This subject is the fruit of observations which I could make during my six years of study at the National school of Architecture of Rabat, and my exchange year at the Polytechnic University of Valencia, in Spain. It is through my various travels and observations that I realized the importance of Space in Architecture, and the impact of this space on our everyday’s lives. The sensibly to the space may vary from a person to another.
As an Architects and space builders, we must be conscious of the importance of the hidden dimensions of an architectural design, that goes beyond the aesthetic dimension and the financial one. Thus, we must project ourselves in every user in order to discover the senses touched by the space and to propose best than we can a confortable and pleasant place of life.
Architecture is a multidisciplinary science that may concern every field and science. Considering that the persons the most affected by a spatial dimension are the mentally ill persons, I chose to work on psychiatric healthcare facilities, which suffers from an apparent discomfort. Considering that Architecture could take part in the therapy of the patients, how far can we take part in this Therapy?
We can clearly notice that Morocco is trying to improve its hospital equipments by adapting them to the current changes and constraints. The psychiatric institutes are not concerned by those improvement, and are treated as any other healthcare equipment. It is the time to be aware of the importance of taking care of our patients with mental disabilities, and to improve their spaces of therapy, which can significantly help them improve their mental state and reduce the duration of therapy and stay.
The psychiatric hospital is now considered as an isolation place where one can hide people reached of madnesses. These person must endure the consequences of a system that separates and isolates ill persons while classifying them by diseases or degree of agitation.
A marginalized persons that do not find other refuges but being interned in a psychiatric hospital. An ideal scene where the patients can express their madnesses without worrying about the jugements of a society without pity, a society that could probably be the main cause of these disorders and the reason for which the patients are interned.
Architecture could be a way of releasing the patients from their isolation and make them feel in a confortable place of life. This could be used is adaptation and therapy, and may help them to get rid of their disorders with less suffering .
The architect must be able to understand the psychology of the patient in order to propose an adequate space of therapy . This leads us today to deepen our researches on the use of space in the cure for the mentally ill patients.
The exchanges between psychiatrists and architects were a long time established. To succeed on the process of creation of psychiatric spaces, many specialists should participate in this act of creation. Ferrus states that “The construction of a lunatic asylum must be less the work of an architect that the realization of the principles of mental medicine”
This work concerns emotional architecture for the treatment of the psychiatric diseases. Architecture has an impact on the user through an interaction of the users with built environment. This interaction takes more importance in the field of psychiatry considering the sensitivity developed by the users with mental disorders.
This work is an architectural answer to problems of insertion of the mentally ills in a decent healthcare facility.
In order to guide my reflection, it was important to investigate into the environmental factors of psychiatric space. The question of space perception of the patients was an important element to explore the subject. It is important to understand what the patients feel and live to be able to propose alternatives to the current situations.
Indeed, the people reached of mental illness require a particular architectural environment to contribute to their wellness and have an effective therapy. We have accepted to take up this worthy challenge and try to understand the complexity of this architecture.
Lastly, my research enabled me to determine the needs for the patients and to better understand their insertion within psychiatric hospital space.
Questioning and progress achieved
In order to succeed and have effective results, it is important to raise the good questions. In this research paper, the questioning will be interested in the real need for improving the mental health through architecture, by analyzing interior and external spaces and by putting the light on the impact of scenography and psychology of space on the attitude of the patients.
What is the madness?
How does the people reached of mental disorders perceive the architectural space?
How could architecture release the patients from their isolation?
Does a therapeutic dimension of architecture exist?
How could one create a hospital space which would offer to its users, through the taking into account of the body, a possibility of appropriation?
In order to answer our questions, we chose in this work for deductive approach, which will enable us to carry out the analysis of each elements of the subject to succeed finally has effective solutions. It thus acts, in the first time, to approach more general topics concerning the scenography and the psychology of space, which will help us on better understanding the space that we try to improve in this research.
Thereafter, we will be delayed on the studies of spaces of psychiatry, or places of madnesses with an aim of releasing all the anomalies and the constraints which generate discomfort and frustration among patients. This analysis will comprise various typologies of mental illness which would require a special attention as well as a particular architectural and space treatment.
In order to support this analysis, we will work in-situ and analyze a psychiatric hospital in the city of Salé in Morocco : hospital Ar – Razi. Thus, and while approaching more of the patients, their families, as well as medical staff, we will have a clear image on the actual situation in order the improve it. The close cooperation of the architect with psychiatrists and psychologists of space remains necessary in order to lead to concrete results in the improvement of spaces of care for the mental illness.
4- Theoretical definitions
We find an ambiguity between madness and mental illness, indeed, unquestionable manifestation of the madness can be regarded in other circumstances as normal actions of mentally healthy people. This pushes us to explain this ambiguity in order to reveal the leading causes of dysfunctions and to suggest an adequate architectural solution.
Encyclopaedia Universalis: “The term of madness, quite former to the institution of the scientific language of modern psychiatry, never had really course in this one. This relative incompatibility has a very great meaning. The idea to compare the madness to a disease, to want costs which costs that it is similar in its principle to the other diseases, in spite of differences which remain irreconcilable towards and against all, this idea, though extremely old, never could impose itself absolutely. Even the decisive influence that the scientific thought exerts on the Occidental culture could manage to operate this complete assimilation. The concept of mental illness thus does not recover purely and simply that of madness.”
According to Larousse, scenography is defined like the art of like art to represent and design scenic decorations.
Thus, scenography, as a discipline of space is unquestionably connected to architecture and represents a paramount element in the space design. An architecture which integrates scenography in its parameters is often an architecture who adapts to the user’s need and who seeks at the same time to transmit a particular idea.
The psychology of space
One cannot think architecture without thinking of the space which we conceive, as well as the emotions that released these spaces can.
Extremely fortunately, a negligible part of the architects is conscious of important space in the process Architectural design.
II- Scenography and Space psychology
1- Psychological impact
Le Corbusier described this concept in his work architecture of Today “architecture is judged by the eyes which see, by the head which turns, by the legs which go. Architecture is not a phenomenon synchronic, but successive, fact of shows being added the ones to the others and being followed in time and space, like besides the fact the music.”
Thus, through the discovery of space through the directions, this sum of money could get comfort and wellness to him, or then a feeling of seclusion and discomfort. Several elements return in consideration for the determination of the emotions which space could reflect has its users like the light, the form or then matter.
The visual factor
It is through our eyes that perceiving us the external world, a space which surrounds us and transmits several information at the same time to us. In fact the first direction enables us to transmit to the brain an image environment which surrounds us. We interpret then this image and approve feelings through this space observed. We feel through our eyes of the positive or negative impressions which impact our mood and behaviors.
The scientists estimate that 40% of the sensory impressions of the brain come from the direction of the sight. Space is interpreter by our directions. This enables us to make an assessment what surrounds us.
The sound factor
To optimize the sound factor in a space and to take account its significant role in the wellness of a person.
Thus, it is of our duty to propose an adequate sound environment with each use of space.
At the time of a sensory architectural design, the wellness and the comfort of the user are a major stake and must take into account all the factors sensitive which act on space.,
The olfactive factor
The odor lives the space which we practice. In order to control the environments architectural in a space, it is necessary to control environments and the lived sensitive one very as much as the functional and aesthetic aspect. The sense of smell makes party of the parameter sensitive in the process sensorial of the design. In the daily experiment of the places, the man tends has to go towards the good odor which gets happiness and serenity thereafter to him. Several experiments testify some.
The envelope of the building is the means of registering the building in its environment and its time. The architect then chooses to make his work accessible and communicative, reflecting his function and his use through a well defined bias, or then to remain in the negation and the refusal, and thus to keep its use interns a mystery discovered as the discovery of interior architectural space. It is the impression which the Architect chooses to give of his Architecture. An image transmitting a particular message of the Architectural work, which plays a part defined in the space choreography of the life.
The envelope plays the part of protection.
“One can say that architecture is the considered manufacturing of spaces. It is the filling of surfaces given by the customer. It is the creation of spaces which evoke the feeling of suitable use. For the musician, the partition is to see what he hears. The plan of a building should be read like a harmony of spaces in the light.”
THE TANGIBILITY OF INTANGIBLE – MATERIALIZATION OF TIME are The effect more searched in the Pantheon of Rome, generated by the oculus, making it possible the ray of the sun to penetrate inside the building while assembling the evolutions of the structure constantly of the light and the color. The light thus enables us to feel the sacredness of the places and to materialize time in a divine space. “Architecture … is one of the kinds which was created to express by oneself and in oneself a whole cycle of emotions of which most intense will come from the mathematical radiation (proportions) in which the plastic game is symphonic (volumes, colors, matters, light).”
Charles Moore and Gerald Allen underline the fact that: “In general, a building whose forms have a direction for the man us will be more sensitive than a building which would try to remain in keeping with dimensions of the body. The first represents what we understand by “human scale”.
To use the expression “a direction for the man “is thus not pain-killer because referring to a quality of space based on interpretation, individual or collective, and on the emotion, which is opposed then almost to a normalized evaluation of the medium.”
III- Psychiatric Architecture
1- Psychiatric asylums and hospitals
The 19th century marked by the creation of psychiatric asylums the purpose of which are to treat the people reached of mental disorders and confusions and their “to return the reason”. It has this moment there or the Mental illness term was recognized by medicine.
In 1853, following several travel throughout the world, Parchappe published a work which marks the history of psychiatry. This work comprises 19 plans of asylums of the United States and Europe. Asylums psychiatrise of found apart from the cities. The Parisian Architect in the beginnings Florentine Donato severo insists on the return towards nature (J. – J. Rousseau). He speaks in his work “urban Health and psychiatry. Thresholds, porosity, hybridization, fusion” to neutralize the effects socially destabilizing of the industrial town.
Emil Kraepelin, psychiatrist German who is regarded today as the founder of modern psychiatry, created in 1896 a system of identification and classification of the mental disorders which became thereafter a base of study of modern psychiatry.
2- Mental disorders
In order to take part in the process of cure of patients, it is initially necessary to know the causes of these anomalies for then taking part in the reduction or the elimination of these elements releases.
The issue covered of insane, an absurd being and without reason could suffer from disturbances without to be reached of a mental illness. It is because the other regard that a person is abnormal and insane that it is it really. The insane one, not being conscious of its own madness, cannot understand its doubts safe in the presence of the other.
In effects, there exist several factors responsible for mental illness.
On a medical dimension, we may talk about continuum, successions of events which engages the disease through cumulation. On a social and realistic dimension, the mental illness can result from a stress generated by the advanced rhythm of life, by a city which never stops and which its rhythm could deteriorate the perception of the individual. A city deteriorated by all kinds of noise and pollution. Not having spaces of escape and relaxation, cumulates it these factors can cause many kinds of illness as the depression which becomes more widespread of our times.
“What guarantees the healthy man against is delirious or the hallucination, it is not its criticism, it is the structure of its space. ” phenomenology of perception
Space is only because we perceive it. In the case of a mental illness, space is perceived differently. Mental pathology influences the perception of space directly. This space could be disturbed and unstable according to the degrees and the type of the mental illness.
Indeed, we perceive our existence in a space through the image that we do ourselves us same. Antoine Porot, French psychiatrist, confirms this theory. According to him, it is “the image which we have of our own body, total or segmentary image, in a static state or a dynamic state, the report of its constituent parts enter they and especially its reports to space and the objects which surround us. ”
However, our report with this space can differ from an individual to another with causes of the certain mental health disorders. Schizonphfrania, anxiety, agorafobia, dements, each disorder has its own effects and impacts of the perception of the space. We will detail those illnesses in further parts of this thesis.
3- The madness in the Arts
The concept of madness for the artists is complex and pushes us has to put the following question: Is the madness essential for imagination and artistic creation?
According to several studies, artists and the creators are more likely to suffer from mental illness. It incontestably puts the link between the creativity and the madness. Indeed, according to a study made by Dr. Simon Kyaga of the Swedish Institute Karolinska in a study published in September 2012 in the Newspaper of Psychiatric Research, a study that tries to find the link between the mental creativity and disorders, it has been discovered that the artists are more likely to suffer from mental troubles than the other people who use less their creativity.
It quotes: “Except the bipolar disorder, the people with total creative professions were not to suffer from the studied psychiatric disorders only of controls. However, being an author was specifically associated with the greatest probability of schizophrenia, the bipolar disorder, the unipolar depression, the disorders of anxiety, drug-addiction, and the suicide. Moreover, we found an association between the creative professions and the relatives of the first degree of the patients with schizophrenia, turbid bipolar, anorexia nervosa, and for siblings of the patients presenting the autism.”
Several painters show this relation said above. The disorders are related to the hyper-creativity and their mental activities which generally are out of the ordinary.
This cinematography masterpiece Shutter island is the perfect illusion of the madness. He takes again all the attempts of refusal and refusal of reality, and a refuge in one erroneous present which makes it possible to flee reality to be able to continue has to live while giving up the atrocity of the life and our acts.
The last counterpart of interpreter the actor Leonardo Di Caprio shows this refusal clearly. He says has his attending physician after being cured of his pathology: “What is there the worst for you? To live in monster or to die as a man of property?”
This clearly shows the strong will to give up the unhappiness and the misery of its acts and to undergo the consequences while being regarded as a man without reason, a man of property. Another movie that illustrates the madness of the patient in psychiatric hospital is « One Flew Over the Cuckoo’s Nest » of Miloš Forman. This work describes the daily sufferance of the internist of a psychiatric asylum. Based on actual facts, this movie clearly shows the petrifying situation that have to endure the patients without any power to take a reasonability or to decide for themselves. The main actor does not stop infringing the instructions of silence. He refuses to be subjected to a mode and an internal regulation which deprives the internees of any kind of freedom. Mc Murfy is a rebel of the unpleasant situation within a morose and oppressing space.
Psychiatry in Morocco
Psychiatry in Morocco had been relying on traditional therapies which makes it difficult to convince the ill persons and their families of the importance of a psychiatric Hospital. Il fact, it is believed that traditional therapeutists are able to provide effective care on persons with disorders. The same cultural believes are shared among a large side of the population. The treatments offered instead of the medicine are Coranique recitations or some kinds of exorcism that help the person to get back to a « normal » state of mind.
Many institutions that offer this kind of « treatment » has been closed. The mausoleum of Bouya Omar, a place for traditional therapy that had 822 internees living in inhuman conditions was close in 2015 and replaced by a new Psychiatric hospital in the region that offers medical and scientific therapies.
The hospital Ar-Razi, created in 1963, is going to be our field of study with an in-situ analyze. This institution plays a significant role in Moroccan medical care. It has introduced new psychiatric specialities beside the classical psychiatry.
“If psychiatry attempts to repair the defect of link between the patient and his environment, it can be based on architecture, by regarding it as a means which allows, patiently, of giving again with people who suffer a positive image from their body and their presence in the world. To build for the man who suffers from a mental illness constitutes a splendid proof of recognition.”
According to a study made at the University of Alberta, Health Science centers, Edmonton, Alberta, Canada, the duration of stay and of therapy of the patients who present depressive disorders, in sunny rooms on average 16.9 days was compared with 19.5 for the patients which were in less luminous and badly directed rooms, that is to say a difference of 2.6 days or 15% of duration. This says some much on the importance of the natural light in the process of wellness and cure of the patients and their mental health status.
Several Architects worked on a space adapted for the patients reaches of a mental disorder. Nicole SONOLET, architect, focusses on “the means of making safe the patient, of stimulating perception and of supporting the communication”: “The clearness of the forms and spaces, their diversification, must make it possible to identify them: some private, calm, withdrawn, hot, comfortable; others open, broad, luminous, brilliant, noisy. Contact with materials hard, soft, rough, smooth, with round, enveloping, angular forms; choked odors, silence or noises, resonances; sights of forms, matters, openings; lightings, clock with needles which turn. All the physical characteristics and their combinations must stimulate perception and support memorizing: repetitions, redundancies, micro events.”
“The patient must be able to adapt space gradually: To look at, mark, explore, remember. By the window or the door, of a bed, one can see a tree, a dog, a bird, a person. Of a hall, of a waiting room, one can see or to cross races which enter, leave, pass; by entrebâillement of a door, to see a doctor who will look after you. One can listen, see by far, to pass in front of, without risk.”
“The world must be able to widen without rupture and fear: sleep with the alarm clock; loneliness towards the group; calm towards the noise, respiratory movement, easy return ticket of the room towards a small stay from where one can return or throw a glance towards a larger stay, to risk itself there and from there towards another space. It must always be possible to retrogress or fork, to stop or continue.”
Psychiatric spaces of care evolved through the history while creating a new definition of the therapy. Architecture is a very important means which takes part has the cure of the patients.
The field of psychiatry is in quick change. Unfortunately, the establishments of care do not follow this evolution and becomes increasingly unsuited.
In order to lead to a successful adaptation of the environment, it is important to apply certain principles of wellness of the person.
Architecture and Psychiatry (Editions the Monitor, 2004)
Hidden dimension – Edward T. Hall
it concern of the other of Marie de Hennezel
– Tea troubled relationship between architecture and aesthetic: exploring the coil and emotional beauty in design –
– Emotional Structures Scenographic studies in the works of Barragan (1940-1980) – Nicolas Gilsoul
– Towards an Architecture – Le Corbusier
– Jean-Charles PASCAL: “Architecture and theories of the care in psychiatry”. The Monitor, January 2004.
Report on psychology and structures by W. Bro. Victor G. Popow, December 2000.
Psychiatry in Morocco. History, difficulties and challenges – Fatima-Zahra Sekkat