partner multiple times.

As OT interns, our role was to problematize these situations with the users, creating educational processes from everyday life, that is, looking at activities, roles, habits, routines, and patterns performed by coloniality (Huff et al., 2018). They are women who live the life that is possible, with few sociocultural possibilities for remaking and resistance. We create educational videos on STIs and other topics for wide dissemination in the territory (LAPET UFPel, 2022). At this point, the importance of decentering the orientations of heteronormative and monogamous sexual relationships became evident.

As a whole, the actions prioritized collective care, of a political and affective nature, through the bonds of sisterhood. Thus, we understand that the object of our interventions - the occupations - were nothing more than Spatio-temporal coordinates of reproduction and, above all, resistance to the social order (Angell, 2014). In this regard, there is an accumulation of evidence in the literature asserting the perpetuation of oppression and social inequalities through engagement in occupations, especially those provoked by the naturalization of gender roles (Alet & Morrison, 2021; Huff et al., 2018; Townsend, 1997). Huff et al. (2018) present useful elements of Africana Womanism to think about a research agenda on occupation from a critical perspective, such as: thinking about gender situationally and beyond the Western binarity; understanding the relationship between gender, occupational roles, and the economy, as in mothering; understand occupations from the collective point of view and power relations. We, similarly, find in control images and in translation other theoretical tools that help to face the problem of captivity reproduction in everyday life. In dialogue with other studies, we could say that we catalyze social changes through the restorative potential of collective occupations (Motimele & Ramugondo, 2014) and we incite what Ramugondo (2015) calls occupational awareness, which is manifested by the awareness and resistance to how oppression and occupation are intersected.

Becoming an occupational therapist: translating experiences

Considering the practical and theoretical dilemmas of the internship, we assume that the occupational dimension concerns the “complex network of metaphorical elaborations and re-elaborations” (Acevedo, 2021, p. 65, our translation) – understanding metaphors as the ordinary systems in which we think and we act, and the actions inscribed in an everyday historical-cultural plot of domination, struggle and resistance (Angell, 2014; Ramugondo, 2015; Guajardo-Córdoba & Galheigo, 2015).

We opted for the methodological disobedience typical of occupational therapies in the south (Costa & Alves, 2017; Silva et al., 2019). Thus, we ask how to translate life stories (metaphorical re-elaborations) without assuming a univocity, that is, an essential similarity between what the Other and We are saying. Thinking about translation as ontology and language, it was possible to redefine the importance of the activity as a zone of cultural contact, underlining the misunderstanding as the foundation of alterity. Based on this, we proposed the following process, which we called Cultural Translation Activities (CTA):

1. 1

   Record of personal and group stories, conflict situations, events, and scenes;

2. 2

   Transcription of information is based on the principle of alterity and misunderstanding in translation (ontological paradigm), that is, we focus on some aspects of the report, aware that the material contours that determine perception are not equivalent. Thus, we raised some occupational elements that evidenced singular/group/institutional problems referring to the matrices of oppression to create a space for the negotiation of meanings;

3. 3

   Translation (linguistic paradigm) of the same information, intentionally subverting the source language to create contrasts, astonishment, and estrangement to the interlocutor. There was no concern for the original truth - the translation could even result in totally fictitious contours. Therefore, we transform biographical content into letters, collages, music, parodies of popular works, short stories, etc.

4. 4

   Presentation of the translation to the participant to create the contact zone, that is, a space for dialogue where metaphors could be contested, recreated, tensioned, and negotiated, instead of being imposed by interpretation. This moment consists of an exercise in metaphorical re-elaboration capable of producing new ways of acting in the world.

When coming into contact with so many life stories, we see contrasts. On the one hand, white women from a public university, with lives marked by financial opportunities, family support, and personal recognition, are guided by feminist thinking. On the other hand, migrant women, black, mothers, abandoned, unemployed, with uncertain fates. They were different worlds touching each other.

One of the CTAs was conducted with a CRAS user. She was referred for individual follow-ups by the service's social worker. Paloma (not her real name) is a mother of two, taking care of her elderly mother and her disabled older sister, and has been unemployed for six years. She arrived at the interns after the death of her father, with whom she had until then shared the care of the house and family. During follow-ups, her narrative was the intense care routine, assuming responsibility for all family members. Paloma had difficulties in recognizing how her work overload was related to gender norms, with reflexes felt in the form of anguish, anger, and loneliness.

For the CTAs, we created an image (Figure 1) that represented what was perceived by the intern about Paloma's life story.

Figure 1
Paloma's cultural translation activity.

As his gender performance was marked by care, we decided to create an image of a tightrope walker, highlighting the elements of the user's daily life and the loneliness in this role. After the presentation of the image, the user stated that she felt provoked, as she agreed that she dealt with many demands, but questioned the absence of any record about her moments of leisure, in a clear effort to subvert a finished interpretation, which enabled the translation.

Paloma reflected on what she exposed in the meetings, using metaphorization of other biographical elements. From this, we intervene more sensitively in the denaturalization of roles, interests, choices, and forms of dependence. We asked together why situations like this are common and, in addition, we try to think of possibilities for them. The main question was: How can we see possibilities for coping with situations like hers? At this and several other moments, the importance of a support network became clear, as the perceived support always came from another woman (friends, sisters, etc.), which reveals the importance of informal sorority networks and the restorative and emancipation of collective occupations (Motimele & Ramugondo, 2014).

Experimenting with another language to communicate with users was an initially complex process for us, students, decolonizing our way of conceiving technical-professional training. The method allowed us to see how we women (interns and users) used our personal experience as an instrument of interpretation and action - rationalities that were not reduced to scientific knowledge. This method also triggered forms of experimentation and new ways of thinking and acting, overcoming contradictions.

Final Considerations

In complete agreement with Morrison & Araya (2018), we see feminism as a way to reflect and denaturalize systematic practices of injustice. Black and Latin American feminisms provide solid foundations for OT, especially when the issue is centered on the relationship between subjectivity and culture. In this sense, we narrate here how control images operate in the institutional scope of reception and the production of captive life forms.

Thinking from new theoretical assumptions also requires using new approaches that respond to the needs of individuals. In this way, we show the strategy that we named Cultural Translation Activities, whose principles supported interventions through cultural differences in favor of new forms of experimentation, awareness, collectivization, and incitement to resistance. This process was equally significant for us, student-interns, in terms of our critical training.

• 1
  In the government of President Jair Bolsonaro, the Bolsa Família income transfer program was replaced by the Programa Auxílio Brasil (Brasil, 2021).
• How to cite: Silva, R. S., Elesbão, K. F., Chagas, M. M., & Almeida, D. E. R. G. (2022). Decolonial feminism and Occupational Therapy: an experience report of a curricular internship in the context of the COVID-19 pandemic. Cadernos Brasileiros de Terapia Ocupacional, 30, e3278. https://doi.org/10.1590/2526-8910.ctoRE250532782

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Edited by

Section editor

Prof. Dr. Adriana Miranda Pimentel

Publication Dates

• Publication in this collection
  22 Aug 2022
• Date of issue
  2022

History

• Received
  19 Feb 2022
• Reviewed
  04 Mar 2022
• Accepted
  15 June 2022