On Vitality

The neuroscience of creating vitality

The Therapist's Office

How our environment impacts our practice.

1111 Lincoln Road
NY Times
As a psychiatrist practicing for over 20 years, I am fascinated by the relationship between what’s inside our head and the world around us. In The Beauty Prescription, we discuss the Beauty Brain Loop and how each aspect of the loop impacts the other. Our inner beauty, outer beauty, health and environment are all connected.

After 20 years of practicing in a hospital setting, I recently moved to 1111 Lincoln Road the famous “parking lot” building. The change has been dramatic. My office has a balcony where I can now incorporate the healing effects of fresh air and viewing nature with the more traditional practice of psychotherapy and psychopharmacology. My mood has lifted, I am dressing differently and attracting a very special and diverse patient population.

Today I share with you a thought provoking story written by Inessa Freylekhman, MA, a Feng Shui Practitioner. Her story is meant as a starting point for a discussion on how our space impacts us.

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Can office décor stand in the way of good therapy?

My fiancé, Max and I spent months searching for the right couples therapist in Miami. I recently moved from Seattle and never thought it would be so difficult. When I found Karen, I was excited. Her web site depicted the type of holistic practitioner I was looking for: spiritually minded and emotionally grounded. She treats the mind, body and spirit.

We arrived at Karen’s office on a weekday afternoon. It was located in a strip mall, wedged between a nail salon and a teriyaki restaurant.

“Hmmm, interesting location” I said to Max. He raised an eyebrow.

As a seasoned feng shui practitioner and a therapist in training, I’m very environmentally sensitive. I’m wired to look at the space as an extension of the person. So naturally it’s important for me that my therapist and his/her office be in alignment.

Taking one look at Karen’s lobby, I was transported to a waiting room I had once visited while getting an oil change in Seattle. Her decor and furniture dated back to the early 70's and today might get rejected as a donation by the Salvation Army. There was a tacky looking plastic water feature on one of the tables, and an inspirational quote on the wall- curled at the corners, almost ready to fall apart.

In general, everything seemed flimsy and like it was about to fall apart. Not a very good sign for someone that is supposed to help you reconstruct your relationship.

“Let’s just hope it gets better inside,” I said to Max, somewhat reassuringly.

Karen greeted us. She seemed friendly with an overall pleasant personality and tidy appearance. I was confused. I wished she was cold, arrogant, and frumpy, so I could have a better excuse for why I didn’t want to work with her. I didn’t want to be shallow.

As Karen led us to her office, we walked through a large room, which was where she held workshops. The carpet was dirt brown and most likely pre-dated Max and I. We passed by a desk with some diplomas on the wall, and then a pile of old and tattered mattresses with floral prints stacked just outside the room where we were going to talk

It was a small space and looked like she had thrown a few things together haphazardly. The walls were bare and there was an uninviting cream colored coach that we sank into, but not in a comfortable way. To be fair, she had a really beautiful Tibetan singing bowl on the floor that I wanted to play with.

Surprisingly, there was immediate rapport between the three of us. Within minutes she assessed that I do too much enabling, and should try and allow Max to finish his sentences.

“If you do all of his work, it can breed resentment down the line.”

Karen was clever and intuitive, yet I couldn’t help but notice the large brown stain on the ceiling above us. As she talked about energy and raising our vibration, I wondered why the cracks in the wall hadn’t been plastered.

“This work will be very deep. Sometimes you may feel like you want to give up,” she said. I looked up at the florescent lighting. Was it flickering?

“But overall, this work will be very rewarding, for the both of you,” she smiled.

My thoughts distracted and interfered with the session. It was hard for me to hear her at times. I felt guilty. Especially since Karen was just so nice.

So what do you think, I asked Max on the ride home.

“I liked her.”

“I did too,” I said, “but I’m just not sure I can do the deep work there. It’s too much of an eye-sore.”

Max said he felt the same way. We both wondered how many clients she loses monthly.

“How can she talk about energy and not know that the energy in her office stinks,” I sort of asked/told Max. “Spaces are just as important as the people who work in them!”

That night I wrote Karen an email and explained the situation. She wrote me back immediately. She was very gracious and understanding and even offered to continue our work and do a trade with me; feng shui for therapy. Wow, that was a first. I was open and curious, but then Max brought me back to reality.

“Are we expecting her to remodel her space for us overnight? Isn’t that somewhat presumptuous?”

He was right. Also, treating my therapist might set up the wrong kind of precedent. It could breed resentment down the line.

I called my best friend Alexis in Texas with this conundrum. She’s always thinking outside of the box. She suggested I call HGTV Extreme Makeover.

It was a crazy thought, but I have to admit, I considered it for a day, and even talked it over with Max before deciding to just call the whole therapy thing off.

A few weeks have passed. There’ve been a couple nights before going to bed where Max and I agree that we strangely miss Karen. I’ve even thought about writing her just to give her some free feng shui tips. But Max says if she really wanted help she could hire me or someone else. Maybe this experience will plant the seed in her mind. In the meantime, I’ve been better about letting Max finish his sentences and we’re looking for the right therapist in the right setting and we’re definitely not settling.

For the therapist:

This is a (true) story of a qualified therapist that is overlooking the role environment plays in the treatment process. Yet, I question how many other analysts in the world are simply unaware of the impact of their setting on their client’s psyche?

In my opinion, providing a healing milieu for the client should be intrinsic, common sense, and a foundational piece in therapy. Without it, how can an individual move into a deeper state of connection with themselves and their analyst?

I think Karen’s lack of attention and investment into her office is a reflection of her values. I don’t believe she valued her surroundings, on some level that translates into: she doesn’t value me.

One of the most important steps in creating a healing space is making sure that it accurately reflects the intention of the practitioner. Will this space make my clients feel welcome, at ease, comfortable, and most importantly, safe?

When the analyst’s office is not in alignment with the goal of therapy, then it will be more challenging for the client to feel at ease and ultimately do the important work necessary for healing and change to take place.

At any moment you can begin the process of enhancing your office by mindfully introducing elements, symbols, color, plants, images and materials that have meaning for you and that could support your client in receiving the deepest level of healing possible in that session.

I think there are some important keys that an analyst can take away from my story:

• Spaces are just as important as the people who work in them.

• Keep your clients in mind when arranging your office.

• You don’t have to spend thousands of dollars on remodeling. A small investment into your environment can really pay off in the long run

• The lighting, objects, furniture, colors, images and their arrangement can have a negative or positive impact on your client’s process.

I have created some questions you can ask yourself while enhancing your setting. There is really no right or wrong answer here. These questions are intended to get you thinking symbolically about your space.

There is no one finite way to set up a room. Every therapist is different, so I stay clear from one traditional model of office arrangement. I hope these questions begin to stimulate in you a new way of experiencing and creating your office.

You will need paper and pen for this exercise. Ask yourself these questions in no particular order. You can pick one or two to start with. Either write down the first thing that comes to mind, or sit with the question for a few hours or days, and see what begins to emerge.

1. Walk into your office as if you were the client. Observe the objects, art, or absence of things, the wall color, markings, spots, pictures and upholstery. What is the first thing that catches your eye?

2. What story is this office telling? What’s in between the lines?

3. What mood does my office evoke now?

4. What mood do I want my office to evoke?

5. Sit in the client’s chair, what’s his/her perspective of the room, and of you?

6. Ask a friend to come to your office and sit there with you for a few minutes and just observe the space. Then reflect back to you what they see. Have a stranger do this.

7. Is the lobby well lit, accessible, warm, and tranquil?

8. Are the couches, furniture and upholstery comfortable to the touch?

9. How does the lighting, wall color and objects affect you?

10. Do the art and symbols evoke tranquility; are they dramatic, distracting, or conversation starters?

11. Ask this question, “If my office had a voice, what would it say?” Go through each object and let it speak.

 

Eva Ritvo, M.D. is vice chair of psychiatry at the University of Miami and co-author of The Beauty Prescription: The Complete Formula for Looking and Feeling Beautiful.

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