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Built environment and schizophrenia is it the product of poor behaviour setting design?

Presentation to the World Congress of the International Academy of Design and Health, Fairmont Royal York Hotel, Toronto ON, July 11th 2014 at 4:00pm

Jan Golembiewski

on 19 November 2014

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Transcript of Built environment and schizophrenia is it the product of poor behaviour setting design?

The built environment and schizophrenia: Is high incidence because of poor behaviour setting design?
Jan A Golembiewski PhD
Urban locality is the highest-known risk factor for schizophrenia.
Urban upbringing
alters the brain.
Haddad, Schafer, Streit et al. 2014
The DLPFC is the area most affected by an urban upbringing. Other studies show it's also the area of the frontal lobe that's most implicated in psychotic expression -
Healthy controls inhibit this area when exposed to negative stimulus and 'let go' when exposed to positive.
Psychiatric patients do the opposite.
(Northoff et al. 2004, Golembiewski 2012)
Over the long-term, design gives rise to structural changes to parts of the brain, and this appears to be aetiologicaly linked to psychosis.
The built environment has a powerful capacity to change the way we feel, think and behave.
* it can limit and suggest choices
* it's an important source of meaning
* it's a major site for the expression of identity
* it provides for shelter, respite and other basic needs
* it's loaded with semantic messages
This argument defies the common wisdom that well-being is achieved through 'inner work'.

Now we are discovering that the our endeavours to redress the dissonance between desire and reality are corporeal.
Hoarding is very common behaviour among shizophrenic patients and others with hypofrontal disorders.
We perceive by reacting to what we sense on a neural level. The more reaction, the stronger those neural pathways become.

The DA neurons of the PFC are inhibitory - therefore the more developed it is, the more we inhibit our reactions. This ability is only needed in 'negative' circumstances. Without this inhibition, behaviour becomes peculiar and symptomatic.
Reactions are emotionally charged. Objects, colours, and even symbols don't cause us to react much on their own...
...but how objects and symbols are situated among other objects gives us a context that almost always elicits a response. Especially if they affect us or things we care about.
The loss of frontal processing means a functional oversupply of dopamine (by 20-40%), the root cause of psychotic symptoms.

A happy, equitable and forgiving environment encourages the activation of post-synaptic neurons.
* Design the whole experience: the designers job is to manage narratives - like the director of a stage set.
What if the city
was the hospital?

"He whom has no need (because he is sufficient) must be either beast or god"
Aristotle [Poetica II]
The limbic organs comprehend stories.
* hippocampi monitor structure:
The beginning middle and end of a storyline.
* amygdalae drive the need to solve stories:
They report how this involves me.

The environment may cause psychosis...
but may also be a cure.
The more stimulated they are, the stronger neurons become.
With every 'trigger', the environment suggests behaviour - but in hypofrontal conditions these 'suggestions' become compulsory.
Choice is lost.
entering the fountain
Full transcript