Experiential Psychopathology - Dr John Howells

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IV - Vector Therapy

Successful Application

Careful assessment of an individual can bring to light the pattern of adverse forces that brought, and maybe still brings, trauma into his life. The main areas of exploration are threefold – the patient’s life experience in his preceding family, the patient’s life experience in his present family, and the patient’s experience outside the family circle. An invaluable procedure for this exploration is to meet the patient together with his family – either his preceding or present family – a procedure termed Family Group Diagnosis (Howells, 1975). A particular development is worth mentioning here. Hitherto, the usual procedure in the exploration of the preceding family has been to invite an individual patient to remember and relate his experiences in it. How full of errors is this procedure! Far better is to adopt the practice, whenever the preceding family is available, to put it with the patient and observe the adverse process at work. We have found this practice of great value at our Institute.

Starting with Family Group Diagnosis, it may be useful to summarise the essential steps in the application of Vector Therapy. Each step is concerned with assessing psychic factors or effecting psychic changes. The steps are:

  1. A careful assessment through family group interviews to clarify the pattern of the emotional forces at work in a particular family, i.e. Family Group Diagnosis
  2. To bring understanding of its particular set of forces to the family
  3. To help the family, through a supportive relationship, to accomplish a change in the pattern of its adverse set of forces
  4. When necessary, to put the family in touch with community agencies that can facilitate the change
  5. To create community agencies able to effect changes in family psychic patterns. The agencies bring not material relief, but emotional relief, to the family. This may involve adjusting present community agencies or establishing new agencies.

Vector Therapy can be effective when facilities for interview psychotherapy are absent or scarce. This is a situation common in many countries. When resources are limited, Vector Therapy has the added advantage of being economical. It demands the same degree of skill in the psychiatrist as interview psychotherapy, but it saves the psychiatrist’s time because it utilises less interview time as change is produced by monitored therapeutic situations outside the interview.

Vector Therapy can also be effective when there are facilities for interview psychotherapy, but they are unlikely to be availing; an example would be the treatment of a hard core or problem family. Again Vector Therapy can be utilised when the situation demands an urgent solution, when someone may be damaged or endangered during the interval before interview psychotherapy becomes effective, e.g. when an infant at risk of being battered in his own home has to be urgently removed to a safer mileau. Given ideal resources, the quickest and best results are obtained by combining interview psychotherapy and Vector Therapy.

Vector Therapy throws into relief the value of facilities in the community that can bring beneficial influences to bear on families. Thus around a family, particularly when its children are young, is a pattern of positive emotional forces. Over generations a system so developed creates a health promoting, salutiferous society.

REFERENCES

  1. FRANK, Jerome D. 1961. Persuasion and Healing. Symptom Relief and Attitude Change. London : Oxford University Press: Baltimore : The Johns Hopkins Press.
  2. HOWELLS, John G. 1963. Extra-Interview Therapy in Family Psychiatry. Public  Health 77, 368-372
  3. HOWELLS, John G. 1975. Principles of Family Psychiatry. New York : Brunner/Mazel; London : Pitman Medical.

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