WHEN patients stretch out on Dr. Harvey Kelman's couch, they look at the clouds overhead and describe what they see in them -- like the Rorschach blots (a personality test).

The big (5-by-5-foot) central skylight in the pyramid shaped roof over Kelman's office is the central feature for both his office and his house and they work fine in both.

Rosalind and Harvey Kelman bought the 10-year-old house in Maryland in 1976. The former owners told them that the office of the late architect of the Kennedy Center, Edward Durell Stone, designed the house. "Our roof started to leak about the same time as the Kennedy Center's," said Dr. Kelman. "We had to put on an entirely new roof."

The Kelmans, who had been looking for a lot to build on, loved the house but realized it was too small for them. Kelman, as well, wanted to practice at home, so he needed an entire office suite. The Kelmans hired the architectural firm of Imas Gruner to design an addition.

Lelia Imas, the partner in charge of the design, was given a strict program of requirements. The doctor's office had to be absolutely private, both sight and sound. The Imas Gruner answer was to design the waiting room, foyer, half bath and doctor's office as a separate unit, heavily soundproofed. The psychiatrist has to walk to work -- the office is across a patio from the house, with the facing walls both blank. The office is a smaller version of the house in style, roughly a square.

The Kelmans also needed more house space, since the original house had three bedrooms and the Kelmans have four children.

Imas Gruner designed an 18-by-34-foot family room along with two new bedrooms, a bath and a short hall to reach them.

The total new addition was 1,800 square feet, added to the house's original 3,300. The construction cost by Al Cissel of Nale Construction Company was a bargain $28 a square foot, making the total cost $50,000, cheap even for 1976. The construction time was a quick four months. Nale did some other things as well -- a private driveway for the doctor's office, the new roof, an enlarged door into the kitchen from the new room, and a revamped three-zone electric heating system.

The electric heating, though dreadfully expensive, is less so with the option to keep the zones at a separate temperature. Once, when the Kelmans were having a big winter party, they turned off the heat in the office and used it as a refrigerator.

Dr. Kelman did some of the work himself -- he laid quarry tile in the original family room, now the family dining room, and the kitchen. He also paneled the kitchen with teak, the garden room with redwood (on the ceiling) and the bedroom with exterior grade Texture III, adding wainscotting for posh. He laid a new floor in the sewing room, converted from a small bedroom. pAnd he built three decks: at the entrance, in the court between house and office, and at the rear. Dr. Kelman also added some more wiring to the kitchen.

It's an interesting house, in the classic modern manner. The original house is a brick square. The living room, lighted by another big skylight, serves as the plaza of the house, with all other rooms around it.

You come in on the side of the house, through an arrival court, a recognition of the fact that most people arrive by car in the driveway. The front door leads through the pleasant foyer. The pierced brick grill wall begins outside to shield the dining terrace from the front door and extends inside to shield the dining room. To the left as you come in is a den and half bath, doubling as a guest bedroom. Next is a small greenhouse/sun room, giving the master bedroom a sitting area. All open of the living room.

Through the living room is the kitchen/family dining room with three skylights -- one added by the Kelmans. The skylights work well here, because the kitchen is a totally interior room. It would seem very dark without the skylights. But as it is, the lights are strategically placed so you never have to turn on a light during the day.

The kitchen also borrows light through big doors from the new family/ballroom, the scene recently of a splendid bat mitzvah with a hundred guests. This big room, perfect for ceremonial occasions (next one a wedding?), has a 7-by-7-foot skylight in it. "It seemed to me that the origninal design was so good, it was worth repeating," said Imas.

The family room looks out onto a pleasant garden -- Kelman is the landscaper in the family. When he ran out, of dirt, he put in water lilies in the handsome pond in the front of the house.

A small bedroom became a sewing room and a hall is now lined with closets. Naomi and Ruth got the two big rooms. Abigail and Eve have the smaller ones.

The house and office complex works perfectly for the Kelmans. They have lots of family and family parties are easily accommodated in the house. Mrs. Kelman describes herself as a professional volunteer -- the Girl Scouts and PTA. Kelman always arranges his schedule so he's free to walk down to the corner at the time the children come home and have a few minutes for a coffee with them.

The Kelmans thoroughly enjoy their house with its head in the clouds. "Of course, during the winter, I have to sweep the snow off the skylights," Kelman said. "And it's noisy when it rains. But we don't have to turn on the lights during the day, and plants thrive."

And all those patients can trace their dreams in the clouds floating overhead.