Therapeutic improvisation in Cambodia: Moderated exposure, the Tuol Sleng Museum of Genocidal Crimes, and the quest to weave the “world’s longest krama”

Abstract

This piece examines efforts by Cambodian mental health workers to incorporate two sites of cultural significance into narrative psychotherapy among Khmer Rouge survivors. As part of the “exposure” element of an imported form of Testimonial Therapy (TT)—in which patients retrieve traumatic memories from the past—a subset of patients was taken to the Tuol Sleng Museum of Genocidal Crimes. While embodied engagement with the memorial site served as an effective mnemonic device for participants, it also proved more emotionally overwhelming than counselors initially anticipated. As an antidote, counselors then decided to add another site to the patients’ therapeutic itinerary—an exposition where they could participate in efforts to weave the world’s longest krama. In examining this case of “therapeutic improvisation,” I explore the dynamic social life of memory sites and how they may assist people in renegotiating cultural memory (and identity) in the wake of traumatic social rupture.