Thinking Through the Therapeutic Landscapes of Social Anxiety Disorder

By Louise Boyle

Troubling Institutions: Exploring Spaces of Security and Care – 11th December 2014 

On the 11th December 2014, Anna Schliehe and Cheryl McGeachan of the Asylum and Post-Asylum Research Group organised an extremely exciting and engaging conference session and workshop exploring institutional geographies through spaces of security and care namely the orphanage, prison and psychiatric hospitals.

My contribution as discussant to Victoria J Wood and Sarah Curtis’ (2014) paper titled ‘Therapeutic Landscapes and Emotional Ties to Past Settings: Salvage and Abandonment as Considerations in Psychiatric Hospital Design’ enabled an engagement with emotional reactions to changing spaces of care. In the context of my own research, exploring the social and anticipatory geographies of Social Anxiety Disorder (SAnD), I engage with the ways in which the social, material, imagined and symbolic importance of space and place shapes and is shaped by socially anxious experience. In terms of spaces of care, my research takes a rather different approach from the inpatient psychiatric facilities explored by this paper. I engage with alternative therapeutic landscapes, particularly, but not limited to, those which are located in the virtual sphere to explore how such spaces, e.g. online forums, which are used for communication, socialising, exchanging and sharing knowledge, are tools for self and collective help for people with Social Anxiety Disorder engendering new spaces of ‘self-directed’ care.

By definition, Social Anxiety Disorder is linked to a concern with how the self is perceived and evaluated by others particularly in social or performance situations. These aspects may then be projected on to future settings. Wood and Curtis (2014) explored theories of emotional reactions related to changing medical spaces of care,  the meanings attributed to these therapeutic experiences  and how these ideas may contribute to better future built designs of psychiatric inpatient facilities by adopting notions of ‘nostalgia’ (Sedikides et al.  2008), ‘solastalgia’ (Albrecht et al. 2007) and ‘stigmatizing memories’ (Parr et al. 2003). The emotional experience of individuals with Social Anxiety Disorder echo most prominently through ‘solastalgia’ and ‘stigmatizing memories’ whereby senses of identity and home environment are undermined by the perceived disorder in/of/to their socio-spatial worlds and the individual feels ‘socially marked’ (Wood and Curtis, 2014) by people and places. The themes of my own research resonate with the impact emotional reactions and environmental influence can have on experience of SAnD, whereby the ‘situational’ and environmental nature of SAnD is often triggered by embarrassing experiences in particular situations or environments which generate anxiety-drenched anticipations of what could potentially ‘go wrong’ for someone in future settings. Consequently, SAnD is wrought with ‘memories’ and ‘triggers’ in that individuals have a tendency to recall negative experiences of social events and therefore anticipate negative outcomes before entering social situations. These aspects therefore shape and inhibit future conducts, movements and relationships, in some cases such situations are painfully endured by ‘putting on a face’ or they are shut down completely with serious implications for career, sociality and wellbeing. Ultimately reducing the individual’s social geography to one of home-bound isolation.

The discussions surrounding the influence past emotional experiences have on the design of future psychiatric units, although not typically related to my own research, certainly opened up avenues through which to explore the often entangled way Social Anxiety Disorder shapes and is shaped by social space and the interactions that occur within those spaces. The session presented questions regarding how we can open up and create caring spaces for individuals who find social interaction and communication difficult and whose home environments are often invaded by feelings of unhomeliness and insecurity.


Albrecht, G., Sartore, G-M., Connor, L., Higginbotham, N., Freeman, S., Kelly, B., Stain, H., Tonna, A., & Pollard, G. (2007). “Solastalgia: the distress caused by environmental change”. Australasian Psychiatry 15:1, 95–98

Parr, H., Philo, C., and Burns, N. (2003) ‘That awful place was home’: Reflections on the Contested Meanings of Craig Dunain asylum’, Scottish Geographical Journal, 119:4, 341-360

Sedikides, C., Wildschut, T., Arndt, J., & Routledge, C. (2008). Nostalgia: Past, present, and future. Current Directions in Psychological Science, 17, 304 –307

Wood, Victoria J. and Curtis, Sarah. (2014) ‘Therapeutic Landscapes and Emotional Ties to Past Settings: Salvage and Abandonment as Considerations in Psychiatric Hospital Design’, paper presented at Troubling Institutions: Exploring Spaces of Security and Care, University of Glasgow, 11/12/14

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