In an attempt to give back to all of the fine publishers that send me review copies of books, I’m striving for a couple of weeks of posts in the spirit of the ‘Overdue Book Report’. First on the list is a great book that I just finished this morning, “Healing Spaces: The Science of Place and Well-Being” by Esther M. Sternberg, MD (published by Harvard University Press).
I have a keen interest in the healing dimensions of space, and in particular the role of landscape architecture and exterior spaces to provide this function. This comes from doing a lot of work and research in the realm of therapeutic garden design over the years in hospital, hospice, and eldercare facilities. I first became interested in the phenomenon while doing my undergraduate final project related to a cemetery design that utilized physical space design to aid in the bereavement process, and was fascinated by the connection between environmental design and health. There is an innate connection between space and health – but sometimes the connections, both physiologically and spatially, are a bit fuzzy. There are a number of successful examples in literature and design, but often there is either dismissal of designs as unscientific by the medical community, or by inadequate application and understanding of scientific concepts and mechanisms by designers – resulting in poor or partially realized applications.
That’s where Ms. Sternberg’s book shines. It is not neccesarily a ‘how-to’ (there are a growing number of resources out there in this genre), but more aptly a bridge between the scientific research of the concept of healing and how this work in the design of spaces. The book spans the available research, starting with some of the more intuitive architectural concepts of Wright, Aalto, and Neutra, touching on the pioneering work of Ulrich, and expanding on the growing design-science connections being made by collaborations between space design and health research, and looking specifically at both the microcosm of hospitals, and the macro-scale of cities, and the range of designs that this thinking can inform.
Discussing the intimate connection of space and physiology, Sternberg summarizes the interactions: “There are many things that can influence the release of these chemical signals from the brain, and our surroundings play a very important part. How we percieve the world around us, its features of light and dark, sound and smell, temperature and touch, feed into the brain through all our senses and trigger the brain’s emotional centers, which make us react. These emotional centers release nerve chemicals and hormones that can change how immune cells fight disease. In turn, through this communication, our awareness of space and place changes when we are ill, and changes yet again when we begin to heal.” (p.20-21)
By examing the physiology (loosely constructed in chapters 2-4 aligned with the senses of sight, smell, hearing, touch, and taste) – we gain a medical understanding of the body’s cause and effect relationships between disease, medical intervention, and space. I found this at times more difficult to understand, but it was in no way overly technical – just requiring a bit of slowing down to soak in the information. This is really the meat of the book, and offers a valuable resource to return often for review.
The next sections discuss more spatial related connections, including mazes and labyrinths (the ideas of both confusion/stress vs. meditation/relaxation. This continues into the concepts of how our brains work in relation to memory and wayfinding of place – including imprinting of patterns and landmarks – and investigates the loss of this ability in patients with Alzheimer’s and other forms of dementia. The concept of topographic memory was an interesting concept – and the ability to visualize and represent a space, even when not being able to physically navigate one, being a powerful idea of the brains connection to space.
The most interesting chapers, for me at least, were those discussing ‘Hospitals and Well Being’ (Ch. 10) and ‘Healing Cities, Healing World’ (Ch.11) which discuss the worlds of evidence-based design in medical facilities, and looks at the connections between urbanization and public health. Both of this tracks of inquiry discuss both historical underpinnings and modern usage, offering both background and inspiration of how this can be applied. From a hospital specific perspective, the work of Roger Ulrich, the idea of Fable Hospital, and the integrated Pebble Project amongst other examples all will be familiar to those interested in the concept – and offer a good primer on design concepts for healing and therapeutic environments that can guide designers.
From a city-scale there was an interesting conceptual framework that included the dual interesting ideas of the ‘urban penalty’ (issues associated with poor city conditions on health in early urban zones) and the subsequent ‘rural penalty’ (issues associated with suburban form and and how they impact public health due to sprawl). There is also interesting work on urban epidemics and the search for causes in both the water and air.
There are definitely some strange examples and quirks – such as using Frank Gehry as an example of an architect that is tapping into these mechanisms of biophilic design (i’m not buying that one bit), the constant and annoying (to me!) descriptions of people, or references to Harry Potter (ugh) to describe certain points. These are more than made up for with a wide range of interesting case studies, including some of my favorites, the healing properties of Lourdes, Charles Jencks and the work dedicated to his late wife, the transformation of musician and recording engineer Daniel Levitin into a neuroscientist , and the CDC evolution of obesity trends maps over time.
This book should be required reading, and remain close at hand, for any designer attempting to delve into the difficult terrain of healing spaces. The ability of Sternberg to connect research, physiological response, and spatial concepts will provide designers not necessarily with ideas for implementation, but an understanding of, and justification for, the design concepts that they propose. It’s imminently readable and engaging – meaning short-attention span designers won’t lose interest in too much technical jargon – but get an education in the process.
As a bonus, a video of Sternberg discussing the book in her own words.