Made available in DSpace on 2016-04-27T18:47:25Z (GMT). No. of bitstreams: 1 Maria Cristina de Mello Avelar.pdf: 833952 bytes, checksum: 49e3ccc86f9f5a77169953254dd80867 (MD5) Previous issue date: 2007-12-12 / This research studied the daily life of a given long-permanence institution for senior people, Instituição Assistencial Nosso Lar , located in the city of Santo André in the Metropolitan region of São Paulo, Brazil. Based on field research and dialogues with its residents, the aim was to identify elements that can contribute to the debate related to the services offered by those asylums. The literature proposes thinking about the institutionalization of old people through analytical categories such as: the different concepts of Aging; the Family s role; the Daily life; the House; and the Long-Permanence Institutions (here also indistinctly called asylums, resting or sheltering houses, and geriatric clinics). This research intends to better understand the daily life of the studied institution, discussing it under the guidance of main authors. Observing visits were carried out in the Instituição Assistencial Nosso Lar , capturing data regarding its routine. Six interviews were made with the residents (three ladies and three men), all aged 60 years or more, asking their opinion about their daily life in the institution as well as their day-by-day relations with other persons. As the main conclusion, the research demonstrated that each resident has adapted differently to the studied institution, producing dissimilar perceptions about their own current conditions at the house. Such result is also supported by the literature, which talks about singular aging forms, influenced by the history of life of each person (including familiar relations, friendships, and different routines of life at past dwellings). The differences in the adaptation process are also associated to the particularly difficult circumstances experienced by each of the interviewed persons before their institutionalization. In all the cases, the arrival to the Institution is presented as an alternative. Nevertheless, the research showed that, in fact, rather than an alternative, the institutionalization represented for those persons the lack of alternative, i.e. the last housing option given their precarious financial and health conditions, as well as their poor familiar bonds / Nesta pesquisa, estudou-se o cotidiano de uma instituição de longa permanência para pessoas idosas, a Instituição Assistencial Nosso Lar , localizada no município de Santo André, na região Metropolitana de São Paulo. Com base na fala de seus residentes, procurou-se identificar, por meio desta pesquisa de campo, elementos que pudessem contribuir para a reflexão e o debate sobre o atendimento asilar. Na literatura, encontraram-se reflexões acerca da institucionalização das pessoas idosas, mediante categorias de análise, como: Conceitos de Velhices; o Papel da Família; o Cotidiano; a Casa; e a Instituição Asilar (aqui também denominada indistintamente de asilos, casas de repouso, abrigos e clínicas geriátricas). Porém, o objetivo desta pesquisa foi conhecer melhor o cotidiano dos residentes de uma instituição asilar, discutindo-o de acordo com a revisão da literatura. Foram realizadas visitas de observação na Instituição Assistencial Nosso Lar , para capturar dados de sua rotina, tendo sido realizadas seis entrevistas com seus residentes (três senhoras e três senhores), todos com 60 anos ou mais de idade, para saber a opinião sobre o cotidiano asilar e, portanto, o dia-a-dia das pessoas. Como principal conclusão, a pesquisa demonstrou que os residentes se adaptaram à Instituição de forma diferenciada, gerando percepções distintas sobre suas condições atuais na casa. Esse resultado também é sustentado pela literatura, na qual expõe-se sobre as diferentes maneiras de envelhecer, influenciadas pela história de vida de cada pessoa (incluindo suas relações familiares, de amizade, com sua rotina de vida e suas moradias). As diferenças no processo de adaptação ainda estão associadas às condições particularmente difíceis vivenciadas por essas pessoas, antes da institucionalização. Em todos os casos, o ingresso à Instituição é apresentado como uma alternativa. Contudo, através desta pesquisa, demonstrou-se que, na verdade, antes de ser uma alternativa, a institucionalização se apresenta como uma falta de alternativa, isto é, como última possibilidade de moradia, dadas as condições precárias, tanto financeiras, quanto de saúde ou de vínculos familiares, de cada um

How much was a medieval monastery reminiscent of a modern prison? Or insane asylum? And if it was in the least - what can such a metaphor tell us about power relations structuring the life of medieval monks? The purpose of this compilation thesis (sammanläggningsavhandling) is to render explicit and analyze relations of power and modes of control comprising the social tissue of early medieval Benedictine monasteries. By bringing up the examples of tenth- and eleventh-century monasteries of St Gall, Fulda, and Bury St Edmunds, this thesis seeks to understand what power was in medieval monasteries, how and between whom it was exercised, what and how it affected in terms of collective and individual identity. The thesis consists of three introductory chapters, four previously published empirical articles, and a concluding remarks section. Article 1 investigates the problem of surveillance and patterns of social control dispersed in the monastery of St Gall. Article 2 studies the early and high medieval institutional expectations and means of enforcement of the monk’s role. Article 3 scrutinizes an example of a persecution process and a set of defense measures in the hands of the St Gall community warding off an unwanted visitor. Article 4 examines a number of internal monastic conflicts from several monasteries and strategies, both political and cognitive, guiding them. In investigating these problems, the thesis proceeds in a manner of deliberate anachronism. It asks questions about how human subjectivity was manufactured in early medieval St Gall, what were a medieval monastery’s ‘conditions of possibility’ to operate as a social regime, or oral and literary means of conflict management etc. The crucial modern social theories on which the thesis hinges are: Erving Goffman’s notion of ‘total institution’, and Michel Foucault’s analysis of power, as well as Pierre Bourdieu’s logic of action.

Ce travail aborde les développements de la psychiatrie dans les colonies italiennes de la Corne de l’Afrique et de la Libye. La psychiatrie coloniale – que l’on appelle aussi ‘ethnographique’, ‘comparée’, ‘raciale’ – se nourrit de théories anthropologiques consolidées, de mensurations anthropométriques, d’observations cliniques ; c’est dans ce cadre complexe qu’elle émerge comme discipline autonome, en partie au moins, par rapport à la psychiatrie de le mère-patrie et qu’elle contribue au bon fonctionnement du régime colonial. Les protagonistes sont en premier lieu les médecins et les patients ; à l’arrière plan on trouve aussi les administrateurs et les hommes politiques, ou encore les familles et les communautés d’origine des patients. À travers des documents précieux comme les dossiers médicaux, il est possible de reconstituer les parcours des patients, de raconter des histoires de vie et d’identifier des éléments récurrents dans les différentes expériences. De plus, grâce à la documentation privée de certains médecins coloniaux, il est possible de saisir les motivations qui poussaient certains spécialistes à venir exercer dans les colonies. L’étude de la littérature psychiatrique de l’époque, associée à l’analyse des parcours des médecins, fait apparaître les échanges et les influences qui marquaient l’activité des psychiatres coloniaux. En ce sens il m’a semblé important d’analyser les modèles anglais et français dont les médecins italiens déclarent s’inspirer dans leur réflexion théorique et donc dans la construction de la discipline ainsi que dans les solutions pratiques mises en œuvre pour faire face à la question psychiatrique dès le début des différentes expériences coloniales. Le nœud de l’assistance aux colons et aux militaires qui présentaient des troubles psychiques, ainsi qu’aux indigènes considérés fous, a plus retenu l’attention dans la colonie libyenne (déjà en 1911-1912, avec des réalisations institutionnelles dans les années trente) tandis que dans les colonies de l’Afrique orientale italienne, la question de l’assistance psychiatrique a été moins débattue, débouchant par conséquent sur très peu de réalisations pratiques. / The dissertation reviews the ways in which psychiatry developed in the Italian colonies in the Horn of Africa and in Libya. Colonial psychiatry – variously called “ethnographic”, “comparative”, or “racial” psychiatry – drew on established anthropological theories, anthropometric measurements and clinical observations, the consistently-organized framework within which it emerged as an discipline supporting colonial government and at least partially independent of psychiatry in the home country. The primary interaction within this colonial psychiatry was that between doctors and patients; in the background were the colonial administrators, the political decision-makers, and the patients’ families and home communities. Precious documentary resources such as medical records let us trace patients’ careers, tell their life stories, reconstruct typical cases and confirm recurrent features in their various experiences; from the private papers of some colonial doctors we can gather the specialists’ motivations to move to the colonies; and an examination of the psychiatric literature of the day enables us to reconstruct the discussions and inspirations which fostered the work of the colonial psychiatrists. I have recognized the importance of analysing the British and (still more) the French models from which the Italian clinicians claimed to draw their inspiration, both in terms of theory (and the construction of the resulting discipline), and in the practical solutions implemented to tackle psychiatric issues from the earliest days of the various colonial experiments. This issue – of supporting psychiatrically-afflicted colonists and soldiers and natives regarded as “mad” – was paid most attention in the Libyan colony, starting in the very first months of the occupation (in 1911 and 1912) and then taking institutional form in the 1930s; in the colonies of what was known as “Italian East Africa”, on the other hand, there was less discussion of psychiatric support and correspondingly limited practical achievements. / La tesi percorre gli sviluppi della psichiatria nelle colonia libica e nelle colonie del Corno d’Africa. La psichiatria coloniale – che assume denominazioni diverse: ‘etnografica’, ‘comparata’, ‘razziale’ – si nutre di teorie antropologiche consolidate, di misurazioni antropometriche, di osservazioni cliniche ed è in questo quadro articolato che emerge come disciplina autonoma, almeno in parte, rispetto alla psichiatria della madrepatria, e funzionale al buon ordine del regime coloniale. Nella cornice della psichiatria coloniale interagiscono in primo luogo medici e pazienti; sullo sfondo ci sono gli amministratori e i decisori politici, le famiglie e le comunità di provenienza dei pazienti. Attraverso documenti preziosi come le cartelle cliniche è possibile tracciare le traiettorie dei pazienti, raccontare storie di vita, ricostruire casi esemplari e fissare dei punti ricorrenti nelle diverse esperienze. Grazie alla documentazione privata di alcuni medici coloniali è possibile cogliere le ragioni che spingevano gli specialisti in colonia. Infine la letteratura psichiatrica del periodo preso in esame permette di ricostruire gli scambi e le ispirazioni che alimentavano l’attività degli psichiatri coloniali. In tal senso si è ritenuto importante analizzare i modelli inglese e soprattutto francese a cui i medici italiani dichiarano di ispirarsi, sia nella riflessione teorica e quindi nella costruzione della disciplina, sia nelle soluzioni pratiche attuate per far fronte alla questione psichiatrica sin dai primi tempi delle diverse esperienze coloniali. Tale questione, ovvero il problema dell'assistenza ai coloni e ai militari che presentavano disturbi psichiatrici nonché agli indigeni ritenuti folli, ha ricevuto maggiore attenzione nella colonia libica, e questo sin dai primi mesi della sua occupazione, tra 1911 e 1912, per poi manifestarsi in realizzazioni istituzionali negli anni Trenta; mentre nelle colonie della cosiddetta Africa Orientale Italiana il tema dell’assistenza psichiatrica è stato meno dibattuto, sfociando pertanto in scarse realizzazioni pratiche.

L’émergence de la psychiatrie comme discipline distincte de la médecine somatique, dans la première moitié du XIXe siècle, s’inscrit dans le cadre de la réforme de la législation sur les aliénés, qui conduit à la création de nouveaux asiles publics dédiés au traitement des malades mentaux en Angleterre, dont celui du Comté du Middlesex, à Hanwell, en 1831. L’Asile de Hanwell, situé près de Londres, est un asile pour aliénés indigents, qui fonctionne de manière complémentaire par rapport à des institutions telles que les workhouses – emblématiques de la nouvelle Loi sur les Pauvres de 1834 – dans la prise en charge d’individus qui sont dans l’incapacité de subvenir à leurs besoins. Sous la direction du docteur John Conolly (1794-1866), qui, dès sa nomination à la direction médicale de l’établissement en 1839, met en place une politique de non-restraint (abandon des moyens de contention mécaniques) à une échelle jusqu’alors inédite, l’Asile de Hanwell est explicitement conçu comme un outil dont la fonction première est thérapeutique, dénué de toute intention punitive. L’influence que cet établissement exercera sur les institutions similaires en Angleterre dès les années 1840 contribue à l’optimisme thérapeutique quant au traitement des aliénés qui prévaut alors, et l’asile victorien, en dépit de ses imperfections, se veut un authentique refuge et un lieu de soins. La conception thérapeutique du Dr Conolly s’inscrit dans la continuité du traitement moral défini par le médecin français Philippe Pinel, mais s’inspire également des expériences menées à La Retraite (York), ou à l’asile de Lincoln. Cette thérapie innovante a la particularité de mettre l’accent sur la qualité de l’environnement et du mode de vie des patients, ainsi que sur les distractions diverses qui leur sont proposées : jeux, fêtes de Noël, kermesses, lecture, musique, sport et danse. La logique de soins qui s’applique alors, le moral management, repose sur une thérapie d’occupation. L’originalité de ce traitement sur le plan médical s’accompagne d’une dimension sociale, voire politique. En effet, loin de limiter ses ambitions au strict domaine médical, le Dr Conolly, connu pour son engagement en faveur de l’éducation populaire au sein de la Society for the Diffusion of Useful Knowledge, tout autant que pour son soutien au mouvement chartiste, mène un combat permanent, de 1839 à 1852, pour que les patients, hommes et femmes, aient accès à une instruction au sein de l’école de l’Asile, dont la création et le maintien sont loin de faire l’unanimité. Conolly envisage l’éducation comme un élément central, qui va bien au-delà d’une simple distraction pour les malades et représente un véritable outil d’insertion sociale et d’émancipation des classes populaires. Il rejoint en cela une conception owéniste de l’éducation, et l’école de l’Asile de Hanwell copie quasiment trait pour trait l’école de New Lanark telle qu’elle se présentait au début du XIXe siècle. Robert Owen (1771-1858) rend d’ailleurs visite à John Conolly dès sa nomination, au printemps 1839. Étudier l’expérience menée dans cet établissement emblématique sous l’autorité de John Conolly – non sans lien avec les expériences sociales menées par les owénistes – et l’influence que cette expérience a pu avoir par la suite dans le paysage psychiatrique victorien, permet d’analyser le non-restraint dans sa dimension thérapeutique, sociale et politique. L’Asile de Hanwell sera pendant près de trente ans une référence dans le traitement des aliénés, et servira de modèle à bon nombre d’institutions, particulièrement en Angleterre. L’influence de Hanwell s’estompera dans les années 1870, qui verront l’émergence de théories de l’hérédité peu compatibles avec le traitement moral. / The emergence of psychiatry as a separate discipline from general medicine, in the first half of the nineteenth century, was linked to the Lunacy Reform movement (County Asylums Acts) that led to the creation of new public asylums dedicated to the treatment of the mentally ill in England. The Middlesex County Asylum in Hanwell, built in 1831, was one of them. Hanwell Asylum, situated in the western suburbs of London, was a pauper lunatic asylum that operated as a complementary institution to the numerous workhouses – symbols of the New Poor Law of 1834 – taking care of people who were deemed unable to take care of themselves. As soon as he was appointed medical superintendent of the institution, in 1839, Dr John Conolly (1794-1866) implemented a whole new policy of non-restraint, applied on an unprecedented scale, and Hanwell Asylum under his leadership was explicitly and primarily intended to be a therapeutic tool, devoid of any punitive purpose. The influence of Hanwell on similar institutions, from the1840s onwards, contributed to the prevailing therapeutic optimism of the time, and Victorian asylums, despite their defects, were meant to be genuine places of refuge and care. Dr Conolly’s therapeutic methods were coherent with “moral treatment” as defined by French doctor Philippe Pinel, but were also based on previous experiences conducted at the York Retreat or Lincoln Asylum. One of the main features of this pioneering treatment was the special emphasis it placed on the high quality of the patients’ environment and way of life, as well as on the wide range of entertainment offered to them: games, Christmas parties, summer fêtes, reading sessions, music, sport and dancing. The approach favoured in terms of health care, a “moral management” approach, was grounded on the principles of occupational therapy. The originality of this treatment from a medical point of view was reinforced by its social and, indeed, political dimension. From 1839 to 1852, far from limiting his ambitions to a strictly medical field, Dr Conolly – well-known for his commitment to the cause of popular education, as a member of the Society for the Diffusion of Useful Knowledge, as well as for his support of the Chartist movement – actually kept on fighting for the right of male and female patients alike to receive proper instruction within the asylum school, which remained highly controversial and constantly threatened with closure. Conolly viewed education as a central element, going far beyond a mere distraction for the insane and truly constituting a tool for social insertion and a means of emancipation for the lower classes. His views on education were similar to the Owenite conception of education and the asylum school at Hanwell was a faithful replica of the New Lanark School at the beginning of the nineteenth century. Besides, Robert Owen (1771-1858) came to Hanwell Asylum and visited John Conolly soon after he was appointed superintendent there, during the spring of 1839. Studying the case of this emblematic institution and the experience carried out within its premises under John Conolly’s authority – an experience which may not be unrelated to Owenite social experimentation – and analysing the impact this experience may have had within the Victorian psychiatric landscape in the years that followed, is an invaluable way of understanding the non-restraint movement through its various dimensions: therapeutic, social and political. For nearly thirty years, Hanwell Asylum remained a benchmark in the treatment of the insane, and served as a model for many other institutions, particularly in England. Its influence began receding in the 1870s, with the emergence of theories of heredity that were hardly compatible with the tenets of moral management.

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