Working with individuals who are facing mental and physical health challenges is a relatively new area of work for museums and may cause concern, distress, fear or anxiety for those running such projects.
Helen Chatterjee and Guy Noble
Museums Offer Much Potential for Healing Work — But Safety Must be a Primary Concern
New and powerful exhibition trends include a greater focus on emotional engagement and linkages to broader social activity. Most notably, disruptive exhibitions convey sensitive and controversial content, create forums for public discourse, and present myriad perspectives. Within these highly participatory, intellectually active, visitor-directed experiences, heightened emotions and discord are often part of the experience. These exhibitions often include programming, reflective spaces, and opportunities to share, look and listen — with the intent of raising awareness and consciousness. However, a necessary consideration for disruptive exhibition practitioners — indeed for any museum that presents deeply sensitive content — is the psychology that is activated (intentionally or otherwise) and the need for mindful practice. The rallying of raw emotions — outrage, anger, grief — can heal as well as harm. As noted by Chatterjee and Noble (2009, 51):
Accordingly, this page presents an overview of current interests and challenges in designing for exhibitions that are likely to provoke strong emotions. Here we take the general observations and recommendations of our museum research and explore them in specific scenarios. We present clinical considerations for working with trauma, grief, and similar issues, and we share clinical perspectives on the ethical responsibility of museums for visitor reaction and response. We also suggest further pathways for creating or facilitating support mechanisms to assist visitors in engaging and processing emotional content.
In the mental health field, clinicians use the term vicarious trauma to describe a range of situations in which people are traumatized by witnessing the trauma of others (Rothschild 2006). It is often associated with counselors and care workers, is related to compassion fatigue, and is sometimes called secondary traumatic stress or secondary victimization. Despite the plethora of terms, the impact of vicarious trauma is specific: it is trauma, like any other, and it impacts the body-mind in profound and lasting ways. Vicarious trauma is not a lighter or less serious form of trauma. Like other traumas, vicarious trauma can happen quickly and unexpectedly, can circumvent even the best psychological defenses, and can be a serious illness (Brantbjerg 2005).
When museums create provocative exhibitions, some visitors will experience vicarious trauma. This cannot be avoided – but it can be planned for, and the risks of lasting damage can be mitigated through mindful design and engagement. After all, protecting people from the many kinds of trauma in the world is not always helpful. War, natural disasters, diseases, cultural genocides, and other issues that provoke psychological stress are important aspects of the human story; grappling with them, learning about them, reflecting upon them is how we learn, how we make different choices — perhaps — about who we wish to be:
In all situations with people, the goal of not traumatizing anyone is not achievable. However, the goals of connecting, working toward trust in relationships, cultivating belonging and hope, finding unity in diversity, exploring pathways of health and healing: those goals are achievable with most people and in most situations. If people are aware, engaged, and interactive, much can be done.
Often, in clinical work, we must prepare clients for situations that are likely to be traumatic: court appearances, incarceration, enforced addictions treatment, and so on. Even family meetings can be traumatic, as can family separation. It is best, in these situations, to recognize the risk of trauma and to take practical steps to prepare. The same is true of any person in any environment: sometimes things are hard, we know we will be hurt, and we need to go forward anyway.
What does that look like in a museum setting? How might museums encourage visitors to encounter exhibitions that might well traumatize them? Where is the zone of safe enough — in which visitors can encounter intensely provocative situations but not accrue lasting harm? In the following sections we provide our clinical perspectives on these questions and offer recommendations for finding the middle ground.
Trauma is an experience that exceeds our ability to manage the stress of the moment (Levine 1997; van der Kolk 2015). In clinical terms, trauma breaks containment: we lose our self-regulation, we are drawn into instinctive coping, and we are usually unaware of what’s happening. This is how trauma can happen invisibly and can go unseen. It is unusual for a person to notice that they are being traumatized while it’s happening. One of the defining features of trauma involves the bypassing of (most of) our cognition: we just act — and we don’t notice. Therefore, in a museum setting, asking people if they feel traumatized is not an effective strategy for helping. Deeper approaches must be used, and they in turn must be based on knowledge of the dynamics involved in traumatic imprinting.
Traumatic situations involve high levels of emotional and psychological stress. That stress, in turn, damages our ability to modulate the thoughts and emotions we are experiencing. We enter into a primordial consciousness that is focused on survival. The situation does not have to be authentically threatening to our survival — most traumas are not. But in the moment, as events unfold, as the stress of exposure increases and our coping abilities vanish, the defenses of our psychology begin to crumble and the body takes over. The body possesses millions of years of evolutionary wisdom about survival. It knows — without hesitation, without doubt, without thinking — how it will respond. The human animal has perfected four distinct pathways of response: flight, freeze, orient, or fight (Levine 1997). These pathways are deeply interwoven with childhood development (Bentzen & Hart 2015) and the nervous system. They are automatic, autonomic, and highly effective — at least, effective from the point of view of the body, which simply wants to survive.
But what if the situation is not a threat to our survival? What if we’ve just entered a museum gallery and we see a whip once used in the slave trade, the crushed remains of human beings, or photographs of a mass execution? (These are actual examples from our research and conversations with colleagues.) There is no risk to our physical safety in these situations, no threat to our survival. But as trauma clinicians know, our particular vulnerabilities to trauma are the result of our previous histories, our experiences and our cultures, our prior exposure to trauma and its sequelae: what’s happening now, in the gallery, is the direct result of what happened then, to me or my people:
We respond to these moments — flight, freeze, orient, fight. We seek to escape, or we shut down, or we become anxious, or we get angry. Perhaps we start with one response and then shift to another. Or we blend them together. People are different; many things can happen.
Although individual stress responses play out in a multitude of ways, they share one common feature: the responses lock (Levine 2004). The deep coping mechanisms of the nervous system are not transient states when it comes to trauma. The patterns of behavior and emotion that accompany these states – driftiness, depression, fatigue, sleeplessness, irritability, impatience, overwhelm, and many others — persist long after the event. Sometimes they resolve in the days and weeks following exposure — people will say I felt weird after that experience, but I’m OK now — and sometimes they do not. In clinical practice, we often work with clients struggling to recover from traumatic situations that are decades in the past, and that often stretch back to early childhood (Bentzen 2015; Levine 2004).
In a museum setting, visitors can be traumatized vicariously by exposure to intense exhibitions. Or, their preexisting trauma can be re-awakened by such intensity. Volunteers can be traumatized by exposure to visitors in distress. In their efforts to support visitors and volunteers, staff can be traumatized both vicariously and directly. They can also become overwhelmed with compassion fatigue, or hollowed out by empathy depletion. As emphasized by Chatterjee and Noble (2009, 50):
These are serious risks. Should museums avoid them altogether? Not at all. Trauma is a wound, yes, but it is also a great teacher if handled properly. With help from mental health professionals, museums can — and should — implement processes for containing stressful exposure and for helping visitors (and staff, and volunteers) understand and manage their experiences. After all, this is how the trauma clinician works (Jørgensen 2004; Levine 1997; Picton 2004): by helping to contain activated clients, helping them identify locked imprints, and assisting them in learning the skills of self-regulation required to shift and unlock deeply-held patterns in the body and the nervous system. These shifts happen in therapy (Novak and Hukovskyy 2017), and they can happen in facilitated museum activities:
Museum professionals are not clinicians. However, many clinicians are trained in trauma work. Two well-known and robust clinical models for working with trauma are the Bodynamic system, developed by Lisbeth Marcher and her colleagues, and Somatic Experiencing, developed by Peter Levine. Bodynamics is best-known internationally, and Somatic Experiencing is best-known in the United States. Both systems share the same roots in developmental somatic psychology, which focuses on the integration between our present experience and developmental resonances, or imprints, that manifest in traumatic and stressful situations. Mental health professionals trained in trauma work can help museums develop structures and systems to reduce (but never completely eliminate) the likelihood of vicarious trauma, to respond ethically and professionally to situations of trauma, and to honor the duty of care that accompanies work with the general public.
Grief and loss are essential features of human life. Because of their ubiquity, it’s easy to underestimate the impact of grief and loss in people’s lives. Moreover, our cultural norms tend to minimize these impacts and to disparage those who do not quickly bounce back. Despite these values and norms, grief and loss can be debilitating, and indefinitely so. Indeed, grief can be lasting trauma.
It’s useful to think about grief and loss in slightly different ways. Loss can be described in simple terms, as “experiences that we wished/wanted to be better than what they were, more than what we had, or different than what was experienced” (James & Friedman 2009). Many people can experience the same loss but with different impacts. For example, in one of our case studies, a participant shared two cameras with us. One was hers, and one had been her father’s (and a gift from him). As she described the cameras, and her feelings about them, it became clear that her father’s camera represented at least two emotions: her grief about her father’s death, but also her keen sense of loss in response to his absence from her life. These emotions were distinct; they carried different (but related) meanings. One member of our team — Jason — had a strong reaction to the subject’s story. At the time, neither the subject nor the other interviewers knew that Jason had also received the gift of a camera; in his case, from his grandmother, before she passed away. Therefore, the story of the two cameras in the interview resonated with Jason, reconnected him with his own, personal and similar loss. Loss affects everyone, and can be triggered and re-triggered in surprising ways:
Grief is loss on a deeper level. Loss is inevitable in the human experience; however, grief is what the body experiences when loss has happened and we are in the midst of processing it. Grief typically develops in situations of extreme loss: absence, disability, death. Like trauma, it is a coping and survival response deep in the nervous system and is not readily accessible to modulation via the thinking mind. Grief just takes over, and we succumb.
However, as with trauma, natural rhythms and resolutions often accompany the grieving process. For almost all situations of grief, relief comes with time (except in special cases of extreme trauma, such as the loss of a child). We move through our emotional processing, and we move forward. However, sometimes grief can lock — just like trauma – and in those situations it is best to think about grief as traumatic. Common terms for this are complicated grief or unresolved grief. And although these mechanisms play themselves out in distinct ways, they share the common feature of incompleteness: the loss is not yet resolved or finished.
Many forms of clinical work for grief are designed to help clients work through the loss towards a process of completion — which does not mean the client will never again feel fragility and vulnerability in relation to the loss. Completion, in these situations, simply means that the client develops the ability to experience those feelings in the present moment differently — in a more contained and modulated way — as the result of finding closure from grief and loss. In this sense, recovery from grief is almost identical to recovery from trauma: both require self-regulation.
In the museum setting, helping visitors navigate grief and loss means helping find pathways that nudge toward completion. Simple expressions of grief are the beginning of healing, perhaps, but they are not sufficient to carry visitors all the way back from the depths of their inner struggles. Expression must be accompanied by doing, by the rituals and creative practices that people have used for millennia to help them heal. Rituals and creative practices help guide us toward important answers to pressing questions: what remains unspoken, unseen, unheard? How might we craft our necessary messages? In this book, we’ve seen many examples of the power of objects to facilitate these conversations with the self, to help bring containment and completion to those in distress:
Shame often accompanies trauma, grief, and loss. People can come to feel that they are the cause of their wounds (sometimes they are), that their punishment is logical and natural, that their suffering is appropriate to their transgressions. I deserved it. Often, in our clinical work, we hear clients describe trauma and grief not as experiences that happened to them but rather as natural consequences of who they are. Such clients do not only say something bad happened to me; they also say I must be bad. These wounds to the core self, to identity and to self-regard, are typically the result of repeated traumas over a long period and are usually rooted in childhood neglect, abuse, or trauma (Bentzen 2015). But whatever the cause, the present behavior of such people is almost always in reaction to the past. During a visit to a museum exhibition, such a person might experience nausea and assume they are coming down with a cold. However, the nausea might be their body’s response to the color of paint on the gallery wall — because it is the same color as the room in which they were abused as a child. Sometimes this revelation will come later, sometimes not. But the resonance is there, for people who carry such damage. They are among the most vulnerable in our society; caring for them is complex and requires much trust and safety.
Shame is a confluence of many other, prior, emotional experiences and imprints. Shame often combines trauma, grief, and loss, winds them together into a powerful knot that cannot be easily untangled. In the museum setting, working with shame means being aware of these complexities, taking the time to build trust and safety (months, not days or hours), being attentive to moments when visitors might be triggered unexpectedly — and caring for them appropriately when (when, not if) this happens.
Being aware of the trauma, grief, loss, or shame that visitors might bring (or that staff and volunteers might be experiencing) will allow museums to act professionally and ethically in situations of emotional intensity. An informed and intentional approach to the design, layout, execution, and processing of exhibitions will help deepen the education, experience, evocation, and even provocation that might be utilized — but will do so as safely as possible. As Laura Phillips (in Chatterjee 2008, 203) notes, in her study of object reminiscence at the British Museum:
Provocation can be an important goal in exhibition design, and certain kinds of exhibitions are well-suited to that approach. At the same time, it is possible for provocative exhibitions to be too activating — to create so much emotional turbulence that personal connection and discussion are impaired or impossible. In our discussion with Tony Butler, Executive Director of Derby Museums and Founder of the Happy Museum project, he noted his concern about the possible consequences of provocative exhibition experiences:
And, as exhibition planner and museum strategist Sara DeAngelis affirms:
In many ways, museums are reflections of the ongoing themes and struggles of people: their traumas and their resilience, their griefs and joys, their pride as well as their shame. Museums are participants in the larger discourse about what humanity is, where it has been, and where it’s going. As Sara DeAngelis notes:
It should be clear by now that in the absence of a strategic and therapeutic approach to emotional safety, museum exhibitions can — and likely will — harm visitors. This unintended result casts a wide net: traumatized visitors will avoid the museum, will have lasting emotional impacts, will often be unaware of those impacts, and will typically try to forget the whole thing — which, of course, is the opposite of what the museum intends.
Navigating the continuum between trauma and safety can be achieved — with mindful attention, professional assistance, and commitment to caring for people. Finding the right balance is possible — if museum practitioners understand the ethical and fiduciary aspects of their practice.
However, mental health professionals know that sometimes, despite the proper balance and sensitivity, despite the availability of services and supports, despite careful and mindful attention to process and outcomes, things go wrong. We have grappled with many situations in which clients spiral into crisis, or become homeless, or act out in ways that harm themselves or others. Some problems get worse rather than better, no matter how hard we try, no matter how skilled we are. Sometimes people die. This is the reality of working with human complexity and vulnerability. Anyone seeking to do this kind of work — whether in a museum, in psychotherapy, or elsewhere — needs to be prepared for these possibilities, aware of the ethical dimensions of their actions, and committed to dealing with the consequences of unpredictable human behavior.
In the work of our team we have repeatedly emphasized the importance of museums forging partnerships with mental health professionals. This serves the broader function of museums helping to promote the public good, but it is also specifically important in the context of conducting research and similar activities with a therapeutic focus (such as our case studies, for example). Beyond the regular guidelines that apply to human subjects research, museum professionals wishing to facilitate interviews such as those in this book must seek training and support from mental health professionals. There is simply no other way to develop professional competence in dealing with trauma and related themes. When engaging with participants in the context of sensitive or provocative exhibition content, researchers must anticipate that the act of initiating a dialogue with a subject will likely activate a therapeutic process. As our research team experienced throughout our field work, the emotional impact of museum participation can become apparent years following object donation, or one day following a museum visit, or after months of working at a visitor services desk. During the data collection process, subjects often discover previously unknown emotions, thoughts or beliefs which provide researchers with a wealth of information about the human-object relationship — but which are also complex and sometimes difficult to contain.
Museum staff can develop excellent skills in empathy and active listening. Cathy Sigmond, Research Associate at Randi Korn & Associates, stresses that “active listening is the most important tool.” And, in turn, Randi Korn confirms that “when you are conducting evaluation and interviewing participants, it’s about them, not you. Set a slow pace and make sure you understand what they are sharing.” These are useful recommendations from professional facilitators. At the same time, skills such as these cannot be mastered through reading about them; they must be practiced, with supervision, in an environment where a supportive expert is on hand to help when things suddenly go south (as they so often and so dependably do).
Active and empathic listening skills are extraordinarily complex. The activation of empathy in a listener also requires activation and awareness of their own emotional state, their resonance with the speaker as well as the resonance of the subject matter with the listener’s own history. The listener’s beliefs, biases, and judgments must be laid aside, during the practice of listening — which means they must be grappled with, mapped, and known prior to the interview. The blind spots and unconscious impulses of the listener — both positive and negative — must be known and managed. The speaker responds to innumerable cues sent — intentionally or otherwise — by the listener, and much unspoken discourse occurs when people are talking about something else. The speaker’s voice tone, rhythm, posture, demeanor, eye patterns, clothing, and a multitude of other factors all contribute to the conversation, sending their own messages of support or subversion.
Effective listening — active, empathic, supportive — is a deep skill that requires much self-awareness, mentorship, and practice. Without training, most people are not good at it (Zenger & Folkman 2018). However, most people are capable of learning how to co-facilitate a basic, supervised, emotional interview — with about 50 hours of training. At an introductory level, trainees are not prepared or skilled enough to conduct interviews on their own. They need a professional to be present: in the next chair at the beginning, then nearby, then in the next room, as their skill improves.
These are complex and consequential skills, and they require much training and experience. We do, however, hope that these glimpses of the challenges — and opportunities — of working with emotional situations in museums encourages readers to pursue the appropriate partnerships and pathways to develop similar initiatives on their own.
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Adapted from Museum Objects, Health and Healing, by Brenda Cowan, Ross Laird, and Jason McKeown