Abstract

This article is part of a study aimed to map antiracist knowledge and practices in mental health by monitoring the practices of three collectives of professionals working in/with the psychosocial care network in the city of São Paulo, allowing us to characterize their intervention strategies. To contribute to the conceptualization of this article, through a review of the decolonial literature, three major ideas have been outlined that have allowed us to give substance to the decolonization of Psychiatric Reform: bewilderment, which, in dialogue with Achille Mbembe and Frantz Fanon, invites us to affirm madness and blackness without, however, establishing fixations; the antimanicolonial, which occurs in the promotion of the free and countercultural exercise of imagining diasporas, in light of that proposed by Édouard Glissant, Paul Gilroy, and Lélia Gonzales regarding an Atlantic (de)orientation in which elements of the black diaspora and Latin America can re-signify blackness and unreason; and aquilombar, as a liberatory praxis whose genesis lies in the quilombos as a living metaphor for the radicalisation of relationships in differences, based on Abdias do Nascimento’s quilombismo, Clóvis Moura’s quilombagem, Beatriz Nascimento’s (k)quilombo, and Mariléa de Almeida’s devir quilomba.

Key words:
Coloniality; Racism; Mental health; Psychosocial care; Black population’s health

Introduction

Recent studies indicate that race relations are rarely debated within Brazilian Psychiatric Reform¹1 Passos RG. Holocausto ou navio negreiro? Inquietações para a Reforma Psiquiátrica brasileira. Argumentum 2018; 10(3):10-22.

2 Passos RG. Frantz Fanon, Reforma Psiquiátrica e luta antimanicomial no Brasil: o que escapou nesse processo. Soc Debate 2019; 25(3):74-88.

3 Santos AO. Saúde mental da população negra: uma perspectiva não institucional. Rev ABPN 2018; 10(24):241-259.

4 Leal FX. A Reforma Psiquiátrica brasileira e a questão étnico-racial. Argumentum 2018; 10(Esp. 3):35-45.^-55 David EC. Saúde mental e racismo: a atuação de um Centro de Atenção Psicossocial II Infantojuvenil [dissertação]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2018. and, when addressed, they are not necessarily contemplated/sustained from an intersectional perspective⁶6 Passos RG, Pereira MO. Luta antimanicomial, feminismos e interseccionalidades: notas para o debate In: Pereira MO, Passos RG, organizadoras. Luta antimanicomial e feminismos: discussões de gênero, raça e classe para a reforma psiquiátrica brasileira. Rio de Janeiro: Autografia; 2017. p. 25-51.. The limited debate on race and hospitalizations in mental asylums in Brazil is a contradiction that can only be explained by racism itself, which hinders or prevents us from perceiving the meanings of race (and its functioning) in the colonial organization of/in the processes of hospitalizations in mental asylums in our country. Therefore, it is important to remember what the composer Marcelo Yuka⁷7 Yuka M. Todo camburão tem um pouco de navio negreiro [música] In: O Rappa. O Rappa [álbum]. Warner Music Brasil; 1994. claimed: “Every police vehicle is a bit of a slave ship”. In the same vein, intellectual Rachel Gouveia Passos¹1 Passos RG. Holocausto ou navio negreiro? Inquietações para a Reforma Psiquiátrica brasileira. Argumentum 2018; 10(3):10-22. questioned if every Brazilian mental asylum didn’t in fact contained the racist and colonial heritage of slave ships.

Marco José de Oliveira Duarte⁸8 Duarte MJO. Racismo, subjetivação e saúde mental: contribuições para a reforma. In: David EC et al., organizadores. Racismo, subjetividade e saúde mental: o pioneirismo negro. São Paulo, Porto Alegre: Hucitec, Grupo de Pesquisa Egbé, Projeto Canela Preta; 2021. p. 21-34. suggests the structural dimension of the heritage of slavery in health/mental health, and considers that the political economy of health requires the understanding that slavery continues, even after its end, as an economic and political regime, and thus leaving material and subjective marks on Brazilian society. Fátima Lima⁹9 Lima F. O trauma colonial e as experiências subjetivas de mulheres negras: raça, racismo, gênero. In: Pereira MO, Passos RG, organizadoras. Luta antimanicomial e feminismos: inquietações e resistências. Rio de Janeiro: Autografia; 2019. p. 68-85., in turn, demonstrates that race, racism, and gender make up the processes of subjectivation in dialogue with colonial traumas.

This logic is not limited to mental health institutions; it also extends to relationships between subjects and to territories. As Mbembe¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018. pointed out, race, and racial groups themselves, are the result of unequal and hierarchical relationships typical of colonization in modernity, and mental asylum relations have not still escaped the “burden of race”¹¹11 Mbembe A. O fardo da raça. São Paulo: n-1 Edições; 2018..

For Mbembe¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018., the production of a “psychic abnormality” may be one of the effects of racism that aims to produce in those who have been violated a state of morbidity, produced by a break from their authenticities. When discussing psychic morbidity, Mbembe¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018. establishes a dialogue with Fanon¹²12 Fanon F. Pele negra, máscaras brancas. São Paulo: UBU Editora; 2020., given that the Martinican psychiatrist points out that racism causes a kind of self-hatred among black individuals who have been inserted into a world of white people, which would produce in the black subject a denial of everything that would lead to his blackness itself, that is, an attempt to separate what racism itself does not allow to be separated from it: the black race.

This production of a psychic “abnormality” generated by racism is the very exercise of the mental asylum, which operates in coloniality - manicolonialization - as the institutionalization of madness also needed to create bodies and racial territories doomed to a supposed psychic abnormality in order to justify their mental asylum conduct: The conception of pathological changes would apply to both the black woman and the insane woman.

The insane and the black (or vice versa) were not created separately in the West. It is not for nothing that Basaglia¹³13 Basaglia F. Escritos selecionados em saúde mental e reforma psiquiátrica. Rio de Janeiro: Garamond; 2005. equates asylums with black apartheid or ghettos. As Mbembe points out, “by granting skin and color, the status of a fiction of a biological nature, the Euro-American worlds in particular, have made black people and race two versions of one in the same figure: that of coded madness”¹¹11 Mbembe A. O fardo da raça. São Paulo: n-1 Edições; 2018. (p.13). In this movement, white people and reason are affirmed as norms, anchored in Western reason, with madmen and black people being excluded from the domain of truth. In Brazil, the “crazy creole” and the “crazy nega” are expressions of this manicoloniality¹⁴14 David EC, Vicentin MCG. Nem crioulo doido nem negra maluca: por um aquilombamento da Reforma Psiquiátrica Brasileira. Saude Debate 2020; 44(3):264-277..

These manicolonial relations produce logics of separation, exclusion, and death guided by theories of scientific racism, which articulate race and pathologization; thus, social Darwinism, eugenics, the whitening theory, medico-legal theories on heredity, prohibitionism, and the criminalization of drugs, among others, were proposed. In different historical times, these mechanisms, based on the mental asylum coloniality of racism are updated. This historical relationship has required the Brazilian Psychiatric Reform to radicalize the inseparable anti-asylum and anti-racist struggles, which, together with Bárbara dos Santos Gomes¹⁵15 Gomes BS. Encontros antimanicoloniais nas trilhas desformativas. Porto Alegre: Universidade Federal do Rio Grande do Sul; 2019., we call the antimanicolonial struggle.

We understand that the Anti-Asylum Fight and Psychiatric Reform are not synonymous, although they are often treated as such. We rather endorse the perspective of Rotelli et al.¹⁶16 Rotelli F, Leonardis O, Mauri D. Desinstitucionalização. São Paulo: Hucitec; 1990. Amarante17 and Yasui¹⁸18 Yasui S. Rupturas e encontros: desafios da Reforma Psiquiátrica brasileira. Rio de Janeiro: Editora Fiocruz; 2010., who understand Psychiatric Reform as a complex social process that affects the governmental, legal, social, professional, and research spheres. According to Bezerra Junior¹⁹19 Bezarra Junior B. Desafios da reforma psiquiátrica no Brasil. Physis 2007; 17(2):243-250., in Brazil, Psychiatric Reform²⁰20 Brasil. Presidência da República. Lei nº 10.216, de 6 de abril de 2001. Dispõe sobre a proteção e os direitos das pessoas portadoras de transtornos mentais e redireciona o modelo assistencial em saúde mental. Diário Oficial da União 2001; 6 abr. “definitively departed from the position of ‘alternative proposal’ and consolidated itself as the fundamental landmark of the official mental healthcare policy”19 (p. 243). This policy is organized in the form of a network of territorial and community-based services, known as the Psychosocial Care Network (Rede de Atenção Psicossocial - RAPS), taking into account the uniqueness of users and their existential territory²¹21 Brasil. Ministério da Saúde (MS). Secretaria de Atenção à Saúde. Departamento de Ações Programáticas Estratégicas. Saúde Mental no SUS: os Centros de Atenção Psicossocial. Brasília: Ministério da Saúde; 2004..

The Anti-Asylum Struggle, as Passos and Pereira⁶6 Passos RG, Pereira MO. Luta antimanicomial, feminismos e interseccionalidades: notas para o debate In: Pereira MO, Passos RG, organizadoras. Luta antimanicomial e feminismos: discussões de gênero, raça e classe para a reforma psiquiátrica brasileira. Rio de Janeiro: Autografia; 2017. p. 25-51. remind us, is above all a social and collective movement that is dedicated, with countless banners, to the deconstruction of the mental asylum, in its different forms, and to combating the pernicious relationship among madness, psychological suffering, the use of drugs, and dangerous diseases, in a logic that is harmful to human rights and that promotes mental asylums, medicalization, and mass incarceration.

Proposing a racial dimension to Psychiatric Reform requires knowledge and practices that do not agree with the designs of coloniality and that undertake the anti-racist transformation of care practices in national Psychiatric Reform. Therefore, this article is based on the doctoral research of the first author (DAVID, 2022)²²22 David EC. Saúde mental e racismo: saberes e saber-fazer desnorteado na/para a Reforma Psiquiátrica brasileira antimanicolonial [tese]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2022, guided by the co-authors, and seeks to present three key ideas that aim to contribute to psychosocial care committed to the critical analysis of race relations, as well as to libertarian and decolonial mental health care. Such propositions were constructed based on the cartographic monitoring²³23 Kastrup V, Passos E. Cartografar é traçar um plano comum. Fractal 2013; 25(2):263-280. of the practices of three groups of professionals - Kilombrasa, Margens Clínicas, and Café Preto - working in/with RAPS in the city of São Paulo, from 2019 to 2021. The material collected in this study, in the participation-observer of activities, including interviews and conversation circles, allowed us to identify the work of resignifying blackness and unreason. The review of decolonial literature made it possible to conceptualize their intervention strategies, which are performed in the sense of quilombamento. The main ideas include: bewilderment, in dialogue with Achille Mbembe and Frantz Fanon; the anti-manicolonial, which occurs in the promotion of the free and countercultural exercise of imagining diasporas, in relation to that proposed by Édouard Glissant, Paul Gilroy, and Lélia Gonzales regarding an Atlantic (dis)orientation in which elements of the black diaspora and Latin America can re-signify blackness and unreason; and the quilombo, as a libertarian praxis that has in its genesis the quilombos as a living metaphor for the radicalization of relationships in differences, based on the quilombismo of Abdias do Nascimento, the quilombagem of Clóvis Moura, the (k)quilombo of Beatriz Nascimento and the becoming quilomba of Mariléa de Almeida.

Toward a bewildered mental health

It is not uncommon to hear users of the Psychosocial Care Network (RAPS) referring to the idea of bewilderment as a synonym for madness: “I came here because I am bewildered”. This sense seems to indicate an acute perception of the subordination of madness to the “north” in two directions: that of the epistemological subordination of the south to the north in the form of Eurocentrism; that of the subordination of madness to the norm of reason and Western rationality. Such is the analytical direction of Fanon and Mbembe when they highlight that colonial functioning hierarchizes knowledge and cultures. For black people (and Africa), what commonly remained was the fixation on the subjection of their humanity and the condemnation - in the form of clandestinity and/or proscription - of their culture; on the other hand, whites (and Europe), had a fixation on the condition of human-generic-universal, master of colonial reason.

In this sense, we will follow the contributions of Frantz Fanon and Achille Mbembe in the construction of theoretical-clinical references that strive for the subjective and material-concrete liberation of colonized populations and territories so as to design what we are entitling the idea-force of bewilderment as an affirmation of madness and blackness, without, however, establishing fixations.

Frantz Fanon²⁴24 Fanon F. Medicina e colonialismo. Brasil: Editora Terra Sem Amos; 2020., in his text “Medicine and colonialism”, presents a rigorous analysis of how Western medical science entered the Algerian context, bringing with it oppressive racism and social humiliation, characteristic of colonialism. When analyzing medical and health practices in that context (1954-1962), he warns that, to consider the relationship between doctor (European) and patient (native), “[it is] necessary, with patience and lucidity, to analyze each of the colonized patient’s reactions, and each time we do not understand a fact, we must repeat that we are facing a deeper drama, that of the impossible encounter in the colonial situation”²⁴24 Fanon F. Medicina e colonialismo. Brasil: Editora Terra Sem Amos; 2020. (p. 11), which produces a double refusal: on the side of the colonized, the fear of the institution of the colonial hospital, which does not consider other human/subject ethnic-racial groups; and, on the side of the so-called colonizers, the refusal to consider (or compose) the traditional care/health elements of the native/local population, establishing a heated battle (especially for the patient) and the production of corporeal expressions and rigid verbals²⁴24 Fanon F. Medicina e colonialismo. Brasil: Editora Terra Sem Amos; 2020. (p. 13).

This scenario presented by Fanon is common in the care provided by RAPS: the technicians, with their instruments of small power - coat, stamp, medical records, whiteness (often), faced with peripheral users (patients), poor, many black people, mostly women and children; abbreviated speech and rigid body on the part of users; quick and clinical examinations by technicians, followed by diagnoses that pathologize the most fragile part of this encounter. If the disregard of elements of care/health of traditional peoples is in force in the vast majority of Brazilian health policies²⁵25 Gomberg E. Hospital de orixás: encontros terapêuticos em um terreiro de candomblé. Salvador: EdUFBA; 2011., in the field of psychosocial mental health, the contradiction is even greater. In fact, interaction with arts and crafts of care from the African diaspora occurs day to day, but is rarely named, perceived, or understood as such. Thus, psychosocial care activities, such as round dances, graffiti workshops, percussion groups, among others, are disassociated from Afrodiasporic culture²⁶26 David EC, Silva LAA. Territórios racializados: a Rede de Atenção Psicossocial e a Política Nacional de Saúde Integral da População Negra. In: Silva ML, Farias M, Ocariz MC, Stiel Neto, A, organizadores. Violência e sociedade: o racismo como estruturante da sociedade e da subjetividade do povo brasileiro. São Paulo: Escuta; 2018. p. 233-248..

How can we (re)affirm this position in the Anti-Asylum Fight? Damico, Ohnmacht and Souza²⁷27 Damico J, Ohnmacht T, Souza TP. Antinarciso e o devir revolucionário de Franz Fanon: diálogos entre psicanálise, política e racismo. In: David, EC; Assuar G, organizadores. A psicanálise na encruzilhada: desafios e paradoxos perante o racismo no Brasil. São Paulo, Porto Alegre: Hucitec, Grupo de Pesquisa Egbé, Projeto Canela Preta, Sedes Sapientiae; 2021. p. 159-181. state, echoing the work of Isildinha Baptista Nogueira²⁸28 Nogueira IB. A cor do inconsciente: significações do corpo negro. São Paulo: Perspectiva; 2021. that “it is necessary to re-signify this body and this history, which is also the history of a people” (p. 164), alerting the field of psychoanalysis (and here psychosocial care) that this process of resignification has been carried out by black movements over time and that these fields, mental health and subjectivity, need to be placed in an unhindered relationship with Afro-Brazilian and diasporic culture, joining them with the black movements.

We now return to Fanon, who highlighted the capacity for political and subjective change arising from/in these relationships of/in the libertarian struggle. In them, the difficulty in the encounter between doctors (autochthonous or European) and colonized people disappears as they enter the liberation struggle together. When this revolutionary political motto is lived by both parties, a commonality is produced: “The reticence of the period of absolute oppression disappears. He is no longer ‘the’ doctor, but ‘our’ doctor, ‘our’ technician”²⁴24 Fanon F. Medicina e colonialismo. Brasil: Editora Terra Sem Amos; 2020. (p. 35).

Like Fanon, philosopher Achille Mbembe²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. considers that the decolonization processes pass through “organized social and cultural forces” (p. 25) that promote creativity.

For Mbembe, decolonization seeks “a radical metamorphosis of the relationship”²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 18), since colonization represents “a great moment of disconnection and bifurcation of languages”, comprising two categories of people²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 18). This reinvention involves repairing ties that have been broken or frayed, and that new meanings are attributed to original bonds. This form of relationship requires movements of white and black people, as the desire to overcome the condemnations of race is not limited to judicial reparations and economic restitution, it also imposes radical changes in ethical (affective) conduct, social bond³⁰30 Mbembe A. Existe um único mundo apenas. In: Bordas MA, organizadora. Caderno Sesc Videobrasil 09: geografias em movimento. São Paulo: Edições Sesc; 2013. p. 45-51..

The author considers that the path - the ‘get up and walk’ of the South African experience - towards a true democracy is “addressed to everyone, the enemies and the oppressed of the past”²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 54). This path should not take the direction of a policy of revenge, states Mbembe²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019., which would promote a fantasy that, by murdering the colonizer and taking his power, well-being in relationships would be reestablished. The philosopher is strict in showing that “concern with reconciliation, in itself, cannot replace the radical demand for justice”²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 54). Therefore, walking imposes justice. However, for this to occur, Rolnik³¹31 Rolnik S. Esferas da insurreição: notas para uma vida não cafetinada. São Paulo: n-1 Edições; 2018. reminds us, it is necessary to let oneself be affected by the other and recognize what life demands in order to be created in the face of the tension that this experience causes, in the way in which life is shaped in our existence.

This Mbembian perspective invites what the author called new mobilizations²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 31), which would require the recognition of “social multiplicity - multiplicity of identities, alliances, authorities and norms - and, based on this, imagine new forms of struggles, mobilization and leaders”²⁹29 Mbembe A. Sair da grande noite: ensaio sobre a África descolonizada. Petrópolis: Vozes; 2019. (p. 31).

This direction, which seeks the common and the world community, Mbembe called Open, an anti-asylum and antimanicolonial direction:

In a bewildered decolonization, in mental health, we should not be afraid to affirm madness and race, since this affirmation contributes to the disabling of the Eurocentric and racist character of asylum; but such an affirmation is not fixed (leaving the north towards the south, or even from madness as pathologization towards a madness of life - bewildered life), affirmative of displacement and circulation in a culture of mobility and mobilization.

This subjective perspective we consider to bebewildering, after all, it doubles the relationship of subordination of madness to the norm “as a guide”, in addition to criticizing the Eurocentric anchoring of knowledge and the know-how of (traditional) Brazilian mental health, which psychopathologizes and medicalizes certain means of relationship with the Outside, making black and indigenous people the first and historical victims of asylum - manicolonialization.

Finally, we point out that, for these bewildered movements to be common to the field of mental health, we cannot avoid relationships across differences, and for this to happen, it is necessary to break discourses of fixed origin, which aim to prevent incorporation/integration into otherness. The production of racial equity in health/mental health will occur in racial relations. Therefore, the (enormous/joint) encounter with those whom colonial reason imposed as crazy Creoles and crazy black women is a condition of this process of resignification and decolonization of racial madness, based on the experiences and protagonism of those who have always been the biggest victims of this manicolonization process: black people.

A proposal for Antimanicolonization

If inferiority, dangerousness, and criminality anchored in race manicolonialize black subjectivities and bodies, we have seen that by bewildering and working towards non-fixation, we disconnect the black signifier from madness and dangerousness. However, antimanicolonial care brings another bewildering step into play: the promotion of the free and countercultural exercise of imagining diasporas, following Gilroy’s³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012. clues, with the notion of black and transatlantic diaspora.

Let’s take a closer look at this proposition, which seeks to articulate this diasporic clue with the proposition important to reforming the notion of unreason as a decolonial tool. In fact, the relationship between unreason and reason is at the heart of the perspective adopted by Foucault in the early 1960s and of the movements critical of post-war psychiatry, which called for the critique of Western reason, the deinstitutionalization of mental illness, and a right to madness and unreason.

Gilroy³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012. proposes the idea of the black diaspora as a political, cultural, and social tool due to its power of countercultural transformation and liberation. The permanent black transformation into diaspora counterculturally modifies global geopolitics and geoculture, in a process of permanent creation. According to the author, the cultural elements of this communicative system, which is this diverse transnational movement of the “Black Atlantic”, foster different subjectivations of freedom, imagined and forged along Atlantic routes, seeking to recover the humanity stolen by colonization, coloniality, and racism. This recognition and exercise of political and subjective transformation, which is built over centuries, Gilroy³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012. called sublime, considering it to be countercultural.

In line with this, Lélia Gonzalez³³33 Gonzales L. A categoria político-cultural de amefricanidade. In: Rios F, Lima M, organizadoras. Lélia Gonzales, por um feminismo afro-latino-americano: ensaios, intervenções e diálogos. Rio de Janeiro: Zahar; 2020. p. 127-138. proposes, based on the idea of amefricanity, a “power that flows from the transatlantic experience and forges experiences and subjectivities in the new territory”³⁴34 Alves MC, Paula T, Damico J. Amefricana: racismo, sexismo e subjetividade em Lélia Gonzales. In: David EC, Passos RG, Faustino DM, Tavares JSC, organizadores. Racismo, subjetividade e saúde mental: o pioneirismo negro. São Paulo, Porto Alegre: Hucitec, Grupo de Pesquisa Egbé, Projeto Canela Preta; 2021. p. 86-113. (p.88) in a “gigantic work of cultural dynamics that does not take us to the other side from the Atlantic, but which brings us from there and transforms us into what we are today: Amefricans”³³33 Gonzales L. A categoria político-cultural de amefricanidade. In: Rios F, Lima M, organizadoras. Lélia Gonzales, por um feminismo afro-latino-americano: ensaios, intervenções e diálogos. Rio de Janeiro: Zahar; 2020. p. 127-138. (p.138), recognizing that this power has already manifested itself in the black presence in Latin America throughout the centuries as a form of cultural resistance and free social organization, in the form of black revolts and quilombos. Gilroy³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012. also recognizes that the goal of a Black South Atlantic must carry out what Édouard Glissant³⁵35 Glissant E. Introdução a uma poética da diversidade. Juiz de Fora: Editora UFJF; 2005. conceptualized as Relationship, which is the possibility of moving from the established/fixed position of “I am” to the fluid and temporary position of “being”. This repositioning forges processes of subjectivation that move us away from the colonial perspective of conquering to the decolonial perspective of knowing. In the Relationship (with a capital letter), the meeting of differences does not hierarchize or even stifle the voice/presence of those considered political minorities, unlike the relationship (with lowercase letter), which promotes the encounter of differences, but does not fail to establish logics of power, preventing movements of speech and bodies.

Our study suggests that the Atlantic diaspora fulfills an antimanicolonial function: the openness to the Atlantic movement is based on “thought in circulation, a thought of the crossing, a thought-world”¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018. (p.309), contrary to fixed or defined thinking, eternal and irrevocable, typical of coloniality. The black diaspora is thus a possibly interventional tool in the cloisters of modernity³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012., an immobility that, in this work, we consider to be a colonializing asylum.

By thematizing the historical distance between unreason and madness, formulated by Foucault³⁶36 Foucault M. História da loucura na Idade Clássica. São Paulo: Perspectiva; 2014. in his book “History of Madness” in the formula of an eclipse of the tragic and cosmic experience of madness during the Renaissance and the migration from an unreasonable experience to that of a reasonable folly that reaches the “social type of the madman”, Pelbart³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. indicates the possibility of relations of a ‘back and forth with the Outside’, towards an Outside of the enclosure, in a relationship to unreason, or of an enclosure of the Outside in an exiled character, who would represent the experience of madness³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. (p. 169).

Thus, as in certain moments, a society can confine access to the Outside only to madness (thus forcing poets, artists, and thinkers from the Outside to go crazy); at other times, other spaces may be open to a relationship with the Outside (prophetic, shamanic, mystical, political, poetic, literary spaces, etc.)³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. (p. 180). Admitting the epistemological problematicity of the notion of understood as the plurality of Forces, or the distance between the Forces, that between the Forces, the availability for the difference between them, allowing us to perceive the indissoluble relationship with Difference and Force - Pelbart³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. signals that the Thought of the Outside³¹31 Rolnik S. Esferas da insurreição: notas para uma vida não cafetinada. São Paulo: n-1 Edições; 2018. is one that exposes itself to the forces of the Outside, but maintains a relationship with it, that of back and forth, exchange, transit, adventure³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. (p.96). In this sense, while in the medicalized experience of madness there is a closure of the Outside, it is possible to think of a back and forth - a game with Unreason.

We argue that, in Brazil and Latin America, Afrodiasporic culture is a way of relating to the Outside³⁷37 Pelbart PP. Da clausura do fora ao fora da clausura: loucura e desrazão. São Paulo: Brasiliense; 1989. (p. 126), a movement of displacement in Relationship³⁸38 Glissant E. Poética da relação. Rio de Janeiro: Bazar do Tempo; 2021. that fosters unique modes of subjectivation. We understand that, for an antimanicolonial know-how, Brazilian Psychiatric Reform must not retreat to diving into the Black Atlantic: not to “go crazy” outside, or settle there, but in a Relationship with the Outside - to affirm Decolonial unreason. In this back-and-forth movement, Atlantic and diasporic³²32 Gilroy P. O Atlântico negro: modernidade e dupla consciência. São Paulo, Rio de Janeiro: Editora 34, Universidade Candido Mendes, Centro de Estudos Afro-Asiáticos; 2012., it is possible, as we point out in the bewilderment, to have a constant entry and exit into race and madness, which allows us not to be crazy and black all the time, without ceasing to be so.

Aquilombação: an ethics of freedom

Still in the search for theoretical clues for a freedom device that is not for the protection of the privileged and normative who understand themselves (and/or are understood) as universal, we resort to the theoretical understandings of “kilombo”³⁹39 Nascimento MB. Kilombo. In: Nascimento MB, Rattz A, organizadores. Uma história feita por mãos negras: relações raciais, quilombos e movimentos. Rio de Janeiro: Zahar; 2021. p. 247-251. (Maria Beatriz Nascimento [1942- 1995]), “quilombagem”⁴⁰40 Moura C. História do negro brasileiro. São Paulo: Ática; 1989. (Clóvis Moura [1925-2003]), “quilombismo”⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019. (Abdias do Nascimento [1914-2011]), and “devir quilomba”⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. (Mariléa de Almeida) as tools for the aquilombação device of the Psychosocial Care Network.

In “O Quilombismo”, Abdias do Nascimento⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019. (p. 271) points out the need to recover the memory of black Brazilians beyond that supposedly initiated in transatlantic trafficking. For the author, this performed memory is a quality of black consciousness and quilombista feeling, which would rule out/hinder the incorporation of racial discrimination in the psyche of black women.

Ensuring the existence of black people still requires the defense of their survival, and, according to Abdias⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019., this vital requirement is one of the memories we bring back from enslaved Africans. However, he observes that this movement of life did not occur only through the courageous act of escape, but, above all, through the creation and organization of forms of free society. These modes produce the memory of quilombos as symbolic and subjective forms of a singular organizational movement, which can foster strong ideas of dignity in different people and groups.

This dignity that the author confers occurs in quilombismo because its history is associative. The search for defense and socioeconomic organization would require a relational performance, with an important social function, as this associative essence would occur through religious, sporting, cultural, mutual aid, recreational, and charitable relationships, among others, which would generate networks in associations, brotherhoods, terreiros, samba schools, tents, afoxés, brotherhoods, etc. For Abdias⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019., this is how quilombos were built and are being built in a broad and permanent movement: “This complex set of meanings, this Afro-Brazilian praxis, I call quilombism”⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019. (p. 282).

It is important to highlight that, for the author, quilombism is not fixed or material, it is an idea-force, an energy present since the 15th century and in constant updating, in broad connection with the demands of the current historical time, which thus promotes different modes of libertarian organization, without losing “the psychosocial appeal whose roots are embedded in the history, culture and experience of Afro-Brazilians” ⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019. (p. 282).

We know that quilombism was not limited to a theoretical-scientific concept, it also brought a political proposition based on freedom, justice, equality, and respect. Therefore, at its core, it carried a proposal for an economic system against exploitative and racist capitalism.

In Clóvis Moura, this economic dimension becomes central: “Enslaved Africans and their descendants were protagonists of the class struggle in Brazil. [...] The constant action of the enslaved denying the colonial system was one of the elements that forged the transition from the colonial political regime to independence”⁴³43 Farias M. Quilombismo e quilombagem: divergências e convergências entre Abdias do Nascimento e Clóvis Moura. NEPRAFO - Núcleo de Estudos e Pesquisas da Afro-América; s/d. (p. 3). This dated movement (16th century until 1850), Clóvis Moura conceptualized as quilombagem.Moura recognizes this movement of enslaved people as radical emancipationist and immediately warns of the basic difference between quilombagem and the abolitionist movement; this one, according to Moura, is liberal. In quilombagem, there is a direct confrontation, since the context of slavery required this type of political action, often driven by violence and rebellion⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019.. Without rebellion, the economic, military and social bases of the slave system would not be impacted/eroded. This rebellion allowed constant actions throughout the Brazilian territory during the period of full slavery in Brazil.

Abdias Nascimento and Moura, with their perspectives on quilombismo/quilombagem in its power of social transformation, of the “reinvention of ourselves and our history” through “the use of critical and inventive knowledge of its institutions battered by colonialism and racism”⁴¹41 Nascimento A. O quilombismo: documentos de uma militância pan-africanista. São Paulo, Rio de Janeiro: Perspectiva, Ipeafro; 2019. (p.288) and in the construction of a political-social place for the undesirable offered us elements to suggest that the RAPS absorb this praxis of the black community in a critical and inventive way in the antimanicolonial direction, when we proposed a quilomba ethics for Psychiatric Reform⁵5 David EC. Saúde mental e racismo: a atuação de um Centro de Atenção Psicossocial II Infantojuvenil [dissertação]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2018., recognizing the quilombo as a place that “aimed (and still aims) to achieve freedom, struggle, emancipation, human dignity, cultural rights, demarcations of land for housing, among other egalitarian and citizenship principles”⁵5 David EC. Saúde mental e racismo: a atuação de um Centro de Atenção Psicossocial II Infantojuvenil [dissertação]. São Paulo: Pontifícia Universidade Católica de São Paulo; 2018. (p. 122).

However, we want to introduce the micropolitical dimension of the quilombação struggle, as did the two black intellectuals with whom we spoke below. With Beatriz Nascimento, the quilombo gained subjective aspects, in addition to the specific territorial relations of a certain group of people who were born (or lived) in a particular land/place where enslaved ancestors took refuge and fought in resistance to the various oppressions suffered by enslavement. Thus, Beatriz Nascimento³⁹39 Nascimento MB. Kilombo. In: Nascimento MB, Rattz A, organizadores. Uma história feita por mãos negras: relações raciais, quilombos e movimentos. Rio de Janeiro: Zahar; 2021. p. 247-251. conceptualized (k)quilombo as a force of singularization: “As an (intensely) lived history, it did not interrupt its trajectory, and was deeply rooted in the minds of Brazilian individuals”³⁹39 Nascimento MB. Kilombo. In: Nascimento MB, Rattz A, organizadores. Uma história feita por mãos negras: relações raciais, quilombos e movimentos. Rio de Janeiro: Zahar; 2021. p. 247-251. (p. 247).

In this sense, she points out that the memory of being in adversity constructs us and that the recovery of the quilombo identity, in memory, history, and existence, would allow each individual to be a quilombo, in their power of subjectivation. The author highlights the repetitive nature of agglutination; this necessary repetition, the result of agglutinations, allows people to constantly unify. If colonialism promotes the cultural, social, and subjective disaggregation of the colonized, the repetitive agglutination of the quilombo, in turn, promotes an awareness of belonging, a real ideology of community, acceptance, and singularization⁴⁴44 Nascimento MB. Historiografia do quilombo. In: Nascimento MB. Beatriz Nascimento, quilombola e intelectual: possibilidade nos dias da destruição. São Paulo: Editora Filhos da África; 2018. p. 125-165..

Mariléa Almeida⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. proposes becoming a quilomba. Becoming, a concept that presupposes changes, plus the word ‘quilomba’ evokes the historical conditions that produced the feminization of the idea of quilombo, enabling the contemporary visibility of women”⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. (p.30). For this intellectual, in the fight for land, aspects of feminization processes are essential, “such as the ethics of caring for oneself, others, and the space where one lives. [...] I emphasize that becoming quilomba concerns the need to build a coming into being that opposes the naturalization of the masculinist model of doing politics and living”⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. (p. 30).

Mariléa de Almeida⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. invites us to follow the collective and solidary, historical, and singular conditions of practices in devir quilomba. Thus, the intellectual focuses on and presents us with narratives of quilombola women. She demonstrates how they weave their relationships based on affections and produce political and subjective becomings, even in the midst of constant risk, a product of racist and sexist devices of power and death.

In dialogue with psychiatrist and psychoanalyst Neusa Santos Souza, Almeida⁴²42 Almeida M. Devir quilomba: antirracismo, afeto e política nas práticas de mulheres quilombolas. São Paulo: Elefante; 2022. considers that, at times, when the black population accesses mental healthcare services, “[t]he therapeutic space gains a political dimension that, [...] simultaneously involves, on the one hand, the knowledge of being black and the recognition of the traumas caused by racist devices, and on the other, the ability to recreate the potential” (p. 281).

According to Lúcia Xavier⁴⁵45 Xavier L. Prefácio. In: Pereira MO, Passos RG, Nascimento A, Correa LC, Almeida OM, organizadoras. Luta antimanicomial e feminismos: formação e militâncias. Rio de Janeiro: Autografia; 2020. p. 25-27., this fight for freedom and recognition of humanity produces different knowledge, understandings, and ways of facing and combating the processes of subordination and hierarchization. Thus, these black women produce different standards of civility, in the exchanges, writings, and narratives of their life stories, “Women who also refuse to take any chance to reinforce alliances with cisheteronormative patriarchal racism as an opportunity. Therefore, they question institutions, science, practices, and power”⁴⁵45 Xavier L. Prefácio. In: Pereira MO, Passos RG, Nascimento A, Correa LC, Almeida OM, organizadoras. Luta antimanicomial e feminismos: formação e militâncias. Rio de Janeiro: Autografia; 2020. p. 25-27. (p. 27).

To experience quilombos as a living metaphor is to radicalize relationships in differences, seeking freedom. Such radicalization would be aimed at an Antimanicolonial Struggle, which leads the Brazilian Psychiatric Reform to daily quilombation, as a transversal praxis in RAPS. However, it is considered that this know-how cannot be distant from black and black women’s movements; on the contrary, it is necessary to identify what is in fact antimanicolonial in these movements and in their communities and territories. In the black diaspora, we will thus find some of the civilizational elements that do not seek domination (decolonial), in addition to the modes of relationship and disoriented cultural aspects that allow relationships within this difference, in the common coming and going of race relations. Displacements necessary for the establishment of democracies and the much-envisioned humanity, as said “for those who suffered colonial domination [...] the recovery of this part of humanity often involves the proclamation of difference”¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018. (p. 315).

Final considerations

In the famous book “History of Madness in the Classical Age”, Foucault³⁶36 Foucault M. História da loucura na Idade Clássica. São Paulo: Perspectiva; 2014. demonstrated that the madman is a historically constructed subject, thus the ingenuity of mental illness intended the exclusion of certain bodies and ways of life from society. With the subject of race, it was not very different. Mbembe¹⁰10 Mbembe A. Crítica da razão negra. São Paulo: n-1 Edições; 2018., in the book “Critique of black reason”, states that the creation of black people is intrinsically linked to the history of capitalism, because, anchored in racial subsidies, this system (in its different times and models) distributes violence to certain bodies and ways of life, seeking the maintenance and growth of the “productive forces” of capital.

However, it is through coloniality that black people were understood as lacking subjectivity/humanity. In the renowned book “Black skin, white masks”, Frantz Fanon¹²12 Fanon F. Pele negra, máscaras brancas. São Paulo: UBU Editora; 2020. points out that the rescue of this humanity requires a psychological process that is aligned with economic and social consciousness.

Both creations, race and madness, were anchored in Western reason for their exercise of exclusion, confining mad people and black people to unreason - to spaces of exclusion. The manicolonial idea that, combined with racism and its intersections, forges the crazy Creole and the crazy black woman in Brazil. The search for freedom in this country cannot be dissociated from anti-racist, anti-capitalist, and feminist agendas, which would require a movement to decolonize thought and power, understanding that anti-racism operates between subjective, institutional changes and the structure itself, which is a promoter of other records of the unconscious, which combat the “colonial-racializing-capitalistic” regime³¹31 Rolnik S. Esferas da insurreição: notas para uma vida não cafetinada. São Paulo: n-1 Edições; 2018..

To achieve this, we proposed three main ideas: bewilderment, antimanicolonial, and quilombação. Understanding that the direction for antimanicolonial mental health care is to encourage the free and countercultural exercise of imagining diasporas; thus, we not only position ourselves against the racist structure of capitalism, but we also seek to foster bewildered modes of subjectivation that create new strategies of aquilombação both inside and outside the Psychosocial Care Network.

The living memory of quilombos as a symbol of the black diaspora is communicated in/to us Brazilians as a psychosocial idea-force. Discovering what is antimanicolonial in this diasporic back-and-forth encourages the production of subjectivities, in the bewilderment of bodies and territories through the dream of freedom.

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