Bowen  Family  Systems  Therapy  

 by:  Erin  Carpenter  

University  of  San  Francisco  

For  Today  •  Review  any  ques-ons  about  the  genogram  •  Con-nue  with  our  a6en-ve  listening  skills  •  Video  •  Ac-vity  

•  Discuss  three  strategies  you  would  use  with  children/adolescents  

•  Go  over  in  detail  some  of  Bowen’s  theory  •  An  ac-vity  with  the  Haefner  (2014)  ar-cle  •  Share  our  thoughts  •  Time  to  work  on    •  Genograpm  -­‐  6/12/17  •  Thought  Process  –  6/14/17  

Happy  &  Sad  Behaviors  •  Group  One  INSIDE  -­‐  -­‐  -­‐  -­‐  -­‐  Group  Two  OUTSIDE  •  Then  we  will  switch  •  5  minutes  each  -me  •  Purpose:    •  Working  on  a6en-ve  behaviors  and  its  affect  on  our  clients  •  Situa-ons  where  this  could  occur  •  Ideas  

Murray  Bowen  •  Began  looking  at  schizophrenia  &  mothers  •  With  the  NIMH  he  began  to  study  the  en-re  family  •  “All  families  were  pre6y  much  alike”  (1978)  •  Worked  at  Georgetown  Medical  Center  •  Each  family  has  an  emo-onal  system  •  Transgenera-onal  approach  

Murray  Bowen  •  Inevitable  chronic  emo-onal  anxiety  present  in  family  •  Chronic  anxiety  is  the  source  of  family  dysfunc-on  

•  Differen-a-on  of  self  &  emo-onal  fusion  •  Ability  of  a  person  to  dis-nguish  from  family  •  Ability  of  individuals  to  func-on  autonomously  

•  There  are  8  stages  •  Differen-a-on  of  Self  •  Triangles  •  Nuclear  Family  Emo-onal  System  •  Family  projec-on  process  •  Emo-onal  Cut  Off  •  Mul-genera-onal  transmission  process  •  Sibling  Posi-on  •  Societal  Regression  

Theoretical  Formulations  •  Describes  how  the  family  –  as  a  multigenerational  network  

of  relationships  –  shapes  the  interplay  of  individuality  and  

togetherness  using  Eive  key  concepts:    

•  1.  Differentiations  of  self    

•  2.  Triangles  

•  3.  Multigenerational  emotional  processes  

•  4.  Emotional  cutoff  

•  5.  Societal  emotional  processes    

Differentiation  of  Self    •  The  capacity  to  think,  reElect,  and  not  respond  automatically  to  

emotional  pressures  (e.g.  anxiety)    

•  Analogous  to  ego  strength    

Undifferentiated  people   Differentiated  people    •  Easily  moved  to  emotionality  

•  Tend  to  react  impetuously  toward  others  

•  Find  it  hard  to  maintain  their  autonomy    

•  Either  agree  with  everything  or  argue  with  everything  

•  Able  to  balance  thinking  and  feeling    

•  Capable  of  taking  their  own  stands  on  issues    

Triangles  •  Virtually  all  relationships  are  driven  by  third  parties    

•  Third  parties  decreases  anxiety  in  the  dyad  by  sharing  anxious  feelings  among  three  people  instead  of  two  

•  If  the  third  party’s  involvement  is  temporary  or  pushes  the  two  

people  to  work  out  their  differences  the  triangle  doesn’t  become  

Eixed  

•  A  group  of  three  doesn’t  necessarily  imply  an  emotional  triangle    

•  In  a  healthy  threesome  each  pair  can  interact  independently  

•  Triangulation  lets  off  steam  but  freezes  conElict  in  place  

A  Triangle  in  Action  •  A  wife  who  is  upset  with  her  husband’s  distance  begins  to  more  intensely  involve  herself  in  their  daughter’s  life  in  an  

anxious  way    

•  This  allocation  of  time  may  take  pressure  off  the  husband  

yet  it  also  decreases  the  likelihood  that  the  couple  will  

develop  interests  they  share  together  and  it  could  

undermine  the  daughter’s  independence  

•  Take  away:  What  makes  this  is  a  triangle  is  diverting  

energy  that  might  otherwise  go  into  the  marriage    

Other  concepts  •  The  Nuclear  Family  Emo-onal  System  •  Impact  of  undifferen-a-ng  and  dysfunc-onal  fusion  •  Marital  Conflict  •  Polariza-on  of  a  spouse  •  Psychological  impairment  in  a  child  

•  Mul-genera-onal  Transi-on  Process  (Next  slide)  •  Family  Projec-on:  •  Parents  transfer  anxiety  and  level  of  differen-a-on  to  children  

•  Sibling  Posi-on  (Walter  Toman,  1961)  •  Importance  of  birth  order  in  development  of  personality  

•  Emo-onal  Cut  Off  •  Societal  Regression  

Multigenerational  Emotional  Processes  •  Describes  excessive  emotional  reactivity  known  as  fusion  

•  Lack  of  differentiation  in  families  à  reactive  children  à  

fusion  in  the  child’s  relationships  (e.g.  with  other  family  

members,  peers)    

•  The  child  most  involved  in  the  family’s  fusion  moves  toward  a  

lower  level  of  differentiation  (and  chronic  anxiety)    

•  The  child  least  involved  in  the  family’s  fusion  moves  toward  a  

higher  level  of  differentiation  (and  less  anxiety)  

•  Higher  differentiation  leads  to  more  optimal  functioning  

Emotional  Cutoff  •  Describes  how  some  people  manage  anxiety  in  relationships  

•  The  greater  the  fusion  between  parents  and  children  the  

greater  chance  that  emotional  cutoff  will  occur    

•  Some  people  seek  physical  distance  by  moving  away  while  

others  seek  emotional  distance  by  avoiding  intimacy  or  

using  third  parties  to  “protect”  themselves    

•  Emotional  cutoff  ≠  maturity    

Societal  Emotional  Processes  

•  Societal  inEluences  impact  family  functioning  

•  Examples  include  sexism,  class  and  ethnic  prejudice,  and  

discrimination    

•  Bowen  believed  that  families  with  higher  levels  of  

differentiation  are  better  able  to  resist  destructive  social  

inEluences    

Normal  Family  Functioning    •  Optimal  development  takes  place  when:    •  Family  members  are  undifferentiated  

•  Anxiety  is  low    

•  Partners  are  in  good  emotional  contact  with  their  own  families    

•  People  tend  to  choose  mates  with  similar  levels  of  differentiation  

•  Bowen  was  convinced  that  differentiation  of  autonomous  personalities  –  accomplished  primarily  in  the  family  of  

origin  –  was  both  a  marker  of  development  and  a  

prescription  for  therapeutic  progress    

Family  Life  Cycle  Stages  (Carter  &  McGoldrick,  1999)    

•  Leaving  home    

•  Joining  of  families  through  marriage    

•  Families  with  young  children    •  Stage  with  the  highest  divorce  rate    

•  Raising  adolescents  

•  Launching  of  children  and  moving  on    •  Liberating  or  midlife  crisis?    

•  Families  in  later  life    

•  *Divorce      

People  with  high  chronic  anxiety  •  Management  happens  in  4  ways:  1.  Marital  Conflict  2.  Health  or  Emo-onal  Problems  3.  Health  or  Emo-onal  problems  of  a  child  4.  Triangula-on  •  Purpose:  reduce  the  level  of  chronic  anxiety  experienced  

Development  of  Behavior  Disorders  •  Symptoms  result  from  stress  that  exceeds  the  system’s  ability  to  manage  it  (we  do  not  operate  in  a  vacuum)  

•  The  underlying  cause  of  psychological  problems  is  emotional  fusion  passed  down  from  one  generation  to  the  

next    

•  Emotional  fusion  is  based  on  anxious  attachment  which  may  manifest  as  either  dependency  or  isolation    

•  Symptoms  break  out  when  the  vertical  problems  of  anxiety  and  toxic  family  issues  intersect  with  horizontal  

stresses  of  transition  points  in  the  life  cycle    

Emotional  Fusion  •  Reac-ons  w-hin  a  rela-onship  •  In  a  fused  rela-onship  •  People  react  emo-onally  without  being  able  to  think  •  Anxiety  =  level  of  external  stress  

•  Greater  the  fusion  =  less  flexibility  •  Chronicity  occurs  when  •  Family  cannot  think  through  their  responses  to  dilemmas  •  Con-nue  to  react  emo-onally  

•  Families  in  high  fusion  response  to  crisis  with  feelings  •  “A  person  who  is  able  to  self  differen-ate  possesses  the  ability  to  adapt  to  changes  of  their  environment  and  thereby  experience  less  emo-onal  stress”  (Brown,  1999  &  Bowen,  1978)  

Views  on  Therapy    •  Therapy  is  an  opportunity  for  people  to  learn  about  themselves  and  their  relationships    

•  Process  of  active  inquiry  in  which  the  therapist  helps  

family  members  to  get  past  blaming  in  order  to  explore  

their  own  role  and  assume  responsibility  in  family  issues    

•  Pays  attention  to  process  and  structure    

•  Process  –  patterns  of  emotional  reactivity  

•  Structure  –  interlocking  networks  of  triangles    

•  Detriangulation  and  differentiation  are  overarching  goals    

Conditions  for  Behavior  Change  •  Understanding  –  not  action  –  is  the  vehicle  for  change    

•  Sessions  are  designed  to  minimalize  emotionality  

•  Therapists  ask  family  members  questions  once  at  a  time  vs.  

encouraging  group  dialogues  which  may  get  heated    

•  Therapists  must  strive  to  control  their  own  reactivity    

•  Part  of  the  process  of  differentiation  is  to  develop  a  personal  relationship  with  everyone  in  the  extended  family  

•  Enables  an  individual  to  spread  out  his  or  her  emotional  

energy      

Assessment  •  History  of  the  presenting  problem(s)  

•  History  of  the  nuclear  family  

•  Genograms  –  schematic  diagrams  showing  family  members  

and  their  relationships  to  one  another    

•  Traces  relationship  conElicts,  cutoffs,  and  triangles  

•  Process  of  collecting  information  is  sometimes  therapeutic  in  

of  itself    

•  Family  members  often  say,  “It  never  occurred  to  me  how  all  of  

those  events  Eit  together”    

 

Therapeutic  Techniques    •  Process  questions  –  designed  to  slow  people  down  and  get  them  

thinking  in  order  to  explore  what’s  going  on  inside  people  and  

between  them  

•  “When  your  boyfriend  neglects  you,  how  do  you  react?”  

•  “When  your  daughter  goes  on  dates,  what  do  you  worry  about?”  

•  Relationship  experiment  –  designed  to  help  clients  try  something  

different  than  their  usual  emotionally  driven  responses    

•  Ex:  Pursuers  are  encourage  to  restrain  their  pursuit,  stop  making  

demands,  decrease  pressure  for  emotional  connection  and  see  

what  happens    

Therapeutic  Techniques  •  Neutralizing  triangles  –  the  therapist  must  stay  free  of  reactive  emotional  entanglements  in  order  to  avoid  the  

same  process  of  emotional  triangulation  families  use  to  

stabilize  their  conElicts    

•  Coaching    

•  The  therapist  hopes  to  avoid  taking  over  for  clients  or  becoming  enmeshed  in  family  triangles  

•  Does  not  involve  telling  people  what  to  do    

•  Involves  asking  questions  designed  to  help  people  Eigure  out  family  emotional  processes  and  their  role  in  them    

Therapeutic  Techniques  •  The  “I”-­‐Position    

•  A  calm  and  clear  statement  of  personal  opinion    

•  Often  has  a  stabilizing  effect  in  times  of  tension    

•  Taking  a  personal  stance  instead  of  what  others  are  doing    

•  Ex:  “You’re  lazy”  vs.  “I  wish  you  would  help  me  more”    

•  Therapists  not  only  encourage  clients  to  take  “I”-­‐positions  but  

they  also  do  so  themselves    

•  Ex:  “I  believe  your  children  have  the  right  to  know  this”  (but  what  

the  client  does  is  of  course  up  to  them)    

Bowenian  Therapy  with  Couples  •  Secret  is  to  stay  connected  with  both  partners  without  letting  them  triangle  you    

•  As  partner’s  talk  the  therapist  concentrates  on  the  process  

of  their  interaction  not  on  the  details  under  discussion    

•  The  therapist  is  viewed  as  a  coach  or  consultant  who  

guides  the  couple  with  strategic  questioning  

•  Important  to  discuss  the  nuclear  family  but  also  each  

partner’s  families  of  origin    

Summary    •  The  major  problem  in  families  is  emotional  fusion    

•  The  major  goal  is  differentiation    

•  The  triangle  is  the  universal  unit  of  analysis    

•  Therapists  are  encouraged  to  remain  neutral  while  

exploring  emotional  processes  with  process  questions    

•  Clients  are  hopefully  able  to  learn  to  see  their  own  role  in  

how  their  family  system  operates  in  order  to  move  towards  

more  optimal  functioning    

Haefner  (2014)  Activity  •  Read  the  case  study  about  Aus-n,  a  14-­‐year-­‐old  boy  •  Pages  837  -­‐  838  

•  Come  up  with  the  following,  be  prepared  to  share  as  a  class:  •  5  key  points  that  you  would  want  to  focus  on  •  2  process  ques-ons  you  would  ask  Aus-n  •  2  ques-ons  that  can  help  to  facilitate  the  coaching  process  •  3  “I”  statements  that  you  feel  you  would  use