The Institute of Family Psychiatry
Dr John Howells, MD, FRCPsych, DPM, AKC, DFAPA, was Director of the Institute of Family Psychiatry from 1950 to 1985. The Institute was associated with the University of Cambridge and was part of the post-graduate medical programme of that university.
After training at the National Hospital, Queen's Square, London, in neurology and at the Maudsley Hospital in psychiatry, Howells became disillusioned with the psychopathology in practice at that time. He worked for a period in the Psychoanalytical Unit at the Maudsley Hospital. He became increasingly dissatisfied with psychoanalysis because its practice gave no assistance to his patients. Thus he left the Maudsley Hospital in the hope of being able to practice a different psychopathology elsewhere. This was at the inception of the National Health Service when innovation was encouraged and this unit was set up in a general hospital. It was understood that most of his time would be devoted to research and his contract allowed him to undertake clinical work for one day a week and research for the remainder of the week.
The Institute was filled up over the years to have a staff of six whole time consultant psychiatrists. These were supported by a large number of professions in associated clinical fields such as psychology, social work, occupational therapy, speech therapy, radiology. The staff co-operated with all the other clinical departments of a general hospital. Referrals came from the General Practitioner and the waiting list remained at two weeks for the whole length of the 35 years. Referrals could include individuals, such as children, adolescents and adults, dyads - such as marital couples, and family groups. Research had shown that the individual was brought up by the family rather than by any one individual within it. Therefore diagnosis and treatment was based on this realisation, hence family diagnosis and family psychotherapy.
Psychoanalysis was replaced by experiential psychopathology. The individual's psychological experiences resulted from real experiences with his or her emotional environment. The understanding of real events and experiences replaced the utilisation of symbolism and the speculations of psychoanalysis.
Research also showed that the individual lived in a web of interacting forces - vectors. These vectors could be understood and evaluated and, more than that, could be manipulated to the advantage of the individual and the family, hence vector therapy.
More and more, over the years, it became apparent that the key to an improved emotional life of society lay in being able to guarantee a satisfactory childhood to every child. To arrange a new media for every child of the population called for a complete re-organisation of the facilities associated with child upbringing. Only thus could be created a health promoting society, a salutiferous society.
Thus Howells's contribution was to develop experiential psychopathology, family psychiatry, vector therapy and the concept of a salutiferous society.