Els NFT

Understanding family emotional systems and how they work is central to Bowen's theory.

The nuclear emotional process refers to how the family system operates in a crisis.

The family projection process refers to how parents pass good and bad things on to their children.

The multigenerational transmission process refers to how a family passes its good and baggage between generations

Bowen focused on how family members could maintain a healthy balance between - being enmeshed (overly involved in each other’s lives)

- and being disengaged (too much detachment from each other).

Although all family therapists are interested in resolving problems presented by a family and decreasing symptoms, Bowen therapists are mainly interested in changing the individuals within the context of the system.

They contend that problems that are manifest in one's current family will not significantly change until relationship patterns in one's family of origin are understood and addressed. Emotional problems will be transmitted from one generation to the next until unresolved emotional attachments are dealt with effectively. Change must occur with other family members and cannot be done by an individual in a counseling room.

Living systems and all the other system-related processes--move forward through key "horizontal"

transitional stages (brought about by time and change).

Symptoms occur when vertical stressors (old issues, past mistakes, emotional legacies) impinge on the system during a transition.

Families are likeliest to be conflicted and symptomatic when key horizontal transitions like marriage, the birth of children, children going to school, children moving away from home, changes of jobs, etc. coincide with a resurfacing of vertical stressors like old emotional baggage.

Example: a workaholic husband driven to succeed by high internalized standards that equate esteem with production (vertical stressor) puts in even more overtime to stuff the loneliness he feels when his eldest son leaves for college (horizontal stressor).

In this case, part of the therapeutic agenda would include giving the family tools for negotiating the "empty nest syndrome" while helping the husband get in touch with his mourning, examine his expectations of himself, and reconnect with his family.

Calibration: setting of a present-oriented, systemwide range limit around a comfortable emotional "bias."

A typical situation: an unintense family with a cool emotional atmosphere unconsciously selects a member to turn up the heat; brother and sister start fighting. This turns into an argument between the parents, the drama escalates, and then, before it gets too hot, a child who plays the role of family ambassador calms everybody down.

In that family the bias, the emotional level setting, is too low; a good dose of constructive intensity might recalibrate the bias and make explosions unnecessary.

Self-regulating via feedback loops--negative (toward stability) and positive (toward change)--that maintain the bias.

Every seasoned drug and alcohol counsellor knows that when one member of the family stops drinking or using, the family will subtly try to push him back into his old vices--not because they want him sick, but because families, like other organisms, naturally resist changes that might further destabilize the system.

So one day the husband says to his abstaining wife, "Why not skip your AA meeting tonight so we can catch a movie?" Or the mother of a teen who's quit using congratulates him on finding a job--in a head shop.

Introducing positive (= system-changing) feedback loops into these families might include warning them about enabling, relapses and resistance to change and examining what family members gain from having a malfunctioning member (control? A scapegoat? Distraction from other conflicts? Someone to rescue?).

5) Sibling Position.

Bowen adopted Toman’s (1993) conceptualization of family constellation and sibling (or birth) position.

Toman believed that position determined power relationships, and gender experience determined one’s ability to get along with the other sex.

In addition to noting the unique positions of only children and twins, Toman focused on ten power/sex positions:

1. the oldest brother of brothers;

2. the youngest brother of brothers;

3. the oldest brother of sisters;

4. the youngest brother of sisters;

5. the male only child;

6 – 10 and the same five configurations for females in relation to sisters and brothers.

Under this conceptualization, the best possible marriage, for example, is hypothesized to be the oldest brother of sisters marrying the youngest sister of brothers; in this arrangement, both parties would enter the marriage with similar expectations about power and gender relationships. Conversely, the worst marriage would occur between the oldest brother of brothers and the oldest sister of sisters. In this case, both parties would seek and want power positions, and neither would have had enough childhood experience with the other sex to have adequate gender relationships.

Toman supported his hypothesis by noting that the divorce rate among couples comprised of two oldest children was higher than any other set of birth positions. The absence of divorce, however, is not the same as a happy marriage. When we consider the critical traits in a happy marriage, his predictions based on birth order start to lose credibility. Happiness in coupling or marriage is demonstrably more related to attitudinal and behavioural interactions within the spousal system—especially during periods of family stress—than to birth order (Gottman, 1994, Walsh, 2003).

Guerin (2002) discussed the importance of what he called the “sibling cohesion factor” (p. 135), especially when there were more than two children in the sibling subsystem, allowing for triangles to form. The sibling cohesion factor is the capacity of the children within the sibling subsystem to meet without their parents and discuss important family issues, including their evaluation of their parents. Healthier families tend to have this factor as part of the family process; the lack of it suggests to Guerin that there is intense triangulation between the parents and children.

Normal Family Development

To Bowen, all families lie along a continuum. While you might try to classify families as falling into discreet groups, there really are no "types" of families, and most families of one type could become a family of another type if their circumstances changed. In many ways, Bowen was among the first of the culturally sensitive family therapists.

Bowen believed that optimal family development occurs when family members are differentiated, feel little anxiety regarding the family, and maintain a rewarding and healthy emotional contact with each other.

Fogarty offers that adjusted families

 are balanced in terms of their togetherness and separateness, and can adapt to changes in the environment

 view emotional problems as coming largely from the greater system but as having some components in the individual member

 are connected across generations to extended family

 have little emotional fusion and distance

 have dyads that can deal with problems between them without pulling others into their difficulties

 tolerate and support members who have different values and feelings, and thus can support differentiation

 are aware of influences from outside the family (such as Societal Emotional Processes) as well as from within the family

 allow each member to have their own emptiness and periods of pain, without rushing to resolve or protect them from the pain and thus prohibit growth

 preserve a positive emotional climate, and thus have members who believe the family is a good one

 have members who use each other for feedback and support rather than for emotional crutches

Family Disorders

Bowen believed that family problems result from emotional fusion, or from an increase in the level of anxiety in the family. Typically, the member with "the symptom" is the least differentiated member of the family, and thus the one who has the least ability to resist the pull to become fused with another member, or who has the least ability to separate their own thoughts and feelings from those of the larger family. The member "absorbs" the anxiety and worries of the whole family and becomes the most debilitated by these feelings. Families face two kinds of problems. Vertical problems are "passed down" from parent to child.

Thus, adults who had cold and distant relationships with their parents do not know how to have warm and close relationships with their children, and so pass down their own problems to their children. Horizontal problems are caused by environmental stressors or transition points in the family development. This may result from traumas such as a chronic illness, the loss of the family home, or the death of a family member.

However, horizontal stress may also result from Social Emotional Processes, such as when a minority family moves from a like-minority neighbourhood to a very different neighbourhood, or when a family with traditional gender roles immigrates to a culture with very different views, and must raise their children there. The worst case for the family is when vertical and horizontal problems happen at once.

Family Therapy with One Person

Family therapy can be done with one person. Such therapy typically focuses on differentiation of the person from the family. The therapist helps the individual stop seeing family members in terms of the roles (parent, sibling, caretaker...) they played, and start seeing them as people with their own needs, strengths, and flaws.

The individual learns to recognize triangulation, and take some ownership in allowing or halting it when it happens. The individual client should have good insight into the family (genograms may be especially helpful in this), and be very motivated to make changes either in his or her own life, or in the family.

Goals of Therapy

The practice of Bowen family therapy is governed by the following two goals:

(1) lessening of anxiety and symptom relief and

(2) an increase in each family member's level of differentiation of the self (Kerr & Bowen, 1988).

To bring about significant change in a family system, it is necessary to open closed family ties and to engage actively in a detriangulation process (Guerin, Fogarty, Fay, & Kautto, 1996). Although problems are seen as residing in the system rather than in the individual, the route to changing oneself is through changing in relationship to others in the family of origin.

Bowen encouraged his clients to come to know others in their family as they are.

He helped individuals or couples gather information, and he coached or guided them into new behaviours by demonstrating ways in which individuals might change their relationships with their parents, siblings, and extended family members.

He instructed them how to be better observers and also taught them how to move from emotional reactivity to increased objectivity.

He did not tell clients what to do, but rather asked a series of questions that were designed to help them figure out their own role in their family emotional process

Treatment entails

 reframing the presenting problem as a multigenerational problem that is caused by factors beyond the individual

 lowering anxiety and the "emotional turmoil" that floods the family so they can reflect and act more calmly

 increasing differentiation, especially of the adult couple, so as to increase their ability to manage their own anxiety, transition more effectively to parenthood, and thus fortify the entire family unit's emotional wellbeing

 using the therapist as part of a "healthy triangle" where the therapist teaches the couple to manage their own anxiety, distance, and closeness in healthy ways

 forming relationships with the family member with "the problem" to help them separate from the family and resist unhealthy triangulation and emotional fusion

 opening closed ties with cut off members

 focusing on more than "the problem" and including the overall health and happiness of the family

 evaluating progress of the family in terms of how they function now, as well as how adaptive they can be to future changes

 addressing the power differential in heterosexual couple based on differences, for example, in economic power and gender role socialization (this is a contribution of those who have reconsidered Bowen's theory through a feminist lens)

In general, the therapist accomplishes this by giving less attention to specific problem they present with, and more attention to family patterns of emotions and relationships, as well as family structures of dyads and triangles.

More specifically, the therapist

 tries to lower anxiety (which breeds emotional fusion) to promote understanding, which is the critical factor in change; open conflict is prohibited as it raises the family members' anxiety during future sessions

 remains neutral and detriangulated, and in effect models for the parents some of what they must do for the family

 promotes differentiation of members, as often a single member can spur changes in the larger family; using "I" statements is one way to help family members separate their own emotions and thoughts from those of the rest of the family

 develops a personal relationships with each member of the family and encourages family members to form stronger relationships too

 encourages cut off members to return to the family

 may use descriptive labels like "pursuer-distancer," and help members see the dynamic occurring;

following distancers only causes them to run further away, while working with the pursuer to create a safe place in the relationship invites the distancer back.

 coaches and consults with the family, interrupts arguments, and models skills...

Techniques

Bowen did not believe in a "therapeutic bag of tricks." Questioning the family and constructing a family genogram are the closest things to basic techniques all Bowenian therapists would use. Carter has assigned tasks to the adult couple to help them realize more about their family history, and encourages letter writing to distant members, visiting mother-in-laws... to speed things up. Guerin accepts the family's opinion of who

"has the problem" and works from there with a variety of techniques to help all family members own some responsibility for helping that sick member get better. He will also use stories or films to present another real or imaginary family with the same problem as the family in therapy, and highlight how the family in the story or film overcame their difficulties.

Other concepts:

Emotional divorce (like when a sick child holds the parents together); theory is important; no one ever really leaves the family system; mother-child symbiosis when unresolved predisposes to schizophrenia; solid self vs. pseudo self; over- under adequate reciprocity.

Two natural forces: growth of individual and emotional connection. Emphasized the first.

Fusion breeds anxiety and increases emotional reactivity. Three outcomes of fusion: physical or mental dysfunction in a spouse; in a child; chronic marital conflict.

Dysfunctional reciprocal relationships: include over adequate/under adequate, decisive/indecisive, dominant/submissive, hysterical/obsessive, schizoid/conflict, or cut-off between spouses.

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