Author: mjmarine

Background

Chronic pain (i.e., pain lasting ≥3 months) is a debilitating condition that affects daily work and life activities for many adults and has been linked with depression, Alzheimer disease and related dementias, higher suicide risk, and substance use and misuse. Addressing chronic pain and improving the lives of persons living with pain is a public health imperative. (CDC.gov)

According to pain psychologist Dr. Rachel Zoffness, ALL pain is contributed to by biological, psychological, and sociological factors. Chronic pain is most commonly treated through pharmaceuticals in Western medicine, however this does not treat the psychological and sociological factors that also significantly contribute to pain.

This healing garden intends to help reduce those factors of pain through creating space for community gathering, multi-sensorial walking areas for mindfulness, and gentle exercise opportunities through space for tai-chi and yoga. The garden design prioritizes creating diverse sensorial spaces to meet the needs of people who may be spatially sensitive in different ways. 

Research-backed design ideas to relieve pain:

Site Introduction:

Design concepts

Site Plans

Sections

Embodied Views

https://arthritis-research.biomedcentral.com/articles/10.1186/ar1950

“It is well known that persistent or intense nociception can lead to neuroplastic changes in the spinal cord and brain, resulting in central sensitization and pain. This mechanism represents a hallmark of FM and many other chronic pain syndromes, including irritable bowel syndrome, temporomandibular disorder, migraine, and low back pain. Importantly, after central sensitization has been established only minimal nociceptive input is required for the maintenance of the chronic pain state. Additional factors, including pain related negative affect and poor sleep have been shown to significantly contribute to clinical FM pain.”

http://www.bcwomens.ca/health-info/living-with-illness/fibromyalgia

Basic information about Fibromyalgia, a common cause of chronic pain. “The main symptom of FM is body pain that is felt in many parts of the body and has been present for at least 3 months. The pain may be burning, searing, tingling, shooting, stabbing, deep aching, sharp, and/or feeling bruised all over. Patients may be hypersensitive to painful stimuli (hyperalgesia), or experience pain from a stimulus e.g. light touch, that is not usually painful (allodynia). Over time, the pain becomes more constant and affects more areas of the body. The pain can vary in its location and how severe it is, and can be made worse in cold or humid weather. Stress can also cause the pain to become worse.”

https://www.alieward.com/ologies/dolorology

Ologies podcast featuring Dr. Rachel Zoffness: a Health and Pain Psychologist, international speaker, author, and thought-leader in pain medicine. She is an Assistant Clinical Professor at the UCSF School of Medicine, lectures at Stanford, and is a Mayday Fellow.

-Pain is comprised of 3 equal functions- biological, psychological and sociological. Pain is located in the brain, so how you think changes how you feel. Things like anxiety, depression, trauma, socio-economic status, racism, and support networks affect a person’s pain levels. Pain can be treated pharmacologically but there are also proven treatments for pain that are non-pharmacological.

https://www.youtube.com/@DrRicArseneau

Youtube page by Dr. Ric Arseneau about complex chronic ilnesses, often involving chronic pain

Shown in this post are the first draft of the planting palette, plan and section. My plant choices are based on creating a multi-sensorial experience through varied texture, smell and sound in the garden. I mostly chose plants that feel calming, some medicinal plants, and some plants to invigorate and enliven. The plants are placed to give an more open, expansive feel on the East side, and a more deep green, forest feel on the West side. Plants are also located with regard to their sun requirements.

The next steps in my work are to arrange the plant palette in groupings that will be next to each other on the plan, and add my notes about individual plant requirements. I will also be digitizing my planting plan next.

Design to provide the garden visitors with pleasant multi-sensory experiences in order to distract from their unpleasant experiences of pain. There is proof that pain sensation is heightened when someone is focused on the sensation, rather than when they are focused elsewhere. Creating a path through the garden which is full of interesting, calming sensations will allow visitors to have an experience that is mindful of their surroundings rather than focused on their pain. Design to incorporate space for community gathering. Chronic pain is often coupled with depression. People with chronic pain are often alienated physically because they cannot be as active, and because they do not feel understood. Creating space for people with chronic pain to meet and enjoy a peaceful place together can improve their quality of life.

Design for gentle exercise. Chronic pain often makes people less active because they believe rest will help, and because fatigue is associated with pain disorders. However, research shows that in in most cases (except people with ME), gentle exercise can greatly help improve pain symptoms. The healing garden has a Tai Chi/yoga pavilion to encourage people to participate in community exercise, and the walking path through the garden allows visitors to move as they enjoy the space.

New version of site plan with cross-section

The program includes a yoga/Tai Chi pavilion, which will be a covered space. It has room for 4 people to practice Tai Chi and 9 people to practice yoga. There will be seating around two sides of the pavilion for people to watch and/or rest.

Wall design:

The wall through the middle of the site intends to separate garden spaces while still creating specific views through for curiosity and for safety. Here are some preliminary design ideas:

Site Circulation:

  Views while walking around site, views from seating on site:

In this version of the plan I was looking at how the planting can be incorporated into block swath patterns. The East side of the plan is ‘grass-flower-plains’ concept, and the West side of the plan is ‘deep forest’ concept. The two sides are broken up by an angular wall which creates smaller planting spaces to be explored.

Initial 5 Concept Diagrams

Garden for People with Chronic Pain

Design elements:

• comfortable seating and reclining areas in peaceful spaces
• meditative walking areas for calming the nervous system
• small gathering spaces for fostering community
• spaces with varied sensations to focus on different physical experiences

Option 1 Concept

Option 2 Concept