Alain de Botton’s “The Architecture of Happiness” was one of the books that first got me thinking about how buildings can physically affect us. At Yekize, we believe that the placebo effect, is not just about what you take, but also about other factors such as the doctor-patient relationship and the clinical setting – so why not take architecture into consideration as well?
Here’s what de Botton taught me about the relationship between humans and the buildings we inhabit:
“Where we are critically determines what we are able to believe in”
Where better to start in our thoughts about architecture and the placebo effect, than by looking at the relationship between architecture and belief? In this statement, de Botton suggests that our environment has an effect upon our beliefs. From my own experience, I very much believe this to be true: being amidst the ruins of an ancient acropolis makes it easier to believe that powerful nations can fall; standing in St Peter’s Basilica in the Vatican, makes it easier to believe in God; sitting comfortably at home makes it easier to believe that you’re safe. When you step out of those atmospheres, your beliefs can change and readjust. So how could we put this to use for health?
The placebo effect has long been embroiled with belief. Until recently, it was thought that for a placebo to work, you had to believe in it – although Ted Kaptchuk’s open label placebo research has largely refuted that. But it is likely that belief does have a part to play. I would hypothesise that if you’re in a hospital that you believe to be highly effective, you’ll probably recover faster than in a hospital which you believe to be totally incompetent and disorganised. But what if hospitals used architecture to communicate their effectiveness? Modern high-tech design, glass walls, order, minimalism and a clinical feel, could help to inspire confidence in the hospital as an institution, potentially having a positive impact on patients.
“We seem incapable of looking at buildings… without tying them to the historical and personal circumstances of our viewing; as a result, architectural and decorative styles become, for us, emotional souvenirs of the moments and setting in which we come across them.”
De Botton highlights how we interpret buildings through our own personal lens. That lens is based upon our unique historical and cultural perspective, but also our experiential moments of other architectural environments. Despite our individualism, there is a visual language of architecture that resonates with others with a shared cultural background, although the memories that punctuate that architectural language are different for all of us. For example, if you were standing in a vast open hall with high ceilings and large windows, you may feel it is cathedral-like, even if it is not a cathedral. If you have visited a number of cathedrals, you may even feel it evokes a particular cathedral and a particular time period. With this in mind, I’d like to consider what a healing space would look like.
Within our lives there are a number of places that may embody healing qualities. Clinical environments are perhaps the most obvious, but what about spas or religious spaces? If we try to identify what makes an environment clinical, we may say that it is:
- White (or pale green)
These clinical cues may help to encourage the healing process, as they adhere to our expectations of a healing environment. If we expected to be recovering in a clinical space, but found ourselves instead in a small, dark room where everything was different shades of brown, our expectations would not have been met and we may begin to doubt the efficacy of the hospital.
So what about elements of other healing spaces? Spas and religious places are often:
- Large windows
- Softly lit with natural light
- Large open spaces
- Ordered design
- Neutral colours
What if we could incorporate these other elements into hospital design? What if we could have wards that looked clinical, but also embodied the peace and tranquility of a spa? There’s a reason people go to spas – it makes them feel better. In a hospital, wouldn’t it be great to have an architecture that also helps you to feel better?
“We like order in buildings because it gives us a place to rest our minds”
As we mentioned above, many healing spaces have quite ordered appearances, whether it’s the rhythmic columns in a cathedral or temple or the evenly spaces beds and uncluttered interiors of a spa. A common theme in de Botton’s book is how we are drawn to buildings that embody qualities we need. He summarises this in the following quote: “we value certain buildings for their ability to rebalance our misshapen natures and encourage emotions which our predominant commitments force us to sacrifice.”
Modern life is a busy place and it can be hard to switch off, so it’s no surprise that we are drawn to these places of order and calm. But these features are so often absent in clinical environments. When we imagine a hospital, we may picture nurses and doctors frantically running between patients, dodging gurneys as they’re pushed down the corridor and alarms going off every few seconds creating a tide of illness which the staff are constantly trying to get under control. That perception may well be exacerbated by too many medical dramas, but even in reality, hospitals are not peaceful environments by any stretch of the imagination. But what if they were?
The Victorian era saw the construction of a huge number of large-scale hospital buildings. Whilst the internal corridors may have been rather cramped and serpentine at times, they often embraced order in the rest of their architecture:
- Columns or arches on the facades.
- Windows evenly spaced along a ward.
- A door in the centre of the wall, leading in a straight line to the nurses station, with beds flanking both sides.
Hospitals in this time were run in an almost militaristic style, so it’s no wonder that order featured so prevalently, but order is something not often found in the architecture of modern hospitals. From the outside, they may have rows and rows of windows evenly spaces, but from a patients perspective, in their isolated room, they only see one and the effects of the order is lost. But maybe it’s time we brought back some order into hospital design, to “give us a place to rest our minds” whilst our bodies recover.
“It is in dialogue with pain that many beautiful things acquire their value.”
It has long been said that “youth is wasted on the young” or “you don’t know what you’ve got until you’ve lost it”. These ideas summarise that in order to understand a concept, you must understand its opposite. For example, could you ever truly appreciate happiness without ever knowing sadness? or could you understand the value of health, without having experienced illness? In “The Architecture of Happiness” De Botton suggests that our relationship with great architecture is often bittersweet, because the contrast between the ideals embodied by architecture highlight that those ideas are seldom found elsewhere. The more we are acquainted with disorder, the more calm and order appeal to us.
When we are ill, hospitalised or in need of healing, we are often “in dialogue with pain”, be it emotional or physical. In this state, we are uniquely susceptible to the environments we are in. We are receptive to the influence of our environment. I think this is something that many hospital architects under appreciate.
Many of us will have experience of standing in a beautiful space and how that affects us. The human connection with beautiful spaces is so strong that the visualisation of such spaces is a common tool in trauma therapy, to help the victim recover. I suspect that if hospital architecture were able to engage with our emotions and to engender feelings of happiness, calm, peace and wellbeing, that health outcomes may well improve. After all, research has shown that these positive emotions can help the healing process, but architecture has not yet been examined for its value as a stimulus.
You may have guessed that I absolutely love de Botton’s “The Architecture of Happiness” – I find it incredibly thought provoking and I’d recommend it to anyone interested in architecture, psychology, health or happiness. De Botton writes like a poet, in a very beautiful way. One of my absolute favourite sections is when he describes his experience of Westminster Cathedral, London. The book is worth buying just for that. I wrote this piece in direct response to the book, there’s very little firm scientific basis to anything I’ve said in this article, but it is informed by my own knowledge and experience. If you have anything to add, please do comment on this post and start a dialogue – I’m always happy to learn what others think about the subject.
I could have gone on writing forever, but as this article was already getting pretty long, I decided to include the rest of my favourite quotes from “The Architecture of Happiness” below – enjoy!
- “It seems reasonable to suppose that people will possess some of the qualities of the buildings they are drawn to”
- “When we speak of being ‘moved’ by a building, we allude to a bittersweet feeling of contrast between the noble qualities written into a structure and the sadder wider reality within which we know them to exist”
- “Acquaintance with grief turns out to be one of the more unusual prerequisites of architectural appreciation”
- “John Ruskin proposed that we seek two things of our buildings. We want them to shelter us. And we want them to speak to us – to speak to us of whatever we find important and need to be reminded of”
- “We honour these works for revealing to us who we are, rather than who we would like to be”
- “Why are we vulnerable, so inconveniently vulnerable, to what the spaces we inhabit are saying?”
- “We value certain buildings for their ability to rebalance our misshapen natures and encourage emotions which our predominant commitments force us to sacrifice”
- “It is perhaps when our lives are at their most problematic that we are likely to be most receptive to beautiful things”
- “Beauty lies between the extremities of order and complexity. Just as we cannot appreciate the attractions of safety without a background impression of danger, so too, it is only in a building which flirts with confusion that we can apprehend the scale or our debt to our ordering capabilities”
- Beautiful architecture satisfies “needs we never consciously knew we even had”.