Bowenian Family Therapy

Bowenian Family TherapyOverview of CE Course Created by Eric Lyden, M.A., M.F.T

forPractical CE Seminars

To complete the full CE course, visit:www.practicalceseminars.com

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OBJECTIVES

• Explore the fundamental tenets, assessment issues, goals and interventions of Bowenian Family Therapy.

• Discuss the usefulness of Bowenian Family Therapy in actual practice, especially in the context of managed care.

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FUNDAMENTAL TENETS

• Works well with individuals, couples and families

• Longer term approach

• Depth-oriented approach

• Bowen advocated for at least 4 years of therapy although aspects of Bowen’s approach can be applied in 5 or 10 sessions



FUNDAMENTAL TENETS

• Bowen would use a Genogram, which was an assessment tool and a treatment tool

•You can integrate interventions from other theories, as long as they serve to meet the primary goal of Bowenian theory

• So, if you do an experiential technique, explain how that would work to raise your client’s level of self-differentiation, the long term goal of Bowen therapy



FUNDAMENTAL TENETS

• Bowen was not as interested in labels, especially in diagnostic labels.

• He believed that by alleviating the anxiety in the system, by raising the differentiation, that the symptomology itself within the system would be alleviated as well.



MURRY BOWEN•Medical doctor

• Trained as an analyst during his studies with hospitalized schizophrenics in the 40’s and 50’s

• He integrated many aspects of systems theory

• Extended Family Systems Therapy, which he developed, is really a result of his psychodynamic training and elements of original systems theory

• As a therapist he acted as a coach and an educator, which is a reflection of his process



ASSESSMENT, GOALS AND INTERVENTIONS

• Assessment = how you diagnose according to your theory

• Goals = what you want to accomplish (always start with verbs, e.g., Raise the level of self-differentiation)

• Interventions = techniques used to accomplish the goals (e.g., Genogram)



ASSESSMENT ISSUES

Bowen’s assessment issues = his way of describing a situation, a family, and the dynamics within a family

1. He took an extensive family history by interviewing each member of the family

2. He constructed a detailed Genogram. (Depending on the family, he might even have them each construct their own Genograms.)

3. The Genogram is the primary means of gathering information.

This is a family tree, constructed by the client(s), which goes back three generations and highlights names and pertinent information, as well as dysfunction that could be repeating itself generationally.



BOWEN’S INTERLOCKING CONCEPTS

These are the core issues that form the basis of this theory

1. Self-Differentiation2. Emotional Triangles3. Nuclear Family Emotional System4. Family Projective Process5. Emotional Cut-off6. Multigenerational Transmission Process7. Societal Regression8. Sibling Position



SELF-DIFFERENTIATION• It is the ability to separate thoughts and feelings• This can be both an interpersonal as well as an inter-psychic process• Differentiation is the ability to take a more neutral position • With higher differentiation, if a person says something to you, you are able to hold that thought as a cognition and not allow it to turn to a feeling• Every other concept in Bowenian Family Therapy basically gets back to self-differentiation

Differentiation-of-self scale 0 25 50 75

100 Fusion Self-

Differentiation



FUSION• The lower the individual's level of differentiation, the greater the likelihood that he/she will be unable to differentiate him/herself from other family members

• This causes him or her to become "fused" with the emotions that dominate other family members

• When an entire family is fused it is called an undifferentiated family “ego mass.”

• This is a term used by Bowen to describe the emotional "stuck-togetherness" of families that have inadequate interpersonal boundaries



EMOTIONAL REACTIVITY

• When people don’t RESPOND, they REACT

• The lower a person’s level of self-differentiation, the greater their likelihood to be emotionally reactive



EMOTIONAL TRIANGLES• Bowen thought of family groupings of three individuals as the “molecules” or “building blocks” of the family

• Emotional triangles develop their own rules

• Bowen also believed that the more one person tried to change two other people, or one person and his or her habit, the more that person reinforced the relationship



NUCLEAR FAMILY EMOTIONAL SYSTEM

• A family’s coping mechanisms• Or the means it has to deal with tension and instability• Some of these means are dysfunctional, such as poor communication between spouses or triangulation of a child



FAMILY PROJECTIVE PROCESS

• A chronic process of triangulation of the most vulnerable child

• This may be the youngest child, the weakest or even the oldest

• This process creates a lower level of differentiation in the targeted child



EMOTIONAL CUTOFF

• A stage of “pseudo differentiation” ‑

• A person may appear to be differentiated but actually has many unresolved issues and difficulty separating thoughts and feelings

• A person does not have to be physically cutoff from his or her family of origin to be emotionally cutoff



MULTIGENERATIONAL TRANSMISION PROCESS

• Bowen believed that family dysfunction is passed on generationally

• Lower levels of differentiation are therefore created by the multigenerational transmission process

• An individual with a certain level of differentiation seeks out a spouse with a similar level of differentiation

•They have children with lower levels of differentiation, and then they have children with lower levels of differentiation, etc.

• Bowen originally stated that it took three generations to create a schizophrenic; later he changed that to ten generations and he expanded that to other pathologies



SOCIETAL REGRESSION

• Bowen also referred to this as the “process of society”

• He hypothesized that the same principles that apply to the emotional system within the family can be applied to society at large.



SIBLING POSITION

• Bowen borrowed the term “sibling position profile” from Walter Toman (1961)

• Toman spoke of how spouses deal with issues according to how they dealt with their siblings

• There are “typical” behaviors that are expressed by individuals according to their sibling position

• The child who is a part of the family projective process is always infantilized, regardless of sibling position



NUCLEAR FAMILY SYSTEM

• Bowen believed that most families sought help when dysfunction surfaced in one or more of the three main stress areas of the nuclear family system:

1) Marital conflict

2) Dysfunction in a spouse, or

3) Dysfunction in a child



Marital Conflict1. Results from one spouse showing more passivity under pressure

than the other. This spouse is typically more dependent and often more symptomatic, and is called “overadaptive.”

2. The other spouse is referred to as “overfunctional.” This spouse is often unaware that the other is symptomatic, is higher functioning and has a higher level of self-differentiation.

3. Together, this relationship has been referred to as a “dysfunctional reciprocal relationship.”(Other forms of dysfunctional reciprocal relationships include overadequate/underadequate, passive/aggressive and distancer/pursuer.)

4. This can lead to fusion.



UNDIFFERENTIATED FAMILY EGO MASS

• A conglomerate emotional oneness that exists in all levels of intensity

•These relationships are cyclical, in that they can shift from anxiety, or a state where the members are repelling each other, to extreme closeness



TRIANGLES

• Triangles are often used to “balance” the undifferentiated ego mass

• Bowen described the triangle as the “basic building block” of the family

• In essence, two family members recruit a third one to “siphon off” their anxiety onto



ROLE OF THE THERAPIST-11. The therapist is neutral, encouraging the family members to

speak through the therapist rather than to each other. He or she is a coach, in that he teaches “differentiation moves,” or ways for the client to


maintain his or her own state of neutrality. And finally the therapist acts as an educator by continually teaching the family about family systems dynamics.


ROLE OF A THERAPIST-2

2. Thinking in terms of the system and not the emotionality or the content is important, which means that the therapist must have a high degree of differentiation. The therapist must be high functioning in the sense that he or she can separate thoughts from feelings and manage emotionalreactivity. In addition, he or she must have a healthy separationfrom his or her family of origin.



ROLE OF A THERAPIST-3

3. The therapist is a coach and an educator, teaching the clients about family systems dynamic, differentiation and the multigenerational transmission process. Teaching is a critical element of Bowenian family therapy and the role of educator is important to the success of the approach.



GOALS-SHORT TERM

1. Bowen uses the Genogram to gather information and offer insight into patterns of multigenerational relationships



GOALS-INTERMEDIATE

1. Increase the level of self differentiation of ‑each family member

2. Reduce emotional reactivity3. Help each family member detriangulate from

his or her family of origin 4. To “detriangle” pre-established three person

systems in steps



GOALS - LONG-TERM

1. Self-differentiation and the development of solid self

2. Transition client from therapy to other environment and educate them that differentiation is a lifelong process

3. Aid client in bridging his or her emotional cutoffs without being pulled back into repeating old patterns in relationship



INTERVENTIONS-EARLY STAGE

1. Genogram2. Begin to discuss generational patterns3. Lessen emotional reactivity4. Objectivity



INTERVENTIONS-MIDDLE STAGE

1. Coaching2. Therapeutic Triangles 3. Taking “I position” stands4. Marital psychotherapy5. Individual therapy



INTERVENTIONS-LATE STAGE

1. Education is important throughout therapy, but in the final stage it can help the clients with transition. It’s important to emphasize that differentiation is a lifelong process.

2. Reaffirming that differentiation is a lifelong process and that the client has gain a deeper understanding of him- or herself that facilitate his or her ability to continue the process.



Summary Bowenian Family Therapy can be used with individuals, couples or

families It is a long-term therapeutic approach Differentiation, or the ability to separate thoughts from feelings both

intra-psychically and inter-personally, is the core concept of Bowenian Family Therapy

When working with couples, Bowen would always have each individual talk “through” him, rather than “to” each other

The primary “intervention” in Bowenian Family Therapy is the Genogram

Therapy is complete when each member of the family has successfully raised his or her level of differentiation



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Bowenian Family Therapy

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Transcript of Bowenian Family Therapy