WORK AND SUFFERING: MENTAL HEALTH CHALLENGES OF SOCIAL WORKERS

ABSTRACT.

This research aimed to investigate the staff mental health at the Specialized Reference Center for Social Assistance (CREAS), Corumbá, State of Mato Grosso do Sul, in 2014. For this, we adopted the theoretical-methodological approach of work psychodynamics to focus on the experiences of pleasure and suffering at work, starting from the hypothesis that the care of individuals in vulnerable situations and violation of rights requires a cognitive and emotional over-investment, causing suffering and psychic wear. Ten professionals of CREAS with elementary and higher education participated in ten meetings for collective interview, which proposed the following questions for discussion and analysis: conditions, organization and labor relations, recognition and valuation, and feelings generated on cases of violence. The experiences of suffering were attributed to lack of infrastructure and equipment, the work overload caused by the demand from other institutions, leading to feelings of anguish, helplessness, sadness and professional devaluation. The pleasure at work was observed by the appreciation for the work done on the part of the users and identification with social work. We concluded that working with the violation of rights affects social and personal relationships of workers, as the discrepancy between prescribed (design) and the actual (implementation) showed reactions of anguish, tearfulness, sadness, helplessness and negative thinking.

Keywords:
Mental health; violence situations; employees of CREAS

RESUMO.

Esta pesquisa teve como objetivo investigar a saúde mental da equipe de funcionários do Centro de Referência e Assistência Social (CREAS) de Corumbá-MS, no ano de 2014. Adotou-se a abordagem teórico-metodológica da psicodinâmica do trabalho para abordar as vivências de prazer e sofrimento no trabalho, partindo da hipótese de que o atendimento aos indivíduos em situação de vulnerabilidade e violação de direitos exige investimento cognitivo e emocional excessivo, gerando sofrimento e desgaste psíquico. Participaram dez profissionais do CREAS, com escolaridade de nível fundamental e superior, os quais foram submetidos a dez encontros de entrevista coletiva, que tiveram como proposta a discussão e a análise das condições, da organização e das relações no trabalho, o reconhecimento e a valorização, e os sentimentos gerados diante dos casos de violência. Verificou-se que as vivências de sofrimento foram atribuídas à falta de estrutura e equipamentos, sobrecarga de trabalho pela demanda advinda de outras instituições, decorrendo em sentimentos de angústia, impotência, tristeza e desvalorização profissional. O prazer no trabalho foi constatado pela valorização por parte dos usuários e identificação com o trabalho social. Foi possível concluir que o trabalho com a violação dos direitos afeta as relações sociais e pessoais dos trabalhadores, pois a discrepância entre o prescrito (concepção) e o real (execução) demonstrou reações de angústia, choro, tristeza, impotência e pensamento negativo.

Palavras-chave:
Saúde mental; situações de violência; funcionários do CREAS

RESUMEN.

Esta investigación tuvo como objetivo investigar la salud mental del personal del Centro de Referencia y Asistencia Social (CREAS) en Corumbá-MS en el año 2014. Se adoptó la psicodinámica del trabajo y el estudio se centró en las experiencias de placer y sufrimiento en el trabajo, partiendo de la hipótesis de que el cuidado de personas en situaciones vulnerables y de violación de sus derechos requiere una sobreinversión cognitiva y emocional, causando sufrimiento y desgaste psíquico. Diez categorías profesionales del CREAS participaron de las reuniones, que tenían educación primaria y superior, y se sometieron a diez sesiones de entrevista colectiva, que siguieron las cuestiones de debate: condiciones, organización y relaciones laborales, reconocimiento y aprecio y sentimientos generados en casos de violencia. Se encontró que las experiencias de sufrimiento se atribuían a la falta de infraestructura y aparato y a la carga de trabajo exigida por otras instituciones, surgiendo sentimientos de ansiedad, desamparo, tristeza y devaluación profesional. El placer en el trabajo fue observado por la apreciación por el trabajo realizado por los usuarios y la identificación con el trabajo social. Llegamos a la conclusión de que el trabajo con la violación de los derechos afecta a los trabajadores sociales y las relaciones personales, ya que la discrepancia entre el prescrito y la realidad (aplicación) mostró reacciones de ansiedad, lágrimas, tristeza, impotencia y pensamiento negativo.

Palabras-clave:
Salud mental; situaciones de violencia; funcionarios CREAS

Introduction

Research in Brazil aimed at the work done with groups and individuals who have suffered or who are threatened with some type of violence usually refer to interventions and care for the victims, highlighting the psychosocial conditions of those who need and seek help, both in non-governmental organizations and in public institutions (^{Oliveira, 2017}; ^{Barbiani, 2016}; ^{Faraj & Siqueira, 2012}; ^{Neves, Castro, Hayeck, & Cury, 2010}). However, little attention has yet been paid to the psychic suffering experienced by professionals who attend rights violations, as is the case of workers in Specialized Reference Center for Social Assistance (CREAS).

Maintained by the Unified Social Assistance System (SUAS), with a transfer of funds from the three political spheres (municipal, state and federal) (^{Brasil, 2011}), CREAS consists of a public and state unit that offers specialized and continuous services to families and individuals in situations of threat or violation of rights (^{Law 12435, 2011}), which serves those who require medium and high complexity Special Social Protection (PSE), such as in cases of abandonment, negligence, drug users, homelessness, sexual abuse, child labor, discriminated because of their sexual orientation and/or racehy, victims of trafficking in persons and adolescents in compliance with social educational measures in open environment. In order to deal with these situations, CREAS offers different programs including the Specialized Protection and Assistance Service for families and individuals (PAEFI); the Specialized Social Approach; the Social Protection for Adolescents in Compliance with the Socio-Educational Measure of Assisted Freedom (LA), and the Community Service Provision (PSC); the Social Protection for Persons with Disabilities, the Elderly and their Families (National Classification of Social Assistance Services, 2013) that work in interface with the Network of Institutions, such as the Psychosocial Attention Center (CAPS), the Public Prosecutor, the Guardianship Council and the Social Assistance Reference Center (CRAS).

According to the Secretariat of Social Assistance (Brasil, 2011), guidelines should be followed in the management of CREAS and in the development of social work in the event of violations of rights perpetrated by family members or members of society, which define that its operation takes place in a network, allowing individuals access to their rights and benefits; that preventive actions be taken with the families, since these are constituted by contradictory relations of protection and violence; and that attendance takes place in a specialized and qualified manner, providing for the strengthening of family ties and the empowerment of those who are in a situation of vulnerability. Also, for the development of actions, the characteristics of the territory of action must be considered, since several factors can contribute to the increase and exposure to situations of violence. In this way, the records are of fundamental importance for the social, cultural, geographic and occupational knowledge of the population and of the threats, damages, victims and vulnerabilities in each place, in order to provide analyses on the main risks and possibilities of intervention, as well as to define the need for another unit in the locality, according to the demand served.

The unit investigated was located in a Brazilian municipality with an international border, permeated by a river and its tributaries, which meant that not only the population living in the urban area but also the riverside population and people from the neighboring country were provided with services. When receiving denunciations sent by dial-up report (100), by justice, by the victim’s own interest or at the request of other institutions, it received a high and diversified demand, sometimes related to issues of illegality and drug trafficking, sexual exploitation of children and adolescents, false imprisonment, people trafficking (mainly women and children), among other forms of violation of rights. In quantitative terms, between January and October 2014, the institution had accounted for 114 cases of child and adolescent abuse and sexual abuse and 108 cases of negligence and financial abuse of the elderly, demonstrating the variation in occurrences and the different types of action required by professionals.

During the study, the staff consisted of 15 professionals, including psychologists, pedagogues, social workers and administrative assistants, and developed specialized activities aimed at guaranteeing social and welfare security, through psychological listening, legal, pedagogical support and benefits of assistance to families of children, adolescents, elderly and citizens in situations of vulnerability.

In line with a critical assessment of reality, the social welfare worker must be able to ensure that human rights are respected, with fruitful practices, interventions, politically grounded and scientifically connected with the transformation of reality (^{Iamamoto, 2012}). In addition to the technical content, social work requires affective availability, which can bring emotional distress to those who attend violence against children, as seen in the study by ^{Correa, Labronici & Trigueiro (2009}), who, when studying nurses, experienced experiences of anguish, sadness and helplessness, indicating the need for training and welcoming to elaborate the feelings deriving from the work.

^{Lopes (2017}) points out that suffering due to direct contact with situations of violation of rights and social vulnerability adds up to the lack of resources and personnel, generating anguish and frustration to make the work done. Also, ^{Santos (2017}) identified in a unit of CREAS a scenario of precariousness that entailed dissatisfaction, insecurity and psychic suffering.

Given the importance of the work carried out by social assistance and the suffering that crosses the daily practice in CREAS, it is understood that the mental health of professionals who deal with violence deserves more attention. Thus, this study discussed the main aspects regarding the suffering experienced by the professionals of a unit of CREAS, and analyzed the subterfuges used in the adverse situations in their work context, from the perspective of the Psychodynamics of Work.

Guiding concepts of Psychodynamics of Work

The process of psychic suffering from the world of work has been explored by the Psychodynamics of Work (PDW) since the 1980s, especially by the French physician Christophe ^Dejours. This approach considers different factors relevant to the mental health process, such as issues related to work environment recognition, identity, suffering and the possibility of sublimation in the clash with reality, symbolic resonance, subjective mobilization, experiences of pleasure and resignification of the suffering (^Dejours, ^Abdouchelli, & Jayet, 2011; ^{Bueno & Macêdo, 2012}).

Psychodynamics of Work considers that several factors influence the attainment of psychic balance, in which the work context is constituted by the organization and working conditions, and by social-labor relations (^{Mendes, 2007}). Working conditions involve the physical and mechanical pressures of the environment (such as instruments, equipment, raw material, organizational support, and remuneration policies), and can cause somatic illness, wear and aging, or even physical illness. The work organization is composed by the division of tasks, time, rhythm, deadline and pressure types, control, characteristics and content of the task, which influences the psychic functioning of the subject (^{Dejours et al., 2011}). Socio-professional relations are established between employees and immediate boss and/or superiors, users and members of the staff, and are one of the main elements to ensure psychic health. It is from the dynamics of recognition of contribution, creativity, intelligence and know-how on the part of the peers that the individual bases its identity and feels integrated to the collective, which contributes to the professional achievement and growth (^{Augusto, Freitas, & Mendes, 2014}).

It is in the distance between the norms and rules envisaged and the way of working in reality that the possibility of recognition takes place, since the organization is never able to encompass the totality of the living work, which includes zeal, transactions, as well as the use of cognitive and emotional processes. According to ^{Dejours et al. (2011}), the distance between the prescribed and the real in the labor situation consists of a source of suffering that will not always bring a pathogenic destination to the worker, because depending on how it will deal with reality and with the difficulties imposed, it will be possible the free exercise of its intelligence and skills in solving problems and situations not foreseen by the work organization. When this action is recognized by the collective, it is possible to base the professional identity and experience pleasure at work. ^{Mendes e Cruz (2004}) stresses that maintaining healthy does not imply in the absence of suffering, but rather in the reaction to the situation, according to the internal and external possibilities to transform and resignify suffering, through the awareness of its causes, conflicts and frustrations. Thus, subjective identification with work presupposes that the activity has a gratifying sense for the subject in the form of symbolic retribution, which, by making use of its personality and intelligence, confronts the subjective reality of work and finds ways to transform its suffering into something positive, assuming a sublimatory investment that is called creative suffering.

The strategies of subjective mobilization favor mental health by allowing the resignification of suffering through the transformation of work situations, since the use of practical intelligence presupposes the transgression of prescribed work, which, based on personal, group and cooperation recognition allows the development of the organization of work towards the trust and solidarity of the group (^{Mendes & Duarte, 2013}). Pathogenic suffering is developed from the moment when the worker does not have the freedom to act and transform its labor reality and uses defensive strategies to be able to adapt to work, which are alienating to the worker. Alienation in this sense means that the worker blocks the full knowledge of his/her doing through these defensive strategies that impede the development of his/her awareness at work. According to Mendes and Morrone (²⁰¹²), the subjects use certain defense strategies to deal with this reality, refusing it, rationalizing, joking, becoming faster, avoiding the scripts or innovating verbal expression.

METHOD

This was a qualitative research carried out with the multiprofessional team of CREAS in the interior of the State of Mato Grosso do Sul, in 2014. The proposal of action research through the Clinical Psychodynamic of Work emerged from the elaboration of the organizational diagnosis in the institution, in which the team exposed the need for a listening moment about suffering at work. This method is intended to work in the subjective processes of labor relations, providing an environment of emancipation and collective reconstruction based on the reflection of doing, the understanding and analysis of the work organization in front of the defensive strategies used in the face of labor suffering (^{Mendes & Vieira, 2014}).

According to ^{Dejours (2004}, p.28), the methodology in Psychodynamics of Work is “a clinical subject that relies on the description and knowledge of the relationships between work and mental health”. Thus, as a Work Clinic, this study sought to survey the psychic suffering and coping strategies used by the workers to deal with the aspects generating suffering (Dejours, 2004), which were possible to be accessed from the listening and speaking of the participants, because Psychodynamics stresses that it is from the word that workers are able to name their suffering and become aware of mobilizing actions, in order to overcome and transform the pathogenic suffering into creative suffering, and promote their mental health.

Participants

Ten workers from different professional categories participated in the study, being three psychologists, two administrative technicians, three social workers and two social educators. The group was built based on the institutional demand and according to the interest and availability of schedules of each worker. For this purpose, a meeting was held with the team to detail the objectives and method of the research, at which time the signing of the Informed Consent Form was requested and the meetings were scheduled, according to the availability of the institution and the attendance and commitments of the workers. The research was approved by the Ethics Committee of the Federal University of Mato Grosso do Sul as of 11/08/2014, under number 32445314.8.0000.0021.

Instruments

For data collection, the participants answered a sociodemographic and occupational questionnaire, containing questions such as age, sex, schooling, formation and professional qualification, work accidents, specialization and remuneration. Ten sessions of semi-structured collective interviews were conducted, guided by topics, based on the reflections produced at each meeting. The meetings were held at a meeting room of CREAS from July to October 2014.

Guiding questions of each meeting

1^st Meeting: Ten professionals participated and the meeting was guided by the discussions about the importance of developing the research in that place.

2^nd Meeting: Nine professionals discussed the conditions and organization of work: “what I do and how I do it”; “difficulties faced”; “how do I feel the relationship between managers and peers”; “I am qualified for the work I do.”

3^rd Meeting: Nine professionals discussed the emotional cost of care: “How do I feel before the cases of violence.”

4^th Meeting: Seven professionals debated on the socio-professional relations and the existence of recognition/appreciation by managers, colleagues and users: “gratification for the work I do”; “are my superiors, bosses and managers valued?”; “do my superiors, bosses and managers value me?”.

5^th Meeting: Seven professionals discussed the socio-professional relations between the members of the work team and with people from external institutions.

6^th Meeting: Eight professionals presented their work experiences on the meaning of CREAS work, results and feelings in front of the results achieved with their work.

7^th Meeting: Eight professionals reflected on the experiences at work and the feeling of indignation and sadness, recurrent in the attendances of violation of the rights.

8^th Meeting: Ten workers participated, who reflected on the elaboration of a plan of action in the face of the problems faced, for a collective management of the work organization, with a debate on possible solutions.

9^th Meeting: Nine workers reflected on the material elaborated by the group regarding the career plan, salary floor, SUAS and Public Policies that regulate the functioning of the Social Assistance Network, and what would be the reason for not meeting the standards, since they are recommended.

10^th Meeting: Ten workers reflected on the material prepared, and the report underwent validation of ideas and was later sent to the coordination of the institution for possible application. There were closings of the meetings..

Data analysis

All the interviews were recorded and transcribed in their entirety, and later analyzed according to the Nucleus of Meaning analysis (ANS), which allows to explain the symbolic and real aspects in the interaction process of the subject with its work routine (^{Mendes & Araújo, 2012}).

The listening and interpretation of the speech allowed to visualize and to deepen the experiences and relations that involved the workers and the suffering at work, through the reflection and awareness of the effects of the labor organization, looking for the meaning of the work (^{Mendes, 2007}). Thus, the core meanings generated through the verbalizations were chosen based on the objective of research, relevance and recurrence in the reports of the participants, being organized in: precarious working conditions, work organization, recognition and defense strategies.

Results and discussion

The study was performed with nine women and one man, aged between 24 and 57 years, six participants with complete higher education, one incomplete and two with complete high school. Eight were married, one single and one divorced. The working time at the institution varied between three months and nine years, with income between one and three minimum wages, as the workload for most employees was 40 hours per week, and could extend due to prevention campaigns in commemorative dates (such as carnival) or night approaches. There were no reports of work accidents.

Precarious working conditions

Core meaning: “the structure for us is a bit negative, because we cannot track who we should” (Interviewee 7).

The Technical Guidance of CREAS (2011) provides that the physical environment has at least three rooms for each type of service, being specific rooms for technical staff, administration and coordination, respecting the conditions of secrecy and privacy, besides two adapted and collective bathrooms. However, the unit studied did not offer the recommended building structure, with two rooms for attendance, one adapted especially for child care and the other one that served for all other activities (attending to families, groups and meetings with the staff), revealing that the expected working conditions were very different from the reality faced for the accomplishment of the activity. There was no accessible structure with ramps and handrails for the accessibility of wheelchairs and disabled people, and it is necessary to attend these cases at home. Still, lack of driving was one of the greatest difficulties, in which the vehicle was shared with other programs of CREAS, leading to delays in home visits, active search and other services. According to Interviewee 5: “(...) what we lack at the moment would be an appropriate car only for social approach (...) More computers, training, structure, to continue our work”.

In relation to daily contact with situations of violence, professionals reported the tension of living with this reality, exposed to many unsafe situations, including suffering threats during home visits and active search. In certain cases, the team reported feeling very inhibited in taking action against the complaint, because often the aggressor was someone very close to the victim or to the family: “(...) regarding insalubrity and dangerousness, when we are often intimidated, as it has happened several times here, in the matter of bullet threat, in the threat of being with a person who was a member of PCC [criminal organization]” (Interviewee 3).

This is aggravated by the fact that most of the team is female, there are no guards or police officers present at the institution or for follow-up during the development of the work:

...I even called my colleague to stay with me and it was an issue that the person threatened me with a gun and with the support of the colleague is that we still managed to get the person who threatened me to leave satisfied, but you see how unhealthy and dangerous it is (Interviewee 2).

Having the physical security guaranteed was a predominant preoccupation in the meetings and reports. It was found that professionals who worked on the guarantee of rights were not protected, feeling neglected because they did not have their own rights guaranteed. Because they deal daily with situations of extreme violence and fear and insecurity are often present, the need for psychological support by the team was mentioned.

It was possible to show the lack of adequate working conditions, mainly in relation to infrastructure, resources and equipment, noting the inadequacy for developing activities proposed by the institution, which, according to ^{Dejours et al. (2011}), can lead to emotional exhaustion, aging, triggering somatic diseases, and be a source of physical health problems. According to Interviewee 3:

... the need for a staff training and one important thing that we have always tried to plead is a supervision for the professionals who attend cases so that they have a really quiet mental health, a supervision like a laboratory so that they can be well mentally ...

The workers also said that it would be extremely important to implement another unit, in order to support the work that was already being developed and to meet the needs of the population of that region. To do so, it would be necessary to carry out a social and territorial diagnosis to survey demands and data on the incidence of situations of personal and social risk, mapping of services, programs and projects in the territory, factors that, according to the participants’ speech, would justify another service unit.

Work organization

Core meaning 1: “The demand is much greater than is quantified” (Interviewee 7).

As a result of the rush taken to deal with the overload, the professionals reported difficulty in formally recording the cases in reports after attending, contrary to the regulations for updating the data system, making it impossible to prove the demand received, even though it was large and cumulative. Such overloading made it difficult to develop a subjective mobilization of the team, which could not put into practice their intelligibility and creativity by speeding up its work pace in order to handle as many cases as possible, given the lack of sufficient professionals. Thus, if the professionals followed the recommended standards of registration, most of the cases would be left unattended.

Therefore, there was in this context a great distance between the tasks foreseen, present in the public policies, and the actual activity of the service provided. The workers experienced a conflict between the assignments that were formally prescribed to them and the technical attributions and demands of the actual work, according to Interviewee 5: “(...) all the people that come to be attended at CREAS, if we are 100% technical, they will not be well attended the way they deserve (...)”.

Working with cases of violence on a daily basis was tiring and exhausting, due to emotional overload, and this exhaustion is indicative of suffering capable of inducing a process of labor sickness.

... it is a hard, boring service, and there are days that you leave here wanting to not come back, because of heavy things that happen, and then you see and talk like this - My God how it can happen ... (Interviewee 3).

Interventional work required, among other factors, a lot of caution from professionals, since they should be able to assess the severity and the imminence or not of exposure to violence, identify risk situations, prevent aggravation and continuity of the situation of violence, seek the proper accountability of the authors, provide legal, psychological and assistance. Thus, there was a need for staff training to ensure the quality of care, which was insufficient. According to Interviewee 2: “(...) there is a lack of time to study, an incentive for training, that we do not have ... and it is necessary to make the work flows better (...)"

Another fact raised in the discussions was related to the relationship maintained with the Network, which formed by different advocacy bodies, played a key role in guaranteeing access to justice and mechanisms of legal protection. These institutions sent cases and requested the assistance of CREAS professionals, who were not within their competence and did not fit the institution’s actions and objectives. This factor implied an increase in demand, since once the team began to respond to the requests of the cases sent, it was established the difficulty in limiting the daily workload, which was characterized by being intense and exhausting.

... the superior management cannot understand what CREAS really is, they have this difficulty, sometimes they make a requirement for people who are not ours, it is outside, and we even comply with, we swallow hard ... and lack for them this technical knowledge of our doing (Interviewee 1).

This lack of articulation with the Network, which was unaware of the tasks and attributions of CREAS, caused the team to wear out psychically when having to perform functions beyond what is expected, representing a risk of developing pathogenic suffering, by requiring the accomplishment of activities neither recommended nor valued. Faced with this situation, it was reported the feeling of insecurity and incapacity, both in the resolution of cases and in welcoming all the demand coming from the Network. Although meetings and case studies were conducted with the Network, with health psychologists, the Guardianship Council and others, in the search for an interdisciplinary and contextualized work in cases considered more difficult, the participants reported that there was no engagement and interest of the colleagues of the institutions. However, despite the difficulties noted, it was possible to perceive the existence of identification with social work and the feeling of pride in being able to help others in some way.

... gives pleasure and joy because we like what we do, but professionally I grew a lot and as a human being too, due to the nature of the work performed ... (Interviewee 5).

Therefore, it is understood that when the activities are carried out according to the adequate demand, there is pleasure in the development of their assignments, especially when there is success in the cases attended.

Core meaning 2: “we can complement each other ... and try to share everything, the case of one or the other, we ask for opinions and always prefer to be together in the decisions, even for judicial matters, I will not answer alone (...)" (Interviewee 3).

During the development of the research, the unit was in a process of changes in the dynamics of operation, mainly due to the insertion of a new coordination, much more participatory, that showed flexibility, access and good communication. According to ^{Dejours (2016}), by respecting individual ingenuity and mode of working in the face of unforeseen situations, management is able to activate cooperation. Thus, through the propagation of values such as loyalty and esteem, the improvement in coexistence and trust began to be established (Dejours & Gernet, 2011), with space for collaborative actions to occur, even in judicial situations that generated wear and stress, and could at another time call into question the quality of work done.

... we deal very much with judicial situations and any of the technicians can answer judicially for any error that happens, and I see that sometimes there is some resistance from other sectors of the city hall with some cases of the service (Interviewee 2).

The possibilities of an open dialogue about the cases attended also strengthened the identity in the work, since the majority of the employees liked the function that exerted and presented consolidated career in the area of social assistance.

... currently the coordination has a great opening, which is considering our difficulties and potentialities, I feel quite easy and also with the Secretariat to be putting any kind of need or not or praise (Interviewee 5).

Although the tasks of reporting and filling out forms were standardized and bureaucratic, workers had the autonomy to describe cases from their own perspective, which provided a sense of identification with social work and its tasks.

Recognition

Core meaning: “because valuation comes from a conducive working environment, from a favorable remuneration and that we realized that we still have not succeeded” (Interviewee 3).

The dynamics of recognition is one of the main elements for the worker to remain in its position, and when this does not exist the individual feels difficulties to find meaning at work, and can lead to a pathogenic dynamic of psychic or somatic decompensation (^{Dejours, Abdouchelli, & Jayet, 2011}). Despite the challenge and the daily effort to deal with the most diverse cases of violence in an inadequate working environment, employees did not feel valued in terms of salary nor sufficiently recognized by management, society and professionals from other institutions (Network). According to Interviewee 10 “(...) the Network, they think that we are incompetent, that we cannot manage our demands, and for us it is a little more complicated (...)”.

On the other hand, there was a consensus among the workers that recognition and appreciation of peers and leadership were in a state of progress, according to Interviewee 6: “(...) she [the coordinator] makes me feel comfortable, and at no time did she put me a negative thing, she believes in what I do.” Even so, the pleasure at work was mainly from the recognition made by the users, generating the feeling of personal gratification: “(...) the users perceive that, from the moment they create a certain relationship, a bond, they value the service, they have a form of gratitude” (Interviewee 5).

Recognition influenced the process of forming the identity of the subject in the social field and in the construction of the collective identity (^{Moraes, 2013}), constituting one of the factors to trigger the subjective mobilization in the face of the realities imposed by the work situations, fostering cooperation to deal with such situations. According to Interviewee 7: “(...) I do it with passion and dedication, and I really enjoy what I do”. Therefore, the use of creativity, the possibility of imprinting their personal brand and the admiration for what they did were observed elements that favored the re-signification of work to obtain pleasure and health (Ferreira & Mendes, 2003).

Another factor relevant to the subjective mobilization was the possibility of the use and recognition of astute intelligence, that is, intelligence in constant rupture with social norms and rules (^{Nascimento, 2015}), based on the professional experience and knowledge of each one and possible to be put into practice, because the characteristic of the unit, at the time of the research, allowed the use of creativity, evidenced in conducting the interviews autonomously, in the resolution of cases according to their experience and professional knowledge, and in the sharing of experiences with the team during the meetings.

Defense strategies

Core meaning: “(...) so I do not let myself be shaken, I try to be really tough, to be strong” (Interviewee 10).

Given the cases attended, it was observed the recurrent use of rationalization, a strategy through which workers sought to justify the causes of suffering to mitigate its implications, seeming to be a positive effect of the organization of the work for its performance, but ineffective because it mobilize forces towards changes to be effective, as shown by Interviewee 8 “(...) these are cases that despite being heavy, we create that force, we create that shell, that force, to perceive others people need us too”.

Jokes, gags and irony were also apprehended at workplace, and exercised a role of escape from the daily suffering of the unit, because through good humor professionals built a space of illusion that allowed the ironic fantasy to establish a feeling of softness and relief:

... I make more jokes when I’m sad, when I’m bored ... But it’s good, because that’s what makes us alive ... (Interviewee 9).

Denial was another identified resource, manifested to the extent that workers claimed to like their doing, counteracting the recurring feelings of anguish, crying, sadness and impotence in the reports, such as Interviewee 10: “(...) there is the sadness, yes, we are very sad too, but with life we learn, with our day to day”.

Final considerations

From the action research provided by the practice of the Psychodynamics of Work Clinic it was possible to understand the experiences of pleasure and suffering, highlighting the importance of building the collective for the achievement of mental health. During the research, it was verified the strengthening of social bonds, from the mutual recognition of the ingenuity and skills involved in the development of the functions of each one, providing satisfaction and strengthening the professional identity, the responsibility in the performance and the perception of relevance by the service provided. In this context, emphasis was placed on the coordination of the unit, which sought to ensure that cooperation and solidarity occurred, through free debate on rules and experiences in the work environment.

Due to the high affective and emotional costs involved in the service, defensive strategies were identified for coping with violence against children, with common invasion of worry, sadness and loneliness in family and social life. It was also observed the use of self-acceleration and activism, strategies considered essential by the collective so that they could supply the demand of the unit, and that made possible, although precariously, the engagement and adaptation to the work organization.

Even when permeated by the feeling of impotence in the face of the imposed work overload, in the preparation of the action plan, it was validated the need to adopt a rhythm of care consistent with the task of registering the services performed, as a way of demonstrating to municipal management the need for hiring more professionals, better working conditions and valuation of the category. In this sense, the Clinical Psychodynamic of Work assisted in the re-elaboration of the experiences of suffering due to the clash between the prescribed way of working and the adaptation to the hierarchical impositions, being the clinical practice validated by the participants themselves, which suggested the establishment of a space for listening and reflecting the suffering related to work.

However, as a limitation of this study, it is necessary to say that new activities and organizational relationships are still necessary to be incorporated and concretized at CREAS, so that efficiency is not linked to quantity, but encompass the dimension of living work, persistence in work, the creation of new solutions and ways of working, facing the difficulties of the reality lived, characterized by urgent, unpredictable and impactful situations, which called for a rapid resolution. In this sense, for appreciation and recognition of the work done, it is necessary that the Network knows the real attributions of CREAS, enabling an integrated and cooperative social work.

Referências

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Publication Dates

• Publication in this collection
  13 Mar 2020
• Date of issue
  2018

History

• Received
  16 Aug 2017
• Accepted
  12 Feb 2018