“Eu rezo e tomo meus banhos de ervas”: narrativas ribeirinhas de padecimento e cuidado em saúde mental na Ilha do Combu - Belém / Pará.

Abstract

This doctoral thesis in psychology is based on the interest in understanding the interaction processes involved in the experiences of illness and care in mental health, in riverside communities on Combu Island, located in the city of Belém do Pará, which build the repertoire of narratives of the explanatory models of illness and care. When the illness is seen only from the biological side, when there is no recognition of the meanings in a broad way for the users and their family members, there is an interference in the recognition of problems that can be disturbing, but potentially treatable in the user's way of life. Illness is polysemic, experiences are varied and therefore it is worth examining each of the senses, both from a clinical and anthropological perspective. Thus, the interpretation of what illness is can also contribute to more effective care work within a territorial logic. In accordance with the assumptions of medical anthropology, it was decided to use the term “illness”, as we refer to the popular understanding and experience of illness and/or suffering, as indicated by the definition of illness. Another concept that we will also use throughout the work is that of explanatory models, understood by the ways in which a health/illness/care process is scientifically and popularly understood, including forms of prevention, treatment, control, relief or cure of a certain condition. The work gives visibility to the ways of understanding, explaining and caring for issues related to mental health in this community, and through the narratives of the community itself and participant observation, it seeks to understand how these understandings were constructed. Knowing what is in place and entering the field of what is not in place. Thus, the study begins with a question: how do the processes that result from the experience of illness and mental health care occur in these riverside communities? Recognizing and allowing mediation between technical, popular and traditional knowledge helps us understand the therapeutic itineraries followed by a certain population. Ethnography called us to immerse ourselves in the field of research, to experience the field and be with the research subjects, establishing a relationship with the subjects so that we could enable them to play a leading role in the process. As a result of this study, we identified that suffering models and self-care practices in mental health in the riverside community were constructed from personal and group experiences that were passed down from generation to generation of families of quilombola and indigenous origins, in addition to biomedical practices. The effects of enchantments are also present and the narratives are permeated by the knowledge of the psychiatric institution, with a double possibility of explaining the illness located between madness and mysticism, in addition to a lofty influence of neo-Pentecostal religions in the narratives of illness and self-care. Would it be a narrative that is repeated and retold about the colonization of the life history of the traditional communities of this territory? With this, we propose a reflection on the intervention in riverside explanatory models carried out both by the hegemonic biomedical model and by neo-Pentecostal Christian religious practices.