Transgenerational - Bowen Family Therapy

Question 1

According to Bowen, How do we make functional decisions?

Answer 1

Balancing and differentiating between the feeling guidance system (emotions, instincts, reactions), and the intellectual/reasoning guidance system (logic, rational thought).

Question 2

What did Bowen believe about anxiety?

Answer 2

Anxiety:
- Moves through a system from one person to the next
- Creates relational tension
- Impairs our ability to think & reason
- Leads to many presenting problems

Question 3

What did Bowen believe about togetherness vs separateness?

Answer 3

Togetherness is a force that leads us to be with others, seek approval and become attached to others

Separateness is an opposing force that leads us to have our own beliefs, be independent, and not be smothered by others.

People strive to balance these; if we strike a balance, we can be close to our loved ones without losing our sense of self. This is called differentiation.

Question 4

What is differentiation?

Answer 4

Differentiation of self is the ability to separate cognitive and emotional functioning. This idea came from Murray Bowen.

People who are differentiated are aware of their emotions vs. reason, and can choose to be led by one or the other.

They can also differentiate themselves from others and don’t get wrapped up in other peoples’ emotions, expectations, etc.

People who are differentiated can have intimacy with others while also being separate and individuated.

Differentiation is a continuum: psychotic and neurotic symptoms are a degree of impairment at the lowest end of the scale of differentiation.

The process of differentiation never ends.

Question 5

What affects differentiation, according to Bowen?

Answer 5

• Your FOO
• Current level of stress
• Whether you are the “symptom bearer” in the family
• Learned coping skills you employ

Question 6

How fixed is a person’s level of differentiation, according to Bowen?

Answer 6

Differentiation is relatively fixed for life, Bowen believed. You can raise it by:

• Managing emotional reactivity
• Detriangulating from your FOO, esp your parents

Question 7

Who created the idea of triangulation?

Answer 7

Dr. Murray Bowen

Question 8

What is triangulation?

Answer 8

The process of the predictable, patterned moves of emotional forces between any three people.

As the emotional flow and counterflow in an anxious twosome increase, it naturally triangles the most vulnerable other person into the twosome, either by pulling in the third person, or by overflowing onto the third person, or by attracting a third person to initiate the involvement. This stabilizes the twosome, initially increasing their stress tolerance and calming anxiety.

There may be interlocking triangles. Triangles in families live on, embedded in emotional patterns that continue across generations, with new family members taking on ancestor’s functional roles/positions within triangles.

Within triangles there are inside positions and outside positions.

One person may be more aware of tensions in a twosome or triangle.

Question 9

Can triangulation be functional?

Answer 9

Yes. Bowen believes that functional triangles solve problems, while dysfunctional ones perpetuate problems. The difference is in differentiation, emotional awareness, and coping skills.

Bowen posited that the triangle is the smallest stable relationship system, because a two-person relationship operates under a constant push-pull of differing togetherness, separateness, and needs, and has a low tolerance for anxiety.

An unstable twosome can be stabilized by the addition or removal of a third person.

Question 10

What are goals of Bowenian therapists?

Answer 10

- Increase client insight: how current behavior is connected to multigenerational processes
- Teach clients how family systems work so clients can understand their own family
- Increase clients’ differentiation: balance of independence and interconnectedness. A balance of high intimacy & high autonomy is ideal
- Help clients become more independent
- Help clients take responsibility for self: learn to change self, not others
- Increase intimacy one-on-one with important others
- Detriangulation
- Reduce emotional reactivity to chronic anxiety in system: Promote self soothing so clients can respond thoughtfully instead of react
- Help clients communicate needs in a differentiated way

Question 11

Who are the founders & leaders of Bowen therapy?

Answer 11

• Murray Bowen – founder/director of the Georgetown Family Center in Washington, DC (1975), now called the Bowen Center
• Michael Kerr (works with natural systems), the subsequent director of Bowen Center
• Edwin Friedman
• Walter Toman (foundational ideas about sibling position)
• Dr. Philip Guerin; collaborated w/Bowen; created “Bowenian” therapy

Question 12

What is the role of the therapist in Bowen therapy?

Answer 12

• Coach (providing objective input)
• Educator
• Expert - not a collaborator
• The therapist is part of the system, but neutral, non-anxious and differentiated - Models differentiation
• Be aware of own reactivity & differentiation
• Stay emotionally de-triangulated (the “I position”) & model this to clients
• Therapist is not directive or confrontational, but coaxes clients to increase their understanding; this then creates change

Question 13

What does the therapist assess in Bowen therapy?

Answer 13

• Emotional reactivity
• Degree of differentiation, autonomy, enmeshment
• Ways that people manage anxiety
• Family themes
• Triangles
• Repeating generational patterns

The genogram is used as an assessment tool.

Question 14

How does change happen in Bowen therapy?

Answer 14

Change occurs when each client achieves a reasonable level of understanding of family history, their own role, and the roles of others. This allows client to change and differentiate. Key is therapist’s use of self.

• Anxiety is reduced through separation of thoughts & emotions (cognitive awareness)
• Reduced anxiety leads to responsive (not reactive) thoughts & actions, changed affect, and changed relationships
• When we think & respond, change occurs (planning thinking). When you know how you’d like to behave, you can plan it, making it easier to change actions.

Question 15

What are self of the therapist considerations in Bowen therapy?

Answer 15

SOTT is important in this model
- The differentiated, calm therapist with a “nonanxious presence” is a key tool.
- Therapists MUST be differentiated to recognize & reduce reactivity. Clients can only become as differentiated as we are.
- Thus, therapists need coaching to increase our own differentiation
- Therapists don’t need to join the system (this contrasts with notes in role of the therapist…)

Question 16

When does termination of therapy happen in Bowen therapy?

Answer 16

Clients decide when they have worked enough on the presenting issue. Therapy can be ongoing because we are never fully differentiated.

Question 17

What are key interventions in Bowen therapy?

Answer 17

• Use a Genogram - as both an assessment & change tool
• Ask Qs designed to reveal family function, patterns, & history
• Work with most motivated & differentiated person in family
• Help clients plan for intense situations
• Introduce process questions with self-focus: “How do you think about this?” “How does that work?”
• Ask family members about reactions to conversations they heard between therapist & other family members
• Detriangulating one-on-one relationships
• Psychoeducation about how emotional systems work
• Decrease emotional reactivity (can use humor) and increase thoughtful responses.
• Coach Cts on changing own patterns in FOO
• Therapist (calm + differentiated) enters triangle with Cts

Question 18

What are Relational Experiments in Bowen therapy?

Answer 18

Behavioral homework assignments designed to reveal and change unproductive relational processes

Question 19

What is Going Home Again in Bowen therapy?

Answer 19

The ability for clients to maintain stronger and clearer sense of self in their nuclear family (higher differentiation)

Question 20

What are some assumptions of Bowen therapy?

Answer 20

• People have inherent potential for growth and change
• The past is currently influencing the present
• Change happens as Cts become more & more differentiated
• Differentiation is a continuum and the process never ends
• Anxiety inhibits change & must be reduced
• A balance of high intimacy & high autonomy is ideal
• Emotions are a physiological process. Feelings are the thoughts that name and mediate emotions and give them meaning.
• Symptoms are indicators of stress, anxiety, & lower differentiation
• Stress can make anyone symptomatic. More differentiated ppl can withstand more stress and recover more quickly.
• Families naturally have interlocking triangles as a reaction to stressors, to relieve anxiety between dyads

Question 21

What is the relevance of sibling position in Bowen therapy?

Answer 21

Bowen believed that people who grow up in the same sibling position predictably have important common characteristics. For example, oldest children tend to gravitate to leadership positions and youngest children often prefer to be followers. The characteristics of one position are not “better” than those of another position but are complementary.

Bowen theory on sibling position incorporates the research of psychologist Walter Toman. Bowen observed the impact of sibling position on development and behavior in his family research. However, he found Toman’s work so thorough and consistent with his ideas that he incorporated it into his theory.

Question 22

What are the 4 ways people respond to/manage anxiety, in Bowen therapy?

Answer 22

• Conflict
• Personal dysfunction
• Triangulation
• Distance

Question 23

What is the concept of “undifferentiated family ego mass,” in Bowen therapy?

Answer 23

“A conglomerate emotional oneness that exists in all levels of intensity” (1966, p. 355). “On one level each family member is an individual, but on a deeper level, the central family group is as one.”

Question 24

What is the concept of “societal emotional process” in Bowen therapy?

Answer 24

The concept of societal emotional process describes how the emotional system governs behavior in whole societies. Cultural forces are important in how a society functions but are insufficient to explain the ebb and flow in how well societies adapt to the challenges they face.

The triangulation process plays out in society: emotional tension grows between two groups; emotionally vulnerable others are involved and anxiety spreads; emotional reactivity, defensiveness, and counterattacks feed the anxiety; emotional energy is spent, and the system calms.

Question 25

What is the concept of “Family projection process,” in Bowen therapy?

Answer 25

The family projection process describes the primary way parents transmit their emotional problems to a child: Differentiation levels are transmitted across generations (within the nuclear family).

The projection process follows three steps:

(1) the parent focuses on a child out of fear that something is wrong with the child;
(2) the parent interprets the child’s behavior as confirming the fear; and
(3) the parent treats the child as if something is really wrong with child.

These steps of scanning, diagnosing, and treating begin early in the child’s life and continue. The parents’ fears and perceptions so shape the child’s development and behavior that she grows to embody their fears and perceptions. One reason the projection process is a self-fulfilling prophecy is that parents try to “fix” the problem they have diagnosed in the child. For example, perceiving a child to have low self-esteem, parents repeatedly try to affirm the child, and the child’s self-esteem grows dependent on their affirmation.

The projection process can impair the functioning of one or more children and increase their vulnerability to clinical symptoms. Children inherit many types of problems (as well as strengths) through their relationships with their parents, but the problems they inherit that most affect their lives are relationship sensitivities such as heightened needs for attention and approval, difficulty dealing with expectations, the tendency to blame oneself or others, feeling responsible for the happiness of others or that others are responsible for one’s own happiness, and acting impulsively to relieve the anxiety of the moment rather than tolerating anxiety and acting thoughtfully. If the projection process is fairly intense, the child develops stronger relationship sensitivities than his parents. The sensitivities increase the person’s vulnerability to symptoms by fostering behaviors that escalate chronic anxiety in a relationship system.

Question 26

What is the Multigenerational Transmission Process, in Bowen therapy?

Answer 26

Summary: Emotional processes are passed down generation to generation

Multigenerational transmission process is one of the 8 core concepts in Bowen’s Family Systems Theory. This concept refers to the similarities of learned, taught, and genetic behaviors transmitted across generations through relationships. Transmission can occur on a number of levels including conscious or subconscious teaching of emotion regulation and behavior to genetic inheritances of certain tendencies or behavioral patterns. Children innately respond to the emotions of their parents and will develop patterns of emotional response and expression based on their relationship with their caregivers.

Question 27

What is chronic anxiety in Bowen therapy?

Answer 27

Automatic physical and emotional reactions that aren’t mediated through conscious/logical processes

Question 28

What is the concept of emotional cutoff, in Bowen therapy?

Answer 28

The concept of emotional cutoff describes how people manage their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them. Emotional contact and conflict can be reduced by moving away from family and rarely going home, or it can be reduced by staying in physical contact with family but avoiding sensitive issues.

This is an instinctive biological process that acts like an emotional safety valve in relationships. A person enforces a rigid boundary to avoid a stressful relationship; represents lack of differentiation (i.e., fusion), and unresolved emotional attachment to the object of cutoff. Relationships may look “better” if people cutoff to manage them, but the problems are dormant, not resolved. Plus it may create a problem by separating people from important relationships and intensifying fusion in remaining relationships.

Question 29

What is “nuclear family emotional process” in Bowen therapy?

Answer 29

The concept of nuclear family emotional process describes four basic relationship patterns that govern where problems develop in a family. These basic relationship patterns result in family tensions coming to rest in certain parts of the family. The more anxiety one person or one relationship absorbs, the less other people must absorb. This means that some family members maintain their functioning at the expense of others.

The patterns operate in intact, single-parent, stepparent, and other nuclear family configurations.

The four basic relationship patterns are:

• Marital conflict – As family tension increases and spouses get more anxious, each spouse externalizes his or her anxiety into the marital relationship. Each focuses on what is wrong with the other, tries to control the other, and resists the other’s efforts at control.
• Dysfunction in a spouse – One spouse pressures the other to think and act in certain ways, and the other yields to the pressure. Both spouses accommodate to preserve harmony, but one does more of it. The interaction is comfortable for both people up to a point, but if family tension rises further, the subordinate spouse may yield so much self-control that his or her anxiety increases significantly. If other necessary factors are present, the anxiety fuels the development of a psychiatric, medical, or social dysfunction.
• Impairment of one or more children – The spouses focus their anxieties on one or more of their children. They worry excessively and usually have an idealized or negative view of the child. The more the parents focus on the child, the more the child focuses on them. He is more reactive than his siblings to the parents’ attitudes, needs, and expectations. The process undercuts the child’s differentiation from the family and makes him vulnerable to act out or internalize family tensions. The child’s anxiety can impair his school performance, social relationships, and even his health.
• Emotional distance – This pattern is consistently associated with the others. People distance from each other to reduce the relationship intensity but risk becoming too isolated.

Question 30

What is reciprocal functioning, in Bowen Therapy?

Answer 30

The process of one person borrowing strength at the expense of another member’s functioning.

Relationships often have predictable patterns of over/underfunctioning, with people playing complementary and predictable roles: decisive/indecisive, dominant/submissive, etc. The presence of one trait in one family member can predict the presence of its complement in another family member.

Question 31

How does Bowen’s systems thinking differ from General Systems Theory?

Answer 31

Bowen’s systems thinking is built on facts gained through direct observation of the family, while general systems theory attempts to apply mathematical set/subset models to behavioral, social, and physical sciences. Bowen saw these as very different.

Question 32

What systems are interrelated within a person, in Bowen’s systems thinking?

Answer 32

• The Emotional system encompasses all evolutionary and instinctual functioning. Emotions are constantly activated by reactions to internal/external sensory inputs. This system incorporates all guidance systems that direct life: instinct, reproduction, subjective emotional and feeling states, and interaction with relationship systems.
• The Intellectual system directs our ability to think, reason, and reflect
• The Feeling system bridges between the emotional and intellectual systems, and attaches meaning to emotional reactions

Reality becomes the interaction of what goes on inside humans, and between humans (Relationship systems).

Question 33

What are the 8 interlocking concepts of Bowen Family Systems Theory?

Answer 33

1. Differentiation of Self
2. Triangles / triangulation
3. Nuclear Family Emotional System
4. Family Projection Process
5. Multigenerational Transmission Process
6. Sibling Position
7. Emotional Cutoff
8. Societal Emotional Process

Question 34

What is triangulation?

Answer 34

Predictable, patterned moves of emotional forces between any three people: a dyad draws in a third person to alleviate anxiety/tension.

As the emotional flow and counterflow in an anxious twosome increase, it naturally triangles the most vulnerable other person into the twosome, either by pulling in the third person, or by overflowing onto the third person, or by attracting a third person to initiate the involvement. This stabilizes the twosome, initially increasing their stress tolerance and calming anxiety.

There may be interlocking triangles. Triangles in families live on, embedded in emotional patterns that continue across generations, with new family members taking on ancestor’s functional roles/positions within triangles.

Within triangles there are inside positions and outside positions.

One person may be more aware of tensions in a twosome or triangle.

Question 35

What is the pseudo-self and solid self, in Bowen Family Systems Therapy?

Answer 35

The Pseudo-Self defines self in terms of others, and defines others in terms of self. This person alters or adopts principles and beliefs without thought, for the sake of relationships. They are unstable: emotional pressure affects them greatly. They blame others for consequences of their own personal choices. The pseudo-self is created within families marked by fusion, as people give up or rearrange their authentic self for the sake of togetherness.

The solid self knows who they are, what they believe and stand for, and what they will and won’t do. They act on their own clearly defined principles and beliefs, even under stress. They assume responsibility for their own actions/choices and have integrity of word/action. They are stable and well-differentiated.

Question 36

What kind of clients benefit from Bowen Family Therapy?

Answer 36

• Clients whose family members have anxious relationships within their families on various issues, or secrecy
• Clients with emotional cutoffs
• Clients with marital issues, anxiety, anger, depression, sexual abuse, and other family conflicts - to identify emotional relationship patterns to gain insight

NOT good for clients who don’t want to look at painful pasts, or who want therapy to progress quickly without getting into the “whys,” or clients who blame family members for their issues.

Question 37

What are the steps of Bowen Family Therapy?

Answer 37

• Phase 1 - Joining & building rapport (initial Genogram)
• Phase 2 - Understanding the presenting issue
• Phase 3 - Assessing Family Dynamics (add to Genogram)
• Phase 4 - Developing Goals:
  –Putting presenting problem in multigenerational context
  –Decreasing anxiety
  –Detriangulation
  –Increasing differentiation
• Phase 5 - Amplifying Change through increasing understanding of family patterns & functioning
• Phase 6 - Termination

Question 38

What does a well-differentiated person do in relation to sibling position?

Answer 38

Demonstrate expected characteristics for their place in the birth order

Question 39

What is Family-of-Origin Therapy?

Answer 39

Three-stage model for couples involving:
- Couples therapy
- Group couples therapy
- Sessions with family-of-origin

Question 40

What are Bowen’s 8 Core Concepts?

Answer 40

• Differentiation of self
• Triangles
• Cutoff
• Sibling Position
• Nuclear Family Emotional System
• Family Projection Process
• Multigenerational Transmission Process
• Societal Emotional Process