How does that chair make you feel? Island mental health professionals discuss comfort

0
Dr. Charles Silberstein has three identical Barcaloungers in his office at the hospital — Photos by Lynn Christoffers

Do you lie down, or sit up when talking to a therapist? Do you face them, or…somewhere else? Do you visit them in an office in their home, a separate studio in the woods, at the hospital? Does a certain light source, or a color on the walls, or any particular artwork, help you feel comfortable enough to share your issues? Five working therapists talk about why comfort matters and describe how they, and the offices they’ve created, help clients relax.

Charles Silberstein, M.D.

Psychiatrist

Martha’s Vineyard Hospital

Oak Bluffs

Hospital Office

I love being here at the hospital;  it allows me to do consultations on acute care at the nursing home and Windermere; I’m part of a community. I might feel isolated if I were off in a corner of the Island. I do worry about that in terms of my patients sometimes, whether they will feel comfortable coming into the hospital. Many people associate hospitals with places where they’ve been traumatized, or frightened, where they were sick. But I find it easy access to services at the hospital such as the lab and it’s easy to find. People are comfortable in my office; it’s fairly private and located apart from much of the hospital in a separate section where it’s quieter and personal.

Chairs matter

To me, it’s very important that everybody has the same chair. When I start a relationship with someone, I want to communicate that this is a partnership: There’s not somebody with a bigger chair or better chair. I can think of other physicians where there’s clearly a power differential, and I think that undermines the healing process.  

All three chairs in my office are the same Barcalounger model. One of the things I love about these chairs is that they recline. So it’s easier to get comfortable and for some people to free-associate and think without looking at someone in the eye. Some people put the chair all the way back, put the pillow behind their head, and even close their eyes. And sometimes that can liberate people to talk about things and think about things with a sense of freedom and sometimes safety.

On the other hand, for many people it may feel safer to sit up, not to feel vulnerable.

I also think about the way the chairs are situated. I like there to be a certain closeness between me and someone I’m working with, and yet it can’t be too close because one of the things about any good therapeutic relationship is a sense of boundaries. So it’s the kind of thing that I’m always hoping to be conscious of and to dialogue about to enhance that sense of partnership between the person and me I’m working with.

Sometimes I do turn the chair toward someone, but there’s something nice about not being straight on with someone; at a slight angle gives you both the opportunity to move forward or away. It’s harder if you are straight on, face to face.

If I have a couple, I want them to be able to look at each other. I often turn the chairs before they come in, so the three of us can have a conversation. There should be a group partnership among the three of us.

Lighting and Artwork

I don’t have a lot of flexibility with lighting, as the office came with overhead lighting that I

almost never turn on. The three desk lights create a nice glow without being glaring.

The artwork is all by local artists: Two are scenes of Martha’s Vineyard. Both feel dreamlike to me and otherworldly; I find them both relaxing and soothing, and I feel like they are windows into another world. The piece that intrigues people more than any is the piece by Suesan Stovall. Everyone who has commented on it loves it. I’m always seeing new things in the piece that I never saw before. The artwork all feels to me like a window to another dimension — consciously or unconsciously.

I want to help the people I work with to find ways to enter other dimensions of themselves.

Dr. Rufus Peebles

Psychologist

99 Great Plains Road

West Tisbury

Office as a Safe Place

I see people right here in this room in my home. A person gets to choose where he wants to sit:  the chair you are in, or the one next to it (a pair of black leather side chairs). Couples tend to sit

in the two chairs. I will rearrange them so that they are more facing each other. For a family session, I put things in a circle, there are plenty of chairs to bring in.

The sofa is available to people as well. When I purchased it I thought it would be good; however, it is not the most comfortable place to sit. I get the straight-back chair because it’s good for my back. And I have another straight-back chair just like it should someone prefer it.

What is important to me is creating a safe space so that when a person comes in, they feel, “Aha, I can let down. I can venture into doing the challenging and difficult of work of trying to learn more about me and who I am. How does my past influence the present. How do I come to difficult decisions.”

I want the place to be safe and warm and supportive — and pleasant.  

Part of feeling safe is the sense that no one else is in the house to overhear what we are saying, being reassured on this small Island that there is confidentiality. I want the setting to say that non-verbally.

Plants and Nature

There are plants, there’s tea if someone wants it (on a table in the corner); there is art on walls (a rubbing from a cathedral in London and pen and ink sketches).

I chose the wall color to be bright and cheery. I love the view of nature, so we are private in here but also looking out on the world. Sometimes the deer walk through. It is very peaceful, and I am delighted I am the only house on this road. So there is wonderful privacy which talks about safety: here is a place you can relax into yourself, a safe secure place for you to come and do your work, with my help.

What I found coming here from Cambridge 26 years ago is that I have a wonderful group of people that I work with on the Island, bright and kind and verbal. Working with them is pleasurable and fun for me.  A lot of wonderfully creative people.

Judy Hartford, LICSW

Psychotherapist

93 Dukes County Avenue

Oak Bluffs

Husband & Wife Offices in Home

This particular practice of Thad’s and mine is in our home, so it’s a little more informal than most. We don’t actually have an official waiting room or bathroom, so when people come in, there’s a button on the wall they press, the light goes on, and we know that someone is here.

We’ve been working this way a long time, and we are very comfortable doing it this way.

The Big Room

We call this room that I use for my practice the Big Room. It was originally my husband’s glass studio. Then when I closed my store on Circuit Ave [Judy currently owns Bananas clothing store in West Tisbury and Vineyard Haven], the room became what we called the Red Mannequin; these doors opened to the outside for customers to enter. That’s why it’s painted the way it is — a peachy yellow color, with dark red trim — more of a gallery or boutique look.

The walls are covered with local art. The couch is a fold-out, so when we have guests it becomes a guest room; the TV is behind the screen; most times this is our family room.

The dressing room is now an office cubby (behind a curtain) so every bit of this space is used.

The most important thing here is to create an environment that is warm, inviting, safe, and not sterile. Where people can feel immediately comfortable. They come in — it’s just a big warm room, colorful with lots to look at. I have my books that give a personal, professional look.

Some of the furniture have been with us for years and years; we moved here with it: the coffee table is a blanket trunk. It’s like a ship — every little space is used.

I see individuals and couples in their 30’s to 70’s.  All kinds of people — in arts, in business, in trades — a real variety of pretty wonderful people on the Vineyard. I usually sit in that chair (shaped wicker with pillows). Couples sit on the sofa. I don’t think anyone has ever used that other chair. It’s just here should I need it. It’s the same as other chair: two wonderful garage sale finds.  

It’s totally intuitive, it’s what I like, and I think it holds together. I don’t think about it formally at all.

Working with people in the way that we do, it really is all about safety — providing a comfortable environment. However, you do that reflects your vision of how you want to be in this world.

The office should reflect that standard.

Thad is next door in a totally different space. You’ll see.

Thad Harshbarger, Ph.D.

Licensed Psychologist

93 Dukes County Avenue

Oak Bluffs

A Choice: Wicker Chair or Couch

I see both individuals and couples in therapy. There is a choice for seating: some people prefer the chair, it’s a little better support, a little higher than the couch. The chair is an antique wicker of some sort. I just like original stuff better. The sofa — from Jordan’s or some place — is a nice size, not too large. I can get two or three people on there as needed, which makes it reasonably convenient. It depends on the couple where they sit: sometimes they may sit next to each other and hold hands on the couch. Others may sit as far away from each other as possible, with one at the far end of the couch, the other in the chair.

Some people will use the couch to lie on, to be as relaxed as possible; others may lie sideways.

I was trained analytically…part of that is you want to get people relaxed as possible, and it’s best to give them more control over where they arrange themselves relative to me.

The basic analytic concept is to have no eye contact (face to face is distracting): the person turns inward. So, in these situations, I move to sit in that side chair…but that’s a matter of preference.

My chair is a comfortable chair. Well, I do sit kind of reclined. I had a  supervisor years ago, who sat off in a corner in an upright chair; he looked so tense.

High Ceiling and Soundproof Walls

We built this room with the idea that it would be a therapy room — it has special construction to make sure the beams don’t touch both sides, as they are staggered. So if you are talking in here, there’s no sound conduction through the walls. Typically, a wall serves as a diaphragm that conducts sound to the other side and you can hear. We went to great trouble to make sure no sound travels. I have double doors, with weather stripping around the doors. The doorbell turns the light on, also there’s a white noise generator that goes on. The client comes in the separate entrance and flips the switch so I know they are here.

We had a choice, when we added this room on to the house, to have high ceilings or a second floor. I think it’s really helpful because you don’t feel so enclosed.  There’s a problem with people coming here anyway — nobody wants to go to a therapist — they don’t want to talk about a lot of the stuff they have to talk about. If you have a room that’s comfortable and not oppressive, it helps. We added the skylight as it was really dark without it, and I have antique lamps. The trick is to get it so people can see well enough but not so it’s so bright. I have the kind of environment that I feel comfortable in, with light blue walls and my clients seem to be comfortable as well, they like the color.

I had one woman years ago who paced…she couldn’t sit still. Basically, we had to hospitalize her, unable to manage.  

Most people would rather sit.  

Julia Kidd, LICSW

Psychotherapist

State Road

Vineyard Haven

The Office Space as Calm

My main objective is to make the space calm, and comfortable and clean. Everything has energy, so everything matters that’s in the room. Keeping it simple and keeping it clear allows people to have their thoughts come through without distraction. It’s fairly neutral in here for that reason.

The things I’ve selected to be in here are things that represent beauty or the abundance of nature. Things that are available to us: shells and crystals and stones — flowers.

I keep that jar of acorns there because it reminds me of what I’m here to do: sprout seeds, grow trees, help people to expand to their fullest potential. That’s my work.

Clients tend to come in and choose where they want to be. There’s a two-seat sofa. Sometimes people like to sit on the sofa because it’s comfortable. There’re a variety of options — people can sit together if they want to or sit apart. The side chair is wicker with soft cushions. I have a spare chair should I have a family group.

I always sit in this chair [by the desk].

Energy

The furniture itself per se is not as important as the energy in the room.

It’s important to keep it quiet, not to have too much lighting. I usually spray a little lavender to clear the air in between sessions; I don’t have a phone that rings, there’s not a  lot going on.

It’s pretty simple, uncluttered. I think simple is the thing. It’s the absence of things that makes being able to create space for other things to occur. Personal items (such as family photos) can create a distraction. I’m very careful of what happens with space in here.