In this Q+A, Healthcare Design talks with Ingrid Fetell Lee, designer and founder of The Aesthetics of Joy, on how to bring joy to healthcare spaces. I loved reading this interview and encourage all designers to do so. We often think of joy as something intangible but research proves that the built environment can have a direct effect on our emotional well-being. In this Q+A, Lee provides specific elements that she uses in her designs to invoke Joy.
Healthcare Design: Why is joy an important aspect of design?
Ingrid Fetell Lee: We often think of joy as superfluous, a nice-to-have feeling, but not something essential to our lives or our well-being. But, in fact, joy is one of the six universal emotions, along with surprise, anger, fear, sadness, and disgust. Joy evolved as part of our internal reward and motivation system. For countless generations, our ancestors relied on this emotion as an indication of what to move toward; it was their emotional guide to the things that could sustain life and help them flourish. Now, when we find environments that elicit joy, what we really are feeling is a sense that we’ve found a place that has sensory characteristics conducive to human thriving.
As a designer, when did you start thinking about the role of physical spaces to promote joy and health?
During a review at the end of my first year of design school, a professor made an offhand comment: “Your work gives me a feeling of joy.” This struck me because I’d always thought of joy as something intangible and ephemeral, and yet here was a professor saying it could be created by ordinary, mundane objects like a cup, a lamp, or a stool. I asked the professor to explain, hoping to hear a scientific rationale for how physical objects might influence our emotions, but he couldn’t. And neither could any of the other professors on the review panel. So I began researching this connection myself and discovered that there’s an emerging body of research that demonstrates a link between our environment and our emotional well-being. I wrote my recent book “Joyful” to share my research and help people become more aware of the deep, unconscious ways that their surroundings affect them.
What’s one thing you learned through your research that surprised you?
How robust the research is that shows that certain environmental elements can influence mental and physical health. For example, a growing base of research out of Japan on the practice of “forest bathing” shows that phytoncide chemicals produced by many trees (and found in certain essential oils) boost the activity of natural killer cells, which play an important role in the body’s response to viruses and cancer cells. Similarly, studies show that amplifying broad-spectrum light in long-term care homes can have a beneficial effect on both depression and cognitive decline associated with Alzheimer’s disease. And a meta-analysis of studies on light therapy has shown it to be effective not only in treating seasonal depression, but also non-seasonal depression—as effective in some cases as antidepressants.
One of the most intriguing areas of research for me is around multisensory therapy, a form of treatment that uses a robust palette of pleasurable sensations, such as colored light, plush fabrics, and fruit aromas, to address conditions such as dementia and traumatic brain injury (TBI). This research is still early, but it’s been shown to alter TBI patients’ brain activity in ways similar to meditation, as well as reduce apathy and agitation among dementia patients. All this research suggests that our physical environment has the potential to deeply affect our well-being, though currently there’s insufficient awareness of these effects.
What design elements can be used to create the feeling of joy?
Color is a powerful one. As the German painter Johannes Itten once said, “Color is life; because a world without it appears to us as dead.” Environments that can support life usually are rich in vibrant color, while dull environments either lack sufficient light, water, or nutrients to support life. So, the presence of vibrant color (even a small pop) creates a feeling of joy.
Another important element is curves. Many of the most joyful objects are circles or spheres: bubbles, balloons, spinning tops, frisbees, merry-go-rounds, hula hoops. Research shows that when people are placed in fMRI machines and shown pictures of angular objects, the amygdala part of their brains, which is associated in part with fear and anxiety, lights up. When they look at curves, this part stays silent. Yet the built environment is often full of hard angles. Introducing curves into man-made spaces cultivates both joy and ease.
What areas do you think could be explored to make healthcare spaces, specifically, more joyful?
Nature and daylight are both vitally important elements for restoring joy to the built environment, but it’s worth noting that both rely on bringing something natural into the man-made. My research suggests it’s important not just to look at balancing out the man-made elements, but also to work with these elements to make them more joyful and sensorially enriching. The spartan quality of many healthcare environments evokes a kind of minimalist feeling, which may advertise their clean and sterile nature, but also feels distinctly unwelcoming to the senses. Adding elements of abundance with surface patterns or textures; softening hard edges with curves; supplementing natural light with broad-spectrum artificial light; and expanding the color palette beyond gray, white, and beige can help make these environments more joyful and comforting for patients and staff alike.
Sound is another element to consider. The hard surfaces found in healthcare environments can create harsh reverberations that amplify noise, which research shows can be stressful both mentally and physically. Softening hard surfaces, therefore, can play an important role in making a space more conducive to well-being. Also, natural sounds, such as birdsong, have been shown to relieve stress and promote joy in man-made environments.
Lastly, I think scale is an important consideration in healthcare spaces. In this respect, I think current trends may not be beneficial. I recently had a pre-operative appointment in a new hospital building, which seemed to follow the conventions of modern office buildings with vast hallways and spacious rooms with high ceilings. But, in the context of healthcare, it made me feel small, and this smallness increased my sense of vulnerability. Out-of-scale environments can be joyful in other contexts, but in healthcare, maintaining a sense of humanness in the scale can help avoid triggering this sense of vulnerability.
What about designing for staff members’ mental and physical well-being, as well?
Light is important here, too, especially given the fact that many doctors and nurses work long shifts or night shifts that disrupt their circadian rhythms. Research with acute care nurses, for example, shows that greater exposure to daylight increased the amount of spontaneous laughter on a ward. Again, supplementing with artificial light can be beneficial if natural light isn’t available.
Another element to consider here is elevation. If possible, providing staff with a place to take a break that has an elevated view, either outdoors or indoors, can help provide perspective. In studies, gaining a small amount of physical elevation (the equivalent to a flight of stairs) prompted people to take a more big-picture view of situations, which could be helpful in relieving the stress of healthcare roles and aid in problem-solving.
Healthcare is traditionally a risk-averse industry. What advice would you give designers working with organizations that are resistant to change?
To some extent it depends on the barriers. If the resistance to change is about risk or cost, start small. If a living wall is too risky, try a few plants first. If a mural is too costly, hang paintings. If painting patient rooms is too much of a commitment, change out the blankets. Do before-and-after tests to gauge the effects of small interventions.
If the resistance comes from a “this is the way we do things here” attitude, engage clients in the process of change. Ask them to try a small change in their homes, for example, and report back on the effects. If you’re thinking about adding an art installation, invite staff members to help choose between the different palettes. Test with patients, family, and community members to show the broader support for the new ideas.
And if the resistance is about not believing that the changes will really impact patient health or the bottom line, show them the research. Start with interventions that have well-developed evidence bases around them, such as nature and light, and translate those abstract numbers to the specific situation at the facility.
Where else might designers push their clients to think differently?
Functional demands on design in healthcare environments and the lack of understanding of how aesthetics influence well-being has, at times, pushed out considerations of aesthetics and made them seem like decoration rather than an integral part of the healthcare journey. I believe that raising awareness about the emotional and physiological effects of aesthetics can help bring these two facets of design back together and make for a more integrated healthcare design experience.
What lessons do you hope attendees will take away from your talk?
I’m excited to share a palette of ways to cultivate joy and well-being in the built environment, both from within healthcare spaces and also from other categories of design. My goal is to broaden attendees’ understanding of how we can create healthcare environments that truly help people thrive.
Anne DiNardo. “HCD Expo Preview: Opening Keynote To Discuss Aesthetics of Joy.” HCD Magazine, 31 Oct. 2018, www.healthcaredesignmagazine.com/news/awards-events/hcd-expo-preview-opening-keynote-to-discuss-aesthetics-of-joy/.