Design on My Mind

Psychology as design tool.

Maggie's by Design: A Blueprint for Cancer Care Centers

Maggie Keswick, a "Woman by Design," transformed place in the face of death.

When Maggie Keswick Jencks learned that her breast cancer had spread, she was told that she would be dead within months. An accomplished landscape designer/writer and adored wife and mother, her instict was not to curl up and die. Instead Maggie’s battle with cancer inspired her to create—to lay out a vision for a Cancer Caring Centre retreat in Edinburgh for those similarly struggling with cancer. She died two years later in 1995, but the center prototype she envisioned was the seed of an idea that blossomed: Seventeen "Maggie’s Centres" now have been established around the UK and abroad with more in the planning stages.

Given her legacy, it seemed fitting that the exhibit, Maggie’s Centres: A Blueprint for Cancer Care opened in March (Women’s History Month) at the New York School of Interior Design. The exhibit and lecture by Charles Jencks, Maggie’s esteemed architecture critic husband and the Centres’ co-founder, highlighted both the Centres’ mission and their varied designs.

Based on her own struggle, Maggie conceived the idea for the first center in Edinburgh as offering “free practical, emotional, and social support to people with cancer, their family and friends.”(1) Providing input on the blueprint until the day before she died, Maggie’s vision emphasized the creation of a homey oasis, a welcoming social, yet intimate place where people could relax, chat, do yoga, make a cup of tea and feel embraced. The Maggie Centres now established on National Health Service hospital grounds throughout the UK serve as counterpoints to traditional, typically clinical-looking hospitals focused on treating the body, not the soul.

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The scope of the Maggie’s Centre’s effort as an architectural exercise alone is enormous and, overall, the project’s accomplishments are groundbreaking on a number of fronts:

Star Architects of Hope—Impossible to get the top architects of our time to each design a UK cancer caring center? Where there’s a will, there’s a way. The exhibit featured the completed and in-progress designs of five Maggie’s Centres by star architects Frank Gehry, Rem Koolhaas, Richard Rogers, Steven Holl, and Piers Gough. Others beyond these famed-five now have created Maggie’s Centres. Pritzker Architecture Prize-winner Zaha Hadid’s first building in the UK is Maggie’s Centre in Fife, for example.

If you missed the exhibit(2), the book The Architecture of Hope(3) documents such designers’ varied approaches to the same challenge of creating a patient-focused retreat, albeit at different sites. The big question, it seems to me, is “were these stars able to translate their high art into buildings that make whomever enters feel comfortable?” Cancer, after all, is an equal opportunity disease open to people of all walks of life, not just the design cognoscenti! Architects are not known for their in-depth study of the importance of Design Psychology. For instance, “cozy” would not be the way I’d describe the exterior images of the modernist Fife Centre.

A Cancer Caring Center Model—While I can’t speak for all of the Maggie’s Centres, I did visit the Maggie’s at Charing Cross Hospital in London(4) which, in my mind, strikes the perfect balance between architectural noteworthiness and a user-friendly vibe. “Hybrids,” as Jencks describes the Maggie Centres, this one truly combines a:

Domestic house—bright, warm, welcoming, inviting

Hospital—a place to feel better, healthier, and meet with professionals

Museum—stimulating and uplifting

Church—to reflect on the deeper meaning of life(5)

This Maggie’s modern, red-orange exterior is bright, warm, and easy to spot. Moreover, the building color echoes Maggie’s own childhood experience of place. Growing up in the Far East, Chinese gardens (which included this optimistic and energizing red(6)), particularly influenced her design sensibility, the gardens she created and her well-respected book, The Chinese Garden.(7)

I’m sure Maggie would have loved this center’s winding, landscaped entrance that feels like an idyllic escape route from the noisy outside road. Once inside, there’s a Zen-like flow between inside and outside space that’s uplifting and inspires contemplation. Plants are used with subtle, exquisite effect: Looking out at one garden nook, I thought for a minute that the London fog was a tropical mist—that I’d arrived (aahh...) in Tahiti.

The informal kitchens and tables at the heart of this and all Maggie’s Centres as well as comfortable living room couches and throw pillows resemble the functional ease, warm ambience, and harmony Maggie created in her own home.(8) As Jencks has commented:

Maggie liked very modest things; her values from her father were against ostentation. She didn’t like pretentious architecture...She had a terrific sensitivity of feeling, a highly developed feeling system...She could sense subtle differences that were extremely important and she never knew why—in people, situations, and environment. All of them.(9)

Transforming Place, Transforming Self—Above all, Maggie was “interested in exploring new ways of helping people find their own way of helping themselves.”(10) Her way of helping herself, was not to give up, but to help herself through the power of design. The notion of patient-empowerment was the conceptual, not just bricks and mortar foundation for Maggie’s Centres. As one user remarked, “Maggie’s is like an oasis. It gives you the tools to take your future forward, to take control over your life.”(11)

Besides the model combination of support groups, courses, professional advice, and camaraderie offered both on-site and online(12) via Maggie’s Centres, could Maggie also be a model of how patients can use the very process of design as a powerful tool in hope and healing? While research shows(13), that not everyone feels confident and interested in participating in the design process, one doesn’t have to be a trained designer to experience the therapeutic power of creativity. For example, visuals of Maggie’s Centres jump-started discussion by cancer patients and staff whom, themselves, created a healing “oasis by design” at the YWCA Breast Cancer Resource Center in Princeton, N.J.(14)

Since architects usually are reluctant, however, to offer users a seat at the drawing screen, perhaps Maggie’s Centres’ "designers-in-residence" could hold workshops that engage patients in creating oases in patients’ own homes—oft-neglected places during illness yet where many

spend the most time. By making even modest changes of pillows or blankets, colors or aromas, or including photos, artwork, etc., patients can transform their bedroom, spare room, library into their own, personal house-hospital-museum-church.

As we know from art therapy, neurobiologically speaking, creative, visual, endeavors which emanate from the right side of the brain often can break through one’s "thinking head" to offer more heart-filled expression and release(15). Above all, taking control of one’s own space can be a metaphor for taking control of one’s life, thereby empowering patients who so often feel a lack of control.

Could Maggie’s patients be their own "art stars" via participation in a new type of “Design Therapy?”(16) No matter what, Maggie Keswick Jencks remains a pioneering heroine, a “Woman by Design”(17) who transformed place and, in the process, transformed life in the face of death.

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1 See https://www.maggiescentres.org/our-centres/

2. The exhibit runs from March 7 - April 25, 2014 http://www.nysid.edu/news-events/exhibitions/maggies-centres-a-bl...

3. Charles Jencks and Edwin Heathcote, The Architecture of Hope.(London: Frances Lincoln Limited, 2010.)

4. Designed by Rogers, Stirk Harbour & Partners

5. Charles Jencks lecture comments, New York School of Interior Design, March 7, 2014.

6. Charles Jencks and Edwin Heathcote, The Architecture of Hope, p.140.

7. Maggie Kewick, The Chinese Garden: History, Art and Architecture. (Cambridge: Harvard University Press, 2003.)

8. Jencks particularly was referring to their modest family home on Cape Cod.

9. Toby Israel, Some Place Like Home: Using Design Psychology to Create Ideal Places, 2nd Ed.(Princeton: Design Psychology Press, 2010), p. 88.

10. Comments by Marcia Blakenham in Maggie Keswick Jencks, “A View from the Front Line.”(London: Maggie Keswick and Charles Jencks, 1995.), p. 6.

11. Quote from ‘Barbara’- Maggie’s Edinburgh.

12. Available 24 hours a day all year round: https://www.maggiescentres.org/our-centres/maggies-online-centre/

13. Toby Israel, The Art in the Environment Experience: Reactions to Public Murals in The UK. (City University of New York: Unpublished Dissertation, 1988.)

14. Toby Israel, “Think Tangerine Trees (Not Pink) for Breast Cancer Centers,” Psychology Today, “Design on My Mind” blog, April 17, 2013: http://www.psychologytoday.com/blog/design-my-mind/201304/think-t...

15. In Invisible Heroes: Survivors of Trauma and How They Heal (New York: Bantam Books, 2004), author Belleruth Naparstek writes, "If a person has been deeply impacted by trauma, it's more than likely that he first needs to find an oblique route through the imaginal realm, using metaphor and symbolic language, to help him manage his symptoms, find a sense of safety, recontact his whole self, and make language a viable avenue again." p. 13.

16. The Robe to Wellness Project similarly provides patients with the opportunity to create poetic ‘well-wishes’ messages for those battling breast cancer. Those messages, transferred onto labels, are sewn into empowering hospital gowns by Robe to Wellness Sewing Circle cancer patients, their family and friends who support one another as they sew: www.robetowellness.com

17. For more on “Women by Design: Transforming Home, Transforming Self” see http://oasisbydesign.net/presentation.html

 

Toby Israel is an environmental psychologist who studies design psychology.

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