262 Perspectives in Psychiatric Care Vol. 42, No. 4, November, 2006

Blackwell Publishing IncMalden, USAPPCPerspectives in Psychiatric Care0031-5990© Blackwell Publishing 2006424

ORIGINAL ARTICLE

Integrative Prespectives

Integrative Perspectives

Creating a Healing Environment

Mary Ann La Torre, RN, MA, CCNS

F

or most of us, providing a healing environmentconsists of working with the process that occurs in theinteraction between client and therapist. When consid-ering the concept

healing environment

, what comes tomind is the therapeutic focus, the sense of connectionand rapport that is created. But there is a larger picturethat occurs around and beyond the relationship;the actual environment itself where psychotherapyis done. This external setting can have an importantimpact on healing by significantly reducing or increas-ing stress as well as empowering the client in theirown process (Moore, 1998).

Research as early as 1980 has shown the effect ofthis environmental impact on both clients and staff invarious healthcare settings (Rice, Talbott & Stern,1980). Just adding a window to a room was shown toreduce recovery time and hospital stay (Ulrich, 1984),while using color, art, and plants created a space wherepeople felt safer and calmer (Moore, 1998). The impor-tant discovery of the power of the environmentalsetting has created a whole discipline called

supportivedesign

and research continues which explores therestorative benefits of the external setting (Ulrich,Zimring, Joseph, & Choulhary, 2005). Applying theseconcepts to the therapeutic workplace can add adeeper dimension of healing and empowerment to thetherapeutic interaction. This column will explore theseconcepts in general as well as discuss the specificpractice of Feng Shui, a Chinese art of placement thatfocuses on harmonizing the environment by rearrang-ing the room to balance energy (Jeffreys, 2000).

General Environmental Concepts

To begin a discussion of the environment as a heal-ing tool it is helpful to look at some basic premises. Afundamental one being that since earliest evolutionarytimes human beings have had to be aware, responsive,and sensitive to their environment. It was essential forsurvival. From these evolutionary premises, environ-mental psychologists have done research in a numberof areas to show how the quality of the environment can

support well-being. Such research demonstrated thatthe more familiar, comfortable, and in control of theenvironment an individual felt, the greater the positivehealing response (Bilchik, 2002). Thus, health care cannotbe separated from the setting in which it is done (Malkin,1992). Design elements have a significant impact on theindividual and awareness of how specific componentsin the environment can be used to change a client’s stateof mind is an important part of the therapeutic process.

The practitioner who decides to work with theenvironmental setting to enhance the therapeuticprocess may find that there are structural restrictionsin the building and rooms that make many healingconcepts difficult to implement. There are, however,some important design concepts that can be used inany setting to promote health no matter what thestructure and can be a good beginning towards creat-ing a supportive atmosphere.

Color is an important component that can affect theentire setting and change the essence of a room. Coloris one of the most powerful energizing forces andthoughtfully employing color in the therapeuticsetting can make a significant difference in the stressor relaxation of a client. Research shows that color hasan effect on our pituitary and thyroid gland, creatingmood changes and physiological effects (Long, 2001).Colors as blue and green have been shown to promoterelaxation and balance, while yellow and orange seemto activate and energize a room (McKahan, 1993). Theintensity of color is also an important factor and oftenleads to the choice of lighter hues to make a roommore spacious. Room color can also be altered throughthe use of lighting that can play off interesting featuresand draw the eye towards positive aspects such as artor views (Long).

Daylight and windows are another importantcomponent in any room since they significantly reducefatigue and depression and help reconnect to nature(McKahan, 1993). Even if there are no windows, how-ever, plants can create that sense of nature indoors andsimply viewing nature can have a profound stress-reducing effect (Long, 2001). Research has shown that

Perspectives in Psychiatric Care Vol. 42, No. 4, November, 2006 263

negative emotions such as fear or anger diminishwhen looking at nature while levels of pleasant feelingincrease (Ulrich et al., 2005). Even nature paintings canhave a positive effect (Flower, 2005).

Thus, the environmental setting does make a differ-ence in the healing process, and creating a space that iscomfortable, light, and nature connected can enhanceany treatment program. Practitioners who wish toexpand their skills in healing design can explore theevidence-based research in the area as well as lookto the Chinese since they have developed a whole dis-cipline for harmonizing the environment called FengShui. Based on thousands of years of observation ofhow human beings react to their environment, FengShui (meaning wind and water) focuses on creating asupportive environment where the client’s personalenergies work well with the objects in the room(Jeffreys, 2000).

The Concepts of Feng Shui

Developed over 3,000 years ago by the Chinese,Feng Shui is an energy discipline that aims to create aharmonious environment in which the individual’senergy is enhanced and supported (Jeffreys, 2000). It isa perspective—a way of looking at our surroundingsthat has at its core the belief that the invisible breath oflife called

chi

runs through all things and that maxi-mizing this energy can improve our life (Butler-Biggs,1999). The principles of Feng Shui are based on thepremise that people are affected by their surroundingsand by adjusting, enhancing, and balancing the envir-onment through the positioning of items in the room,the energy can flow more freely in the surroundings aswell as in the individual (Rossbach, 1991).

Accomplishing this harmonious balance is done byexamining the environmental space as if it were abody with its own metabolism. Doors and windowsare the openings, which allow the energy to enter.Furniture, plants, and inner doors channel the energythroughout and the aim is to promote a smooth evenflow that does not get blocked or stuck in spaces

(Rossbach, 1991). In a dysfunctional environmentwhere energy is blocked, the Chinese believe that theenvironment becomes a negative stressor creating dis-comfort in the individual and leading to poor health.To turn this situation around rooms are rearrangedusing a specific set of rules designed to balance the

chi

( Jeffreys, 2000). Where it is not possible to do thatbecause of the structural design in the space, specifictools are employed to help

cure

the space such asmirrors, chimes, fountains, fish tanks, and plants. Thepurpose of these

cures

is to expand the space, softenareas around corners, and generally enhance the flowof energy in the room (Rossbach & Yun Lin, 1991).

It takes an expert in Feng Shui to understand howthese cures are implemented as well as how the wholespace is readjusted because it is a complicated process.Thus, it is not an activity that can be done withoutadequate preparation. It is possible to get a sense ofwhether an environmental intervention is necessaryby taking a moment alone in the space and consider-ing the negative and positive aspects of it.

Clinical Considerations

An understanding of the space that one works in iskey to using it effectively. That understanding beginswith an assessment of the workplace. Is it providingwhat is needed? A really clear and finely tuned spaceis so healing that people will feel different as theyenter it (Butler-Biggs, 1999), and people will commentthat the room feels good, not understanding why thisis so. Looking at a space with a fresh eye can helpidentify areas that need adjustment such as items ina room that hold no significance and have becomeclutter and congestion. Identifying areas that need tobe cleaned or spaces that need the softening touch of aplant or artwork can create a fresh feel in a stagnantspace. Awareness of how the setting is structured canbring a deeper sense of how the space can be adjustedto accomplish the goal of supporting the therapeuticprocess. Such insights allow for an expanded scopeto the healing practice. There are many good books

264 Perspectives in Psychiatric Care Vol. 42, No. 4, November, 2006

Integrative Prespectives

available on the theory and practice of Feng Shui thatcan give you a starting point to look at your work-space and determine how to bring more light andpeace to the area. There are also expert Feng Shuiconsultants available to help you create a more healingenvironment.

Search terms:

Psychotherapy, environment, Feng Shui

Author contact: malinvis@yahoo.com, with a copy to theEditor: mary@artwindows.com

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