© 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.

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Re-inventing Phototherapy in Italy

by Ayres Marques Pinto, 2006

I didn’t know anything about the existence of Phototherapy when I had the idea of
sharing with other people the pleasure of taking pictures. What I did know was that some
changes took place inside myself whenever I went out carrying my camera with me. I paid
more acute attention to the things around me, emotion became stronger and a new kind of
visual contact with the other people came out.

That was enough for me to write down a project called "Photo-Unconcious" which
consisted basically on getting the guests of a psychiatric community to take active part in the
various moments of the photographic process: from posing to shooting (inside and mainly
outside the community), from creating their life album to writing about it; from developing the
film to printing the photos in the darkroom, from scanning the pictures to manipulating the
images using the computer, from choosing the pictures to organizing an exhibition.

The idea first occurred to me in 1995, in Natal, RN, Brazil, while making the video
anthology “Um Dia – A Poesia”(One Day – The Poetry), to celebrate the National Poetry
Day, 14th March.

The visual poet, Doctor Franklin Capistrano, was the first one to accept the invitation to
take part in the video anthology which was made at his work place: the town asylum.

While the psychiatrist said his visual poem along the corridors of the hospital, I noticed
that the patients looked at us with curiosity and that many of them wished to take part in the
performance. It was in that period that I began to imagine how interesting it would be to use
photography in activities with mentally disturbed people.

The opportunity to carry out that idea was offered to me in 2001, in Italy, when a friend
of mine, the psychologist Rita Messi, mentioned my work to Loredana Chielli, the director of
the psychiatric community “Il Filo di Arianna” (The Arianna’s Thread), administrated by the
social co-operative ASS.COOP of Ancona.

When I first visited “Arianna’s Thread”, I was received by an elegant and polite
gentleman who listened attentively while I presented the project. When I finally finished, he
conducted me to the director’s office. It was only then that I understood I had not talked to
the psychiatrist but to a guest of the community.

There were two other people in the office with the director: a young man who chewed
nervously the ends of his long hair, and a woman with fire red hair and a heavy make-up
who spoke in a low pitch voice while smoking avidly.

Noticing that I felt uncofourtabe to talk about the project in the presence of the others,
Loredana introduced me to those strange people: they were two operators.
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

I explained again, this time with less enthusiasm, the proposal of initiating an itinerary
to be explored by the community guests and operators together through the world of
photography. It was approved.

For about two years we went around Ancona taking pictures and developing the films
and enlarging the photos which then became a powerful and original exhibition whose
success went much beyond our expectations. We learned from this experience the
therapeutic value photography could have.

It’s true that everything is potentially therapeutic; walking, sleeping, practicing sports,
going to the cinema, playing an instrument, laughing, chatting -- and also taking pictures is
therapeutic, but in a very particular way, for at least one reason: As the photographic image
is not hand-made but directly captured from the exterior world, photographers are obliged to
get out of themselves", to make a contact with reality and by doing so to install a connection
between the inside and the outside world. This kind of inside-outside relationship mediated
by a camera gives photographers a decision power that very few other activities can offer
them . The photographer is the only one to decide, among the infinite possibilities, what to
immortalize.

During that experience, I saw people who were usually completely absorbed by their
own thoughts, people who didn’t usually get out of themselves lift their eyes to start looking
at the world, just because of carrying a camera. I saw people who thought very little of
themselves proudly show to the public the beautiful pictures they’d taken and printed
themselves.

I asked once a fifty-year-old guest, F.D., who had spent most of his life in different
kinds of psychiatric institutions why he enjoyed taking part in the project so much, and how
he thought photography was helping him. He told me he had always suffered from anxiety,
but when he went out to take pictures he was able to spend a lot of time looking through the
viewfinder -- and while waiting for the right moment to shoot a picture the way he wanted,
this would happen without any feeling any anxiety. On the contrary, he felt as if he were
suspended in time as if there were no past, no future to worry about, but only the present
moment.

He revealed himself to be a very original photographer with an acute sense of

geometric composition, in which the town appears a urban empty landscape without any
inhabitants.

I asked a similar question to the youngest guest in that community, L.C., a self-
harming teenager who had left home at a very early age and had experienced all sort of
things before ending up in that psychiatric community. She explained to me that she had
always lived in a sort of simultaneously "360 degrees" way. She had always wanted to see
everything, to experience everything at the same time. Although she felt completely free to
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

photograph whatever she wanted, and the way she wanted, she had to choose only a small
slice of the world at a time. This showed to her that she could be herself and express herself
even if she had to deal with the limits imposed on her by a camera, and by extension from
society. For the exhibition she preferred to show a lot of small pictures put all together to
form big panels, rather than enlarging a few pictures to a bigger size.

Coincidently both of these people left the community. She is now taking her Art
Degree, “DAMS” at Bologna University. He went to live by himself in his flat. He leads a very
normal life, attending language courses to travel all around Europe, even by plane. And now
he’s planning to become Mathematics teacher.

I certainly don’t assume that photography alone was responsible for the happy end of
these two cases, but I’m convinced that it played an important role in the process of their
healing.

I believe three factors were particularly important for the success of that first
experience:

1. to have always refused the role of being a photography instructor. I had no

intention of teaching them anything, and actually I learned a lot from them. The few technical
things they needed, they learned by themselves, by doing it or by making “mistakes”, and
not by asking me. It was important to respect the unique way each one perceived reality and
the original way each expressed themselves rather than teaching them to please the others
by producing “nice” images. It’s very easy to "kill" the photographer each person has inside
themselves by starting to talk about light, composition, contrast and other photographic
details.

2. photography is familiar to everyone of us. We all have been taken pictures

of since our birth. We see pictures everywhere around us. Most of us have at least once
taken a picture. According to Marshall McLuhan, modern man sees photographically. For
these reasons photography is less threatening and less demanding than other more
traditional means of expression as acting, dancing, painting, writing and singing, but at the
same time, photography can lead people naturally to other forms of communication.

3. Photography put people together.

By the conclusion of that first experiment , I felt the need to get more information
about the use of photography as therapeutic tool. I started by asking the community's
psychologist and psychiatrist but they were not able to recommend any book title or any
article in a specialized magazine. I then asked a Psychology University teacher and also all
the photographers I knew but without any success. I began to think that I had probably
invented something myself, which I called "Active Phototherapy".

Then one day, L.C. invited me to attend the opening lesson, of the DAMS
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

Photography course at the Bologna University, given by Professor Claudio Marra. Before
travelling to Bologna, I passed by a book shop and bought a Marra’s book intitled “Le Idee
della Fotografia” (The Ideas of Photography), published by Mondadori. This book brings
together about a hundred theoretical writings on Photography by philosophers, historians,
communication and semiotic experts, writers, artists, photographers, sociologists, and also
by psychologists and psychiatrists. Barthes, Eco, Calvino, Valery, Sontag, Wenders,
McLuhan , Dubois, and Bazin, are just some of the famous names that appear in that
anthology.

Among these many essays there was an excerpt from the book “Fototerapia e Diario
Clinico” ("Phototherapy and Clinical Diary") by Giusti and Proietti, published by Franco
Angeli and no longer sold. This was a guide to the use of photography and writing in the
context of psychotherapy.

As Giusti and Proietti themselves explained, they tried to synthesize the whole
argument by following the trails opened by those psychotherapists who had already been
using Phototherapy techniques in their practice for many years. They were particularly
inspired by the works of Judy Weiser and Linda Berman, to whom they said they were
deeply grateful.

Linda Berman’s book, “Beyond the Smile: The Therapeutic Use of Photography” was
translated into Italian as “La Fototerapia in Psicologia Clinica”, and published by Edizioni
Centro Studi Erickson in 1993 (and reprinted in 1997). This is really a great book in which
Berman re-visits the itinerary she had created while using photography in her psychotherapy
practice all these years. She writes about her experience, her reflections and discoveries, as
well as some clinical cases.

Judy Weiser is an American psychologist who wrote “PhotoTherapy Techniques –

Exploring the Secrets of Personal Snapshots and Family Albums” and created the
phototherapy centre’s site.

While visiting her site I found interesting the distinction she makes between
Phototherapy and Therapeutic Photography. According to Weiser, Phototherapy means the
use of photography to assist the psychotherapy process. As she defines it: “using photos in
therapy”. Therapy, in this case, means a formal process where a trained mental health
professional assists another person to resolve that person's own emotional distress". Any
other use of photography-based activities, for personal healing purposes outside the
psychotherapy context, is called "Therapeutic Photography". In this case, "therapeutic" has
the same meaning as what the Greeks named “terapeia” which meant care, treatment,
healing. This terminology is not adopted everywhere. Joe Spence and Rosy Martin, two
important english pioneers in this field, have a different opinion about the subject. For Joe
Spence, Phototherapy means “quite literally, using photography to heal ourselves” and
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

remarks that “Phototherapy should be seen within the broader framework of psychoanalysis,
but should always take account of the possibility of ACTIVE CHANGE”.

So, what we did at the psychiatric community might be called either Phototherapy,
according to Joe Spence’s definition, or "Therapeutic Photography", according Judy
Weiser’s, as the project we carried out wasn’t based on activities guided by a therapist in a
formal psychotherapy setting, nor was it used as a starting point to produce verbalization or
as an instrument to investigate someone’s feelings, emotions and memories. On the
contrary, we never made very serious conversation about ourselves. We got together for the
pleasure of been together, to focus our attention on the outside world, to forget for a while
our everyday thoughts and feelings -- and it is these very activities that were therapeutic,
although perhaps not "therapy" in the formal sense of the word!

Meanwhile, Alessandro Finucci, the librarian risponsable for the Loreto Town Library,
continued to contact libraries, all over the world, to borrow books for me about
Phototherapy. It was only when I read “Phototherapy in Mental Health”, that I finally felt I had
found a guide that was most useful both to those who intended to use photography in
therapy as well as to the people searching for a broader outlook to Phototherapy. David A.
Krauss and Jerry L. Fryrear, the editors of this book that was published Charles C Thomas
Publisher, explain that their purpose was to “give an overview of the field of phototherapy, to
introduce the reader to the history of photography and therapeutic uses of photography, as
well as to show how photography is being used in therapy and what concepts of
psychotherapy ar most applicable”. “Phototherapy in Mental Health” helped me to plan the
course of action for the project “The Mind in the Viewfinder – Wandering around the Town”,
which was carried out by the Mental Health Centre of Osimo, from 2004 to 2006.

The rehabilitation programm was characterized by the attention it was given to team
work. The team was formed by two psychiatrists, one psychologist, three operators and I as
a “socio-cultural mediator” or “play leader” (animatore, in italian) with some experience on
therapeutic photography.

The role of this new social operator, “animatore”, (as far as I know, there is no
equivalent to “animatore” in the english or american professional system), is little
understood even here in Italy. The aim of of this operator is to contribute to the well being of
the client, taken either individually or in group, by using specific entertaining and expressive
tools. Guido Contessa, Italian psychologist and a pioneer professional “animatore”,
demonstrates in his books, how this new operator can take part in educational, artistic and
therapeutic programmes although mataining his specific role.

The multi-disciplinary way of working allowed the team, that was coodinated by Doctor
Vinicio Burattini, to organize better the activities by holding regular valuation meetings. The
group was formed by 10 patients of the age that varied from 25 to 40 years old with severe
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

mental disturbs, who lived in their family home and went to to the Mental Health Centre only
for the visits and ambulatory care. The main activities of the programme consited on
organizing photographic expeditions in different towns of the Provinces of Ancona and
Macerata and then elaborate the assembled material.

The programme was concluded in Loreto, with the exhibition-seminar “150 Years of
Phototherapy”. Professionals of various fields presented and discussed a number of
initiatives connected to phototherapy that had taken place in the Marche Region. The event
was supported by Loreto Social Service and Culture Assessors, Francesco Baldoni and
Maria Teresa Schiavoni. Mrs Assunta Lombardi, psychologist of CSM – Ancona Nord,
coordinated the debates.

The president of the social cooperative ASS.COOP and professor of psychology at

Urbino University, Professor Franco De Felice, made some considerations about the project
Photo-Unconscious and about the thesis that some of his psychology students wrote related
to phototherapy.

Doctor Vinicio Burattini examined some aspects of the rehabilitation program “The
Mind in the Viewfinder” that was carried out at the Mental Health Centre of Osimo.

On that occasion, I presented the book I had written the year before, “The Face and
the Voice of Time”, published by BrasiLeMarche Edizioni. The book describes many
initiatives in which photogrphy was used to build generational bridges in order to bringing
together people of different age groups. In one of the projects described, school students
were given pictures of elderly people, who were living in nursing homes, and were asked to
write the imaginary biography of the person they only the face of. Afterwards they were
introduced one to another and soon both of them felt as if they were old friends.

The exhibition-seminar “150 Years of Phototherapy” was an important incentive for the
strengthening of the Phototherapy Research Group GRIFO, (Gruppo di Ricerca sulla
Fototerapia).

At the end of the seminar, a young psychologist came to me to express her surprise for
learning that phototherapy existed for so many years and she could hardly hide her
disappointment for finding out she hadn’t invented phototherapy herself. I knew exactly how
she felt as I myself had felt the same way some years before. I believe that even today,
many people don’t know that on 22nd March 1856, Doctor Hugh Welch Diamond, an amateur
photographer and psychiatrist of Surrey Asylum, presented his paper to the Royal Society of
Medicine, in London, in which he considers the possibility of using photography as a tool for
treating patients with mental disturbs. Doctor Hugh Diamond had the idea to use the new
technological invention, photography, to document the mental pathologies of his patients.
The english psychiatrist noticed that some of his patients responded in a surprising way to
the pictures of themselves. They became more conscious of their physical identity and
 © 2006, Ayres Marques Pinto, Photographer - fototerapia@libero.it

began to pay more attention to teir appearance. He also noticed that their self esteem was
strengthen each time they saw they looked better. The photographes taken by Hugh
Diamond, his speech and the drawings inspired by his pictures are in the book “The Face of
Madness” edited by Sander L. Gilman, published by Citadel Press, 1976.

I hope that many people, all around the Earth, continue to re-invent the phototherapy
for many, many years. For this reason I call for a toast:

PHOTOTHERAPY INVENTORS OF THE WORLD, UNITE!

Loreto, 22nd May 2006

Ayres Marques Pinto - Photographer – fototerapia@libero.it