**1. Introduction**

It has always been known that humans find reassurance in nature. Therapeutic sanctuaries have been sought out through the ages by individuals who have a sense of disorientation or likely future ambiguity. For example, those diagnosed with acute and terminal illness often search for a space of solitude, needing time and space for reflection on significant life and health changes [1]. Explanations for this phenomenon find that the brain is capable of two types of attention: directed attention, belonging to the higher cognitive centres, and soft fascination, linked to the old parts of the brain [2]. In natural environments, the higher cognitive centres of the human brain can rest and reset, lending some of the first scientific evidence to the healing powers of nature.

Most recently, as social tensions associated with the Covid-19 pandemic, climate change and racial inequity deepen the need for places of emotional retreat and

healing, therapeutic landscapes have become an increasing topic of interest [3, 4]. However, while more and more research [5–7] finds that contact with nature plays a critical role in psychological well-being, and for those in need, a faster recovery from psychological trauma or stress, Ulrich & Gilpin found when researching hospital gardens, an example that had a measurable negative effect on patient's health [8]. Similarly, following an extensive review of healing gardens, Stigsdotter & Grahn found that not all gardens are healing gardens [9], leading to the question, what is a therapeutic landscape or a healing garden?

The term therapeutic landscape was originally defined in 1992 by the geographer William Gesler as a place "where physical and built environments, social conditions and human perceptions combine to produce an atmosphere which is conducive to healing" [10]. This definition was contested, critiqued and elaborated on over the next two decades, extending from a literal relationship between health and place with the acknowledgment of extraordinary places to a much expanded and refined characterisation. The extended literature reflected the growing interest in the relational and situated approach to well-being, which acknowledged the therapeutic nature of places in the context of those social, cultural, material, affectional and sensual aspects of human and non-human factors [1]. Such therapeutic encounters are defined differently by others, such as 'networks' [11], 'experiences' and 'environments' [12], 'taskscapes' [13], 'mobilities' [14], 'assemblages' [15] and 'enabling places' [16], with the latter gaining particular purchase amongst health and cultural geographers alike.

This theoretical turn saw a much greater emphasis on qualitative and ethnographic methodologies in the study of health designed to reveal the histories, discourses, and lived experiences of a place. Building on the contention that different people experience therapeutic landscapes differently or at different times, the potential healing outcome of the landscape can be seen as a relational process, and therapeutic landscapes become socially and culturally responsive. People's behaviour is deeply embedded within a place, particularly around health [17]. It is not just the space that is healing but the intention of those using the space [18]. Places should not only be defined by the fact they are conducive to healing but also places that are conducive to the maintenance of health and well-being [19, 20].

Successful therapeutic spaces generally reflect a society's current values and aspirations, and as such, become part of its identity. Situated in the current context, 'place' becomes even more challenged and implies that such spaces may need to be flexible to changing interpretation to remain therapeutic over time. Foley & Kistemann [21] considered therapeutic spaces as emergent through a set of embodied experiential practices linking affects, emotions, and bodily sense that arise from being immersed in such therapeutic environments. This form of assemblage can therefore be better understood through its material, metaphorical, and inhabited dimensions [15, 22]. The material component would contain the tangible aspects of landscape that people experience due to their therapeutic qualities. The metaphorical component comprises the ethnographic and cultural values expressed through narratives, myths, and stories that are crucial in defining site-specific rituals and cures. Inhabitation brings together mind, body, and spirit because it draws from lived, experiential, and performative health dimensions.

To this concept, Andrews [17] proposed two streams of application. One relates to the impact of landscape on human experience. The other pertains to how therapeutic landscapes are shaped by the influence of different belief systems, leading to the cultural specificity of the therapeutic landscape concept. In this way, culture and requirements for health create an assemblage of layers that combine in bespoke combinations depending on the individual and the time. The implication is that a healing environment cannot be achieved by a set of design requirements or details

#### *Therapeutic Landscapes: A Natural Weaving of Culture, Health and Land DOI: http://dx.doi.org/10.5772/intechopen.99272*

you need to meet, it must facilitate a healthcare service that is patient-focused and centres on the diverse needs of all [23]. This extends the therapeutic landscape concept to encompass both tangible and intangible values, supporting the proposition that health, well-being, and place are intricately intertwined and emergent through the layering of architecture and material; with practices and responses in a narrative of individual and communal history where people are simply seeking well-being.

Indigenous methods of restoring health and well-being offer new opportunities for understanding the complexity of health and well-being. Most of the Western understanding around therapeutic landscapes has come from the healing properties of the physical space and adopting a bio-medical approach, translated into spas, mineral springs and mountain retreats [24]. For example, in areas of natural springs, much was made of the unique chemical make-up of the water until scientists uncovered the lack of chemical difference [11]. With this narrow view, what was overlooked was the non-physical dimension to these spaces [24], as scientists failed to engage with and quantify the practices and traditions associated with these landscapes that enabled the healing process [25]. Similarly, what has not been translated into Western culture is the deep-rooted connection with the land and its relation to self-identity on an everyday basis. The associated values and practices embedded in culture and practice are often the foundation of the healing nature of the therapeutic landscapes. Practices in Indigenous cultures are able to be embodied and translated into everyday places and landscapes.

In fact, only a small portion of the literature on therapeutic landscapes discusses the inclusion of Indigenous methods and the relationship between the environment and health and well-being that most of their spiritual connections are grounded by. However, 80% of people in developing countries still rely on traditional medicines or methods. They are inexpensive and easily accessible, they are also believed to be stronger and more effective than treatments offered at a healthcare facility [26]. Indigenous methods and practices often combined with everyday health and well-being, mainly when connected to a sense of place and the sense of identity and symbolic healing the environment can enable [24].

This chapter explores therapeutic landscapes and landscape architectural approaches that can be applied to creating or understanding therapeutic landscapes that are culturally and socially responsive. It addresses the gap in the literature regarding therapeutic landscapes to understand how different social and cultural contexts can affect physical, mental, emotional, and spiritual health. Our intent is to illustrate landscapes that include cultural practice and Indigenous healing methods to promote well-being at both individual and community levels. Examining a series of case studies from around the world, it explores landscape architectural responses to healing. The case studies have been selected based on their success in catering to the social, mental, physical and emotional needs of the user. The chapter unpacks the social and cultural contexts that have shaped these environments and discusses how this can be applied to the universal design of everyday therapeutic landscapes.
