ARCHITECTURE AND THE ASYLUM sunny views for melancholic patients, and the benefits of disciplined
recreational gardening and productive agrarian work at new
Design for Therapy and Control
Arthur Allen
At both extremities of ancient Egypt, a country which was at that
time exceedingly populous and flourishing, were temples
dedicated to Saturn, whither melancholics resorted in crowds in
quest of relief. The priests, taking advantage of their credulous
confidence, ascribed to miraculous powers the effects of natural
means exclusively. Games and recreations of all kinds, were
instituted in these temples. Voluptuous paintings and images
were everywhere exposed to public view. The most enchanting
songs, and sounds the most melodious, “took prisoner, the
captive sense.” Flowery gardens and groves, disposed with taste
and art, invited them to refreshing and salubrious exercise. Gaily
decorated boats sometimes transported them to breathe, amidst
rural concerts, the purer breezes of the Nile. ........Those ancient
establishments, so worthy of admiration, but so opposite to the
institutions of modern times, point out the objects to be aimed at
in every asylum, public or private, for the reception of
melancholics.
. Phillipe Pinel, 1801 (23)
The experience of architecture and landscape as forms of therapy I
treat in two ways. First, the sensory experience of beautiful
surroundings, both natural and man-made; second, the intentional
design of orderly environs in the belief that patients would respond
with orderly behaviour.
The pleasures of architectural and landscape environments was
central to Phillipe Pinel’s vision of ancient temples of healing, as
well as to the practical writings of Thomas Kirkbride. Kirkbride
urged pleasant rural settings for mental hospitals, with wide and
institutions.
The building should be in a healthful, pleasant, and fertile district
of country; the land chosen should be of good quality and easily
tilled; the surrounding scenery should be varied and attractive,
and the neighborhood should possess numerous objects of an
agreeable and interesting character. While the hospital itself
should be retired, and its privacy fully secured, the views from it if
possible, should exhibit life in its active forms, and on this account
stirring objects at a little distance are desirable. (24)
Dr. W.A.F. Browne, Commissioner in Lunacy for Scotland, and first
superintendent of the Crichton Royal Hospital wrote in 1837 about
moral treatment employing .....“kindness and occupation”....and of
an ideal, highly civilized hospital setting
Conceive a spacious building resembling the palace of a peer, airy,
and elevated, and elegant, surrounded by extensive and swelling
grounds and gardens. The interior is fitted up with galleries, and
workshops, and music rooms. The sun and the air are allowed to
enter at every window, the view of the shrubberies and fields and
groups of labourers is unobstructed by shutters or bars; all is
clean, quiet, and attractive. The inmates all seem to be actuated
by the common impulse of enjoyment, all are busy, and delighted
by being so. (25)
John Conolly, a prominent English reformer (1794-1866) wrote of his
hopes for asylum life;
Calmness will come, hope will revive, satisfaction will
prevail........Cleanliness and decency will be maintained or restored;
and despair itself will sometimes be found to give place to
cheerfulness or secure tranquility. (26)
p1/13

Andrew Jackson Downing, American landscape architect, (1815-52)
wrote extensively on this subject, and stated;
Many a fine intellect, overtasked and wrecked in the too ardent
pursuit of power or wealth, is fondly courted back to reason, and
more quiet joys, by the dusky, cool walks of the asylum, where
peace and rural beauty do not refuse to dwell. (27)
The energy of architects in response to a new field of important
practice, and the excitement of psychiatrists and hospital
administrators at the first appearance of powerful symbols of
recognition and status, are easy to understand. Add to these factors
the enthusiasm of benefactors, orators, and politicians, and
exaggeration was inevitable. I use this illustration to reinforce my
interest in the autobiographies of former psychiatric patients
presented in Part 3 of this book. The extravagance of some
architectural comments originating outside the walls of asylums is
ridiculous when compared with lucid and sensible observations
coming from some of the patients within.
The sensory enjoyment of landscapes and architecture, and their
therapeutic value, continues to attract the attention of design
professionals in relation to general and mental hospitals. In a 1999
essay, Architecture as Medicine, Daniel Willis resists a mechanistic
approach to general medicine, and rejects the concept of buildings
as ....”efficient instruments”. In his appreciation of the Hospital of
the Holy Cross and St Paul, in Barcelona, Willis especially notes the
presence there of ample sunlight, air, and plants, contending that
the architect deliberately intended to create.......”an invisible air of
regeneration and recovery.” (28) Willis repudiates the intimidating
quality of institutional buildings and the sometimes frightening
imagery of high technology, concluding that these qualities as
reflected in large contemporary hospitals work in opposition to the
intended function of the institution.
A personal account, from Lia Govers, recently a psychiatric patient
in an Italian hospital and half-way house, agrees with Willis. Lia is a
nature lover, and advises that in spite of boredom, lack of views to
open space, and the frustration of restraint within high walls, the
joy of living things in a perfumed garden courtyard is always with
her.
Kirkbride, in his thorough and candid writings of the 1850s, showed
that he was well aware of the medical and public value of
landscapes, and proposed that the pleasures of accessible gardens
and recreational areas should be made available to asylum visitors
as well as patients, so that visitors would develop trust in the care
givers of the institution.
Recent Canadian efforts on architecture as therapy include a 1980
article by historian Tom Brown; Architecture as Therapy, and a 1998
paper, Origins of Therapeutic Landscape Design in Ontario:
Lakeshore Psychiatric Hospital, by Cecelia Paine, landscape
architect. Brown contends that ...”lavish attention was devoted to
every detail of asylum architecture”...in order to build a therapeutic
setting. (29) Paine notes that numerous Canadian landscape design
firms are currently specializing in the design of therapeutic
environments. Her paper is specific to the history of the site design
of Lakeshore Psychiatric Hospital near Toronto, (originally it was
named Mimico Asylum), and includes comment on the 2
therapeutic design to current professional practice. Pleasance
Kaufman Crawford, a Toronto landscape historian, has been active
for many years in studies and publications of landscape design in
mental hospital settings, including her chapter, Subject to Change:
Asylum Landscape, in a book, The Provincial Asylum in Toronto,
edited by Edna Hudson. As with architectural writers on the subject
of mental hospitals, recent publications regarding landscape
architecture are awakening professional interest. Books include the
work of David Schuyler on the life of Andrew Jackson Downing, (30)
a landscape designer of the mid-nineteenth century, and Kenneth
Hawkins, on the therapeutic use of landscape design. (31)
The therapeutic value of well-designed architectural and landscape
developments is a fascinating topic, but on a note of caution I am
careful about the fact that even wonderful views of fine buildings
and natural landscapes in Western Canada sometimes fail to give a
thrill, or a moment of profound tranquility. At times of high feeling
we perceive a wonderful world. When low, the once beautiful world
appears to be dull and miserable. In dealing with patient’s feelings
of this kind I wonder how far designers can go in claiming that the
order of external architectural things can help to improve mental
life in our inner spaces? It seems possible that the delights of space
and color, perception of order, and enjoyment of light, fresh air, and
shade that are provided by architectural and landscape designers
can be exaggerated in the context of psychiatric service where inner
order and social relationships can be so badly awry. We need
caution in this area because designers of buildings and landscapes
operate in business frameworks, and professionals must not
oversell their services in competition for commissions by
exaggerating benefits of attractive facilities. Designers on public
projects will always compete for required funds, but must not forget
that relative to excellence of medical service and qualifications of
staff, the quality of social activity and relationships between
hospital patients, staff, and visitors, and the quality of food service,
the architecture of a mental hospital does not have first call on
available funding. This is not news to architects who face the issue
daily on their drawing boards. It is also well known to those clients
who favour common sense designs. Austin MacCormick, a prison
warden, said;…...”If only I had the right staff, I could run a good
prison in an old red barn”...32)
Architectural order enters the psychiatric field in the work of
sociologist David Rothman, who addresses therapeutic possibilities
expected of the external appearance of 19th century mental
hospital buildings;
There were alternative designs available to medical
superintendents. .......But in fact, they welcomed the regimented
quality of the wing design because it fit so neatly with their ideas
on order and regularity. ...... This represented, in visual form,
their faith in the ability of a fixed order to cure the insane. (33)
3
 these plans are based on single room confinement, with outdoor
airing courts, chapels, and small spaces for social reception
purposes, and where rank possibly refers to ability to pay as often
as to noble entitlement. Strict axial symmetry, with classification
and separation of patients by type of illness, passive and violent
behaviour, social rank, and by sex, was a design feature of
eighteenth century buildings in Europe. Symmetry, with areas
showing social classification, continued into the 19th century. That
did not occur in post-revolutionary France where the Maison
Nationale de Charenton, shows segregation for medical reasons
Samuel Sloan, Architect.
only.
The idea that mental disorder has close and important connections
with social order is a common theme in writings that relate social
Order in landscape design has been used as an expressive and
development to histories of psychiatry and institutional care.
functional component of the principles and forces of social order. In
Rothman argues that post-colonial America provided asylums,
a discussion of the formal gardens built by the English nobility
prisons, orphanages and other buildings in order to remove
during the reign of the Stuart monarchs, John Prest argues that the
undesirable people from communities, and to enable proper care of
extension of garden avenues far beyond the palace represented a
abandoned people. Rothman observed that psychiatrists of the
projection of aristocratic power and social order into the unruly
nineteenth century believed that architectural order had a place in
countryside of the Stuart era. The result, in Prest’s opinion, was the
this scheme, whereby the design of new asylums would contribute
reinforcement of an orderly, or possibly a subjugated society, (34),
to medical recovery, thereby reinforcing the value of well-ordered
with the avenue serving as: ........”the policeman’s truncheon of
institutional life in responsible communities. Thomas Kirkbride
topography”...... This idea is compatible with Rothman’s
agreed, adding the politically astute opinion that hospitals should be
observations on the hoped for medical and social value of
designed in a style compatible with worthy public buildings of the
architectural order and regularity in asylum design, and links the
time, a style not to be confused with factories or warehouses.
highly formal and palatial gardens of many European asylums to the
world of social power and order. The fact that the architecture of
Some asylum plans clearly indicate segregation of occupants by
magnificent landscapes and buildings was simultaneously used for
social rank, as at the radial Glasgow Insane Asylum of 1810; the
the benefit of people at the top and the bottom of social ladders is
Danish asylum at Schleswig, (1818, then in Denmark); and the
an interesting issue in comparing civil and psychiatric 4
healing and nursing institution of 1837, in Illenau, Germany. All of
architecture of the time.
European landscape designs for asylum lands relied on formality to
a good extent, with informal connections to surrounding natural
landscapes. Some designs, especially of French origin, show an
unmistakable influence of Beaux Art symmetry and complexity.
American and Canadian landscape designs of the nineteenth and
twentieth centuries reflect both formal and informal conceptions.
Prominent design influences were based on the writings of
Downing, and on the naturalistic ideas of F.L.Olmstead, as at the
1870 asylum in Buffalo, New York. Olmstead, pre-eminent among
American landscape designers, was also responsible for mental
hospital grounds at the McLean Retreat for the Insane, (Waverley,
Massachusetts), and at the Hartford Insane Retreat.
Regarding the therapeutic value of landscape and architecture, I am
skeptical of the alleged curative value of symbols of order in
environmental design. Expression and perception of order forms a
strong link between aesthetics and function in landscape and
building design , connecting a patron’s intentions to public
understanding of those purposes. In cases of personal or political
monumental works, there is no question about intent; the beholder
is expected to feel small, and to view the work in a state of awe
while feeling mixed reverence and fear, and showing respect and
admiration for the patron and the architect. I have my doubts about
this practice in design of psychiatric facilities. When a strong sense
of architectural order combined with huge scale in the design of a
mental hospital is intended and perceived as a symbolic expression
of social order and power, and is alleged to help with the
restoration of disordered minds, it seems possible that feelings of
awe and subjugation will be inappropriate if they serve to further
intimidate some people already struggling with feelings of
insignificance.
In the late 18th century when psychiatry applied the new scientific
practice of classification to mental illnesses, and added to it
segregation by sex and social class, psychiatrists and architects were
bound to meet on common ground. One result was their agreement
that orderly life, work, and surroundings would restore balance to
disordered minds. Sad to say, the excited rhetoric on that issue is
hollow when compared with the high level of dominance and
submission that came with it. I feel that we must be more cautious,
and mindful of the dulling effects of imposed order in the lives of
mentally ill people. I am intensely skeptical of architects who have
credited architectural design with the creation of good behavior and
social order. The Asylum Project (approx. 1800 to 1960) has made a
pragmatist of me, and persuaded me to pay attention to the
everyday experiences and opinions of building occupants, as well as
those of outside observers.
Regardless of their therapeutic good intentions, hospitals built for
the pleasure and gentle treatment of social outcasts invited
criticism for palatial appearance and costly ornamentation. In
Britain, in the late eighteenth century and throughout the
nineteenth, public interest generated considerable discussion on
issues of architectural design of general hospitals and asylums,
especially their cost. Christine Stevenson’s Medicine and
Magnificence discusses attitudes about charity and luxury in the
design of buildings for people dependent on charity. She quotes
from the Abbe Laugier, a renowned French architectural 5
 theorist, who declared that; ...”too much beauty in a house (of
charity) stifles charity, because curiosity becomes sated; the poor
must be lodged like the poor”. (35) Stevenson comments;
The image of the curious gaze getting snagged, distracted from
charity, by madly inappropriate beauty would be a durable one.
Laugier’s French successors would develop a more general
doctrine of architecture as a ‘species of expressive language’,
which culminated at the end of the century in a full theory of
character extolling its potential for shaping human psychology
and society. (36)
Asylums funded by generous private patrons, (notably W. H.
Crossland’s Holloway Sanatorium, at Virginia Water), were designed
with external and interior opulence, The often impressive exterior
design of public asylums was negated by the barren living spaces of
their interiors. Stevenson quotes Thomas Brown, (1663-1704) on
the grand facade of the 1676 Bethlem building;
The Outside is a perfect Mockery to the Inside, and Admits of two
Amusing Queries, Whether the Persons that ordered the Building
of it, or those that inhabit it, were the maddest (37)
The discrepancies between elaborate and costly buildings, and the
small benefits actually received by their users, raised hackles in the
eighteenth and nineteenth centuries as they do now. There were
some deliberate falsehoods constructed, where appearance
contradicted reality. At St Luke’s Hospital for the Insane, London,
1751, high window sills were intentional, designed to reduce
frenzied excitement of patients taking the view. (38) In nine Irish
asylums built between 1820 and 1835, false windows viewed from
the outside appeared to have low sills, as if occupants had fine
views to the exterior landscape. Interior sills, however, were
projected upward to eight feet above the floor, preventing any
view. (39)
As the development of new buildings continued through the
nineteenth century, many public mental hospitals became highly
developed in visual design. Symmetrical and natural landscape
designs were used and elaborate formal gardens were common. It
seems that exterior designs were controversial from the start.
Medical authorities, politicians, and tax-paying citizens regretted
the grand scale, overpowering order, and ornamental expense of
the buildings. Dr F.J. Mouat, writing in the Lancet in 1881, approved
of a 1567 opinion by Philibert de l’Orme;
It would be better for the architect to fail in ornamentation, such
as columns and facettes, which all study most, than in those rules
of nature which tend to the convenience, use, and profit of the
inhabitants, and not the decoration, beauty, and enriching of
buildings, which are for the contentment of the eye, and bring no
advantage to the life and health of man. (40)
To some writers, the contradiction of palatial exterior and
workhouse interior was disturbing. Now that art historians are
working in this field, differences of opinion remain. In a tone
reminiscent of the enthusiasm of early moral reformers, Harold
Cooledge has eulogized the Sloan-Kirkbride buildings as ...”objects
of great civic pride”..(41) Carla Yanni is not excited;
While such large psychiatric hospitals currently have almost no
medical credibility, the edifices (or their ruins) remain, witnesses
to the history of medicine and testaments to a once-common
faith in a partly architectural cure for insanity. (42) 6
Psychiatrists, Architects and the Asylum Project.
Some of the …..”institutions of modern times”…. mentioned by Pinel
are shown in the following plans and drawings of European
buildings of confinement of the eighteenth and nineteenth
centuries. Some were circular in plan, possibly derived from cells
constructed within the walled fortifications and towers of a town,
and used for chained isolation of insane or criminal people. A few
indicate combined use, as at the prison and madhouse in Celle,
Germany, 1731, and the Narrenturm, (Fool’s Tower), in Vienna,
1784. The latter shows a particularly heavy structure, and the
typical use of individual cells. Contemporay with Pinel’s work,
Jeremy Bentham, from 1789 to 1812, was active in the design and
promotion of his Panopticon concept for penal and industrial
facilities. It may have influenced the design of radial asylums and
hospitals of the same time.
Pinel’s vision of wonderful temples of healing was a centrepiece of
nineteenth century plans for moral reform in treatment of mental
illness. From 1800 to 1960, reform stimulated a massive
construction project in the building of mental hospitals throughout
the western world. Phillipe Pinel was a physician, employed as the
director of the asylums of Paris during and after the French
Revolution, and the man in charge when patients were released
from the chains by which they were bound. A dramatic painting of
that 1794 event, by Tony Robert-Fleury, and a bronze statue of Pinel
on the grounds of the same hospital commemorates his life and
work for posterity. Vincenzio Chiarugi in Italy; Phillipe Pinel and
Etienne Esquirol in France; Lord Shaftesbury, William Tuke, and
John Connolly in England; Johann Reil in Germany; and Dorothea
Dix and Thomas Kirkbride in America, were notable leaders of the
moral reform movement.
The importance of architecture in assisting moral treatment within a
mental hospital was paramount in the minds of early reformers.
According to Andrew Scull, the administration of Tuke’s York
Retreat was not for the sake of kindness alone. Everything was
done, in architecture and operation, to facilitate the recovery of
self-control by the patients. Nancy Tomes, in her work on the career
of Thomas Kirkbride, has written;
Kirkbride’s professional concerns reveal his conviction that the
“moral architecture” and moral order of the new hospital were
the most powerful means he possessed to summon up belief in
the new asylum treatment. His reputation as a healer of mental
disease depended almost entirely on his ability to inspire
confidence in his most persuasive asset, the hospital. (43)
Architects of the Modern Movement, beginning near the end of the
19th century, wrote with passion claiming that their revolutionary
designs would improve physical and mental health. Adolf Loos, in
Vienna, in 1908 said that..”Lack of ornament is a sign of spiritual
strength”…. (44) Bruno Taut wrote that the “efficiency” of modern
design would improve the behavior of people within the new
buildings. Le Corbusier in 1933 felt that society was sick, and took
the astounding position that; ....”only architecture…. can provide
the exact prescription for its ills,”……(45)
That kind of talk, in more modest form, fitted well with some
psychiatrists of the time. In Vienna, the Purkersdorf Sanatorium
(1904) and the Steinhof institution (1907) were designed by 7
 two modern architects in the service of psychiatrists who agreed
with the importance of simple and rational architecture as an aid to
their own work. Later illustration of their Vienna buildings includes
details of that collaboration.
In Great Britain, the passage of the 1845 Lunatic Asylum and Pauper
Lunatics Act obliged all counties to provide public mental hospital
facilities. Architects responded with vigour, and some became well
known for practices specializing in mental hospital design.
Professional seminars were held to educate designers in
requirements of the new buildings, formal presentations were made
to the Royal Institute of British Architects, and public design
competitions fostered open and widespread discussion of design
and cost benefits.
In North America, architects of the eastern seaboard of the United
States led the way, with Canadian architects often relying on
American work as precedent. Samuel Sloan, a prominent architect
in Philadelphia and a lifelong friend and advisor to Dr. Thomas
Kirkbride, became a leader in this work. The firm of Sloan and
Stewart designed 32 mental hospitals in the second half of the
nineteenth century, all based on conceptual plans of organization
and treatment known as the “Kirkbride System”. Sloan urged
architects to support the cause of the insane, which in his opinion
was the worst of human suffering;
Nothing speaks more favorably for the true civilization of a
community than the state of perfection in which its hospitals of
every class are kept, and there is not one among these that
requires the unbounded sympathy of our people, more than does
the hospital for the insane;.....(46)
19th century psychiatrists and administrators wrote books of
practical advice, some with glowing words in praise of their new
buildings and the humane treatment proposed within. Technical
studies of efficiency in design and planning were produced by
practicing architects in mid-nineteenth century Britain. They
concentrated on efficiency of nursing and food supply, with traffic
of critical concern in the very long corridors of some institutions. I
have not seen any study of patient reactions to the extended plans
of innovative British plans of the time, (see Claybury and Hereford
plans). Presumably because they spent their lives in a particular
“cottage” or “villa” the sprawling complex was not part of a
patient’s consciousness.
In his vigorous efforts to initiate construction of mental hospitals in
North America, Dr. Thomas Kirkbride of Philadelphia opposed any
resemblance to factories or warehouses, and maintained interest in
architectural quality and style for benefit of patients and visitors. I
suspect that he also used architecture as a promotional measure in
political and private fund raising. He was assisted in design by
architect Samuel Sloan, of Philadelphia, who was credited by
Kirkbride for ..” taste and ability”…..,and for “improving the style
and... convenient arrangement”...of mental hospital buildings.(47)
Although it is not desirable to have an elaborate or costly style of
architecture, it is, nevertheless, really important that the building
should be in good taste, and that it should impress favorably not
only the patients, but their friends and others who may visit it. A
hospital for the insane should always be of this character, it
should have a cheerful and comfortable appearance, everything
repulsive or prison-like should be carefully avoided,…. (48)
8
The process of engaging architects to draw plans formulated by
medical advisers seems contrary to the pride of the architectural
profession, but at present the practice is common. Correctional
authorities are known for laying out plans of their projects. In recent
decades both public and private projects may involve programming
architects in that work. They do not undertake actual planning or
design, but assist owners in preparation of lists of rooms,
equipment and service requirements. They may also prepare
suggested floor plans to illustrate important functional intentions
and relationships of rooms. A design architect is then appointed,
with or without formal competition, to provide construction
documents. There is no loss of pride in an architect accepting that
kind of commission.
In hospital planning, participatory design is the answer. The extent
to which the architect contributes to conceptual planning will
depend on his or her awareness of the behavioural effects of
design. If it can be shown that the troubles of oversized asylums
derived in part from the eagerness of psychiatrists and architects to
establish those buildings as monuments to their own growth and
prestige, then evidence well informed by patients and researchers
may be able to put on the brakes if the situation arises again.
Design for Confined Control and Social Engagement.
In primitive confinement, stone walls did little to control movement
within a space. In quarries, caverns under a Roman floor, or in old
Bedlam, lunatics and criminals, both young and old, quiet and
excited, dangerous and harmless, were held in congregate
chambers. They were obliged to deal as best they could with
anyone close at hand. Single cell housing in prisons, and small wards
and rooms in asylums after the 18th century, took control of
inmates’ movements in the interests of protection and
management.
In design of 19th century asylums, it was common practice to
appoint the director of another asylum to act as a professional
advisor. An architect was then engaged to design the enclosing
building with suitable elevations, and prepare detail plans. In this
work, psychiatrists insisted that they alone were qualified to
undertake the conceptual planning of a mental hospital. (49) One
result was the unrelenting symmetry of most building plans,
providing a centre-line that divided men from women on opposite
sides of the building. Ward wings, or separated pavilions, provided
the segregation of patients by type and severity of illness, also
conceived as an operational control feature in mental hospital
planning and design. That practice may be a fact of life in psychiatric
facilities, but the possibility that spaces and walls may at the same
time be planned to encourage spontaneous social interaction is
central to my interests. Whether architectural arrangements have
facilitated development of social skills during patients’ stays in
hospital, or have confirmed them as numbered cases to be boxed
and stored, is of high concern.
Some scholars have argued that asylum psychiatry failed because
psychiatrists gained too much power. I make no comment on that
idea, but I am intrigued by the similarities of plans for palaces,
mansions, and asylums. I do not believe that a psychiatrist 9
 who chose a palatial plan was necessarily a tyrant; a symmetrical
plan made sense in planning for sexual separation and medical
classifications. More likely, I think, that public prominence of Classic
Revival architecture in the 19th century, in Britain and especially in
the United States, led many architects and psychiatrists to
symmetrical plans, with neo-classical colonnades at the entry. My
interest does note the intentions of monarchs and psychiatrists, but
focuses on the social influence exerted by the solid walls of the
buildings regardless of medical intentions and plans on paper. I
emphasize that the architecture of both mental hospitals and grand
mansions can be done in such a way as to deny or encourage social
engagement of occupants with each other and with staff in
attendance.
In contrast, the irregular plans of a few early hospitals, for example
the York Retreat of 1796, are usually identified with comfortable
functionality, not dominance and control. Nikolaus Pevsner, in an
address on the change from informal Elizabethan mansions of
England to the symmetrical neo-classical designs of Inigo Jones in
the early 16th century, explained the social background of that
important transition. He ended his talk by quoting Francis Bacon,
who wrote;
Houses are built to live in and not to look at; therefore let use be
preferred before uniformity, except where both may be had. (50)
Confined Control; Walls as Enforcement.
In a custodial asylum the planning of spaces using formal or
informal layouts was designed to provide for, and to help enforce,
the activities required by the building’s programme of operations.
When a disturbed patient, of danger to self or others, was held in a
cell in a back-ward, every movement to or from the private cell, for
any purpose, was subject to surveillance and escort. In that
situation the cell walls and locked doors or gates were active agents
in the work of controlling the activities of the patient. A
staff/patient ratio of 1 to 1 could not have succeeded. No less than
chains or straight-jackets, architectural restraints were essential to
the control desired.
In following the instructions of a psychiatric advisor on programme
and function in a mental hospital, the architect agreed to assist the
activities intended by the advisor. Plans and specifications did so by
providing walls, doors, locks, and bars that helped enforce the
regimen intended within the building. Walls guided and limited the
movements of all occupants, or became the backdrop for immobile
patients where there was no activity. I see no way for architects to
disclaim their share of responsibility for the consequences arising
from those situations.
In spite of a reputation for over-emphasis on the aesthetics of their
work, I believe that the majority of architects are practical in the
knowledge that diligent floor planning is essential to satisfying most
commissions. I learned very early that the planning of useful spaces
was interesting work. My first impression when I began alterations
work at mental hospital was that the building was a very large
device for physical restraint; an eye opener to my young mind. At
times I felt that architects were not conscientious, but absolutist
tyrants in disguise, seeking power in the name of order. In my own
practice some early clients, who are still long-time friends, 10
were social scientists and psychiatric personnel who engaged me for
residential design. I remember many lively talks about the conflicts
of control and freedom in designing a building, whether a home or a
mental hospital. In designing buildings of confinement, architects
need to struggle with the paradox of order, of submission and
resistance, and to reconcile their creative freedom with their role as
assistants to the keepers of locked buildings.
Social Engagement; Furniture as Opportunity.
In regal ceremonies, and in other large groups of people in ritual
processions or pilgrimages, landscape, urban, and architectural
designs perform their guiding functions. In those situations bonds of
common feeling and purpose may arise, but that does not in itself
establish personal relations. Some people in those situations may
establish contact on their way, but acquaintances in large groups
do not necessarily become close friends. They are companions on a
journey. Architecture is celebrated for its contribution to powerful
feelings of mass energy and bonding that arise at religious and
political ceremonies, and at sports and festival gatherings of many
kinds. In those situations, the prime attention of crowding
individuals is directed not to one another, but to an altar, a podium,
or to actors and athletes performing their roles.
The social function of a psychiatric facility intended for active
treatment is to assist in the recovery of patients. Where an asylum
was intended for inactive, custodial detention, the issue of social
engagement of patients was neglected. Under moral management it
was central to the regime of life in therapeutic confinement. In
active treatment facilities, the geometries of interior floor plans and
furnishings can be used to alleviate, as well as enforce, control of
occupants.
Enforced confinement alone in a small room is social isolation, and
easily recognized as such. Involuntary and often unrecognized
isolation also occurs when the limited social skills of patients are
reinforced by rigid furniture layouts. Seats in back-to-back rows do
not encourage casual conversation of sitters. Avoidance of long,
straight walls, use of movable partitions, and flexible arrangement
of tables and chairs, can soften or reinforce the rigid geometry of
fixed architectural plans. Semi-private gatherings in open floor
space can be encouraged with movement of furniture, or
handicapped by immobile, linear organization. In early asylums,
nursing and maintenance staff had more control of chairs and
tables than any other physical element of the building. They placed
furniture to suit their own ideas about control of patients and
movement of floor cleaning equipment. Patients themselves
aggravated this problem by staking claims to specific chairs in
certain locations. Attendants reinforced those claims in order to
minimize territorial quarrels. The importance of furniture
arrangements in relation to opportunity for social encounters
cannot be overemphasized.
11
23 Pinel, Phillipe, A Treatise on Insanity, New York: Hafner 33 Rothman, David J, (1971). The Discovery of the Asylum,
Publishing Company, reprint (1962), page 180. Boston: Little, Brown, and Company, page 153.

24 Kirkbride, Thomas S., Construction, Organization, and 34 Prest, John, (1981). The Garden of Eden, New Haven: Yale
General Arrangements of Hospitals for the Insane, Mental University Press,
Hospitals, May 1955, page 14.
25. W.A.F. Browne, quoted in Porter, Roy, (1987). Mind Forged 35 Stevenson, Christine, (2000). Medicine and Magnificence,
Manacles, London: The Athlone Press, page 156 New Haven: Yale Univ. Press, page 97

26 Conolly, John, quoted in Showalter, Elaine, (1987), The 36 IBID, page97

Female Malady, London: Virago Press, page 33
27 Yanni, Carla,The Linear Plan for Insane Asylums in the
United States before 1866, in the Journal of the Society of
Architectural Historians, 62/1, March 2003, page 34.
28 Willis, Daniel, (1999). Architecture as Medicine, The
Emerald City, New York: Princeton Architectural Press,
pages 3-22
29 Brown, Tom,. Architecture as Therapy, Archivaria, vol 10,
summer 1980
30 Schuyler, David, (1996), Apostle of Taste: Andrew Jackson
Downing, 1815-1852, Baltimore: Johns Hopkins University
Press.
31 Hawkins, Kenneth, (1991), The Therapeutic Landscape:
Nature, Architecture, and Mind in Nineteenth-Century
America, PhD diss., University of Rochester.
32 Nagel, William G., (1973). The New Red Barn, New York,
Walker and Company, ( attributed to Austin MacCormick)
37 IBID, page 90
38 IBID, page 100
39 Kennihan, Ryan. On An Asylum, Building Material Ten, from
www.irish-architecture. com, (June 2004)
40 Taylor, Jeremy, (1991), Hospital and Asylum Architecture in
England, 1840-1914, London: Mansell, page41
41 Cooledge, Harold N., (1986), Samuel Sloan, Architect of
Philadelphia, Philadelphia: University of Pennsylvania Press,
page 43
42 Yanni, Carla,The Linear Plan for Insane Asylums in the
United States before 1866, in the Journal of the Society of
Architectural Historians, 62/1, March 2003, page 46.
43 Tomes, Nancy, (1981), A Generous Confidence, In Scull,
Andrew T. (Ed), Madhouses, Mad-Doctors, and Madmen,
Philadelphia: University of Pennsylvania Press, page 124
12
44 Loos, Adolf, (1908), Ornament and Crime, In Munz, Ludwig,
and Kunstler, Gustav, (1966) Adolf Loos, Pioneer of Modern
Architecture, London: Thames and Hudson, page 231

45 Le Corbusier, (1967). The Radiant City, New York: Orion

Press, page 143.

46 Sloan, Samuel, Hospital for the Insane, St Peter, Minnesota,

Architects’ Review and American Builder’s Journal 2, (June
1870), page 712.

47 Kirkbride, Thomas S., (1880), On the Construction,

Organization, and General Arrangements of Hospitals for
the Insane, New York: Arno Press, (reprint 1973), page 152

48 IBID, page 52

49 Yanni,Carla, The Linear Plan for Insane Asylums in the

United States before 1866, in the Journal of the Society of
Architectural Historians, 62/1, March 2003, page 39

50 Pevsner, N. B. L., (1960), The Planning of the Elizabethan

Country House, London: Birkbeck College, page 24.

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