#11 Designing the psychoanalytic consulting room (Part One)
My new office // "Wellness" spaces
Hello friends,
In a very slow and drawn out journey through adamant refusal, tentative fantasy, and administrative purgatory into actual reality, I recently acquired the space next door to my current consulting rooms. We’re a few weeks out from a good old-fashioned sledge hammer through the wall and the creation of a bigger space including four consulting rooms in total. All very exciting and harrowing.
In anticipation of creating a new office for myself and others, I have been deeply preoccupied with the question of therapeutic spaces, specifically, the psychoanalytic consulting room. I also had the opportunity at the start of the month to present some of these ideas at POPIG (the Psychoanalytically Oriented Psychology Interest Group of the APS) and have a really cool conversation with some colleagues about how our spaces impact our work.
All therapists do their work somewhere, and the specific nature of that ‘somewhere’ forms a central part of the vessel for each treatment, as well as holding the therapist themselves through the highs and lows of their work. Over the next little while, I’m going to share a few of the thoughts I’ve gathered about this, hopefully alongside the creation of my own new psychoanalytic consulting room.
“Wellness” Spaces
Most literature about therapy spaces - both in psychology and design-related fields like architecture and interior design - focusses on creating environments that cultivate “wellness” and patient comfort. The following suggestions have made their way into the zeitgeist as accepted means to achieve this:
Utilising natural elements (like indoor plants), and natural finishes like wood, which are documented to be associated with better mental health. Although, too much wood - reportedly more than 45% - starts to have the opposite effect (for some reason I found this piece of data extremely funny);
Enough personalisation to make the therapist seem human, likeable and trustworthy, but not so much as to be intrusive;
The therapist should hang their qualification certificates to invite trust and a sense of legitimacy;
Furniture should reflect equality between patient and therapist, particularly in terms of quality and the height of chairs;
Incorporation of soothing elements - soft furnishings, colours like dusty blue and sage green, “positive distractions” like books, landscapes, fish tanks for patients to look at in moments of overwhelm;
Soft, orderly, not too shabby or too fancy;
Have ample natural light as well as adjustable lighting - dimmable bulbs and lamps;
Cultivate a sense of privacy, both in rooms themselves but also entrances and exits;
No “potential triggers” like artwork depicting sadness or trauma, or neglected elements like broken furniture, dysfunctional waiting areas or too much clutter.
While some of these suggestions seem intuitive and useful, many reflect specific assumptions about what therapy is and how it works. Specifically, they paint a picture of a spa-like environment, implying a therapeutic style organised around keeping the patient calm, happy, not too activated and, perhaps, compliant.
Form and Function
Ideally, the design of a psychoanalytic consulting room, as with any space, should be informed by its function. In reality, psychoanalysis has therapeutic goals that have very little to do with the contemporary notion of wellness. Our offices should not feel like a spa because our patients are not pursuing a kind of generic sense of serenity. They are seeking a greater truth, an honest way in which they can be deeply embedded in the real world as who they really are. When we are doing our jobs well, we invite regression, the reactivation of repressed, denied or hidden states and the mess that comes with the reemergence of these shadow elements.
Consequently, we need spaces that can hold mess, spaces that acknowledge the past, spaces that value truth, that value story, that invite investigation. Our consulting rooms must be welcoming, and provide wellbeing. But they must also be guardians over unfolding mysterious, relational and spiritual alchemical process between the therapist and each patient. They must hold the past, acknowledge the present, and leave room for a new future.
What might such a space look like, you might ask? I believe the answer requires consideration not only of the goals of therapy itself, but also of the identity and preferences of each therapist, how they secure comfort and safety, how visible or hidden they wish to be or believe they should be, and their own nuanced beliefs about what they offer to others.
I’m confident it probably isn’t as simple as a plant and a sage green wall.
More soon - stay tuned/subscribed for next time if you want to talk about Freud’s consulting room (how could we not?) and the impact of different elements of spaces on patients and therapists.
In love, and the pursuit of a shared path to a greater truth,
Kate