(Christakis & Fowler, 2009). Lots of intriguing material in the sections of the book I have read, including the authors’ Rule 2: “Our network shapes us.” Cascading effects in network dynamics tend to drive behaviors in positive or negative directions. The authors are known for health studies in eastern Massachusetts in which they demonstrated over time that obesity tends to increase in clusters, and that smoking cessation also tends to grow through network effects.In my work as a therapist, I have found that many patients discount the importance of their social relationships as modifiers of their conditions. Yet the evidence is very persuasive that health is as much a result of building relations with other healthy people as with any medical or “therapy” intervention. To a degree, a therapist should focus on aiding the patient to rebuild and extend their social networks. Traditionally, this has been the domain of couples or family therapy, working to repair communication and family roles, but usually within a limited scope network. Individual therapy may address the issues but tends to be somewhat more internal- than network-driven. Yet, object relations theory would seem to point out to the network rather than inward.
Often, in the specific treatment of, say, substance abuse (to use a modality I am very familiar with), the groups formed are of “unhealthy” people, i.e. those bearing a specific diagnosis. Normally, these groups are also opportunistic, with very little patient matching, although there is sorting by “co-occurring disorders”, which covers a multitude of issues, not all compatible. On one level, the content and setting address the common diagnostic problem, but the relative paucity of positive social connections in the group blunts the effectiveness of the therapy.
Recently, I started a group with the express intention of focusing solely on the network effects for the patients. Unfortunately, the group ended very prematurely when I left the agency, but I am looking to find a venue to explore the power of the network on health. Right now, I am actively looking for supporting materials and ideas for activating network effects for therapy.
This blog is in part directed at these issues.
Links: The Christakis Lab at Harvard
