Occupational therapy and culture: ethical-political dimensions and resistances

Abstract

This reflective work proposes to debate of culture as a polysemic term and intrinsic to the life of human beings and the development of any societies. It reflects on the neoliberal rationality tied to the social model of capitalist production that affects the economy and politics and also on the production of meanings, desires, and ways of relating to the world, directly impacting human activities, daily life, and the reality that surrounds us. Thus, it intends to provoke and question, from a critical perspective, how occupational therapy can be articulated in the quest to build possibilities of care, emancipation, participation, and citizenship of multiple collective subjects. Occupational therapists who take on the ethical-political commitment to dealing directly with cultural and social demands, especially from a critical perspective, can co-create and strengthen against hegemonic and resistance movements.

Keywords:
Culture; Occupational Therapy; Public Policy; Neoliberalism

Resumo:

Este texto reflexivo propõe discutir a cultura como termo polissêmico e intrínseco à vida dos seres humanos e para o desenvolvimento de quaisquer sociedades. Reflete sobre a racionalidade neoliberal atrelada ao modo social de produção capitalista que afeta a economia e a política. Mas também, a produção de sentidos, os desejos e as formas de se relacionar com o mundo, impactando diretamente as atividades humanas, os cotidianos e a realidade que nos cerca. Assim, tem-se a intenção de provocar e questionar, a partir de uma perspectiva crítica, como a terapia ocupacional pode se articular na busca por construir possibilidades de cuidado, emancipação, participação e cidadania de sujeitos-coletivos múltiplos. Defende-se que terapeutas ocupacionais que assumem o compromisso ético político de lidar diretamente com as demandas culturais e sociais, sobretudo a partir de uma perspectiva crítica, são capazes de criar coletivamente e potencializar movimentos de resistência contra hegemônicas.

Palavras-chave:
Cultura; Terapia Ocupacional; Políticas Públicas; Neoliberalismo

1 Introduction

Thinking about occupational therapy in the current scenario considering the political and economic dimensions is a challenge and an ethical necessity. What are the possibilities and strategies we have unveiled to deal with the neoliberal rationality? It is one of the questions that impact daily life when adopting a critical and reflective positioning. Maintaining a focus on inclusive practices and propositions that embrace, aggregate, and produce power in contemporary rationality that fragments, insists on the individualization, and devaluation of much of human life approaches that may represent resistance to the hegemonies that guide us.

This essay is a reflexive invitation, based on critical occupational therapy in the interaction with culture, seeking to building possibilities of care, emancipation, participation, and citizenship of subjects and multiple collectives. Thus, we can think of the occupational therapist's action in favor of the emancipation of people and communities, the strengthening of spaces for the joint creation of strategies to overcome human violations and degradations (SILVA et al., 2016).

To this end, this essay shows three reflexive scenarios and a conclusion. The initial scenario discusses the field of culture from the conceptualization, its citizenship, symbolic and economic dimensions, and propositions against hegemony, producing value in the diversity of existences as a power of resistance.

The second scenario makes us reflect on the economic and historical processes, principles, and discourses of neoliberalism to its rationality implied in daily life and human lives. Thus, the invitation is also to engaged occupational therapies, care, and concern for each other and with the life events of the individuals and collectives, so that they critically and consciously can act and resist in this context.

In the third moment, we proposed a reflection on the resistances: the unique discourses, the rigid formats, the attempts to control thinking, and feeling. For new compositions, there are connective possibilities for an occupational therapy that is conscious, critical, and diverse, capable of broadening vocabularies and practices, sustaining cultural, social, community, and responsible practices to minimize the processes of exclusion and inequality.

The essay concludes with proposals, reflections, and interrelated connections to suggest ways and continuity of thinking/doing/creating occupational therapies against hegemonic, situated and engaged with the complexity of the current scenario and human relationships.

2 Culture: Concepts, Dimensions, and Politics

There are many possibilities and constructions to debate about the meanings and concepts of culture over time and its historical, social, political, among others features. The conceptual and theoretical repertoire employed here brings together the dimensions and debates of culture in the interconnected macro-political and economic challenges that base and incite conscious, engaged and situates knowledge and practice in the current and urgent social issues.

Thompson (2000) points out that existence without culture is not possible and suggests cultural conceptions as descriptive and symbolic. The descriptive conception would be interested in the beliefs, values, and practices of a people, society at a given time. The symbolic conception addresses the phenomena of human life, behavior, spirit, and actions.

Bauman (2012) stated that the term culture could not be used without being evaluated as a “concept”, “structure” and “praxis”. We will dedicate to conceptual understanding and culture as praxis, from the analysis of its relevance to reflection that is intended to be produced for this essay, for the occupational therapy.

As praxis, the human culture happens in the constitution of being through creativity, of the action of creation that enriches the human experience. As a way of praxis, the culture is both knowledge and interest in seeking meanings and learning about the world (BAUMAN, 2012). The author points out that in this category, culture is made inapplicability, in everyday events, so the choice is in the intrinsic relationship with living, in its most creative, intense and diverse forms and formats about/in the world (BAUMAN, 2012).

As a concept, Bauman (2012) reported three categories: hierarchical, differential, and generic concepts. We believed that due to the complexity of culture, as a web of relationship and ways of life, the generic concept is what most broadly dialogues with the conceptual idea of this work. For Bauman (2012), culture could be conceptualized as human activity: the arrangements and rearrangements of actions, composing cultural material that is in constant transformation and modification.

In the current liquidity scenario, proposals quickly lose value, programmed, and perceived obsolescence mark the immediate unconscious productions and consumption that objectify relationships, producing materials, people, natural resources, and time disposal.

“Volatile and ephemeral, our experience today is unaware of any sense of continuity and is exhausted in a present sense as a fleeting moment” (CHAUÍ, 2008, p. 62). In this context, culture is also limited by an incessant driving logic, emphasizing that we have clients to serve, desires to be created, neutralizing the possibility of satisfaction (BAUMAN, 2013).

Bauman (2012, p. 40) discussed the danger in this scenario of culture as a “beleaguered fortress”, that is, as a motivation for imperialism and colonialism, for the construction of enemies and walls, justifying depreciation and annihilation. However, the author mentioned that even during all the challenges presented, working with reflexivity on the cultural dimension today is essential to rethink and reinvent possibilities because culture can survive the devaluation of being and the decline of diversity in the era of use, abuse and disposal (BAUMAN, 2013).

Santos (2006, 2014) showed a perspective of thought that triggers the project of contradiction and economic, political, and epistemological domination between North and South, which does not refer to geographical representation, but its geopolitics. His perspective contributes to the understanding of culture intrinsic to the economic, political and epistemological dimensions whose dominant epistemologies support and reproduce capitalist, colonial and patriarchal domination.

Epistemology is the whole notion; idea reflected or not about the conditions of what is valid knowledge. Through valid knowledge, a given social experience becomes intentional and intelligible. Therefore, there is no knowledge without practices and social actors. Since both exist only within social relationships, different types of social relationships can create different epistemologies (SANTOS; MENESES, 2010, p. 9).

Considering that social policies are also ruled by conceptual dimensions, disputes of meaning in hegemonic discourses, and the domains of cultural and popular understanding. They can interfere with the processes of apprehension, understanding, and action that disseminate culture in one culture of the community. Thus, the relation of culture is directly linked to the production of knowledge, organization of social life, implicated in human life.

In the dispute for the discourse that expanded culture for cultural policies in Brazil, we had the construction of diverse assumptions that express the citizenship, symbolic and economic dimensions of culture, in the National Culture Plan (BRASIL, 2013), defining the field of culture, its epistemologies, and democratic conceptualizations.

In the case of the citizenship dimension, “[…] culture is a basic right of citizenship” (BRASIL, 2013, p. 17). Cultural activities can enhance proposals for inclusion and socio-cultural participation of populations in situation or at risk and vulnerability as well as favoring the performance of individuals and collectives in society as actors and mediators of it.

The dimension of culture as a right

[...] places cultural individuals beyond their status as consumers, spectators or contributors, but considers them as political individuals, cultural workers, and citizenships responsible for the work of cultural creation (VILUTIS, 2009, p. 24).

In the symbolic dimension, “[…] all human beings can create symbols” (BRASIL, 2013, p. 16). Through the contextualization of products and aesthetic values, the multiculturalist attitude is developed and reformulated (CASTRO; SILVA, 2007). This dimension highlights:

[…] The role of the individual, agent, producer, creator of culture as the subject of his practice, author of his own narrative, creator of his memory, and expression of his identity. […] It is important to highlight the importance of the processes by which cultures are produced, considering the different elements that make up their political struggles and the roots of their cultural creations. Thus, symbolic goods occupy significant space in the dispute for hegemony and the construction of power against hegemony (VILUTIS, 2009, p. 24).

Symbols are the daily productions of human making and feeling, material or immaterial; symbolic projects express the existence of an individual or collective, their life marks, and the differences that reveal them as a power in the perspective of culture.

Sodré (2017) recovers our trajectory of crises and ruptures in cultural policies and pointed out that the current stage requires not only an effort to demonstrate cultural diversity but to give autonomy and voice to this diversity, “[…] using people's technology - corporeality, craftsmanship, knowledge - from the inside out” (SODRÉ, 2017, p. 20), is a truly symbolic and against hegemony policy.

The third economic dimension is the interaction between the plural and democratic cultural creation, production, circulation and consumption to be able to promote the “[…] synergy capable of leveraging endogenous development that would allow Brazil, a new growth alternative” (BRASIL, 2011, p. 14), focused on localities, on populations, in a sustainable and inclusive way, that is, an articulation that values the ways of life.

Although we emphasize the significance of culture as a symbol, citizenship, and form of inclusive economic and social organization, these dimensions are implicated and interrelated. To promote such dimensions of culture, the interest of the different political spheres to legislate, promote and guarantee rights capable of promoting actions that sustain culture from this plural perspective is necessary.

However, the cultural policies in the country are still extremely embryonic and insufficient for the promotion of culture in these dimensions, besides having recently suffered from the rupture of an ideological political project and is even more subjected to the demands of neoliberal rationality.

Augustin (2011) makes us reflect on the construction of cultural policies guided by the neoliberal context, in which the inclusion and cultural democracy character, in some cases, is not focused on the market and end up corroborating the maintenance of the status quo¹ and the widening of the existing social abyss.

As an alternative to the consequences inherent in the processes of commercialization of policies, Sodré (2017, p. 21) argued that for policies to overcome market relationships, for the real “[…] promotion of dialogical relationships between state, global society and plural forms of existence”, it is necessary the appropriation of territories and the collective participation in the governmentality of the individuals.

The recent crisis taken by the neoliberal leadership may have revealed a situation of apathy of policies and the Ministry of Culture that needs to be faced, but also mobilized the resilience and the politicization of this field that has grown and matured since the dictatorship, with claims processes present in the memories of the political culture of the country (BARBALHO, 2017).

As a concept of larger dimensions, culture is intrinsically articulated with human life and should be considered with greater relevance by the political scenario. As well as being a category of resistance to the current neoliberal logic, militancy for culture as an essential right is fundamental. Conscious acting in occupational therapy demands engagement also in the cultural context, considering its pluralities, dimensions, and political and economic uses. It is about fostering powerful new connections for expanded citizenship and plural expressions of lifestyles with respect and desire for diversity (LIMA, 2003).

3 Macro-structural Awareness for Practices Engagement

In this essay, we highlight the macro-social understanding of logic to which we are inserted, submitted and reproduced through several daily mechanisms.

Consequences flow as the guiding norms of an established neoliberal primer that guides markets, institutions, states, and governments perversely managing to embrace every dimension of human life and to reproduce its insignia as a natural process of the developmental view.

We act as if the aspects coming from this rationality were no less necessary and the most tragic characteristics, exclusion, invisibility, marginality, vulnerability, violence, had to be

[…] properly assimilated by our societies as natural, inevitable and even desirable, even though they represent an unprecedented expansion of the degradation of human and environmental conditions of survival on the planet (ZORZAL, 2006, p. 7, italics by the author).

Through economic liberalism, the consumption and market patterns were intensifying as basic pillars, and in the 1970s, a new neoliberal model began to be designed in the world economy, which epidemically penetrated every day and most intrinsic relationships of human life (DARDOT; LAVAL, 2016).

This order has practically irreversibly expanded in what we call social inequalities, “[...] for the neoliberalism, the exclusion is a component of modernization in charge of the market” (CANCLINI, 2003, p. 23).

For Antunes (2009), this phenomenon is described as concrete forms of “human (de) socialization”, since it produces labor relationships and obsolete individuals to the current social mode of production. Thus, as an alternative to capital crises, profound social mutations occur, resulting in a precarious process of social and labor relationships.

Even from different references, the expression of the mutations described by Antunes (2009) and his forms of human “(de) socialization” dialogues with the reflection proposed by Dardot and Laval (2016). For the authors, the transition from liberalism to neoliberalism occurred due to many aspects, but it can be said that the epicenter of the debates lies in the factor of governability² as an aspect of the development of capitalism. Societies and their contractual exchanges are not effective in taking care of the market; the state must exist and strengthen with this objective (DARDOT; LAVAL, 2016).

[...] [neoliberalism] proposes that human well-being can be better promoted by emancipating individual entrepreneurial freedoms and abilities within an institutional reference characterized by strong private property rights, free markets, and free trade (HARVEY, 2008, p. 12).

Thus, Dardot and Laval (2016, p. 17) define “[...] neoliberalism as the set of discourses, practices, and devices that determine a new model of government of men according to the universal principle of competition”. Such competition acts on the individuals´ outer and inner relationships and constructs, which highlights the core of current individualism (DARDOT; LAVAL, 2016).

Thus, this logic keeps the flow of capital aligned with the individualized actions of people acting as the controlling lever of this great machine and finds in the individuals the gears they produce to satisfy the needs of the arrangement of the set (DARDOT; LAVAL, 2016).

Harvey (2008) mentions that individual freedom would be transposed by market freedom that reflects the very essence of neoliberal thinking. Therefore, there is perverse false freedom that governs the lives of the individuals and which is a prerequisite for the maintenance and ever-greater resumption of the active accumulation of capital in all aspects and relationships of life. Here is the return of laissez-faire³, much more perverse and using human beings and their desires as the ideological and production driver (HARVEY, 2008).

The individuals maintained severe and precarious social and living conditions in a perverse mechanism. Such gear that brings together principles of flexibility, individualism, specialization is managed by the central axis of relationships: always a competition in all instances of work, life, and human relationships (DARDOT; LAVAL, 2016).

In this way, we have individuals not only adapted and skilled to these conditions but reproducers and desirers of the conditions, reinforcing their ability to compete and beat competition as their market. The whole society and the state become a company, which must be able to compete. The only and exclusive responsibility of themselves happens so that the survival mode based on competitive entrepreneurship happens effectively. A false opportunity for freedom and choice is masked by the instability that constantly pervades the daily pressure of individual success or failure (DARDOT; LAVAL, 2016).

In this sense, the neoliberalism instituted as subjectivity forms of the individuals will be a factory of producing desires and subjects of industrial, flexible, fluid, imprecise, and individualistic modeling (DARDOT; LAVAL, 2016). The rationalization of the bureaucracy and the “free choice” or so-called freedom of the “facade” guarantee the unique and dominant speech, denying diversity to functionally happen, as a control technology.

Dardot and Laval (2016, p. 361) discuss the “neo-individual” created and involved by neoliberal principles and rationality, but with tragic characteristics of behavior, personality and culture, isolated, demoralized when incessantly competing, with the pathology of insufficiency in which it can never achieve its concrete or symbolic goals and is eroded by himself and in himself.

These processes directly interfere in human occupations, activities, and relationships in a globalized context, with distinct intensities and repercussions. How to build meaningful and potent life projects that are socially relevant, economically and ecologically sustainable, prioritizing the power of human diversity and prioritizing life? This is a relevant question also to occupational therapy in this complex and urgent scenario.

According to Santos (2001), we live in a globalized society supported by fables since the ideological and discourse dispute mark the power struggles. After all, what we are versus what we should be, the reality versus the reality interpreted by capitalist logic because there are countless arbitrary and contrary dimensions. For example, it is generally aimed at ease of interaction and accelerated communication, but we have an increasingly fragmented and disunited world (SANTOS, 2001). The author also enunciated the ‘perversity factory’, understanding that this current and globalized context systematically aimed at meritocracy and unbridled competition at any cost (SANTOS, 2001).

Bauman (2015) also denounced the illusions preached as central dogmas to be followed for the proper functioning of economic flows. One fundamental lie is the belief that economic growth is the only way to deal with the issues highlighted by human life, coexistence, and survival, and another major farce is the proposition that

[…] permanent increase in consumption or turnover accelerated the consumption of new objects may be the only or at least the main and most effective way to satisfy the human pursuit of happiness (BAUMAN, 2015, p. 40).

There is no happiness generated only by materially. We as relational, sensitive, cultural, and creative human beings need to bet on reflections and doings that go far beyond the act of buying and consuming to the fullness of life. Bauman also reported about fraud that “[…] inequality between men is natural” (BAUMAN, 2015, p. 40), and rivalry between men is what maintains the social order.

The world becomes increasingly guided by a dangerous single, hegemonic, and dominant speech that generates unacceptable conditions of existence within the standards of this model (ADICHIE, 2009).

Dagnino (2005) points out that today, we find many relationships of conflict and antagonisms that try to be diluted and covered by an apparent homogeneity of the speech, but exposed as an alternative: building social policies, social and cultural movements antagonistic to the process of neoliberal speech and strengthening democratic processes and perhaps building new forms of social management and organization.

Understanding and critical reflection of the macro-structural context and its processes of subjectivation for the production of new intelligibility⁴ that lead to current forms of governability, as described by Dardot and Laval (2016), or in new forms of (dis) sociability, as described by Antunes (2009), besides being fundamental, become strategic in the production of knowledge and practice of occupational therapy.

In this sense, occupational therapists can contribute to the production of strategies, reflections, and practices against hegemonic, anti-colonial, anti-heterocyspatriarchal, and anti-racist searching for rupture and overcoming the impacts generated by hegemonic and violent practices, in ways of life and human relationships. The search for justice, equity, and respect for human and environmental diversity are important, whose transformations necessarily go through the cultural dimension of human lives (SANTOS, 2006, 2014).

4 Resisting and Strengthening Diverse Ways of Life

Certainly, the moments of crisis are moments of opportunity, if we make them. What is clear is that we cannot allow ourselves to be immovable, and to undertake new paths without abandoning what the profession is doing well, which is very bad. It is not easy to get into unfamiliar ways, but sometimes it is the only solution (SIMO ALGADO; OLLER, 2013, p. 17).

Given the considerations about the neoliberal context, empowering individuals and collectives, especially those who suffer the direct and most drastic effects of neoliberal rationality, is part of the therapeutic-occupational action. After all, we emphasize occupational therapy as a profession with references traced based on a history in favor of life, caring for others, respecting diversity and differences, guaranteeing and expanding social and human rights.

Also, the occupational therapy “[...] is a field of practices and knowledge historically constituted to answer to problems related to populations that, for different reasons, suffered the action of exclusion processes” (LIMA, 2003, p. 65).

Although occupational therapy is currently able to work with any population, not just the excluded, we highlight the populations that suffer the most direct effects of the processes of exclusion, inequality, and vulnerability are the central focus of this professional.

For Santos (2005), since the paradigm of modernity was reduced to capitalist development, societies began to live the contradictions of the principles of emancipation, that is, equality and social integration versus regulation, or the processes of inequality and exclusion capitalists. Thus, inequality is a hierarchical system of integration, in which the lower position is included, and its presence is indispensable. The processes of exclusion also occur in a hierarchical system, but this time, the one in a lower position is out (SANTOS, 2005).

Therefore, we emphasize the importance of occupational therapy in understanding and acting in the processes of inequality and exclusion, encompassing plural and intrinsic dimensions to the life processes of most of the population, and establishing them in the complexities of life in the neoliberal scenario.

[…] some forms of doing occupational therapy in the contemporary have reversed the disciplinary logic and produced paths that point in the opposite direction, affirming the right to difference and finding positivity in the most singular life forms and the most adverse situations (LIMA, 2003, p. 65).

The expansion of occupational therapists implicated and engaged in the struggle for social and human rights of individuals and collectives has been a fundamental pillar of the profession, associated with the understanding of the potential of human and cultural diversity to any society in the pursuit of the full exercise of emancipation and citizenship. That “[…] means to overcome the hierarchical domination with the best redistribution of power and resources” (GALHEIGO, 2012, p. 180).

The occupational therapist is the professional who has the best strategies for the inclusion view, recognized by his work with the population as a result of the construction of inclusive, equitable, and sustainable public policies (SILVA et al., 2017, p. 110).

Therefore, an occupational therapy active in this process of social transformation necessarily must assume its ethical-political commitment in the search for inversion of practices and logic to which the population that hegemonically works is a direct and perverse target (LIMA, 2003).

Considering this critical, sensitive and cultural conception, based on the ethical-political commitment and interested in producing know-how in occupational therapy, we need a broader understanding of the macro-social structure that we are submerged; the search for the production of practices and strategies of resistance against hegemonic that do not fragment, classify, hierarchize or annihilate life; to consider the importance of culture and interculturality as an action and ethical precept; to dematerialize activity and to understand it as a vital and ancestral action of human experience; to respect the bodies and all their marks and corporealities; to consider their nature not only as an environment, but to recover the human dimension as nature and its unchanging interdependence and, finally, the complexity of life is not necessarily considered as diagnosis, abnormality, dysfunction or problem, but above all, powerful individuals and collectives with rights to (r) exist.

The so diverse and plural world has been subtracted from the logic of accumulation and production established as unique and the domination necessary for its sustenance, resulting in the weakening of the bonds of creativity, diminishing our faith and belief in ourselves, in the human abilities, in the potential of doing, collective, genuine, and real (FURTADO, 2012).

On the other hand, facilitating the entrance of mediators and flaccid and material relationships, the capital assumes the role of making and breaking the world as a living organism.

The discontinuities between present and past are not just the fruit of creative ruptures; more commonly, they reflect the prevalence of the logic of accumulation over the coherence of the culture system (FURTADO, 2012, p. 77).

Santos (2001) also revealed that even in the dominant forms that generate competitiveness and misery, there is the possibility for a new society, because this scenario in which we live is not irreversible. It is a new form of globalization, culminating in the sharing of the contestation and dissolution of the founding ideologies “[…] what we see is the possibility of producing a new discourse, a new metanarrative, a new great written account” (SANTOS, 2001, p. 21).

In this sense, it is a critical, complex and situate perspective, such as Southern Occupational Therapies, should be relevant to relevant and consistent to their truly engaged practices, connected to the several dimensions of human life and crossed by concepts such as daily life, human action, praxis, human and cultural diversity, equity and social justice (GALHEIGO, 2012; SIMO ALGADO et al., 2016).

The critical perspective emphasizes the values of equality, equity, and the ethical and political position, and, beyond this principle, we emphasize the need to break with the processes of domination and hierarchy that engender the inequalities and exclusions of a large part of the population. The understanding, affirmation, and performance of occupational therapy in this sense of disruption are not consolidated and may even be part of some occupational therapists' reference of principles.

Therefore, an ethic and a position must be assumed, considering social and human rights, citizenship, and social participation as fields and goals engendered by occupational therapy. The cultural dimension of life, the right to exist/to be, and to express with dignity depends on a context. Therefore, the need for action is supported by respect for diversity and an ethical-political commitment intrinsic to the engaged, ensuring reflexivity and by contextual and complex analysis, by consideration of affection over neutrality and lack of positioning.

Thus, to meet the demands supported by the political ethical commitment, occupational therapies must be responsible for updating and reinventing its understandings, conceptualizations, practices and actions to the detriment of the current scenario, with reflexivity, dialogic and a responsible science for reinvention always be attentive and connected to the real demands that the individuals and collectives unveil.

For the construction of new assumptions, care strategies, practices, and meeting with the other, occupational-therapeutic processes need to be questioned as to their models, patterns, positioning, terminologies, and ethics they are constituted as a profession and science.

These new theoretical positions, comprehensive in OT, require a permanent follow-up of the interrogation. From a critical, transformative stance of the social world that we are part, asking about the suppositions of the OT, the obvious, the natural (CORDOVA, 2012, p. 23).

Galheigo (2012) highlighted that to understand the critical and complex perspective of occupational therapy, it is necessary to understand the origins of the profession so that one can reflect the so-called “problems”, “dysfunctions” and “failures” that were pointed out as the objective of the profession:

The speech that the primary role of occupational therapy is the adaptation of individuals to society betrays that society does not present problems (GALHEIGO, 2012, p. 178).

Considering the importance of

[…] creating a relevant profession for society, it enters into a critical paradigm, based on the fulfillment of human dignity and an ability to improve the present reality”, from the perspective of empowerment, human rights, citizenship, inclusion and sustainability (SIMO ALGADO, 2015, p. 25).

All these aspects reveal a practice made from the critical contestation: the system, the individualizations, the capital resources, the ways of doing, measuring, welcoming, listening, and perhaps creating. In this sense, we also question the processes of colonization of knowledge, the imports of unique models, and what Latin America has produced to address the so particular issues, environments, people and contexts.

When we produce knowledge and practices, we produce identifications; we produce occupational therapies. Among the identifications constituted in Latin American history, there are both the valuation of the individual and the universal, as well as the valuation of the collectives and contexts. However, Occupational Therapy has been the last to stand out as the most important ongoing identification in Latin American after 1990 (GALHEIGO, 2014, p. 220).

In the process of learning about their activities, daily life, stories, and life trajectories and the composition of care strategies, assistance, and support networks, new epistemologies began to be produced not only in Latin America but also in the South (GALHEIGO, 2012).

They are forms breaking with the productivist doing, with the colonizing domains, with the fragmentations. Breaking away from dominations and controls that often lead us to processes of weakening and violence depends on actions aimed at a struggle for the guarantee and expansion of rights, something that occupational therapy faces in the course of its existence. According to Santos (2001, p. 171), all this perverse and vertical construction is not irreversible, but there is much possibility for a new, conscious world construction that transforms territories and creates new paths.

Citizenship and social and human rights are topics that cross the paths of an engaged and critical occupational therapy that, by becoming aware of the current issues of the reality that surrounds it, becomes aware that their work and their condition of existence are, interconnected with the inequalities, weaknesses, ruptures, and violence to a greater or lesser extent and the sufferings produced, fed and impacted by the ways of life proper to neoliberal capitalist systems.

As a right to be guaranteed and present in everyday life, the culture becomes an action dimension of occupational therapy, and the field of cultural policies can and should be more appropriate, contextualized to be understood in a way that will reveal aspects and ways in which struggling and acting can be developed.

Considering the sketches on occupational therapy presented here, corroborates with Furtado (2012, p. 52) when provoking us: “[...] my friends, culture is also pervaded at all times in our lives. I would even say that the cultural dimension of our daily lives is the most significant in a cultural policy”.

Community, social, and cultural perspectives, practices and ethics in occupational therapy, among others, promote conceptions and approaches that find in the collective and plural dimension new forms of understanding about the dimension of the ways of life, their daily lives, and their occupations and human activities.

Occupational therapies engaged politically and contextually understands the culture in all its dimensions as a composition or part intrinsic to human activities, activities that influence and are influenced by neoliberal rationality, in its most perverse form, which systematizes a definitive logic that we could not act against it by proposing an alienating definition.

From a critical and sensitive perspective, we consider the individuals-collectives a contextualized way, and the complex phenomena that permeate their lives are composed of several dimensions: social, political, environmental, symbolic, economic, and, therefore, cultural (SILVA et al., 2017).

In the reflections and invitations proposed in this essay, the culture as a strategy for valuing the being and diversity, cultural, symbolic, social, citizen and economic law, when together, forming a critical and conscious practice of occupational therapy, can be revealed in the relationships against hegemony, a fruitful and sensitive possibility of caring for the other, the individuals and the collective, with resistance to the modus operandi that tries to weaken and isolate us from each other.

Daily, past or recent chores, the trajectory, and experiences that come from actions and emotions makeup and build a person's ways of life; such modes, full of intentions, values, and relational attitudes, material or immaterial, constitute a culture. Diversity is the link that connects cultural doing with the meeting with the other. [...] Culture implies and includes the doing and creation of individuals and groups, at the same time, influencing and being expressed by human activities. Also, culture is understood as the central axis of development. Yes, occupational therapy, of course, has many conditions, from its Critical and Social paradigms, directly interfering with the social conditions of individuals and communities, which must make a path of respect and inclusion to human diversity (SILVA et al., 2017, p. 111).

Silva et al. (2015) mentioned that when prevailing social paradoxes and conjunctures, culture as the most genuine human expression can foster change and engage in the struggle for differences, which is expensive and relevant to occupational therapy. “The human being, in its plurality of characteristics, behaviors, and actions, finds no place to exist in this diversity without bumping into broad violations of their basic rights” (SILVA et al., 2016, p. 202).

Thus, all the dimensions mentioned here are aligned: citizen, symbolic and economic from an occupational therapy that is aware of its professional role in the interconnected social problems, reflected and produced from the political, economic, epistemological and cultural macrostructure, dimensions that corroborate and support the 'Southern occupational therapies.'

5 An Invitation to Reflect and Propose an Engaged Occupational Therapy

The reflections proposed in this essay lead us to understand culture as an intrinsic element to the human being in the relationship with others in society. Its dimensions bring us to its concreteness and magnitude existing in human activities, which comprehends the cultural dimension as the right of every person, recognizing the ability and potentiality of the creation of symbols, meanings and multiple possibilities of being and relating with and in the world and also as a generator of products and values, contributing to local development in a sustainable and inclusive manner.

It also leads us to an understanding of the real ability of the socialist mode of capitalist production to appropriate human potentialities, as it metamorphoses through liberalism and later neoliberalism, in which beyond economics, it produces effects on subjectivity, generating new forms and social relationships, capturing, socializing and transforming into products, elements inherent to human beings (DARDOT; LAVAL, 2016).

It leads us to identify and denounce an ideological crisis that directly affects the ways and life possibilities of human beings. Specifically, in the field of culture, if we evaluated this crisis as proposed by the etymology of the word, it can open us to the possibility of analysis and discrimination of the elements subliminally contained in the speeches and actions of this new rationality, that is, neoliberal rationality.

However, a new form of social thinking is coming, in which there is a refusal of all forms of critical thinking (SODRÉ, 2017). In the reflective exercise of this work, it is up to us to verify that this refusal to critical thinking is part of this new ideology, where it is necessary to camouflage speeches and political/ideological projects.

For the economy and politics, the crisis is characterized by funding cuts and disruption of economic flows. Transposing the crisis in the political economy view, it would be reliable to say that for culture, this results in further cuts in investment in all its dimensions. That is, the culture in the city-market becomes, like all fundamental human rights, a commodity, and, based on the political economy view, the crisis becomes synonymous with lack of funding for its execution (SODRÉ, 2017).

However, the struggle against hegemony and the structural crisis in culture has always been present, especially in marginalized and stigmatized social groups (SODRÉ, 2017), is the movement of resistance and creation against hegemonic and intrinsic to the field of culture.

The occupational therapies proposed here is positioned as a professional engaged in creating possibilities, ruptures, and resistances to ensure meaning and/or re-meaning the distinct and multiple forms of political being, that is, in the understanding of a being who, acting, it is understood as part, in connection that generates changes throughout society.

Its role in the field of culture establishes a relationship of articulation between the dimensions of culture, the human being in its fullness, that is, from his human activities in the individual and the collective. A reading from the micro-social to the macro-social is necessary and present.

From these experiences, the occupational therapist is as an articulate professional between fruition, promotion, production and cultural management to broadly and integrally promoting the different dimensions of culture, symbolic, economic and citizenship, implicated in the occupations of the people and the collectives, in the promotion of their own cultures and in the defense of the citizenship, their belonging, their diversity and their social and human backgrounds (SILVA et al., 2017, p. 116).

Considering the limits of this essay, we aim to weave elements that connect and raise reflexive provocations between neoliberal rationality and occupational therapy as science and practice and the dimension of culture, expanding the possibilities of looking at the dimensions of human life through references and assumptions that support the necessary ethical and political engagements and commitments.

We seek to contribute to productions, reflections, and actions that may find other ways of resistance, tolerance, respect, and primacy to life according to Santos (2005), a revolution in ways of doing, thinking, and producing that is creative, emancipatory and democratic.

Let me add that giving the responsibility of the world to oneself is an ostensibly irrational act. The decision to take it, complemented by the responsibility for this decision and its consequences, however, it is the last chance to save the logic of the world of blindness that it suffers [...] (BAUMAN, 2015, p. 98).

From the above topic, we have new demands for occupational therapies that involve broadening the macro-structural understandings of human life, reflexivity for production of learning about themes not always addressed in the studies and even in the daily practice of the profession, new constructions of knowledge, concepts, use of terms and discourses and new theoretical-practical tools. After all, no one is excluded from this rationality, and consciously acting on it can be a complex task, that requires collective work and willingness to think and rethink alternative ways, as proposed in this essay: a culturally relevant, resistant and sensitive doing.

• 1
  The term is about the maintenance of social phenomena without aiming to change.
• 2
  Coined by Foucault, the term is the forms of behavior management, not only about external subjects, but also about their own behavior (DARDOT; LAVAL, 2016).
• 3
  Expression that represents a liberal statement in which the market and its flows should be free, because without any interference, it could maintain its proper functioning and would be the effective growth formula of capitalist societies.
• 4
  It is the ways of understanding and apprehension of the world.
• Funding SourceCoordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brazil (CAPES) – Financing Code 001, linked to the Occupational Therapy Postgraduate Program of UFSCar.

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Publication Dates

• Publication in this collection
  25 Nov 2019
• Date of issue
  Oct-Dec 2019

History

• Received
  01 June 2018
• Accepted
  01 Mar 2019