“Music has already been tried in this asylum, where we had four or five artists. […] Music seems to me to be a useful aid in the treatment of insanity. Indeed, it has been used for many years in Italy as a means of curing mental disorders. In a country where appreciation of the fine arts is widely cultivated, this resource should undoubtedly be put into good use by physicians tending to the mentally ill.”
This excerpt is from a report dated July 22, 1856, by Manuel José Barbosa, then director of the Pedro II Asylum, the first psychiatric institution in Latin America. Founded in 1852, the asylum operated until 1944 on the grounds that now host the Praia Vermelha campus of the Federal University of Rio de Janeiro (UFRJ) in Botafogo. From its early days, the institution engaged patients in activities such as reading, writing, drawing, and drama. It also provided workshops in shoemaking, tailoring, woodworking, floriculture, and fiber unraveling. These practices aligned with the principles of French alienism introduced by Philippe Pinel (1745–1827), who is widely considered the father of modern psychiatry.
The role of art in the former asylum was explored in a study by psychoanalyst Cristiana Facchinetti, a professor in the Graduate Program on the History of Science and Health at the Oswaldo Cruz Foundation (FIOCRUZ). According to Facchinetti, the earliest accounts of asylum art in Brazil date back to the early twentieth century, a period when prominent physicians such as Osório Cesar (1895–1979) and Nise da Silveira (1905–1999) began to advocate for its therapeutic and artistic value. Both were proponents of noninvasive approaches to psychiatric treatment, introducing patient art workshops.
Facchinetti’s research drew on sources such as scientific publications and daily newspapers kept in Brazil’s National Library Digital Archive. “Brazilian physicians who interned in European psychiatric hospitals at the time adopted the use of art produced by patients for observation and diagnostic purposes. Brazil aligned itself with mental health theories circulating in the West, although no formal museum collection was created to preserve the resulting artwork,” explains Facchinetti.
Osório Cesar Museum of Art Collection / Courtesy: Juquery Hospital Complex and Franco da Rocha City Hall / Reproduced from Orlando JuniorAn untitled, undated artwork by Aurora Cursino dos Santos Osório Cesar Museum of Art Collection / Courtesy: Juquery Hospital Complex and Franco da Rocha City Hall / Reproduced from Orlando Junior
The Pedro II Insane Asylum, later renamed the National Asylum for the Insane (HNA), not only encouraged patients to produce artwork but also made it a point to display their creations. In 1892, during the early years of the Brazilian Republic, a law was enacted calling for an annual exhibition within the asylum to showcase art created by the so-called “alienated.” The patients’ artwork soon began to attract media attention, sparking the interest of notable figures such as writer Machado de Assis (1839–1908). In 1895, he published a column in the newspaper A Semana titled “On an Exhibition of Works by Patients at the National Asylum for the Insane.”
It wasn’t until the twentieth century that art created by psychiatric patients found its way outside the asylum walls, in exhibitions at galleries and museums across Brazil, notes art historian Kaira M. Cabañas, associate dean of academic programs and publications at the Center for Advanced Study in the Visual Arts at the National Gallery of Art in Washington, DC. Last year, Cabañas released her book Aprender com a loucura: Modernismo brasileiro e arte contemporânea global (Learning from madness: Brazilian modernism and global contemporary art; WMF Martins Fontes) in Brazil. The book, written during her tenure as a visiting professor at the Pontifical Catholic University of Rio de Janeiro (PUC-RJ) in the 2010s, examines the intersection of art and mental health in Brazilian modernism through key figures such as Cesar and Silveira.
Cesar (see Pesquisa FAPESP issue nº 247) began his work in 1923 at Juquery Psychiatric Hospital, opened in 1898 in Franco da Rocha, São Paulo. “When Osório Cesar arrived at the hospital, many patients were already engaged in painting and drawing, but their work only gained prominence thanks to his efforts,” explains Cabañas. In 1933, Cesar collaborated with artist Flávio de Carvalho (1899–1973) to organize an exhibition of artworks by psychiatric patients at the Modern Artists Club (CAM) in São Paulo. It wasn’t until 1949, however, that hospital managers officially established a Visual Arts Wing, headed by physician Mário Yahn (1908–1977). During the 1950s, this wing was transformed into the Free School of Visual Arts, now managed by Cesar.
Born in Alagoas, Nise da Silveira graduated in medicine in 1926 in Salvador, Bahia, as the only woman in her class. She moved to Rio de Janeiro and, in 1933, passed a public examination to become a psychiatrist. In the 1930s, during the Vargas regime, Silveira was imprisoned on charges of communism, leading to her removal from public service. In 1944, she joined the National Psychiatric Center in the Engenho de Dentro district of Rio de Janeiro. Soon after, in 1946, she established a painting studio for her patients, working alongside painter Almir Mavignier (1925–2018). Six years later, she founded the Museum of Images of the Unconscious to preserve and exhibit these works. “In 1949, the Museum of Modern Art in São Paulo [MAM-SP] hosted an inaugural exhibition of works by Nise’s patients, titled 9 artistas de Engenho de Dentro do Rio de Janeiro (9 artists from Engenho de Dentro, Rio de Janeiro). Brazil was ahead of its time. In Europe, even the most celebrated psychiatric collections, such as the Prinzhorn Collection [see box], were not displayed in art museums until the 1960s,” says Cabañas.
Rafael Adorjan / Bispo do Rosario Contemporary Art Museum Collection / Rio de Janeiro City HallManto da apresentação (Presentation mantle), the title given to this undated piece by Arthur Bispo do RosárioRafael Adorjan / Bispo do Rosario Contemporary Art Museum Collection / Rio de Janeiro City Hall
The exhibition at MAM-SP is considered a landmark. “The exhibition catalog, for example, identified psychiatric patients by their real names rather than using pseudonyms or focusing on their diagnoses,” explains Eurípedes Gomes Cruz Junior, a museology and heritage specialist and author of Do asilo ao museu: Nise da Silveira e as coleções da loucura (From asylum to museum: Nise da Silveira and the collections of madness; Editora Holos, 2024). The book provides a comparative analysis of psychiatric art collections in Brazil and abroad, such as the Museum of Images of the Unconscious and the Sainte-Anne Hospital Center in Paris. Much of the research for her book was drawn from her doctoral thesis, defended in 2016 at the Federal University of the State of Rio de Janeiro (UNIRIO).
Cruz Junior notes that turning psychiatric collections into museum exhibits helped to reshape Brazilian society’s view of mental illness, helping to spark the Brazilian anti-asylum movement. “It’s no coincidence that Brazil now has some of the most progressive mental health laws in the world. Art exhibitions played a crucial role in preparing the ground for these shifts,” he observes.
Cabañas concurs but notes that, paradoxically, while modern cultural institutions in Brazil and critics like Mário Pedrosa (1900–1981) aesthetically incorporated these works, the social exclusion of patient-artists persisted. “The artists themselves were subjected to psychiatric regimens that deemed their isolation from society to be “therapeutic,” even as their works were recognized as art and exhibited publicly in museums,” she notes. “The art institutions that displayed these works failed to account for their origins—psychiatric hospitals—and the marginalized populations within them, including urban poor, immigrants, Black Brazilians, and women, who were often considered threats to social ‘order,’” she adds.
This was the case for figures like Arthur Bispo do Rosário (c. 1909–1989) and Aurora Cursino dos Santos (1896–1959). Bispo, among the last psychiatric patients to create art in an asylum—the Juliano Moreira Colony (CJM) in Jacarepaguá, Rio de Janeiro—never identified as an artist. Nevertheless, his works were elevated to the status of art after his death. In 2000, a museum bearing his name was established on the grounds of the former CJM, which became defunct in the 1990s. Santos, a former sex worker, spent the final 15 years of her life at Juquery Psychiatric Hospital. While there, she attended the Free School of Visual Arts and produced more than 200 paintings, even as she underwent electric shock therapy.
Today, Santos is hailed as a seminal feminist artist for her vivid portrayals of violence against women, says Silvana Jeha, a historian with a doctorate from PUC-Rio. “In the 1950s, her depictions of vaginas, rape, and other abuses prefigured many of the themes that American feminist art would only begin addressing a decade later, and issues that Brazil would only openly discuss in the twenty-first century,” notes Jeha, who, alongside psychoanalyst Joel Birman, a professor at UFRJ, coauthored Aurora: Memórias e delírios de uma mulher da vida (Aurora: Memoirs and delusions of a woman of the night; Editora Veneta, 2022). Jeha concludes: “Regrettably, individual exhibitions of these artists’ works remain rare in Brazil. It’s as though, in the eyes of Brazilian curators, patient-artists are not considered artists in their own right.”
The Prinzhorn Collection in Germany houses around 40,000 works by psychiatric patients from European institutions
Wikimedia CommonsA self-portrait by Elfriede Lohse-Wächtler (1931), a German artist killed by the Nazi regimeWikimedia Commons
Recognized as one of the most important of its kind worldwide, the collection, kept at the Psychiatric University Clinic of the University of Heidelberg in Germany, has been extensively researched since 2018 by Lucia Reily, a professor in the graduate program in visual arts at the University of Campinas (UNICAMP). Featuring items such as drawings and paintings created by psychiatric patients, the collection began to be formed in the late nineteenth century. But it was between 1919 and 1921 that it expanded most prolifically thanks to the efforts of psychiatrist and art historian Hans Prinzhorn (1886–1933) and Karl Wilmanns (1873–1945), then director of the Heidelberg clinic. By that time, the collection had grown to include about 5,000 works by 435 patients from Heidelberg and other European institutions.
In 1921, Prinzhorn analyzed a series of these artistic works. His study culminated in the book Bildnerei der geisteskranken (Artistry of the mentally ill), published the following year. “Rather than approaching the works from a pathological perspective he instead connected them to modern art movements such as Expressionism,” explains Reily.
Prinzhorn left Heidelberg in 1921, before the book was published, and abandoned his career in hospital psychiatry to work as a psychoanalyst. According to Reily, the book caught the attention of artists such as German painter Max Ernst (1891–1976) and French writer André Breton (1896–1966), one of the theorists of the Surrealist movement. Although never published in Brazil, the book also influenced Brazilian psychiatrists, including Osório Cesar. In 1929, Cesar published A expressão artística nos alienados: Contribuição para o estudo dos símbolos na arte (Artistic expression in the insane: A contribution to the study of symbols in art), in which he highlighted similarities between the works of patients at the Juquery Psychiatric Hospital in São Paulo and avant-garde artistic movements such as Cubism.
With the rise of Nazism in the 1930s, the Prinzhorn Collection fell into obscurity until part of it was publicly exhibited in 1963 at the Kunsthalle museum in Switzerland. Today, the collection includes approximately 40,000 works by psychiatric patients, including those by painter Elfriede Lohse-Wächtler (1899–1940), who was institutionalized in a German clinic in 1929. In 2023, 130 of Lohse-Wächtler’s works were featured in an exhibition at the Prinzhorn Collection Museum. “She had already established a professional career as an artist before her institutionalization. Her art often portrayed women, including fellow patients at the clinic,” says Reily. “In 1940, she was sentenced to death under the Nazi Euthanasia Program, codenamed Aktion T4, which targeted individuals with mental disorders and disabilities deemed incurable. Fortunately, her works lived on through subsequent exhibitions, research, and publications.”
The story above was published with the title “The art of madness” in issue 346 of December/2024.
Scientific articles
FACCHINETTI, C. Da produção artística dos alienados: Histórias de teorias e práticas do alienismo brasileiro, 1852–1902. História, Ciências, Saúde-Manguinhos, Rio de Janeiro, Vol. 29, sup. 1, 2022.
REILY, L. Engajamento da sociedade com a criação imagética de pessoas que vivenciam experiências psiquiátricas: O Museu da Coleção Prinzhorn. MODOS: Revista de História da Arte, Campinas, SP, Vol. 8, no. 1, pp. 224–59. 2024.
Books
BIRMAN, J & JEHA, S. Aurora: Memórias e delírios de uma mulher da vida. São Paulo: Veneta, 2022.
CABAÑAS, K. M. Aprender com a loucura: Modernismo brasileiro e arte contemporânea global. São Paulo: Editora WMF Martins Fontes, 2023.
CRUZ JUNIOR., E. G. Do asilo ao museu: Nise da Silveira e as coleções da loucura. Rio de Janeiro: Hólos Consultoria e Assessoria, 2024.
