The Hologram – Peer to Peer Healthcare

Image courtesy of Cassie Thornton
This article is part of a series being shared to highlight activist struggles across Europe and grassroots response to health and economic crisis. These articles are shared in preparation for the event ‘Reclaiming the commons: From austerity and debt to public space and health as commons’ which will take place next Wed 27th Jan.

I had the opportunity to speak with Cassie Thornton about The Hologram a practice of peer to peer and feminist health care inspired by the solidarity health care clinics in Greece. I asked Cassie to briefly introduce herself and tell the story of the Hologram. We spoke about some of the challenges of practicing the Hologram during the Covid pandemic, and how moving the practice online has also been a catalyst for experimentation and development.

You can listen to the introduction in English. An edited introduction is also available to read and has been translated into French, Spanish and Italian. There are also some additional English language extracts from our conversation below.


Can you briefly introduce yourself and the Hologram?

My name is Cassie Thornton and I live in the country currently called Canada. I live right in the middle, in Anishinaabe territory which is also called Thunder Bay. It’s about five and a half hours north of Minneapolis where George Floyd was murdered by police, and about 30 minutes north of the American border. When I’m here I work with issues of decolonization, rematriation and the production of community safety. I organize with a few different groups that are indigenous run or indigenous and settler run. Anishinaabe ways of organizing, learning and sharing resources are very influential to me. My big project for the last couple of years has been a peer to peer health project called The Hologram. It started in about 2016 when I learned about what was happening in Greece during the financial crisis, which was also a refugee crisis in the early 2010s. Many different health care workers, anarchists and volunteers, people of all kinds, organized around 60 completely free health clinics all over Greece that were open to anybody.

One clinic in particular was experimenting with how to give non-hierarchical care, called the Social Solidarity Clinic of Thessaloniki. There were many different experiments run by A Group for a Different Medicine, that looked at how to remove hierarchy from healthcare. So they invented something called the Integrative Model. At this clinic, the patient is called an incomer. The change in title is so that they lose the stigma of the word patient, which infers being unwell or sick. The group believes everybody needs care whether they are well or not. When the incomer enters the clinic, they’re seen by a social worker, a therapist and the doctor at the same time. Health is seen holistically. Since I learned about that, I’ve been working with lots of different people all over to develop a peer to peer model that’s based on that model of three person specialized care, and that’s viral.

I have been an anti-debt activist and artist for a decade. The project very much comes from a hope of being liberated from the boredom, pessimism and impossibility of living in a debt based society. The project of the Hologram is to create a network of people who are stable and healthy, whether or not they have access to medical care. We need to be stable and healthy if we are to survive and dismantle capitalism, and then hopefully build new societal structures that centre life instead of profit. The project is a social practice, but it’s also paired with a para-fictional storytelling, where we talk about the project as if it already exists on a large scale. This is a way to make it possible for it to come into being, because people need to believe that completely new social forms are possible in order for them to begin to form. The project offers people a story and a formal social structure for how they can organize their emotional labor, energy and time differently, where they might begin to have wishes, dreams and ideas outside of brutal individualistic survival.

How has the Hologram changed and developed?

After I learned about the Integrative Model in Greece, I spent about four years thinking about it and about how it would apply specifically to an American context. I was living in Oakland, California at the time, and most people I knew (including me) did not have medical insurance or stable housing. I worked with a series of groups to figure out what it would mean to make the model that was happening in the Solidarity Clinic, the Integrative Model, into something that we could do amongst ourselves. It evolved into something where the incomer is called the hologram. This person receives attention and care in the project, and we see their role as that of an expert (of their own health and history) or a teacher (who teaches what she needs in order to feel cared for). If I am the hologram, I invite three people to support me. Those three people formally meet with me in a rhythmic way over a long time, and basically ask me questions. They are not to be an advisor or an expert, but to be curious, and to become my living medical record.

So in practice this is not mysterious: me and three friends meet every three months for a two hour zoom call. One person asks me questions about my physical health, one person asks me questions about my social health, and one person asks me about my mental and emotional health. Those themes overlap and the conversation is wonderfully messy. We spend about two hours talking in that way, and the triangle gets better and better at asking questions. At the closing of the conversation, the listeners give reflections and feedback. As the hologram it’s my job to say whether the questions they’re asking and the way that they’re treating me is helping or hurting, because they are there for me. That’s a simple way of just describing the atomised version of the project; but it’s also viral. The three people that are in my triangle also have three people for them, and it is my job to make sure they have support to organize that for themselves. They don’t receive the same care from me that they give to me. It doesn’t go back and forth, but they receive that care from three other people. The idea is making a culture of care rather than going back and forth, tit-for-tat in a kind of capitalist or transactional form of reciprocity.

Of course the project became very active during the Coronavirus. I had planned to begin to work on it in a more focused, serious way starting in March 2020 with a group of artists in London called Furtherfield. Then Corona happened and the project became useful and desirable, so we had to figure out how to do it online. The first thing we developed was an online course where people could practice asking questions and thinking about health in relation to socio-economic factors. In it, we also discussed the relationship between individual health and social health, and how to prioritize those things while maintaining our antagonism towards capitalist and racist systems. The four-week course hosted twenty-eight people practicing the hologram. The goal was to support those people to start holograms for themselves.

At the conclusion of the course, which was called “Is this the end or is this the beginning?” many participants did not want it to end. In response, we developed a monthly meeting for course participants called the community of practice. Once you begin practicing the hologram, you can get together with other people that do it also, and remember that it is a political practice and a weird social movement, and not some weird kind of free therapy. Our meetings feel like a laboratory, and we talk about our use of The Hologram as we troubleshoot it and transform it.
Additionally, since the lockdown began in April, we’ve been doing two hour holographic practice sessions called Minimum Viable Holograms. Here anybody can get online with three of their friends and have a facilitated hologram session. It’s like a two-hour ritual that can take someone’s sort of unspoken, feelings, problems, curiosities or frictions and just open it up to be seen with their friends.

Normally we receive care from doctors, people we are not personally connected to, the Hologram receives care from people they know, friends, can that be challenging sometimes?

Many people have two wishes when they first approach The Hologram. First, they wish that they could have three doctors look at them at the same time. Of course, that would be a completely different project because this project is about reclaiming our power to be able to transform ourselves and each other. However, it also speaks to the general difficulty in receiving high quality attention from the people who have been authorized to support our health. The other wish is that people would really like to get support from strangers instead of people they know. There are lots of different reasons why people say that. Many people say that their friends are already too busy, and they don’t want to be a burden on them. Because of the tensions revealed by the requests to receive anonymous care, we have solidified the practice in the hologram of asking for what you want from your pre-existing relationships. We’ve all learned a lot of hard lessons about what it means to get the things that we need from invisibilised people who we don’t see or know, from service workers to the people that build our cell phones. I think it’s important to figure out ways to actually cooperate, communicate, and negotiate with the people that are around us to find out how to get and give what we need to thrive. If you can’t ask for support because you are worried about being a burden, it might just be a matter of asking a person to talk about what burdens them; so that when you invite them into a strategic care practice like The Hologram, you aren’t so afraid of hurting them and you also aren’t projecting your fears on them. It is too easy to avoid doing this tender work, and this project is a structured way to practice engaging in it.


If you are interested in learning more about the Hologram, peer to peer and feminist health care check out the following links.

Website on the Hologram – http://thehologram.xyz
Cassie Thorntons website – http://feministeconomicsdepartment.com/

Pluto press recently published a book on the Hologram
https://www.plutobooks.com/9780745343327/the-hologram/

An interview with Cassie on the Hologram and her artistic practice.
https://www.furtherfield.org/art-debt-health-and-care-interview-with-cassie-thornton/

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