Francisco Ortega | ICREA - Academia.edu (original) (raw)

Books by Francisco Ortega

PAPERBACK JULY 2019. Also available for Kindle. Being Brains offers a critical exploration of on... more PAPERBACK JULY 2019. Also available for Kindle.

Being Brains offers a critical exploration of one of the most influential and pervasive contemporary beliefs: “We are our brains.” Starting in the “Decade of the Brain” of the 1990s, “neurocentrism” became widespread in most Western and many non-Western societies. Formidable advances, especially in neuroimaging, have bolstered this “neurocentrism” in the eyes of the public and political authorities, helping to justify increased funding for the brain sciences.

The human sciences have also taken the “neural turn,” and subspecialties in fields such as anthropology, aesthetics, education, history, law, sociology, and theology have grown and professionalized at record speed. At the same time, the development of dubious but successful commercial enterprises such as “neuromarketing and “neurobics” have emerged to take advantage of the heightened sensitivity to all things neuro. Skeptics have reacted to the hype, warning against neuromythology, neurotrash, neuromania, and neuromadness.

While this neurocentric view of human subjectivity is neither hegemonic nor monolithic, it embodies a powerful ideology that is at the heart of some of today’s most important philosophical, ethical, scientific, and political debates. Being Brains critically explores the internal logic of such ideology, its genealogy, and its main contemporary incarnations.

This book examines the confusions and contradictions that manifest in prevalent attitudes towards... more This book examines the confusions and contradictions that manifest in prevalent attitudes towards the body, as well as in related bodily practices.

The body is simultaneously our reference for the certainties of nature and the locus of a desire for transformation and reinvention. The body is at the same time worshipped and despised; an object of desire and of design. Francisco Ortega analyses how the body has become both a screen for the projection of our ideas and imaginings about ourselves and conversely an object of suspicion, anxiety, and discomfort. Addressing practices of corporeal ascesis (such as bodybuilding and dietetics), medical technologies, and radical anatomical modifications, Ortega documents the ambiguous legacy of a western theoretical tradition that has always despised the body.

Utilising a theoretical framework that is mainly informed by the phenomenology of the body, feminist theory, disability studies and the thought of Michel Foucault, Corporeality, Medical Technologies and Contemporary Culture address several ethical and psychological issues associated with the experience and perception of the body in our cultural landscape. Drawing on these diverse areas of philosophical and analytical work, this book will interest those researching Law, Medicine, and Sociology.

Neurocultures offers «glimpses» into an expanding universe of knowledge, beliefs and practices ch... more Neurocultures offers «glimpses» into an expanding universe of knowledge, beliefs and practices characterized by the conviction that human activity is governed by the structure and functioning of the brain. The 1990s were the Decade of the Brain, and the first hundred years of the new millennium have been proclaimed its Century. Described as the most complex of all organs, the brain has become a major icon of contemporary culture. Brain imaging technologies are used in a large number of disciplines, and are increasingly applied in settings of potential social and legal relevance. It is often proclaimed that the neurosciences will bring about major transformations in notions and practices of the human in areas as diverse as spirituality and self-help, marketing, the law, education, or the classification and treatment of mental disease. Neurocultures explores these expectations, their history, their contexts, and the debates they raise, in a broad range of fields, including enhancement, meditation, neuroethics, the «social brain», psychedelic research, psychoanalysis, psychiatric and neurological conditions, and cinema and literature.

El culto al cuerpo y la posibilidad de modificarlo, personalizarlo o perfeccionarlo es una de las... more El culto al cuerpo y la posibilidad de modificarlo, personalizarlo o perfeccionarlo es una de las tendencias más actuales en la cultura contemporánea. En este volumen se analizan minuciosamente los efectos que sobre el propio cuerpo puede producir la aplicación de esta tendencia y cómo las nuevas tecnologías pueden ayudar a la voluntad de las personas de trascender la materialidad corpórea y de rechazar lo que el cuerpo pueda tener de abyecto. En definitiva, Ortega realiza un estudio a cerca de las diferentes tecnologías médicas de visualización del cuerpo humano, de las motivaciones que pueden llevar a su uso y de los efectos que puede producir su aplicación ante el deseo de perfección corpórea. Además, el autor relaciona de manera clara y concisa los problemas éticos y psicológicos que pueden derivarse del uso de estas tecnologías en la modificación, personalización o perfeccionamiento del cuerpo.

Em Corpo em evidência, Francisco Ortega e Rafaela Zorzanelli abordam o modo como na contemporanei... more Em Corpo em evidência, Francisco Ortega e Rafaela Zorzanelli abordam o modo como na contemporaneidade nossa visão do próprio corpo se tornou cada vez mais mediada pela Medicina. Intervenções cirúrgicas de todo tipo, escaneamentos internos da matéria, medicamentos reguladores das funções são exemplos de como a estrutura corporal se deixou apreender pela prática e pelo discurso normalizador da ciência médica.

Em outro momento, os autores se dedicam a analisar de que forma o corpo é atualmente submetido a todo tipo de intervenção. As próteses visam tanto a suprir deficiências inatas ou adquiridas ao longo da vida quanto a desempenhar tarefas não previstas no projeto original. Se os limites corporais são expandidos, também uma vasta parafernália biotecnológica submete a corporeidade a todo tipo de manipulação.

Como dizem de forma precisa Ortega e Zorzanelli: “Esse rol de processos é compreendido como modulações biopolíticas, isto é, como nuances nos modos como os fenômenos próprios à vida da espécie humana são utilizados no campo das técnicas políticas. As vicissitudes contemporâneas apontam para a emergência de formas de cidadania biológica e informacional”.

A isenção e a profundidade crítica de que é dotado este estudo o torna uma referência indispensável para os que se interessam pelas recentes abordagens da questão corporal, bem como por suas consequências para as experiências sociopolíticas do novo milênio.

È oggi più che mai presente l'ossessione per un corpo "rifatto", rimodellato dalla chirurgia este... more È oggi più che mai presente l'ossessione per un corpo "rifatto", rimodellato dalla chirurgia estetica e dal body-building, adornato di tatuaggi e piercing. Ma l'enorme investimento simbolico di cui il corpo è oggetto nella cultura contemporanea ne mette in evidenza il fondamentale carattere di ambiguità. Da una parte, l'esigenza di vedere l'interno del corpo, riscontrabile attraverso tutta la storia della medicina, dalle prime esperienze di dissezione anatomica, all'avvento dei raggi X, fino alle odierne tecniche di bio-imaging, sembra averlo reso, nella nostra percezione, sempre più disincarnato. E su questo corpo "trasparente", virtualizzato si esercita oggi una diagnostica digitale, come digitali sono le tecniche chirurgiche più avveniristiche. Un corpo virtualizzato sembra essere l'ideale estetico proposto dalle fotomodelle. L'angoscia e l'orrore della carne sono alla base di forme moderne di ascesi corporea e anche di patologie quali l'anoressia. Ma un corpo fisico concreto e sanguinante è quello che le avanguardie artistiche ci mettono sotto gli occhi, da alcune performance della body art alle esperienze di manomissione chirurgica di Orlan. Anche attraverso una originale rilettura di filosofi quali Michel Foucault e della letteratura femminista e psicoanalitica, il saggio di Ortega offre un inquadramento a spunti che rischierebbero di apparire disparati e paradossali, e segnala i problemi etici e psicologici connessi alle percezioni e ai vissuti del corpo.

O assunto jamais havia sido estudado no Brasil com a seriedade, o rigor e o entusiasmo dos bons t... more O assunto jamais havia sido estudado no Brasil com a seriedade, o rigor e o entusiasmo dos bons trabalhos acadêmicos. Isso, por si, justificaria o interesse com que deve ser lido. O autor, porém, vai adiante. Não é apenas uma pesquisa erudita sobre as raízes históricas-filosóficas do termo. Ao redescrever a amizade, re-ilumina seu sentido trivial de complexo emocional ou relacionamento pessoal, e se lança em uma empreitada mais ampla.

review in http://periodicos.unb.br/index.php/les/article/view/1372/1027 Francisco Ortega ressalta... more review in http://periodicos.unb.br/index.php/les/article/view/1372/1027
Francisco Ortega ressalta a importância da amizade como objeto de reflexão filosófica e política, dando continuidade ao tema abordado em seu livro anterior, Amizade e estética da existência em Foucault. Além de retomar o pensamento do último Foucault, Ortega amplia a sua abordagem incluindo as reflexões sobre este tema - tão pouco contemplado pela filosofia - feitas também por Hannah Arendt e Jacques Derrida.
Incluindo-se nas correntes de pensamento que reivindicam para a filosofia a descentralização do sujeito e a tarefa de criar uma nova política da imaginação, Ortega projeta a amizade e o amor no contexto de uma nova ordem subjetiva, além da metáfora familiar aonde estes temas são tradicionalmente reconhecidos e despolitizados. Uma tarefa a ser assumida pela filosofia, no sentido proposto por Foucault, como "o deslocamento e a transformação das molduras do pensamento, a modificação dos valores estabelecidos e todo o trabalho que se faz para pensar de uma maneira diferente, para fazer outra coisa, para tornar-se outro do que se é".

Neste interessante estudo sobre o pensamento do filósofo francês Michel Foucault, Francisco Orteg... more Neste interessante estudo sobre o pensamento do filósofo francês Michel Foucault, Francisco Ortega propicia ao leitor "um mergulho" na visão foucaltiana sobre a amizade, como sendo uma relação não institucionalizada e com sentido diferente daquele que normalmente lhe é atribuído. Ao examinar o tema, Ortega conduz o leitor a pensar e a questionar sua relação com o outro. Um livro que, certamente, vai agradar àqueles que desejam conhecer mais sobre as idéias de Michel Foucault.

book long interview with Agnes Heller

Brainhood / Self and Body by Francisco Ortega

's Being Brains: Making the Cerebral Subject is a fine-grained account of the "neuro-" in a range... more 's Being Brains: Making the Cerebral Subject is a fine-grained account of the "neuro-" in a range of disciplines, and, importantly––crucially––, takes stock of the history and scope of this prefix. But more than this the book is an exploration, a critical engagement with the surge of brain-centered approaches to behavior, to physiology, to mind, to subjectivity, to art and creative enterprises and products––Being Brains is an invaluable appraisal of where those waves (many waves, different waves) crash and what they at times wash away. Vidal and Ortega ask (simply, provocatively), "How did the idea that humans are essentially their brains become thinkable?" (1) The commentaries that follow offer broad and diverse readings of the book. We hope you enjoy.

Since the 1990s, several disciplines have emerged at the interface between neuroscience and the s... more Since the 1990s, several disciplines have emerged at the interface between neuroscience and the social and human sciences. For the most part, they aim at capturing the commonalities that underlay the heterogeneity of human behaviors and experiences. Neuroanthropology and cultural neuroscience, or the “neurodisciplines of culture,” appear different, since their goal is to understand specificity rather than commonality and to address how cultural differences are inscribed in the
brain. After offering an overview of these disciplines, and of their relation to endeavors such as cultural psychology and social neuroscience, this article discusses some of the most representative studies in the area in order to explore in which ways they are relevant for an understanding of culture.

In Suparna Choudhury and Jan Slaby, eds., Critical Neuroscience: A Handbook of the Social and Cultural Contexts of Neuroscience (Oxford, Wiley-Blackwell, 2011), 345-366.

PAPERBACK JULY 2019. Also available for Kindle. Being Brains offers a critical exploration of on... more PAPERBACK JULY 2019. Also available for Kindle.

book long interview with Agnes Heller

In Suparna Choudhury and Jan Slaby, eds., Critical Neuroscience: A Handbook of the Social and Cultural Contexts of Neuroscience (Oxford, Wiley-Blackwell, 2011), 345-366.

Since the 1990s, several disciplines, from neuroanthropology to neurotheology, have emerged at th... more Since the 1990s, several disciplines, from neuroanthropology to neurotheology, have emerged at the interface between neuroscience and the social and human sciences. These “neurodisciplines” share basic assumptions about the brain/mind relationship, a preference for neuroimaging methodology, and the goal of establishing the neurobiological foundations of mind and behavior. A neural turn has also been taken in some quarters within the literary field. The neurosciences have provided writers of literature with resources for depicting characters and psychological processes and states; at the same time, they have inspired new interpretive approaches within literary studies. A twofold motif structures what might be called the neuroliterary field: brains in literature/literature in the brain. There has been a certain convergence between the rise of “neuronovels,” on the one hand, and the neurologization of literary analysis, on the other. This article studies that twofold motif. It first sketches how neuronovels fit into the history of neurological fiction and fictional elaborations of brain-related issues. It then examines three aspects of several major neuronovels: narrativity, solipsism and sociality, and memory. The article concludes by underlining the difference between incorporating “brains in literature” and placing “literature in the brain.”

The research reported here aims at mapping the “cerebral subject” in contemporary society. The te... more The research reported here aims at mapping the “cerebral subject” in contemporary society. The term “cerebral
subject” refers to an anthropological figure that embodies the belief that human beings are essentially reducible to
their brains. Our focus is on the discourses, images and practices that might globally be designated as “neuroculture.”
From public policy to the arts, from the neurosciences to theology, humans are often treated as reducible to
their brains. The new discipline of neuroethics is eminently symptomatic of such a situation; other examples can be
drawn from science fiction in writing and film; from practices such as “neurobics” or cerebral cryopreservation; from
neurophilosophy and the neurosciences; from debates about brain life and brain death; from practices of intensive
care, organ transplantation, and neurological enhancement and prosthetics; from the emerging fields of neuroesthetics,
neurotheology, neuroeconomics, neuroeducation, neuropsychoanalysis and others. This research in progress
traces the diversity of neurocultures, and places them in a larger context characterized by the emergence of somatic
“bioidentities” that replace psychological and internalistic notions of personhood. It does so by examining not only
discourses and representations, but also concrete social practices, such as those that take shape in the politically
powerful “neurodiversity” movement, or in vigorously commercialized “neuroascetic” disciplines of the self.

História, Ciências, Saúde-Manguinhos, 2010

The aim of this paper was to analyze the phenomenon called neuroascesis or cerebral self-help, wi... more The aim of this paper was to analyze the
phenomenon called neuroascesis or
cerebral self-help, within the context of
increasing impact of the neurosciences
and the emergence of neuroculture and
the cerebral subject. In order to
accomplish this, it is important to
understand the sociocultural context of
neuroascesis, which corresponds to what
is being called somatic culture or
biosociality. The purpose of the article
was to explore how a reductionistic form
of subjectivity, the cerebral subject,
enables the appearance of cerebral
practices of the self, i.e. practices of how
to act on the brain in order to maximize
its performance. Such practices lead to the
formation of new types of sociality.

Este artigo pretende analisar o fenômeno
denominado de neuroascese, ou
autoajuda cerebral no contexto do
crescente impacto das neurociências e do
surgimento da neurocultura e do sujeito
cerebral. Para tanto, é importante
compreender o âmbito sóciocultural mais
amplo no qual a neuroascese se insere e
que corresponde ao que vem se
chamando de ‘cultura somática’ ou, mais
especificamente, de biossociabilidade. O
objetivo do artigo é explorar como uma
forma de subjetividade reducionista, o
sujeito cerebral, dá lugar à aparição de
práticas de si cerebrais, isto é, práticas de
como agir sobre o cérebro para maximizar
a sua performance, que levam a formação
de novas formas de sociabilidade.

The spectacular progress of the neurosciences, as well as the intense process of popularization b... more The spectacular progress of the
neurosciences, as well as the intense process
of popularization by the media of images
and information that associate cerebral
activity with practically every aspect of life,
have produced a growing perception of the
brain as the site and agent of all the
properties and actions that define us as
human beings. Today’s socio-cultural
context has seen increased interest in
‘neuroascese’, that is, discourses and
practices aimed at maximizing brain
performance. Tracing elements of the history
of ‘brain ascese’ back to historical
moments of the nineteenth century in
which neuroascetic practices were
commonplace, the article examines their
continued use today, taking into account
the social, cultural, and historical contexts
in which they originated.
O espetacular progresso das
neurociências e o intenso processo de
popularização, via mídia, de imagens e
informações que associam a atividade
cerebral a praticamente todos os
aspectos da vida produzem, no
imaginário social, crescente percepção
do cérebro como detentor das
propriedades e autor das ações que
definem o que é ser alguém. Nesse
contexto sociocultural, aumenta o
interesse pela neuroascese, isto é,
discursos e práticas a respeito de como
agir sobre o cérebro para maximizar sua
performance. Com o objetivo de traçar
alguns elementos da história da ascese
cerebral, resgatam-se momentos
históricos do século XIX em que
práticas neuroascéticas eram comuns.
O artigo problematiza a continuidade
dessas práticas na atualidade, levando
em conta os diferentes contextos
socioculturais e históricos nos quais se
originam.

as a concept to approach the actual subjectivity processes and also the emergence of biotechnol... more as a concept to approach the
actual subjectivity processes and also the emergence of biotechnologies instruments to approach mental disorders,
behaviors and human attitudes. It analyses the use of neuroimages and the new issues they bring to psychological
research field that has to face the biologization of mind.

Políticas terapéuticas y economías de sufrimiento, 2020

Ortega, Francisco.(2020).“Negociación pragmática de categorías diagnósticas:el caso del autismo e... more Ortega, Francisco.(2020).“Negociación pragmática de categorías diagnósticas:el caso del autismo en Brasil”. In Maria Epele. Eds. Políticas terapéuticas y economías de sufrimiento.Buenos Aires: IIGG/CLACSO, pp. 103-127

Somatosphere Presents A Book Forum on Tracing Autism: Uncertainty, Ambiguity, and the Affective L... more Somatosphere Presents A Book Forum on Tracing Autism: Uncertainty, Ambiguity, and the Affective Labor of Neuroscience by Des Fitzgerald

Contributions from:
Elizabeth Fein - Duquesne University; Matthew Wolf--Meyer - Binghampton University; M. Ariel Cascio - McGill University; Michael Orsini - University of Ottawa; Francisco Ortega - State University of Rio de Janeiro
Reply - Des Ftizgerald - Cardiff University

This article approaches the claims of two main parent-activists groups – Light Blue and ... more This article approaches the claims of two main
parent-activists groups – Light Blue and Sky Blue –
in the struggle for the “right to treatment” of autism
in the state of Rio de Janeiro. It focuses mainly on
the forms of discourses and tensions about care and
treatments provided by the Unified Health System
(SUS). Therefore, our purpose is to understand to
what extent their claims about forms of treatments
approach the broader context of national health
policies for autistic individuals. The laws drawn up
by parent-activists along with political figures are
highlighted, as well as the positioning and vocalizations that consider the assistance offered by the
Network for Psychosocial Care (Raps) “insufficient”
and/or “inadequate”. Our research methodology
involved ethnographic research, conducted between
2012 and 2013 in events, meetings, and demonstrations organized by the two mentioned groups of
autistic parents, as well as in-depth interviews with
qualified informants (activist parents and relatives).

In this paper we explore how our cultural contexts give rise to di erent kinds of knowledges of a... more In this paper we explore how our cultural contexts give rise to di erent kinds of knowledges of autism and examine how they are articulated, gain currency, and form the basis for policy, practice and political movements. We outline key tensions for the development of critical autism studies as an international, critical abilities approach. Our aim is not to o er a cross-cultural account of autism or to assume a coherence or universality of ‘autism’ as a singular diagnostic category/ reality. Rather, we map the ways in which what is experienced and understood as autism, plays out in di erent cultural contexts, drawing on the notion of ‘epistemic communities’ to explore shifts in knowledge about autism, including concepts such as‘neurodiversity’, and how these travel through cultural spaces. The paper explores two key epistemic tensions; the dominance of‘neuro culture’and dominant constructions of personhood and what it means to be human.

This article analyzes the neurodiversity movement, organized mostly by so-called high-functioning... more This article analyzes the neurodiversity
movement, organized mostly by
so-called high-functioning autists, who
consider that autism is not a disease to
be treated, but rather a human difference
that should be respected alongside
other differences. The “neurodiversity”
movement must be set within a wider
sociocultural and historical field that
incorporates the growing impact of
neuroscientific knowledge and practices
in the cultural imagination with the
paradigm of the cerebral subject and
the expansion of neuroculture. In the
context of the cerebral subject, the brain
accounts for all that we used to attribute
to the person, and it is becoming a fundamental
criterion for biosocial grouping.
The article shows how a solipsist,
reductionist and scientificist ideology –
the cerebral subject – can act as the
basis for the formation of identity and
networks of sociability and community.
Este artigo analisa o movimento da neurodiversidade
organizado basicamente
por autistas chamados de alto funcionamento
que consideram que o autismo
não é uma doença a ser tratada, mas
uma diferença humana, a qual deve
ser respeitada como outras diferenças.
O movimento da “neurodiversidade” deve
ser inserido em um marco sociocultural
e histórico mais amplo que incorpore o
impacto crescente no imaginário cultural
dos saberes e das práticas neurocientíficas
com o paradigma do sujeito cerebral e a
expansão da neurocultura. No contexto do
sujeito cerebral, o cérebro responde por
tudo o que outrora costumávamos atribuir
à pessoa e vem se tornando um critério
biossocial de agrupamento fundamental.
O artigo mostra como uma ideologia
solipsista, reducionista e cientificista –
o sujeito cerebral – pode servir de base
para a formação de identidade e de redes
de sociabilidade e comunidade.

Although autism is not a contagious disease, the term “autism epidemic” is used in allusion to th... more Although autism is not a contagious
disease, the term “autism epidemic” is
used in allusion to the dramatic increase in
the number of new cases in only a short
period of time. This paper provides an
overview of the socially shared conceptions
surrounding autism in Brazil, through the
narratives that have given visibility to this
topic in the Brazilian press between 2000
and 2012. We regard these narratives
not as representations of a reality a priori,
but through their function of structuring
human experience. On the one hand,
such narratives shape and give content
to the issues and controversies that
surround autism in Brazil, while on the
other hand, they also actively contribute
to such debates, given that they affect the
meaning that readers place on them.

Resumo O artigo analisa o surgimento recente do movimento de neurodiversidade, situando-o no con-... more Resumo O artigo analisa o surgimento recente do movimento de neurodiversidade, situando-o no con-texto dos estudos sobre a deficiência e da organiza-ção política de deficientes físicos. O movimento da neurodiversidade é organizado por autistas chama-dos de alto funcionamento que consideram que o autismo não é uma doença a ser tratada e se for possível curada. Trata-se antes de uma diferença humana que deve ser respeitada como outras dife-renças (sexuais, raciais, entre outras). Os ativistas do movimento de neurodiversidade se opõem aos grupos de pais de filhos autistas e profissionais que buscam uma cura para a doença. No texto, são apre-sentados os argumentos dos grupos pró-cura e anti-cura, avaliando as duas posições e seu impacto na área da saúde e no desenvolvimento de políticas pú-blicas para autistas. Abstract This article analyzes the emergence of the neurodiversity movement in the context of studies about disabilities and the political organization of disabled people. The neurodiversity movement is organized by the so-called high functioning autists, who believe that autism is not a disease to be treated and, if possible, cured. It is instead a human difference that has to be respected just like other differences (sexual, racial, among others). The activists of the neurodiversity movement oppose the groups of parents of autistic children and professionals seeking for a cure for autism. This article presents the arguments of the pro-and anti-cure groups and analyzes both positions as well as their impact upon the field of health and the development of public policies for autists.

Medicalización, salud mental e infancias. Perspectivas y debates desde las ciencias sociales y el sur de América Latina, 2018

Imaginamos este libro, como una contribución a una reflexión que recupere lo mejor de la tradició... more Imaginamos este libro, como una contribución a una reflexión que recupere lo mejor de la tradición crítica, problematizadora e historizante de la medicalización de la sociedad, pero que ofrezca múltiples panoramas actualizados, rigurosos y exhaustivos para observar estos procesos en la Argentina y en los países que
componen el sur de América Latina.
Esperamos sinceramente que la lectura de este volumen se constituya en un disparador que ofrezca claves de diferente índole para aproximarse a los problemas relacionados con la medicalización de las infancias. Claves teóricas, fundadas en reflexiones profundas acerca de los límites y posibilidades analíticas que pueden ofrecer las ciencias sociales para pensar estos temas. Claves metodológicas, que permitan poner de relieve la importancia de diseños de investigación flexibles y que abreven a la comprensión de los complejos fenómenos medicalizadores. Claves, en todos los casos, que resulten útiles para aproximarse al análisis de problemáticas empíricas.
Postulamos la relevancia de realizar estudios basados en el análisis de fenómenos empíricos en la región, que abran posibilidades no sólo de comprensión de tales fenómenos, sino que contribuyan a delinear contornos específicos y posibilidades analíticas propias de América Latina. En función de ello, consideramos que es necesario alentar la construcción de diálogos fructíferos que conduzcan al mutuo enriquecimiento de los estudios provenientes de diversas regiones incorporando referentes insoslayables en la perspectiva considerada. En este sentido, la participación de integrantes de nuestro equipo en el libro "Global perspectives on ADHD. Social dimensions of diagnosis and treatment in sixteen countries", compilado por Meredith Bergey, Angela Filipe, Peter Conrad e Ilina Singh, constituyó un punto de partida que nos permitió poner en diálogo lo sucedido en Argentina con países de los cinco continentes. También, y como resultado de las experiencias investigativas, refrendamos nuestra propuesta de profundizar y recentrar las investigaciones en el análisis de algunos desprendimientos de la perspectiva de la medicalización, tales como la biomedicalización, la farmacologización y la sociología del diagnóstico, que el libro aborda a partir de algunas sistematizaciones de lecturas realizadas en dichas claves. Así fue que, como parte del contenido, y poniendo en diálogo con nuestra investigación de Argentina, invitamos a equipos que estudian diferentes experiencias nacionales sobre medicalización de la infancia en el sur de nuestro continente, una región relevante en América Latina no sólo por su extensión, sino por el hecho de que tiene valores elevados en algunos de los principales indicadores de desempeño social y económico. Se considera la región macro más próspera de América Latina, con una alta esperanza de vida, el índice de desarrollo humano más elevado y un alto nivel de vida, así como con una participación significativa en los mercados mundiales. Pero, a la vez, una zona que tiene profundas desigualdades, y en ese contexto el sistema de salud en general y de salud mental en particular es muy representativo de dichas inequidades. Creemos que la contribución de los investigadores en este campo es un hito relevante y establecerá ricos intercambios a futuro con otras producciones.

Controversias sobre ADHD y metilfenidato en discusiones sobre medicalización en Argentina y Brasil, 2017

Resumen El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de i... more Resumen El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de investigaciones realizadas en Argentina y Brasil relacionadas con el uso del metilfenidato, su prescripción y la regulación de la venta. También examinamos las discusiones entre investigadores y profesionales que asisten a personas diagnosticadas con TDAH en ambos países. El artículo integra dos campos de investigación. En Argentina se analizaron artículos de prensa, datos numéricos de organizaciones oficiales y profesionales y entrevistas semiestructuradas de profesionales de salud individuales y grupales realizadas entre 2007 y 2011. En Brasil se analizaron las revistas científicas, la observación participante y los profesores de las escuelas y los profesionales de la salud. Las conclusiones incluyen que los movimientos sociales en ambos países se han organizado y articulado, en un intento de promover el debate sobre la medicalización de la infancia y su despliegue en la sociedad.
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El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de investiga... more El trabajo tiene como objetivo ofrecer un análisis sistemático de algunos resultados de investigaciones realizadas en Argentina y Brasil relacionadas con el uso del metilfenidato, su prescripción y la regulación de la venta. También examinamos las discusiones entre investigadores y profesionales que asisten a personas diagnosticadas
con TDAH en ambos países. El artículo integra dos campos de investigación. En Argentina se analizaron artículos de prensa, datos numéricos de organizaciones oficiales y profesionales y entrevistas semiestructuradas de profesionales de salud individuales y grupales realizadas entre 2007 y 2011. En Brasil se analizaron las revistas
científicas, la observación participante y los profesores de las escuelas y los profesionales de la salud. Las conclusiones incluyen que los movimientos sociales en ambos países se han organizado y articulado, en un intento de promover el debate sobre la medicalización

Frontirs in Sociology, 2020

Global Mental Health (GMH) is the field of study, research, and intervention, which aims at impro... more Global Mental Health (GMH) is the field of study, research, and intervention, which aims at improving access to mental health worldwide. It is based on the global burden of disease research program and on the existence of a large “treatment gap” between the need and availability of mental health services, displaying individual and social costs of undiagnosed and untreated mental disorders, especially in low- and middle-income countries (LMIC). Few academic publications in Brazil dialogue directly with the field of GMH, although several issues drawn from its agenda have been the subject of mental health policies in the country. Brazil can be classified as a middle-income country with a well-structured national health system. This system is oriented toward primary health care, which integrates both community mental health services and the broader health care network. The debate between GMH advocates and critics has unearthed old controversies in psychiatry such as universality or cultural specificity of mental disorders, their expressions, and their relationship with social and economic factors. We intend to examine how these controversies reverberate in the Brazilian mental health scenario, taking as an illustration the debates around Attention Deficit Hyperactivity Disorder (ADHD) in the country. ADHD discussions oppose those who argue that the condition is underdiagnosed and undertreated, and those who claim that there is overdiagnosis and overtreatment and thus, medicalization of childhood. This article presents the current status of the Brazilian mental health literature on ADHD, with emphasis on tensions around diagnosis, prevalence and interventions. Our aim is to highlight how the differential in discourse shapes the debate on ADHD in Brazil and how this may contribute to the GMH agenda. This goal will be undertaken in three steps. First, we will briefly examine studies around GMH and ADHD. Secondly, we address Brazilian studies on this theme, considering the specificities regarding the constitution of the mental health field. Finally, we will examine the debate of treatment gap vs. medicalization in the country in order to underscore the potentials and limitations of each perspective.

by Angela M Filipe, Claudia Malacrida, Fabian Karsch, Eugenia Bianchi, Francisco Ortega, Manuel Vallee, Sebastian Rojas Navarro, Patricio Rojas, Mónica Peña, Christian Bröer, Rachel Spronk, Junko Teruyama, and Yasuo Murayama

Attention deficit−hyperactivity disorder (ADHD) has been a common psychiatric diagnosis in both c... more Attention deficit−hyperactivity disorder (ADHD) has been a common psychiatric diagnosis in both children and adults since the 1980s and 1990s in the United States. But the diagnosis was much less common—even unknown—in other parts of the world. By the end of the twentieth century, this was no longer the case, and ADHD diagnosis and treatment became an increasingly widespread global phenomenon. As the diagnosis was adopted around the world, the definition and treatment of ADHD often changed in the context of different psychiatric professions, medical systems, and cultures.
Global Perspectives on ADHD is the first book to examine how this expanding public health concern is diagnosed and treated in 16 different countries. In some countries, readers learn, over 10% of school-aged children and adolescents are diagnosed with ADHD; in others, that figure is less than 1%. Some countries focus on medicating children with ADHD; others emphasize parent intervention or child therapy. Showing how a medical diagnosis varies across contexts and time periods, this book explains how those distinctions shape medical interventions and guidelines, filling a much-needed gap by examining ADHD on an international scale.

ORTEGA, F. J. G.; ZORZANELLI, RAFAELA TEIXEIRA ; GONÇALVES, VALÉRIA PORTUGAL . Academic and Profe... more ORTEGA, F. J. G.; ZORZANELLI, RAFAELA TEIXEIRA ; GONÇALVES, VALÉRIA PORTUGAL . Academic and Professional Tensions and Debates around ADHD in Brazil.In: Meredith R. Bergey; Angela M. Filipe; Peter Conrad; Ilina Singh. (Org.). Global Perspectives on ADHD: Social Dimensions of Diagnosis and Treatment in Sixteen Countries. 1ed.Baltimore: Johns Hopkins University Press, 2017, v. , p. 306-329.

The paper aims to offer a systematic analysis of some results from investigations conducted in A... more The paper aims to offer a systematic analysis of some
results from investigations conducted in Argentina
and Brazil relating on the use of methylphenidate, its
prescription and sale’s regulation. We also examined
the discussions among researchers and professionals
assisting individuals diagnosed with ADHD in both
countries. The article integrates two research fields. In
Argentina, newspaper articles, official and professional
organizations’ numeric data, and individual and
group health professionals semi structured interviews
conducted between 2007 and 2011 were analyzed. In
Brazil scientific journals, participant observation and
school teachers and health professionals were analyzed.
Conclusions include that social movements in both
countries have been organized and articulated, in an
attempt to promote discussion on the medicalization of
childhood and its deployment in society.

Desde un análisis crítico de los estudios de la medicalización, y como un aporte a estas perspect... more Desde un análisis crítico de los estudios de la medicalización, y como un aporte a estas perspectivas, describimos y analizamos los modos en que la industria farmacéutica transnacional penetra en diversos espacios sociales, con diferentes estrategias de marketing, interviniendo en la consolidación de procesos medicalizadores en Argentina y Brasil. Se analizan dos modalidades de expansión de los procesos de medicalización, y se desarrollan aspectos y tendencias
específicas del diagnóstico y tratamiento del TDAH en ambos países: la incidencia de la industria farmacéutica en los grupos de apoyo en Brasil y las estrategias de marketing farmacéutico orientadas a actores no médicos en Argentina. Estas dos modalidades se caracterizan por no involucrar sólo al profesional médico. La metodología incluye datos de
investigaciones conducidas en Argentina y Brasil entre 1998 y 2014, con sede en la Universidad de Buenos Aires y la Universidade Estadual do Rio de Janeiro, orientadas al estudio de los procesos de diagnóstico y
tratamiento del TDAH y el consumo de metilfenidato en ambos países. Se emplearon técnicas de entrevista semiestructurada individual y grupal a profesores y profesionales de salud, estadísticas oficiales y de organizaciones profesionales, y revisión de bibliografía general y especializada nacional e internacional. Concluimos que los fenómenos documentados en Argentina y Brasil ponen de relieve la importancia de efectuar investigaciones que contemplen aspectos singulares de los casos empíricos, y sus múltiples vinculaciones con entramados más amplios y en tensión de saberes, dispositivos, normativas y actores involucrados en la medicalización en el siglo XXI.

Medicalización más allá de los médicos: marketing farmacéutico en torno al trastorno por déficit ... more Medicalización más allá de los médicos: marketing farmacéutico en torno al trastorno por déficit de atención e hiperactividad en Argentina y Brasil (1998-2014) Abstract From a critical analysis of medicalization studies, and as a contribution to these perspectives, we describe and analyze the ways in which the transnational pharmaceutical industry penetrates diverse social spaces, with different marketing strategies, to consolidate medicalized processes in Argentina and Brazil. We analyzed two expansion methods of medicalization processes and specific ADHD diagnostic and treatment aspects and trends were developed in both countries: the impact of the pharmaceutical industry on advocacy groups in Brazil and pharmaceutical marketing strategies aimed at non-medical actors in Argentina. These two methods are characterized by involving other actors than medical professionals. The methodology includes data from research conducted in Argentina and Brazil between 1998 and 2014, based in the University of Buenos Aires and in the State University of Rio de Janeiro, focused on the study of ADHD diagnostic and treatment processes and methylphenidate consumption in both countries. We used individual and group semi-structured interview techniques with professors and health professionals, official and professional organization statistics, and national and international

O metifenidato no Brasil: uma década de publicações Methylphenidate in Brazil: a decade of public... more O metifenidato no Brasil: uma década de publicações Methylphenidate in Brazil: a decade of publications Resumo O metilfenidato é um estimulante co-mercializado desde os anos 50 na Suíça, na Alema-nha e nos EUA. Mas foi somente a partir de sua associação com o Transtorno do Déficit de Aten-ção e Hiperatividade (TDAH) que suas vendas alavancaram, tornando-se o estimulante mais con-sumido no mundo. Este artigo tem por objetivo apresentar os resultados de uma análise das publi-cações brasileiras sobre os usos do metilfenidato no Brasil, ao longo da última década. Com isto, visa compreender como as informações são apresenta-das ou omitidas nos diferentes espaços de divulga-ção impressa. Para tal análise, foram pesquisadas publicações científicas, nos principais periódicos de psiquiatria brasileiros, e reportagens de jornais e revistas nacionais destinados ao público em ge-ral. A pesquisa inclui as publicações do período de 1998 a 2008. Destaca-se como ponto relevante da análise a importante participação dos laboratóri-os no financiamento dos grupos e pesquisas sobre TDAH. Os achados indicam que a combinação do uso do medicamento com psicoterapias, a depen-dência do medicamento e a ideia de que existe ex-cesso de prescrição no Brasil são temas controver-sos nas publicações analisadas.

Abstract Methylphenidate is frequently associated with Attention Deficit Hyperactivity disorder (ADHD), though this psychostimulant has been on the market in Switzerland, Germany and the US since the 1950s. After its association with ADHD, Ritalin has become the world's most widely used psychostimulant. The scope of this article is to present the results of an analysis of publications concerning the use of Methylphenidate in Brazil over a decade. It seeks to understand how the information is presented or omitted in the different printed materials. For the analysis, the most important Brazilian psychiatric journals as well as major Brazilian newspapers and magazines for the general public for the 1998-2008 period were consulted. One important point that resulted from analysis of the empirical material was the participation of pharmaceutical laboratories in the funding of research groups on ADHD. The findings reveal several controversial issues in the publications, such as the combination of drugs and psychotherapy, as well as issues of addiction and over-prescription.

The article aims to present the outcome of the investigation of social representations of 20 univ... more The article aims to present the outcome of the
investigation of social representations of 20 university
students on the use of methylphenidate to
improve cognitive performance in healthy people.
In this qualitative and exploratory research, 20
university students between 18 and 25 years from
health and humanities courses were divided into
3 focus groups to discuss about Pharmacological
Cognitive Enhancement. Data analysis revealed that
these students had greater tolerance to methods
that alter neurobiology in favor of the social ideal
of improving the performance of people. However,
respondents expressed great concern about this
procedure intensifying injustices and inequalities
between people, especially in societies where there
are already significant social differences. Thus,
although the subject is little studied in Brazil, the
analysis of data from this research suggests that
Pharmacological Cognitive Enhancement is an
important and relevant topic. Not only because this
practice is related to construction and maintenance
of individuals’ subjectivity in a society that prioritizes
the improvement in cognitive performance, but
also because of the risk that this practice interferes
in matters of social justice and equality.

The aim of this paper was to present ongoing research on the social representations relating to r... more The aim of this paper was to present
ongoing research on the social
representations relating to ritalin in Brazil
between 1998 and 2008. Over this
period, there was a considerable increase
in ritalin usage and expansion of its use
to purposes other than therapeutic use.
Ritalin has been used not only for treating
attention disorders, but also to enhance
cognitive functions in healthy individuals.
The research has developed through
two fields of investigation with different
methodologies. In the first field, Brazilian
scientific and popular publications have
been investigated, with analysis on the
arguments justifying ritalin usage and how
scientific results are disseminated to the lay
public in large-circulation newspapers. In
the second field, focus groups have been
used to explore the social representations
that university students, students’ parents
and healthcare professionals have in
relation to the use of ritalin for enhancing
cognitive performance.

O objetivo do artigo é apresentar
uma pesquisa em andamento sobre as
representações sociais da ritalina no Brasil
entre 1998 e 2008. Nesse período, houve
um incremento considerável do uso da
medicação e sua expansão para outros
fins além dos terapêuticos. A ritalina
tem sido usada tanto para o tratamento
de patologias da atenção como para
melhoria de funções cognitivas em
pessoas saudáveis. A pesquisa se desdobra
em dois campos de investigação, com
metodologias diferenciadas. O primeiro
campo investiga as publicações brasileiras,
científicas e em mídia popular, sobre
a ritalina, analisando os argumentos
que justificam seu uso e a difusão dos
resultados científicos para o público
leigo nos jornais de grande circulação.
O segundo campo de investigação usa a
metodologia de grupos focais para explorar
as representações sociais de universitários,
pais de universitários e profissionais de
saúde, acerca do uso da ritalina para o
aprimoramento do desempenho cognitivo

Frontiers in Medicine, 2024

Introduction: Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a c... more Introduction: Brazilian Primary Health Care (PHC) is responsible for all-sanitary actions for a community-based population, including health promotion and mental health care. Mindfulness Based Health Promotion (MBHP) is an intervention that can promote self-care and psychosocial support in PHC.
Objective: To discuss the effects of mindfulness based psychosocial group interventions for health promotion in primary care units in Rio de Janeiro, Brazil.
Methods: The intervention was based on the MBHP model adapted for SUS. Nine groups were held in Rio de Janeiro. A quali-quanti research was held with two parts: (a) quantitative study, pre and after the 8 weeks intervention, evaluating the effect on mindfulness and self-compassion and their association with levels of anxiety, depression, and quality of life. (b) Qualitative research using Focus Groups with the participants to investigate their experience at the end of the mindfulness groups.
Results and discussion: Sixty-two participants finished the 9 groups where 86% were women, mostly between 30 and 59 years of age and low income, and around 80% under regular medical care in PHC in SUS. In the studied sample 80% had at least one chronic health condition under treatment, including 42% with anxiety and 35% with depression. The effects included significant improvement in Anxiety and Depression and in Quality of Life, mainly in the psychological but also in the physical and interrelation domains. The qualitative study showed that most patients joined the group on the recommendation of health professionals for managing physical and mental health symptoms. Patients reported being able to use the practices taught in the sessions to manage symptoms such as nsomnia and emotionally distressing situations in their daily lives. Including family members in mindfulness practices was a strategy to negotiate not only a space at home to meditate, but also to obtain a different approach to health problems. Participants pointed to mindfulness as a complementary therapeutic option to medication and psychotherapy.
Conclusion: Mindfulness-Based Intervention have shown to be a feasible, well-accepted and efficacious method of offering psychosocial support and promoting well-being for low-income patients in primary care in LAMIC.

Culture, Medicine, and Psychiatry, 2024

The introduction of mental health collaborative care (MHCC) is one of the strategies to scale up ... more The introduction of mental health collaborative care (MHCC) is one of the strategies to scale up access to mental health care in primary health care in Brazil. This article investigates an experience of mental health collaborative care in the city of Rio de Janeiro, Brazil. It is a qualitative study involving interviews with physicians and mental health professionals working in primary health care units located in the northern part of the city of Rio de Janeiro, Brazil. The aim is to examine the various strategies and negotiations that primary health care professionals deploy to identify mental distress and plan health care interventions. We discuss the results within the economy of attention framework. We argue that divergences in diagnostic design and therapeutic planning carried out by professionals and users or observed in MHCC meetings illustrate the health-disease-care seeking phenomenon as a negotiated process, entangled in complex interactions. Our results evince that those interactions are not always evident and configure 'what is at stake' in mental suffering. The incorporation of cultural and structural determinants in collaborative care may enable the expansion of mental health initiatives sensitive to local needs and realities.

Critical Public Health, 2024

The growth of identity struggles and intersectional debates has presented challenges for public h... more The growth of identity struggles and intersectional debates has presented challenges for public health services in Chile and Brazil. In this context, researchers, stakeholders, health practitioners, and activists have recently brought contemporary debates on professionals’ competency to the fore. Debate in Chile and Brazil has primarily centered on US-based discussions on cultural and structural competency. However, emerging concerns regarding identity, intersectionality, and mental health among vulnerable or marginalized groups have confronted local health traditions with the need for specific interpretations of concepts such as ‘culture’ and ‘structure’. In this commentary, we delve into the recent history of psychiatry and public health in Chile and Brazil to reveal how ideologies and politics have influenced local traditions in mental health practice and their interaction with ongoing identity struggles and intersectional debates. We argue that recent historical and sociopolitical factors in both countries have shaped a structural-based approach to mental health practice. The introduction of gender and multicultural policies in public health has contributed to a more complex understanding of Otherness and power relationships in recent decades. Although this understanding largely aligns with those prevalent in the USA and UK, there is a strong emphasis on class in identity struggles and intersectional debates in public health, providing a distinctiveness to Latin American debate. Understanding professional competencies requires consideration of broader sociopolitical processes. Rather than a de-contextualized understanding of ‘culture’ and ‘structure’, the history of psychiatry demonstrates how these categories interact within specific political and ideological contexts.

saude e sociedade, 2023

Planning and implementing health policies and practices in countries with Primary Health Care-ori... more Planning and implementing health policies and
practices in countries with Primary Health Care-oriented
systems must recognize and manage social inequality
issues in health, which hinder comprehensive and
equitable care. A widely advocated strategy for detecting
and dealing with such challenges is the notion of
cultural competence (CC). In this article, we will present
the notion of CC, its criticisms, and theoretical-practical
alternatives and, then, a narrative review of Brazilian
publications related to healthcare in the Family
Health Strategy. Recognizing sociocultural diversity
in planning health interventions in Brazil is essential,
given that it is an extremely diverse country, whose
health system is organized on the premises of the
Health Reform but that presents important inequities
still. We argue that the inclusion and the negotiation
of sociocultural differences in health practices would
benefit from the observation of the social-historical
context and the reflection on the Brazilian health care
experiences and the everyday care practices within the
communities.

Anthropology & Medicine, 2002

Brazilian mental health care reform understands mental health as a complex social proce... more Brazilian mental health care reform understands mental health as a complex social process. There is a large literature production within the country focused on deinstitutionalization policy, social determinants of mental health and human rights, however, with little recognition beyond Latin American borders. In addition, cultural dimensions of mental suffering have been neglected in Brazilian debates which limits an expanded understanding of health care and users’ inclusion. This paper aims to discuss the role of cultural determinants in mental health care in Brazil. We followed a patient in the city of Rio de Janeiro who opted for therapy based on her religious beliefs—using ayahuasca in the context of the Afro Brazilian religion of Umbanda—over the treat-ment-as-usual in mental health. We draw on the notions of autoatención(self, domestic, and group-care in lay contexts) and medical landscapes to examine how therapeutic negotiations reflect embodied cultural traits and both social and political determinants shaping therapeutic spaces. We argue that recognizing sociocultural differences and ther-apeutic negotiations are key elements in making a more inclusive health practice. Moreover, this recognition enables identifying and reasoning the broader social processes framing health practices. This debate is relevant to the Brazilian mental health context and to other scenarios, especially those where local and global knowledge and practices in mental health are entangled.

Medical Anthropology Quarterly , 2021

Mental illness approaches in public health have resulted in controversies around the adequacy of ... more Mental illness approaches in public health have resulted in controversies around the adequacy of interpretative and therapeutic models. These controversies engage polarized debates amid understandings of mental illnesses either as brain disorders or as socioculturally determined entities. Aiming to investigate how mental health care is implemented in a Latin American metropolis, we conducted an ethnographic study of the approach to depression in a primary care unit in Rio de Janeiro between 2016 and 2017. "Life" emerged from our fieldwork as the main local category for understanding the experiences of patients with depressive symptoms and the work of reengagement performed by family physicians. With this investigation, we seek to provide insights into an approach to mental illness in primary health care that moves away from polarized interpretive frameworks and remains open to the singularities of patients' experiences of suffering. [Brazil, depression, life, reparative ethnography] "Francisca, go on living." (Jaime, family medicine resident) "No, I won't go on living." (Francisca, after her son was killed by the police)

Theory, Culture & Society, 2021

Global Mental Health is a field of research and practice that addresses the expansion of universa... more Global Mental Health is a field of research and practice that addresses the expansion of universal and equitable mental health care worldwide. This article explores the ways the concept of culture is employed in Global Mental Health literature. Global Mental Health advocates and critics assume an ontological separation between ‘nature’ and ‘culture’ to typify mental illness, linking it predominantly to one or the other of these two categories. Advocates of Global Mental Health view mental disorders as a nature–culture hybrid, while critics see them as typically cultural phenomena. The cultural critique of Global Mental Health can be strengthened by a sociological approach to both the role of critique and the uses of the concept of culture within social sciences. As an alternative to the ontologization of culture, we propose a different theoretical approach to the social issues involved in the expansion of international public health care in mental health: Arthur Kleinman's and Didier Fassin’s moral anthropological approaches.

Biosocieties, 2021

This article explores the local forms that global controversies around autism and ADHD have taken... more This article explores the local forms that global controversies around autism and ADHD have taken in France and Brazil. Inquiring into the social and historical features of the two contexts makes the abstract, globally circulating ideas meaningful in particular forms, and helps to transcend dichotomies (global/local, biological/relational, mental suffering/disability) through their pragmatic negotiations and integration into the everyday experience of those affected by the conditions. Our research is based on policy reports and regulations, interviews with policy makers, care and school professionals, families, and observations in mental health-care services. We first present inflamed debates in both countries: while autism wars caused the legitimacy of psychoanalysis to be challenged, debates around ADHD focused on the medicalization of social problems. Both controversies impacted policy orientations, the organization of mental health care, and professional knowledge and practices. We discuss the similarities and differences in these transformations in the two countries. We then examine how these controversies unfolded in local configurations of actors and resources. Finally, we call for reflection on how processes of globalization in mental health and local contexts mutually shape each other.

Global Public Health, 2021

Promoting evidence-based treatments and the human rights of people living with mental illness are... more Promoting evidence-based treatments and the human rights of people living with mental illness are the two pillars of Global Mental Health (GMH). Critics counter that human rights narratives must also include social justice frameworks. We draw on the cases of autism and ADHD in Brazil to discuss the role of human rights in mental health in the context of GMH. A human rights perspective involves citizenship rights for individuals living with mental distress and provides a framework to problematise the logic of GMH centred on individual rights and rights to treatment. We begin with an overview on human rights discussions in GMH and examine the introduction of human rights discourses in the Brazilian psychiatric reform. We then explore how autism and ADHD became priorities of GMH interventions as well as the constitution of two styles of activism and mobilisation of human rights around these conditions. One follows the universal public health logic and promotes health as a social right. The other follows the logic of parents’ associations that redefined those conditions as forms of disability to advocate for specialised services and interventions. Finally, we discuss these forms of human rights mobilisation and their implications for Brazilian mental health and GMH.

Forthcoming in Transcultural Psychiatry. Special Issue on Global Mental Health, 2018

Since its emergence in 2007, Global Mental Health has been a growing and polemic area of study, r... more Since its emergence in 2007, Global Mental Health has been a growing and polemic area of study, research and practice in mental health worldwide. Despite having a significant endogenous academic production and innovative policy experiences, the Brazilian mental health field and its actors make few references to, and scarcely dialogue with, the Global Mental Health agenda. This article explores an aspect of this divergence between Global Mental Health initiatives and public mental health care in Brazil regarding the role of culture within mental health policies and practices. Our hypothesis is that part of this difficulty can be attributed to the low relevance of the cultural dimension for the Brazilian mental health field, here referred to as the 'silencing of culture'. We examine the possible historical roots of this process, analyzing the theories about 'anthropophagy' and 'cultural uniformity' of Brazilian cultural matrices. In addition, we describe two recent experiences in public mental health care that incorporate cultural competence: the work of the community health workers and community therapy. The development of cultural competence can be decisive in 2 2 enabling an expansion of the dialogue between research and practice in Brazilian mental health and Global mental health initiatives.

Cad. Saúde Pública 2018; 34(11):e00158017, 2018

Paralelos entre a produção científica sobre saúde mental no Brasil e no campo da Saúde Mental Glo... more Paralelos entre a produção científica sobre saúde mental no Brasil e no campo da Saúde Mental Global: uma revisão integrativa Parallels between research in mental health in Brazil and in the field of Global Mental Health: an integrative literature review Paralelismos entre la producción científica sobre salud mental en Brasil y el campo de la Salud Mental Global: una revisión integradora Resumo A Saúde Mental Global é um campo de ensino, pesquisa e prática, cuja priori-dade é melhorar o acesso e assegurar a equidade no cuidado em saúde mental para todas as pessoas do mundo, propondo ações especialmente em países de média e baixa renda, como o Brasil. Diante desse panorama mundial e con-siderando o avanço local dos processos das reformas sanitária e psiquiátrica, torna-se importante investigar o estado atual da literatura brasileira e sua relação com a Saúde Mental Global, descrevendo como a produção nacional aborda assuntos enfatizados nesse campo. Assim, adotando abordagem quali-tativa e perspectiva descritiva, foi realizada revisão integrativa da literatura do período de 2014-2015, por meio de pesquisa bibliográfica em português e inglês, utilizando os termos saúde mental e Brasil combinados a palavras-chave correspondentes aos principais tópicos discutidos por autores da Saúde Mental Global. Foram encontrados 88 artigos apreciados segundo sua auto-ria, periódicos e regiões de publicação, metodologia e de acordo com as catego-rias de análise e acesso; atenção primária; atenção psicossocial; determinantes sociais da saúde; direitos humanos; e equidade. Constatou-se haver na pro-dução científica nacional um conjunto de estudos muito rico e diversificado com paralelos com a literatura da Saúde Mental Global, mas apresenta um baixo índice de sistematização. Esses achados revelam, portanto, que, apesar dos esforços para a geração de conhecimento local, existem barreiras que, pos-sivelmente, comprometem a participação brasileira no debate internacional. Este é um artigo publicado em acesso aberto (Open Access) sob a licença Creative Commons Attribution, que permite uso, distribuição e reprodu-ção em qualquer meio, sem restrições, desde que o trabalho original seja corretamente citado.

BMJ Global Health , 2020

In this editorial, we draw on examples from Brazil and Chile to explore how, within local mental ... more In this editorial, we draw on examples from Brazil and Chile to explore how, within local mental health systems, ‘contexts’ behave in ways that do not necessarily follow the logic of implementation. Context and culture are not only facilitators or barriers; they are contentious dimensions of identity (as in the case of Brazil), and their relevance is weakened by global assessment technologies (as in the case of Chile). We aim to unsettle and expand the relatively circumscribed place given to culture and context in global mental health. Brazil and Chile are two countries that stand in an ambiguous position concerning the implicit priorities of global mental health; countries that, while not easily classifiable as producers or receivers of global mental health interventions, dynamically respond to its normative and epistemic coordinates. A secondary aim for this editorial is, therefore, to explore the nature of this interaction.

Urban transformations and public health in the emergent city, 2020

interface, 2019

Global Mental Health authors advocate on the one hand, for increased access to mental health care... more Global Mental Health authors advocate on the one hand, for increased access to mental health care including the use of standardized interventions. On the other, patients’ symptomatic expression of
emotional distress hampers its identification by Primary Care professionals in Brazil. This affects the provision of care and demands culturally sensitive approaches. In order to understand patients’ perception of their emotional distress and of the care provided in Primary Health Care, a narrative qualitative method was adopted, involving data collection in groups in waiting rooms and the use of a script based on the McGill Illness Narrative Interview. We performed content analysis and found out that restricting communication of distress is associated with limited access to care. To face this limitation, strategies are suggested to guide the structuring of care that is both comprehensive and culturally
sensitive.
Keywords: Access. Care. Emotional distress. Global mental health. Primary Care.

Transcultural Psychiatry, 2019

Since its emergence in 2007, Global Mental Health has been a growing and polemic area of study, r... more Since its emergence in 2007, Global Mental Health has been a growing and polemic area of study, research and practice in mental health worldwide. Despite having a significant endogenous academic production and innovative policy experiences, the Brazilian mental health field and its actors make few references to, and scarcely dialogue with, the Global Mental Health agenda. This article explores an aspect of this divergence between Global Mental Health initiatives and public mental health care in Brazil regarding the role of culture within mental health policies and practices. Our hypothesis is that part of this difficulty can be attributed to the low relevance of the cultural dimension for the Brazilian mental health field, here referred to as the “silencing of culture.” We examine the possible historical roots of this process with reference to theories of “anthropophagy” and “cultural uniformity” in the context of Brazilian cultural matrices. We then describe two recent experiences in public mental health care that incorporate cultural competence through the work of community health workers and the example of community therapy. We argue that the development of cultural competence can be decisive in enabling an improved dialogue between research and practice in Brazilian mental health and global mental health initiatives.

Cadernos de Saúde Pública , 2018

Parallels between research in mental health in Brazil and in the field of Global Mental Health: a... more Parallels between research in mental health in Brazil and in the field of Global Mental Health: an integrative literature review Paralelos entre a produção científica sobre saúde mental no Brasil e no campo da Saúde Mental Global: uma revisão integrativa Paralelismos entre la producción científica sobre salud mental en Brasil y el campo de la Salud Mental Global: una revisión integradora Abstract Global Mental Health is a field of teaching, research, and practice whose goal is to improve access to mental health and reduce inequalities in mental health outcomes for all people worldwide, especially proposing action in low-and middle-income countries like Brazil. Given this global scenario and Brazil's progress in health and psychiatric reforms, it is important to investigate the current status of the Brazilian mental health literature and its relationship to Global Mental Health, describing how Brazilian research deals with key topics in the Global Mental Health field. The authors performed an integra-tive literature review using a qualitative and descriptive approach. The article search was performed for the years 2014 and 2015 in Portuguese and English, using the terms " mental health " and " Brazil " , combined with key words corresponding to the principal themes addressed by authors in Global Mental Health. The search yielded 88 articles, which were analyzed according to authorship, periodicals and regions, and the analytical categories of access , primary care, community mental health services, social determinants of health, human rights, and equity. Brazil's mental health research revealed a rich and diverse body of studies, showing parallels with the literature on global mental health, but with limited systematization. Although the review revealed efforts to generate knowledge in this field within Brazil, some barriers may be limiting Brazil's participation in the international debate on Global Mental Health.

Since its emergence in 2007, the field of Global Mental Health has faced constant criticism by Tr... more Since its emergence in 2007, the field of Global Mental
Health has faced constant criticism by Transcultural
Psychiatry and the Social Sciences. A main issue is the
field's supposed tendency to make use of biological
explanations so as to explain mental disorders, which
would then have any other dimensions relegated to
background. In order to analyze to what extent Global
Mental Health relies on biological explanations, we
searched during July of 2014 for expressions related
to biology and “global mental health” in PubMed
database and in recent publications associated with the
field. In this article we present some conclusions about
the incorporation of biological references in recent
publications associated with Global Mental Health.
Although there are very few explicit biological references
in those texts, they seem to be used in order to justify
the need for mental health policy. We also make some
remarks about a context-specific view of biology.

This paper presents a theoretical analysis on the integration of mental health within primary car... more This paper presents a theoretical analysis on the integration of mental health within primary care from the perspective of the objectives and strategies of Global Mental Health (GMH). This task is divided into two parts. The first part is dedicated to international review studies on the subject and the second deals with Brazilian regulatory and scientific publications about the issue. The international studies corroborate the integration of mental health within primary health care (PHC) as a fundamental strategy for reaching the goals of GMH. In the Brazilian scenario, this topic is important for policies and research within mental health, but the objective of this integration and the ways in which it is put into operation require better definition. We conclude by pointing out some obstacles that prevent PHC from occupying a strategic role regarding mental health actions within the Brazilian National Health System (SUS).

Biological Psychiatry emerged in the 1980s in the United States with the publication of DSM-III (... more Biological Psychiatry emerged in the 1980s in the
United States with the publication of DSM-III
(Diagnostic and Statistical Manual of Mental Disorders).
This manual intends to be a-theoretical and to provide
objective descriptions of "mental disorders" by using
diagnostic criteria that do not include discussions about
the aetiology of these "disorders". Hence and despite the
“biological” label conferred to this branch of psychiatry,
there is no explicit concern to ascertain the possible
biological origins of "mental disorders" in DSM-III. In
this paper we intend to examine the modifications in
North American Psychiatry following the introduction
of the first psychotropic medications and the subsequent
role played by the pharmaceutical industry in this
process. Thus, what is under analysis in our article is
that, by appropriating psychotropic drugs as the first
therapeutic option, Biological Psychiatry creates an
alliance with the pharmaceutical industry that inserts
it into a technoscientific network that makes it difficult
to know the limits between Biological Psychiatry,
Psychopharmacology and the Pharmaceutical industry.

A compreensão dos processos de formação dos transtornos mentais vem se mostrando desafiadora desd... more A compreensão dos processos de formação dos transtornos mentais vem se mostrando desafiadora desde a fundação do campo psiquiátrico. O desenvolvimento das neurociências proporcionou novo fôlego à expectativa de encontrar estritamente no funcionamento biológico a explicação para o surgimento dos transtornos mentais. No entanto, tal objetivo não vem sendo alcançado com a esperada facilidade, de modo que novas hipóteses começam a se destacar nas pesquisas neurocientíficas. Neste artigo, identificamos as noções de epigenética, neurodesenvolvimento e plasticidade como os principais indicativos de um novo modo de compreender a biologia dos fenômenos mentais. A complexidade genética, o papel formativo do ambiente e as variações que caracterizam a vulnerabilidade implicam importantes modificações nas principais teses sobre a determinação biológica dos transtornos mentais, sugerindo uma reconfiguração dos limites entre o "social" e o "biológico" nas pesquisas em neurociências.

Understanding the processes involved in the development of mental disorders has proven challengin... more Understanding the processes involved in the development of mental disorders has proven challenging ever since psychiatry was founded as a field. Neuroscience has provided new expectations that an explanation will be found for the development of mental disorders based on biological functioning alone. However, such a goal has not been that easy to achieve, and new hypotheses have begun to appear in neuroscience research. In this article we identify epigenetics, neurodevelopment, and plasticity as the principal avenues for a new understanding of the biology of mental phenomena. Genetic complexity, the environment’s formative role, and variations in vulnerability involve important changes in the principal hypotheses on biological determination of mental disorders, suggesting a reconfiguration of the limits between the “social” and the “biological” in neuroscience research.

The term medicalization in the studies by Illich and Foucault was analyzed, in order to provide c... more The term medicalization in the studies
by Illich and Foucault was analyzed,
in order to provide conceptual tools
for studying movements that contest
medicalization. Illich addressed
hypertrophy of medicalization in modern
life by emphasizing the effect of reductions
of subjects’ autonomy, especially through
the fact that medical institutions take
on the responsibility of treating pain,
thus turning its intimate and personal
meaning into a technical problem. Foucault
approaches medicalization from the notion
of biopower, and in examining the concept
of governmentality, he made it possible
to analyze individuals’ ways of resisting
the wielding of that power. Both works
were concerned with proposing forms of
exercising freedom, although Foucault
did this in a more detailed and diversified
manner. They both seem appropriate
for reflecting on the current process of
demedicalization or situations in which the
medical diagnosis is rejected by the patient
or members of his family.
Analisa-se o termo medicalização nos
estudos de Illich e Foucault, com vistas a
oferecer ferramentas conceituais para o
estudo dos movimentos contestatórios à
medicalização. Illich aborda a hipertrofia
da medicalização na modernidade,
ressaltando o efeito de redução da
autonomia dos sujeitos, sobretudo pelo
fato de as instituições médicas assumirem
a responsabilidade de cuidar da dor,
transformando seu significado íntimo e
pessoal em um problema técnico. Foucault
aborda a medicalização a partir da noção
de biopoder, e, quando trabalha a noção
de governamentalidade, abre espaço para
a análise das formas de resistência dos
indivíduos ao exercício do poder. Ambos
os trabalhos, que têm como preocupação
propor formas de exercício da liberdade
– apesar de Foucault o fazer de forma
mais detalhada e diversificada – parecem
apropriados para se pensar o processo
atual de desmedicalização ou recusa do
diagnóstico médico por parte de seus
portadores ou familiares.

Um panorama sobre as variações em torno do conceito de medicalização entre 1950-2010 An overview ... more Um panorama sobre as variações em torno do conceito de medicalização entre 1950-2010 An overview of the variations surrounding the concept of medicalization between 1950 and 2010 Resumo Este artigo analisa a pertinência do con-ceito de medicalização, para a análise sóciocultu-ral, partindo de críticas na literatura internacio-nal surgidas na década de 2000. Essas críticas apon-tam a excessiva generalidade do termo, que pas-sou a abranger situações diversas, perdendo parte de sua acurácia analítica. Analisaremos alguns dos sentidos possíveis do termo medicalização, tais como: 1) as estratégias massivas de sanitarização da população; 2) a transformação de comporta-mentos considerados desviantes em doenças; 3) a ação do controle e imperialismo médico; 4) a par-ticipação de atores fora do campo da medicina. A partir desses diferentes usos, apontaremos a ne-cessidade de uma transitividade do conceito, ou seja, que se especifiquem os sentidos que são a ele atribuídos por ocasião de sua utilização – do con-trário, haveria uma perda de precisão teórica que retiraria do conceito sua possível utilidade para a análise social. Abstract This article examines the pertinence of the concept of medicalization for socio-cultural analysis. The study is based on the criticism which emerged in the international literature between 2000 and 2010. The criticism stressed the excessive generality of the expression that encompasses different situations and thereby loses its analytical precision. The main meanings of the term medicalization are examined, namely 1) the major strategies of hygienization of the population; 2) the transformation of behavior considered deviant into disorders; 3) control strategies and the medical imperative; 4) the participation of non-medical actors. Based on the different meanings of the notion of medicalization, the transient nature of the concept needs to be stressed, i.e. the need to specify the different meanings attributed to the notion depending on the different contexts in which it is used. If this is not done, the concept will lose its theoretical accuracy and will possibly no longer be useful for social analysis.

In psychiatry, the possibilities of intervention in the risk for development of mental disorders ... more In psychiatry, the possibilities of intervention in the risk for development of mental disorders are now receiving greater attention, motivating researches and causing controversies. Among the several investigations about risk and psychiatric categories that have been conducted in the international scenario, proposals intended to previously detect and intervene in the development of psychosis stand out. Programs for early detection of psychosis have two objectives: to reach patients living the first psychotic break and patients considered to be at risk mental state. Despite the controversy about the at risk mental state, with the preparation of a new version of the DSM, the possibility of creating a specific category that could identify the risk for psychosis was pondered. This article analyzed the path of the early intervention in psychosis, starting with the emergence of the actions within the context of clinical enhancement in the first break, going through the controversial systematization of the notion of at risk mental state, finally coming to the formalization of the proposal of a new diagnostic category during the preparation of the DSM-5. RESUMO. No campo psiquiátrico, as possibilidades de prevenir o risco de desenvolver transtornos mentais começam a reunir interesse, motivar pesquisas e provocar controvérsias. Entre as diversas investigações sobre risco e categorias psiquiátricas que vêm sendo conduzidas no cenário internacional destacam-se as propostas destinadas a detectar e intervir precocemente no desenvolvimento da psicose. Os programas de detecção precoce da psicose têm como objetivo atingir duas categorias de pacientes: os que vivem o primeiro surto psicótico e aqueles considerados em estado mental de risco ou pré-psicóticos. Apesar da controvérsia em torno do estado mental de risco, com a elaboração de uma nova versão do DSM aventou-se a possibilidade de criar uma categoria específica que identificasse o risco para a psicose. Neste artigo analisamos as propostas de intervenção precoce na psicose de estratégia clínica dividindo essa análise em três etapas: 1-a do surgimento das ações no contexto de refinamento da clínica do primeiro surto; 2-a da sistematização controversa da noção de estado mental de risco; 3-a da formalização da proposta de nova categoria diagnóstica durante a elaboração do DMS-5.. Palavras-chave: Intervenção precoce; psicose; psiquiatria. INTERVENCIÓN TEMPRANA EN LA PSICOSIS: DE LA ESTRATEGIA CLÍNICA A UNA POSIBLE CATEGORÍA DIAGNÓSTICA RESUMEN. En el campo de la psiquiatría, las posibilidades de intervención sobre el riesgo de desarrollar trastornos mentales comienzan a provocar interés, motivar la investigación y causar controversias. Entre las muchas investigaciones sobre riesgo y categorías psiquiátricas que se han realizado a nivel internacional, se destacan las propuestas para detectar e intervenir tempranamente en el desarrollo de la psicosis. Los programas para la detección temprana de la psicosis tienen doble objetivo: llegar a los pacientes que viven el primer episodio psicótico y a los pacientes considerados en el estado mental de riesgo o pre-psicóticos. A pesar de la

In recent decades, neuroscientific theories began to be adopted as central to the etiology of men... more In recent decades, neuroscientific theories began to be
adopted as central to the etiology of mental disorders
explanation. Aiming to find the foundations of
disorders, investigations took prioritized genetic load
and brain functioning. From the valuation of biological
determination of diseases and the emergence of various
technologies of medical research, one has suggested
the possibility that the causes of disorders were finally
understood. However, several difficulties and challenges
mark the neuroscientific project biological foundation
of disease etiology. The recent introduction of the
notion of epigenetics in the psychiatric field has been
considered essential to renew the hope of understanding
the etiology of disorders. From the analysis of review
articles, this article aims to examine the appropriation of
the concept of epigenetics by contemporary psychiatric
field, identifying their origins and describing their main
characteristics, and reflect on the consequences of their
adoption. Besides contributing to the redefinition of
etiological theories in the psychiatric field, the notion
of epigenetics imposes a reconfiguration of genetic
knowledge and, to some extent, the deterministic and
reductionist design of biological foundation of mental
disorders itself, allowing for more nuanced interpretations
of neuroscience and contemporary psychiatry.

Culture, Medicine and Psychiatry, 2024

Loneliness among young people has been increasing in recent years and is considered a major publi... more Loneliness among young people has been increasing in recent years and is considered a major public health problem. This article delves into the sociocultural dynamics that favour the experiences of loneliness. For this purpose, 40 students between 19 and 24 years of age were interviewed using the photo elicitation interview (PEI) strategy. The results show a gradual normalization of the experience of loneliness and an effort to become accustomed to it. Virtual relationships and isolation linked to the COVID-19 pandemic are considered the two factors that have most enabled a climate prone to loneliness. Young people identify a few elements that feed social loneliness, such as an understanding of instrumental relationships, a scarcity of intimate relationships, a demand for hyperconnectivity, a fantasy of independence and a culture of positivity that hinders the establishment of quality social ties. Faced with hostile relational conditions, youth are sent into a cycle of loneliness. The greater the distrust of the environment is, the greater the defensive reactions and social distancing, and the greater the search for nearby spaces of refuge, security and shelter. Social withdrawal makes in-person relationships difficult and strengthens the need to isolate and become accustomed to loneliness.

The Lancet Regional Health - Americas, 2023

The purpose of this article is to offer conceptual tools that may help one to reflect on the biop... more The purpose of this article is to offer conceptual tools that may help one to reflect on the biopolitics of health, based on the works of Michel Foucault, Agnes Heller and Hannah Arendt. For Foucault, since the 18 th century, biological life and the health of the nation became fundamental targets of a power over life that emphasized the notions of sexuality, race and degeneration in particular, with the objective of optimizing the biological quality of the population. For Arendt, this trend toward the politicization of life is deeply antipolitical. Life fills the void left by the decomposition of the public sphere. In the case of Agnes Heller, the antipolitical character of the biopolitical discourse manifests itself in the ongoing quest for near-scientific legitimization. The thoughts on race, gender and health mimic scientific thinking and replace opinion by truth. If politics is the arena for the confrontation of opinions, dialogue, initiative, novelty, spontaneity and free action, scientifically legitimated biopolitical thinking is the space of truth, certainty, necessity, determinism and causality, where dialogue is substituted by the politics of self-seclusion, of friends and enemies, and the plurality of opinions is reduced to a single politically correct opinion. O objetivo deste artigo é oferecer ferramentas conceituais que possam ajudar na reflexão acerca da questão das biopolíticas da saúde a partir da obra de Michel Foucault, Agnes Heller e Hannah Arendt. Para Foucault, desde o século XVIII, a vida biológica e a saúde da nação tornaram-se alvos fundamentais de um poder sobre a vida que enfatizava especialmente as noções de sexualidade, raça e degenerescência, cujo objetivo era a otimização da qualidade biológica das populações. Para Arendt, esse movimento de politização da vida é profundamente antipolítico. A vida passa a ocupar o vazio deixado pela decomposição do âmbito público. No caso de Agnes Heller, o antipolitismo do discurso biopolítico se manifesta na procura constante de legitimação quase científica. O pensamento de raça, gênero, saúde é um pensamento científico imitado que substitui a opinião pela verdade. Se a política é o campo do confronto das opiniões, do diálogo, da iniciativa, do novo, da espontaneidade e da ação em liberdade, o pensamento biopolítico legitimado cientificamente é o espaço da verdade, da certeza, da necessidade, do determinismo e da causalidade, no qual o diálogo é substituído por uma política da autoclausura, de amigos e inimigos, e a pluralidade de opiniões é reduzida a uma única opinião politicamente correta.

The goal of this article is to present a snapshot of an ongoing debate within epidemiology, pitch... more The goal of this article is to present a snapshot of an ongoing debate within epidemiology, pitching opposing sides in the struggle to define the path it should follow in the years to come. The debate among epidemiologists in the mid-90s pitted those who defended the idea that epidemiology should necessarily deal with a wide context against those who believed that science and public health are better served by focusing on the individual level. Ian Hacking's concept of styles of reasoning was used as a theoretical tool. The literature was reviewed using a core set of articles as an entry point, seeking articles that cited them, and then back-tracking the citations of the resulting set in the Scopus database. The main arguments are presented according to levels (ontological, epistemological, axiological and pragmatic), in order to show an even deeper disagreement, in the very conception of science and its relation to social issues and public policy. DESCRIPTORS: Epidemiology. Public Health. Science. Knowledge. Review. RESUMO O objetivo deste artigo é apresentar o debate em curso na epidemiologia, evidenciando lados opostos na luta para definir o caminho nos próximos anos. Discussão entre epidemiólogos em meados dos anos 1990, que defendem que a epidemiologia deve necessariamente tratar de contexto amplo contra aqueles que acreditam que a ciência e a saúde pública são mais bem servidas focalizando o nível individual. O conceito de estilos de raciocínio de Ian Hacking foi usado como ferramenta teórica. A literatura foi revisada usando um conjunto nuclear de artigos como ponto de entrada, buscando os artigos que os citaram, e então seguindo as citações do conjunto resultante na base Scopus. Os argumentos principais, de acordo com níveis (ontológico, epistemológico, axiológico e pragmático), foram apresentados a fim de mostrar uma discordância ainda mais profunda, na própria concepção de ciência e da sua relação com questões sociais e políticas públicas.

Francisco Ortega. Genealogias da amizade (Genealogies of Friendship). São Paulo: Iluminuras, 2002

Francisco Ortega. Para uma política da amizade - Arendt, Derrida, Foucault (Towards a politics of... more Francisco Ortega. Para uma política da amizade - Arendt, Derrida, Foucault (Towards a politics of friendship - Arendt, Derrida, Foucault). . Rio de Janeiro: Relume Dumará. 2000

Francisco Ortega Amizade e estética da existência em Foucault (Friendship and aesthetics of exist... more Francisco Ortega Amizade e estética da existência em Foucault (Friendship and aesthetics of existence in Foucault). Rio de Janeiro: Graal, 1999

RESUMO Este artigo tem como objetivo analisar o impacto das tecnologias da visualização médica so... more RESUMO Este artigo tem como objetivo analisar o impacto das tecnologias da visualização médica sobre a corporeidade no contexto da cultura do espetá-culo. O sucesso dessas tecnologias para além do âmbito estritamente biomédico deve ser compreendido no contexto da visualidade espetacular. Tanto a visualidade espetacular como a visualidade médica colocam em questão o estatuto do Real corporal e oferecem a imagem do corpo como o próprio corpo, um corpo que é ao mesmo tempo real e virtual. O corpo virtual é um ícone da cultura do espetáculo, na qual a imagem atinge uma materialidade singular que compete pelo estatuto de realidade com a materialidade do corpo físico. A esse modelo se opõe nossa experiência encarnada do corpo físico unificado, como sujeito de ação no mundo, que implica o conjunto dos sentidos e que escapa na mera apreensão visual e objetivante da mídia e das tecnologias de imageamento. Portanto, a corporificação imaterial das tecnologias médicas é uma pseudocorporificação, na qual o que se perde é a substância, o corpo. Palavras-chave: Corporeidade; visualização médica; cultura do espetáculo, fragmentação.

This article deals with the phenomenological dimension of the inner body in light of the success ... more This article deals with the phenomenological dimension of the inner body in light of the success of new medical imaging technologies outside the biomedical field itself. The new technologies contribute not only to the disembodi-ment of subjectivity, but also to the virtualiza-tion and objectification of corporeality. They neglect the constitutive subjective dimension of the living body. The article investigates this fundamental dimension of corporeality, ungras-pable through medical imaging.

Este artigo analisa o sucesso das novas tecnologias de visualização médica, as quais têm dado rel... more Este artigo analisa o sucesso das novas
tecnologias de visualização médica, as quais
têm dado relevância ao interior do corpo
humano que não encontra precedentes
nas nossas sociedades. Essas tecnologias
extrapolam o campo estritamente
biomédico e se introduzem no campo
cultural e jurídico. O artigo traça uma
genealogia das diferentes tecnologias
médicas de visualização do corpo
humano e do cérebro no século XX, desde
os raios X até as imagens mais
sofisticadas de CT, IRM e PET. Pretende-se
explorar as modificações na corporeidade
resultantes da crescente visualização,
assim como a recepção dessas tecnologias
em tribunais e na cultura popular,
especialmente na literatura, no cinema e
nas revistas de divulgação.

Corporeidade e biotecnologias: uma crítica fenomenológica da construção do corpo pelo construtivi... more Corporeidade e biotecnologias: uma crítica fenomenológica da construção do corpo pelo construtivismo e pela tecnobiomedicina Corporeality and biotechnology: a constructivist and techno-biomedical phenomenological review of the construction of the body Resumo O objetivo deste artigo é mostrar que o modelo de corpo oferecido pelas diferentes versões do construtivismo social possui uma surpreendente afinidade com o corpo construído pelas biotecno-logias. Para ambos os discursos, o do construtivis-mo social e o da tecnobiomedicina, o corpo é uma construção e ambos insistem na sua total malea-bilidade e acessibilidade, negando a sua materia-idade. Portanto, o discurso construtivista não pode servir como instância crítica do discurso das bio-tecnologias, como pretendem seus defensores. De-fende-se, por outro lado, que o corpo fenomenoló-gico possui um potencial ético-emancipatório que pode servir de instância crítica do discurso biotec-nológico. Abstract This article argues that the body model advocated by different versions of social construc-tivism has an astonishing affinity with the body in biotechnologies. Both discourses, that of the social constructivism and that of techno-biomedi-cine, claim that the body is a construction and both insist in recognizing its total malleability and accessibility , contradicting its materiality. Therefore, the discourse of constructivist thought cannot serve as a biotechnological discourse critical instance, as their advocates intend. It will be argued that a phenomenological body has an ethical-emancipating potential that can function as a biotechnological discourse critical instance.

Global Public Health , 2022

Strong public health governance and leadership driven by scientific evidence, community participa... more Strong public health governance and leadership driven by scientific
evidence, community participation, and attention to social and
structural determinants of health are key to effective covid-19
containment. Given the failure of the federal government in Brazil to
adopt effective public health measures, state and municipal
governments, as well as community activists, have stepped in to fill the
void. This essay examines the synergistic role that local governments,
public universities, public health institutions and mutual aid initiatives
have played in Brazil to advance pandemic control and mitigate the
damaging effects of central government policies and neglect. Drawing
on literature, media reports, and insights from journalists and activists
based in Rio’s favelas, we show how grass roots groups take actions
that bear complex and vital relationships with local governments,
NGOs, universities, and public health institutions. Effective local public
health governance goes beyond technical public health responses and
involves strategies for countering chronic marginalisation and
disempowerment of local communities which open new pathways for
creative intermunicipal collaboration, social change, power
redistribution. It remains to be seen if actions and emerging networks
at the local level can exert pressure on national government while not
further exacerbating the polarising politicisation of the pandemic.

Arxiu d’Etnografia De Catalunya, 2021

Resumen. La pandemia de Covid-19 representa un desafío sin precedentes de gobernanza de salud púb... more Resumen. La pandemia de Covid-19 representa un desafío sin precedentes de gobernanza de salud pública global que ha puesto en jaque presupuestos teóricos y ha trastocado dicotomías y jerarquías como global/local, norte global/sur global o políticas de «arriba hacia abajo»/intervenciones de base, que estructuran el campo de la salud global. La primera parte de este artículo problematiza las políticas de salud global para la covid-19. Esas políticas no son factibles en muchos países del sur global y pueden exacerbar desigualdades sociales, raciales, de género y económicas existentes. La segunda parte examina la gobernanza de la covid-19 en Brasil en tiempos de Bolsonaro en el contexto de las políticas de salud global. Ese estilo de gobernanza se caracteriza por un «neoliberalismo autoritario» que convive, paradójicamente, con una «gobernanza sin Estado» (government-by-exception, Nguyen, 2009): una forma de gubernamentalidad sin Estado o «para-Estado» (Geissler, 2015) caracterizada por la ausencia o presencia limitada del Estado. Neoliberalismo autoritario y gobernanza sin Estado se alían al negacionismo científico y a la movilización estratégica de la ignorancia

Laboratorio Filosófico sobre la Pandemia y el Antropoceno, 2021

Physis: Revista de Saúde Coletiva

El libro que nos ocupa aquí es el último título de la colección, RESET - Reflexiones antropológic... more El libro que nos ocupa aquí es el último título de la colección, RESET - Reflexiones antropológicas ante la pandemia de Covid-19, editado por la psicóloga Stella Evangelidou y el antropólogo Angel Martínez-Hernáez.3 RESET es un libro extremamente original, escrito de forma coral desde la experiencia del RESET, definido por los editores como “la sensación de reinicio, paréntesis o stand-by que ha sacudido nuestras vidas desde el inicio del año 2020 a consecuencia de la pandemia de Covid-19” (p. 11). El volumen incorpora 48 reflexiones breves (con excepción del primer y el último texto, el resto tienen una extensión media de 2 páginas), elaboradas durante el punto álgido de la pandemia, entre el 14 de abril y el 11 de mayo de 2020 en diferentes países. La mayoría de las contribuciones son en castellano, aunque el volumen incorpora también algunos textos en catalán, portugués, inglés e italiano.

Dissecando o autoritarismo relutante e capacitista frente ao coronavírus no Brasil”. n-1 edições.... more Dissecando o autoritarismo relutante e capacitista frente ao coronavírus no Brasil”. n-1 edições. Available at: https://n-1edicoes.org/031

Physis. Revista de Saúde Coletiva, 2020

Fernandes, Luisa and Ortega, Francisco. (2020). “A Atenção Primária no Rio de Janeiro em tempos d... more Fernandes, Luisa and Ortega, Francisco. (2020). “A Atenção Primária no Rio de Janeiro em tempos de Covid-19”. Physis. Revista de Saúde Coletiva, 30(3), e300309, DOI: http://dx.doi.org/10.1590/S0103-73312020300309

Physis. Revista de Saúde Coletiva, 2020

Global Public Health , 2020

Brazil’s governance of the COVID-19 pandemic has been described as nothing short of tragic by sev... more Brazil’s governance of the COVID-19 pandemic has been described as
nothing short of tragic by several commentators. President Jair
Bolsonaro’s dangerous brew of neoliberal authoritarianism, science
denialism and ableism has plunged this country into catastrophe. In this
article we argue that this form (or lack) of public health governance can
best be described as governance without (central) government. We
begin with an overview of public health governance in the country
before introducing the main theoretical concepts that guide our
analysis, namely the notions of ‘government by exception’ and ‘strategic
ignorance’. Finally, we sketch the main features of this emerging form of
(non)governance of COVID-19. We highlight the new forms of solidarity
and mutual aid that have emerged in favelas and Indigenous
communities, which have stepped in to fill the void left by a limited
federal presence. The article concludes by reflecting on what this
collapse of public health reveals about the limitations of democratic
governance in the age of Bolsonaro.

Revista de Antropologia Social , 2023

Revista de Antropología Social, 2023

Global Public Health, 2022

Brazilian mental health focuses on the social determination model within mental health policies a... more Brazilian mental health focuses on the social determination model within
mental health policies and interventions to address mental and social
suffering as resulting from social exclusion and structural violence.
Structural concerns focused on class stratification and socioeconomic
inequalities overweight cultural ones in Brazilian mental health. In this
article we examine, first the role of culture and interculturality in mental
health practices and mental health guidelines for health professionals
continuing training in Brazil. Second, we explore interviews with health
professionals around Continuing Education in Health provided by
mental health collaborative care initiatives within primary health care as
illustration of a local practice of structural competency in mental health.
Finally, we examine the central role played by the practices of
territorialisation in shaping health care training and care interventions.
The focus on the territory can promote critical apprehensions of the
intercultural and structural factors that shape health practices, enrich
health professional education oriented towards the basic tenets of
social medicine and provide global discussions around structural
competency with innovative ways of thinking about health education,
health care and spatiality. We believe that our results may be useful for
comparing structural competency training initiatives in global health.

The conceptual and practical work done by social medicine and global health have often overlapped... more The conceptual and practical work done by social medicine and global
health have often overlapped. In this paper, we argue that new efforts
to apprehend ‘the social’ in social medicine offer important insights to
global health along five lines of critical analysis: (1) reconfigurations of
the state and new forms of political activism, (2) philanthrocapitalism
and the economisation of life, (3) The economy of attention, (4)
anthropogenic climate change, and (5) the geopolitics of North and South.

Ciência & Saúde Coletiva, 2011

Este artigo analisa o uso de neuroimageamento nas pesquisas da síndrome da fadiga crônica. Revisa... more Este artigo analisa o uso de neuroimageamento nas pesquisas da síndrome da fadiga crônica. Revisam-se alguns dos estudos publicados sobre o assunto na década de 1990 e analisa-se um ponto específico desses estudo, que é a busca de alterações na ativação cerebral ou outros tipos de anormalidade que possam fornecer um padrão para diagnóstico e tratamento da doença. Analisa-se o entendimento da síndrome da fadiga crônica como uma doença reduzida aos achados cerebrais, argumentando em favor de uma visão mais ampliada da doença, que leve em conta os elementos psicossociais da vida do paciente em detrimento de explicações reduzidas ao somático.

Critical Public Health, 2024

História, Ciências, Saúde-Manguinhos, 2010

Analisam-se algumas condições que permitiram ao cérebro estabelecer-se como hipótese etiológica, ... more Analisam-se algumas condições que permitiram ao cérebro estabelecer-se como hipótese etiológica, no caso da síndrome da fadiga crônica (SFC), junto com outras hipóteses relacionadas a causas orgânicas, como os vírus e a imunidade. Aborda-se, a partir do uso de neuroimageamento para pesquisa e fins diagnósticos, o processo de cerebralização da identidade, segundo o qual o cérebro se constitui como lugar preferencial para a busca de causa das doenças - incluída a SFC - no contexto de uma cultura somática, acirrada no final do século XX.

Interface - Comunicação, Saúde, Educação, 2004

O objetivo deste artigo é oferecer ferramentas conceituais que possam ajudar na reflexão acerca d... more O objetivo deste artigo é oferecer ferramentas conceituais que possam ajudar na reflexão acerca da questão das biopolíticas da saúde a partir da obra de Michel Foucault, Agnes Heller e Hannah Arendt. Para Foucault, desde o século XVIII, a vida biológica e a saúde da nação tornaram-se alvos fundamentais de um poder sobre a vida que enfatizava especialmente as noções de sexualidade, raça e degenerescência, cujo objetivo era a otimização da qualidade biológica das populações. Para Arendt, esse movimento de politização da vida é profundamente antipolítico. A vida passa a ocupar o vazio deixado pela decomposição do âmbito público. No caso de Agnes Heller, o antipolitismo do discurso biopolítico se manifesta na procura constante de legitimação quase científica. O pensamento de raça, gênero, saúde é um pensamento científico imitado que substitui a opinião pela verdade. Se a política é o campo do confronto das opiniões, do diálogo, da iniciativa, do novo, da espontaneidade e da ação em libe...

Trabalho, Educação e Saúde, 2012

Featuring the work of 5 researchers, this panel explores the social, political, and health impact... more Featuring the work of 5 researchers, this panel explores the social, political, and health impact of the COVID-19 pandemic in Brazil. Panelists demonstrate the intertwined crises of governance that the pandemic has brought to light in Brazil, and the implications for democratisation and civic participation.