Asylum of the Sensate: Revisiting a Rehabilitative Architecture

Abstract

While our societal perception of mental illness has changed, the concrete nature of architecture has left the built environment for treatment stagnant. Patients receive little stimulation from an environment of containment, leading to an increased dependency, lack of initiative, lethargy and depression. This inattention to users' sensory requirements leads to an environment of desensitisation rather than rehabilitation. An investigation into the history of madness and its respective architecture looks to expose the failures of an architectural quest to treat mental illness. These institutional architectures have long been criticised for their oppressive, impersonal nature. In the case of psychiatric facilities such as rehabilitation centres or asylum hospitals, this thesis argues that the inherent architectural characteristics are detrimental to the very symptoms they are seeking to mitigate. In an attempt to revisit the notion of a rehabilitative architecture with renewed optimism, this research turns to multi-sensory therapy, a relatively recent therapy yielding large potential in the treatment of dementia patients. The architectural implications for this multi-sensory therapy are explored and translated from equipment and gadgetry into the built fabric itself. In focussing on the rehabilitation of dementia sufferers, this thesis seeks to explore links between mental state and the built environment. Drawing on Pallasmaa's understanding of phenomenology, and an understanding of the sensory perceptual systems, an architecture is proposed that not only gives attention to, but challenges the senses, and therefore mind: an architecture that actively engages in the rehabilitative process. The Aristotelian hierarchy and notions of Cartesian ocular-centricity, still placed upon the senses today, are challenged in an architecture that seeks to test the sensory properties of spatial design. Institutional monstrosities remain as a reminder of mental rehabilitation's chequered past, conflicting with efforts to continually reform the way patients are treated. Having reviewed the failures of early environmentally deterministic attempts at an 'architectural cure' in order to prevent a design encumbered by habit or custom, a new architecture as therapy is proposed. Utilising an understanding of these historical failures, in parallel with an understanding of modern multi-sensory therapies, a new psychiatric architecture housing dementia patients is pursued with a renewed sense of optimism. This architecturally-driven sensory therapy, rather than integrating into an existing, conflicting architecture, will promote a holistic approach to the rehabilitative process itself.