Bowen Family Systems Therapy Essay

Abstract This paper was designed to fully describe Bowen’s Theory of Family Systems Therapy. The eight concepts that illustrate this theory will be thoroughly discussed and explained. References of professionals who have worked with and studied Bowen theory will be implemented and relied on in order to adequately understand and depict this theory. And finally, the second portion of this essay will include a case study. The case study will present a family profile, a treatment plan and goals, interventions and a projected outcome for the family’s recovery. Through this case study the reader will be able to identify Bowen techniques and get a more kinesthetic look on how Bowen’s Family System Therapy is applied. Introduction Bowen’s Family System Theory is based on the family as an emotional unit. The theory is based on the idea that the family is so emotionally integrated that the effect each member has on the other members can be overwhelming. Bowen’s Theory focuses on that emotional connectedness and assumes that the family can either promote cohesiveness and cooperation or tension and anxiety. Therefore, according to this theory, a change in one person’s attitude or actions will be followed by a reciprocal change in the functioning of the other members. When anxiety levels rise within the family unit the stress levels will also heighten. Therefore, when this happens one or members will end up feeling overwhelmed, isolated or out of control and then the family unit will be shaken as a whole. During this time of distress, the members who feel most out of control or  stressed will work extra hard to accommodate the other members. This is part of the reciprocal interaction. This member who absorbs most of the tension is most likely the member who will end up most susceptible to problems such as illness, alcoholism and affairs. Eight Concepts In order to implement this theory into a therapy session Bowen created eight interlocking concepts to assist the therapist in working with families. The concepts include triangles, differentiation of self, nuclear family emotional system, family projection process, multigenerational transmission process, sibling position, emotional cutoff and societal emotional process. However, it is important for any therapist to keep in mind that, according to Mike Nichols (1988), the core goal underlying the Bowenian model is differentiation of self, more specifically, the â€Å"ability to remain oneself in the face of group influences, especially the intense influence of family life†(p.2). Triangles The eight interlocking concepts are key to understanding Bowenian Family Therapy. To begin, triangles are a three person relationship system. Triangles are considered the building blocks of the larger emotional system. The reason being that the triangle is the smallest stable relationship system. Three people can take on much more tension than two people. Additionally, a triangle can contain a large amount of stress without bringing in a fourth person because the tension can shift around to all three relationships. However, just because a triangle can bear more tension does not make it healthier. Someone is almost always left out and nothing gets resolved in a triangle formation. Triangles and their undesirable effects on the family unit contribute greatly to the development of clinical problems. Within triangles, members are pushed from outsider to insider positions of conflict. Within this inside/ outside drama members will begin maneuvering and manipulating their positions within the group, thus causing fights and with that heavy strain on the relationships. Getting pushed from inside to outside positions can trigger depression and even a physical illness. For example, two parents focusing on what is wrong with a child can trigger serious rebellion within that child. While triangles may seem  comfortable and stable, they end up being a huge problem within the family unit. Differentiation of Self In opposition of triangles is Bowen’s idea of differentiation of self. According to Fritzland (1991, p. 1), the degree to which a differentiation of self occurs in an individual reflects the extent to which that person is able to distinguish between the intellectual process and the feeling process he or she is experiencing. Thus differentiation of self is related to the degree to which one is able to choose between having his or her actions, relationships and life guided by feelings or thoughts. Individuals with the most fusion between their emotions and thoughts and relationships are the lowest functioning people. These people get to a point where they cannot even tell what feelings and thoughts are their own and which are those of other people. Undifferentiated Family Ego Mass Bowen introduced the concept of the undifferentiated family ego mass. Undifferentiated family ego mass is the idea that there is a syndicated emotional oneness that exists in all levels of intensity. Goldenberg and Goldenberg (1991, p. 171) give a great example of this in the relationship between mother and child and child and father. They write, â€Å"The symbiotic relationship of interdependency between mother and child may represent the most intense version of this concept; a father’s detachment may be the least intense. The degree to which any one member is involved in the family from moment to moment depends on that person’s basic level of involvement in the family ego mass.† When the emotional closeness is too intense and possibly overbearing this may lead to an uncomfortable closeness within the family, closeness that will lead to mutual rejection between members. It may lead to fights that include intense yelling, slamming of doors and phone hang ups. Bowen insists that maturity and self-actualization demand that an individual become free of unresolved emotional attachments to his or her family of origin. Fritzlan (1991, p.4) notes that Bowen’s theory assumes that every human has an instinctive force inside them that propels the developing child to grow up to be an emotionally separate person, able to think, feel, and act as an individual. At the same time, Bowen proposes that a similar life force, also instinctively ingrained, thrusts the child and family to remain  emotionally connected. As a result of these counterbalancing forces, argues Bowen, no one ever achieves complete emotional separation from the family of origin. However, there are considerable differences in the amount of separation each of us accomplishes, as well as differences in the degree to which children from the same set of parents, emotionally separate from the family. Nuclear Family Emotional System The third concept builds on the idea of differentiation of self and is called nuclear family emotional system. The concept of the nuclear family emotional system describes four basic relationship patterns that govern where problems may develop in a family. Marital conflict, dysfunction in one spouse, impairment of one or more children and emotional distance are the patterns which will govern where problems will probably develop within the family. The more anxiety one person or one relationship sucks in, the less other people must absorb. This means that some family members maintain their functioning at the expense of others, which ends up causing a strenuous amount of tension on the people who must accommodate. People do not want to hurt each other, but when anxiety chronically dictates behavior, someone usually suffers because of it. The next concept that Bowen introduces gives the concept of the nuclear family emotional system more reason to it’s’ rhyme. Family Projection Process The family projection process touches on the different type of relationships that parents have with each of their children. When one child is focused on more than another child, the focused on child will typically be more fused with his or her parents than the unfocused on child. Goldenberg and Goldenberg (1990) say that â€Å"differences in parental behavior make for significant differences in how each child functions† (p.221). Furthermore, the child who is most focused on is most sensitive to disturbances and initial signs of instability within the family. Simply put, when the parents select the most infantile child of the family as the object of their attention, Bowen calls this the family projection process. Multigenerational Transmission Process The next key concept that Murray Bowen developed is multigenerational  transmission process. Multigenerational transmission processing describes how the entire family joins in the family projection process that was previously discussed. Bowen wrote that multigenerational transmission process provides a base from which to make predictions in the present generation and gives an overview of what to expect in coming generations. This process entails the way family emotional processes are transferred and maintained over the generations. In this theory Bowen contends that people choose mates with equivalent levels of differentiation to their own. Thus, the highly undifferentiated person will choose a mate that is similarly undifferentiated from their family and the differentiated person will find a mate who is also differentiated from their family of origin. Goldenberg and Goldenberg (1990, p. 198) say that it is probable that these poorly differentiated people, now a marital couple, will themselves become highly fused and will produce a family with the same characteristics. Furthermore, Bowen believes that the resulting nuclear family emotional system will be unstable and will seek various ways to reduce tension and maintain stability by over indulging in such things as alcohol, drugs, and getting involved in codependent relationship. This can affect a child psychologically as well and it can then perpetuate and become a cycle within the family. Goldenberg and Goldenberg (1990, p. 199) say that psychological impairment in a child is enabling to the parents as they will simply focus attention on the child and ignore or deny their own lack of differentiation. This will only further inhibit the child’s development of self as well as support the already dysfunctional marital relationship. Sibling Position Sibling position is a concept that Bowen stressed. He believes that each child has a place in the family hierarchy and therefore was more or less likely to fit certain projections. For example, the oldest sibling is more likely to be the mature, responsible one. Whereas the youngest child will more likely be the class clown, irresponsible and immature one. While this concept is well known and maybe even intrinsic to most people, Bowen believes this to be key when understanding differentiation and working within the family emotional system. Emotional Cutoff The seventh concept that Bowen developed for his theory is called emotional cutoff. Most people have experienced this concept or have at least heard of it. Goldenberg and Goldenberg (1990) write that emotional cutoff is a flight from unresolved emotional ties, and is not true emancipation from the family (p. 225). Emotional cutoffs do several things; they reflect a problem, such as underlying fusion between generations. They solve the problem by reducing the anxiety in the cutoff relationship. And finally, they create a problem by isolating people who might benefit from closer contact. Fritzlan (1991) notes that cutoffs most often occur in families where there is a high level of anxiety and emotional dependence. Bowen has suggested that when emotional cutoffs exist between parents and grandparents, then a cutoff between parents and children of the following generation increases in likelihood. It is easy to see how cutoffs can occur and how the other key concepts if not understood or resolved can cause an emotional cutoff in a family relationship. Societal Emotional Process Finally, the eighth key concept is societal emotional process. This process is in a way like the family projection process except scaled to a societal level. Families that deal with discrimination, prejudice and persecution will pass on to their children coping methods and ways to which they survived these factors. Basically, these are social expectations about racial and class groups, the behaviors or each gender and their effects on the family. Andreas Viklund (2009) noted that the family unit and society as a whole have the task of promoting the long term interest of individual members and the society as an entirety. Evaluation and Validity of Bowen’s Theory While Bowen is considered to be one of the most effective theorists in marriage and family arena of therapy, there are both strengths and weaknesses to his ideas. His eight key concepts are great tools for therapists to use as a guide for therapy, but it is important to note the validity of his theory and to review his theory in a more critical way. The main concept that Bowen teaches is differentiation of self. This is the founding idea for all of his concepts. Differentiation of self is very important, however Bowen did not leave a sufficient tool as a means to measure clients’ differentiation of self. Richard et al (2004) note that Bowen suggested that clinicians could use a differentiation-of-self scale ranging from 0 to 100; however, he provided few guidelines to help clinicians reliably and accurately assign an appropriate score. Indeed, he claimed that the concept was not quantifiable for researchers. Consequently, Bowen’s scale has been useful only as a theoretical tool. In the last decade there have been two scales, Haber’s Level of Differentiation of Self Scale and Kowron’s Differentiation of Self Inventory, that were developed as a means to measure differentiation. Richard et al (2004) researched the validity of these two scales with Bowen’s theory by having two experts in Bowen theory rate the relevance of the items in these scales. The first scale significantly correlated with chronic anxiety and psychological distress, which is consistent with Bowen theory and, thereby, demonstrates sufficient validity. The second scale was also consistent with Bowen theory, the Differentiation of Self Inventory correlated significantly with chronic anxiety, psychological distress, and marital satisfaction. In addition, confirmatory factor analysis demonstrated psychometric support for the four subscales. Bowen theorized that people marry according to their same level of differentiation, this is called the multigenerational transmission process. Bowen simply stated, â€Å"People who marry have the same level of differentiation of self (Kerr & Bowen, 1988, p. 225). This is because each spouse has the â€Å"same need for emotional reinforcement from the relationship† (Kerr & Bowen, 1988, p. 171). This concept is probably one of Bowen’s weakest. There have been numerous studies, Richter (1998), Richards (1988) and Skowron (2000) just to name a few, that totally refute this idea of Bowen’s. While this does not necessarily knock down his entire theory it does poke some holes in it and force the common therapist to rethink their approach to working with married couples and their families. While the above concept is a fairly weak one, there is another aspect of multigenerational transmission process that proves to be stronger. There is a vast amount of research supporting a specific aspect of Bowen’s concept of multigenerational transmission process. The aspect that parents’ and children’s values and beliefs are highly correlated seems to have strong validity according to studies. Many of these studies were conducted in the field of social gerontology and date back to the early 1970s when research about the â€Å"generation gap† was conducted to examine continuity between generations (Troll & Bengtson, 1979). These studies have consistently found that parents’ and children’s values and beliefs are highly correlated, as assumed by Bowen. There is also a substantial amount of literature that gives evidence that levels of individual and relationship functioning are passed on from one generation to another. For example, Richard et al (2004) write that studies have revealed that there is a multigenerational transmission process for violence (Alexander, Moore, & Alexander, 1991), divorce (Amato, 1996), and marital quality (Feng, Giarrusso, Bengtson, & Frye, 1999). Richard at al (2004) also remarks that â€Å"research has also shown that eating disorders (Whitehouse & Harris, 1998), depressed affect (Whitbeck et al., 1992), and alcoholism (Sher, Gershuny, Peterson, & Raskin, 1997) are transmitted inter-generationally† (p. 9). Through many studies testing different aspects of Bowen’s theory there are and will continue to be weak points exposed. However, there proves to be a vast amount of validity to his theory as well. The weakest suggestion is definitely that people marry according to their own differentiation. In my own life Bowen’s idea proves to be untrue and while looking at different marriages around me I do not see any sort of pattern in this regard. If anything, I have observed people marrying opposite of their own differentiation level rather than finding a spouse who matches their level of differentiation. Even still, differentiation of self as a whole demonstrates to be the most valid and prominent idea in Bowen theory, both Biblically and psychologically. Biblical Integration and Evaluation I believe God was first to introduce the idea of differentiation of self, especially differentiation of self when entering into marriage. Genesis 2:24 says, â€Å"For this reason a man will leave his father and mother and be united to his wife, and they will become one flesh.† According to this verse it seems that differentiation is shown by one’s ability to leave their parents before they can rightly cleave to their spouse. Since Bowen emphasizes the need for a person to be emotionally differentiated from parents in order to maintain healthy balances of individuality and togetherness in ensuing relationships, this seems to be paralleled with the command presented in Genesis. According to Bowen and Kerr (1988), only a differentiated person can be securely attached. Furthermore, this seems to be God’s stance on differentiation as well. It seems that God, being omnipotent and all knowing, designed marriages to work out best when spouses are healthily differentiated from their families of origin. In my opinion, differentiation of self is very important and seeing how the Bible supports this idea I feel even stronger about its’ significance. This is the main reason I chose to write about Bowen’s Theory to begin with. I appreciate Bowen’s eight concepts, as I believe they are great tools for therapists. The concepts help the therapist to work within this theory without feeling lost or overwhelmed by the new ideas or different facets they are implementing into the therapy session. Even more personally, I think that my own differentiation of self has been weak until the last year or so. This is another reason I chose to work with Bowen’s Theory. When I first got married I was very attached to my family and often chose them over my husband or even over myself. I know that this not only hurt my husband’s feelings, but also the quality of our marriage. When I finally understood that I was spending too much time with my parents and choosing their events over quality time with Elden (my husband), things drastically changed between us. Many problems we were having fixed themselves and he became significantly happier. Elden emphasized to me that he felt much more respected by me when I began deferring to him rather than my parents regarding issues. And in turn, I began to feel much more loved by him because he became mindful of the way he was treating me since it was  obvious I was making conscience decisions to be more attached to him and to my own independence than my family. While I still spend a good amount of time with my family, Elden is much more willing to spend time with them along with me because he knows and feels that he always comes first. Also, I take much more time for myself and the things I enjoy, which makes everyone happier. Looking back I wish that I would have truly understood differentiation of self before getting married, but I am so grateful that I did learn it early on as it will only help us for the rest of our lives together. Seeing how this very small aspect of a lack of self-differentiation played out on my own life drew me to Bowen’s Theory. I wanted to understand how great of a role this theory could play in everyday life. I see now that differentiation of self has a much larger role in familial success than I had thought. And I believe Bowen’s eight aspects only further make the point of this theory’s significance in family systems therapy. Case Study Looking at my own life would be a perfect case study for Bowen Theory. However, since Elden and I did not get any therapy for our issues it would be difficult to use. Keeping my previous story in mind, here is the profile of the case I have chosen to illustrate: The client family consists of three boys and a mother and father. Stan, the father, called in to make an appointment because his wife, Jen who is in her late 40’s, is having anxiety attacks and is overwhelmed by her three sons. She tends to yell at the boys and feels like she has not patience for them anymore. Stan says he has been out of a job for three years and Jen ‘s parents have been supporting their family for the last 6 months. The boys, Joel, Derek and Steve range in ages from pre adolescent to late teens, the eldest being Steve who is graduating from high school soon. Stan reports that they are very high energy, but well behaved and successful in their school and sports activities. Stan emphasizes that h e is most worried about â€Å"mom†, Jen, and thinks the boys are handling things just fine, as is he. After seeing the family as a whole once it is obvious that Jen is not the main problem, it is Stan. However, since Stan is out of work Jen is taking  on the stress of the family and it is more than she can bear. The three boys are very close to their parents and the youngest one, Joel, is totally fused with Jen. Joel sat on Jen’s lap during the session and acted very much like a baby when she was not able gives him her full attention. Stan seems to have come to terms with not having a job and the fact that Jen’s parents are supporting them, however he continues to call Jen â€Å"mom† and talk about how sensitive and delicate she is. There seems to be a lack of intimacy between Stan and Jen along with a lack of respect for one another. And finally, the only one of the children who does not call Jen â€Å"mommy† is Derek, the middle child. Goals, Treatment Plan and Interventions Before presenting the family’s treatment plan and prognosis it is important to understand what the goal of Bowen family systems therapy is. The goal is to increase the capacity of one or more members to adapt to and deal with the constant change and evolution of family life. Graefe (1955) describes the differentiation effort by using a metaphor from sailing: â€Å"you cannot change the velocity of the winds, but you can change the direction of the sales† (p.2). It is with this goal in mind that the treatment plan can be created. To begin, this family’s treatment plan will be to complete a genogram so that I can fully understand their families of origin. It is easy to see that in this family there is a lot of triangulation, mostly between the parents and Steve, the oldest son. At times Derek takes Steve’s place in the triangulation between Stan and Jen. However, he is mostly in an alliance with Stan and has picked up much of his father’s sexist attitudes. The genogram will allow me to see if there was any domestic violence or abuse in the family’s history and will also allow me to get a better idea of the attitudes men had towards women in Stan’s family of origin. Furthermore, the genogram will help indicate how differentiated Stan and Jen are from their own parents and how self-differentiation looks in their family’s past. The genogram will reveal many aspects of Jen and Stan’s family history, some more important than others, but all useful in understanding this couple. Once the genogram is completed I will be able to focus on generational issues. However, in order to help the family more immediately, decreasing the anxiety that Jen is feeling will be absolutely necessary. When anxiety  is decreased presenting symptoms will begin tomodify or decrease. Nevertheless, this will mean that Stan, Steve and Joel will need to learn to be more differentiated from Jen. Stan is interesting, because he has a very sexist attitude toward Jen, but totally relies on her and her parents for most things in life. He needs to recognize this in order to help Jen lessen her anxiety. One way in which I will help the boys become more differentiated from Jen is by, first of all, asking Stan to stop calling Jen â€Å"mom†. Since Stan sets the tone and attitude for his children, having him break this habit will be helpful. It might also create a more intimate attitude toward the couple. Furthermore, Joel will need to sit at least two chairs away from Jen for all futu re sessions. And finally, Jen will be asked to allow Joel to speak for himself so that he can find his own voice. Part of this family’s treatment plan will rely on my use of interventions. It will be very important that I am able to model to them what healthy parenting relationships may look like. I also will need to develop a functioning healthy triangle between Stan, Jen and myself. I believe that once the parent’s relationship is put into a more healthful place, the children will begin to differentiate themselves from their parents. A component of working on Jen and Stan’s relationship will include Stan having more communication with his own mother and with Jen’s parents. It will also include Jen and Stan taking some time out to research their own family history which will hopefully enlighten both of them on a few different levels. Finally, Jen’s major homework will be to take an hour out of each day where she is not available to her family in any capacity and she must journal about this process three times a week. This â€Å"homework† will expectantly allow her family to learn to differentiate themselves from her and reduce some anxiety in her immediate stage of life. Also, I believe this exercise will be very eye opening for Stan to see how much he actually relies on Jen. Stan and Jen’s family should continue therapy for a minimum of one year, as Bowen believes four years is a more reasonable prognosis schedule. If the children do not continue, Stan and Jen should follow through with couple therapy. I would imagine that couple therapy will be more beneficial in the  long run and that their sons will only need to be in family therapy initially. In fact, if I have done my job properly the children will want to discontinue therapy on their own accord. This will be a great indication of the differentiation they are achieving. However, once Joel, Derek and Steve terminate their role in therapy the reason why Stan and Jen will need to continue is so they can fully appreciate the generational transmission process and understand how their emotional projection onto their children is prohibiting growth and differentiation in their circle of five. Conclusion Bowen Family Systems Therapy is a therapy that focuses on emotional process rather than content. Murray Bowen’s eight concepts outline this idea of emotional process very clearly and make following a system and intervention plan easier for a therapist. While some of Bowen’s Theory and concepts are based on his own secular viewpoint, God shines through this theory in His own way. Biblically, many facets of Bowen’s theory are sound which only make a better case for the knowledge that the Bible has to offer the world. Since God is the Ultimate Counselor, it makes sense that differentiation would be mentioned in His Word first. In conclusion, looking at the case study, along with the treatment plan, interventions and prognosis one can get a much better idea of how Bowen Theory can be implemented into family therapy. The family depicted in the case study thought that the problem was the mother, Jen. But it turned out that she was not the only problem. In the treatment plan it was important to focus on the family’s emotional process rather than â€Å"fixing† Jen. All of the members of the family needed to learn to think on their own two feet and live parts of their lives without Jen’s approval. Once this happens, Jen should feel substantially less anxious and angry. Thus, this case was classic for employing Bowenian Therapy. However, Bowen Family Systems Therapy can be applied to any case and will always achieve satisfactory results as Bowen is a master at family therapy. References Fritzlan, L. (1991). How to Get Your Own Life and Not Get Overwhelmed by Your Family. Pacific Grove. Brooks/Cole Publishing Company. Goldenberg, I., Goldenberg, H.(1990). Family Therapy: An Overview. Pacific Grove, CA. Brooks/Cole Publishing Company Kerr, M., Bowen, M. (1988). Family Evaluation: An Approach Based on Bowen Theory. New York, NY. W.W. Norton & Company. Miller, Richard B., et al. (2004). Journal of Marital and Family Therapy. Family Systems Therapy: Is Bowen Theory Valid? A Review of Basic Research. Blackwell Publishing. http://www.interventions.net/BowenTheoryUpdated.pdf