Graça Pizá de Menezes
Fellow Since 1998
Clínica Psicanalítica da Violência
This description of Graça Pizá de Menezes's work was prepared when Graça Pizá de Menezes was elected to the Ashoka Fellowship in 1998.
Graça Pizá de Menezes has created the Clinic Against Violence, the first civil society organization in Brazil to offer specialized psychological treatment to children and support to relatives of victims of sexual abuse, social discriminations and all forms of violence.
The New Idea
Graça Pizá de Menezes has developed a comprehensive mechanism to identify and treat the victims of domestic violence, while at the same time strengthening efforts to prevent the recurrence of the violence and abuse in society. Driven by the belief that psychological support is fundamental for the recovery of young victims of violence, Graça created a model clinic where psychological counseling and legal advice provide the focus for the treatment and support for sufferers of abuse. Breaking through the wall of silence that shrouds cases of domestic violence and abuse in Brazil, Graça is reaching out to relevant strata of society - schools, hospitals, police, courts, and community organizations - to bring the issue of violence in the home into the public sphere and change the way services are provided for victims of domestic and family abuse. Graça is training teachers, judges, lawyers and social workers how to recognize and deal with family and community violence, what types of intervention are appropriate, and what referral structures are available. This combination of specialized treatment and public consciousness-raising is unprecedented in Brazil, and has already enabled Graça to forge key strategic alliances with state and private entities and afforded her with great influence on public thinking on the issue of domestic violence. Her efforts have already led to an important juridical reform, which makes admissible the court testimony of psychologists who have treated victims of violence or abuse. She is working to break down the taboos surrounding domestic and social violence, while building a juridical framework and a network of institutions that can more capably respond to a problem which reaches epidemic proportions in Brazil.
The statistics on violence and youth in Brazil show a high incidence of injury and abuse resulting from incidents within family and social spheres. While doing research for an academic thesis in 1995, Graça discovered that 90% of the children interned in public hospitals were victims of sexual and social violence. Contributing to the recurrence of this type of violence is the silence of hospitals and schools which effectively deny the scale of the problem. This "conspiracy of silence", according to Graça, is due in part to the general belief that violence in the home or within a closed community is not to be dealt with in public spheres. This situation is further aggravated by the fact that doctors and teachers have no specific training to identify and deal with the issue. Professionals in the health , education and legal fields often feel threatened by the legal implications and family complications to which they would be subjected if they denounced what they saw. In 1995 the National Foundation for Health (FIOCRUZ) produced a report which shows that the department directors, nursery coordinators and professional staff within health institutions had extreme difficulty in diagnosing and treating sexual, institutional and familial violence. Despite the recent creation of Tutelary Councils in Brazil to guarantee the rights of children and adolescents, it is believed that the number of cases of violence reported to authorities is significantly lower than the actual total. Not surprisingly, relatives often resist acknowledging and confronting domestic violence, especially sexual abuse against their own children. Graça's study in 1996 in 7 state capitals in Brazil revealed that among 943 youngsters aged 14-18 years, almost 80% had suffered physical violence. Of 540 cases treated at her clinic over the past two years, 60% involved sexual abuse by parents.The 1989 constitutional reform in Brazil, with its specific clauses on the rights of children, created an important opportunity for the creation of a new institutional framework for identifying and responding to domestic and social violence against young people. Unfortunately, no initiative or leadership has thus far emerged to take advantage of the legislative opening to propose specific reforms to state institutions, again in part because doctors, lawyers, psychologists, and judges don't know how to diagnose cases of violence, or how to involve themselves appropriately when they do. When attention is focused on this type of violence, as at an international conference in Washington D.C in 1994 to which Graça was invited, the discussion is almost exclusively about preventive techniques, with no attention paid to diagnosis or treatment of existing victims.
Graça's experiences of work with young victims of violence quickly convinced her that, while direct and specialized psychological attention was indispensable to her patients' recovery, she would also have to address the legal and institutional dimensions of family violence. She decided that this could best be accomplished by coalition-building among public and community organizations involved in youth work, and as her ideas for a clinic/reference center evolved, she initially thought to launch her response through the health ministry, in order to achieve maximum coverage and impact. But when the bureaucracy and politics of a such a move deterred her, Graça decided instead in 1996 to rent a house and start the initiative herself. She then convinced 8 other psychologists to join her in treating victims of violence. As their caseload mounted, she saw the need to train more specialists from different fields about the issue, and proceeded to negotiate partnerships with the juvenile court, municipal health secretariat, Brazilian bar association and a regional council on psychology to offer workshops on identification and treatment of domestic violence.Using the clinic as a base, and drawing on the positive response she elicited with her training, Graça built a coalition of over 25 organizations, including lawyers, human rights groups, judges, regional hospitals, community groups, schools and social workers. While her immediate objective was to establish a network to identify and refer cases to the Clinic, she ultimately sought to create a movement which could together propose procedures and structures to take advantage of the 1989 constitutional opening. As word spread about her efforts, Graça was invited to give a course in the training program for judges about the needs and available resources for dealing with young victims of violence. She also negotiated with the Municipal Education Secretariat in Rio de Janeiro and the Regional Educational Council to train first and second grade teachers to recognize abuse and violence cases. The Clinic against Violence has established partnerships with public institutions such as the State University of Rio de Janeiro, the Federal University of Rio de Janeiro, the Psychological Council of Rio de Janeiro, the State Civil Cabinet, and the State Council on Education. Legal partners include the Public Prosecutor's Office, Rio de Janeiro Childhood Judgeship, Niteroi Childhood Judgeship, Brazilian Lawyers Association, State Councils and Tutelary Councils of Rio de Janeiro city.Graça has thus far made the Clinic self-sustaining by renting space out to other groups in the evening, by soliciting donations from those patients and their families who can afford to help, through receipt of court-mandated payments from the abusers (who also receive treatment in the Clinic), and through the pro bono generosity of volunteers. Her challenge now is to replicate the model in poor communities and other cities across Brazil. This Graça plans to do by building referral networks, recruiting and training professionals, forming multi-disciplinary teams, and eventually accessing government resources - the Rio de Janeiro state government has already invited her to share her experience and help them systematize the resources which are currently available. Rather than "cloning" the Clinic elsewhere, she foresees a "franchising" strategy wherein she shares her methodology with government agencies and community coalitions, then advises them on how best to adapt her experience to their own circumstances. Graça's work promoting public education on the issue and seeking out potential multiplier agents and network builders is crucial to the spreading of her idea across Brazil. Her efforts to establish a national telephone hotline for violence victims are also integral to this objective.
The daughter of a union leader who was exiled from Spain, Graça has a family history of involvement in community work and human rights defense. During college, she studied clinical psychology and worked with the National Foundation for Child Welfare (FUNABEM). Through her exposure there to marginalized youth, Graça discovered that violence and abuse were daily characteristics of these children's lives. While preparing her thesis, she observed the degree to which violence pervaded the lives of young people exposed to judicial processes. Hence forward, Graça decided to dedicate her life to struggle against violence against children. Despite her rigorous scholarly formation, Graça rejects a strict academic approach to the issue of domestic and family violence. She is convinced that psychological attention should not be the exclusive privilege of the wealthy, and seeks ways to "take it to the streets," and to design systems that make it accessible to those who need it most, regardless of their income level.