NISE: The Heart of Madness directed by Roberto Berliner is a fascinating account of maverick, Brazilian psychiatrist Nise da Silveira (a poignant and stirring portrayal by Glória Pires) who created a ground-breaking therapy for mental patients which assisted them toward self-healing in their lives. In a number of instances her patients were able to be returned to their own communities, despite a prognosis that they were hopelessly beyond “sanity” and would live in institutions for the rest of their lives.
In this exceptional and heartfelt chronicle (screenplay by multiple writers including Berliner), the director outlines the arc and miraculous impact of Nise da Silveira’s efforts. He highlights her experiences beginning with her return to work as a psychiatrist after an eight year period. Berliner takes up the journey of how da Silveira, with patience, intuition and love encourages the transformation of her patients over time.
Berliner recreates the horrific setting of the National Psychiatric Center in Rio De Janiero that houses chronic schizophrenics who are treated as low life forms, imprisoned and are clothed in rags when we are first introduced to them. They are out of control and violent; their madness has completely overtaken any ability for them to communicate easily. We are convinced that they are hopeless and beyond the reach of the medical profession.
The male, conservative doctors (the ensemble is outstanding) outnumber Nise da Silveira. They embrace “modern” treatments (electroshock, lobotomies, insulin treatments, imprisonment,) which appall her. We understand that the doctors have a ready population of guinea pigs (these patients) upon which to experiment and exercise their preconceptions and stereotyping. The parallel of the violence which the medical profession enacts upon patients which are supposed to be served, but which are used to serve doctors is a theme which threads throughout the film.
Though we don’t realize it at first and fall into the trap of believing these brutal treatments may have efficacy, because of da Silveria’s response and courage in the face of the doctors’ oppression, we come to realize that these men have a proclivity to select the aggressive, immediate, lazy-man’s way of solving problems. As the film progresses and Berliner shows the slow, painstaking, intuitive approach of da Silveira with trial and error and observation, we realize that the mainstream doctors have selected wrong-headed treatments that are counterproductive and that yield harmful, fatal results on a population that cannot speak up for itself. The patients have no advocates and have been dumped in asylums by family members who have signed away their autonomy and free will to the state.
Berliner creates a frightening, heartfelt and uplifting historical pastiche of how da Silveira single-handing opposes these renowned men of the psychiatric profession in Brazil and world-wide by countering their use of these barbaric medical treatments which she labels as violent. These colleagues ridicule her and punish her with a demotion by placing her in charge of Occupational Therapy for the patients. They relegate her to a section of the hospital which is a filthy, run-down garbage heap, perhaps with the intention of forcing her resignation. She has been consigned to a no prestige placement, apart from their company and away from any potential of career advancement. However, she remains curious and positive though she will be spending her days with an ill-equipped staff, a group of violent schizophrenics and a situation which seems beyond improvement. This is a David and Goliath story with a twist.
Clearly, the conservative doctors have underestimated her will, intuition, brilliance and empathy for the individuals under her care. With the assistance of the nurses and aides, she transforms the garbage dump into a clean and workable unit that her patients and staff appear to acknowledge and recognize. Through observation, love, humanity and the Golden Rule, da Silveira proves her own methods (she stumbles upon activities that elicit the individuals’ inner world through art-painting, sculpture, wood-working, etc.) have more efficacy than those of her conservative, brutality oriented, male peers.
As she learns from her patients’ art which is astounding in its expressiveness of their inner world because they are allowed the freedom to be who they are in their artistic endeavors, their unconscious allows them to self-heal. Nise da Silveira encourages them to become a community with each other as they take interest in their own person-hood and thrive. Nise da Silveira studies the symbols in their work and researches the concepts of Dr. Carl Gustav Jung and the collective unconscious. She contacts Jung and receives his affirmation and she eventually pioneers the acceptance of Jungian Psychology in Brazil. However, her colleagues do not recognize Nise da Silveira’s efforts. They threaten her job security and even have performed a violent act which sets the patients backward.
Undaunted, she holds an exhibit of the amazing art work on the hospital premises and invites the renowned Brazilian art critic Mário Pedrosa (Charles Fricks) to attend. He is thrilled to view the artistry of these “mad” individuals and recognizes they see beyond into another world of consciousness which they are able to express freely so they can bring others in touch with who they are.
Berliner shows that this is an important crossroads in da Silveira’s amazing career as a psychiatrist who continued to research, write and foster “mad” ones’ artistic achievements, as well as successfully employ the therapy of animals to encourage self-healing.
The artistic achievement by these individuals and many other “mad” ones, has been acknowledged to be some of the finest, most valuable of modern art produced in Brazil. These works have been registered (127,000 thus far) and are recognized around the world for what they represent. They are in the Images of the Unconscious Museum (da Silveira donated the works so they would be protected). There have been 150 exhibitions in Brazil and abroad.
The many themes of this film concerning the obtuseness of the medical profession to employ quick and dirty and wrong treatments and medications resonates profoundly for us today. So does the patients use as guinea pigs to serve science and not the other way around, with the exception of the Holistic approach (observation, patience, humanity) which is what da Silveira practiced. The last part of Berliner’s poignant and triumphant film is absolutely breathtaking. You will have to see this wonderful film for yourself. I will not spoil it for you.
For more information about Nise da Silveira CLICK HERE.
Photographs of the paintings taken from this site. Poster courtesy of the film.