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Mind the Design: Health and Illness and How they’re Affected

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Jan Golembiewski

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Transcript of Mind the Design: Health and Illness and How they’re Affected

Mind the Design: Health and Illness and How they’re Affected by Healthcare Architecture
Prof. Jan Golembiewski (MArch,PhD)
The relationship between the mind and the environment is possibly more profound than the relationship between the mind and the body.
Rene Descartes,
1641 'no relationship'
This concept was embraced
by the Enlightenment and
medical science.
Juvenal, 200 AD
'healthy body = healthy mind'
Harlow, 1848 'the brain
determines behaviour' -
In this case even more than health
Skinner, 1938 - refuting dualism: a single body-mind-behaviour axis
JJ Gibson, 1978 'ecological perception': Perception = action
Why does this matter?
- because the brain is affected by the environment, and through the brain, mental and somatic health is also.

-Mental illness is diagnosed ONLY by behaviour.
Therefore the environment has a direct CAUSAL relationship with mental illness.
What stimulates attention?

1. Perceptual impact.
2. Meaning.


- When circumstances don't match learned expectations
- Violations of natural order (rhythms, colours, sounds, smells etc.)
These cause interrogation behaviour.


In most mental illness, dopamine supply to the inhibitory receptors increases. Meanwhile dopamine supply to the excitatory receptors decreases.



We want to rearrange, not change dopamine levels.
Tone is more or less continual, and low-level. It is likely caused by inhibitory receptors (D2, 3 & 4)
Spikes only happen periodically.
These are thought to trigger declarative attention. Spikes are usually a response to POSITIVE information (leading to dopamine / reward theory).
Perceptual impact:
What do we find meaningful?

1. Things I understand or have learned about
2. Things that affect me
3. Things that demand action
4. Things that affect those I care about


The urban environment is wholly designed: Each and every designed object is replete with meaning.

Nowhere are there more objects and events that demand attention. To some degree every crumb makes some kind of latent perceptual demand on us.

Phasis consumes 10 times more available dopamine.
The difference is in the way we react to stimuli:
With awareness or with automaticity.
The capacity to process story creates meaning.
And it is how the story affects ME that that will allow this 'healing' engagement - phasis to occur...

- This is unique for humans. Other mammals have mostly inhibitory receptors, even in their prefrontal cortices. Humans have mostly excitatory ones. This means humans don't just react to stories, we engage in them. And with stories we can predict events.

Stories that affect ourselves and people and matters we care about are the most important ones: but we want to see action - not helpless reaction.

People who are vulnerable are far more reactive to negative perceptions - especially those with severe mental illness - about 65 times more! (Golembiewski, Med Hyp, 2013).
THE DESIGNED ENVIRONMENT
Hippocampi (one on each side): narrative processing-shrinks with smi
Amygdalae (on each side):
ipseity proccessing - enlarges with smi.
We read narrative information all around us, but some places are richer with meaning (both good and bad).
And so it's the designer's job
to tell that story.

- Design with an unmistakably 'positive' lexicon: joyful, fun, natural, engaging, aesthetic.
- Design for positive stimulation
- Design out possible 'negatives'.
- In healthcare and for housing, design opportunities for perceptual respite.

What stories does your hospital design tell? (Be honest.)
ICU at Mass. Gen. by NBBJ Architects
Patient spaces at KTP by CPG Architects
Set for Grey's Anatomy by ABC (USA) - Emergency = Disaster.
Amb at RCH. by Billard Leece& BSA
This paper is really just a teaser.
Some of the materal has been published -
More to follow. Look on the web.

Jan Golembiewski
greenmanarch@gmail.com
call me: 0424 936 263

- research in design and health at QUT
- available as an independent consltant.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington.
Andreasen, Nancy C. (1992). Linking Mind and Brain in the Study of Mental Illnesses: A Project for a Scientific Psychopathology. Science, 275, 1586-1593.
Arnfield, A. John. (2003). Two decades of urban climate research: a review of turbulence, exchanges of energy and water, and the urban heat island. International Journal of Climatology, 23(1), 1-26.
Ashby, F.G., Turner, B.O., & Horvitz, J.C. (2010). Cortical and basal ganglia contributions to habit learning and automaticity. Trends in Cognitive Sciences, 14(5), 208-215. doi: 10.1016/j.tics.2010.02.001
Bargh, John A, & Dijksterhuis, Ap. (2001). The perception-behavior expressway: Automatic effects of social perception on social behavior. Advances in experimental social psychology, 33, 1-40.
Baumeister, Roy F, & Showers, Carolin J. (1986). A review of paradoxical performance effects: Choking under pressure in sports and mental tests. European Journal of Social Psychology, 16, 361-383.
Bavelier, D., Tomann, A., Hutton, C., Mitchell, T., D. Corina, Liu, G., & Neville, H. (2000). Visual Attention to the Periphery Is Enhanced in Congenitally Deaf Individuals. The Journal of Neuroscience, 20(RC93), 1-6.
Bilder, R. M., Volavka, J., et al. (2004). The catechol-O-methyltransferase polymorphism: relations to the tonic-phasic dopamine hypothesis and neuropsychiatric phenotypes. Neuropsychopharmacology, 29(11), 1943-1961.
Boehringer, A., Tost, H., Haddad, L., Lederbogen, F., Wust, S., Schwarz, E., & Meyer-Lindenberg, A. (2015). Neural Correlates of the Cortisol Awakening Response in Humans. Neuropsychopharmacology.
Bromberg-Martin, E. S., Matsumoto, M., & Hikosaka, O. (2010). Dopamine in motivational control: rewarding, aversive, and alerting. Neuron, 68(5), 815-834. doi: 10.1016/j.neuron.2010.11.022
Buckley, PF, & Stahl, SM. (2007). Pharmacological treatment of negative symptoms of schizophrenia: therapeutic opportunity or Cul de sac? Acta Psychiatrica Scandinavica, 115(2), 93-100.
Csikszentmihalyi, Mihaly, & Halton, Eugene. (1981). The meaning of things: Domestic symbols and the self: Cambridge University Press.
Damasio, Antonio R. (1994). Descartes' error : emotion, reason, and the human brain. New York: G.P. Putnam.
Damen, Tom G. E., van Baaren, Rick B., & Dijksterhuis, Ap. (2014). You should read this! Perceiving and acting upon action primes influences one's sense of agency. Journal of Experimental Social Psychology, 50, 21-26.
Descartes, René. (1641[tr. 1986]). Meditations on first philosophy : with selections from the Objections and Replies. Cambridge Cambridgeshire ; New York: Cambridge University Press.
Faris, R.E.L., & Dunham, H.W. (1939). Mental disorders in urban areas: an ecological study of schizophrenia and other psychoses.
Fletcher, Paul C, & Frith, Christopher D. (2009). Perceiving is believing: a Bayesian approach to explaining the positive symptoms of schizophrenia. Nat Rev Neurosci, 10(1), 48-58. doi: 10.1038/nrn2536
Fowler, J. S., Volkow, N. D., Wang, G. J., Pappas, N., Logan, J., MacGregor, R., . . . Zezulkova, I. (1998). Neuropharmacological actions of cigarette smoke: brain monoamine oxidase B (MAO B) inhibition. J Addict Dis, 17(1), 23-34.
Freeman, D, & Freeman, Jason. (2008). Paranoia the 21st Century Fear. Oxford, New York: Oxford University Press.
Gallagher, S. (2007). Pathologies in narrative structures. Royal Institute of Philosophy Supplement, 60(1), 203-224. doi: 10.1017/S1358246107000100
Gibson, James J. (1979). The Ecological Approach to Visual Perception. Boston: Houghton Mifflin Company.
Ginovart, N, & Kapur, Shitij. (2010). Dopamine Receptors and the Treatment of Schizophrenia. In K. A. Neve (Ed.), The Dopamine Receptors (pp. 431-477). New York: Springer, Humana Press.
Golembiewski, Jan. (2012). All common psychotic symptoms can be explained by the theory of ecological perception. Medical Hypotheses, 78, 7-10. doi: 10.1016/j.mehy.2011.09.029
Golembiewski, Jan. (2013a). Are diverse factors proxies for architectural influences? A case for architecture in the aetiology of schizophrenia. Curēus, 5(3), e106. doi: 10.7759/cureus.106
Golembiewski, Jan. (2013b). Determinism and desire: Some neurological processes in perceiving the design object. International Journal of Design in Society, 6(3), 23-36.
Golembiewski, Jan. (2013c). The subcortical confinement hypothesis for schizotypal hallucinations. Curēus, 5 (5), e118. doi: 10.7759/cureus.118
Golembiewski, Jan. (2014). Introducing the concept of reflexive and automatic violence: a function of aberrant perceptual inhibition. Archives of Psychiatry and Psychotherapy, 16(4), 5-13. doi: 10.12740/app/33358
Golembiewski, Jan. (In review) The designed environment and how it affects brain morphology and mental health. HERD
Grossberg, S. (2003). Linking brain to mind in normal behavior and schizophrenia. Behavioral and Brain Sciences, 26(1), 90. doi: 10.1017/S0140525X03300020
Haddad, L., Schafer, A., Streit, F., et al. (2014). Brain Structure Correlates of Urban Upbringing, an Environmental Risk Factor for Schizophrenia. Schizophrenia Bulletin.
Harlow, John Martyn. (1848). Passage of an iron rod through the head. The Boston Medical and Surgical Journal, XXXIX(20), 389-393.
Hebb, Donald O. (1949). The Organization of Behavior. New York: John Wiley & Sons Inc.
Hohwy, J, & Frith, Christopher D. (2003). Can neuroscience explain consciousness? Trusting the Subject?: The Use of Introspective Evidence in Cognitive Science, 180.
Horga, G., Schatz, K. C., Abi-Dargham, A., & Peterson, B. S. (2014). Deficits in predictive coding underlie hallucinations in schizophrenia. J Neurosci, 34(24), 8072-8082. doi: 10.1523/JNEUROSCI.0200-14.2014
Johnson Abercrombie, ML. (1960). The Relation between Inside and Outside Worlds: Seeing Pictures The Anatomy of Judgement. London: Hutchison
Juvenal. (Circa 200AD). Satire X (G. Ramsay, Trans.). In G. Ramsay (Ed.), Satires.
Kapur, Shitij. (2003). Psychosis as a State of Aberrant Salience: A Framework Linking Biology, Phenomenology, and Pharmacology in Schizophrenia. Am J Psychiatry, 160(1), 13-23. doi: 10.1176/appi.ajp.160.1.13
Kean, Clara. (2009). Silencing the Self: Schizophrenia as a Self-disturbance. Schizophr Bull, 35(6), 1034-1036. doi: 10.1093/schbul/sbp043
Kelly, B.D., O'Callaghan, E., Waddington, et al. (2010). Schizophrenia and the city: A review of literature and prospective study of psychosis and urbanicity in Ireland. Schizophrenia Research, 116(1), 75-89.
Le Hunte, Bem, & Golembiewski, Jan. (2014). Stories have the power to save us: A Neurological Framework for the Imperative to Tell Stories. Arts and Social Sciences Journal, 5(2), 73-77. doi: 10.4172/2151-6200.1000073
Lederbogen, F., Haddad, L., & Meyer-Lindenberg, A. (2013). Urban social stress--risk factor for mental disorders. The case of schizophrenia. Environ Pollut, 183, 2-6. doi: 10.1016/j.envpol.2013.05.046
Lederbogen, F., Kirsch, P., Haddad, L., Streit, F., Tost, H., Schuch, P., . . . Deuschle, M. (2011). City living and urban upbringing affect neural social stress processing in humans. Nature, 474(7352), 498-501.
Lhermitte, F. (1983). 'Utilization Behavior' and its relation to leisons of the frontal lobes. Brain, 106(2), 237-255. doi: 10.1093/brain/106.2.237
Lhermitte, F. (1986). Human autonomy and the frontal lobes. Part II: Patient behavior in complex and social situations: The 'environmental Dependency Syndrome'. Annals of Neurology, 19(4), 335-343.
Lhermitte, F., Pillon, B., & Serdaru, M. (1986). Human autonomy and the frontal lobes. Part I: Imitation and utilization behavior: A neuropsychological study of 75 patients. Annals of Neurology, 19(4), 326-334.
Liebschutz, J., Saitz, R., Brower, V., Keane, T. M., Lloyd-Travaglini, C., Averbuch, T., & Samet, J. H. (2007). PTSD in urban primary care: high prevalence and low physician recognition. J Gen Intern Med, 22(6), 719-726.
Liu, Y., Yu, C., Liang, M., Li, J., Tian, L., Zhou, Y., . . . Jiang, T. (2007). Whole brain functional connectivity in the early blind. Brain, 130(Pt 8), 2085-2096. doi: 10.1093/brain/awm121
Mitchell, Edwin A, Hutchison, Lynne, & Stewart, Alistair W. (2007). The continuing decline in SIDS mortality. Archives of Disease in Childhood, 92(7), 625-626. doi: 10.1136/adc.2007.116194
Northoff, G, Kötter, R., et al. (2004). Orbitofrontal cortical dysfunction in akinetic catatonia: a functional magnetic resonance imaging study during negative emotional stimulation. Schizophrenia Bulletin, 30(2), 405.
Peen, J., Schoevers, R. A., Beekman, A. T., & Dekker, J. (2010). The current status of urban-rural differences in psychiatric disorders. Acta Psychiatr Scand, 121(2), 84-93. doi: 10.1111/j.1600-0447.2009.01438.x
Pennebaker, James W. (2000). Telling Stories: The Health Benefits of Narrative. Literature and Medicine, 19(1), 3-18. doi: 10.1353/lm.2000.0011
Seeman, Philip. (2008). Dopamine D2High receptors on intact cells. Synapse, 62(4), 314-318. doi: 10.1002/syn.20499
Taylor, JG. (2007). CODAM: A neural network model of consciousness. Neural Networks, 20(9), 983-992.
Ullman, Shimon. (1980). Against direct perception. Behavioral and Brain Sciences, 3(3), 373-415. doi: 10.1017/S0140525X0000546X
van Os, Jim, Kenis, Gunter, & Rutten, Bart P. F. (2010). The environment and schizophrenia. Nature, 468(7321), 203-212. doi: 10.1038/nature09563
van Os, Jim, Rutten, BP, & Poulton, R. (2008). Gene-Environment Interactions in Schizophrenia: Review of Epidemiological Findings and Future Directions. Schizophrenia Bulletin, 34(6), 1066-1082.
Vassos, E., Pedersen, C. B., Murray, R. M., Collier, D. A., & Lewis, C. M. (2012). Meta-analysis of the association of urbanicity with schizophrenia. Schizophr Bull, 38(6), 1118-1123. doi: 10.1093/schbul/sbs096
Wise, Roy A., & Rompre, P. P. (1989). Brain dopamine and reward. Annual Review of Psychology, 40, 191-225.
REFERENCES
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