ORIGINAL ARTICLES

The power of aesthetic experimentation in the process of self-knowledge: a sociopoetic study

Paula Isabella Marujo Nunes da Fonseca1,2,Rejane Ferreira Eleutério1, Cláudia Mara de Melo Tavares1, José Carlos Carvalho2

1Fluminense Federal University
2Nursing Higher Education School of Porto

ABSTRACT

Aim: to make the participants realize how they have acted and what has led emotionally to a positive and a negative personal situation, and to encourage them, based on the emotional conducts reported, to perceive better what they feel. Method: a study with a sociopoetic approach, conducted with nine advanced transplant coordinators. We carried out the aesthetic experimentation from the generating theme “The emotions we feel and the paths we follow” to produce the data. The data analysis was womanly and philosophical. We used the Emotional Education assumptions of Juan Casassus. Results: we observed greater freedom of expression in terms of emotions in the non-working environment. The approaches toward relatives and crying were common confrontations in both positive and negative situations. Discussion: emotional self-permission was the focus, pointing to the construction of emotional competence in relation to oneself. Conclusion: the experiment allowed the increase of participants’ emotional awareness in emotionally positive and negative situations, opening the way to self-knowledge.

Descriptors: Expressed Emotions; Organ Donation; Psychiatric Nursing; Health Mental.

INTRODUCTION

Today, due to the great amount of information we receive and activities we develop, whether in our personal lives or in the work environment, we are becoming more and more occupied with things of the world, which in turn become more and more attractive to us as individuals. In this way, we have become less attentive to our own behavior, emotions and our own choices.

This reality, in terms of the lack of consciousness in the contact with ourselves and others, is bigger when we talk specifically about health professionals who deal daily with situations that demand rapid fulfillment of protocol and procedural demands, including those involving life and death, such as in the case of those who work in organ donation.

In this context, ethical dilemmas that are often wrapped up in emotions that arise in daily practice, and the professionalism that is demanded in order to serve the client are challenges that require an attentive view, since the biomechanical model based on specialization and codes of ethics is not enough to present the most humanized responses to these situations(1).

In this direction, even with studies recognizing the emotional complexity involved in the work of advanced transplant coordinators, especially with regard to the moment of the family interview, we have observed the reproduction of training and courses aimed solely at improving the technique of communicating bad news. In this way, we reproduce the model of emotional withdrawal on the part of the professional and this, consequently and unconsciously, also increases the emotional distance between the professional and the patient. Thus, the root of the issue, which is emotional health care, receives no attention(2,3).

These capacitations, in turn, take place in predetermined steps, as can be seen, for example, in the Spikes Protocol(4), widely used to guide the communication of bad news. Although it addresses the way in which the news will be reported, this protocol disguises the fact that the interviewer is also an emotional being, leaving that trait only to the relative of the donor.

Studies(5) regarding the reporting of death in health care institutions state that most professionals receive no theoretical training or emotional support to deal with the suffering and death of their patients. They reiterate that these officials would like to be prepared to deal with difficult communication situations by proposing examples of real situations of how to behave in their professional role, to not become psychologically involved, to accept death better, and to obtain psychological support(6).

In this regard, the provision of emotional support suggests the idea that, in order to communicate difficult news, the advanced transplant coordinator must have previous preparation, given the variety of emotional reactions he may have to deal with at the time(7).

Thus, the replication or even the application of experiences that aim to help develop the emotional preparation of these professionals in order to prepare them not only to offer a more humanized care to the relatives of the donor, but especially to be more aware of their own emotional confrontations by identifying their emotions in the face of difficult situations with which they often come in contact, is little observed.

In this respect, we know that in order to better recognize and deal with emotions, we must enter into a process of self-knowledge which includes actions also used in the development of emotional intelligence and education(3,8).

Therefore, and in view of the arguments set forth herein, we sought to follow a path in this study that could stimulate the exercise of self-knowledge among advanced transplant coordinators, so that they would begin the process of knowing and recognizing their own emotions. For this, in turn, we used an aesthetic experiment - a measure the sociopoetical approach uses to produce data - with the purpose of making fellow researchers perceive how they acted and conducted emotionally a positive and a negative personal situation; And to encourage the fellow researchers, from the emotional conducts reported, to perceive better what they feel.

METHOD

A research work with a sociopoetical approach. This is a study based on sociopoetics - a knowledge study approach that addresses the human being as a political and social entity with equal rights, and which considers body, creativity and spirituality for the construction of knowledge in the production and assimilation of data(9). According to the specialized literature(10):

As a method, sociopoetics defends the collective construction of knowledge by researchers and research subjects, stating as a basic assumption that all people possess knowledge (intellectual, sensitive, emotional, intuitive, theoretical, practical, and gestural) and, as equals in law, transform the act of searching into a poetic event (from the Greek poiesis = creation)(10).

The fundamental notion of the unconscious inspired by Freud, Jung, Marx or Levi-Strauss is added to these orientations. This is because unconscious production - which is too evident to deserve to be said or is prohibited from being accessed by consciousness - often allows the limitations and constraints imposed by classical research approaches to be unleashed(11).

Another point to emphasize is the valuation of the participants, who are here called fellow researchers. The production of the data seeks to cause to emerge the traditions lived by these people. In the quest for veracity and translucency of truth expressed in words and in the interpretations of the participants, the greater the insertions (dialogue) of those who reveal the events and senses, the greater the trustworthiness of the findings and, we believe, the greater the applicability/setback of a theory emerged from practice - guided by the living cycle of knowledge - to (another) practice, again(11).

So, 10 advanced transplant coordinators of the Intra-Hospital Organ Donation and Transplant Tissue Commission (CIHDOTT) and of the Organ Procurement Organization (OPO) of the city of Porto Alegre, Rio Grande do Sul, Brazil participated in the study. We included in the study coordinators who had conducted family interviews for organ donation for at least 6 months, excluding those not involved in family interviews, even if they have worked on any department that was part of the donation process up to organ transplantation.

Thus, the production of the data was carried out in the first half of 2016, through aesthetic experimentation in a workshop format, with an instrument by which the researcher in sociopoetics, produces the research data. Experiments can occur through theatrical, plastic arts and poetic techniques(11).

The author also authorizes researchers who use sociopoetics in their work to create new research techniques. He states that such experiments may be many and, of course, in each context, some are more pertinent than others, depending on the type of generating theme and, above all, on the characteristics of the researcher group(11).

The following material was used for the workshop: A4-format panels ornamented with magazines pictures that show different situations involving emotions; Colored cardboard cards; felt tip pens; 1 iron panel with colored magnets; 2 A0-size offset paper sheets (to form a large panel); emoticons/smileys representing negative and positive situations; 1 wide adhesive tape roll; magazines for clipping material; and pens.

The participants made a circle, sitting in front of the large panel with the smileys. The experiment was explained, and they carried out the relaxation activity based on the air element. Then the facilitator negotiated the generating theme: The emotions we feel and the paths we follow. The experiment consisted in asking the fellow researchers to leave personal or magazine-clipped pictures on their tables representing a positive situation and a negative situation. After that, they wrote in the colored cards words they considered key representations of how they faced the positive and the negative situations represented by the photos. With cards written, each participant went to the iron panel with magnets, placing on one side the positive photo with the confrontations related to it, and on the other, the negative situation and its confrontations. When they finished talking about the positive and negative confrontations, a photo of each individual panel was taken.

Figure 1: Fellow researcher explaining his emotional conduction in a positive and in a negative situation, 2016, Porto Alegre, Brazil.

Figure 1

Source: researcher’s archive.

Then, the cards were glued on the larger panel with the smileys representing the positive and negative parts. In the end, the panel with the smileys was filled with the cards produced. Then the colored A4 sheets and pens were distributed, and we explained that, from what was arranged on the bigger panel and based on the theme "The emotions we feel and the paths we follow", they should compose poems which were read at the conclusion of the workshop.

Figure 2: Panel composed of the cards that represented the emotional conducts of the fellow researchers regarding the positive and negative situations, 2016, Porto Alegre, Brazil.

Figure 2

Source: researcher’s archive.

Based on the sociopoetical analytical studies, the data generated were submitted to the female analysis - which highlights continuities, ambiguities and convergences in the structure of thought - and also to the philosophical one - that uses theoretical references chosen by the facilitator(13) and carried out considering concepts and principles of emotional education, according to Casassus(10).

This study was approved by the Ethics in Research Committee (CEP) of the Antonio Pedro University Hospital (HUAP), a part of the Fluminense Federal University (UFF), under number CAAE: 51110915.5.0000.5243, respecting the resolution of the National Commission of Ethics In Research (Conep) nº 466/2012. Participants signed the informed consent form (TCLE) and also the consent form of image rights (TCDI).

RESULTS

We emphasize that the purpose of asking the transplant coordinators to bring a personal photo to talk about emotional conduct was to make the contact with emotions clearer and more legitimate because the photo objectifies a real, personal, and specific situation.

The situations were previously pre-defined as being positive and negative, so as to facilitate the admission to the emotional dimensions accessed in the memory and the unconscious of the fellow researchers.

In the data produced, however, we could observe actions common to the emotional conducts of both positive and negative situations. It is important to clarify that these emotional conducts are the actions practiced at the moment when the emotions were experienced in positive or negative situations.

Another point to note is that aesthetic experimentation, in the way it was designed and applied, allowed the emotional conducts of the fellow researchers to be unveiled, as shown below.

The table below shows the actions taken by the fellow researchers in the situations they brought to the surface.

Table 1. Conduct of the emotional memories related to positive and negative situations as demonstrated by the fellow researchers, 2016, Porto Alegre, Brazil.

Table 1]

Source: elaborated by the author based on the division of the emotional (in)competences as proposed by Casassus(10).

We highlight the greater incidence of the item “sharing good news with loved ones and friends,” which appeared at least three times in the emotional conducts in positive situations. “Crying” and “getting closer to family members” were also incidents in the group's comments. The first action taken in positive and negative situations was marked as a direct connection between action and emotion.

In relation to the poems, some chose to write them, while others preferred to speak their arguments more informally. Based on the emotional conducts of the situations brought by the participants, it was possible to observe the strong presence of self-perpetuation and assertiveness accompanied by self-legitimation, as if in the poems/writings there was some kind of authorization for the participants to experience again the possibilities known and accepted by each one in terms of emotional conducts, being thus liable to be replicated / applied in new situations.

I can cry, I can sleep, but I can change. Starting by talking, and not just regretting. I can report, I can cry, I can be alone, but I can like myself too. I can approach my friends, I can be with my relatives, I can show some solidarity. I can say no, I can say yes to life. I can be myself, I can cry, I can smile. I can have more time to enjoy life. I can hug, but I can cry. (Alecrim)

The fact has happened, wept, mourned, spoken, embraced, cherished. It came like a gunshot, a redhead. The pain exploded in my chest, blinded my eyes, burst into tears. To disappear, I want to disappear. To sleep, to vanish, to die. I told you, I said it would happen. Why the surprise? But she heard me. Ah, she always listened. And I did not see it. Life is beautiful, she used to say. So let the sun shine. I feel the heat taking over me. And without the pain, I go back to bed. (Violeta Claro)

To have more time, as much as possible, the family, to be able to travel more with them, to talk more to them, there is not enough time, right? To be there with the family and talk, to visit friends, to talk to them, to show support, also to stop to think, to meditate, to speak with God. To have some time just for yourself. For example, this exercise we did here was so hard to start, wasn’t it? You do not stop to think about what you're feeling, what you need to do to change it, we do not have time to stop. I have many things to do when I get home ... I do not remember having time to sit and do nothing at all. There's always something to do. I think we need to take more time and slow down, that would be the words. Slow down a bit. That’s it. (Vermelho Escarlate)

DISCUSSION

The aesthetic experimentation was built based on the principles of sociopoetics and the assumptions of emotional education aimed at the creation of emotional competences related to emotional awareness(8).

The product of this union of principles and presuppositions made it possible for the group to bring their personal experiences in a free way, while leaving aside the ties of the work situation, which corroborated with the expansion of the affective and empathic “outside-walls” bond between the fellow researchers.

Regarding this, the formation of groups with health professionals was strongly cited by different studies as a means of strengthening / initiating / increasing knowledge about themselves(12,13).

The action of surpassing the merely professional relationships, strengthening the group's closest connection, demonstrated an openness, understood as one of the aspects to be highlighted in the development of emotional awareness, which has, we can safely say, fields of application related to itself, to the environment and to the others(8). This latter fits the first step taken by the fellow researchers.

Based on the reports, it was possible to observe that the fellow researchers feel freer to express their emotions in a non-working environment, judging by the incidence of the situations that emerged (100%). When making their emotional experiences emerge, the fellow researchers began to develop two competencies necessary to know and act in the world - the ability to link emotion to thought, by getting experiences from their stories connected to positive or negative emotions; And the ability to understand and analyze information related to the emotional world by constructing the poems/writings based on the records of their behavior at the time they experienced the referred emotions(8).

In Table 1, the highest emotional behaviors were those related to themselves, in which the actions regarding their own desires and limitations were made explicit by the expressions “to learn to say yes”, “to learn to say no”, “to like themselves more”, “to allow happiness feelings”, “to allow themselves to feel relieved”. Identifying such actions, the fellow researchers demonstrated an action towards the knowledge about themselves.

On this, we state that the knowledge about the information with regard to our emotions allows us to act with greater power, and that knowing the circumstances in which the emotions are triggered in ourselves is an important exercise of freedom and personal deprogramming(8).

In this direction, self-knowledge is also linked to the recovery of self-esteem, the sense of well-being, happiness and the reduction of stress(14). Moreover, as we begin the self-knowledge movement, we can also reflect about our lifestyle and the personal and family damages we cause(13). Self-knowledge added to dialogue, spirituality, as observed in Table 1, and to self-control, act as strategies for coping with conflicts(12).

Emotional conducts related to each other and to the environment also emerged in the workshop. In this regard, Casassus(8: 140) states that “distinguishing emotional space and shared space is a necessary step, prior to any intention of transformation.” For this to happen, it is necessary first to pay attention and to be open to one’s conscience, in order to identify what happens to it and how it happens, in a process called “awareness”(8).

That said, we know that in the exploitation of emotions, all areas of this awareness process are used, such as situations, facts and people, among other things, that generate emotions in different ways. Also contemplated are the experiences we had and the images, fantasies, memories and thoughts that provoke emotional reactions, which may or may not be related to what happens in the present(8).

Proposed as a creative-poetic way of recording what the researchers perceived of their emotional conducts, the poems/writings spelled out messages in which emotional self-perpetuation was the highlight, pointing to a greater freedom to experience what one feels, which indicates the beginning of the construction of emotional competence in relation to oneself, according to Casassus(8).

In this direction, it is relevant to highlight the creative power of emotions, which makes the competency of understanding and analyzing information related to the emotional world an important aptitude, allowing a greater predisposition to face particular problems and situations, such as conflicting situations at work.

CONCLUSION

The aesthetic experimentation allowed the amplification of the participants' emotional awareness in situations emotionally marked as positive and negative, opening the way to self-knowledge.

By putting themselves in face of their own confrontations and those of the other fellow researchers, it was possible to take a closer look at the actions experienced in terms of emotional conducts, enabling a conscious and extended contact with themselves. The result of this was the creation of poems/writings in which we observed greater assertiveness, self-control and self-involvement related to the emotions for the future. This argument was reiterated by the motivational character of the poems, which fulfilled the goals of the study.

Therefore, we suggest the production of more studies that deal with the subject, in order to know/recognize the power of aesthetic experimentation as a means of awakening self-knowledge.

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Financial support: Foundation Carlos Chagas Filho Research Support of the State of Rio de Janeiro – FAPERJ

All authors participated in the phases of this publication in one or more of the following steps, in according to the recommendations of the International Committee of Medical Journal Editors (ICMJE, 2013): (a) substantial involvement in the planning or preparation of the manuscript or in the collection, analysis or interpretation of data; (b) preparation of the manuscript or conducting critical revision of intellectual content; (c) approval of the version submitted of this manuscript. All authors declare for the appropriate purposes that the responsibilities related to all aspects of the manuscript submitted to OBJN are yours. They ensure that issues related to the accuracy or integrity of any part of the article were properly investigated and resolved. Therefore, they exempt the OBJN of any participation whatsoever in any imbroglios concerning the content under consideration. All authors declare that they have no conflict of interest of financial or personal nature concerning this manuscript which may influence the writing and/or interpretation of the findings. This statement has been digitally signed by all authors as recommended by the ICMJE, whose model is available in http://www.objnursing.uff.br/normas/DUDE_eng_13-06-2013.pdf

Received: 12/22/2016 Revised: 01/09/2017 Approved: 01/09/2017