For most of us, providing a healing environment consists of working with the process that occurs in the interaction between client and therapist. When considering the concept healing environment, what comes to mind is the therapeutic focus, the sense of connection and rapport that is created. But there is a larger picture that occurs around and beyond the relationship; the actual environment itself where psychotherapy is done. This external setting can have an important impact on healing by significantly reducing or increasing stress as well as empowering the client in their own process.

Research as early as 1980 has shown the effect of this environmental impact on both clients and staff in various healthcare settings (Rice, Talbott & Stern, 1980). Just adding a window to a room was shown to reduce recovery time and hospital stay , while using color, art, and plants created a space where people felt safer and calmer (Moore, 1998). The important discovery of the power of the environmental setting has created a whole discipline called supportive design and research continues which explores the restorative benefits of the external setting . Applying these concepts to the therapeutic workplace can add a deeper dimension of healing and empowerment to the therapeutic interaction. This column will explore these concepts in general as well as discuss the specific practice of Feng Shui, a Chinese art of placement that focuses on harmonizing the environment by rearranging the room to balance energy .

General Environmental Concepts

To begin a discussion of the environment as a healing tool it is helpful to look at some basic premises. A fundamental one being that since earliest evolutionary times human beings have had to be aware, responsive, and sensitive to their environment. It was essential for survival. From these evolutionary premises, environmental psychologists have done research in a number of areas to show how the quality of the environment can support well-being. Such research demonstrated that the more familiar, comfortable, and in control of the environment an individual felt, the greater the positive healing response. Thus, health care cannot be separated from the setting in which it is done. Design elements have a significant impact on the individual and awareness of how specific components in the environment can be used to change a client's state of mind is an important part of the therapeutic process.

The practitioner who decides to work with the environmental setting to enhance the therapeutic process may find that there are structural restrictions in the building and rooms that make many healing concepts difficult to implement. There are, however, some important design concepts that can be used in any setting to promote health no matter what the structure and can be a good beginning towards creating a supportive atmosphere.

Color is an important component that can affect the entire setting and change the essence of a room. Color is one of the most powerful energizing forces and thoughtfully employing color in the therapeutic setting can make a significant difference in the stress or relaxation of a client. Research shows that color has an effect on our pituitary and thyroid gland, creating mood changes and physiological effects. Colors as blue and green have been shown to promote relaxation and balance, while yellow and orange seem to activate and energize a room (McKahan, 1993). The intensity of color is also an important factor and often leads to the choice of lighter hues to make a room more spacious. Room color can also be altered through the use of lighting that can play off interesting features and draw the eye towards positive aspects such as art or views.

Daylight and windows are another important component in any room since they significantly reduce fatigue and depression and help reconnect to nature. Even if there are no windows, however, plants can create that sense of nature indoors and simply viewing nature can have a profound stressreducing effec). Research has shown that negative emotions such as fear or anger diminish when looking at nature while levels of pleasant feeling increase. Even nature paintings can have a positive effect.

Thus, the environmental setting does make a difference in the healing process, and creating a space that is comfortable, light, and nature connected can enhance any treatment program. Practitioners who wish to expand their skills in healing design can explore the evidence-based research in the area as well as look to the Chinese since they have developed a whole discipline for harmonizing the environment called Feng Shui. Based on thousands of years of observation of how human beings react to their environment, Feng Shui (meaning wind and water) focuses on creating a supportive environment where the client's personal energies work well with the objects in the room.

The Concepts of Feng Shui

Developed over 3,000 years ago by the Chinese, Feng Shui is an energy discipline that aims to create a harmonious environment in which the individual's energy is enhanced and supported. It is a perspective-a way of looking at our surroundings that has at its core the belief that the invisible breath of life called chi runs through all things and that maximizing this energy can improve our life. The principles of Feng Shui are based on the premise that people are affected by their surroundings and by adjusting, enhancing, and balancing the environment through the positioning of items in the room, the energy can flow more freely in the surroundings as well as in the individual.

Accomplishing this harmonious balance is done by examining the environmental space as if it were a body with its own metabolism. Doors and windows are the openings, which allow the energy to enter. Furniture, plants, and inner doors channel the energy throughout and the aim is to promote a smooth even flow that does not get blocked or stuck in spaces. In a dysfunctional environment where energy is blocked, the Chinese believe that the environment becomes a negative stressor creating discomfort in the individual and leading to poor health. To turn this situation around rooms are rearranged using a specific set of rules designed to balance the chi (Jeffreys, 2000). Where it is not possible to do that because of the structural design in the space, specific tools are employed to help cure the space such as mirrors, chimes, fountains, fish tanks, and plants. The purpose of these cures is to expand the space, soften areas around corners, and generally enhance the flow of energy in the room.

It takes an expert in Feng Shui to understand how these cures are implemented as well as how the whole space is readjusted because it is a complicated process. Thus, it is not an activity that can be done without adequate preparation. It is possible to get a sense of whether an environmental intervention is necessary by taking a moment alone in the space and considering the negative and positive aspects of it.

Clinical Considerations

An understanding of the space that one works in is key to using it effectively. That understanding begins with an assessment of the workplace. Is it providing what is needed? A really clear and finely tuned space is so healing that people will feel different as they enter it, and people will comment that the room feels good, not understanding why this is so. Looking at a space with a fresh eye can help identify areas that need adjustment such as items in a room that hold no significance and have become clutter and congestion. Identifying areas that need to be cleaned or spaces that need the softening touch of a plant or artwork can create a fresh feel in a stagnant space. Awareness of how the setting is structured can bring a deeper sense of how the space can be adjusted to accomplish the goal of supporting the therapeutic process. Such insights allow for an expanded scope to the healing practice. There are many good books available on the theory and practice of Feng Shui that can give you a starting point to look at your workspace and determine how to bring more light and peace to the area. There are also expert Feng Shui consultants available to help you create a more healing environment.