Bowen Theory and Therapy

1. Bowen Theory and Therapy Friedman, E. H. (1991). Bowen theory and therapy. In A.S. Gurman & D. P. Kniskern (Eds.), Handbook of family therapy: Vol. II (pp. 134-170). New York: Brunner/Mazel.

2. The Breadth of a Bowenian Perspective • Bowen theory is not about families, but about life. • Bowen emphasized that humans have more in common "with other forms of protoplasm … and that traditional social science to emphasize differences have … increased our denial about what really makes us tick" (p. 135). • The human animal is part of evolutionary emotional processes. Dr. Ronald Werner-Wilson

3. A Perspective of Universals • Bowen theory emphasizes universal continua rather than discrete categories (i.e., nature/nurture, male/female, patient/therapist). • Bowen theory embraces aspects of multiple social and behavioral sciences. • The family is the unit of observation and treatment. Multigenerational forces can create symptoms at one of three locations: • the marital relationship; • the health of one of the marital partners; • children. • Implications of a "universal" perspective: • diminishes the importance of becoming an "expert" in specific symptomatologies; • there are cross-cultural universal experiences. Dr. Ronald Werner-Wilson

4. The Emotional Being of the Therapist • Differentiation of therapist is emphasized: "Bowen has consistently maintained that it is hard for the patient to mature beyond the maturity level of the therapist, no matter how good his or her technique" (p. 138). • Capacity to apply Bowenian theory is a function of the therapist's own differentiation. • "Maintaining a non-anxious presence … is connected to the being of the therapist, not to his or her know-how" (p. 138). • Bowen and Kerr (1981) have suggested that learning Bowenian theory requires an emotional chance that is only possible by apprenticing with someone who is a "master" or a disciple of a "master". Dr. Ronald Werner-Wilson

5. Concepts in Bowen Theory • Four Seminal Constructs • Differentiation • Emotional System • Multigenerational Transmission • Emotional Triangle • These major constructs are interdependent. Dr. Ronald Werner-Wilson

6. Chronic Anxiety • Anxiety is natural. It is an emotional and physical reactivity. • Chronic anxiety is an "exaggeration of a basic rhythm of life: the instinctual, nonthinking response necessary of wilderness survival as well as the habits required for playing a sport" (p. 140). • Anxiety is transmitted by families cumulatively and idiosyncratically. • Chronic anxiety is considered to be the primary promoter of all symptoms. Dr. Ronald Werner-Wilson

7. Differentiation • A "lifelong process of striving to keep one's being in balance through the reciprocal external and internal processes of definition and self-regulation" (p. 140). • This refers to a process rather than a goal that can ever be achieved. It is a direction in life. • Differentiation is not synonymous with • individuation, • autonomy, • independence. • Differentiation includes a connectedness to others. • Differentiation is concerned with strength not pathology. Dr. Ronald Werner-Wilson

8. Emotional System • Emotional system refers to any group of people (or collection of animals, for that matter) that have developed emotional interdependencies. • The group has an organized structure. • Family emotional system includes • the members thoughts, feelings, emotions, fantasies, associations, and past connections (individual as well as group connections); • the members physical makeup, genetic heritage, and current metabolic state; • each individual sibling position and parents' sibling positions; • the emotional history of the system itself. Dr. Ronald Werner-Wilson

9. Multigenerational Transmission • This does not simply refer to the influence of the past. It is the "presence" of the past. • Nature and degree of intensity of emotional responses are passed down from generation to generation. • The distinction between generations is a false dichotomy because all generations are part of a continuous natural process. • Family of origin work does not emphasize identifying relatives or even patterns of interactions. Rather, it is the process of connecting and re-connecting with the natural processes that go back generations. • Self-differentiation is the process of getting in touch with intergenerational processes, to know them, to experience them, and to be emotionally affected by them. Dr. Ronald Werner-Wilson

10. Emotional Triangle(a/k/a "triangle") • An emotional triangle is more complex than a triad. • This refers to any three parts of an emotional system. • It can include either three individuals or two individuals and an issue. • Rules that govern emotional processes: • One person cannot change the relationship between two others or between another person and her or his habit. • The more you try to relationship of another, the more likely it is that you will reinforce the aspects of the relationship that you want to change. Dr. Ronald Werner-Wilson

11. Emotional Triangle(cont.) • Clinical Implications: • If a clinician is recruited into a triangle with a couple and is able to refrain from overfunctioning or emotionally reactive, the clinician can help facilitate change that would not be possible if the two had the same conversation alone. • A clinician inducted into a triangle is likely to experience the stress of the couple. This is positional and should be expected. • Clinical focus is on phenomenology rather than interpretation of other's motivation. Dr. Ronald Werner-Wilson

12. Bowen Therapy • Objectivity • Objectivity does not refer to an intellectual/cerebral process. It is an emotional phenomenon. • This refers to a clear headedness that is a prodict of differentiation. • All procedures to maintain objectivity (differentiation) will help promote change. • Procedures to foster an objective state: • mischievous, paradoxical responses; • avoiding interpretations; • diagramming; • telling (disguised) stories about other clients as projective techniques; • make clear one's own positions; • ask questions (this is considered the major "intervention" in Bowenian therapy). Dr. Ronald Werner-Wilson

13. Bowen Therapy(cont.) • Proximity and Protoplasm • Lack of differentiation can be destructive. • Major problem of families: not to get them closer but enable them to be clearer about where they end and others in their life begin. • Therapeutic goal: encourage self-differentiation of individual members. • Healing is a Self-Regenerative Phenomenon • A Natural Systems View of Pathology • Inability to differentiate self from others causes problems. • Inability to regulate self prevents maturity. • Problems that persist continue because others tolerate them. Dr. Ronald Werner-Wilson

14. Bowen Therapy(cont.) • A Natural Systems View of Healing • Health is natural. • Therapeutic processes: • reduce chronic anxiety than inhibits healing by being a well-differentiated, nonanxious presence; • stimulate the clients own resources. Dr. Ronald Werner-Wilson

15. Bowen Therapy(cont.) • Therapy Process: • Longevity in therapeutic contact promotes deeper involvement with multigenerational processes. • Change is not equated with symptom relief or feeling better but with an increase in differentiation level of the family. • Frequency of sessions is less important than time in therapy (over time, clients may have longer time between sessions). Increased time between sessions may reduce dependency. • Time frame for evaluating change: • Bowen suggested that it takes four years to help a family so that multigenerational patterns will not automatically continue to the next generation -- an four years is not a guarantee. • Two criteria for evaluating fundamental change in a family: • Change associated with one's own family of origin that also influences the nuclear family is likely to be "fundamental" change. • Change associated with adapting to a symptom or symptom bearer is unlikely to last. Dr. Ronald Werner-Wilson