The quality of the analytic relationship and the space in which such a relationship occurs are constituted not only by the cognitive context but also by the immediate and pervasive physical context. “The analytic room should have the capacity to evoke different kinds of associations and be able to accommodate richly variegated desires of the occupants. The effect of the architecture on the analytic relationship, and hence the analysis, in direct and indirect awareness, is profound” (Danze).
Giuseppe Civitarese and Antonino Ferro, defining the analytic field, say that it contains not only psychological processes inside the analyst’s and patient’s minds – linked like two dynamic systems that interact in real time – but “it also contains everything that furnishes the place where people are, because it is a potential source of productive stimuli” (The Analytic Field and its Transformations).
The organization and distribution of the external space (I mean, of the consulting room itself) is strongly influenced by the analyst’s way of functioning, personality, technical assumptions, feelings, and opinions about the relational space, degree of involvement in the analytic relationship, and how much his or her internal objects can be in contact with the analyzand’s internal objects in transference-countertransference dynamics.
In the same way, the architectural, aesthetic, and functional organization of the physical space containing the psychoanalytic sessions’ setting (i.e., the consulting room) cannot be immutable or repetitive. Rather, it must deal with the need for continuously contextualizing tastes, communications, or habits and modifying building materials, furniture, forms, and uses of light – all things that continuously change. In spite of the fundamental need to consider all these socio-cultural and technological modifications, I believe that we cannot ignore the foundations of the psychoanalytic theory and practice or the relevance of the demands of a deep level of communication that, after Freud, focus on the pre-oedipal phases of the mind and the care of psychotic states. I think we must consider the necessities of the analytic couple not according to already defined modalities, but according to creative ones.
From Freud’s analysis room to contemporary ones
If we were able to go back in time and observe Freud’s consulting room, we would see a narrow space, interconnected with domestic spaces and thus with its smells and noises. It was neither a neutral nor an institutional space but rather a common place in everyday life. It was full of furnishings, carpets, decorative objects, and relics able to give clear indications of the taste and cultural interests of the analyst. Because all these objects were familiar in the analyst’s everyday life, we can say that they functioned so as to reduce his solitude (we can say that this solitude was often emphasized by the continuous contact with the uncanny). Further, because these furnishings highlighted some aspects of the analyst’s privacy, they were able to “organize this place of intimacy” (Eiguer) and become part of the contents of the analysand’s fantasies. Thus by exhibiting his collections, Freud was literally able to reveal things about himself. That is to say, to operate a self-disclosure that brought together the past of the single person and that of civilization.
For some years now, we have seen an increasing number of published photographs of consulting rooms. This is curious because it contrasts with the well-known discretion of psychoanalysts about their personal life and therapy places. From 2004 to 2004 the magazine International Psychoanalysis published pictures of the consulting rooms of the members of the International Psychoanalytical Association. The German photographer Claudia Guderian’s 2004 book Magie der Couch (‘The magic of the couch’) can be considered the first exploration of the contemporary consulting rooms with a camera. The pictures draw attention to the modifications of space and furniture over time not only by virtue of scientific and ideological assumptions, but also of socio-cultural changes in the environment.
Similarly, Sebastian Zimmermann’s Fifty Shrinks (2014) was the first photography book to feature portraits of psychoanalysts in their work spaces, exploring the dynamic triad between the analyst, the patient and the environment. The book contains a number of interviews in which the analysts discuss how they think and work (“the inside”) and their ideas and the choices they made when setting up and decorating their analytic spaces (“the outside”).
After the “too full spaces” of Freud’s and first Freudian analysts’ rooms (International Psychoanalysis, 2000), traces of some of which can be found also in some contemporary analysts from Vienna and London, we attend to the idea of reduction, simplification, and deprivation (this idea is based on the German architect Ludwig Mies van der Rohe’s maxim “less is more”, and his so-called “skin and bone” architecture) and thus to the too empty spaces of the subsequent analysts’ rooms.
These studies are generally furnished in Franciscan style, that is to say, they are simple, frugal, essential, and cold – almost anonymous. On the one hand, these studies are affected by the American Puritanism of the 1940s with its tendency toward uniformity and stability so that, for many decades, nothing can be changed in the analyst’s study or clothes (Guderian); and, on the other hand, by the minimalist claims of modern architecture. There is only an armchair, a couch, sometimes a writing desk and closet. No books, no paintings on the walls, and no decorative objects are allowed – they could give indications of the analyst’s personality and interfere with the analysand’s phantasmatic and associative freedom. The basic idea is to reduce as much as possible the analysand’s projections to objects that belongs to the analyst and, in a certain sense, to foster the analysand’s expression of dreams, fantasies, and experiences without any supporting material provided by the analyst.
Thus, the neutrality of the room allows a mediation of the physical and psychical, thereby fostering a safe separation – that is to say, a safe passage from the centre of the world (represented in the analytic relationship) to the external world for both analyst and analysand.
In general, the most recent generations of analysts deal with the issue of allowing the presence of the analyst to emerge as something fundamental for the analytic relationship.
It is clear that there are different degrees through which the analyst can reveal himself or herself as a person. The definition of the setting is between two polarities, one in which the analyst has the function of a “blank screen” or “hanger”, and one in which he or she makes an excessive use of inter-subjectivity. This use can lead one to excessively define the setting on the basis of the analyst’s personal tastes and of his or her self-disclosure (i.e., the analyst’s act of conscious and deliberate revealing personal information to the analysand. It is completely different from the accidental and “unconscious” revealing of personal information. It can strongly interfere with the analysand’s tastes and experiences and with the freedom of expressing them).
Today, the presence of a plain interior design that is able to communicate the analyst’s aesthetic-cultural interests is no longer anything to avoid. I think that it is necessary that analysts maintain “their good sense and good taste in limiting themselves to a perceptible but usually sober personalization of the environment, avoiding a narcissistic invasion of the working field with the exhibition of their private iconography” (Bolognini).
The inside and outside in the analytic room
A number of commentaries on the various photographs of analysts’ studies refer to the spatial dimensions of the rooms, the height of their ceilings, and the size of their doors and windows – which, together with the spatial subdivision and the position of the pieces of furniture and decorative objects, define the horizontal and vertical position between two bodies by measuring and defining their architectural scale.
In general the spaces of the European analysts’ consulting rooms are smaller than those of Americans. This means that the distances between the analyst’s armchair and the analysand’s couch and between the analysand’s perspective and the room’s different furnished parts are smaller, too. In this sense, the room seems to harken back to a primitive refuge. This implies a change at the perceptual level – that is to say, a different mutual way of listening, of visual observation, and of proprioception in relation to proximity and separation, but also to material, acoustics, lights, and all the physical elements we must consider.
Rooms of different forms and material reverberate in a different way (Rasmussen). The sound can be hard or soft, reflected or absorbed, depending on the different features of forms and material. In this sense, these features can define in many different ways the issues of proximity, security, and fear that the presence or absence of sounds near the consulting room can provoke (for example, those sounds or voices coming from the street or the waiting room). Further, it would be beneficial that there be between analyst and analysand “a sensible listening and a continuous dialogue, similar to what happens in an execution of a work for a piano four hands. This execution requires piano players a continuous critical attention, good taste and a common capacity of letting emotions go” (Petrella).
The experience of intimacy is reinforced by the presence of a window that marks the distinction between the unmeasurability of the outside and the intimacy of the inside. If this experience can be called into question by the distraction provoked by windows that may be too large, a vision of the horizon or of distant places can give a concrete idea of the infinite. Similarly, the sense of closure of the interiors reminds us of something finite and tangible. Each polarity needs the other for its fulfilment (Danze).
The quantity and the quality of natural light into a consulting room is very important because, in architecture, all the things that the eyes see and the other senses perceive are determined by light and shadow conditions (Holl). The consulting rooms of American analysts seem to have much more light than the ones of European analysts not only because of the size of the windows, the colour of the walls, or the use of material, but because of the combination of these three elements. All these elements influence the perception of natural light, which can be excessive for an intimate and private place such as a consulting room.
I received positive comments from patients when I substituted in my consulting room a chaise longue designed by Le Corbusier with a wider and softer couch. This is probably because the shape of the former put an objective spatial constraint, a lack of comfort, and a difficult in the bodily movements of the patients, whereas the shape of the latter fostered relaxation in their bodily movements and thus helped them remember their dreams and fantasies.
I remember the experience of temporariness and promiscuity of a patient who, before asking to start analysis with me, had been in treatment with an analyst who made him lie down on a common living-room sofa. The patient fantasized that on this sofa his analyst used to drink coffee with his guests. In this sense, he fantasized that no place – that sofa included – could be a non-promiscuous place and unique for him. That is to say, he thought he could not have an intimate place only for him and with a well-specified function.
I believe that we cannot speak of consulting rooms without considering the spaces near them. The sequence of arrival contains many thresholds and subtle and powerful elements in establishing territory and the dialectic between inside and outside (Malnar & Vodvarka). The reception desk of a building, its hall, its stairs, its elevator, its anteroom, its waiting room, and also its toilets are examples of the spatial sequence we must cross from a public space to a private home. “As one enters the building’s precinct and proceed towards the analytic room, layers of space are penetrated slowly, at a walking pace, preparing for the inner sanctum, while insulating the analysand and the analyst from the outside world” (Danze).
“Architecture could be viewed as a series of suggestions and experiments on the nature of internal and external relations, a machine programmed to manipulate and regulate these links. Therefore, one can see architecture as a sublimation in which we bind our experiences of being connected to nature and society while maintaining sophisticated levels of differentiations from those same ever-present larger unities” (Sperber). Architecture is a reflection on entering and exiting which is able to define the frames containing our lives (ibid.).
Entrance, exit, and greetings are fundamental parts of the analytic experience. The borders are certainly physical and concrete but can occur in many different ways. Some are clearly visible, other are invisible, and others still are only implicitly suggested but nonetheless are strongly felt at the physical and emotional level. The real or imaginary borders of the room refer to the real or imaginary borders of the analytic relationship also at the spatial level. The quality of such a curious relationship between analyst, analysand, and the space in which the analysis takes place does not depend only on the cognitive context but also on the immediate and pervading physical context. “The analytic room should have the capacity to evoke different kinds of associations and be able to accommodate richly variegated desires of the occupants” (Danze).
Of course, I have no intention of proposing an architectural model for a consulting room. I am aware of the risk of having excessive simplifications and reductions making us pay less attention to the unique and original features of every consulting room, as well as to the integration between the spatial and perceptual spaces, the patient’s internal world, and the peculiarities of analysand-analyst relationship. In spite of this, I believe it is useful to stress certain historical, geographical, architectural, sociological, and technical aspects. For example, it is a matter of fact that, unlike American analysts, European analysts tend to have their consulting rooms inside their homes; that external spaces are wider in America than in Europe; that American analysts give more relevance to interior illumination than do European ones; the increase of professionalization of the psychoanalytic work and its consequent display of certificates as trophies; and the various theoretical models in psychoanalysis that are discussed in my book.
All these aspects can have a non-neutral role in the constitution of the analytic setting and also in the experience and interpretation of transference and countertransference. I think that knowing and scrutinizing the effects of the consulting rooms’ architectural aspects and furniture on the analytic relationship’s dynamics can promote an assessment of the different components of the rooms themselves. The same applies to the assessment of the consulting room.
Cosimo Schinaia is a psychiatrist who worked as Director of Mental Health Centre of Central Genoa for many years. He is a training and supervising psychoanalyst of SPI (Italian Psychoanalytical Society) and a full member of the International Psychoanalytical Association. He has published many scientific papers for both Italian and international journals and books, including Dal Manicomio alla Città; Il Cantiere delle Idee; Pedofilia Pedofilie: La Psicoanalisi e il Mondo del Pedofilo; and his book On Paedophilia (Karnac, 2010). He currently lives and works in private practice in Genoa.
His latest book, Psychoanalysis and Architecture: The Inside and the Outside, has just been published by Karnac.
All photographs of analysts in their offices are taken from psychiatrist and photographer Sebastian Zimmermann’s book Fifty Shrinks (2014), a remarkable collection of intimate portraits of psychotherapists in their private offices, and are reproduced here by kind permission of Sebastian Zimmermann.
Reviews and Endorsements
‘Metaphors of restoration or of moving house are often present during analysis to convey the idea of profound changes in the patient’s emotional life. In this fine book, the author goes further, finding in ‘creativity’ the common denominator of psychoanalysis and architecture. These two ‘sciences’ continually cross over into art. The office of a psychoanalyst and the office of an architect are constantly called upon to become ateliers of transformations and inventive dwellings in the internal and external world. This book opens a door to new adventures of the mind. Definitely not to be missed.’
– Antonino Ferro, author of The Analytic Field and its Transformations