Restorative Environments, Returning Combat Veterans, and PTSD
Lindy McAra Spring 2012 Thesis M.Arch with an Emphasis on Interior Architecture
Contents
Proposal Research- PTSD Site Selection Research- Precedents Spatial Studies Rendered Drawings Rendered Spaces Bibliography Exhibition
Spatiality study models
Restorative Environments, Returning Combat Veterans, & PTSD
Proposal
“You teach a man to kill, but you can’t teach a man to die or to see death and dying.” -Cpl. Chris Duggan, British Army,Vietnam Veteran In the early twentieth century, biophilic design, design based on human’s innate connection to living systems, was used in sanatoriums through the integration of sun, water, air, and nature to help cure disease. Since then, healthcare architecture has become more and more functional and standardized in support of a clinical system whose goal is to treat symptoms. Although architecture plays an important role in public health care policy, it actually should be seen as supporting a more integrated and holistic approach to health and well-being. In designing an environment for returning veterans with PTSD, post-traumatic stress disorder, my approach propositions the creation of significant and meaningful relationships among people, therapy, service animals, and the environment. Users need to be able to preserve personal relationships, communicate freely and openly, be informed and aware of opportunities, and utilize the aid of therapy and service dogs. Architecture will not heal their PTSD, but biophilic design, spatial awareness, and design for therapy animals can create a restorative environment to promote relaxation and selective thinking while assimilating to civilian life. To this end, the relationships between architecture, landscape, microclimatic conditions, and material enables the potential of less functionally programmed spaces that contribute to the healing process. Quotation Source: Gould, The Guardian
Restorative Environments, Returning Combat Veterans, & PTSD
Research- PTSD
Post-traumatic stress disorder (PTSD) The person has been exposed to a traumatic event in which: - The person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others & the person’s response involved intense fear, helplessness, or horror
Common trauma experiences in OEF/OIF (Operation Enduring Freedom/Operation Iraqi Freedom) - Having a friend who was seriously wounded or killed - Seeing dead of seriously injured non-combatants - Witnessing an accident resulting in serious death or injury
- The traumatic event is persistently re-experienced
- Smelling decomposing bodies
- The person often avoids of stimuli associated with the trauma and numbing of general responsiveness
- Being physically moved or knocked over by an explosion
- The person exhibits symptoms of increased arousal
Common triggers of PTSD reaction in veterans - Loud, sudden noises
- The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning Source: A.P.A., DSM-IV.
Source: Jaycox & Tanielian, “Invisible Wounds of War.”
- Startling visual stimuli - Debris - Large crowded spaces
Source: Jaycox & Tanielian, “Invisible Wounds of War.”
Restorative Environments, Returning Combat Veterans, & PTSD
Research- PTSD & OEF/OIF
PTSD occurrence in veterans from Operation Iraqi Freedom and Operation Enduring Freedom
Reasons for not seeking treatment Personal thoughts - Medication might have too many side effects - My family or friends would be more helpful than a mental health professional - I would think less of myself if I couldn’t handle it on my own - Religious counseling would be more helpful than mental health treatment - Even good mental healthcare isn’t very effective Institutional or cultural beliefs - It would harm my career - I could get denied a security clearance in the future - My co-workers would have less confidence in me if they found out - I don’t think my treatment would be kept confidential - My commander or supervisor might respect me less
~1.64 million veterans have served since Oct. 2001
~15% report having PTSD =10,000 Veterans
Source: US National Library of Medicine, “Post Traumatic Stress Disorder.”
Logistical reasons - It would be difficult to get childcare or time off work - Mental healthcare would cost too much money - It would be hard to schedule an appointment - I wouldn’t know where to get help or who to see - It would be hard to arrange transportation to treatment Source: Jaycox & Tanielian, “Invisible Wounds of War.”
Restorative Environments, Returning Combat Veterans, & PTSD
Research- PTSD & Service Dogs
PTSD Owner- Service dog Relationship Owner’s State
Service Dogs’s Action
Feels anxiety
Tactile stimulation
Feels isolated
Makes owner aware of their presence
Hypervigilant
Alerts to the presence of others
Fear Rumination, avoidance Nightmares
Turns on lights, safety checks Focuses, stays with handler Interrupts, turns on lights to calm and reorient, turns off lights to resume sleep Source: Alaska Assistance Dogs,“PTSD.”
Photographer Craig F. Walker documents OIF Veteran Brian Scott Ostrom and his challenges with PTSD before and after having his service dog, Jibby. Source: Walker, “Welcome Home.”
Restorative Environments, Returning Combat Veterans, & PTSD
Research- PTSD & Biophilia
Biophilia “A complex of weak genetic tendencies to value nature that are instrumental in human physical, material, emotional, intellectual, and moral well-being.” Source: Kellert, Building for Life.
Restorative environment Environments that “help improve one’s capacity for concentration and promote selective thinking after the brain has been depleted by stressful activities.” Source: Zardini, Borasi, Campbell, Imperfect Health.
Recovery gallery, Clairvivre Sanatorium, Dordogne, France, 1937 Source: Zardini, Borasi, Campbell, Imperfect Health.
Sensory responses to nature Natural light - Rhythmical living life, patterns, sparkle - Changes direction, intensity - Re-directs our attention, relieves stress and mental fatigue - Different heights of entering - Directional Natural ventilation - Movement of air - Changes in air temperature - Scents Open and moving water - Visual, acoustic, symbolic - Evocative universally shared symbol of life - Source of survival, aesthetic, recreation Source: Stewart-Pollack,“Biophilic Design.”
Restorative Environments, Returning Combat Veterans, & PTSD
Research- Current Treatment Outlook
Present
Everyday life
Military service
Life without support
Military service
Re-adjustment with support
Proposed
Everyday life
Life with support
Restorative Environments, Returning Combat Veterans, & PTSD
Site Selection
E 55th
S Lakeshore Drive
S Everett
S Shore Drive
Promontory Point Park
Lake Michigan Chicago, IL E 56th
E 57th
55th & S Shore Drive, Hyde Park N Site: 332,000sf
Restorative Environments, Returning Combat Veterans, & PTSD
Site Selection- Qualifiers
Site Analysis (.3 sq. mi)
Determined Priorities
Site
Nature & landscapes Quiet neighborhood Easy transit Hospital nearby Community buildings Nature
Community buildings
Quiet neighborhood
Transit
Hospital (1.7mi away) Source: maps.google.com
Restorative Environments, Returning Combat Veterans, & PTSD
Maggie’s Centres Founded by Maggie and Charles Jencks, Maggie’s Centres are non-profit caring centers that empower people who have or have been affected by cancer by bringing together professionals, communities, and building design. “Architecture acknowledges their plight and affirms their worth, a recognition rare in a culture where cancer is usually hidden.” -Charles Jencks
OMA
Zaha Hadid
Page & Park
Rogers Stirk Harbour
Frank Gehry
Page & Park
Richard Murphy
Frank Gehry
Research- Precedents & Maggie’s Centres
Form
Circulation
Programming
Source: Jencks & Heathcote, Architecture of Hope
Site & Landscape
Comparison of Maggie’s Centres’ buildings Source: Jencks & Heathcote, Architecture of Hope.
Restorative Environments, Returning Combat Veterans, & PTSD
Research- Precedents & Space
Bringing outside in
Site awareness
Rogers Stirk Harbour Maggie’s Centre Calm spatial qualities
Gathering spaces
Frank Gehry Maggie’s Centre Framing views & wood paneling
Hiroyuki Tanaka Architects High-rise residence
Steven Holl Knut Hamsun Center
Rogers Stirk Harbour Maggie’s Centre Spatial layering & awareness
Sanaa Theater Almere
Restorative Environments, Returning Combat Veterans, & PTSD
Spatial Studies- Diagrams
Restorative Environment
Veterans
Spatial layering
Security & comfort
Place of being
Limited level change
PTSD
Clear sightlines
Open plan
Humanist scale
Biophilic
Comfortable isolation
Easily accessible for service animals
Restorative Environments, Returning Combat Veterans, & PTSD
Spatial Studies- Proposed Programming
Spaces
Approx. sf
Spatiality Goals
Private 1on1 Counseling (3 rooms at 140sf) Family Counseling (2 rooms at 160sf) Group Counseling Lounge Lofts (5 rooms at ~180sf)
Private, serene Private, area for children Secure, sociable Comfortable Safe, peaceful, refuge
720 320 240 230 900
Public Dog run/cleaning/play Art Room Music Room Multi-Sensory Room
Functional, different scale Bright, ownership Acoustically sound, ownership High level stimulation of senses
1160 160 130 220
Private-Public Entry Gallery Kitchen & Dining Indoor Gathering Outdoor Gathering Green Roof Entertainment Classroom Offices
Transparent, welcoming Adaptable, welcoming Bright, sociable Comfortable, multi-functional Adaptful, ownership Serene Comfortable Adaptable, bright Ownership, adaptable
150 400 420 4100 2120 2770 340 330 280 Total: 15,000sf
Restorative Environments, Returning Combat Veterans, & PTSD
Spatial Studies- Spatiality Exploration Subjective study of spatial reaction Wall angle
Opaque walls
Wall texture
Ceiling angle
Circumference
Spatial relativity
Volume
Restorative Environments, Returning Combat Veterans, & PTSD
Spatial Studies- Spatiality Exploration
How to strategically define spaces for purposeful reaction
Warm
Secure
Comforting
Serene/Passive
Sleeping
1 on 1 counseling
Family counseling
Group counseling
Contemplation
Exercising
Cooking
Playing
Learning
Conversing
Remembering
Activated Relaxing
Spatiality Reaction
Isolated
Activity
Restorative Environments, Returning Combat Veterans, & PTSD
Spatial Studies- Programming Analysis
Programming Goals
Programming Spatiality Comparison Activated/loud Multi-sensory
Music room
Privacy (Re-connection)
Entertainment Kitchen Dining
Indoor gathering
Classroom
Art room Offices
Isolation 1on1 counseling
Camaraderie Gallery Outdoor gathering
Camaraderie (Maintaining connection)
Space for dogs Family counseling
Green roof
Purpose (Re-connection)
Group counseling
Entry
Stability (Re-connection)
Lofts
Lounge Serene/quiet
Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Drawings
Birds-eye view N Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Drawings- Plans
classroom 300sf
memorial gallery 400sf
entertainment 340sf
kitchen 420sf
outdoor gathering 2120sf
office 280sf courtyard 1120sf
dog run 670sf
gathering 4100sf
dog cleaning 220sf dog play 270sf counseling 160sf counseling 140sf counseling 140sf
wc 240sf
group counseling 240sf waiting area 70sf
counseling 140sf counseling 160sf
Level 1
N Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Drawings- Plans
green roof 2770sf
music room 160sf art room 140sf gathering 2900sf Lounge 230sf
wc 240sf
loft 200sf loft 170sf
multi-sensory room 220sf
loft 170sf loft 170sf
loft 200sf
Level 2
N Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Drawings- Sections
A
B
A
B
C
A B
C
C Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Drawings- Sections
1
2
1
1 2 3
2
3
3 Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Spaces
Public Entrance Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Spaces
Indoor gathering featuring seating, atrium, and dog care
Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Spaces
Open programing featuring green roof, technology area, and lounge
Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Spaces
Outdoor gathering featuring productive garden and dog run
Restorative Environments, Returning Combat Veterans, & PTSD
Rendered Spaces
Counseling rooms with dog accessible doors and glass flooring covering water Restorative Environments, Returning Combat Veterans, & PTSD
Bibliography Alaska Assistance Dogs. "PTSD." Alaska Assistance Dogs, n.d., alaskaassistancedogs.org/programs/ptsd/.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-IV. Washington, DC: American Psychiatric Association, 1994.
Gould, Mark. “You Can Teach a Man to Kill but Not to See Dying” The Guardian. October 9, 2007. www.guardian.co.uk.
Jaycox, Lisa H. & Tanielian, Terri. “Invisible Wounds of War: Psychological and Cognitive Injuries, Their Consequences, and Services to Assist Recovery.” Center for Military Health Policy Research, RAND Corporation, Santa Monica. 2008.
Kellert, Stephen R. Building for Life: Designing and Understanding the Human-nature Connection. Washington, DC: Island, 2005.
Stewart-Pollack, Julie. “Biophilic Design.” Ultimate Home Design. Issue 4 (July 2006). www.ultimatehomedesign.com/oph/uhd04gb02.pdf.
U.S National Library of Medicine. “Post Traumatic Stress Disorder PTSD: A Growing Epidemic / Neuroscience and PTSD Treatments." U.S. National Library of Medicine, n.d. Winter 2009. www.nlm.nih.gov/medlineplus/magazine/issues/winter09/articles/winter09pg10-14.html.
Walker, Craig F. “Welcome Home.” Photo Essay: , The Story of Scott Ostrom.” Denver Post, n.d. photos.denverpos.com/2011/12/30/special-project-welcome home/26786/.
Zardini, Mirko, Giovanna Borasi, and Margaret Campbell. "Demedicalize Architecture." Imperfect Health: The Medicalization of Architecture. Montréal: Canadian Centre for Architecture, 2012.
Restorative Environments, Returning Combat Veterans, & PTSD
Tele-vision, SAIC Design Thesis Show, June 2012
Restorative Environments, Returning Combat Veterans, & PTSD