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Room of silence: an explorative investigationof design students’ redesign of an arena forreflection and existential meaning-making

Anna Petersson, Gunnar Sandin & Maria Liljas

To cite this article: Anna Petersson, Gunnar Sandin & Maria Liljas (2015): Room of silence: anexplorative investigation of design students’ redesign of an arena for reflection and existentialmeaning-making, Mortality, DOI: 10.1080/13576275.2015.1046825

To link to this article: http://dx.doi.org/10.1080/13576275.2015.1046825

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Room of silence: an explorative investigation of designstudents’ redesign of an arena for reflection andexistential meaning-making

ANNA PETERSSONa , GUNNAR SANDINa & MARIA LILJASbaFaculty of Engineering (LTH), Department of Architecture and Built Environment, Lund

University, Lund, Sweden, bUppsala Religion and Society Research Centre, Uppsala

University, Uppsala, Sweden

ABSTRACT This paper explores design students’ proposals for a redesign of the interior of a room of

silence at the SUS hospital in Malmo. Reflection and existential meaning-making are discussed in

relation to the material culture of design, and more specifically in relation to four different themes

found among the students’ proposals: nature as common symbolic framework and salutary force;

lighting creating a visual and spatial ambience for retreat; interactive objects allowing ritualised

activities; and the presence and absence of religious symbols. In this paper, we argue that architec-

ture and design more profoundly could support people with varying existential viewpoints when it

comes to providing religiously and culturally shared public spaces for dealing with existentially cru-

cial moments. We also argue for an interdisciplinary research approach to healing environments,

where existential meaning-making is included in the overall discussion of the design of health care

architecture.

KEYWORDS: architecture; design; health care; healing environments; existential meaning-

making

1. Introduction and aim

1.1. Introduction

Rooms of silence can now be found in a great variety of public and semi-public

contexts, such as airports, universities, hospitals, large companies and even

shopping malls. In the west side of the Visitors Lobby in the New York United

Nations General Assembly Building, there is a room of silence, one of the first

of its kind in modern times, planned by the Swedish diplomat and former UN

Secretary General, Dag Hammarskjold. Built in October 1952, this room – the

‘Meditation Room’ – is presented as a space which is open to people of ‘all

faiths and religions’, and is dedicated to ‘silence in the outward sense and

stillness in the inward sense’.1

Correspondence: E-mail: anna.petersson@arkitektur.lth.se

© 2015 Taylor & Francis

Mortality, 2015

http://dx.doi.org/10.1080/13576275.2015.1046825

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An important objective of rooms of silence is their capacity to afford

moments of reflection, which is often declared in their name as in the example

above. Other commonly used names are ‘reflection room’, ‘calm room’, ‘quiet

room’ and ‘serenity room’. We have in this text settled for the ‘official’ English

term – ‘room of silence’ – used by Skane University Hospital [Skanes Univer-

sitetssjukhus, referred to in the following using the Swedish abbreviation, SUS]

in Malmo, even though the term ‘multi-faith space’ is becoming more fre-

quently used in architectural discourse (e.g. Brand, 2012; Crompton, 2013).2

Although the noun ‘silence’ could suggest certain religious practices (Brand,

2012, p. 219), we consider the term ‘room of silence’ to be more inclusive than

the term ‘multi-faith space’.

Openness to a diversity of existential meaning-making frameworks is an

important aspect of the function of rooms of silence. When one is confronted

with life-changing experiences, existential questions about the meaning of life

and how to navigate in the world come to the foreground (Liljas Stalhandske,

Ekstrand, & Tyden, 2011a, p. 348; Park, 2005; Schnell, 2010). Someone’s indi-

vidual cognitive effort to frame his or her existential questions and experiences in

a comprehensible and meaningful way in the psychology of religion is often

referred to as a process of meaning-making (e.g. Park, 2005, pp. 708–711;

Schnell, 2010). This process can be tied to religion as a system of meaning as

well as to more secular frameworks (DeMarinis, 2008; Rosenkranz & Charlton,

2013; Udo, Danielson, & Melin-Johansson, 2013). The openness of rooms of

silence to a multitude of meaning-making frameworks is visible in the material

culture of their design, in that they often strive to reflect a basic and supposedly

general symbolic ambience suitable for many (Brand, 2012; Crompton, 2013).

The use of rooms of silence as space for reflection and meaning-making is

perhaps most obvious in milieus tied to challenging situations. As an example,

the stressful effects of illness, injury and bereavement create a need for desig-

nated places at large hospitals where people can rest and be alone with their

thoughts for a while. The room of silence is one example of such a place, offer-

ing a secluded area away from the clinical hospital environment where people

can spend some time in prayer, meditation or contemplation. The actual need

for and theoretical discussion of rooms of silence could however be seen as

wider than that, and as especially urgent today in societies where a plurality of

different life views – religious as well as secular – are expressed, practiced and

negotiated in the public domain (Brand, 2012; cf. Baker & Beaumont, 2011).

Contemporary Sweden could be seen as one example of such a society, and

also the other Scandinavian countries, as well as, for example, the Netherlands

(cf. Inglehart & Baker, 2000).

1.2. Aim of the study

Issues relating to reflection and existential meaning-making, and to the design

of religiously and culturally shared spaces for it, are remarkably absent in the

current international discussion on healing environments within the field of

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health care architecture (e.g. Evans & McCoy, 1998; Fornara & Andrade,

2012; Fornara, Bonaiuto, & Bonnes, 2006; Nagasawa, 2000; Ulrich, 2006).

The aim of this paper is to look at this neglected issue from an interdisciplinary

perspective that includes the psychology of religion and the material culture of

design. We do this through an explorative study of design students’ proposals

for developing the interior of a room of silence at the SUS hospital in Malmo.

Our primary object is to investigate practice-based assumptions regarding

future design of rooms of silence within a Swedish health care context; in our

conclusions, we also lift the general issue of how well design in health care

architecture reflects and supports existential needs.

2. Background and theories

2.1. Architecture for health care

The healing effect that the environment itself can have on diseases is histori-

cally speaking a relatively new part of medical treatment policies (Nightingale,

[1859] 1863; in Nagasawa, 2000, p. 218; Fornara & Andrade, 2012, p. 297).

However, today it is widely acknowledged that the design of health care envi-

ronments has an impact on people’s health (Evans & McCoy, 1998; Fornara

et al., 2006; Fornara & Andrade, 2012). Architecture for health care has a vital

practical part to play in this field since it has been shown that specific design

features can shorten or prolong patients’ recovery by promoting well-being or

inducing stress (Ulrich, 2001).

In recent years, studies of the relationships between medicine, environment

and spatial design have advanced, in particular in the field called evidence-

based design (EBD) (Ulrich, 2006). EBD argues for more humane hospital

environments and aims to include both quantitative and qualitative inputs in its

empirical research findings. Of particular interest in EBD is the difference in

experience between ‘experts’, such as technicians, architects and designers, and

‘laymen’ such as patients and visitors (Fornara et al., 2006, pp. 321–322).

However, in practical application, the EBD approach suffers from drawing on

quantifiable environmental parameters or aspects, often with the aim of show-

ing particular clinical improvements or better workplace performance, thus

eventually also suggesting cost effectiveness. This line of functionalist thought

has the result that diversities and subtleties in experience arising from cultural,

ethnic, social or gender-based specificity are often overlooked (Fornara &

Andrade, 2012, pp. 298–299; Nagasawa, 2000, p. 226; Sandin & Stahl, 2011,

pp. 72–73). Another unexplored aspect, implying the importance of cultural

difference, is the expanded function of hospitals to provide a social and cultural

resource for the community (Macnaughton, 2007).

2.2. Existential moments and their setting

The social and cultural norms that are inevitably tied to the physical setting of

places become especially apparent in religiously and culturally shared spaces,

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such as rooms of silence in health care environments. Interior design is

acknowledged to have restorative effects in ‘certain types of settings such as

religious sanctuaries and hospitals’ (Evans & McCoy, 1998, p. 91), however

the material aspects of multi-faith spaces need to be investigated as part of the

general commitment to explain the connections between health and existential

meaning-making (e.g. Bekke-Hansen et al., 2013; Bullington, Nordemar,

Nordemar, & Sjostrom-Flanagan, 2003; Liljas Stalhandske, Ekstrand, & Tyden,

2011b).

Studies into religion as a meaning-making framework for coping with stress

usually support the hypothesis that religious belief is beneficial for an individ-

ual’s psychological health (Ano & Vasconcelles, 2005; Pargament, 1997). The

beneficial function of religion in existential situations however must be under-

stood in a cultural and societal context, which makes it important to underline

the fact that most studies about religious coping have been conducted in the

US (DeMarinis, 2008, pp. 63–68; La Cour, 2008, p. 770; Park, 2005,

pp. 722–723). In a society and culture where the influence of religious institu-

tions is comparably weak, such as the Scandinavian context, it might be

difficult for citizens to turn to religious institutions as a resource for meaning-

making (DeMarinis, 2008, p. 67; La Cour, 2008, p. 770). Religious belief and

practice becomes, in these secular or ‘non-religious’ societies, more a matter of

personal concern of the individual’s free choice (La Cour, 2008, p. 770;

cf. DeMarinis, 2008, p. 65).

Existentially crucial moments, such as a sudden death, a serious illness or some

other life-changing event, may drive the individual to (re)choose religion as a

meaning-making framework (La Cour, 2008). But equally, it might also drive

people to invent their own existential practices and symbolic meaning-making

frameworks (Liljas Stalhandske, 2005; Petersson, 2013), sometimes by creating a

mix of different existential world views (DeMarinis, 2008, p. 66). There are also

some individuals who are unable to choose at all, and for whom a lack of a basic

existential world view leads to a crisis of meaning-making (DeMarinis, 2008,

p. 67). Groups of people that fall into this category include, for example, certain

marginalised immigrant groups, who once had a functioning world view system

that no longer works due to the new and different Swedish context, and a grow-

ing number of ethnic Swedish young people, who have lacked an existential

world view system from the start (DeMarinis, 2008, p. 67). This lack of common

structuring narratives and existential practices can be described as ‘existential

homelessness’ (Liljas Stalhandske, 2005, pp. 128–137), in the sense that it leaves

these people in an existential and ritual void.

2.2.1. Design for existential meaning-making in the late modern context. However,

both common existential practice, such as traditional religious rituals, and more

individual ritualised symbolic acts, such as leaving flowers at a site of sudden

death, can function as tools that help people reconcile conflicting feelings of life

as meaningful and life as meaningless (Akesson, 1997, pp. 112–113, 150; cf.

4 A. Petersson et al.

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Bell, 1992, pp. 30–46; Grimes, [2000] 2002, pp. 5–7; Schechner, [1993] 1995,

pp. 230–233; Quartier, 2010; Quartier & Hermans, 2007). The design of reli-

gious buildings, and also of cemeteries, monuments and spontaneous memor-

ials, can be said to support existential practice and meaning-making by

providing a physical location and a defined space with an orchestrated and

recognisable visual and material symbolic framework (Collins, 2006, 2013;

Grimes, 2007; Petersson, 2013; Petersson & Wingren, 2011). Rooms of silence,

which address people of different cultures and with different religious faiths

and practices as well as non-believers, are often designed with the combined

aim of being non-denominational, so as to suit all visitors (or at least not upset

anyone), and yet of appearing to be ‘sacred’ to a certain extent in order to

suggest a place conducive to the enactment of traditional religious rituals (cf.

Petersson, 2009, pp. 138–139).

In recent discourse relating to the architectural and spatial considerations of

shared public spaces, particularly what have been called multi-faith spaces

(Brand, 2012; Crompton, 2013),3, the problematic nature of this composite

ambition in multi-faith design has been described as an issue of ‘how to prevent

a space [from] becoming meaningful in an inappropriate way’ (Crompton,

2013, p. 474). Some researchers even see this complex issue as leading to a

type of secular iconoclasm that purifies, privatises and profanes public faith

(Howe, 2009), replaces faith-related values with those of architectural excel-

lence (Sandin, 2003, pp. 217–219) or creates anti-architecture by designing

rooms ‘saying nothing’ (Crompton, 2013).

In the late modern context, debate on cosmopolitan ‘post-secular society’ has

examined the role of the city as a scene for people’s expressions of and expo-

sure to societal religio-secular change (Baker & Beaumont, 2011; Habermas,

2008). In line with this debate, architect Brand (2012, p. 222) highlights two

mutually opposing standpoints commonly expressed in criticism of multi-faith

public spaces: they are viewed as being indicative of a re-sacralisation of the

West; or equally, as an attempt by an increasingly secular western society to

keep religious observance out of sight. At the same time, however, rooms of

silence might also be seen as a particularly well-founded example of spaces

which support the ‘blurry middle ground’ of both belief and unbelief (cf.

Maddrell, 2009, p. 690), explicitly designed for multi-religious as well as

non-religious usage.

In the following sections, we will look more closely at the function and

aesthetic expression of a particular room of silence at the SUS hospital in

Malmo. The reason for choosing this particular room is its location, at the large

general and university hospital in Malmo, where both staff and patients repre-

sent a wide variety of cultural and religious backgrounds. Another key factor

was the fact that the hospital chaplaincy had decided that the room should be

renewed. This remaking process actualised existing opinions and experiences

from those that have a professional relation to the use of the room, and it also

provided an opportunity to communicate some of the findings on-site as a

direct input to the official design process.

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3. Material and methods

3.1. Background data

The SUS hospital has approximately 11 700 employees, stationed in both

Malmo and Lund. In its current form, the studied room of silence at SUS in

Malmo is a furnished, superficially renovated, already-existing ordinary room,

bordering onto an open public interior part of the hospital used as a visitors

centre. It is a temporary solution, expected to remain in use for 5–10 years,

while waiting for the construction of a more permanent, specifically designed

space. At the inauguration in June 2011, the room was explicitly declared as

being a multi-faith space, with the intention to do without traditional, specifi-

cally religious symbols and objects. The decoration of the room of silence grew

out of a process of dialogue involving the hospital’s chaplaincy, which has

employees from the Church of Sweden, the Mission Covenant Church of

Sweden [Svenska Missionskyrkan, a protestant denomination] and the Catholic

Church, together with a religious network with representatives from various

Orthodox Christian denominations and the Muslim, Jewish and Buddhist

faiths. At the time of our study in 2011–2012, the decor of the room consisted

of an intarsia in the parquet floor representing a star pointing out the four

points of the compass as well as Mecca; a plate for candles, erected on legs of

wrought iron and filled with green sand; some movable wooden chairs; a high

rectangular wooden table on which a guest book is placed; a low wooden

cabinet where prayer mats, religious texts, icons and crucifixes are kept; a black

clothes hanger in the form of a tree; some white window curtains; wall and

ceiling lighting; and a few green plants (Figure 1). At the entrance to the room

of silence, there is a sign in the same standard style as the rest of the hospital’s

sign system, saying ‘Room of Silence’ [‘stilla rum’] in Swedish and in Braille.

Figure 1. The Room of Silence in 2012, view of the entrance.

Source: Photograph by Jekaterina Potapova.

6 A. Petersson et al.

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According to one of the hospital chaplains working at the room of silence,

the room is well visited and the use of it seems uncomplicated. The room is

open every day from 7 am to 6 pm and people come there to pray, meditate,

write in the guest book or just rest and gather their thoughts for a while. The

guest book on the table is filled with entries in different languages – some of

them thankful for a relative or a friend who has been cured, others telling the

story of bereavement and loss and yet others commenting on the fast pace of

modern life, urging their fellow human beings to slow down. Once a week, the

hospital chaplaincy holds a lunch-time Christian service, where the attendance

is usually around five persons consisting of different hospital personnel, patients

and their relatives and friends, as well as the occasional visitor, and once a

week, the religious network holds meditations in the afternoon, mainly attended

by revisiting hospital personnel of about five persons, with the different

representatives taking turns to act as host.

The hospital chaplain talked of the lighting of candles in the candle holder as a

central symbolic ritual for Christians. However, this ritual is only allowed once a

week, during the service, because of the hospital’s fire regulations. Due to the

fact that the room of silence has no wash basin of its own, the green sand in the

candle holder has proved to have an additional function in that it provides

Muslims with an opportunity for a ritual washing of the hands before prayer.

3.2. Outline of the study

The study of the room of silence was made up of two phases: the first consisted

of the gathering of background data, presented in section 3.1 above, in the

form of photographic documentation and on-site interviews with a hospital

chaplain working at the room of silence; the second comprised year-three stu-

dents from the Industrial Design Programme, bachelor level, at the Faculty of

Engineering (LTH) at Lund University, engaged on the project. This student

group consisted of 24 Swedish and international students, with six international

students in the minority and mainly coming from other European countries,

with one exception, from Asia. The data were used as a basis for a course

assignment, called Room of Silence, where the design students were asked to

plan a transformation of the interior of the room of silence at SUS in Malmo.

It is important to note that the study was an explorative investigation.

Methodologically, it leaned on practice-based research in architecture and

design, where inventory, documentation, intervention and the framing of pro-

posals are often used as methods of investigation (Stahl & Grillner, 2003). The

study can be seen as heuristic to the extent that a temporary answer is obtained

through the very process of trying something out in an existing physical space

in the hospital context.

3.2.1. Course assignment – room of silence. The course of which the assignment

was a part is a compulsory course, led by researcher and design teacher Anna

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Petersson. Petersson started the assignment with an oral introduction in which

the background data were presented to the bachelor students. It was explained

that their assignment was to work with the use, space and interior design of the

given room of silence at SUS in Malmo (including both permanent aspects

such as walls, floor and ceiling, and movable items such as furniture, curtains,

lighting, plants and so on). The students were told that their suggestions could

range from redistributing the room’s furniture or altering the room’s existing

interior to adding a new piece of furniture designed by themselves or finding

other ways to alter the use of the space. Particular interest was to be devoted to

the kind of aesthetic effects that could divert attention from the otherwise

medically defined hospital environment and create a sense of well-being. The

students were also given the option of working with religious symbols as well as

other symbolic features of their choice. They could follow the practice of this

particular room of silence – and not publicly display any religious symbols – or

choose to go against it. The students were also free to choose if they wished to

keep their suggestions within the framework of the hospital chaplaincy’s budget

– the small sum of SEK 5 000 (approximately 766 USD) – for the upcoming

renewal of the room. The hospital chaplaincy also explained that if a student

proposal was accepted for practical implementation, there was a possibility of

seeking further funding.4 These financial considerations were not, however,

something that the students had to take into account in order to pass the

course. The assignment was open to both conceptual proposals and more

concrete suggestions.

In addition to the practical design work, which included study trips to the

room, the students were also given a series of lectures: by the SUS Malmo

hospital chaplaincy and representatives from their religious network (hospital

chaplain Corinna Friedl, and the representatives Imam Rizwan Afzal and

Dharma teacher Ming-bao); by architect and textile designer Akane Moriyama;

by environmental psychologist Caroline Hagerhall; and by a researcher in the

psychology of religion, Maria Liljas.

The students worked in five groups of four to five persons each; each group

produced a poster (A1 standing format), a model and/or a prototype. The

groups had three weeks, with three to four days of scheduled work per week, to

complete their suggestions. At the end of the course, the students’ work was

exhibited inside and outside the room of silence at SUS in Malmo (posters)

and in the exhibition hall at the School of Architecture, Lund University

(posters and models/prototypes).

3.3. Analysis of design suggestions

The students’ work was subjected to an interpretive and exploratory analysis,

focusing on the students’ oral presentations of their physical models, drawings

and posters. This analysis began, as part of the final course assessment at the

School of Architecture at Lund University, with the students’ interpretations of

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their own work as well as their examination of each others’ proposals. It went

on as a general discussion with the researchers and design teachers Anna

Petersson and Gunnar Sandin, and the hospital chaplain Corinna Friedl.5 After

this assessment session, the authors further explored, by inductive analysis and

intersubjective validation, the idea of qualitative differences (Larsson, 1986;

Uljens, 1989) with the aim of discerning qualitative variations (rather than

quantitative commonalities) among the students’ design themes and conceptual

ideas, concerning the way these underpinned reflection and existential

meaning-making.

3.4. Findings

In the five student groups, suggestions for the room’s decor featured a range of

images and themes taken from nature, such as walls covered with layers of cur-

tains patterned to look like moving water and ceilings representing drifting

clouds or the star-filled night sky. Nature was also represented in specific

material objects, such as a large natural stone used as a sculptural element in a

fountain design and wooden constructions shaped like trees made to hold

memorial notes written on small pieces of paper like leaves on their branches

(Figure 2). These paper notes were designed to have different colours in differ-

ent seasons of the year so that the visitors would get the feeling of the eternal

cycle of nature’s seasonal changes. Another specific material object was the

sand-filled table, currently functioning both as candle-holder and ritual

hand-washing facility, which one group of students developed further into a

‘symbol sandbox’, which could be illuminated from below and where each

person could draw a (temporary) symbol, word or name in the natural sea sand

(Figure 3). Furthermore, a couple of suggestions showed more escapist uses of

nature: one group wrote a poem inspired by the detached feeling of diving

Figure 2. Trees with memorial notes and ceiling with clouds.

Source: Photograph by Madeleine Axelsson.

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beneath the surface of the sea – a metaphor often used for the subconscious;

another group made the bold suggestion to open up the outer wall of the room,

enabling (voluntary) contact with the outdoor environment.

Three of the student groups also worked with creating a special ambience

using different kinds of lighting: one group used weak light sources directed

from below to create a mysterious and dreamlike setting; another envisaged sev-

eral small LED lights set to shine through different types of fabric and resemble

the glow of an iceberg beneath the surface of the sea or stars shining from a

clear night sky (Figure 4); and another projected symbols, names or words onto

the ceiling of the room of silence through the under-lit symbol sandbox.

Two of the suggestions included plans for interaction between the visitor and

the material environment, and also on to other visitors – such as writing a

memorial note on a piece of paper and hanging it in a tree for others to see; or

drawing a religious symbol or writing a name or note in the sand with the

possibility of either erasing it or leaving it as a message to a subsequent visitor.

All the project designs were also open to more traditional religious observances

– like lighting candles or kneeling in the direction of Mecca to pray – by

providing adequate space for these ritual acts.

Although all the proposals supported the individual use of religious objects

(such as prayer mats, crucifixes, icons and religious texts, which are normally

kept in a closed cabinet), none of the students’ projects actively worked with

the public display of religious symbols or religious narratives. However, in one

of the suggestions – the symbol sandbox – the option of drawing a religious

symbol and leaving it in the sand was at hand, and in another suggestion, an

already-existing tapestry with a blue triangle motive, suggestive of the Christian

Trinity, was kept intact with the addition of a drape at the sides to cover it up

if needed (Figure 5).

Figure 3. Under-lit symbol sandbox.

Source: Photograph by Andreas Hansson, Jekaterina Potapova, Katarina Segerberg, Qingxi Hui

and Timara Lindell.

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Figure 4. Underneath the Surface.

Source: Photograph by Axel Hjertman.

Figure 5. Tapestry with drapes.

Source: Photograph by Ylva Granstrom.

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4. Discussion

In our analysis of the students’ proposals, we have discerned four main themes:

(1) Nature is used as a common symbolic resonance;

(2) Lighting is used to create a visual and spatial ambience for retreat;

(3) Interaction is used as a way to express and embody crucial life experi-

ences; and

(4) Specific religious symbols are displaced from public display.

4.1. Nature: a common symbolic resonance

The visual and material representation of nature in the students’ suggestions

serves as a common symbolic framework aimed to promote existential thought

and contemplative distraction from the hospital environment,6 similar to the

way religious motifs and artefacts are used in traditional religious rituals as

‘contemplative focus for wandering attention’ (Grimes, 2007, p. 155). This use

of nature, as a source of symbolic resonance, is evident in, for example,

Swedish cemetery construction from the eighteenth century onward: ranging

from Christian ideas of nature as God’s creation (cf. Gustafsson, 1973) to the

way nature can be a reminder of death and the afterlife by its endless circle of

life-death-life, but also to more secular thoughts of the embodiment of hope in

the stability and renewal found in nature (e.g. Lundquist, 1992; Westerdahl,

1995; Wingren, 2013). Examples of how this symbolic potential of the natural

world is used in the design of ceremonial spaces include modernist church and

cemetery architectures (Petersson, Sandin, & Stahl, 2011); the newly built bur-

ial chapels, of the kind called ceremonial halls or ceremonial buildings, which

are conceived and presented as neutral or non-denominational (Gordan, 2013;

Nilsson, 2012); and newer kinds of multi-faith spaces (Brand, 2012;

Crompton, 2013).

For people who have no religious belief, and do not consider religion as a

natural resource for their ritual and existential needs, nature may be a way of

meeting these needs by providing continuity, comfort and the strength to move

on (Liljas Stalhandske et al., 2011a, p. 362). And from the healing perspective,

the inclusion of nature in the design of health care environments is held to have

beneficial effects (cf. Adevi, 2012; Nanda, Eisen, & Baladandayuthapani, 2008;

Ulrich, 1999), not least with regard to the restorative function, when treating

stress-related illnesses of both direct contact with natural elements and views of

natural countryside (e.g. Hartig & Evans, 1993; Kaplan & Kaplan, 1989;

Korpela, Hartig, Kaiser, & Fuhrer, 2001). There is also evidence of how nature

can have an ‘aesthetic placebo effect’, which has been taken into account in the

design of hospitals, ranging historically from the outdoor environments of

sanatoriums to contemporary green interiors in hospital architecture (Sandin &

Stahl, 2011, p. 69).

12 A. Petersson et al.

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That being said, one should be cautious about drawing any general

conclusions from observing these effects: different societies, cultures and reli-

gions may have differing views with regard to the symbolic capacity of different

kinds of natural environment or phenomena (cf. Bergmann, Scott, Jansdotter

Samuelsson, & Bedford-Strohm, 2009). Furthermore, our perception of nature

can change over time. As an example, landscape architect Westerdahl (1995,

pp. 30–33) contrasts, in her studies of Swedish woodland cemeteries, the selec-

tive perception of nature in Swedish agrarian society, where inaccessible forests

and woodlands were considered potentially dangerous in comparison to the

cultivated areas of tamed farmland, with the romantic and idealistic perception

of nature in early industrial society. This shows that a specific type of nature in

fact might not be associated with any stable common experience or meaning.

4.2. Lighting: creating a visual and spatial ambience for retreat

The therapeutic benefits of light on various psychological and physiological

stress reactions (e.g. Beauchemin & Hays, 1996, 1998; Kuller, 1981) – both in

the form of natural daylight and in the form of artificial lights of certain colour

temperature – are well known and often used in the design of restorative inte-

rior hospital environments in order to minimise patient anxiety and stimulate

recovery (Johnston, 2011; Ulrich, 1984). The students’ suggestions used vari-

ous types of lighting to create a visual and spatial ambience that contrasted

with that of the ordinary clinical hospital environment. This unexpected ambi-

ence may give rise to curiosity and help stimulate exploratory behaviour in the

room (Karnik, Printz, & Finkel, 2014; Rollins, 2011). Establishing a distinction

between ordinary space and time and the experience of something beyond the

ordinary could also be seen as a way of underlining the meaning and impor-

tance of the thoughts and interactions that take place in the room, helping to

lift them from being everyday actions to the status of ritualised activities (cf.

Bell, 1992; Grimes, 2007; Liljas Stalhandske, 2005).

4.3. Interaction: a way to express and embody crucial life experiences

Ritualisation can be understood as a way of setting bodily practices apart from

ordinary life (Grimes, 2007, pp. 157–162; cf. Bell, 1992; Liljas Stalhandske,

2005). The students’ proposed interactions, involving encounters with the

material environment as well as acts of communication, help frame crucial life

experiences and make them physically perceptible and hence easier to deal with

and contextualise (Petersson, 2010, pp. 149–152; Warnier, 2001, pp. 13–17).

Writing a note to pin on a branch in a tree or drawing a symbol in the sand

engages not only the mind and the motor functions of the body, but also the

senses – and especially the sense of touch, which could be seen as linking the

present to the absent by way of the material, where the materiality and

immediacy of that which is touched in some way compensates for that which is

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inevitably absent, such as a person lost or a moment gone by (Petersson &

Wingren, 2011, pp. 59–61; cf. Gibson, 2004; Hetherington, 2003).7 Hence,

the multiple function of the candle holder, further developed in one student

proposal to become a ‘symbol sandbox’, and the proposal for a ‘memorial tree’,

are both, in all their simplicity, interesting examples of how a material device –

an object inviting visual attention as well as bodily action – can serve many

different visitors’ ritual, symbolic and existential needs.

4.4. Specific religious symbols: displaced from public display

In general, the students’ projects demonstrated a hesitation towards involving

visual and material representations of religious belief. This may partly be

explained by respect for the prevailing policy of the room of silence: to not dis-

play symbols specific to any particular religion. Another plausible explanation

could be that young persons in Sweden today are commonly brought up in

more or less non-religious environments, making them inexperienced in making

use of established existential concepts and practices (DeMarinis, 2008, p. 67;

Liljas Stalhandske et al., 2011a, pp. 365–366). Furthermore, as cultural geogra-

pher Howe (2009) points out, when societal policies and community habits dis-

place religious symbols from public space, whether that displacement has been

effected consciously or not, this inscribes the supposedly neutral space with

specific and local cultural and religious norms that may be difficult to defy.

Despite there being a mix of Swedish and international students in the group,

the class as a whole seemed to have reached consensus about the extent to

which existential practice can be expressed and underpinned using aesthetical

means, which might have to do both with peer pressure and with the fact that

design students are schooled in a certain way of thinking through their educa-

tion. In this sense, design students are an interesting group to study since they

are a sample of the community of ‘designers-to-be’, and their proposals may

provide a clue to the characteristics of future design. One question, then, when

it comes to designing culturally and religiously shared spaces, is whether archi-

tecture and design students – who in Sweden still constitute a fairly homoge-

neous group in terms of social and cultural background (i.e. the majority of

them are middle-class ethnic Swedes) – have the ability to meet the needs of

user groups with a more diverse range of social, cultural and religious experi-

ences. There is a risk that a difference in experience of the built environment

arises, similar to the one noted above concerning the clash between ‘experts’

and ‘laymen’ (Fornara et al., 2006, pp. 321–322; Nanda et al., 2008, p. 298).

4.5. Designing multi-faith spaces in a health care context

A relevant task for health care research, as well as for the architecture and

design professions, would be to actualise the multifaceted issues described in

this paper in relation to the design of healing environments. Education

14 A. Petersson et al.

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programmes in Architecture and Design have a great responsibility in this

respect, and must continuously encourage students to engage with alternatives

to the prevailing values that are embedded in the community of design practice

and in the discourse of design. In doing so, one needs to ask firstly what multi-

faith spaces actually convey, and secondly what they need to convey. This is

necessary if one is to move towards architectural solutions based not only on

general assumptions about people and their existential needs, but on the actual

differences in societies’ and individuals’ cultural and religious values. This is

especially crucial when it comes to designing culturally and religiously shared

public spaces in a health care environment, where people are faced with par-

ticularly tense situations in life and need to make meaning on an existential

level to restructure their hopelessness and confusion (Liljas, 2014). The imple-

mentation of this task could benefit from an interdisciplinary approach to heal-

ing environments, where existential meaning-making is included in the overall

discussion of the design of health care architecture. This paper should be seen

as an initial attempt in that direction.

Acknowledgements

We would like to thank the year-three students from the Industrial Design

Programme, Bachelor level, at the Faculty of Engineering (LTH) at Lund

University and hospital chaplain Corinna Friedl for their participation, our

colleagues Eja Pedersen and Mattias Karrholm for contributing valuable

comments on this article as it neared completion and Graham Bowers for

proofreading the text, as well as the reviewers and editors of Mortality.

Funding

This work was supported by Vetenskapsradet (Placebo: Aesthetic Replacement Strategies inHospital Architecture) [grant number 421-2008-2287]; Vetenskapsradet (The Impact ofReligion: Challenges for Society, Law and Democracy) [grant number 349-2007-8656]; Formas(Architecture in Effect: Rethinking the Social in Architecture) [grant number 249-2011-74];and Formas (CAMINE: Cemetery Architecture and Meaning-Making Intentions) under [grantnumber 259-2011-582].

Disclosure Statement

The funding sources had no involvement in the study design, the collection, analysis andinterpretation of data or the writing and submitting of this article. The submitted article has notbeen published elsewhere, and it has not been submitted simultaneously for publication. The firstauthor has secured permission to reproduce the submitted illustrations.

Notes

[1] These quotes are taken from the online document Fact Sheet: Meditation Room. Retrieved7 November 2012, from http://visit.un.org/wcm/content/site/visitors/lang/en/meditation_room/.

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[2] The Swedish term is Stilla rum, a term that probably derives from the German Raum derStille. For the history, architecture and design of multi-faith spaces, such as rooms ofsilence, see RIBA (2011/2012, p. 43), Brand (2012, pp. 221–222) and Crompton (2013,pp. 475–478).

[3] See also: Multi-Faith Spaces – Symptoms and Agents of Religious and Social Change.Retrieved September 9, 2013, from http://www.sed.manchester.ac.uk/architecture/research/mfs/.

[4] After the course, the hospital chaplaincy decided to apply for further funding in order toimplement certain elements of the students’ proposals. They received 250 000 SEK(approximately 38 950 USD) from Malmo Forskonings- och Planteringsforening, and theinauguration of the remade room took place on 23 January 2014.

[5] Concerning the assessment of creative processes in art, architecture and design see forexample Gordon (2004), Cowan (2006) and Sandin (2011).

[6] The concept of nature can be described in a number of ways. In this text, we follow acommon usage of the term in the area of landscape architecture, where nature includeswilderness, cultural landscapes and gardens (cf. Adevi, 2012, p. 17).

[7] Philosopher Levinas (1987, p. 116) even goes so far as to trace the phenomenologicalgrounds of religious ritual back to the touch and the caress.

ORCID

Anna Petersson http://orcid.org/0000-0002-5495-3806Gunnar Sandin http://orcid.org/0000-0002-0381-5665

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Biographical Notes

Anna Petersson is an associate professor in Architecture at Lund University, with a researchinterest in the material culture and the built environment as ritual and symbolic tools inprocesses of grief and remembrance. She has a specific experience in interdisciplinary researchwith a phenomenographic approach, including material culture theories and death studies.

Gunnar Sandin is a docent in Architecture at Lund University, with a research interest in socialand cultural site specificity in relation to architecture and the built environment. He has aspecific experience in practice-based research with a cultural analysis approach, including trans-disciplinary theories and inter-art studies.

Maria Liljas is a docent in the Psychology of Religion at Uppsala University, with a researchinterest in existential needs and psychological health in the late modern context. She has aspecific experience in interdisciplinary research with a narrative analysis approach, includingritual studies and play perspectives.

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