Centre Médical et Esthétique Auber - COSEM
Sky Factory © 2013

Centre Médical et Esthétique Auber - COSEM

Sky Factory as Designers

The Sky Factory Illusions of Nature as Architecture Client Brief COSEM, a multidisciplinary medical group offering a wide range of healthcare services, sought to refurbish its 3rd center in Paris, which serves a demanding urban clientele of 800,000+patients annually.The high volume of patient and visitor traffic required that the reception areas be as spacious and inviting as possible to make waiting times for patients pleasant and relaxing in what is unavoidably a high-density clinical environment.


COSEM Auber hosts multiple practices in this 1,600 square meter facility, including a radiology imaging center in the basement. The general reception lounge on the first floor is also found deep inside the building. The design brief called for sparse, contemporary interiors to underscore the clean geometry of the space with special emphasis on a unique approach to counter the claustrophobic nature of these enclosed locations where over 2,800 people per week wait for their appointment time.


Like most contemporary commercial real estate spaces in Paris, COSEM Auber resides in a prestigious historic building dating back to the 19th century. The symmetrical stonework of the façade in classic Haussmann style symbolizes one of the main architectural legacies of the Parisian capital. Unfortunately, the exterior envelope imposed limitations on the design team’s ability to connect the deep plan interiors to the outside.


French law forbids architects and designers from altering the Haussmann façades that have given Paris its famous cosmopolitan style over the last two centuries, which meant that the basement radiology lounge and first floor general reception area would remain isolated, unless access to daylight or restorative views to nature could be devised through unconventional means.


Beyond Positive Distraction


The standard evidence-based design approach in healthcare facilities and clinical environments is to use nature art imagery in the form of photography, artwork, and graphics to elicit a positive emotional response. Based on Roger Ulrich’s seminal study on the effect of window views to nature on patient recovery,and his subsequent findings, which confirmed the positive impact of representational nature art on patient anxiety, stress, and even pain perception (Ulrich et al. 1993), continue to dominate the thinking of evidence-based designers.


The incorporation of nature art in healthcare settings is well known as positive distraction,which is defined as “an environmental feature that elicits positive feelings and holds attention without taxing or stressing the individual, thereby blocking worrisome thoughts” (Ulrich 1999).


In other words, the restorative impact of nature art was attributed to the emotional response it elicits due to its representational or symbolic properties. And this affective attribute in turn was valued because, according to neuro-scientific studies, the emotional response is immediate and can occur before other higher-level cognitive responses (Nanda 2011).


Interestingly enough, until recently, neither the designers of nature imagery nor the researchers involved in dissecting the visual properties of nature art have considered the cognitive and clinical implications of introducing a much more profound visual phenomenon—biophilic illusions—in healthcare settings.


Biophilic Illusions & the Malleable Nature of Spatial Perception


Biophilic illusions are a powerful phenomenon that alter the established nature imagery calculus, not only in terms of how illusions engage the organs of perception, but also in how they can be designed to affect our psycho-physiological response to enclosed interiors in a manner that leads to a much deeper, positive health outcome.


Unlike representational nature images, illusions of nature have an added dimension. While they provide information that reference prior experience, like any successful illusion, in order to create an alternate convincing reality, they also deliberately trigger misperceptions in the observer due to specific misleading cues.


The deliberate creation of biophilic illusions is possible by manipulating our ingrained habits of perception, habits that research in neuroscience has discovered are hard-wired in our brain. Learn about the malleable nature of perception and the idea of creating simulated portals into open skies holds fascinating potential in terms of changing our relationship to physical space.


Until recently, research in the field of environmental psychology has been mostly preoccupied with identifying the visual properties of nature art that elicit a neural response corresponding to relevant emotional states (Nanda 2011). However, there is another cognitive function that humans are also hardwired to register immediately—spatial cognition.


Representational Imagery versus Illusions of Nature


While cognition itself is a complex subject, it is enough to note that human spatial cognition is fundamental to human life (Mark 1993). And by spatial cognition we understand “the knowledge and internal or cognitive representation of the structure, entities, and relations of space; in other words, the internalized reflection and reconstruction of space in thought” (Hart and Moore 1973, as cited in Mark 1993).


In this light, while most nature art is introduced in healthcare environments to elicit an emotional response, a positive distraction from the stress and anxiety inherent in entering highly artificial environments like hospitals under vulnerable circumstances (illness), nature art has not been mined for its ability to create more sophisticated cognitive phenomena such as biophilic illusions.


What would happen if nature images were deliberately designed to be perceived as life-enhancing spatial representations of sky views—our most universal experience of nature—which then engaged areas of the brain involved in spatial cognition?


That is precisely what biophilic illusions of nature accomplish. They alter our perception of space.


Views to nature represent a deeply restorative phenomenon that can be described under the framework of Prospect & Refuge Theory. In terms of evolutionary biology, humankind tends to favor places where we feel safe and have an unimpeded vantage point to our surroundings. Neurologically, that is, we’re wired for panoramic vistas and open skies.


Environmental psychologists have also established that even our relationship to time is directly linked to our perception of space; large open spaces lead to the perception of time slowing down whereas small, confining spaces lead to the perception of time speeding up and hence, our observed lack of patience, increased stress and fatigue when confined in artificial environments.


Biophilic illusions’ ability to restore a high degree of inner stability and genuine relaxation in the observer is due to their tapping deeper mechanics than those used in positive psychological distraction. While we are well acquainted with distraction technologies to divert people’s attention, few have considered deploying a visual technology that instead reduces mental activity in order to mitigate emotional distress.


By drawing the mind inward, biophilic illusions effortlessly eliminate the root cause of worrisome thoughts and feelings, which is an overactive mind.


Distracting a restless mind does not reduce its level of activity—it replaces one form of content for another—whereas the visual content in biophilic illusions does reduce mental agitation as the observer resonates with the illusion’s perceived spatial properties, as well as the positive emotional content.


Biophilic illusions immerse the observer in a deeper experience, one born of the environmental cues that effortlessly engage and mirror our genetic memory. And that’s precisely what our physiology instinctively clamors for in confined artificial spaces: a palpable connection to natural exteriors. Biophilic illusions can provide this perceived experience, altering the psycho-physiological dynamics of enclosed spaces.


The design brief called for an architectural feature that would dramatically change the perception of the interior by giving the visceral illusion of open skies. Luminous SkyCeilings, realistic simulations of the sky that trigger genuine psycho physiological benefits, were selected for their unique ability to engage and alter spatial cognition.


The Neurophysiology of Illusions


A study published in the peer reviewed journal Health Environments Research & Design (winter 2014) conducted by Texas Tech University found that Sky Factory’s photographic Open Sky Compositions activate the cerebellum, a part of the brain involved in judging depth. The seven custom virtual skylights at COSEM Auber were designed to be experienced as illusions of nature.


Realistic virtual skylights deepen biophilic engagement, a cognitive process that leads to an automatic ‘relaxation response’ in the physiology. This phenomenon is related to the Biophilia Hypothesis proposed by Edward O. Wilson, the eminent Harvard biologist, which states that our innate genetic-based need to affiliate with nature holds profound psycho physiological benefits.


When views to nature are available in enclosed interiors, cognitive function improves, stress, anxiety and fatigue can be mitigated, emotional balance restored. This experience of biophilic engagement is an automatic ‘relaxation response’ that we all experience effortlessly in natural environments (the opposite of the Flight-or-Fight response).


Texas Tech University’s peer-reviewed study, Neural Correlates of Nature Stimuli; an fMRI Study, uncovered the neural pathways involved in the perception of open sky photography used in the design of biophilic illusions of nature.


The study examined whether there are unique patterns of brain activation associated with exposure to photographic sky compositions (representing nature stimuli) as compared with other positive, negative, and neutral images. The positive impact of nature images on health outcomes traditionally has been measured using behavioral and physiological indicators.


However, there was a lack of understanding of the underlying neural mechanism that explains the positive influence. The study generated brain maps of the neural pathways and regions associated with subjects’ perception of Sky Factory Open Sky Compositions’ unique imagery and compared those results with the mapped responses of the subjects viewing imagery established as being positive, negative or neutral.


Initial analysis of the brain maps indicates that the photographic sky compositions shared all of the characteristic neural activations of other positive images, while, additionally, activating several other unique brain regions. Of particular interest to the researchers were the activations found in the cerebellum.


“Brain activation of the cerebellum is often associated with aspects of spatial cognition, in particular the experience of extended space, as well as imagined, or real, motion through that space,”said neuroscientist Dr. Michael O’Boyle. “By way of speculation, it may be that viewing Sky Factory compositions evokes a sense of expansion into or through this extended space,” he remarked.


The research project was spearheaded by College of Human Sciences’ researchers Drs. Debajyoti Pati, Michael O’Boyle, and Cherif Amor, who investigated the effects of Sky Factory’s photographic sky compositions on brain activation, and also studied the effects of the Sky Factory’s virtual skylights on inpatients at a medical-surgical unit in a second study, In the Lap of Nature: Benefits of Nature Stimulus in Patient Room Ceilings, currently undergoing peer review process at an academic journal.


Dr. Debajyoti Pati said that, “Neural activations in response to the visual stimulus used in this study suggest that cognitive diversions induced by photographic sky compositions may result in significantly different and higher levels of positive physiological responses as compared to positive images in general.”


This pioneering study in neuroarchitecture earned the Best International Research Project Award at the Design & Health International Academy Awards held in Toronto, last July, and on the eve of its American publication also earned a top award at Qatar Foundation’s Annual Research Conference in Doha, in December 2013.


The Fine Art & Technology of Open Skies…


Virtual skylights have traditionally employed representational pictures to symbolize nature panoramas, including the sky, but only biophilic illusions are able to engage spatial cognition effectively and elicit the feeling of vastness that we experience outdoors, in a much smaller footprint, indoors.


Representational nature photography, artwork and other imagery is traditionally used for its decorative appeal. Nature art imagery is usually out of spatial context with the interior envelope of a given room or area. The discrepancy in scale, perspective, and compositional elements is what collectively lends interior décor its visual power to attract and render space alluring.


However, symbolic images of nature do not alter the perceived spatial dimensions of the environment that contains them.


Illusions of nature, on the other hand, are designed to be misrepresentations of the external perimeter of a given space. They are designed according to scale, fitting within the bounds of the interior envelope,essentially providing visual miscues about the architectural space that will lead to the misjudging of what lies beyond the walls and ceiling.


This neurological conceit sets up the observer to experience a connection to the outdoors, a simulated Prospect & Refuge dynamic that our physiology finds profoundly restorative because it allows the mind to wander and feel at ease, rather than on alert.


Using mega format digital photography, the proper light color temperature and intensity,calibrated color management and high resolution printing techniques,illusions of nature can recreate the subtle hues and saturation of real skies. This patented technology transforms enclosed interiors into healing, sustainable spaces for long–term human occupancy.


These virtual skylights leverage a cognitive principle called amodal perception, our inherent habit of completing occluded shapes and restoring the hidden whole suggested by discrete fragments. Because of the grid system, and the possibility for mullions, the matrix of panels in a hung ceiling offers an ideal structure for exploiting amodal perception.


Completion: June, 2013.


Sustainability and Wellness in Deep Plan Interiors


According to the Institute for Sustainable Efficiency, in developed economies, at least 50% of the buildings that will be in use by 2050 have already been built, which means a huge percentage of the workforce, including healthcare professionals and their patients, can be expected to reside and labor out of outmoded buildings for the next 35 years.


Furthermore, the European Buildings Performance Institute calculates that a substantial share of the 5 billion m2 of useful floor space in the EU 27, Switzerland and Norway, is older than 50 years and that many of the renovation projects take place in buildings over 200 years old. This means a substantial segment of our buildings date back to a time before biophilic design strategies were well known, let alone incorporated. According to Edward Mazria, the visionary architect and founder of Architecture 2030, an organization dedicated to achieve carbon neutrality in new building design, the average global life span of a building is 80 years.


With such a long lifecycle for commercial legacy buildings like COSEM Auber, it is imperative to apply innovative technologies that will allow enclosed interiors—usually impervious to sustainable design strategies—to find substantive solutions that are both cost-effective and yield quantifiable wellness benefits.


The interior core of these large buildings will continue to pose a threat to human health, productivity, and well-being unless we find a way to redefine our perception of the interior envelope, particularly when its structure represents an immovable perimeter.


Unlike virtual reality gadgetry like the Oculus Rift, Microsoft’s HoloLens, and other holographic platforms, biophilic illusions do not seek to isolate the observer in a reconstructed digital environment, but fuse the physical environment to a bone fide biophilic experience within the context of the interior environment.


The Sky: A Universal Experience


Why are we focused on the beauty of the sky? The sky is humanity’s most universal experience of nature. No matter who we are or where we live, we all see and love the sky. Everyone, in every culture, has experienced lying on their back looking up into cloud floating across a blue canopy.


Even our bodies are attuned to the blue of the sky. It is no accident that our eyes and mind register the coolness of blue as distant space. (This is a fundamental principle behind “Impressionism” and bright red stoplights.) It is no accident that “blue sky” is the symbol for freedom and infinite possibilities.


Furthermore, the clouds that inhabit the sky occur in patterns and these patterns are actually exquisite visual expressions of the physical laws of nature that govern fluid dynamics. (We can see these same patterns repeated in the sand at the seashore, the bottom of streams or even in the large-scale erosion of patterns on Mars.) In short, the sky is not only beautiful but also a place where the workings of nature are easily accessed by humanity.


And it’s from this colossal visual display of nature’s forces that we can also reflect on the scale and meaning of man-made architecture and interior design. The psycho physiological relief the sky provides outdoors can be astutely mimicked indoors. Our innate, genetic-based need to affiliate with nature, our biophilia, is most apparent in our visceral connection to the sky.


Illusions of Nature: a Biophilic Solution to Intractable Architecture


While so much of our architecture focuses on new buildings and technology, the fact is that most people live and experience much older architecture. While we realize that progress means looking ahead, it is equally important that technological breakthroughs are not only privy to a handful of new buildings in the most expensive plazas of our global metropolis.


If architecture is to have a meaningful impact on the lives of millions of ordinary people, it is imperative that we do not forget the hundreds of thousands of older buildings that, designed with the limited knowledge of the time and economic pressures of their era, continue to cast a long shadow on the health, productivity, and well-being of the citizens of every nation.


Leveraging today what we know about the nature of human perception, our uncanny ability to concoct an external environment when given the proper miscues, represents a virgin canvas for imaginative designers. Biophilic illusions give a second chance at restorative architecture within buildings that do not get a second look in the busy day-to-day world of retrofit renovation.


Biophilic illusion open the door to everyone, not only in buildings where the most vulnerable populations gather such as clinics and healthcare facilities, but in any enclose interior where people labor, reside, study, or dwell for a prolonged time.


Open Skies Image Technology allow people to perceive illusory skies deep inside a building, gaining genuine cognitive restoration by using one of the most marvelous architectural gifts we’ve inherited: our brain’s ability to redefine space.


Harnessing our understanding of spatial cognition and the rich history of Trompe l’oeil, biophilic illusions restore buildings to life.


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