The Family Research Behind Bowen’s Theory

This blog summarises key research of Dr Murray Bowen that shaped his theory. It was a key part of my PhD discussion of results. Hence it is timely to post it. I recommend that any who are interested in family and relationships have a read of the quotes from Bowen’s research (this article was originally posted March 2014 www.thefsi.com.au)

A feast of key quotes:

“Anxiety is inevitable if you solve the problem. When anxiety increases, one has to decide whether to give in and retreat or carry on in spite of it. People can even grow and become more mature by having to face and deal with anxiety situations.” p119

The Origins of Family Psychotherapy – Unique insights into the development of Bowen systems theory

Blog post by Jenny Brown

What a satisfying experience to read: The Origins of Family Psychotherapy, This book contains the key research papers from the NIMH* project led by Dr Murray Bowen in the latter 1950s. (Edited by Jack Butler PhD)

Family Systems Institute, Bowen

Why, you may well ask, was this high on my summer reading list? Don’t I know how to switch off with some good beachside appropriate fiction? Well I did manage to also enjoy a satisfying piece of fiction but I found Bowen and his team’s research papers totally engrossing.  They took me on an excursion into how a new paradigm emerged from carefully constructed observational data. It was such a unique vantage point to see how Bowen and his collaborators, over a 5 year period of observing 18 families who were in hospital (averaging a year) with their highly symptomatic young adult member, began to see and document clear evidence of how the family is an interdependent unit. (additionally data was gathered from a number of outpatient families)

I have written copious notes from this book but thought I would try, for this blog, to pick some highlights. It’s not easy to edit out any of my standout quotes but I have chosen some that I think best express the key themes that stood out for me:

Focussing on the family as a unit – more than a group of individuals and beyond the “sick” one:

The observations reveal how the symptomatic individual is wired to the responses of all family members.  In the same way each family member, whether responding with distance or with intense helping efforts, is continually shaped by each other. While this research involved people with severe forms of psychosis, the term schizophrenia could be replaced with the term “symptoms in offspring”.

There was “A shift from seeing schizophrenia as a process between mother and patient or as an illness with the patient influenced by the mother to an orientation of seeing schizophrenia as the manifestation of a distraught family that becomes focussed in one individual.” P25

“It was possible to see the broad patterns of form and movement that had been obscured by the close up view of the individual. ….The family view in no way detracts from the importance of the familiar individual orientation. …..the individual orientation can be more meaningful after it has been possible to see the family patterns.” P 158

“On one level each family member is an individual. But on a deeper level the central family group is as one. Our study was directed to the undifferentiated ego mass beneath the individuals.” P 109

Seeing how helpers can become part of the family’s helplessness or alternatively, facilitators of family’s problem solving efforts:

There are valuable insights in these papers about the way the workers can be inducted into being rescuers or experts and the effect of such postures. The worker’s self-awareness comes to be seen as of equal importance of the family’s problem solving efforts.

The therapist aims “to be helpful while staying detached from the other person’s immaturities…It is helping with a problem without becoming responsible for the problem….Our greatest philosophy I would say that our greatest help is in helping people to define their dilemmas. Our greatest energy goes into preventing staff from trying to solve dilemmas.” P 54

“When I feel myself inwardly cheering the hero, of hating the villain in the family drama, or pulling for the family victim to assert him/herself, I consider it time to work on my own functioning.” P 116

The senior social worker/case worker on the research project Ms B Basamania writes:

Anxious family members “didn’t deal with each other but turned to therapist as ‘expert’. The higher the anxiety and tension, the greater they turn to the outside as though the tension decreased with distance.” P141

“The philosophy on the project was based upon a regard for the family and its capacity to nurture human growth…. Therapeutically a guiding principle was to respond to the families in a way that would promote growth.” P143

Seeing how growth comes about from within the family:

The research papers describe the detail of the ‘action dialogue’ of the family member’s reactions to each other (both psychologically and physiologically). The emerging theory is seen in descriptions of repeating patterns such as “the interdependent triad” of parents and “patient” (it was a number of years before Bowen clarified his concept of the triangle), the circuitry of the “over adequate/ strong one and under adequate/helpless one”.  There are some clear descriptions of how growth occurs “in-situ” of the family and not in the restorative (healing) relationship with the therapist. This paradigm shift in therapy approach was a direct outworking of the paradigm shift from individual thinking to seeing the family as an interdependent unit.

“The families present a group picture of helplessness and inadequacy. They deal with many life problems as burdens to be endured rather than problems to be solved. Therapeutic emphasis is directed at this helplessness. When either parent is able to become active in solving such a problem, the emotional adjustment of the entire family changes.”P39

“Families are not really helpless. They are functionally helpless. When the family is able to become a contained unit, and there is a family leader with motivation to define the problem and to back his(her) own convictions in taking appropriate action, the family can change from a directionless, anxiety-ridden floundering unit, to a more resourceful organism with a problem to be solved.” P118-9

The parent’s sureness of themselves may be almost more important than what they do. If they are filled with doubts and apologies, the patient resets adversely; whereas, if they feel sure of themselves, they can behave in bizarre ways without alarming or disturbing the patient, or without upsetting the patient.” pP97

At the heart of systems change is finding a way to tolerate anxiety: If I had to summarise this important research project and its findings it would be:Managing self in relationships in the midst of arousal. (The concept of Differentiation of Self) Or : How families and workers strive to find a way to operate thoughtfully  in the presence of the inevitable anxiety generated in close proximity to other human beings; especially when some are reacting out of helplessness (and equally out of anxious helpfulness). This finishing quote I have selected from Bowen is a valuable encouragement in this effort:

“Anxiety is inevitable if you solve the problem. When anxiety increases, one has to decide whether to give in and retreat or carry on in spite of it. Anxiety does not harm people. It only makes them uncomfortable. It can cause you to shake, or lose sleep, or become confused or develop physical symptoms, but it will not kill you and it will subside. People can even grow and become more mature by having to face and deal with anxiety situations. Do you have to go on treating each other as fragile people who are about to fall apart?” p119

Reference

The Origins of Family Psychotherapy: The NIMH Family Study Project.  Murray Bowen, MD. Ed Jack Butler PhD. With contributions by Michael Kerr, MD, and Joanne Bowen, PhD. New York,: Jason Aronson, 2013.

http://www.amazon.com/The-Origins-Family-Psychotherapy-Project/dp/0765709740

Note: the proceeds of this fine book are being donated to the work of the Bowen Archives.

*National Institute of Mental Health

The Self in the System: How much autonomy is possible?

Each of us can raise our ‘periscope’ (capacity to observe self and others) a little above the murkiness of human subjectivity. There is always the possibility of the ‘self’ increasing his/her understanding of the part they are playing out in relation to others.

This was the topic of the family System’s Institute’s 14th annual conference; held June 15-16 2017. After listening to the range of informative presentations I asked myself how I would answer the question that our conference topic proposed.

Firstly, how would I define the ‘self’, the individual, from a family systems perspective? 

The ‘self’ is an individual organism who is part of the human species. The human ‘self’ has much in common with other species, as demonstrated by the mirroring of Professor Suomi’s rhesus macaque baby monkeys as they interacted with human researchers. The human ‘self’ is set apart from similar life forms by his/her cerebral cortex with its ability to think, reason and reflect. This enables a limited capacity to manage life in certain areas according to reason. The human ‘self’ struggles to see the presence of chronic anxiety which plays such a significant role in the development of symptoms and the transfer of symptom vulnerability within a group.  I like Dr Kerr’s suggestion that a possible new name for this species could be: ‘homo-dysrationalis.’ This is out of respect for the degree to which emotionality influences so much of what the human ‘self’ perceives and does.

The ‘self’ is born into a multigenerational family with multiple dynamic variables of emotional and relational process. Context is crucial to understanding the development and expression of each ‘self’.

Can the self ever be autonomous?

The ‘self’ is never autonomous among other selves. She/he is both an actor and a reactor in relationships. Such processes influence which of the person’s genes are expressed, over expressed, or under expressed. Each ‘self’ shares a drive to be attached: to be mutually attended to and supported, and to be separate: to operate independently in life tasks and creative expression. These 2 counter life forces guarantee a dance like pattern of movements fuelled by both seeking togetherness and seeking distance for autonomy. The relationship dynamics are always being powered by these pushes and pulls in the space in between different ‘selves’. Each ‘self’ is significantly influenced by the brains around him/her. As such the ‘self’ cannot be reduced to cause and effect thinking where external influences and biological makeup are lineally seen to shape the ‘self’. It is always an interaction.

All ‘selves’ sit on a continuum from almost ‘no selves’ who have become lost in the merging of anxious involvements with others; to selves who have a sense of where their responsibilities begin and end, while maintaining meaningful involvement with others. All ‘selves’ in their family systems are qualitatively similar but each ‘self’ and their family is quantitatively different in levels of merged boundaries with each other.

Can a person grow a bit more ‘self’ on this continuum?

There is a platform of hope for such progress where reversals of anxious interactions occur at both relational and biological levels. Each of us can raise our ‘periscope’ (capacity to observe self and others) a little above the murkiness of human subjectivity. There is always the possibility of the ‘self’ increasing his/her understanding of the part he/she is playing out in relation to others.

Those in a helping role can assist such small steps of growth of more ‘self’ by patiently asking non-judgemental and non-pushy questions about interactions – the “who, what, when, where and what next”? This may assist another ‘self’ to gain more awareness of the affect they have on others and other on them. As a result of this knowledge a ‘self’ may shift from instinctively controlling or being controlled by others, to better control of ‘self’. This will involve either less eclipsing others or giving way to being eclipsed. The progress of growing more ‘self’ will entail choosing to think in terms of years rather than just the day.

Autonomy is not possible given relationship interchange is always at play. The ‘self’ can slowly increase responsible autonomy but is wise to never underestimating the strength of human interdependence.

A thought I posted on Facebook prior to the conference:

Self in Bowen theory is NOT about self-actualization or selfishness autonomy. Rather it is all about the ways in which an individual is affected by the relationship environment and the way they affect others within their system. How much is each ‘self’ dependent on relationships to function?

Some relevant quotes from Dr M Kerr’s presentations:Self, Family Systems Institute

“Each person’s emotions not only reflect their internal states, but also function to change each other’s internal states and functions.”

“It is a nonsense to blame one another because they both help create changes in each other to which both react. Blaming the other amounts to blaming oneself.”

“Poorly differentiated people are not good at acting based on long term reward versus automatically opting for instant gratification….Reasonably well-differentiated people may feel like taking the easy way out, feel like acting to relive the anxiety of the moment, but can fall back on fact and principle to stay the course.”

“Awareness of chronic anxiety (subjective, persistent sensitivity to imagined threat [my definition of Chr. Anx. JB]) can be important because of its apparent role in supporting the chronic inflammation that plays an important role in many mental, bodily, and behavioural symptoms. Chronic inflammation is one of the potentially silent killers.”