Jungian studio work and the Museum of Images of the Unconscious (Nise da Silveira)

1. Introduction

Version followed: Nise da Silveira's model as the Museu de Imagens do Inconsciente (MII) and Casa das Palmeiras publish and practise it. That means three layers. (a) The historical Seção de Terapêutica Ocupacional (STO) at the Centro Psiquiátrico Pedro II, Engenho de Dentro, Rio de Janeiro, taken over by Silveira in 1946. (b) Its continuation as the MII (founded 1952) and the Casa das Palmeiras day clinic (founded December 1956). (c) The MII ateliers as they ran in 2026. Silveira's own books (Imagens do inconsciente, 1981; Casa das Palmeiras: a emoção de lidar, 1986; Gatos, a emoção de lidar, 1998) are not drawn on directly. They are cited here through Portuguese-language secondary sources that quote them with page numbers. Where the layers differ, this guide says so. [source: Melo 2009; Melo 2010; Lemos 2015; Agência Brasil 2026] [uncertain: primary books]

What it is: this is not a manualised therapy. It is an institutional model of expressive studio work for people with psychosis, mostly long-stay inpatients diagnosed with schizophrenia. Silveira called it terapêutica ocupacional and later a emoção de lidar, "the emotion of handling" materials. It sits inside a research programme on images of the unconscious that draws on C. G. Jung's analytical psychology. [source: Melo 2009 pp. 45–49; Almada & Peres 2026; Agência Brasil 2026]

Core idea of change, in the authors' terms:

Psychotic experience "abala as próprias bases da vida psíquica" (shakes the foundations of psychic life) (Silveira 1986, p. 9, cited in Melo 2010). Affect is not extinguished beneath the apparent blunting. [source: Melo 2010; Carvalho & Amparo 2006]
Free, non-verbal giving of form to inner images, in a non-coercive setting, gives those images a way out (Silveira 1981, p. 14, cited in Pereira et al.).
A warm, steady relationship with the monitor (and with animals) acts as an afeto catalisador, an affective catalyst. Under it, in Silveira's phrase, the loose bonds of thought tighten ("os laços frouxos do pensamento apertaram-se") (1981, p. 85, cited in Almada & Peres). [source: Melo 2009 p. 48]
Read through Jung, spontaneous mandalas and mythological motifs in a person's series of images show the psyche's own attempt to reorganise itself, a self-healing tendency. Jung confirmed this reading in his 1954 reply to Silveira. [source: Pereira et al., citing Silveira 1981 pp. 53–54; CCBB catalogue]
Expression is not the end point. "A expressão não se encerra na expressão" (expression does not end in expression): the aim is rehabilitation and return to social life. [source: Melo 2009 p. 49]

Professional frame:

No separate credential, register or certified training in "the Nise da Silveira method" was found. The MII Study Group is free and open to anyone, in person and on YouTube. It is a study forum, not a qualification. [source: MII Study Group page]
Historically, the studios were run by occupational-therapy monitors with no higher education, supervised by Silveira as psychiatrist. Today the MII ateliers are coordinated by a psychologist (Adriana Lemos) and take referrals from the Brazilian public health system (SUS): CAPS (psychosocial care centres) and Clínica da Família (family health clinics). [source: Melo 2009 p. 47; Agência Brasil 2026]
Outside Brazil, run it within your own registered role. In the UK, sustained art-therapy work is the protected title of HCPC-registered art psychotherapists (BAAT); in the US the credential is AATA/ATCB. A psychotherapist without art-therapy training can host a free-expression studio as described here. They should not offer art therapy, and should not offer clinical reading of image series, without art-therapy or Jungian training and supervision. [synthesis]
In Brazil, occupational therapy is a regulated profession, and art therapy has its own professional associations. Check current requirements locally. [uncertain]
This is a psychosis-care model and depends on a team: psychiatric oversight, monitors, and a place to keep the works. Do not offer it as a stand-alone private treatment for acute psychosis. [synthesis]

2. Framework

This is an institutional programme, not a protocol with set phases. The sources give no fixed session count, and attendance is open-ended. The stages below are a [synthesis] arrangement of procedures that the sources do describe.

Stage A. Referral and entry

STO, historically: clients entered only on prescription from doctors in other hospital sectors (criterion 1 of the STO). [source: Melo 2009 p. 46]
MII, 2026: clients are referred from CAPS and Clínica da Família. [source: Agência Brasil 2026]
Casa das Palmeiras: day attendance (externato) for people discharged from psychiatric hospitals. The founding statute (art. 2) gives its aim as the recovery of these egressos. Silveira had found that 17 of every 25 admissions were readmissions. [source: Melo 2010]

Stage B. First activity and observation

STO: the monitor chose the initial activity and observed the client (criterion 2). [source: Melo 2009 p. 46]
MII, 2026: the client chooses the atelier. [source: Agência Brasil 2026]
Version note: this guide offers both. Use monitor-proposed starts for withdrawn people who cannot choose, and client choice otherwise. [synthesis]

Stage C. Daily free expressive work, the core stage

Painting, drawing, modelling, carving and other expressive work, in mixed-sex groups (criterion 3), with no models to copy and no aesthetic standard (criterion 4).
Format: the 1946 painting studio ran daily from 10:00 to 14:30 [source: Carvalho & Amparo 2006]. At the Casa das Palmeiras, painting and modelling ran on weekdays from about 13:00 to 15:30, with 6–12 people a day in painting, followed by a snack and a collective activity [source: Lemos 2015].
Duration: long-term, often years; Silveira followed some clients for decades [source: CCBB catalogue; Pereira et al.]. No minimum or maximum was found.

Stage D. Collecting and studying the series (staff-side, runs alongside Stage C)

Every work is dated, kept and catalogued by person.
Staff compare works across days and emotional states to notice small changes.
The works are discussed in weekly supervision and in end-of-day staff recording.
[source: Melo 2009 p. 45; Pereira et al. p. 218; Lemos 2015]

Stage E. Widening into utilitarian, recreational and cultural activity

Utilitarian work (carpentry, shoemaking, sewing, gardening, bookbinding, basketry) was kept for patients "já bastante melhorados" (already much improved) (Silveira 1966, p. 26, cited in Melo 2009 p. 47).
Recreational activity meets the need for immediate satisfaction and leads on, through sport, towards work-like activity.
Cultural activity includes a school, a library and client newspapers.
[source: Melo 2009 pp. 47–48]

Stage F. Bridge to the community

The Casa das Palmeiras serves as "um degrau intermediário" (an intermediate step) and "espécie de ponte" (a kind of bridge) between hospital and society (Silveira 1986, pp. 9 and 11, cited in Melo 2010). It has open doors and no uniforms, and clients are free to go out into the city.
Clients take part in a self-run club assembly, outings and festivals. [source: Lemos 2015]

Criteria for moving between stages

The sources state only two:
- utilitarian work is for patients who have improved considerably;
- discharge to the Casa follows hospital discharge.
Not found in the sources: operational criteria for when a person "moves on", or for ending attendance. [uncertain]
Practical markers you could use [synthesis]:
- steadier attendance;
- initiating work without prompting;
- more organised or more varied forms across the series, such as a shift between abstract and figurative work, or emerging circular/ordering forms;
- more contact with others in the room;
- interest in utilitarian or group activities.

3. Guiding principles

Each principle is followed by what it means in practice.

Freedom of expression is the "pedra de toque" (touchstone) [source: Melo 2009 p. 48]. Offer materials, never models, themes or corrections.
Spontaneity is the rule, and product quality is not a goal [source: Melo 2009 pp. 46, 48]. Never praise or criticise a work on aesthetic grounds. At the Casa, staff avoid commenting on content and reassure people who feel their work is inferior [source: Lemos 2015].
Affective catalyst (afeto catalisador) [source: Melo 2009 p. 48; Pereira et al. p. 213]. Your warm, steady, non-intrusive presence is the active ingredient. Stay available, share the experience of the materials, and do not direct.
The same person can be a catalyst for one client and an inhibitor for another (Silveira 1981, p. 69, cited in Lemos 2015). Watch each person's response to each staff member, and change who accompanies a client when needed.
Constancy, patience and freedom from coercion (Silveira 1981, cited in Almada & Peres). Keep the same times, place and people, and never force attendance or participation.
No demand for verbal translation. Silveira said of asking patients to explain their images: "Nunca recorri a esse método" (I never resorted to that method) (Silveira 1990, cited in Pereira et al.). Do not ask "what does it mean?". Let the image be the communication. Abstract forms carry no fixed code (Silveira 1981, p. 19).
Read series, not single images [source: Pereira et al. p. 218; Melo 2009 p. 45]. Keep and date everything. Make clinical observations only across the run of works.
Images as the psyche's attempts at reorganisation, within a Jungian frame. Mandalas and myth-like motifs are understood, in Jung's and Silveira's theory, as self-healing attempts and as signs of the Self's ordering function (Jung, cited in Silveira 1981, pp. 53–54). This is the tradition's theory, used as staff research. It is not fact and not a diagnostic test (see Section 4.10). [source: Pereira et al.] [synthesis on framing]
Value non-verbal, manual activity in a culture that over-values verbal reasoning (Silveira 1981, p. 66, cited in Lemos 2015). Do not treat the studio as a lead-in to "real" talking therapy.
The emotion of handling (emoção de lidar). The bodily pleasure and emotion of working matter, such as clay, is itself therapeutic. Offer tactile materials, and let a material's qualities invite form. Accounts of the term differ: Lemos (citing Quatérnio 2001, p. 24) says a client coined it, while Almada & Peres say Silveira adopted it in place of "terapia ocupacional" (1998, p. 28). [uncertain on origin]
Dignity, freedom and open doors. At the Casa, "Médico lá não veste roupa branca" (doctors there wear no white coats), and doors and windows stay open (Silveira 1977, cited in Pereira et al.). Call people by name and refer to them as clientes, not "patients". Avoid uniforms and locked rooms where you can. [source: CCBB catalogue; Lemos 2015]
Opposition to violent or numbing treatment. Silveira refused electroshock and lobotomy. She also warned that high, prolonged medication suppresses creative activity, and used it to reorganise acute episodes. [source: Carvalho & Amparo 2006; CCBB catalogue] In practice, a psychotherapist works with the prescriber, reports what they see in the studio, and never advises a client to change medication. [synthesis]
Mixed, social settings. Sectors were mixed, against medical opposition at the time [source: Melo 2009 pp. 46–47]. Run studios as shared rooms, not in individual isolation.
Expression aims at rehabilitation ("a expressão não se encerra na expressão") [source: Melo 2009 p. 49]. Keep in view the movement towards relationships, work, culture and life outside hospital.
Long, attentive observation; affect persists. Silveira challenged the idea of "affective blunting" in schizophrenia [source: Carvalho & Amparo 2006]. Assume there is inner life, and watch over months.
Animals as co-therapists. In Silveira's terms, animals are excellent affect catalysts and a "ponto de referência estável" (stable reference point) in the outer world (1981, p. 87, cited in Almada & Peres). Where it is safe and permitted, a cared-for animal can be part of the setting.
Clinic as research. The ateliers are also places to study the inner world [source: Agência Brasil 2026; MII Study Group]. Document carefully, and study as a team.
Attention to families and social vulnerability (MII, 2026) [source: Agência Brasil 2026]. Link studio work to family contact and social support.

4. Intervention inventory

This inventory covers every procedure the sources describe, grouped as follows.

4.1–4.10: core studio procedures.
4.11–4.18: the wider activity sectors and institutional procedures.
4.19–4.20: procedures for clinicians and the institution.

The sources describe what was done, not word-for-word facilitation. All example language is illustrative. The step detail is [synthesis] unless a source tag says otherwise. [source for the inventory as a whole: Melo 2009 pp. 45–49; Lemos 2015; Pereira et al.; Agência Brasil 2026; Almada & Peres 2026]

4.1 Entry by referral and an orienting first contact

Purpose: to bring someone into the studio as a prescribed treatment rather than as "occupation". It also gives the monitor a referral context.
When to use: at every new entry. Historically, entry was by prescription from other doctors [source: Melo 2009 p. 46]. Today, referrals come from CAPS and family clinics [source: Agência Brasil 2026].
Steps:
1. Take the referral. Ask the referrer for a short summary covering mental state, risks, medication changes, physical limits, allergies, and any animal phobia or allergy.
2. Meet the person by name, informally, without a white coat [source: Pereira et al., citing Silveira 1977].
3. Show them the room, the materials and the routine.
4. Say plainly that attendance and use of the materials are free, that nothing will be judged, and that works are kept.
5. Ask for consent to keep and photograph works and to discuss them in the team. Exhibition consent is a separate request (see 4.18). [synthesis]
Example language (illustrative): "This is the studio. People come here to paint, model clay and make things. There's nothing you have to make and nothing to get right. We keep what people make so we can follow how things go. Is that all right with you?"
Watch for:
- fear, suspicion or paranoid ideas about the keeping of works: offer to keep them in a folder the person can see;
- acute agitation: agree a later start with the psychiatric team.

4.2 Monitor-proposed first activity with observation (historical STO criterion)

Purpose: to get very withdrawn or disorganised people started. Choosing can be impossible for them.
When to use: with people who do not choose or cannot choose. The STO used this routinely [source: Melo 2009 p. 46]. The MII now lets clients choose [source: Agência Brasil 2026].
Steps:
1. Look for cues to what the person might take up: what they touch, where they look, the textures they gravitate to.
2. Set out one simple, inviting material, such as paper and gouache, or a ball of clay.
3. Sit near the person without demanding anything.
4. If they do not begin, begin something yourself alongside them, without making a model for them to copy.
5. Note what they do: their gestures, how long they stay, the marks they make.
6. Offer a different material on later days if the first gets no response. [synthesis on steps]
Example language (illustrative): "I'll leave the clay here. You can just hold it if you like."
Watch for:
- signs of engagement: lingering, touching, the first marks;
- persistent refusal: never insist (principle of no coercion);
- switching to client choice as soon as the person shows a preference.

4.3 Free painting and drawing atelier (ateliê de pintura)

Purpose: the central activity. It gives inner images a non-verbal outlet. Silveira described her innovation as "abrir para eles o caminho da expressão" (opening for them the path of expression) (Silveira 1996, cited in Pereira et al.). The main function of the atelier is the expression of unconscious images; resocialisation comes later (Silveira 1981, p. 14).
When to use: daily or on fixed weekdays, as the core of the programme. The 1946 studio was set up with the painter Almir Mavignier and ran daily from 10:00 to 14:30 [source: Carvalho & Amparo 2006; CCBB catalogue]. At the Casa, it ran on weekdays from 13:00 to 15:30 [source: Lemos 2015].
Steps:
1. Set out paper and canvases of several sizes, gouache or other water-based paints, brushes, crayons, pencils and water.
2. Use the same room at the same times every week.
3. Let people take the materials themselves.
4. Give no theme, model or technique instruction ("no models to copy") [source: Melo 2009 p. 48].
5. Stay present and available (4.7).
6. At the end, collect, date and name every work, including fragments and unfinished pieces (4.8).
7. Close with tidying and, at the Casa, a snack and a shared activity [source: Lemos 2015].
Example language (illustrative):
- "Use whatever you want; there's more paper here."
- When asked what to paint: "Whatever comes. There's no right subject."
Watch for:
- repeated forms, and changes in colour, structure, or abstract versus figurative work across days [source: Pereira et al. p. 215];
- the person's mood and contact with others;
- signs it is working: attendance, longer spells of work, initiative, more organised or more varied series, warmth towards staff.
Materials safety: use non-toxic, water-based paints. Avoid solvents and aerosols. Supervise sharp tools, and keep a note of anyone who might ingest materials. [synthesis]

4.4 Clay modelling (modelagem) and the emotion of handling

Purpose: tactile and bodily engagement with matter. Clients recorded "A alegria esfuziante que passa das mãos enlameadas para os nervos e músculos" (the effervescent joy passing from muddy hands into nerves and muscles) (Silveira 1991, in Mello 2009, cited in Pereira et al. p. 220). The term emoção de lidar is tied to this kind of work.
When to use: for people who find painting too exposing or too flat, for agitated people who need a physical outlet, or simply as one of the regular ateliers. At the Casa, modelling took place on a covered outdoor veranda from 13:00 to 15:30 on weekdays. Psychology interns watched people's emotional reactions during it. [source: Lemos 2015]
Steps:
1. Prepare moist clay and boards, with water, simple tools and cloths.
2. Offer a lump of clay with no instruction.
3. Allow any use of it: kneading, pounding, flattening, forming.
4. Keep finished pieces, and photograph pieces that will not survive.
5. Plaster casting or carving can follow for those who want permanence. The Casa's sources mention a plaster sculpture of a caged figure. [source: Melo 2010]
Example language (illustrative): "Just see how it feels in your hands."
Watch for:
- the quality of handling (calm or frantic) and how it changes over a session;
- whether forms emerge;
- relief or settling after the work.
Materials safety: use wet clay. Sweep wet or vacuum with a HEPA filter, never dry-sweep, because of silica dust. Kiln work needs a trained operator. Keep clay away from anyone who might eat it. [synthesis]

4.5 Woodcut (xilogravura), carving and sculpture

Purpose: working with resistance and permanence; producing prints that can be repeated.
When to use: for stable clients who can handle tools. At the Casa, woodcut took place on the second floor, mostly with men, and with safety care because of the cutting tools. [source: Lemos 2015] Carving was among the STO's expressive activities. [source: Melo 2009 p. 48]
Steps:
1. Check the person's stability and current risk with the team.
2. Demonstrate the safe use of tools only: cutting away from the body, and the use of a bench hook or other non-slip holder. This is safety instruction, not artistic instruction.
3. Count the tools out and back in.
4. Keep supervision close.
5. Leave the design free. [synthesis on steps]
Example language (illustrative): "I'll just show you how to hold the gouge safely. What you cut is up to you."
Watch for:
- frustration with the material, and any self-harm ideation;
- signs it is working: absorption, satisfaction with the print.
Risk: remove the tools and offer clay or paint if risk rises (see Section 5).

4.6 Material-led making (fabrics, velvet, collage, tapestry)

Purpose: to let the qualities of a material call out a form. Silveira, following Bachelard, wrote that creative imagination prefers a substance to clothe itself in (1998, p. 28, cited in Almada & Peres).
Example from the sources: Luís Carlos was drawn to a piece of velvet on a table and turned it into a cat. The monitor, Maria Abdo, noticed his interest and supported it. [source: Almada & Peres 2026] The Casa runs collage and applied arts/tapestry for about 8 people a day [source: Lemos 2015].
When to use: with people who do not paint or model; when someone shows an interest in an object.
Steps:
1. Leave varied materials within reach: fabric scraps, velvet, yarn, magazines for collage, glue.
2. Notice what draws the person.
3. Make it available, along with whatever they ask for.
4. Do not suggest what to make. [synthesis on steps]
Example language (illustrative): "You keep coming back to that piece of fabric. Would you like it?"
Watch for: spontaneous transformation of a material into a meaningful object, which is the kind of event the sources record.

4.7 Accompaniment as affective catalyst (the monitor's core stance)

Purpose: to provide the relationship that makes the work therapeutic [source: Melo 2009 p. 48; Lemos 2015].
What the sources say monitors did:
- they went to clients in the hospital corridors and yard;
- they stayed available without interfering in the creation;
- they shared the experience of the materials [source: Pereira et al. p. 213];
- they kept records, such as Elza Tavares's notes on Carlos and the dog Sultão [source: Almada & Peres 2026].
When to use: throughout every session.
Steps:
1. Greet each person by name on arrival.
2. If someone does not come, go and find them at the usual time without pressing them (the STO monitors went into the hospital yard).
3. Sit at a comfortable distance and work with materials yourself if it helps, without producing a model.
4. Respond to whatever the person offers, such as a glance, a word or a work held out, with warm interest rather than evaluation.
5. Hold steady times and steady people (constancy).
6. Record brief observations after each session. [synthesis on steps 1, 3–6]
Example language (illustrative):
- "Good to see you today."
- When a work is shown: "You've been working on this all afternoon." (a description, not a judgement)
- Avoid: "That's beautiful" and "What does it mean?"
Watch for:
- whether this staff member is a catalyst or an inhibitor for this person (Silveira 1981, p. 69, cited in Lemos 2015). Signs of inhibition are stopping work, leaving, or tension when that staff member comes near;
- signs of catalysis: more work and more contact. Silveira saw thought becoming more organised under the influence of affect (1981, p. 85).

4.8 Keeping, dating and filing every work in series

Purpose: to make series study possible, and to honour the work. Each client's works form a "livro vivo de material plástico, simbólico" (a living book of plastic, symbolic material), filed as study material and as part of the clinical record [source: Lemos 2015]. Cataloguing each client's production in series was one of the STO's four founding lines of work [source: Melo 2009 p. 45].
When to use: after every session, for every piece.
Steps:
1. Write the name and date on the back of each work, in pencil.
2. File it in chronological order in a folder for that person.
3. Photograph 3-D works.
4. Note the context: mood, events, any medication change the team has told you about.
5. Store the works securely, as you would clinical records.
6. At the Casa, interns, or clients who want to, help with the filing [source: Lemos 2015]. [synthesis on steps 3–5]
Example language (illustrative): "I'll put today's with your others, in your folder."
Watch for:
- clients who want to take works home or destroy them: respect this, and photograph the work first only with their consent;
- data protection: records and images are confidential clinical material [synthesis].

4.9 Series study in team supervision

Purpose: to understand a person's inner process over time and to guide the team's attitude. It is not given back to the client as an interpretation.
What the sources describe:
- Silveira gathered a person's works and compared them across days and emotional states to notice small changes [source: Pereira et al., citing Silveira 1981].
- She tracked phases, for example shifts between abstract and figurative work [source: Pereira et al. p. 215].
- At the Casa, observations from the ateliers are recorded and discussed with the technical team at the end of the day, and the works are discussed in weekly supervision [source: Lemos 2015].
Steps:
1. Lay out a chronological run of works, for instance a month's.
2. Note recurring forms, colours, structure, the degree of organisation, and themes.
3. Set these alongside the clinical notes: mood, events, admissions.
4. Agree on the team's attitude, for example more presence, a different monitor, a new material, or links to group activities.
5. Record your hypotheses as hypotheses. [synthesis on steps]
Example language in the team (illustrative): "Over these six weeks the paintings have moved from scattered marks to enclosed shapes. That coincides with her coming every day."
Watch for:
- over-reading. Silveira held that abstract forms cannot be assigned fixed codes (1981, p. 19);
- validity: no reliability or validity data for series reading were found. Never treat a series as diagnostic evidence, including evidence of abuse. [uncertain; synthesis]

4.10 Jungian amplification: recognising mandalas and mythological parallels (staff research)

Purpose: to understand images within Jung's theory of the psyche.
What the sources record:
- From 1949, Silveira noticed circular forms in works that otherwise showed fragmentation. In 1954 she sent photographs to Jung, who replied that they were mandalas expressing the psyche's self-healing potential. [source: Carvalho & Amparo 2006; Pereira et al. pp. 216–217; CCBB catalogue]
- She studied mythology to understand the ancient meanings in the works. Examples: Adelina Gomes's paintings of women turning into plants, read through the myth of Daphne; a client's shifting moods compared with the Egyptian goddess Bastet; a Carlos Pertuis sun image linked to a case Jung described in 1906. [source: CCBB catalogue; Carvalho & Amparo 2006]
- Carvalho & Amparo say the mythic parallel gave the patient a frame for their experience that reduced isolation. How such parallels were shared with clients, if they were, is not described. [uncertain]
When to use: in staff study and supervision (4.9, 4.20), by clinicians trained in analytical psychology.
Steps:
1. In a series, note circular, quaternary or centred forms and recurring mythic motifs.
2. Consult the literature on symbols (Jung; Silveira's books).
3. Write down possible parallels as amplifications, not conclusions.
4. Use them to deepen the team's respect for and understanding of the person's process, not to label them.
5. If you share anything with a client, offer it only lightly, as a story or picture, and only if they are curious. [synthesis]
Example language (illustrative, with a curious client): "People in many times and places have painted circles like this. Would you like to see some?"
Watch for:
- Jung's theory (the Self, archetypes, self-healing) is the tradition's own theory, not established fact;
- imposing meaning;
- feeding delusional elaboration in someone who is acutely psychotic. In that case, keep amplification inside the team. [synthesis]

4.11 Other expressive ateliers: music, rhythm, dance and movement, theatre, women's circle

Purpose: expressive forms beyond the visual arts, run in the same spirit of free expression.
What the sources list:
- The STO ran music, dance and theatre; the dance provoked medical hostility [source: Melo 2009 pp. 46–48].
- The 2026 MII ateliers are painting, ceramics, ritmologia (rhythm), body and movement, visual arts, theatre, and a women's circle (roda de mulheres) for women's issues [source: Agência Brasil 2026].
- The Casa runs theatre on Thursdays (16:00–17:30), music on Tuesdays (from 15:30), fairy tales, a dance (baile) on Fridays, monthly poetry and fortnightly flower arranging [source: Lemos 2015].
Not found: the sources do not describe how these ateliers are facilitated step by step. The steps below are general good practice. [uncertain; synthesis]
Steps (synthesis):
1. Keep the free-expression stance: no performance standard, and anyone may join in or just watch.
2. Rhythm and music: offer simple percussion and voice. Keep the volume moderate, provide ear protection for prolonged drumming, and let people step out.
3. Movement and dance: clear the floor, check footwear and mobility, offer seated options, and have no touch without asking. Partnered work is optional and agreed out loud each time, and never involves touch to intimate areas.
4. Theatre and fairy tales: use chosen roles, step out of role at the end, and let people stop whenever they want. Do not stage people's own traumas.
5. Women's circle: a single-sex space with a clear agreement about confidentiality.
Example language (illustrative): "You can play, move or just listen. If you'd like to pair up, just say so. No one has to."
Watch for:
- over-arousal and disorganisation in group enactment with acutely psychotic people. Reduce the stimulation, return to concrete tasks, and allow quiet withdrawal;
- cultural and trauma sensitivity about touch and mixed-sex movement;
- falls.

4.12 Writing, poetry and client publications (cultural activities)

Purpose: verbal expression and cultural participation, and a public voice for clients.
What the sources record:
- The STO opened a school (1948) and a library (1950), and produced the illustrated magazine Flausi Flausi (1950) [source: Melo 2009 p. 48].
- At the Casa, Melo treats writing and poetry as central to the method [source: Melo 2010]. The Casa also produces the quarterly newspaper Arauto [source: Lemos 2015].
- A client, Albertina Borges d'Rocha ("Beta"), founded the newspaper O Universo [source: CCBB catalogue].
Steps (synthesis):
1. Provide notebooks and a regular writing slot.
2. Accept any form of writing, including invented words. Melo's 2010 article discusses neologistic "original language" writing at the Casa.
3. Offer, without pressure, the chance to publish in a house newsletter edited with clients.
4. Get consent for every piece published, and agree whether names appear.
Example language (illustrative): "If you want any of this in the next issue, tell me. Otherwise it stays in your folder."
Watch for:
- writing that discloses risk to self or others: follow the risk procedures in Section 5;
- the pride and social contact that publication brings.

4.13 Utilitarian workshops (carpentry, shoemaking, basketry, sewing, gardening, bookbinding)

Purpose: affirmation of the mature personality and a move towards work. Le Gallais, cited by Melo, described this as "a afirmação da personalidade madura".
When to use: for patients "já bastante melhorados" (already much improved) (Silveira 1966, p. 26) [source: Melo 2009 p. 47]. At the Casa, there was woodworking, and the client José became its monitor at Silveira's invitation [source: Melo 2010].
Steps (synthesis):
1. Introduce the workshop once expressive work and attendance are stable.
2. Teach the craft's technique; here, unlike in the expressive ateliers, instruction is appropriate.
3. Let personal style show. José's chairs and mailbox carried heart shapes [source: Melo 2010].
4. Graduate responsibility, up to a monitor role (4.19).
Watch for:
- tool safety: counting tools, guards, supervision;
- pressure to perform. Keep it voluntary.

4.14 Recreational activities, outings and festivals

Purpose: immediate satisfaction (satisfação imediata), shared enjoyment, and contact with the city.
What the sources record:
- The STO offered games, parties, cinema, radio, television, sport and outings [source: Melo 2009 p. 48].
- The Casa holds outings on the last Wednesday of each month, and parties at Easter, the June festival (Festa Junina), spring and Christmas, organised together with clients [source: Lemos 2015].
Steps (synthesis):
1. Plan with clients.
2. Check mobility, medication timing, money and transport.
3. Keep staff ratios safe.
4. Make attendance voluntary.
Food hygiene: handwashing, attention to allergies, and safe storage at parties and snack times. [synthesis]
Watch for: overstimulation in crowds; a plan for anyone who wants to leave early.

4.15 Animals as co-therapists

Purpose: to provide an affective catalyst and a "ponto de referência estável no mundo externo" (a stable reference point in the outer world). Silveira wrote that a dog "nunca provoca frustrações" (never causes frustration) and gives unconditional affection. She suggested cats, being discreet and evasive, may suit the way people with schizophrenia show affection. (1981, p. 87, cited in Almada & Peres 2026)
What the sources record:
- From the 1950s, Silveira introduced cats into the ateliers.
- In 1955 the patient Abelardo adopted an abandoned dog, Caralâmpia, with her encouragement. He built it a wooden house, which other clients painted.
- Monitors cared for and bathed the animals.
- Staff resistance included the poisoning of animals, which Silveira named a central cause of her suffering at the hospital.
- [source: Almada & Peres 2026; CCBB catalogue]
Steps (synthesis; adapt to current animal-assisted intervention standards):
1. Get institutional approval and veterinary care for the animal, and ensure an infection-control protocol.
2. Screen clients for allergies, phobias and any history of cruelty to animals.
3. Let contact be voluntary.
4. Give clients care tasks (feeding, grooming) if they wish.
5. Protect the animal's welfare and rest.
Example language (illustrative): "The cat likes to sit on that chair. You can stroke her if she comes to you."
Watch for:
- bites, scratches and hygiene;
- the animal being harmed;
- grief if the animal leaves or dies;
- signs it is working: a client who has withdrawn from people reaching out to the animal. Silveira recorded these cases (Carlos and the dog Sultão, 1981 pp. 83–85).

4.16 Client self-governance: the monthly assembly (Clube Caralâmpia)

Purpose: participation, responsibility and voice.
What the source records: since 1961 the Casa has held a monthly assembly. A client serves as president and a team member as secretary, and the roles rotate so that everyone can lead. [source: Lemos 2015] The Casa also holds open dialogue about clients' views of the house [source: Pereira et al., citing Silveira 1991].
Steps (synthesis):
1. Fix a monthly date.
2. Rotate the client chair and keep a staff secretary.
3. Take an open agenda: activities, outings, complaints, the house.
4. Minute the decisions and report back on what was done.
Example language (illustrative): "This month you're chairing. What's first on the list?"
Watch for:
- domination by a few voices;
- staff overriding decisions without explaining why.

4.17 The open day clinic (externato) as a bridge: Casa das Palmeiras

Purpose: to prevent readmission by offering a free-entry intermediate setting between hospital and society. Silveira called it "um pequeno território livre" (a small free territory) (1986, p. 11).
What the sources record:
- The Casa was founded in 1956 by Silveira, Maria Stela Braga, Lygia Loureiro and Belah Paes Leme, with space from Alzira Lopes Côrtes.
- It has open doors and no uniforms, and clients go out into the city freely.
- Daily ateliers are followed by collective activities.
- The staff are psychiatrists, occupational-therapy monitors, interns and social workers. Silveira supervised the medical teams on Thursdays.
- It is an autonomous philanthropic association, with low rehospitalisation reported but no figures given.
- [source: Melo 2010; Lemos 2015; Agência Brasil 2026; Carvalho & Amparo 2006]
How a psychotherapist works with it (synthesis):
1. Refer recently discharged clients to a day service of this type.
2. Keep individual therapy separate but coordinated: get consent to share information, and agree who handles risk.
3. Do not interpret the client's studio images in your own sessions unless the client brings them.
Watch for: dropping out after discharge. Stay in contact with the service.

4.18 Exhibitions, films and contact with the art world

What the sources record:
- A first exhibition was held within three months of the 1946 studio opening [source: Carvalho & Amparo 2006].
- The exhibition "A esquizofrenia em imagens" was opened by Jung at the Second International Congress of Psychiatry in Zurich in 1957 [source: Carvalho & Amparo 2006].
- Darcílio Lima was introduced to the artist Ivan Serpa, which launched his career [source: CCBB catalogue].
- In 2026, MII ateliers open to the public once a month [source: Agência Brasil 2026].
- The museum holds over 400,000 works, 128,000 of them listed by IPHAN, the national heritage institute [source: Agência Brasil 2026].
Purpose: to change public views of madness, to give clients recognition, and to support research [source: Agência Brasil 2026; MII Nise page].
Steps (synthesis):
1. Get specific, informed consent from each client for each exhibition, image and publication, including whether they are named, with the option to withdraw.
2. Where capacity is in doubt, follow local capacity law and involve the client's representative.
3. Never show works in a way that identifies a diagnosis without consent.
4. Agree ownership and any sale proceeds in writing.
Watch for:
- exploitation;
- the strain of public attention;
- aesthetic judgement creeping into the studio once works are being exhibited.

4.19 Clients taking on roles: monitor, editor, club president

Purpose: a graded return to social roles.
What the sources record: José became woodworking monitor at Silveira's invitation [source: Melo 2010]. Clients chair the assembly and help with filing [source: Lemos 2015]. A client founded a newspaper [source: CCBB catalogue].
Steps (synthesis):
1. Notice someone's competence and steadiness.
2. Offer the role with support and a review date.
3. Make sure it is voluntary and fairly recognised.
Watch for: stress and loss of boundaries in peer roles. Give them supervision.

4.20 Clinician and team training: monitor courses and the Study Group

What the sources record:
- With no university OT courses then available, Silveira ran training courses for the monitors [source: Carvalho & Amparo 2006].
- The Study Group grew out of lectures she gave from 1968 for medicine and psychology students. It studies the psychotic process, its links to universal themes of the psyche, and clinical cases followed through spontaneous artistic expression. It also took up mythology, which led to the journal Quatérnio.
- The 2025 edition, "Imagens do Inconsciente – Leituras possíveis" (Images of the Unconscious – possible readings), worked through Silveira's books Imagens do Inconsciente, O Mundo das Imagens and Benedito. It was coordinated by Maddi Damian, Walter Melo and Paula Barros, and was free, in person and streamed on YouTube.
- [source: MII Study Group page; Carvalho & Amparo 2006]
How to use it (synthesis):
1. Join the Study Group online.
2. Run a regular team seminar that pairs a client's series (with consent) with reading in Jung and Silveira.
3. Train new monitors in the stance of 4.7 before they work alone.

4.21 Family and social-support work alongside the ateliers (MII, 2026)

What the source records: the current MII team addresses clients' social vulnerabilities and works with families [source: Agência Brasil 2026]. Methods are not described. [uncertain]
Steps (synthesis):
1. With consent, invite family members to an open session or an exhibition.
2. Link the client to benefits and housing support through social work.
3. Keep the studio a place of freedom, not of family monitoring.

5. Handling problems

The sources say little about handling problems. Each item below is marked as either source-based or [synthesis].

Client does not come or will not start (stuck, withdrawn).
- Source-based: STO monitors went to clients in the corridors and yard [source: Pereira et al. p. 213]. Communication required constancy, patience and freedom from coercion (Silveira 1981, cited in Almada & Peres). A monitor proposed the first activity [source: Melo 2009 p. 46]. An animal or a material that catches the person's interest can be the opening (4.6, 4.15).
- [synthesis]:
  - Keep inviting at the same times, and accept sitting together without any work as participation.
  - Try a different material or a different monitor (catalyst versus inhibitor: Silveira 1981, p. 69).
The same image repeats for weeks (apparent stagnation).
- Source-based: Silveira compared works across days to notice small changes [source: Pereira et al.].
- [synthesis]: Lay the series out before deciding that nothing is changing. Do not push for new subjects. Offer a new medium alongside the old one, not instead of it.
A staff member inhibits a client.
- Source-based: the same person can catalyse one client and inhibit another (Silveira 1981, p. 69, cited in Lemos 2015).
- [synthesis]: Change who accompanies that client and review it in supervision. Do not treat this as the client's resistance.
The client asks what their picture means, or wants it judged.
- Source-based: Silveira did not ask for verbal translation [source: Pereira et al.]. At the Casa, staff avoid commenting on content and support clients who feel their work is inferior [source: Lemos 2015].
- [synthesis]: Turn the question back with curiosity ("What do you notice in it?"), describe what you can see, and never give a verdict.
Overwhelm, agitation or acute psychotic decompensation in the studio [synthesis].
- Lower the stimulation: move to a quieter corner, move from liquid paint to firmer clay, or stop.
- Stay calm and present, and alert the psychiatric team.
- Silveira used medication to reorganise acute episodes and limited heavy sedation because it suppresses creative activity [source: Carvalho & Amparo 2006]. Medication decisions belong to the prescriber, so report what you observe.
- Keep Jungian amplification out of conversation with clients who are actively delusional.
Distressing or violent content in images or writing [synthesis].
- Content alone is not a risk indicator. Watch behaviour, and ask directly about suicidal or violent intent when content and context suggest it.
- Follow your service's standard risk assessment and safety planning. Share concerns with the team and record them.
- Lethal-means counselling covers safe storage and removal of means only: lock away sharp tools and solvents.
Images read as evidence of abuse or of a disorder [synthesis].
- No validity or reliability data for reading image series were found in the sources [uncertain].
- Never treat artwork as diagnostic or forensic evidence. Act on disclosures and observed behaviour through normal safeguarding channels.
Children and young people [synthesis].
- The model was built in adult psychiatry. No child version was found [uncertain].
- If you adapt it:
  - get parental consent and the young person's own assent;
  - follow mandatory safeguarding and reporting duties;
  - use age-appropriate, non-toxic materials;
  - be clear with parents and carers about what is shared, and keep works confidential from them unless there is a risk.
Touch, body and movement ateliers [synthesis].
- Ask before any touch, every time, and offer opt-outs.
- Never touch intimate areas, and avoid sexualised contact.
- Respect cultural norms about mixed-sex movement; offer single-sex options (compare the women's circle).
Non-adherence, dropping out after discharge, readmission.
- Source-based: the Casa was designed to answer readmission [source: Melo 2010].
- [synthesis]: Keep the door open, so that a return after absence is welcomed without reproach. Coordinate with community teams, and make a phone or home contact after a missed fortnight.
Rupture with the institution or with medical colleagues.
- Source-based: Silveira faced hostility over mixed sectors and dance, the poisoning of animals, and the low status of OT work [source: Melo 2009; Almada & Peres 2026].
- [synthesis]:
  - Document outcomes and the care you give.
  - Invite colleagues to see the studio and the series.
  - Protect animals and works with clear policies.
  - Do not set up the studio in opposition to medical care. Run it alongside.
Rupture with a client (felt judged, works lost or shown without consent) [synthesis].
- Acknowledge the hurt, apologise, and repair concretely: return or protect the work, and change the procedures.
- Hold firmly to consent rules for exhibitions (4.18).
Fame, sales and exploitation [synthesis]. When a client's art gains public value, as with several MII artists, separate the therapeutic setting from the market. Involve the client, their representative and a neutral adviser over sales and rights.
Spiritual or archetypal concepts [synthesis]. Jung's Self, archetypes and the self-healing function of mandalas belong to analytical psychology's own theory. Do not present them as fact, as treatment for physical disease, or as a substitute for psychiatric care.
Materials and physical safety [synthesis].
- Use non-toxic, water-based media.
- Clean clay wet, with no dry dust.
- Count and supervise cutting tools.
- Allow no open flames.
- Manage volume in rhythm work.
- Give the movement work clear floor space.
- Follow food hygiene at snack time.
- Get animal-welfare and infection-control approval.
Using the model outside Brazil or with non-psychotic clients [synthesis].
- The sources concern psychosis and the Brazilian public system.
- Keep the core (free expression, affective catalyst, series keeping, no interpretation demanded) and adapt the rest to local law, professional registration (art therapy, OT) and the service context.
- Do not market it as "the Nise da Silveira method". No such training exists.

Sources

Sources: