The Incredible 'Shrinking' Office

An office where design and the therapeutic process are attuned?

Posted Nov 11, 2010

It's the first time you've gone for counseling. You're nervous. (Is this the right address?) You walk up to . . . An office building? . . . a home office? You open the door and cross the threshold, stepping into this new place and relationship. What do you see? An incredible space where design and the therapeutic process seem perfectly attuned or a ‘shrinking' office where décor plays only a bit part in nurturing/healing?

In fact, every therapist's space provides the backdrop against which clients' personal dramas will be revealed. Yet, psychologists typically receive little, if any, training about how to set an effective stage for the client-practitioner interplay. As a design psychologist, I believe that it's crucial for every healthcare professional to be keenly aware of the messages and mood conveyed by their therapeutic environment. Thus, they can consciously create a space with positive (even therapeutic) benefits for their patients.

Inevitably, for example, every counselor's office has two main vantage points: the therapist looks towards the patient; the patient looks toward the therapist. With this in mind, care should be given to choose a layout, style, colors, furniture, window treatments and office artwork/special objects as experienced from these two very different visual perspectives.

When working with a patient, for instance, Freud explained that he placed his chair to the side of his famous couch where patients couldn't see him. It is said that he commented, "I could not let myself be stared at for eight hours daily."(1) Another theory suggests that it was his hearing problem later in life that caused him to place himself right behind his patient's head.(2) Yet another theory suggests that a "patient had tried to make advances to the doctor," thus he was careful to maintain appropriate boundaries (3), keeping himself out of the patient's line of sight.

Back at his desk, Freud sat in a chair that appeared more like a Henry Moore sculpture than a conventional seat. Freud's son, an architect, had a friend custom-design it to accommodate Freud's penchant for swinging his legs over the chair's arm and leaning back sideways.

From that perch, Freud could look out of the huge doors/windows to the lovely English garden in his backyard, a place that provided him with great pleasure. If he looked straight ahead, beyond his inspirational collection of antiquities and above his legendary couch, he could see a lithograph of French doctor Jean-Martin Charcot (1825-1893). (4) It depicted Charcot demonstrating his technique of hypnosis to a group of doctors. Perhaps this print (that became famous in its day) proved inspirational to Freud, as it represented the increasing curiosity about and public acceptance of the science of the mind.

Since most patients today no longer lie down a couch with their eyes closed, therapists can consider these Design Psychology TIPS when designing their office space:

  •  Aesthetic Satisfaction Think about your own personal and therapeutic style.  What office look and feel would bring you pleasure yet remain open-ended enough to allow your clients to feel secure, comfortable and free to reflect? Too much clutter may make it hard for clients to focus. One therapist/ design psychologist (5) designed an office with a beautiful, framed, blank shoji screen hanging in the patient's sight line. Thus those in counseling could stare at this neutral backdrop and ‘write' their story on this ‘blank slate.'
  •  Social Satisfaction  Do you work with individuals? Couples? Groups? Be sure to provide seating options to allow people to establish comfortable personal space and inter-personal distances. Of course, where clients sit in relation to you and to others, may provide you with clues regarding their own sense of attachment, appropriate boundaries and intimacy. Privacy achieved through solid doors/good soundproofing and window treatments also reassures patients that their comments are private and confidential.
  •  Psychological satisfaction Zen-like, calming colors, soothing sounds, soft textures and pleasant aromas can all have a calming effect. A Caregivers Center (6) I helped create includes a gentle waterfall. Adults there also benefit from moveable ‘toys' : They can push and pull a tiny rake through a miniature Zen garden - - a mindless action that helps them to de-stress. Yet another therapist interested in Design Psychology keeps smooth, loose stones by her patients' chair, allowing them to finger them and then take them home, thus providing "subtle touchstone" for patients to keep until the next session. (7)
  •  Growth This same therapist's office contains a lovely abstract print of a mountainous scene that her patients can view when meeting with her. The print utilizes tremendous depth of field to draw your eye in and upwards towards a breathtaking pink sky.  Thus it provides a subtle, positive suggetion to each client: You can move forward, upward, and grow.


1. The Freud Museum, 20 Maresfield Gardens: A Guide to the Freud Museum London. (London: The Freud Museum, 1998), p. 54.

2. Fuss, Diana, The Sense of an Interior: Four Writers and the Rooms That Shaped Them. (New York: Routledge, 2004), p. 93.

3. The Freud Museum, 20 Maresfield Gardens: A Guide to the Freud Museum London, p. 54.

4.Ibid., p.55.

5. Constance Forrest, Ph.D.

6. The Ken Hamilton Caregiver Center, Northern Westchester Hospital, Mt. Kisco, N.Y.

7. Therapist Julie Wald.

Copyright Toby Israel, 2010.