The Bowenian Approach to Family Therapy Essay
The Bowenian Approach to Family Therapy
This paper will summarize the theory of family systems developed by Murray Bowen. It will describe the eight key components to Bowenian therapy and the techniques used during practice. Strengths and limitations will be exposed, followed by a summary of the importance of integration between psychology and family systems theory.
Keywords: Bowen, integration, family systems theory
Bowen family systems theory is based on the view that the family is an emotional unit. The theory uses systems thinking to describe the interactions and relationships within the family. Given families are deeply emotionally connected, family members can influence each other’s thoughts, feelings, emotions and actions. The connectedness of the members of a family provides for each person to unknowingly solicit approval, support and attention from the other members. (Brown, 1999). Likewise, when one person in the family experiences a change, it has a ripple effect as it carries out to the other family members. All families share some amount of interdependence. Anxiety and tension can cause more than one member to show stress due to the emotional connectedness of the members. The interaction is reciprocal. Bowenian therapy was designed for use with families, but has also proven to be useful in marital therapy (Glade, 2005).
Development of Bowenian Theory & Leading Figures
Dr. Murray Bowen (1913-1990) was trained as a psychiatrist and originally treated patients using the psychoanalytic model. In the late 1940’s, he began to involve mothers in the therapeutic plan for schizophrenic patients. Originally practicing at the Menninger Clinic, he moved to the National Institute of Mental Health (NIHM) in 1954. During this transition, he started to view patients as part of a family system rather than as individuals. As he continued to practice, Dr. Bowen invited more and more family members to be involved in the treatment of his schizophrenic patients (Brown, 1999) After moving to Georgetown University in 1959, he opened the Georgetown Family Centre. It was during his work here that he began to use his family approach to other clients as well.
For the next few years, Dr. Bowen began to research families across generations, looking for commonalities and patterns in emotional health. As he found more and more similarities in family patterns, his theory began to take shape. He hypothesized that a psychosis in the patient was merely a symptom of a bigger family problem that had not been discovered (Becvar, 2009). In 1966, Dr. Bowen published his ideas for the first time. It was also during this time that Bowen used his developing theory on his own family, and subsequently used them as an example in a 1967 conference (Brown, 1999). His eight core concepts have not changed much since their inception, additional areas of focus such as the focus on life cycle stages and feminist approaches have been added.
Bowenian therapy consists eight interlocking concepts (Rabstejnek, 2012). These concepts include:
1. Differentiation of Self
3. Nuclear Family Emotional Process
4. Family Projection Process
6. Multigenerational Transmission Process
7. Sibling Position
8. Societal Emotional Process
In family systems theory, dysfunction occurs when members are undifferentiated from one another (Becvar, 2009). Differentiation of self is at the foundation of Bowen’s theory. It is based on the psychological separation of the emotion and the intellect, and the ability to become independent from others (Kerr & Bowen, 1988). Differentiation of self is having the ability to independently think through an issue without reacting emotionally to pressures from others. People who are differentiated have the ability to choose between guiding themselves with their thoughts or their feelings. They are able to have strong emotions but also practice self-restraint (Brown, 1999). Those who are differentiated think things through, make decisions on their beliefs, and then respond in accordance. Those who are undifferentiated, on the other hand, react emotionally and impetuously. Unable to maintain their own autonomy, they become fused with others in their family. Their emotional patterns are in sync with other members and they have a difficult time separating what they feel from the emotions of the family unit (Kerr & Bowen, 1988).
Intelligence does not determine the level of differentiation. Highly intelligent people can have low differentiation. The level of differentiation refers to the degree in which a family member can think and act for themselves while dealing with an emotional issue (Kerr & Bowen, 1988). Intimate relationships often include bouts of anxiety. In families, as the anxiety increases between two people, they make seek to bring in a third person to attempt to gain stability. This process is known as triangulation. With the involvement of the third person, the anxiety is spread across more people and appears to lighten. While the tension may appear to decrease, the possibility of increasing the original problem persists. With three players now involved, the original dyad fails to solve the problem which caused the anxiety to begin with (Bevcar, 2009). Bowen researchers consider triangles to be a normal part of relationships. Triangles are the basis of Bowen’s multigenerational theory (Rabstejnek, 2012).
If anxiety and reactivity can be properly managed, triangles can be positive. The system has the opportunity to resolve itself if the third member of the triangle can remain calm and emotionally connected with the other two parties. Excessive emotional reactivity and fusion is known as Nuclear family emotional processes. This can be triggered by a lack of differentiation and can lead to an emotional cutoff. When met with conflict, family members may argue, fight, criticize and blame each other. One person assumes a dominant role and another assumes a subordinate role, leaving the dominant person to assume all of the responsibility and the other person to become lost (Rabstejnek, 2012). This can lead to spousal dysfunction or the focus on a child. When a family passes on their differentiation to their children, it is known as the Family projection process. The parents of a nuclear family might both be undifferentiated, and they focus their anxiety on their child. As a result, the child develops a problem which they seek the help of a professional therapist to solve (Rabstejnek, 2012).
In the Bowen family system theory, the parents would receive the therapy to improve their differentiation, and once their anxiety is removed, the child improves. Emotional cutoff happens when family members stop emotionally interacting with one another. Thinking back to triangles, if the third party is healthy, the family anxiety can be absorbed as it is spread out. With a situation of an emotional cutoff, future generations are in jeopardy because there is no extended family to absorb the anxiety. As anxiety increases, families look for new relationships to fill the roles of those who have been cut off (Kim-Appel & Appel, 2015). Emotional cutoffs can happen for different reasons, but is generally a result of a high degree of fusion. The Bowenian term multigenerational transmission describes how anxiety is passed from generation to generation.
Parents who have a lack of differentiation create children who are less differentiated, resulting in a higher level of anxiety. The concept is meant to describe patterns of emotional behavior from one generation to another (Kim-Appel & Appel, 2015) Sibling position is a concept adopted from Walter Toman and refers to the birth order of children. As children are born into a family, they take on certain preconceived family roles. Sibling position affects family function and differentiation levels as well. Certain personality traits can be linked across generations to those born in the same birth order (Goldenberg & Goldenberg, 2013) Bowen’s last concept, societal emotional process, is the social influence placed upon a family. Economic hardships, natural disasters, and epidemics affect society as a whole but also impact individual families. Those families portraying higher levels of differentiation tend to have better responses to such conditions (Kim-Appel & Appel, 2015)
The Bowenian approach is not based on specific techniques. The overall goal is to understand the family, decrease anxiety, and increase the differentiation of all family members. The strategies used by Bowenian therapists, according to Brown (1999) include genograms, detriangling, using a multigenerational lens, and coaching. The original assessment of the family leads to the creation of a genogram. A genogram is a chart which covers three generations of the family and depicts history, relationships, conflicts and triangles (Butler, 2008). Relationship struggles such as fusion, abuse, and emotional cutoffs are also noted on the genogram. By plotting this out for the therapist and family to view, a familial map is made. Detriangling, according to Brown (1999) is a technique central to Bowenian therapy.
As previously discussed, triangles occur when a dyad brings in a third party to help deal with anxiety. Communication is imperative in families, and bringing in a third party may distort the message being sent. Another downfall is that the third party might become aligned with one of the original dyad members, leaving a third person to be isolated and hurt. During therapy, triangles are identified and broken down. During the multigenerational lens process, the Bowenian therapist uses questions to spark a conversation among the family members about the influence of other generations on their current life. Patients are asked to discuss how previous generations might have influenced their decision making skills and belief system.
The therapist strives to help the patient understand how attitudes about religion, child-rearing, finances, and family roles play a part of their current family structure (Rabstejnek, 2012). Coaching is used when individuals need to gain a greater level of differentiation. As implied in the name, coaching is a way to show the family members how to use thought and emotion to make decisions. While it was created as a family technique, it is used one on one. By supporting the family member through role play and using “I” statements, the therapist shows the patient how to stand on their own.
Bowen’s therapy emphasizes emotions, while others like cognitive-behavioral focus on thoughts. His theory is well researched and has provided the foundation for many discussions in the therapy world. The concepts of differentiation, fusion and triangulation have been proven tools for assessing dysfunction (Glade, 2005). While designed as a family therapy, other studies have shown that these techniques have been beneficial in chemical dependence counseling and trauma counseling for victims of sexual abuse (Cook, 2007, Mackay, 2012). Glade (2007) and Brown (1999) both found that Bowen’s theory is widely accepted in counseling today. With the push for managed care, perhaps the biggest drawback to the Bowenian model is the amount of time it takes to adequately move through the counseling process.
In the field of counseling, spiritual and religious issues are often avoided. With the integration of psychology and spirituality moving forward, I find myself questioning how I would combine Bowenian theory with Christianity. In America, we try to separate church from most forms of business. Church and state, church and education, church and politics have all been divided so as not to offend anyone who has a religious view that is different than ours. What we have failed to realize is that it’s not the church that defines us; it’s the church (or religion) that serves as the foundation of our existence. Providing counseling that fails to enrich the person’s spirit would be less than fulfilling. God is our ultimate provider, the light, and the way. I believe the first step in integrating Christianity and therapy is through the use and power of God’s grace. God’s grace if offered to every human, Titus 2:11 (English Standard Version) states “For the grace of God has appeared, bringing salvation for all people”. In a counseling setting, forgiveness and grace, especially between those in a family, should be emphasized.
Those who present to counseling with a low level of differentiation might not feel they have received God’s grace. They might feel stuck within their family, unable to stand on their own two feet. In order to raise the level of differentiation, the counselor must be willing to show that God recognizes us as individuals, and appoints grace accordingly. We must stand up and accept the gift of grace that God has chosen to give to each of us. The use of grace in HURT Intervention 20-5 from Ripley and Worthington’s Couple Therapy (2014) defines grace as “an altruistic action of undeserved love” (p. 277). When we remind our patients that even when they do not deserve love it is still given, we empower them to love themselves as an individual. According to Walker, Gorsuch, and Tan, “more than two thirds of Americans consider personal spiritual practices to be an important part of their daily lives” (2004, p. 70).
Knowing that spirituality plays such an important role for so many Americans, it seems only natural to want to integrate counseling and religion. Being an educated counselor is imperative in this process. Whether it is due to lack of education, training, or cultural awareness, most of the integration happening today is based on the therapists own religiousness and not the spiritual intervention needed by the patient (Walker et al., 2004). In order to be able to provide the best integrated counseling, you must fully understand the client’s foundation of religion or spirituality. My goal for future counseling is to focus on holistic wellness. The mind-body-soul connection is very important to me. I believe you can maximize your physical growth when you strengthen your spiritual self. I am planning to offer counseling services that integrate physical relaxation (such as meditation or yoga) with spiritual healing (such as prayer) along with a family systems approach to therapy.
Finding a sense of calm sets the tone for emotions to stabilize. In Bowenian theory, the therapist works to breakdown triangles and increase differentiation in family members. In a counseling setting, being able to emotionally support each other through prayer while physically separating yourself through core related exercise would be beneficial to separate the individual role from the family role. Learning how to properly meditate and focus is the equivalent of learning to control your thoughts when emotions are running high. In our society, people often have difficulty managing outside stress. Learning how to internally focus and avoid taking on another’s anxiety is paramount. If meeting with a family that has experienced emotional cutoff, I feel prayer (once consent is received) would be a good way to bring the family back together.
Prayer is a very personal and intimate way of caring for another person that doesn’t involve any physical or emotion contact with them. By first opening your heart and desire to reconnect through prayer, you create a stepping stone to reforming those cutoff relationships. Taking a lesson from James 5:16 (ESV) “Therefore, confess your sins to one another and pray for one another, that you may be healed. The prayer of a righteous person has great power as it is working”. We must encourage our clients to confess their sins, how they contributed to the cutoff, and then encourage them to rise above what has been done to pray for emotional healing.
In Bowenian theory, anxiety within the family causes the family to triangulate and become dysfunctional. Anxiety can be relieved in many ways, and spiritual awareness is one of them. The closer we are to God, the more solutions are made available to us. Peter 5:6-7 (ESV) tells us to cast all of our anxieties upon God because he cares for us. For the counseling patient who feels stuck and unable to move forward, reminding him that God will take his anxiety and leave him healed can be a powerful statement.
Going forward, I will continue to monitor the empirical evidence on the integration of psychology and theology. In turn, I will do my part to contribute research on the importance and benefit of embracing the mind-body-soul connection in therapy. We are just at the beginning of understanding how living the life God gave us impacts our mental health. Societal influences can work against us when we don’t have our head held high looking to God for the answers. Until we meet again, be well and God Bless.
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