In Canada, an incredible new program allows doctors to prescribe museum visits to their patients. Hyperallergic’s Zachary Small visited the Montreal Museum of Fine Arts to talk with Stephen Legari, the first full-time art therapist on staff at a North American museum (he sees 1,200 patients a year), about his work in the city’s encyclopedic museum and what role art can plan in healing.
It’s a fascinating story that might also point to new possibilities for art museums eager to play important roles in their local communities by teaching people to learn from and engage with art.
As an added bonus, I ask Zachary about the Thierry Mugler exhibition, which is also on display at the institution — you can also read his full review.
A special thanks to Dried Spider for the music to this week’s episode. You can visit driedspider.bandcamp.com, for more information.
Stephen Legari: Museums taking up identities as places where wellness and health can also happen, I think that’s the future of museums
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Hrag Vartanian: Welcome to the March 14, 2019 edition of the Hyperallergic weekly podcast, Art Movements. This week we have Zachary Small in the studio.
Zachary Small: Hi there.
HV: And Zachary, you just came back from Montreal where you were checking out the Thierry Mugler exhibition, but then you discovered something else at the Montreal Museum of Fine Arts.
ZS: After I saw the exhibition, I had the chance to meet with the museum’s art therapist on staff, Stephen Legari.
HV: I’ve never heard of that — a museum therapist. Is he the only one with that kind of job?
ZS: There are a few other full-time therapists at museums, but Legari was the first. He’s been doing this as his full-time job since 2017. He’s also been a practicing therapist since 2011.
HV: Sometimes, I’ve seen work that I wish somebody would help me work through, but this is a pretty unique take. How does it work? Can you just request a therapist to join you?
ZS: We’ll get to that, but it’s important to first note that Canada is spearheading this movement. They are setting up systems where you can have a doctor prescribe you to the museum.
HV: Oh yeah, that’s a trend. Weren’t they also doing that in the United Kingdom?
ZS: Exactly. The UK actually started this movement and really innovated art as a therapy tool. That started in the mid-1990s with psychologists who found that art had some really positive effects on the brain.
HV: What’s the scale of the Montreal Museum’s program?
ZS: In total, the museum’s health, wellness, and community programs serve about 26,000 people a year. And for art therapy, they usually operate in closed groups consisting of about 8 people with a total of nearly 1,200 people per year.
HV: You are blowing my mind with this idea that you are going to a museum under the direction of a doctor. I love it, but at the same time it seems so strange.
ZS: But if you actually think about it, a lot of other creative disciplines are doing this. Theater therapy is popular, especially with military veterans. I think the greater question we can ask is: Can art be used as a tool for therapy? When I sat down with Stephen a few weeks ago to discuss his work, I was thinking about that, and how art therapy actually functions in the room.
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ZS: Let’s say that I wanted to do art therapy.
ZS: How do I get prescribed art therapy? I know this is something that’s happening in Montreal, right?
SL: The museum prescription was inspired by a movement in what’s called social prescribing. This has kind of taken off more in the UK. And in looking at the literature, we see that doctors were prescribing, in addition to things like eat better and get out there and walk more often, they were prescribing social activities within the patient’s community, with the belief that that was going to accelerate their healing and give them opportunity for more agency, that I am a participant in my healing. I’m not just waiting for something to be fixed for me.
ZS: What are the first questions you would ask me?
SL: I would first place an emphasis on welcoming you. If we’re going to talk about safer spaces, we know that starts with the humans occupying those spaces. So I would pay attention to how your body seems to be responding to the environment, and I would try to attune myself to providing a place of comfort for you. I would then want to know your relationship to art — including if you have none, which is fine and welcome.
ZS: I have a little relationship to art.
SL: So we’ll capitalize on that.
SL: Art therapy is a therapeutic practice where we can explore your feelings, your memories, your desires, your thoughts about yourself and your life through making art — and then also through reflecting on it. In art therapy, we are focused on the process of making art, of being in the art-making and seeing what that feels like, and less on the product as something that we necessarily want to put a magnet on the fridge with, though many people do find that they feel good about the art that they make, and they want to keep it.
ZS: Right. I’m very product oriented.
SL: So I would ask you, “Is that something that you’d like to work on?”
ZS: Loaded question.
ZS: Let’s say yes. [Nervous laughter.]
SL: Okay. So I might select some materials that would help us get started, where you can create something fairly easily that is a product. Let’s say collage is a favorite. Now, collage is readymade materials, where you can project your identity onto shapes, colors, pictures, forms. I might give you a smaller format of paper to work on, so it’s realizable in a short period of time. But further on, if we continue to work together, I might start inviting you to push outside of that frame, to challenge yourself and see where you can become flexible in your own need to produce a product.
ZS: So when I’m creating that collage, are you giving me any direction for my art?
SL: I try to evaluate how much the person needs that direction. Ideally, I want to give them very little direction so that something spontaneous or, if I’m working more psycho-dynamically, something unconscious is going to emerge. But I don’t want to leave the person blowing in the wind if they’re having a terrible time. I will support them as much as needed.
ZS: So it’s like a really nice version of an art critic session?
SL: Yes, I definitely put the gloves on. My goal is not to challenge you in the sense that you need to make art in a certain way. The ways that I want to challenge you is to be more gentle with yourself and your self-image, and your sense of self as a creative person. But I also want to know, in reflection, what happened? What happened in that last half hour? What was that like? What thoughts were going through your mind? Do you have associations to those thoughts? Were they fleeting? Often people will say, “I wasn’t thinking about anything at all,” and that’s a holiday for someone living with a diagnosis.
SL: After we’re finished with the reflection, I might ask some more guided questions.
ZS Like what?
SL: I might refer back to one of your objectives for the therapy in the first place. I will try to make links with why you came here in the first place and what happened during the process. The guided question might be asking you to look for those elements for yourself, so that there’s a consolidation and there’s some integration of the experience.
ZS: How do you recommend I take that session with me into the real world, besides taking my collage home, of course?
SL: Well, art therapy is about flexibility. In any kind of therapy, I like the idea that we’re trying to help people remove obstacles between where they are and the life that they went to have, and that’s not for me to decide. That’s for them to decide the life that they want to have. So if they’ve experienced even a little bit of flexibility with themselves, with their self-critique, with their sense of who and how they are, if they’ve experienced those moments, they can then apply those to the real world. They can apply them to the relationships that they’re having, and they can practice, perhaps most importantly, naming and sharing their feelings, which is something I’m pretty sure none of us are encouraged to do.
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ZS: One of the questions I had going into art therapy was: What constitutes good art from bad art? This is a question us critics like to ask, but what does it mean from a psychological standpoint?
HV: How does that factor in here?
ZS: Yes, and in my conversation with Stephen we go back and forth about what he chooses for his own patients. And of course I have my own ideas about this. I’m curious, though, what’s an artwork that would soothe your soul?
HV: I would assume it would be a beautiful, soothing film or something of the sea where I can sit in a dark room and shut the world out.
ZS: I’ve been thinking about this question for the past three weeks, and I keep going back to how I decorate my apartment. It’s a little embarrassing to say, but I have a lot of Matisse reproductions. I think that his cut-outs are really soothing. It’s about those beautiful planes of color. In contrast, what are works that might trigger you?
HV: Anything with violence. I can’t imagine that Stephen is taking his patients to a room where they are shown videos of people being beaten.
ZS: Probably not, but they can definitely tackle some difficult things in therapy. This is something I actually discussed with Stephen.
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SL: The artwork that gets selected for visits, which can be anywhere between one and five works, depends on the group. The objectives that we’ve co-developed with our community partners will inform what we examine. So we can either be very specific about looking at a subject like body image through everything from ancient Greek art to contemporary representations of body. Or we can appreciate that what our participants want is to move aside their diagnosis for the afternoon, and we can go into the romantic galleries and get lost in landscapes. It really depends on what we hope the participants are going to connect with.
That said, I recently designed a visit around going to see some Monet with a group of folks that all have a shared history of trauma. Now, for me, it was an opportunity just to sort of bask in some color for a little while before we went into the harder work of creating and discussing. But one of our participants was triggered by the Monet. The darkened windows incited what I appreciated as a mild flashback. And I supported him. I asked him to find an antidote in the room that could counterbalance that effect, and he was very quick to find a wide open landscape that extended beyond the borders of the frame, and he found comfort in that. So we never know. Art is more powerful than I know of yet.
ZS: That’s an interesting point, because many critics talk about how art has lost its resonance with people today, and that it lacks the aura it once had. There are stories, of course, of people standing before a Rothko painting and being moved to tears. You might not see that as much in a gallery, but from what you were saying, for those that might need it or those that are seeking art therapy, it does have that same effect.
SL: The experience of being in front of paintings, sculptures, photography installations — I think it has the opportunity to reach us on a variety of levels. Contemporary art is really stimulating on an intellectual level because we need codes, we need messages, we need recipes to try to figure out what’s going on with it. It’s an exciting puzzle. Abstract Expressionism still has the opportunity to allow us to bathe in affect, in wonder, in mystery, to connect purely on a visceral level.
And art history has that too. If we’re going to go look at the Dutch masters, there’s a refinement and an elegance. And I completely agree with you that sometimes these different eras in art history are going to be lost on certain audiences either because, one, our relationship to image is too accelerated, or, two, we’re coming from a different perspective. We’re coming from a different cultural moment, and we might not see ourselves in the galleries. That’s not my face. That’s not my family. That’s not my culture. That’s not my history.
ZS: So when you work with patients, is that something you screen for, so you can talk to someone and say, “This guy’s kind of a Rembrandt guy. He needs a Rembrandt in his life?” Is that the kind of conversation you need to have first?
SL: In some ways, yes, without making assumptions. I don’t want to assume that folks coming from our Syrian community necessarily want to look at Islamic art. Some of them are really enraptured by looking at the most recent contemporary or modern art that we have. That comes through relationship-building, and I think that’s something that we’re always trying to strive toward.
[ZS: At this point in the conversation, I noticed that there were a few artworks resting against the wall of Stephen’s office. These artworks were made by some of his patients; I asked him to show me some.]
SL: This is a group of self-identified patients, who had all been through the medical health system, who are now advocates within that system. They work as educators.
ZS: So this was created by someone that went through the art therapy program, is what you’re saying?
SL: Yes. We came together and co-created this project together. They co-designed the exhibition around a theme of contrasts. Then my colleague Linda says, “Oh, let’s go look at the contrast between symbolism and impressionism as one of our visits.” Drastically different experiences, but the patients, they’re looking at te contrast between before and after their diagnoses. How does life change?
ZS: So if we look at one of these works, can you tell me a little bit about it and the story behind it?
SL: They’re all potent. They’re all charged with the idea of witnessing. For this participant who had experienced a traumatic brain injury and had a near-death experience, this work is actually called “Near Death Experience.”
ZS: What we’re looking at is a yellow background and a white mask. There’s some thread being spun to the mask’s eye with scissors cutting it off on the side. And there’s also this red blotch that’s almost gruesome. It’s bleeding out of the head. So this is about a really traumatic experience?
SL: Yes. And of course, the trauma began with the injury and then was sustained through different qualities of care. So when this participant is revisiting that experience, they’re invited to do whatever they want. I work in what’s called a very non-directive way. I don’t ask the participants to make something specific. I invite them to kind of look at the buffet of materials available and let them go with that. But when we also turn this artwork around, we see contained within the mask … What do you see here?
ZS: In the mask, it looks like there’s a family portrait hanging in the cranium, and then there’s also this black felt that’s coming in, splitting the middle of the head, and going inside the eye socket.
SL: Masks are both in theater and art. In art therapy, they are a really valuable material for exploring two sides of something, that which is protected and hidden, and that which is exposed to the world. You can think of the divine comedy as the smiling and sad masks next to each other.
ZS: Right. Or even Commedia dell’Arte where you have these stock characters that are also using masks to convey specific emotions or traits. When someone with a traumatic experience comes to you, have they already had psychotherapy before? Do you get anyone that’s never had therapy?
SL: When we’re building a partnership, we’re careful to evaluate the needs of each person. we hope they are being supported by a family doctor, psychologist,, or someone so that when our program is finished, they have resources that they can return to. We also hope that they are going to stay connected with the museum, and that’s where things like our open studio come in, the Art Hive. Many of our participants have had experiences in therapy. Many of them have kind of come in as therapeutic experts themselves. Often, it’s the first time people are doing art therapy, though, and it’s very special for me that they’re doing it in a fine art museum. Normally, I would have encountered folks doing art therapy for the first time in a school or in private practice somewhere, because art therapists are really eclectic in the places that they work.
ZS: I’ve seen art therapy described as curative therapy. What does that mean?
SL: That’s a charged word. I describe art therapy as a healing journey through the use of art and a therapeutic relationship. That’s maybe the shortest and best definition I’ve ever come up with. Art therapists believe in the containing power of art. So a participant like this can share something really traumatic, and the art helps to contain it. It’s not flowing out into the room and overwhelming everyone. We can stay connected together. We can help each other regulate, but we can still go into the some dark corners of those experiences together as well.
ZS: Right. So for victims of violence, this becomes a really powerful too for coping.
SL: Absolutely. And I don’t present art therapy as a replacement for any other kind of healthcare practice. It’s an ally.
ZS: Which is probably pretty important for people to know.
SL: Many people will choose art therapy because they’ve done talk therapy in the past and have reached a certain point where they want to try something different. They want to learn to express themselves and the complexity of their experience in a new way. It’s not a replacement for talk therapy. We’re not in a competition with each other.
ZS: Is there anyone that you’ve worked with where art therapy just wasn’t for them?
SL: Oh, sure. And we even find that within our own groups. But this is the interesting thing of working in a fine art museum. We have participants who love the visits. They are so delighted by the opportunity to have personalized access to the collection, so our mediators are working with them to really tease out their personal experience and responses to artworks. It unfolds something for them. And they may come back to the studio and go, “Oh, yes, I’ll make something, but I’m not really an artist.” But what that gives me information about is a part of themselves that they’re not yet connected with.
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ZS: No two patients are made alike, and Stephen treats many different types of patients. People will come ot him with various physical and mental ailments. Anything from cardiac arrhythmia, Alzheimer’s disease, eating disorders, and epilepsy.
HV: I never thought you could treat epilepsy that way. What an interesting idea that museums can become places where healing can happen.
ZS: How I understand it is that there are many ways to approach this. Stephen may not be looking at the brain chemistry specifically, but people have emotions. People with epilepsy, for instance, may emotionally process their diagnosis in different ways. Art can help people confront their diseases and how it affects them.
HV: In the mid-1990s, Globe and Mail art critic John Bentley Mays wrote a fascinating article about how living with work by Toronto artist David Urban actually helped him with his depression. So I keep thinking about this. It’s unique that art serves all these different purposes in our lives.
ZS: And it goes beyond illness. Stephen also works with immigrants who have just arrived in Canada, victims of violence — there’s a whole spectrum of people. That’s what makes his job really interesting and challenging; he has to figure out what artworks are going to help patients and edge them toward a deeper understanding of themselves.
HV: I love that idea. Let’s continue with the conversation.
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ZS: Maybe if you could talk about how you design an art therapy session. For instance, how do you work with someone with Alzheimer’s?
SL: The Alzheimer’s programs are situated outside of the art therapy frame. These are more about well-being experiences. People living with Alzheimer’s will come with a family member, a loved one. They’ll have a guided visit through the galleries. That’s a custom-made experience. We’re looking for associations. We’re watching for memories. We’re paying attention to any kind of spontaneous association, and then we’re giving them a pleasurable creative activity to do together for the afternoon. Some of those programs are assisted by art therapists coming with their organizations.
When I am building an art therapy project, it’s often based on request. I’ll use the example of a current research project we have for women living with breast cancer. There was a local foundation, a provincial foundation that provides services to people that are in treatment or in remission, which we met with to appreciate the needs of their population. We ran a pilot project, which I facilitated. We asked questions to each individual ahead of time about what their expectations were, what their needs were, who they were surrounded by, and how we could appreciate the system that they were embedded in.
We did an eight-week process. They would come for three hours a week. We would go for five visits during that time, again, looking at themes as simple and broad as a dream. But that can be dreams that are lost, dreams that have yet to come true, dreams that are being mourned, or just the dream for the morning. Like, I’m just going to dream about getting through this day.
We then worked through a variety of materials based on that theme, but participants can also leave it aside and just work in the here and now of what’s important to them. And then we always have a reflection process. So we bring all the artwork back together, we bring all the participants back together. It’s usually a maximum of eight people at a time, to really encourage that intimacy. And each person has the opportunity to reflect on their process, to reflect on each other’s process, while taking ownership of what they’re seeing. And my task is the same as any group therapy facilitator. I hold, I listen, I attune. I’ll provide some interpretation when it’s appropriate, but really that’s not my objective. I really want to explore the work together.
[ZS:At this point, I started to realize I was probably taking up too much of Stephen’s time. After all, he does have many patients to treat. I just had one last question for him.]
SL: I would like to remind people that their connection to themselves as creative human beings is an important piece of a healthy life, and whether they do that through looking at art, through making art, or for using therapies, creative arts therapies as part of their health journeys is something that is under-exploited. The arts are nothing new. The arts and health are nothing new. We’ve been dancing since we formed our first societies together, so reclaiming that as a way to connect is something so available. I’d like to encourage your listeners to look in their homes, in their communities, and in their museums for those opportunities.
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HV: That conversation gives me hope that museums are not the traditional temples on the mountain that people often saw them as.
ZS: And the great news is that the Montreal Museum of Fine Arts is working with other museums across the world to implement these same strategies and programs.
HV: Before you go, I want to talk about the Thierry Mugler show because that’s something you’ve just reviewed. Can you give us a little taste.
ZS: Well, I’m still going through therapy about it.
HV: Given his designs, I’m not surprised.
ZS: The Montreal exhibition really shows just how important Mugler was. I wasn’t so familiar with his work before — I’m not a huge fashion person — but the show demonstrates just how important he was to bringing performance into the fashion world and combining elements of Hollywood kitsch with glamor. Mugler’s really good at making this strange clash of counterculture with glamor.
HV: I always think of leather when I think of Thierry Mugler. Was there a lot of leather?
ZS: Oh, for sure. And definitely a lot of references to kink and queer subcultures in his work. When you see some of his more elegant works, sometimes a beautiful evening gown will just not have a backside — and that’s fine.
HV: And that should be the way it is. Any surprises in the show?
ZS: I really wasn’t expecting to see an entire room dedicated to fishy couture, but there was indeed an entire room dedicated to fishy couture.
HV: Wow, that definitely makes me want to see it. Thanks so much for doing the legwork up to Montreal, Zachary.
ZS: Thank you.
Editor’s note: An earlier version mistakenly identified the position at the Montreal Museum of Fine Arts as the only full-time art therapist on the continent. While the Montreal position appears to be the first, there is, in fact, another therapist, Lauren Daugherty, who was hired last November by the Eskenazi Museum of Art at Indiana University in Bloomington, Indiana.