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A fter 15 years of intensive research on the perception of space and stress by seriously ill patients
and their connection to the hospital environment, we finally achieved a breakthrough in 2020.
We were able to sufficiently prove empirically that seven design-relevant factors, so-called environ-
mental variables, exert an influence on stress perception and have an impact on health and recovery.
We call these “The Healing Seven”: 1. orientation, 2. smell, 3. soundscape, 4. privacy and retreat, 5.
power points, 6. view and foresight, and 7. human scale. The Rotterdam Study laid the foundation
in 2010. Until January 2024, the Architekturmuseum der Technischen Universität München in the
Pinakothek der Moderne has been showing these “Healing Seven” in the exhibition “Das Kranke(n)
haus. How Architecture Helps to Heal”. If architects base their design decisions on scientific findings,
the design result is called “evidence-based design”. Architectural psychology is the key discipline of
the related research. The American architecture professor Roger S. Ulrich coined the term in 2006.
He referred to studies that proved that single-bed instead of multi-bed rooms, the reduction of back- Abbildung: Kopvol architecture & psychology
ground noise on the wards and the creation of visual relationships to green outdoor spaces had a
positive influence on the well-being and pain perception as well as the quality of sleep of patients.
Scientists in Europe were initially sceptical about this trend but, in 2010, we succeeded in providing
the theory. Under the name “spatial anthropodysmorphia”, it sums up complex relationships in a (6) Der PCPU-Patientenzimmer-Prototyp von Kopvol Architecture & Psychology für ...
simple formula: “When the body falls seriously ill, the space falls ill with it.”

La Infirmita: Human scale for healthcare buildings of the future

In order to focus the designers on these changes in spatial perception and to encourage them to refer
to them when making design decisions, we developed the figure La Infirmita (3). This is a measure
derived from the body experience and the related altered spatial experience of sick people. The Dutch
organization Ipse de Bruggen, for example, cares for over 6000 people with mental disabilities. In
2021, it commissioned an ensemble of buildings that is intended to help reduce the extremely high
intensity of care for the most severely handicapped and help them to become more independent (1,
2). We designed a cross-shaped typology of residential buildings, from the centre of which all interior
and exterior spaces are visible. The result is an architecture that functions as a co-therapist. Those Abbildung: Kopvol architecture & psychology
who are anxious or stressed hardly perceive their surroundings. The attention span is drastically
reduced to less than three minutes. Complicated signage in the hospital are then of little help. The
Friendship Hospital in Bangladesh designed by Kashef Chowdhury is an example providing a solu-
tion (4). Through visual relationships to the outside and organizing elements on every conceivable (7) ... das Princess Máxima Centrum für Kinderonkologie in NL-Utrecht
scale, the architecture succeeds in relieving stress and tension. Many sick people are hypersensitized.
They either smell nothing at all or too much. In this condition, it is painfully unpleasant when the
smell of food, disinfectants and cold sweat determine the sensory impression as soon as one enters (8) Narrative Isometrie der Patent-Child-Patient-Unit (PCPU) von Kopvol entworfen
a clinic. Healthy sleep is indispensable for recovery. In 2010, we were able to prove in the Rotterdam
Study that cancer patients in particular benefit from the farsightedness factor. While looking at closed
walls increases their feeling of narrowness and lack of perspective, farsightedness helps them to relax
and develop positive thoughts. Bonnema Architecten (now De Zwarte Hond) have implemented this
aspect in an exemplary way at the Zuyderland Medisch Centrum in Sittard (5). The architecture thus
supports the patients in distracting themselves from their anxious thoughts. In addition, perceptible
relationships are created with a positively evaluated background noise, the level of which can be
regulated by the patients themselves. The need for a view and foresight is usually mentioned in the
same breath as the desire for privacy and retreat. This factor becomes particularly relevant when desi-
gning environments for seriously ill children and adolescents. During long-term hospitalization, their
psychosocial development suffers. To counteract this, we developed a new patient-room typology
for the Princess Máxima Centre for Paediatric Oncology in Utrecht, the Netherlands (6-8): The PCPU
(Parent-Child-Patient-Unit) makes it possible for the first time to regulate privacy between parents and Abbildung: Kopvol architecture & psychology
seriously ill child in hospital.

Phase Zero: The crucial role in the Evidence Based Design process

The impetus for the European flagship project in Utrecht initially came from a non-profit association of Quellen:
parents of children with cancer, doctors, psychologists and carers. They commissioned us to carry out - Tanja C. Vollmer und Gemma Koppen, Die Erkrankung des Raumes:
the research and development work in a two-year competitive preliminary phase, the so-called Phase Raumwahrnehmung im Zustand körperlicher Versehrtheit und deren
Zero. In Germany, with the exception of the construction of the new children’s and young people’s Bedeutung für die Architektur. Utz Verlag: München 2010
hospital in Freiburg, such a Phase Zero has not yet played a role. This is the reason why German - Gemma Koppen und Tanja C Vollmer, Architektur als zweiter Körper.
health architecture is clearly lagging behind in Evidence Based Design in international comparison. In Eine Entwurfslehre für den evidenzbasierten Gesundheitsbau. Gebr.
the coming years, Germany plans to spend several billion euros on the conversion and construction of Mann Verlag, Berlin 2022
large treatment centres and hospitals as part of radical reforms. This opens up opportunities to think - Tanja C Vollmer, Andres Lepik und Lisa Luksch (Hrsg.), Building to Heal.
about innovative models in healthcare construction and to participate in the change by applying New Architecture for Hospitals. ArchiTangle: Berlin 2023
architectural psychological findings. There is every reason not to wait any longer, to finally (again) - Tanja C. Vollmer (Hrsg.), Architekturpsychologie. Perspektiven. Band 1:
complement the art of healing in a meaningful and effective way with science-based architecture! Forschung und Lehre. Springer Verlag: Wiesbaden 2023

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