Mental Health Considerations for Museums

An Emerging Field of Practice and Discovery

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A symbol of connection and remembrance at the 911 Memorial and Museum, New York. Photo credit Jason McKeown.

There is a growing trend in museum practice to evoke — and perhaps provoke — emotional experiences for visitors. The practices of direct creative engagement — touching, making, symbolic representation, metaphoric storytelling, collaborative object creation, immersive experience — are exemplary facilitators of those aims. Their use in psychotherapy, especially in art therapy and wilderness therapy, has a long and well-studied history. In the work of trauma recovery in particular, creative practices are among the most common approaches of skilled practitioners.

And yet, museums are not psychotherapeutic environments. The systems and staffing of museums are not designed nor equipped to promote the emotional safety, containment, and counseling that are often required to assist people in navigating traumatic situations. Museum practitioners do not have the training in ethics and professional psychological practice that would enable them to safely support a visitor in a state of traumatic decompensation, panic, overwhelm, dissociation, or freezing. In the museum research conducted by our team (Jason McKeown, Brenda Cowan, and me), we interacted with participants in all of these states (and a few more). In those situations, Jason and I acted as therapists: shaping the conversations, confirming presence and safety, emphasizing empathy, directing participants toward the resolution of locked response patterns in a multitude of ways with both verbal and nonverbal cues. Had we not taken those steps, it’s likely that a number of our interview subjects — those with strong emotional activation associated with objects resonant of trauma — would have found their experience with us to be traumatic rather than therapeutic.

Highly charged therapeutic situations can emerge and can easily be mismanaged or become overwhelming for everyone involved. The work of therapeutic engagement — creating emotional safety, building trust, cultivating empathy and self-awareness — is among the most difficult skills to master. Even well-trained therapists often struggle to find the right tone, the correct approach, the safest and most helpful path forward. This is not easy or straightforward work, and it is not simply a collection of skills that can be applied to any given situation. Human beings are immensely complex, unpredictable, and fragile.

And yet, we also participated in many moments of safe and simple healing that were led by subjects themselves, without the need for clinical intervention or specialized support. Objects tend to cultivate their own safety and containment, which is possibly linked to the use of hands and the powerful calming effect of touch. As with most subjects of psychological interest, it’s difficult to determine precisely what causes objects to exert their unique power — though we have explored various possibilities in previous chapters. In this chapter, we focus on possibilities for finding and developing the healthful middle ground between staid and boring museum experiences and intensely overwhelming ones. What can museum professionals do, in their own work, to maximize the therapeutic effectiveness of object interactions? How can they best minimize the risk of inadvertently traumatizing visitors with well-intentioned but harmful exhibitions? How might museum professionals and mental health professionals work together to balance risks with opportunities in a turbulent and fast-evolving cultural environment? How would they even start?

Psychotherapy and museum/exhibit design have much in common. They share core values involving the promotion of awareness and change. Both practices utilize education, experience, evocation, and provocation. But they are also different. Psychotherapy is focused on the complexities of human fragility, methods of enhancing human resilience, and possibilities for human wisdom. Psychotherapy involves the quest for self-awareness, and in that sense is a specific practice within a general philosophy of individual wellness and development. Museums, on the other hand, tend to focus on cultural wellness and development. Museums enact their themes and philosophies through engagement with groups, typically for a short period, and through participation in social development in the long run.

A visit to a museum is different from a therapy session. Both can be immensely valuable, transformative even. But the differences in their contexts, their purposes, their structures and their staff: these are real differences, they have important consequences, and we should not fool ourselves into thinking that the creative practices of psychotherapy (as discussed in section three of this book) can be transferred wholesale into museum environments without mindfulness, training, and care. Accordingly, we suggest a few considerations and recommendations, in the next few sections, that are intended to help museum professionals understand both the risks and the opportunities of therapeutic work with objects. This material is neither prescriptive nor exhaustive; we’re not training people in psychotherapy. Rather, we wish to illustrate what psychotherapeutic possibilities might exist in museum settings, what challenges might emerge, and how museum professionals might find the right balance in their power to both harm and heal.

Therapeutic Engagement in Museum Settings

Humans are complex, wonderful, robust, and fragile. Our emotions drive us, guide us, and sometimes betray us. We do not control our emotions (at least, not very well), and we do not control our environment. In this sense, the human experience is one of constant uncertainty, turbulence, and challenge. We do best when we learn to navigate those challenges with growing self-awareness, empathy, and character. Often we do. But sometimes we get lost, or stuck, or traumatized, and those experiences confront us with the strongest and most difficult emotions. Learning to handle the emotions that accompany trauma and mental illness is among the most difficult tasks we face. That same difficulty is presented to the practitioner — the museum professional, or the psychotherapist — who seeks to be of help in our healing.

Objects of personal value tend to anneal and contain strong emotion. This is the first and central insight. This book illustrates many examples of interview subjects managing their activated emotions simply by holding an object of personal value. That object might be an heirloom, a found object, or a provisional object for which the interaction has been brief — perhaps only a few seconds. It doesn’t matter much. The object — its texture, and heft, and character — connects with us in immediate and surprising ways — provided we are drawn to it — and we begin to manage our inner life by way of this outward interaction. A kind of alchemy is at work, in those moments, a simple alchemy as ancient as the human hand and its reaching outward to the world.

Museum environments provide the right conditions for meaningful experiences with objects. They enable visitors to examine the close details of life as well as the bigger picture, to bridge their immediate surroundings and experiences with the entirety of their life context. Museums encourage visitors to examine their roles within society, their relationships to history and its juxtaposition with the present, to make active use of memories, identities, and a multitude of personal expressions. In this sense, therapeutic object experiences are already happening at museums everywhere — though perhaps not always in explicit or programmatic ways.

Psychotherapeutic and mental health practices with objects utilize similar components and processes as innovative museum practices: inviting participants to engage with objects, to feel and sense physical and emotional reactions, to make imaginative leaps of connection and synthesis so that the object is understood to be a symbol or a signpost for the inner life. The scholars who lead the research that connects museums with health practices emphasize the richness of this liminal space of convergence. The scholarship reveals to us that once visitors begin to interact with objects, psychological (and perhaps psychotherapeutic) experiences ensue. The theory that we have developed — Psychotherapeutic Object Dynamics — suggests that when the conditions are right, wellbeing and healing can be integral to the process.

If we understand that meaningful experiences with objects lead organically to engagement with the resources of health and healing, then perhaps we begin to glimpse the enduring and resonant power of museums. The ultimate purpose of an exhibition is to foster connectivity and meaning-making, and it is objects, as the primary elements of the exhibition experience, that serve to illustrate, explain, captivate, and enable the visitor to relate to the content in a way that is personally significant. Object meanings support fundamental psychological functions and psychotherapeutic development. The underlying connection between these separate domains becomes especially easy to see in museum settings in which visitors interact with objects of a cultural or human origin, which tend to readily activate emotional content:

It’s the tactile. The wonder of it [old stone tool]. The history. I think of others’ hands holding it.

Study participant

The Role of Psychotherapeutic Object Dynamics

Our work began outside of the museum context: in the arenas of wilderness therapy, expressive arts therapies, and the world of creative psychotherapy focused on the body and the hand. Our work has a clinical basis, and is grounded in traditions of counseling and psychotherapy that enjoy robust communities outside of museums. We’ve begun to explore how the practices and norms of our clinical traditions might be joined with museum practices, and we are not unique in pursuing that aim. Many others in our clinical fields are following similar trajectories. This makes sense: as we’ve seen repeatedly throughout this book, therapeutic modalities using objects — whether in the woods (see chapter seven), in health and hospital settings (Camic and Chatterjee 2013), or in education (see chapter eight) — utilize objects in the same purposeful ways as do museums, where objects bear powerful communicative, emotional, and personally meaningful characteristics.

As a framework for interacting with objects in museum settings, we envision many ways in which museum professionals and mental health experts might collaborate using the dynamics within their own institutions and practices. The dynamics might be used as instruments for understanding the existing impacts of exhibitions, supporting deeper community engagement, enhancing staff development, and exploring broader opportunities for crafting exhibition experiences. The dynamics work well as evaluation instruments in assessing whether current audiences and participants experience therapeutic impacts from their museum visits. The dynamics also provide strategies for creating highly active, themed, and content-rich exhibitions with the intent of providing healthful and healing outcomes for visitors. The theory also suggest a new model for creative teams to blend the expertise of designers, educators, curators and visitors with psychotherapy professionals, research universities, and other external sponsors. Additionally, protocols for community participation in the authoring of exhibitions and programs might be developed with the help of the specific object criteria outlined by the dynamics.

For example, museums might explicitly target object donations for exhibitions that enact the dynamic of releasing and unburdening. Or, exhibitions could provide giving and receiving experiences focused on visitor-object reciprocity. Or, activity spaces that provide the impacts of making could be designed with a view to long-term visitor engagement and the creation of objects with deep personal connections between exhibition content and visitor participation. Composing provides opportunities to explore the metaphorical possibilities of displays and object interactions, as well as modular and adaptive exhibitions in which visitors actively juxtapose objects and customize exhibition messages. The dynamic of associating lends itself to healthful initiatives for museums to build close ties with their immediate communities and to cultivate repeat visitors through personal object donation initiatives and co-created exhibitions. Finally, opportunities to foster synergizing include exhibitions built around broad themes such as legacy, culture, and historical initiatives that encourage collective experiences among museum participants and the broader public. As Andree Salom (2008, 3) affirms:

A sense of universality may be perceived in museums, and hope in humanity itself can be instilled in visitors if museums are used as agents for the well-being of communities.

Andree Salom

Supporting the Museum Community

Schools, community centers, parks, playgrounds, and museums are all places of social activity and offer a multitude of experiences. They are also places where self and society reveal themselves, where human nature exerts itself in complex, surprising, and unfathomable ways. In any well-designed public environment, rules, regulations, protocols, social conventions, and trained and thoughtful staff all contribute to directing visitors towards successful engagement. The most effective facilitation for these environments entails careful and mindful treatment of both visitors and staff. Humans are both resilient and fragile; they do best when they are cared for (as do all beings).

Bringing a therapeutic perspective into the work of museums — particularly with objects and object interactions — requires consideration of how best to care for staff and the museum organization as a whole. The skills required to do this effectively are not usually part of the scope of practice or educational preparation required of employees. However, understanding the psychological and psychotherapeutic dimensions of donors, visitors, staff, and participants is vital. Too often these areas are addressed only after a critical incident (usually involving trauma). Museum staff and volunteers — or health center staff and volunteers, as in the work of Helen Chatterjee and Guy Noble — need specific training and support in navigating these complexities:

One concern which was repeatedly raised by the students [volunteers] throughout the project was the need to adequately control negative emotions which may emerge during object handling sessions. The possibility of patients revealing negative memories, and showing distress and depression during sessions was discussed throughout the training period and the students were given guidance on how to handle these situations should they arise, including on site consultation with ward staff if the students felt sufficiently concerned (2009, 46).

Helen Chatterjee and Guy Noble

The consensus among clinical professionals who work with museums and objects is that museums incur ethical responsibilities when they enter into the psychotherapeutic realm. Those ethical dimensions include confidentiality, emotional and physical safety, responsible caring, professional integrity, and related practices. Real and lasting harm can be the accidental outcome of a well-meaning project of therapeutic object interaction. In this light, we (and our colleagues) encourage museums to engage with mental health practitioners, psychologists, counselors, and psychotherapists in developing guidelines and protocols for hiring, training, conducting research, managing object donations, and providing healthful and impactful visitor services. Additionally, we encourage museums to identify and develop relationships with external community resources and agencies, such as health and counseling centers, hospitals, and universities. These networks will enable museums to benefit from the expertise of external professionals within the contexts of their own institutions.

Recommendations for Therapeutic Organizational Development

Our co-authors Jason and Ross would like to share, from their clinical perspectives, a few practical suggestions from the mental health field. These are intended to help museums think about what therapeutic might mean and how to get there. The practices outlined below do not require specialized training but, at the same time, are not intended to replace the training that is required to approach object interactions from a mental health perspective. Our aim here is to highlight commonalities among effective organizations and projects and, perhaps, point the way toward a holistic and meaningful approach to museum work.

Ensure strong empathy and mentorship from leaders

A museum that seeks to engage staff, volunteers, and visitors in initiatives focused on cultivating wellbeing cannot do so effectively unless the organization consistently focuses on the importance of wellbeing for its members. The crucial importance of mirroring intention with embodiment seems obvious. And yet, this mirroring is perhaps the most overlooked feature of wellbeing initiatives undertaken by organizations.

Organizational wellbeing begins with — and must be consistently modeled by — organizational leaders who strive toward a culture of wellbeing throughout every level of the organization. No real traction can be achieved unless and until leaders demonstrate this commitment — and when they do, it is visible in their behavior. They act to embody their values, and they practice three core skills: self-awareness, empathy, and mentorship. We’ve seen, in this book, how object interactions can help to ignite and amplify both self-awareness and empathy; mentorship can be viewed as a combination of the two. An effective mentor engages in mentorship as a reciprocal process, joins and contributes to communities, models and teaches ethical practices, and is open to learning from others. A strong mentor is attentive to the emotional needs of everyone and will be in a good position, in a museum setting, to understand and grapple with the complex emotional challenges that will arise when therapeutic object dynamics come into play.

Decide on the purpose of the museum

What is your museum for? What is its purpose? Is it a custodian of objects, a gatekeeper of history, a vehicle for spreading a particular message? Who owns the cultural capital? What do these perspectives say about the museum’s mission and its fiduciary responsibility to the community? And, most important of all: does your museum serve the public good? If it does, then health and wellness initiatives fall squarely within your mandate. However, in our experience, museums are often reticent to develop health and wellness projects – mental health projects, in particular — even when they acknowledge the public good as their core purpose and the community as the museum’s true owners. These are complex conversations that are often fraught with uncertainty and anxiety. For example, allowing museum visitors to touch curated objects is a hard line and a third rail for many museum professionals.

This recommendation follows the one above because the first one — ensuring strong empathy and mentorship from leaders — is required to fulfill the second. Difficult conversations about purpose and meaning cannot happen unless leaders are capable of facilitating courageous conversations that are also safe and inclusive. And, in order to do that, they need the skills of self-awareness, empathy, and mentorship.

Train staff and volunteers in empathy and compassion fatigue

When museums undertake to work with objects in the ways described in this book, they will quickly encounter strong emotions. People will cry. Some will become anxious, or will fall silent and wander off, or become angry. Some will not know what they are feeling, and will behave strangely. These are routine moments for mental health professionals but not for museum staff, who do not have the training to modulate the reactions of visitors or their own emotional reactions in these situations. Museum staff will become emotionally activated themselves, and enact their own versions of anxiety, anger, or wandering off.

How might we mitigate these risks? The first step is to get help from mental health professionals who will provide training and support, in an ongoing way, for staff and volunteers to develop empathic listening skills and to deal with or redirect emotional situations (please see the next chapter for further details). The skills of empathy and active listening require a blend of self-awareness and attentiveness to others. Emotional reciprocity and sharing are at the core of empathy, and its effective use has an inherently stabilizing function on almost everyone. Building skill in empathy also entails developing the skill of self-regulation, which, as we’ve seen, is also developed by therapeutic object interactions. In turn, empathy and self-regulation contribute to self-awareness, the most important psychological skill of all. Opening oneself to the emotional world of others, communicating effectively, building trust, contributing to a culture of collaboration: all of these behaviors grow from a base in self-awareness.

And yet, empathy has — and should have — limits. It is a resource which can be depleted. In our work with museums, we have observed instances of burnout, empathy depletion, and compassion fatigue (to use the clinical term). This is a particularly damaging scenario for a museum staff member or volunteer who holds deep purposefulness and passion for their work. When that work becomes impossible because of over-exposure to emotional situations, or when harm results to visitors because a staff member can no longer demonstrate empathy or self-regulation, the consequences can be far-reaching: visitors can be traumatized, staff can spiral into mental health crises, and the organization can be at risk for liability of harm.

Healthy organizational culture is the best protection against compassion fatigue. In such an environment, staff and volunteers communicate effectively, are aware of each other’s emotional status, and find many ways of supporting one another in stressful situations. Healthy organizations encourage members to be open to giving and receiving appropriate and supportive emotional feedback, embracing and resolving conflicts, developing pathways of self-assessment and self-regulation, and consistently emphasizing the importance of self-reflection.

Additionally, organizational culture works best when staff and volunteers feel a sense of sharing and collective ownership of the overarching aims of the organization: searching for knowledge and meaningful answers together, finding useful solutions to complex problems, developing creativity and collaborative imagination.

Facilitate the therapeutic — but don’t do therapy

As the many examples in this book show, working with objects in museum settings can be very therapeutic. But it is not therapy, or counseling, or psychoanalysis. Those practices require training in their specific disciplines as well as clinical experience and clinical supervision. It is not possible to learn those skills in a few hours — or even a few hundred hours — of training in a museum context. If staff or volunteers are not aware of the risks of going too far with participants — of leading them too quickly or too deeply into emotional states — the results can be catastrophic for everyone.

Psychotherapeutic projects in museums work best when mental health professionals are on site, involved in or facilitating activities, present and able to respond to situations that are beyond the scope of practice of museum staff or volunteers. Staff and volunteers can learn to support participants in therapeutic activities, to direct or redirect them, and much excellent work can be done by people who are not explicitly trained as mental health professionals. But it is neither safe nor ethical to lead participants in explicitly therapeutic activities unless someone with professional skill and qualifications is present. Please see the next chapter for more information and practical recommendations.

Inform visitors of potential emotional activation

This might hurt. Prior warning of impending physical discomfort (such as a vaccination, or the removal of a band-aid) tends to make the discomfort worse. But, with emotional discomfort, advance warning is the best strategy. Preparedness for the possibility of strong emotion is crucial whenever visitors are welcomed into a museum environment that contains provocative material. Surprise is the enemy of calm. Surprised and emotionally activated visitors lose their self-regulation and often their ability to control basic behavior. The healthiest environment is one in which visitors are encouraged to be open to provocation but not corralled by it, facilitated toward emotional awareness but not overwhelmed by it. The duty of care, for a museum working therapeutically, is to stay within a range that in the mental health field is termed safe enough: uncomfortable, perhaps, even highly intensive and activating — but as long as visitors remain in control, as long as they are not hostage to dissociation, freezing, hypervigilance, or anger, they can (usually) navigate safely. Once again, mental health professionals are in the best position to help museums find the right balance.

Craft Appropriate Trigger Warnings

While it is crucial to inform visitors that exhibition content may be emotionally activating, museums also incur a secondary risk in doing so: the warnings will provoke emotions, and those emotions will be somewhat contagious. This is the same mechanism at work in the strategy of effective band-aid removal: if you let people know that this might hurt, it probably will. The middle ground here is to inform but not alarm, to give visitors options and reminders of their own capacity. Prior warning messages work best when they use language that emphasizes self-regulation and resilience, that reinforces freedom of approach with judgment and self-awareness. In general, words such as caution, warning, and stop! will to tend to increase anxiety and activation. Trigger warning is particularly problematic. Conversely, words such as remember, care, connect, and practice are likely to encourage visitors to apply the emotional skills that will assist them in navigating the current moment. Although every situation will be slightly different, positive and helpful messages tend to have the following character:

Remember to take care of yourself.
Stay connected.
You decide how much of this to see.
Some visitors have strong reactions.
Your reactions are unique to you.
It’s OK to be emotional.
Reach out if you need help.
Do this in your own way.
Practice safety.

But, of course, positive messaging is not a panacea; it won’t work for everyone or every situation. For a visitor who is not able to contain their emotions — for whatever reason — no amount of positive messaging will mollify them. Please see the next chapter for more information and recommendations for specific situations.

Provide personal encounters and visibility

In situations of emotional arousal, connection with others is often the most effective balm. In a museum setting, therapeutic activities are best facilitated in small groups or partnered pairs. Conversely, encouraging individual wandering is generally not safe when strong emotions might result. People do not do well on their own (in a museum or anywhere else). For example, a large, empty gallery that contains emotionally provocative content is a significant risk to visitors, volunteers, and staff. But the presence of just one person, in such a situation — a friendly, empathic, self-aware person — can reduce the risk (but cannot, ever, remove it completely).

Create flexible pathways for encounter

The spiral labyrinths used by Ross and Jason in their work (see chapters five and eight) possess a feature that is often overlooked: they have a multitude of pathways but only one center. The center is a place of stillness, possibly, and reflection, and integration. But surrounding the center is a zone of infinite pathways of discovery. One can walk the central spiral pathway, or move back and forth, or skip over the placed boundaries and wander anywhere within the space. These labyrinths are not mazes, not designed to disorient. Rather, they are designed to orient the participant to their own journey, their own choices. The spiral nudges but does not demand. Participants can use their autonomy to create from the path whatever journey they wish: fast, slow, urgent, dawdling.

This flexibility is the key to emotional safety in therapeutic environments. We often say, do as much or as little as you like. Participants must be encouraged to stay safe, to be aware, to find their own rhythms in the unfolding work. In a museum setting, this means creating flexible pathways and many options for physical (and emotional) navigation: passages and pathways in which participants can move about, find different levels of engagement, see and know that they can exit easily at any time. No dead-ends, blocked exits, or enforced pathways.

Provide space and tools for reflection and containment

We have seen many excellent examples of museums using simple tools — paper cards, sticky notes, magnetic feeling words — to encourage visitors to share their emotions in public and private ways. These are excellent strategies for cultivating emotional expression and safety. They are also useful in promoting self-reflection and self-awareness. An entire field of mental health treatment (bibliotherapy) utilizes the written word as a primary tool (Reiter 2009).

In museum settings, simple practices involving handwritten words (or words chosen from among a selection) can be highly effective in helping participants make sense of what they are feeling. These practices work best when participants can see what others have written, and their own contributions can be either private or shared as they wish (again, with emphasis on flexibility, as with labyrinths).

Participants need both time and space to reflect and express. It is best to devote a calm, welcoming space to this purpose. Providing tea and water is also good practice for these spaces and serves to emphasize the reflective mood that is best suited to written expression. Ideally, a calm room, or a comfortable outdoor space such as a garden — a safe space — should be close at hand whenever museum environments are likely to provoke strong emotions. Again, the duty of care rests with the museum: to be sure that in serving the public good, individual patrons are respected, acknowledged, and honored.

Begin with the hand

The hand plays a foundational role in our evolution, our neurology, and our psychology. The hand searches, it holds, it contains, and it reveals. The work of hands — making, building, touching, crafting — is among our most basic impulses and is one of our greatest talents. No other species makes totem poles, or crafts labyrinths, or shapes mud and rock into the multitudinous designs of fired pottery, cut stone, and forged metal. We like to say that these are works of the human brain (or mind), but they are equally products of the hand. The mind can only imagine these things; it is the hand which makes them.

And so, this page concludes with a reminder that the distinctiveness and power of the human hand are exemplary guides in the unfolding of all creative and psychological work. All of the dynamics we have explored in this book depend upon the hand, are led by the hand. With intention for the public good, and with appropriate help from mental health professionals, and with a spirit of creativity and play, museums can make a true impact if they start in the same place as humanity: with the hand. Touching, holding, arranging, making, sharing: the hand facilitates these activities, structures the experiences and moments, helps to contain the emotions that arise. Working with the hand is the simplest and perhaps best way to start any therapeutic project. The hand suggests its own paths, and they are good paths to follow.


Adapted from Museum Objects, Health and Healing, by Brenda Cowan, Ross Laird, and Jason McKeown

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Ross Laird, PhD RCC

Clinical Consultant, Author, Educator

My work focuses on the interconnected themes of mental health, trauma, addictions, and creativity. I provide clinical consulting, professional development services, and community education for a wide range of institutions and organizations.