Space to Heal

HealWinter 2007
Volume 1
Issue 3

Using nature, music, color and other elements in the home can restore the spirit amid the devastation of cancer

When not traveling the world for her consulting business, Healing Landscapes, the retired professor emerita in the departments of architecture and landscape at the University of California, Berkeley, returns home, where she has both consciously and unconsciously translated her research and the research of others into a personal healing environment of light, nature, color and symbols.

In her living room, white and raspberry-colored walls surround soft leather furniture. Family keepsakes fill the room, as do plants — lots and lots of plants. Just outside is a garden anyone would envy — with rich ferns, a waterfall and a greenhouse.

Healthcare settings such as hospitals and nursing homes have begun to understand the importance of designing space that incorporates research on the sensory aspects of healing. An individual can extrapolate from many of the basic findings what elements might offer similar benefit in the home: light and sound impact stress; views of nature can shorten physical healing; color affects mood; being in natural settings has restorative qualities; and symbols and mementos can invoke past feelings of care and comfort.

During her tenure at Berkeley, Cooper Marcus has been involved in the evolution of architecture and design as it has grown from architects simply filling space with functional (and sometimes attractive) buildings to concern about “environmental psychology,” where the needs and feelings of those who will use the space are incorporated into the so-called built environment.

Until the early ’90s, Cooper Marcus focused on user needs in the design of affordable housing and urban open space. Then, as an avid gardener who knew what her garden did for her own feelings of stress, she applied for grants to study four gardens in healthcare settings. (One of the gardens would become her own wandering place after being diagnosed with aggressive, stage 3 breast cancer in 1994.) Since then she has authored or co-authored more than 20 professional articles on the therapeutic aspects of gardens and their designs and co-authored the reference book Healing Gardens: Therapeutic Benefits and Design Recommendations, which is used by architects and healthcare space designers around the world.

In addition, Cooper Marcus moved beyond the academic realm to explore the symbolism of house as home, interviewing more than 60 people in the San Francisco area over a span of more than 20 years for her 1994 book House as a Mirror of Self: Exploring the Deeper Meaning of Home. In the book Cooper Marcus examines the relationships of people with their living space and how they can change, adapt or create space that more fully reflects their souls.

What drove Cooper Marcus to move from studying urban spaces to her own backyard was recognizing the impact her garden had on her stress while coping with breast cancer.

“I would go outside and see how the plants were doing, and there would be weeding or other things to do. The anxiety would drain into the soil,” she recalls.

She added three features to her garden when she returned home from the hospital after her first diagnosis: a waterfall to generate a soothing sound, a greenhouse so she could garden year-round, and a glider, where she would spend her time reading and enjoying the results of her labor.

Two years later her diagnosis of colon cancer led to the exploration of creating a healing space inside her home. She invited a feng shui specialist to evaluate her space. The consultant in this age-old Chinese practice of balancing energies had Cooper Marcus move her bedroom from the front of the house to the back, where it was enveloped by a large plum tree and could absorb the power of nature.

For Cooper Marcus, who was a child in England during World War II, the country and nature became a place of solace and a respite for her family after being evacuated from London when the Germans began relentlessly bombing the city. As a child she didn’t know what to call the feelings that nature invoked, she says. But now she recognizes that the country became for her a healing place, where she saw the cycle of life and death in the “growing, blooming and dying of the plants.”

Nature has proved a powerful positive force even for those who don’t connect it with safety or seek it out. A seminal article on the healing power of nature, published in the journal Science in 1984, detailed research conducted by Roger Ulrich, PhD, today the director of the Center for Health Systems and Design at Texas A&M University, who explored the recovery of a group of patients who had undergone similar surgeries. Half of the patients were in hospital rooms facing trees, while the other half faced a brick wall. The results showed that patients with the view of trees had a shorter postoperative stay than the other group and needed less pain medication.

While the healing changes in the body that allowed such results are little understood, Ulrich suggested in another article that the outcome may confirm other research indicating that natural views bring about positive feelings and reduce fear in stressed subjects and possibly foster restoration from anxiety.

Other studies have shown that contact with nature is beneficial in a number of ways. For example, studies have linked connections with nature to lower blood pressure, less anxiety among dental patients, better pain control among bronchoscopy patients, fewer aggressive acts against spouses, and improved attention among children with attention deficit disorder. Multiple studies report on the ability of nature to reduce stress.

And the use of gardens — both as outdoor spaces designed to encourage meandering and exploration, and as places for planting and tending — has been shown to improve physical capabilities, skill development and social interaction while providing a restorative setting.

Christopher Day, an architect specializing in green buildings, says creating healing space involves challenges such as understanding the difference between being cured, which is purely physical, and being healed, which integrates the physical, emotional and spiritual aspects of life. Day, author of two books on the topic, Places of the Soul and Spirit & Place, explains that these challenges mean a healing environment must be explored at multiple levels, including its impact on the physical body, life energy, moods and feelings, and spirit.

Each level can affect the others, he adds, giving as an example chronic pain, a physical problem that can also cause depression and loss of energy. Also, how the senses are affected in an environment greatly affects every level, he says.

“The living world is mobile,” Day says. “Things are always changing, growing, evolving, dying, moving; forms are curved and mobile and substance transforms — like lettuce into slug or a mouse into cat food.”

So no wonder, he explains, that a day among hard, glossy-surfaced materials and in rectangular buildings and spaces with unchanging light and mechanical background noise leaves us exhausted.

“In contrast, curvilinear shapes and materials that show their living history (like wood grain), vegetation and moving water invigorate us because living movement works into our soul. An hour watching lazily curling breakers or spiraling stream currents washes stress out of us,” Day says.

Light, noise and color each affect the environment and can impact the body in ways both positive and negative. With research showing that “bursts” of sound and light disrupt sleep more than constant sound and light, the neighbor’s barking dog and motion detector light may not only be a nuisance but also may be preventing the deepest sleep that restores and renews. Disrupted sleep results in sleep deprivation and affects circadian rhythms, the body’s reaction to the cycle of day and night.

The sleep/wake cycle is driven in part by the body’s production of serotonin, a brain chemical that also plays a role in feelings of confidence, self-esteem and depression. Being awakened abruptly, or even being dragged from the deep sleep known as rapid eye movement (REM) sleep, can leave a person sleep-deprived. Numerous studies attest to the damage from sleep deprivation, including the “2005 Sleep in America” report from the National Sleep Foundation. That report noted that sleep deprivation affects mood, performance and alertness, the latter of which translates into more accidents.

In addition to their impact on restful sleep, light and sound have been well-documented as important in stress reduction and healing. One article examining the needs of critical care patients identified light and sound as the most “noxious” stimuli following surgery.

Another study, reported in the November 2006 issue of Ergonomics, examined the impact of light and color on the psychological moods of those working indoors. Almost 1,000 people took part in the study, which occurred in real work environments at different seasons and in countries at different latitudes. The researchers found that light and color influenced the workers’ mood, with their lowest mood occurring when the lighting was described as too dark and then improving when the lighting was described as just right. But the mood declined again when the light was thought to be too bright. The study, a joint effort of universities in Sweden, Saudi Arabia, England and Argentina, also found a huge variation during the course of the year in mood stability among workers, depending on their location in relation to the equator.

Workers in countries to the far north showed a significant variation in mood that did not occur in the countries to the south — a fact in part attributed to the amount of daylight coming through the windows.

Day notes that it’s also important to understand the complexities of light, such as its source, duration and intensity.

“Its physical energy powers all life — not only through photosynthesis, but also by stimulating hormone production, which invigorates life processes,” he says, adding that while intensity and duration have been much researched, the “soul effect” of light depends more on its quality in the home. He describes a room filled with daylight that is reflected off colored or textured surfaces and then “moderated” by the movement of fabric or curtains.

That sort of light has a diametrically opposite physiological effect on mood and spirit compared with unchanging fluorescent illumination, he says. But, Day points out, how a person reacts to light and what he calls a person’s “soul needs” from light are influenced by climate, culture, personal background and aspirations to dream or think clearly.

In his research on healing space, Ulrich explored the impact of a variety of sounds found in healthcare settings, writing in a 2006 issue of the medical journal The Lancet that “noise has been associated with sleep loss, fragmentation, high blood pressure and worse rates of recovery” from heart attack.

Day says the “social stressors” of sound that cannot be avoided, such as neighborhood noise, can be masked by design elements such as water, wind chimes or other peaceful sounds.

Music, long recognized for its ability to soothe, can also mask disruptive sound while eliciting other physiologic responses such as relaxation. Music therapy has been a recognized academic discipline since the early ’40s and is currently used in many hospitals to alleviate pain, and counteract apprehension and depression. It can also induce sleep.

Even aromas can impact healing space, with some hospitals using peppermint to reduce postoperative nausea and vomiting, lavender to calm dementia patients, and Citrus bergamia (Bergamot) essential oil, inhaled from a cloth, to ease agitation.

For Cooper Marcus, her colorful walls make a statement about her life.

“White on white is boredom,” she says. “Color is aliveness. I am sure designers would be horrified by my living room, but I am not going to be a slave to someone telling me what color is in this year. It is what I love that surrounds me.”

Art, a vase from a trip to China and another from Australia, and pieces of an afghan created by her mother also adorn the room where Cooper Marcus spends her leisure time. For her writing work she sits at a table in the kitchen, where she is showered with natural light and has views of her garden, or at a local coffee shop surrounded by the comings and goings of her community.

Cooper Marcus recommends that to begin designing their own healing spaces, people should first choose one room and fill it with things they love, such as mementos of times that were important or symbols of happiness and wholeness. Her own walls are covered with art that represents nature, much of it created by friends and family. Her grandmother’s hand-stitched footstool and an heirloom violin also have places of honor.

Day explains that Cooper Marcus’ “sense of place” comes from how her spirit responds to what her home says to her.

“All places, artifacts and materials speak of the values, intentions and priorities behind them,” he explains. “Subliminally, but rarely consciously, we always hear these messages. If we want something that looks good, but results from environmental despoliation or is cheaply, ‘feelinglessly’ made, it will probably look all right but can never be therapeutic. Its message will unavoidably work into us.”

Were he to design his own healing environment, Day says he would start with a strong threshold such as a bridge or garden gate, which would go to a heavy door or dark passage.

“This makes the destination protected, deliberate, special,” he says. “Most of this is about how we passively receive environmental qualities and unthinkingly respond. But there’s also a consciousness-raising aspect. Whenever we pass from room to room, we pass from one mood-space to another. Our own inner state changes accordingly.”

Day says threshold markers, especially those requiring effort from us, such as heavy doors, curving stairs or hollow-sounding bridges, make us aware of these transitions. In such ways, journeys can stimulate change of spirit-state and even bring about a more permanent inner transformation.

Once past the threshold, the room itself would be flooded with light, he says, but gently and from windows in three walls; it would be spacious, not rectangular and probably curved.

Furnishings, he says, would be mostly soft but easily cleaned. The space would feature many cascading plants, and all materials would be natural, with most things handmade.

“But this is my choice, for my circumstances,” he adds. “Obviously, no single prescription can suit all climates, building traditions, cultures and individuals.”

Choosing healing qualities isn’t hard, Day says. First, decide what the place should say to your heart (rather than the heart or minds of others). Then ask which sensory qualities — light, color, space, form, texture, sound — this implies and what objects and materials represent these qualities.

“Such a progressive incarnation process — from spirit to substance — is the surest way to create a healing environment attuned to your needs,” Day says.

Clare Cooper Marcus understands space, having researched and taught design of affordable housing and urban open space for decades. As a two-time cancer survivor, she also understands healing.

People can change, adapt or create their living space to more fully reflect their souls.