Singular and plural trajectories in the production of occupational therapy knowledge in Brazil

Abstract

This paper presents a historical rescue of occupational therapy, composed of individual and collective memories of the Brazilian context, indicating elements that constitute its identity and its field of knowledge The historical and epistemological research analyzed, from the cartographic method, the relations between singular and plural characteristics of five occupational therapists and their professional trajectories dedicated to the construction of knowledge in the area. From the narratives of these interlocutors, it was noticeable the collective construction of stories of the profession in their contexts, highlighting common aspects of their experiences and the plurality of production in the field. We highlight 14 categories that relate to: the unknown and the incipient graduation; the need for continuing education; the repression and resistance of the Military Regime; the political organization of the category; investment in occupational therapy research; understanding of specificities; adoption/enunciation of perspectives, methods or fields; support networks; criticism of academic-scientific standards; enchantment by profession; satisfaction in producing; female protagonism and knowledge linked to practice. The plurality of this field of knowledge is evidenced by professionals, as well as by the weaving of a knowledge network. We identified the challenges, support networks, criticisms, enchantments, protagonism, productions, and diverse perspectives by valuing the solidarity between the singularities that build the plurality of this professional identity. In this understanding, the knowledge is a procedural theoretical-methodological construct effected in networks of affective and ethical relationships, although it coexists with the hegemonic hierarchy of fields, themes, and groups.

Keywords:
Occupational Therapy/Trends; Knowledge/Epistemology; History; Culture

Resumo

Apresenta-se um resgate histórico da terapia ocupacional, composto por memórias individuais e coletivas do contexto brasileiro, indicando elementos constituintes de sua identidade e de seu campo de conhecimento. A pesquisa histórica e epistemológica analisou, com base no método cartográfico, as relações entre características singulares e plurais de cinco terapeutas ocupacionais e suas trajetórias profissionais dedicadas para a construção de conhecimento na área. Com base nas narrativas dessas interlocutoras, foi perceptível a construção coletiva de histórias da profissão em seus contextos, destacando aspectos comuns de suas experiências e a pluralidade da produção no campo. Destacaram-se 14 categorias que se relacionam com: o desconhecido e a graduação incipiente; a necessidade da formação continuada; a repressão e resistência do/ao Regime Militar; a organização política da categoria; investimento na pesquisa em terapia ocupacional; compreensões sobre especificidades; adoção/enunciação de perspectivas, métodos ou campos; redes de suporte; crítica a padrões acadêmico-científicos; encantamento pela profissão; prazer em produzir; protagonismo feminino e o conhecimento atrelado à prática. A pluralidade desse campo de saberes é evidenciada pelas profissionais, assim como pela tessitura de uma rede de conhecimentos. São identificados os desafios, redes de suporte, críticas, encantamentos, protagonismo, produções e perspectivas diversas pela valorização à solidariedade entre as singularidades que constroem a pluralidade dessa identidade profissional. Nessa compreensão, o conhecimento é uma construção teórico-metodológica processual efetivado em redes de relações afetivas e éticas, ainda que conviva com a hierarquização hegemônica dos campos, temas e grupos.

Palavras-chave:
Terapia Ocupacional/Tendências; Conhecimentos/Epistemologia; História; Cultura

Introduction

The historical recovery of occupational therapy knowledge production in Brazil shows proposals recognized by the field for incorporating changes in the effervescent conceptions of the 1980s (Nascimento, 1990; Pinto, 1990; Machado, 1991; Soares, 1991; Francisco, 2001; Medeiros, 2010). Such proposals followed the country's political and epistemological transformations and led to new directions and perspectives for a profession aware of its reality. From then on, theoretical-methodological compositions and perspectives emerged in other areas of knowledge, producing implied, contextualized, and articulated knowledge with the path of occupational therapy in the country.

This article aims to present a composition between trajectories and knowledge production, highlighting singular expressions and aligning common aspects that permeate plural constructions in occupational therapy, seen as an inseparable field of theoretical and practical knowledge.

Commonly, we take this scenario from the point of view of academic trajectories; however, this hierarchy of power structures related to knowledge ignores constructions closely related to the professional profile without academic tradition. To incorporate other voices in this collective construction, we sought to revisit stories together with current interlocutors, contemplating personalities from the institutional academic-scientific circuit and other independent contexts of study and research in occupational therapy, composing with other theoretical and methodological perspectives that are written and write these stories.

Therefore, we carried out research that sought modulations in the construction of trajectories and knowledge in occupational therapy in Brazil, based on memories and narratives, understanding them as singular and plural trajectories for the possible stories to be told about the profession in Brazil. For Nora (2016), the memory is an eternal, living, and affective link between past and present, open to the dialectic of remembering and forgetting, both individual and collective. Every memory record becomes history, which is a problematic and incomplete reconstruction, an intellectual operation in the past, belonging to everyone and no one at the same time (Nora, 2016).

As the memory is constructed socially and individually, it becomes a constituent element of the feeling of identity. This does not mean neglecting to consider criticism, which involves pondering the specificities of hierarchical and heterogeneous contexts and relationships, so it is interesting to admit the plurality of histories, realities, and chronologies (Pollak, 1992).

Against the illusory and dangerous attempt to tell “a unique story” (Adichie, 2009), we understand the singular representation of occupational therapist protagonists always given in the plurality of this collective. We decided to affirm the potentialities and temporal, spatial, and affective limits of memories, leading to an interpretative and analytical reflection, instead of a linear reconstruction of the history.

This research analyzed the relationships between the characteristics of the trajectories and proposals of occupational therapists who dedicated to the production of knowledge about occupational therapy in Brazil, seeking to reveal singularities and pluralities, crossed by common processes in the diversity of knowledge and practices of this profession (Cardinalli, 2017).

Thus, we followed two procedures to invite six professionals to investigate occupational therapy and produce specific knowledge about it in Brazil. Three of them were identified in a survey carried out in 2015, in the Lattes curriculum of the National Council for Scientific and Technological Development - CNPq, which analyzed the trajectories of 196 professionals, members of 31 occupational therapy research groups, looking for those who had invested in understanding topics structural and transversal in/of occupational therapy, such as stories, teaching panoramas, research or production, epistemologies, foundations, concepts, references, perspectives, identities, among others.

The first interlocutors indicated the other three professionals identified by their performance in the assistance or clinic, all of whom are recognized for their investments and conceptual proposals in occupational therapy. Five of the guests became interlocutors and authorized the disclosure of their identities and narratives through the Informed Consent Terms¹ (Cardinalli, 2017).

We interviewed the interlocutors following a semi-structured script with some specific questions about their trajectories and productions and they also freely reported their professional trajectories in an unstructured conversation, revealing facts that contributed to arouse and/or feed their interest in think about the occupational therapy. We transcribed the interviews and went through the interlocutors' appreciation with the possibility of a review or new writing, for approval of the final text.

Instead of collection and treatment, the conception of data production and composition follow Clues from the Cartography Method, advocating joint and procedural thinking as part of the construction of knowledge without necessarily attaching to predefined hypotheses, but considering the procedures as a field of problems and flows of meaning that guide the research. Thus, the data are produced by the effects of the intensities of the process, building a network of meanings between the elements, which is exercised on the researcher, the interlocutors, and the data (Passos et al., 2012).

We carried out a thorough listening and reception of the contents that emerged from the interviews. The data composition was a collaborative construction in dialogue, with unique experiences, thoughts, and reflections guiding the interpretation of cultural, social, and historical phenomena. During the analysis, we gave legitimate attention to different voices, covering counter-hegemonic interpretations and discourses, without generalizations and prejudices (Schmidt & Toniette, 2008).

The subtleties of these processes led to the analytical procedures, which could be monitored by affective and questioning records in a field diary. In this sense, the analysis incorporates the researcher's processes, considering its implication, and the living trajectory of the research, and the derived results. This care is understood as points of strength that lead and consider the collective production of knowledge (Passos et al., 2012).

Flexibility ensured the procedural character of the methodological procedures, showing the paths of analysis, but they remained open to unforeseen events in the concrete relationships established in the field. We adopted procedures to allow the research to remain in motion, following what was presented as interesting in a less controlled way, including suggestions from the interlocutors (Schmidt & Toniette, 2008).

With highlighted excerpts from the transcripts, presenting individual or collective strength situations, we experimented configurations as in an experimental video edition in which it is not desired to have total control of the final result or promote dry cuts, aiming to keep everything that seemed interesting, and the idea of unfinished. With this, we designed groups of meanings: historical paths, singular expressions, composition in a plural network of knowledge in occupational therapy, and shared or common strategies.

Although we expected to look at singularities and plural expressions in the construction of the research, we presented common things, an inevitable conversation between the interlocutors, including intimate relationships. We present here the compositions in a reaffirmation of the groups of meanings, highlighting remarkable contextual facts presented by the narratives.

Knowledge production in Brazil

It is time to play the high role of remembering. Not because the sensations weaken but because the interest shifts, the reflections follow another line and bend over the quintessence of the experiences. The clarity and number of past images grow, and this faculty of remembering requires an awakened spirit, the ability not to confuse the current life with the one you spent, to recognize the memories, and to oppose them to the images of now (Bosi, 1994, p. 81).

The production and differentiation of scientific knowledge of occupational therapy in Brazil were boosted in the 1980s, with the process of institutionalization of the profession in the country, the first occupational therapists in the graduation program, and the development of research. The need for teacher training and the structuring of teaching in occupational therapy was a great mobilizer of the first researches and first dialogues of the category to understand and systematize fundamental themes and other interfaces for graduate education (Lopes, 1991; Emmel & Lancman, 1998; Lancman & Emmel, 2003; Salles & Matsukura, 2016).

The policies of expansion of higher education in the 1970s and the strengthening of movements for the re-democratization of the country that demanded the constitution of social rights, after the Military Dictatorship, contextualized a new political perspective that expanded and offered greater conditions for the construction of responses to significant demands of occupational therapy. In this sense, the encounter of theoretical-practical production with the human and social sciences was essential for the construction of a new scenario, problematizing the eminently technical role and also conquering the need for the ethical and political exercise of the profession. References from philosophy, history, social psychology, sociology, anthropology, education, public health, economics, and the arts are now incorporated. At the end of the 1990s, the first interdisciplinary graduate programs in the country also emerged, which expanded the possibilities of connection between areas of knowledge (Mângia, 1999; Barros et al., 2002; Oliver, 2008).

In the following decade, we could verify that occupational therapists were inserted in almost all major fields of knowledge - Biological, Engineering, Technology, Health Sciences, Humanities, Social and Arts, given the increase in offers and areas in graduate programs of universities, mainly public ones (Cardinalli, 2017).

Occupational therapists started to act more strongly in multidisciplinary and interdisciplinary teams, causing such themes to appear in their productions, and transdisciplinarity (Galheigo, 1999). The profession in Brazil inaugurated different fields of practices, showing its diverse and plural construction in composition with other areas of knowledge. This academic, scientific, and professional investment process grew, affirming certain professional specialties such as Physical Rehabilitation, Mental Health, Public Health, Hospital, Gerontology, Social Field, Education, Work, and Culture. On the other hand, it seems that the production around the transversal knowledge that could weave identity perspectives in the profession has been emptied (Cardinalli, 2017).

It persisted until some publications raised the debate around this diversity as a characteristic of professional identity: indicating a search for cohesion in theories and practices developed with related areas (Lancman, 1998), legitimizing the existence of multiple occupational therapies (Mângia, 1998), questioning the rational fragmentation of the modern scientific paradigm (Lima, 1997; Quarentei, 1999) or proposing to think professional identity in a flexible, positive way (Furtado, 1999), made of differences, procedural, complex (Lima, 1999), plural, multidimensional and multi-referential, transdisciplinary and fluid in opposition to a single, rigid and universal identity (Galheigo, 1999; 2007).

The issue of professional identity is not clarified and shyly returns cyclically to the professional debate, presenting new propositions, as expected from the continuous process of producing a scientific field. In the last decades, the concern about the institutionalization of research and postgraduate studies in occupational therapy has been strengthened in a dubious and contradictory relationship with scientific productivity and dialogue, sometimes critical, sometimes consistent, but increasingly closer to international trends (Cardinalli, 2017).

The construction of knowledge on occupational therapy in Brazil had strong international influences, especially from the hegemonic occupational therapy of European countries, the United States of America and Canada, but also in the dialogue with neighboring countries such as Argentina. However, the interaction with other fields of knowledge is evident since in the search to answer theoretical-practical demands of Brazilian contexts and realities, it contributed in unique ways to the production of its knowledge, located and committed to the daily professional and its knowledge and intrinsic cultural activities.

Given the relationship between singularities and common processes, professional trajectories will be recovered in a weave of individual and collective paths, which reveal different and peculiar debates, concerns, and conceptions of a plural network of knowledge of occupational therapy in Brazil.

Unique trajectories in shared processes

Maria José Benetton, Sandra Maria Galheigo, Roseli Esquerdo Lopes, Maria de Lourdes Feriotti, and Mariangela Scaglione Quarentei will be the interlocutors of this work and protagonists of the trajectories, bringing stories of occupational therapy stories, mostly lived in the state of São Paulo.

Maria José Benetton, recognized as Jô Benetton, joined the Occupational Therapy course at the University of São Paulo (USP) in 1968, having graduated in 1970. A pioneer of countless achievements in the profession, she was approved and took the first occupational therapy public service exams from the state of São Paulo in 1971, and in 1973, the public service exams for the Hospital of the Medical Sciences School of Santa Casa de Misericórdia, a place to create and coordinate the first Hospital Dia in the city of São Paulo.

Jô went to study in the United States of America and France to bring new references to Brazilian professionals. During the Military Dictatorship, she was expelled from Santa Casa by the Department of Political and Social Order (DOPS), being unemployed for six years. During this period, she participated in the creation of Hospital Dia A Casa in 1979, where she worked until 1983 when she went to Cuba to spend a month invited by the group linked to Frei Betto and the Communist Party. In 1980, she also started the Center for Studies in Occupational Therapy (CETO). She took a position at the Federal University of São Paulo (UNIFESP) working between 1983 and 1996. Between 1985 and 1989, she completed her master's degree in Social Psychology at the Pontifical Catholic University (PUC), with an investigation into occupational therapy. Her doctorate was in Mental Health between 1990 and 1994 at the State University of Campinas (UNICAMP), focused on the creation of his professional method. In 1995, she launched the journal of CETO. Between 1996 and 2002, she taught at the University of São Paulo (USP). In 2005, CETO was upgraded to the Occupational Therapy Specialty Center and, in 2015, the Dynamic Occupational Therapy Method (MTOD) was the first Brazilian method of occupational therapy to be registered.

Sandra Maria Galheigo started the physiotherapy course in 1975, at the Rehabilitation School of the Brazilian Beneficent Association of Rehabilitation (ABBR) in Rio de Janeiro, but in the second year (moment of the division of the classes) she opted for occupational therapy due to proximity to healthy mental and social sciences, graduating in 1977. Her teaching career began in 1978, at FRASCE - Rehabilitation School of the Solidarity Association of Exceptional Children, where he stayed until 1979. During this period, she contributed to the Association of Occupational Therapists of Rio de Janeiro and the Brazilian Association of Occupational Therapy, a record of political activism that has become an important mark in her trajectory.

In 1980, she joined the School of PUC Campinas - São Paulo. She started a master's degree in Education at UNICAMP, between 1981 and 1988. She participated in the interinstitutional group formed by professors of occupational therapy to discuss the foundations of the profession. In 1989, she started a doctorate in Social Sciences at the University of Sussex, in England, completed in 1996. She participated in the formation of the Interinstitutional Group on Social Occupational Therapy, Metuia, in 1998, in which she was a member until 2005. Among the representation positions, she composed the second Committee of Specialists in Teaching Occupational Therapy in 1998with the Ministry of Education (MEC); in 2000, she participated in the creation of RENETO - National Education Network in Occupational Therapy, being the first president; in 2004, she formed the Advisory Committee for the Occupational Therapy Area of ​​MEC and also became a member of the Bank of Assessors (BASis). In 2005, she became a professor at USP. Currently, she represents the profession in international organizations and invests in the foundations of the profession, focusing on theoretical and methodological references of Critical Occupational Therapy.

Maria de Lourdes Feriotti studied at USP between 1976 and 1978, revealing militant characteristics of her undergraduate class that, during the military period, resisted as actively and collectively as possible the repression. After graduating, she sought the first group of studies in occupational therapy, coordinated by Jô Benetton, having significant influence in the field of mental health. Her teaching career began in 1982 at PUC Campinas, where she lived innovative work processes from the point of view of the profession and the university organization. Between 1984 and 1985, she also taught at USP. She also participated in the interinstitutional group of studies on fundamentals of the profession, such as Sandra, for teaching subjects of such content and dedicated to the topic in her investigations and propositions.

In 2000, together with her colleagues, she created G.E.I.T.O. (Group of Interdisciplinary Studies in Occupational Therapy), offering studies and supervision in occupational therapy, with an interdisciplinary approach. Her Master´s in Education carried out between 2005 and 2007 represents one of the remarkable moments of a conflicting and passionate relationship with the academy. In 2010, she participated in the formation of the Occupational Therapy course at the Federal University of Paraíba (UFPB), but returned to PUC-Campinas, in 2014. She works in management with the Mental Health Coordination of the Municipal Health Department of Campinas, she is a clinical-institutional supervisor and promotes the Theory of Complexity for Occupational Therapy together with G.E.I.T.O.

Mariangela Scaglione Quarentei joined the University of São Paulo in 1976, in the same class as Lourdes; however, she graduated in 1979. She developed political activities with Academic Centers, the reconstruction of the National Union of Students (UNE), the movement for the daycare center in the city of São Paulo, and the reform of psychiatric treatment in Brazil, participating in the organization of the First Meeting of Mental Health Workers, in 1979. During her graduation, she interviewed Jô Benetton and was delighted with her thesis defense of occupational therapy, she began to participate in her study group, in which, after graduating, she became a monitor and then taught at CETO. She entered the São Paulo Judicial Asylum contest in 1980, however, she did not stay there since she was called to work at the Medicine School of the Paulista State University de Botucatu (FMB/UNESP), where she had a voluntary internship, during graduation, indicated by Jô.

She started working in Botucatu in 1980, as an occupational therapist and internship supervisor at Hospital Dia and at the outpatient clinic, and she taught to undergraduate medical students and residents of psychiatry. In 1981, she started to receive occupational therapy interns at the Federal University of São Carlos (UFSCar). In 1985, in Botucatu, she created the first Professional Improvement Program for Occupational Therapy and Psychiatry in the state of São Paulo. Between 2003 and 2012, she created to study and supervision groups in Botucatu and São Paulo, which were part of the Collective of Studies on Occupational Therapy and Life Production. In recent years, she worked with the Laboratory of the Formative Process in São Paulo and continues to invest in the perspective of the Collective with the Laboratory of Human Activities and Occupational Therapy, at UFSCar.

Roseli Esquerdo Lopes studied at the University of São Paulo between 1977 and 1979. During that period, she met Jô Benetton (her thesis defense for occupational therapy also motivated her to invest in the profession) and participated in the student movement. When graduated, she participated in the movement to open a public service exam for occupational therapy by the State Department of Health of the state of São Paulo. As soon as the exam was published in 1980, Roseli passed it (as Mariangela), taking a place at the Judicial Asylum. In 1984, she was hired as a professor by USP. She did a master's degree in Education at UFSCar between 1985 and 1991. In that period, she had an experience in Cuba. She participated in the organization of national meetings of professors of the profession, since the first one, in 1986.

In 1991, she was an effective professor at UFSCar. Between 1995 and 1999, she received a doctorate in Education from UNICAMP. She participated in the formation of the Metuia Group, together with Sandra, where she has remained since then. She has been included in the Graduate Program in Education (PPGE) at UFSCar since 2003 and also in the Post-graduate Program in Occupational Therapy (PPGTO), since her post-graduation in 2009. She won her first position as a full professor in 2012, at the Department of Occupational Therapy at UFSCar. She participated in the reformulation of the Brazilian Notebooks of Occupational Therapy, works with the National Network for Teaching and Research in Occupational Therapy (RENETO), also occupying several representative positions in her career as Sandra did and, on several occasions, together with her. She affirms her current investment in research on the fundamentals and history of occupational therapy.

In the research work, during the individualized listening of these trajectories, we could find numerous points of convergence and sharing of processes in their trajectories. When analyzing them, we recognized elements that converged between the narratives and corroborated the construction of knowledge in occupational therapy such as the interest in the unknown; incipient and precarious graduation; continuing training in occupational therapy; marks of repression and resistance of the Military Regime; and category development and political organization.

The interest in the unknown shows a chain of situations that began with a curiosity for the newly discovered profession and resulted in a questioning process that composed the movement for the transformation of the profession in the country. For some, the graduation in occupational therapy was discovered by chance and brings together curiosities about the choice of the course, such as the focus on care, the idea of the combination of subjects (medical, biological, human, psychological, artistic, etc.), the union from different areas and interests or even the intermediation of personal desires (in the arts) with family pressures (in the sense of medicine) when choosing training, for example. The interest in an initial discovery led to processes of autonomy, freedom, and new learning in university life.

Periods of graduate education very close, sometimes simultaneous, most in São Paulo, and the late 1970s, reveal shared marks of incipient and precarious graduation. The scarcity of bibliographies that, until then, were only a few foreign manuals and newspapers, some of them translated and circulated informally, resulted in the oral teaching of the practice, transmitted by very few occupational therapists who were already trained, most of whom were guests who told about their experiences, without systematization of knowledge and with biomedical, technical and conservative characteristics. The lack of their expectations summoned them to the construction, fostering a deep commitment to the profession, which would re-signify their understandings thereafter.

The graduation would have the emerging need for qualification, leading them to participate, or even to propose study groups as an alternative for continuing education in occupational therapy. The possibility of dialogue with other professionals naturally led to the construction of autonomous groups, fulfilling a role that the university has not yet reached. Jô Benetton's investment in studying the profession generated the first independent group in the city of São Paulo, in which Lourdes, Mariangela, and Roseli participated at some point, with s graduation that remains autonomous and recognized. Consequently, there was also a demand for postgraduate studies in related areas as was possible at that time, looking for connections with occupational therapy, especially in education programs, but also in Philosophy, Psychology, and Social Sciences.

In addition to the formative content, there is a generation or very close generations that share the marks of repression and resistance of the Military Regime, with pro-democracy and rights activists. This strengthened the involvement with collectives and/or social movements and the social and political positioning. The same questions led to the proposal of alternatives to respond to the demands of this social context in which they worked, to organize the professional category, and to participate in the struggles for the rights of the populations involved. Consequently, they also suffered from reprisals, violations, sanctions, and harassment, both at the university and in different jobs.

These professionals were at the beginning of the development and political organization of the category, in the creation or participation of associations, meetings, and congresses, aimed at the curricular reformulation of the courses, considering the corporate demands, dialoguing, and co-producing knowledge in the area, among other themes. Congresses and other professional meetings were highlighted as important spaces for production and exchange for the category. The first National Meeting of Professors of Occupational Therapy (ENDTO), for example, was one of the proposals to promote the discussion at the national level about professional training and the production of knowledge in the area.

In this sense, we emphasize the statement of the political role in occupational therapy. Sandra, Roseli, and Lourdes bring together numerous representations that they held in national and international associations in the professional category or related to higher education, in specialist commissions, national teaching, and research network, among others, such as the evaluation of higher education in the country. In the sphere of professional practice, Jô, Mariangela, and Roseli reported their participation in movements that resulted in the opening of the first vacancies for occupational therapists in public service exams in the state of São Paulo, or even in the Anti-asylum Fight and Psychiatric Reform. We can also highlight the scope of the expansion policy of federal universities, which offered possibilities for the academic career of Roseli and Lourdes.

Recognizing pluralities in the production of occupational therapies

Among the shared paths and processes, there are unique developments that call for the production of meanings in occupational therapy. Research in occupational therapy, for example, was associated with reflections and conceptual formulations that characterized the construction of the field of knowledge for the profession. Those who completed a post-graduate course faced more difficulty in studying occupational therapy, depending on how open the program and orientation enabled them to do so. Some of the investments in occupational therapy research were around themes such as training in occupational therapy, curriculum structure of courses, biomedical and positivist influence on training and practices, methods, foundations, and histories of the profession.

The approach with the human and social sciences and the adoption of their references happened with all the interlocutors, stimulating philosophical and epistemological discussions about the foundations, histories, and identities of the profession. The plural singularity of each interlocutor's path with each new possibility of route, interest, curiosity, or conduction of the graduations required the affirmation of theoretical and methodological references in the productions. The teaching experience, in particular of specific knowledge in occupational therapy, was responsible for the review of the curricular structure in the courses and the production of understandings about specificities of the profession.

The “fundamentals” contain the idea of building a field, explaining what supports that field in our case, for this practice. [...] I'm sure that for me to talk about fundamentals, I take some references, but that does not make them references for occupational therapy. [...] This diversity of occupational therapy is also a diversity of paths (Roseli Lopes).

Regardless of your theoretical and methodological perspective [...] which are more advanced reflections, on the constitution of occupational therapy knowledge, [...] I think you have key concepts such as activity, daily life, ways of life, and a set of other concepts such as social participation, citizen participation, social inclusion, social transformation, citizenship, the autonomy that are important (Sandra Galheigo).

The adoption and identification of theoretical and methodological references together with the demands of intervention and investigation enabled to build or implement perspectives, methods, concepts, and fields of action for occupational therapy. In the reports, there is also a predominance of the understanding that there are other possibilities to conceive and interpret professional reality. In the composition between plural singularities, in the trajectories of each interlocutor there was the adoption and/or enunciation of concepts, perspectives, methods or fields: Dynamic Occupational Therapy Method, Complexity Method, Critical Perspective in Occupational Therapy, Occupational Therapy as Production of Life and Social Occupational Therapy, as reported below:

I think there are different ideologies in occupational therapy, they are ideologies because they are the beginning of the idea, the central core of the idea is different from one to the other. They are different logics, and when it comes to logic it is Ideology and Epistemology. And the three ideologies start from the three different paradigms: one of illness, another of rehabilitation, and another of health. I identify with the health ideology that comes from the occupational therapy paradigm. And the central core of intervention in occupational therapy is still the triadic relationship, from which the intervention is born. The Dynamic Occupational Therapy Method is the most important thing I will leave behind (Jô Benetton).

I believe that there are different perspectives and that it should be so. The Complexity Method aims to build unity with diversity and the absence of consensus, complexity, does not threaten unity. The relationship between unity and diversity is a sustainable system: it must have unity and, at the same time, it must respect diversity. The result of this is a dynamic, contextual and systemic interaction. This is what sustains it. If you end diversity you end the system's sustainability and if you don't have unity you don't have a system either. So, there are different perspectives and this is not a choice, it is a condition of nature, of history and it must be so (Lourdes Feriotti).

I think we have developed a Critical perspective on Occupational Therapy using several authors and several different currents. We could say that we have developed several critical perspectives. [...] The critical perspective is problematizing other approaches and perspectives. I think we are in this moment of trying, of thinking about this critical perspective in a more consistent way [...]. There is always a movement to reduce problems and we have to complex the problems. [...] I feel that Complexity Theory is not enough to think about Critical Occupational Therapy, [...] it is a good partner, but we have to look for other elements and perhaps better formulate what this is. This has been my concern at the time (Sandra Galheigo).

I name my study of the epistemology of occupational therapy, in the sense of the search for an archeology of knowledge of occupational therapy, conceptually. [...] I have a conception of occupational therapy as the Production of Life and activity as the creation of existential territory, but it is not a method and not only a way of understanding, it is a way of making occupational therapy think. [...] This thing that we call activity and that territorializes existence; the existence occurs in the activity. The idea of ​​the activity as an existential territory became stronger and stronger for me because that's where life happens (Mariangela Quarentei).

There is a social occupational therapy and that means that there are other occupational therapies, in another way [...]. I think that all occupational therapy wants to produce social insertion - understood as a more autonomous life, with participation, freedom. How she will get there is different [...]. The social perspective of occupational therapy is undoubtedly in the social area, it looks at other problems, at other methodologies, at other focuses. I think that my perspective of occupational therapy, in general, has to do with the performance of life with autonomy, participation [...]. At this point, my perspective is that occupational therapy necessarily deals, when producing its function, with the social issue. To look at specificity in occupational therapy, I have a social perspective, looking at differences (Roseli Lopes).

All knowledge developed by the interlocutors with their respective workgroups research or personal partnerships can be accessed in a series of productions, reports, research, publications, lectures, presentations at events, among others. The previous excerpts showed their voices in a historical portrait, as contemporary protagonists of this construction of the area and understandings in the affirmation of their knowledge in/about occupational therapy in Brazil.

Strengths and resistances in evidence

Due to the singular expressions, we need to send credits to broad networks, which instigate and offer support for investment in the production of knowledge of occupational therapy. From the moment of becoming an occupational therapist until its technical effectiveness and theoretical contribution, there are important influences and supports offered by colleagues who are going through or have already gone through these processes. The meeting between Sandra Galheigo, Roseli Lopes, and Denise Barros for example was called because they were living together with the extinction of social occupational therapy subjects in the courses they were teaching, mobilizing the creation of a collective (Metuia) to stimulate reflection and the production of occupational therapy with social issues.

The work focused on academic production in Brazilian occupational therapy was also related to criticism and/or resistance to academic-scientific standards. The conflicts of formation, construction, and dissemination of knowledge, the prioritized themes, and those invisible by hegemonic science among others are reported, in addition to their influences on the scientific recognition of the profession, investment and resources for production and research, the development of the graduate school and the entire chain of knowledge and recognition linked to this field. The dilemma about submission to the productive logic versus the possibilities of creative, sensitive, and autonomous thinking-producing seems to be inevitable.

Being outside or on the margins of this academic dynamic allows a certain degree of freedom, but the difficulties to dialogue about knowledge production and the recognition of this knowledge produced outside of established institutions also remain. Questions about meaning, method, and scientific legitimacy come into the debate.

Some interlocutors report on the split between theory and practice, between professionals working in assistance and those in teaching/research, implying the production of knowledge as a strictly academic function. This is logic, according to Galheigo (2014), valuing the creation of hierarchical classifications among the agents involved more than the construction of practices and knowledge.

In the resistance, Jô Benetton, Maria de Lourdes Feriotti, and Mariangela Quarentei for example created study groups and developed methods, conceptions, and productions independent of this paradigm - even though they sought, at some point, possible configurations of contribution to academic institutionalization, by teaching at the undergraduate level, by supervising curricular internships or by coordinating professional development.

Lourdes and Mariangela approached perspectives in the sense of complexity and the expansion of knowledge, distancing from academic rigidity and affirming their productions with rigor, creativity, freedom, and pleasure, able to also enjoy other logics of time, production, learning, and certification.

I am working all the time against the institution of a homogeneous or hegemonic model of occupational therapy (Lourdes Feriotti).

I never tried to make a closed theory and methodology, this is very mine because I am a person capable of dealing with very discontinuous and fragmented situations (Mariangela Quarentei).

We can observe in their narratives the enchantment to know and, later, make and create this profession that marked their relationship with occupational therapy. The challenge for the unknown and the difficulty of exercising the profession boosted his productions.

Occupational therapy, first of all, is a profession that has faced the challenge, given the difficulties of individuals and groups, sometimes very serious difficulties, to make life happen in a better way. The profession was [...] born within spaces like the hospital, but looking at life outside. I do not doubt that she wants to produce life, life or lives, for people who are in great difficulty. [...] It is a profession and a professional who, in the face of many difficulties in life, wants to work with the possibility of happening better (Roseli Lopes).

What I think is beautiful about occupational therapy is that we face many problems with people in their activity potential in the world, and we develop knowledge about the activity's potential. I think that life is the power of activity in the world (Mariangela Quarentei).

Despite these difficulties, all interlocutors reported feeling pleasure in producing knowledge in/of/about occupational therapy. They tell of their trajectories with great affection, passion, and satisfaction for the profession, their challenges, and possibilities, for what they built in it. They are part of generations with few occupational therapists in the country so the affective memories of the relationships built, of who their colleagues were, and the exchanges, show a circle of names recognized today that actively helped the construction of the profession.

The difficulty of exercising the profession made me produce. Occupational therapy is the central core of my life (Jô Benetton).

The master's degree gave us a feeling that we were inventing an occupational therapy that was ours. It is the meaning in my life: to believe that it is very important for us to work and build our profession (Sandra Galheigo).

One of the meanings of occupational therapy in my life is that, perhaps, it has authorized me to validate and value, creativity, freedom, and the need to do work with meaning and pleasure (Lourdes Feriotti).

Occupational therapy is an important field for the sacred exercise of caring for life, existence ... and for the exercise of sharing existence and knowledge about this care (Mariangela Quarentei).

Occupational therapy is constitutive, in this trajectory that I followed, with these people who were with me, which is also a support network for life (Roseli Lopes).

Faced with such singular-plural reflections, we see situations, choices, and characteristics that maintain the constant formation, reformulation, or transformation of knowledge into a creative, inventive, and diverse composition. Many powers emerged in these stories and productions, but the role of these five women interlocutors and their actions in the face of lack and questioning are evident, facing difficulties to build what we now call occupational therapy in Brazil. Above all, building knowledge is directly related to doing occupational therapy, believing in the power of this profession, its challenges, and enchantments.

Considerations in constant construction

The work highlighted the role of five interlocutors, recognizing that history is composed of singular and collective trajectories, consequently still interconnecting a plural group of professionals that is not always evident. History is always shared, collective, with multiple versions of the facts coexisting, and multiple networks weave and sustain different productions. However, the existence of divergences and controversies is not ignored, since when considering “versions” about the history and “recognition”, including academic and/or scientific, we are inevitably considering interpretations, values, social and symbolic markers, hierarchies, and internal and inter-field disputes (Bourdieu, 1989, 2004).

When developing its field of knowledge, occupational therapy like any other is established as a field of forces, struggles, and disputes (Bourdieu, 2004), even though this text has not explored this issue, as it was decided for going against the grain and exercising a more affectionate, non-hierarchical professional dialogue and recognition of individual and collective efforts by the profession. In this sense, we value the strengthening of their identity, the possibility of the common through solidarity between the singularities that make up their plurality.

The researcher's involvement in this field of strengthens, whose graduations were in the context presented (state of São Paulo), also incorporates contradictions and hierarchies that are exercised. However, a sensitive perspective was affirmed in the sense of diverse composition, that is, the creation among produced occupational therapies. We were guided by a curiosity about the narratives, in an affective process that accompanied the constitutive and constructive enchantments of the trajectories. The impact of this way of researching affected the conclusion of the research, which required welcoming its unfinished work and the extended time that was necessary to understand some results.

Looking at the processes of these trajectories, the scarcity of resources, the macro-structural clashes external to the common field, and the overcoming of challenges prioritizing creation with new meanings, engagement, and enchantment, we are faced with characteristics commonly attributed to the professional occupational therapist today. Monitoring unique processes called for looking at shared paths, for the insatiable search for responding to complex demands, and, together, weaving threads of this shared network that has been leading a professional profile and identity.

In 2004, Roseli pointed out the reflection between a general path and singular processes in occupational therapy in the state of São Paulo, both in the construction of technical performance and to the systematization and dissemination of knowledge through publications. She highlighted the diversity of occupational therapies designed and the common intention of investing in this field of production of complex knowledge. What she called singular and general is also the articulation between the expansion of an interdisciplinary, intersectoral and interprofessional field, without losing sight of the specificities of the professional nucleus (Lopes, 2004).

In this work, we highlighted 14 thematic categories of this cartography, which showed the singular, the plural, and the common, indicating the weaving and support of a knowledge network of occupational therapy in Brazil, with heterogeneous and shared characteristics of a professional profile with:

a) interest in the unknown; b) incipient and precarious graduation; c) continuing training in occupational therapy; d) marks of repression and resistance by the Military Regime; e) development and political organization of the category; f) investments in occupational therapy research; g) understandings about specificities of the profession; h) adoption and/or enunciation of concepts, perspectives, methods or fields; i) broad networks, which instigate and offer support for investment in the production of knowledge; j) criticism and/or resistance to academic-scientific standards; k) the enchantment of knowing and subsequently making and creating this profession; l) pleasure in producing knowledge in/of/about occupational therapy; m) female protagonism; n) construction of knowledge directly related to occupational therapy.

Such aspects played an instigating and decisive role in the development of individual and collective trajectories in the profession towards the construction of their field of knowledge. Such data helped to systematize stories of the profession in the country, reflect on the development of its identity, indicate paths, and express characteristics that contribute to the specific knowledge of occupational therapy in Brazil.

As an ethical commitment, this work also aims at the hegemonic science, about forms, objects, and interlocutors to recognize, break and find other ways to build knowledge without perpetuating the hierarchy of knowledge, the declassifications, and/or subjugation between themes, groups, areas or fields. In this sense, occupational therapy invests in what Bourdieu (1998) called ignoble objects, that is, those less invested in the scientific field; however, no less important from the social point of view, for the promotion, production, and qualification of people's and collective lives.

Thus, we maintain the specific and transversal debate of Brazilian occupational therapy, contemplating its theoretical-practical plurality from singular insertions in the field of knowledge production, recognizing its potentialities and limits. Finally, ways are indicated for the creative development of new possibilities, for strengthening the (re) knowledge of Brazilian occupational therapy, committed and engaged with the diversity of demands of its context and culture, which are increasingly urgent and complex.

• 1
  All ethical precepts were respected.
• How to cite: Cardinalli, I., & Silva, C. R. (2021). Singular and plural trajectories in the production of occupational therapy knowledge in Brazil. Cadernos Brasileiros de Terapia Ocupacional, 29, e2040. https://doi.org/10.1590/2526-8910.ctoAO2040
• Funding Source Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – CAPES. Code 001.

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Edited by

Section editor Prof. Dr. Sandra Maria Galheigo

Publication Dates

• Publication in this collection
  07 May 2021
• Date of issue
  2021

History

• Received
  20 Dec 2019
• Reviewed
  12 Aug 2020
• Accepted
  09 Sept 2020