Music workshop at EAT with Leandro Freixo. International Encounter: Care as Method # 2, October 3rd, 2017, EAT, Instituto Municipal Nise da Silveira. Photo: Denise Adams

Photo: Denise Adams

Open Music Workshop at Espaço Aberto ao Tempo [Space Open to Time]

Leandro Freixo

This text discusses the open music workshop that takes place regularly at one of the CAPS [Centers of Psychosocial Attention] known as Espaço Aberto ao Tempo [Space Open to Time (EAT) – T.N. The CAPS centers are a system of outpatient mental health treatment established with Brazil’s Psychiatric Reform movements in the 1980s and 90s]. The workshop comprises two sessions of music therapy of two hours duration occurring on Mondays and Tuesdays every week at 2:00 p.m. As a music therapist I coordinate these sessions relying on the frequent participation of the mental health patients receiving treatment at EAT and the possibility of participation by patients from other units belonging to the mental health network of the city of Rio de Janeiro. The workshops are also open to anyone who wishes to participate, such as the family and friends of people in treatment, musicians, music teachers, artists, students or social science professionals, and sometimes artists or health professionals from other countries.

Activities are also carried out periodically in partnership with cultural and educational institutions such as universities, museums, theaters, community cultural centers or other units of the mental health network of the municipality of Rio de Janeiro or other municipalities where the band known as Alterado Jazz Band [Altered Jazz Band] has performed. The band comprises patients and participants in the music workshop and carries out their rehearsals for their presentations as part of the workshop itself.

In order to present the workshop, describe its dynamics of operation, and talk about its objectives and its e/affects, I think it is important to first contextualize the place where this work happens, to talk a little about the history of the EAT, and how the workshop came about and continues to develop.

I first worked at EAT from 1996 to 1998 as a musical therapist trainee. In 1999 and 2000 I returned as a resident teacher following a course of musical therapy at the Escola Nacional da Saúde Pública [National School of Public Health (ENSP)] supported by FIOCROZ [Fundação / Foundation Oswaldo Cruz) a national institution of science, health and technology affiliated with the Brazilian Ministry of Health].1 I was the first musical therapist in Brazil to take this course. In 2001, when the position of musical therapist was created under the Secretariat of Municipal Health of Rio de Janeiro, I returned to EAT as a member of the CAPS multidisciplinary team and remained until 2003. After a period abroad and a time focusing solely on my musical work, I returned to be part of this team again in the 2014, where I remain until the present day.

EAT: Experiencing new practices

EAT is a mental health treatment unit that, since the 1980s, has played a major role in the history of psychiatric reform in Brazil, contributing to the practice of substituting hospital-centric models based on long-term hospitalizations with one of daily psychosocial attention. Here the focus is on the maintenance of the psychosocial bonds with society and on the possibility of subjective expression as fundamental to the subject’s psychic structure, their continuing mental and social health, and to the production of pleasure and joy in creative activities as a proven effective method in promoting health and exercising citizenship.

Psychiatric Reform in Brazil was strongly influenced by the work of the pioneering psychiatrist Dr. Nise da Silveira (1905 – 1999) and the Basagliana psychiatric reform in Italy based on the work of psychiatrist Franco Basaglia (1924 – 1980). Established in the eighties, EAT began with a proposal to transform one of the psychiatric infirmaries of the Centro Psiquiátrico Pedro II [Pedro II Psychiatric Center – today Instituto Municipal Nise da Silveira] into an infirmary that came to known as EPA (Enfermaria de Portas Abertas – Open Door Infirmary). This meant that, people who had been undergoing long-term psychiatric care, treated exclusively with drugs and seclusion as the main therapeutic resources, were allowed to leave the ward and return to the treatment facility whenever they wanted and as many times as they wanted. The work was based on the concept that one should not deprive the individual of his or her right to come and go, and that the decision to initiate and remain in treatment should also be that of the subject’s exclusive right.

Lula Wanderley, a physician and visual artist and other team members decided that they would offer patients who returned to the ward, the possibility of expressive activities via different languages and media. Patients then began to work with painting, drawing, modeling, corporal activities, dance, as well as within conversational or writing groups.

Time here comes to be marked by creative movement with expressive languages. This is what enables the structuring of time and the subject: in so much as time marks the freedom to create and to communicate ideas and affections. A space of encounters, of affective exchanges, and of experiences where time does not assume a preconceived modality filled with routine tasks, but rather where time is the actual space for becoming, intuition, and the pleasure of creation. EPA (Enfiermaria de Portas Abertas EPA – Open Doors Infirmary) came to be called Espaço Aberto ao Tempo [Space Open to Time] in the late eighties.

In the 1990s, the EAT team also began to work in an outreach capacity outside the infirmary unit, conducting home visits to patients who were having difficulty coming to the treatment site. At this time, the team also began to think of social reinsertion strategies for a population that suffered, because of the stigma of mental illness, situations of extreme discrimination and isolation. Thus began the first income generation workshops including carpentry, silkscreen, food production, and festive events as well as initiatives featuring the presentation of content developed in the art workshops, such as exhibitions of visual art work done by patients. From then on, EAT, Casa das Palmeiras [Dr Nise da Silveira’s outpatient clinic] and other services working in Rio de Janeiro and Santos (SP) served as models for the creation and implementation of the de-centralized CAPS treatment centers.

Music at EAT

When I started the workshop in 1996, there were activities programmed in the afternoons of each day of the week. These were dedicated to different expressive languages – body, writing, theater etc. I took on the challenge of inserting the music into the roster via two-hour music therapy sessions, initially with the participation of EAT patients only. Since then sessions are held with the voluntary participation of patients playing percussion instruments and singing with or without the help of the microphone. I ask each of the participants to suggest songs for us to play and sing together. I also spend some time doing instrumental music improvisation. At the beginning when I facilitated the workshop, I also participated by playing guitar and singing. After returning in 2014 I have been using the keyboard, an instrument with which I have greater proficiency, as I have been a pianist and a professional keyboardist since 1989.

Starting in 1997 I began to use popular improvisation games with words sung in the style of “repente” [T.N Northeastern musical tradition of improvisation of words and music between singers 2] and “partido alto” [samba refrains] and the patients then felt stimulated to compose songs. I then produced musical performances during the festivities that were promoted by EAT inside or outside the unit, where patients performed and sang their compositions accompanied by me and other patients playing percussion. I realized then that I was sharing with them the opportunity to experience what it is like to be a professional musician on stage. At the time, authors of Italian psychiatric reform such as Benedeto Saraceno, spoke about the role of a new type of treatment facilitator – the professional who is able to bring some knowledge that he or she possesses to the psychiatric institution and share it with the people in treatment. Ever since I decided to periodically perform shows where patients could play percussion instruments and sing their compositions or songs by well-known authors.

From 1999 onwards, patients from all of the units of the Instituto Municipal Nise da Silveira began to attend the workshop and we also received visits from patients affiliated with IPUB (Instituto de Psiquiatria da UFRJ (Psychiatric Institute of Federal Rio de Janeiro University), Pinel (Instituto Philippe Pinel – psychiatric hospital based in Rio) and CPRJ (Círculo Psicanalítico do Rio de Janeiro – Psychoanalytic Circle of Rio de Janeiro), whom we had the opportunity to get to know when we held our shows at mental health events. Also at this time we began to receive visits from musicians, poets and artistic groups.

In 2003 I stopped my activities in the field of mental health to dedicate myself solely to my work as a musician and I only returned to work at EAT in 2014. On returning that same year, some patients developed interest in learning to play a particular instrument. One of them wanted to play the saxophone and we established a partnership with the Villa-Lobos Music School where he studies saxophone and music theory to the present day. Another patient had already studied the transverse flute as well as other percussion instruments. This was how the Alterado Jazz Band was formed, comprising as core members: myself as a keyboardist, a saxophonist, a flautist, three percussionists, and three singers.

So I began to set some of the workshop time aside to work on some musical theory concepts so that the band’s performance could be in constant development. For example, the most important concepts for the saxophonist and the flautist are functional harmony, improvisation, and study of jazz standard melodies. For patients who are more interested in percussion instruments, I explore musical styles and rhythms. For those who are more interested in singing I work on vocal technique and choral singing through vocal exercises and group harmony. As each technique is worked on, everyone is present ensuring they all have the opportunity to have a broad and diversified contact with the elements of music.

In recent years we have been experiencing an increasing precariousness in Brazilian public health and the mental health field has suffered from the lack of resources and poor working conditions for professionals. Many therapists working in CAPS centers are disinterested in working with artistic languages and EAT no longer has the same dynamic operation. Originally every day of the week featured a different space in the building each with a particular expressive activity (visual arts, carpentry, silkscreen) with open hours in the morning and an expressive language workshop in the afternoon. Currently the only workshops that happen in the afternoons are my twice-weekly music workshop and the cinema workshop coordinated by Lula Wanderley once a week.

Despite the difficulties, EAT’s open music workshop and the activities of the Alterado Jazz Band continue with the same objectives since they began:
• Giving structure to the psyche via contact and creation with making music and musical elements;
• Promotion of the freedom to create and to communicate ideas and affections and of a space of encounters, affective exchanges, and experiences where time does not assume predetermined modality with routine tasks, but where time is a space for becoming, intuition and the pleasure of creation;
• Maintenance of psychosocial links with society and an emphasis on the psychic structuring of the subject via the expression of subjective content through music;
• Continuity of mental and social health;
• Production of pleasure and joy via musical workshops and public presentations of Alterado Jazz Band as a method of health promotion and exercise of citizenship.



Leandro Freixo
Freixo has been a musician and arranger since 1989 in instrumental music groups and orchestras including the Tupi Orchestra and AMB Orchestra and works at the Espaço Aberto ao Tempo as a music therapist. He has a graduate degree in music therapy from the Brazilian Conservatory of Music and specialization in harmony and arrangement from the musical center Cigam. He was also a student of Sônia Vieira. From 2004 – 2006 he played with the Grupo Balaio Brasileiro in Mexico, and from 2006 – 2007 in the United States with the Brian Flynn Band as well as studying Jazz and Cuban Music at the Nashville Jazz Workshop. Since 2016 he has been a member of the Rio Quartet, a group formed by the ex-members of the Os Cariocas group.