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How Kiyoshi Izumi Built the Psych Ward of the Future by Dropping Acid

Inside the late Canadian architect's quest to design an "ideal mental hospital" with a little (OK, a lot) of help from LSD.
Photo via Flickr / CC.

He walked into a warp. As Kiyoshi "Kiyo" Izumi toured a select few of post-war Saskatchewan's aging mental hospitals, absorbing the wards' layouts and interviewing patients along the way, the Canadian architect grappled with hallmark features of the 1950s-era clinical milieu. Otherwise neutral accoutrements flung him into a centripetal mindfuck.

Phantasms crept out of slim gaps between mirrored tiles that lined the hallways, now the hyper-reflective, mocking sheen of a personal Hell that collapsed in on itself the longer Izumi fought, futilely, to look away. Recessed utility closets swung open like massive, gaping mouths that had him convinced he'd be vacuumed down the wormhole of rabbits. The windows were barred, a fixed reinforcement to the slow-crushing reality of life as a caged undesirable. His bed rode too high for sitting with both feet firmly on the ground, and thus was more like a plank dangling precariously over a spiked pit than a place to rest a weary head. He said he wouldn't let the noises haunt him, but the ward's piped-in ambient music and sporadic intercom announcements smelled like garbage, he swore it.

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There were no clocks, no calendars; time, to say nothing of his or any patient's temporal bearings, simply did not exist, which made remembering when to swing through the nurses station, a pill counter-turned police station, damn near impossible. There was no privacy, no moment that didn't feel like standing centerstage, naked, alone, and with no clear exit; at his every entrance and turn, heads turned. And the hallways! The mirrored hallways. It was as if they did not end. They shot straight past infinity, obliterating Izumi's constancy of perception.

He couldn't take it. He felt himself leak away. You could say he freaked out. But that's because he had a head full of LSD.

That Izumi tripped over much of his initial assessment of Saskatchewan's psychiatric wards, a structural and patient survey that lasted from 1954 to 1958, it's perhaps unsurprising to hear about what exactly the architect, then in his early 30s, experienced through the hospital's physical configurations and psychic paraphernalia. Which of course was precisely the point.

Izumi was part of a small, federally-granted team of visionaries, including British psychiatrist and psychedelic researcher Humphry Osmond and Canadian biochemist and psychiatrist Abram Hoffer, tasked with developing a province-wide psychiatric hospital overhaul that addressed the affects that clinical environments had on patients. The trick? Get inside the heads of the mentally ill. The problem? Mere intellectual power and imagination would only take the trio so far.

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Which is to say the success of the Saskatchewan Plan, as the provincial mental-hospital plan was officially known, hinged on mimicking the psychomimetic experince. A true, honest understanding of the at times cripplingly intense psychic distress of schizophrenics, namely, meant taking a good, hard look at the psych ward as only schizophrenics could. It meant occupying, so to speak, the minds and bodies of the committed as a way of forging an eye-to-eye rapport, and to empathize with how certain physical spaces dizzied their psychic boundaries, and stoked their anguish and fears.

To build a better psych ward, a space unshackled from the inhumanity and stigmas of the "insane asylum", Kiyoshi Izumi would have to immerse himself in their world. He'd have to get on their level, the thinking went, to understand a patient's struggles and, crucially, how those struggles could be inverted, blended, stretched, and exploded by various design quirks, ambient anomalies, temporal-spatial glitches, color schemes, light casts and any other features that to outsiders seemed mundane, but to whose grimmery existed only on wavelengths discernible to the afflicted. He'd have to conjure up not only hallucinations but also delusions and perceptual distortions distinct to psychoses. He'd have to eat acid. Or so he and Osmond and Hoffer thought.

It was a bold move. The insights he gleaned from levelling with patients and their surroundings, if we're to take his word for it, found Izumi envisioning what's gone on to be called "the ideal mental hospital", the first of which was raised in Yorkton, Saskatchewan, in 1965. Five more so-called "LSD-inspired" mental health clinics would be built throughout Canada, as well one in Pennsylvania. It was then only a matter of time before Izumi earned praise for the apparent humanity within his acid architecture, and also skepticism, still aired today, over the alleged problem-solving potential of his mind-altering drug of choice and the true extent to which his hospital designs effectively put the mentally ill at ease, or even helped integrate them back into the outside world.

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Weyburn seen from above in 1960, forty-nine years before it was demolished. via Shoo Line Historical Musuem.

Weyburn Mental Hospital opened its doors in 1921. It cut along the leading edge of experimental psychiatric research, but found itself deep in insitutional backwater.

For centuries, the asylum was devoid of compassion. A potent and medieval mixture of fear, superstition, and misunderstanding, Stafford and Golighly write in LSD: The Problem-Solving Psychedelic, fueled this shortsightedness. Only during the nineteenth century did we begin to humanize the clinically insane, and thus begin a long (and in many ways still ongoing) prying open of the doors to compassion. It was around then that medical directors and architects reshaped the architecture of the asylum into a calm, natural domain. The idea was to actively soothe, not outright neglect, the "insane" in the mentally ill.

Too bad we continually bought the absurd myths of countless "manias" and "mass hysterias" of our own invention. So most new and reformed mental hospitals were promptly packed to the brim, the patients crammed in huge common rooms. And then funds for the new digs dried up. And of course the proverbial cure for insanity kept on eluding us. In short time, it was as if not much had ever changed. The asylum was again an institution of oppression.

It is a tragic social irony, Arthur Allen, a Canadian architect who spent time in Izumi's office, wrote (pdf) in Design Observer, that the modern asylum, a product of the heady optimism of nineteenth-century institutional reforms and technological advancements, "ultimately became warehouses to some degree, degrading in part to the function of a waste container for usually harmless but eccentric and inconvenient people."

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So like many paradigm shifts, the Saskatchewan Plan was a direct response to a failed progam. But long before the comprehensive plan mandated that two of the province's massive mental institutions close shop, after which a half-dozen or so modest, community-oriented mental-health centers open up, Izumi's orbit would have to sweep closer and closer to those of Hoffer and Osmond.

Until that point, Izumi never fancied himself a psychonaut. He was 33 when he ate his first dose of Lysergic acid diethylmide, which came by way of psychologist Duncan Blewett and anthropologist Francis Huxley (yes, that Huxley), two trip sitters kind enough to even dose Izumi's wife. She vomitted minutes later, leaving Izumi to lose himself in the floor clicks of his two wired chihuahuas' toenails, the blurring of spacetime, a skipping record, a uneaten slice of chicken, the ability to hear colors, see sounds, and taste smells, and a night sky utterly sand blasted with stars.

You could say he set a fairly high bar for his later architecturally- and patient-centered trips with Hoffer and Osmond at the University Hospital in Saskatoon and the Saskatchewan Hospital in Weyburn. He'd spend a lot of time tripping (and not tripping) at both sites, the latter of which had become a sort of bastion of psychedelic experimentation within the contexts of mid-century psyciatric care and research. It was largely thanks to Osmond, who coined the term psychedelic in 1957, that Weyburn was by then a preserve of research into, among other things, treating alcohol addiction and the throes of delirium tremens with both mescaline and LSD. As such, the hospital was an ideal and well-stocked laboratory for solving a deep-rooted riddle at the intersection of mental studies, institutional geometry, space, and territory.

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For Izumi and Osmond it became clear that so often the domain of the mental hospital only worked to destroy a patient's grip on reality, and to isolate him to boot. What a patient needed most was a hand to help him hang onto some vestige of reality, but the clinical milieu was such that he couldn't easily communicate his feelings, or that he needed a hand. "Schizophrenics are lonely because they cannot let their fellows know what is happening to them," Humphry wrote in response to "Meaning and the Mind Drugs," a paper by Richard P. Marsh, "and so lose the social support, help and encouragement which they need so much yet so rarely evoke."

Which had the brains behind the Saskatchewan Plan attempting more and more to replicate psychosis, to inhabit mental illness within the confines of the hospital. As Barry Edginton, a sociologist at the University of Winnipeg, wrote in 2008, it was a matter of getting a sense of the building from a patient's point of view. And it was acid, which Osmond referred to as "the quixotic giant," that he and Hoffer and, gradually, Izumi believed held the keys to open lines of communication with patients and to building better ways to aid the sick.

Entrace to an abandoned Weyburn, 2008. Via Wikimedia.

That was easy for Osmond and Hoffer, medical professionals steeped in psychedelic research, to swallow. For a still barely-psychonautic architect, it was a leap of faith. Izumi wasn't a doctor. He designed things. In his words:

Psychiatrists talk one language and I talk another. They knew what they wanted but someone had to translate their wishes into architecture. To me there was really no other way. If I were to really understand the fears and problems of the schizophrenic, I would have to look at things the way they did.

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Because really, how else was the architect, in Edginton's words, supposed to create a space suited for insanity without tuning into "its particularity, its essence?"

What they came up with was a plan for a new, improved, near-perfect mental hospital that rested on the principles of what Izumi and Osmond called socio architecture. The Saskatchewan Hospital at Yorkton, Saskatchewan, would facilitate smooth transitions between small rooms and larger ones, say, or from being alone to being in a small group, and would do so without muddying or spinning the senses into a full-on centripetal mindfuck.

It was post-war psychedelic dabbling at places like University Hospital and Weyburn that provided technologies to those inside the Saskatchewan Plan to do this, to carefully turn the asylum on its head. Years later, Izumi recalled in LSD and Architectural Design the close attention paid to patients who struggled to navigate the fragile boundaries of psych-space. The hospital at Yorkton would:

  • Provide "as much privacy" as possible
  • Minimize ambiguity of architecture's "design and detail"
  • Bear no intimidating features
  • Foster spatial interactions that curtail the frequency and intensity of "undesirable confrontations"

The original Yorkton Psychiatric Center concept, a semi-circular, single-story building Izumi called the "sociopetal" plan, seemed to pay off all those criteria. It satisfied three tiers of human association--personal, relatively intimate, and large--with individual "retreats" along the periphery, a central opening for large group activity, and in the space between, nooks for smaller group interaction.

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But just when Izumi thought he had it, the concept would have to be "reinterpreted" due to building codes, the day's hospital construction standards, and the Department of Psychiatric Services' reluctance to get too "far out."

Izumi's sketch of his would-be "socipetal" plan, via Arthur Allen / Design Observer.

The final design for the hospital at Yorkton was made up of cottage-like room clusters--smallish spaces that held 30 patients to a unit--that were linked by a network of underground tunnels. From above, it looked like a modest Maltese cross stamped into the pancake-flat terrain of southeastern Saskatchewan. Read into that what you will.

Or, call it unassuming. To the untrained eye, Izumi's final building likely appeared decidedly non psychedelic. Square, even. But look a bit closer and it becomes clear just how instrumental Izumi's psychomimetic experiences proved in shaping the way he thought about the sort of feng shui of socio-psycho interaction.

It was not a mirrored warp. A cool, "flat" palette lightly colored the rooms and hallways. It was not a wormhole--rather than gaping closets there were large, mobile cabinets, each with an easily discernible back and front side. Nor was it a cage--this was a place of many windows, all low and unbarred. The beds sat low to the floor in individual rooms, each furnished so as to define the floor as close gound, not a distant pit. It was not a theatrical setting. Privacy was paramount. There were social spaces, sure, but the doorways and thresholds to those areas were specially designed to beat back the stock-still horror of feeling on stage.

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It restored time. Clocks and calendars were plentiful, though never positioned as to appear instable, floating, or in defiance of gravity. And it was not synesthetic. Izumi took pains to dampen disorienting architectural minutia that for some patients kick up waves of mish-mashed senses. "Heat, light, and sound sources were designed to avoid creating confusion," Izumi continued in LSD and Architectural Design, "as many of these sources became indistinguishable to a patient who is experiencing perceptual changes and distortions." To wit: "The combined [light fixture] fittings that are used quite commonly in commercial buildings were not used in the psychiatric hospital. In selecting illumination type and distribution, we tried to avoid creating silhouettes of faces and bodies."

Izumi's work featured in the January 9, 1965, issue of the Montreal Gazette via eBay

That's all admittedly a criminally brief flyover of the Yorkton space--for full justice, go read Izumi's full depiction. Regardless, the place caught the attention of numerous influential organizations the likes of the Joint Information Center of the American Psychiatric Association and the National Association for Mental Health, which in 1964 glowed over Izumi's invention as being:

…among the most attractive and architecturally advanced buildings ever constructed for psychiatric services …As for the physical plant, it was a pleasure to view a facility that was more than merely new. Creativity and imagination were evident in scores of details. We felt the wards and day rooms combined efficiency with comfort and cheerfulness to a very exceptional degree.

Still others closer to the man sung his praises, however cautiously. For all he knew, Allen, the fellow Canadian architect who frequented Izumi's office, said there "was no magic intended" in the shape of Izumi's spaces. "But who knows," he added. "There were some unusual and interesting people working in Weyburn Hospital."

Like Osmond, who maybe wasn't off base when he held up the Yorkton center, together with the five other acid-aligned mental hospitals rolled out under the Saskatchwan Plan, as not just an "ingenious" design. It was also a monument to humanitarianism. He took this as further proof of LSD being as much a conscience-expanding tool as it is consciousness-expanding. And yet even he stopped short of deeming Izumi's reported LSD insights as genuine beyond reasonable doubt. It could be said that Izumi, gifted as he was, could've done this all just as well, perhaps better, without tripping on acid. Osmond did not know just how that "could be proved or disproved."

We'd do well to not be fully charmed off a metaphorical dose of Izumi's architecture of LSD. By his own admission, dropping acid, eating mescaline, smoking DMT, or ingesting whatever other psychedelic may in no way bring you any closer to wrapping your head around the gravity of the wide ranging experiences known to cut across mental illness writ large. Izumi didn't assume his acid trips "gave him complete and immediate insight into the needs of the patient," notes Elizabeth Donaldson of the New York Institute of Technology. He worked tirelessly "to check his perceptions" by way of "intense" conversations with patients and his colleagues, which only went so far in connecting the dots between architecture and patient health at Yorkton Psychiatric Center. Or any other hospital drawn up through the lens of psychoses, for that matter.

It's a poignant marker in the story of Kiyoshi Izumi that that sort of thing hadn't yet been rigorously measured by even the time he died in 1996. And he was the first to say that it may always be difficult to gauge.

Yet his ideas still reverberate, presaging a number of recent reforms. Most notably, the American Institute for Architects' call in 2006 for any and all new hospital construction to be based on single-room designs in no small way took root in Izumi's belief in the indivudual's sacred right to privacy--something that arguably could've only crystallized through the psychomimetic gauntlet. By stepping into a warp.

An immersion in their "reality," he said, was "a convincing experience" that forcefully reaffirmed what he considered the selfless and social responsibility of the architect, a worldview that for him ultimately transcend the clinic to include all people, all space. In the end, Izumi took a great hit for an even greater good. If that's not something to build on, maybe we've all lost it.

@thebanderson