What is Bowenian Family Therapy?

Note: this article was originally published on PsychPage.com by Dr. Richard Niolon, Psychologist and Professor of Psychology (reprinted here with permission)

Introduction

The pioneers of family therapy recognized that current social and cultural forces shape our values about ourselves and our families, our thoughts about what is “normal” and “healthy,” and our expectations about how the world works. However, Bowen was the first to realize that the history of our family creates a template which shapes the values, thoughts, and experiences of each generation, as well as how that generation passes down these things to the next generation.

Bowen was a medical doctor and the oldest child in a large cohesive family from Tennessee. He studied schizophrenia, thinking the cause for it began in mother-child symbiosis, which created an anxious and unhealthy attachment. He moved from studying dyads (two way relationships like parent-child and parent-parent) to triads (three way relationships like parent-parent-child and grandparent-parent-child) afterward. At a conference organized by Framo, one of his students, he explained his theory of how families develop and function, and presented as a case study his own family.

Bowen’s theory focuses on the balance of two forces. The first is togetherness and the second is individuality. Too much togetherness creates fusion and prevents individuality, or developing one’s own sense of self. Too much individuality results in a distant and estranged family.

Bowen introduced eight interlocking concepts to explain family development and functioning, each of which is described below.

Differentiation of Self

The first concept is Differentiation of Self, or the ability to separate feelings and thoughts. Undifferentiated people can not separate feelings and thoughts; when asked to think, they are flooded with feelings, and have difficulty thinking logically and basing their responses on that. Further, they have difficulty separating their own from other’s feelings; they look to family to define how they think about issues, feel about people, and interpret their experiences.

Differentiation is the process of freeing yourself from your family’s processes to define yourself. This means being able to have different opinions and values than your family members, but being able to stay emotionally connected to them. It means being able to calmly reflect on a conflicted interaction afterward, realizing your own role in it, and then choosing a different response for the future.

Triangles

Triangles are the basic units of systems. Dyads are inherently unstable, as two people will vacillate between closeness and distance. When distressed or feeling intense emotions, they will seek a third person to triangulate.

Think about a couple who has an argument, and afterward, one of the partners calls their parent or best friend to talk about the fight. The third person helps them reduce their anxiety and take action, or calm their strong emotions and reflect, or bolster their beliefs and make a decision.

People who are more undifferentiated are likely to triangulate others and be triangulated. People who are differentiated cope well with life and relationship stress, and thus are less likely to triangulate others or be triangulated.

Think of the person who can listen to the best friend’s relationship problems without telling the friend what to do or only validating the friend’s view. Instead, the differentiated person can tell the best friend “You know, you can be intimidating at those times…” or “I agree with you but you won’t change your partner; you either have to learn to accept this about them, or have to call this relationship quits…”

The Nuclear Family Emotional Processes

These are the emotional patterns in a family that continue over the generations.

Think about a mother who lived through The Great Depression, and taught her daughter to always prepare for the worst case scenario and be happy simply if things are not that bad. The daughter thinks her mother is wise, and so adopts this way of thinking. She grows up, has a son, and without realizing it, models this way of thinking. He may follow or reject it, and whether he has a happy or distressed relationship may depend on the kind of partner he finds.
Likewise, think of a daughter who goes to work for her father, who built his own father’s small struggling business into a thriving company. He is seen in the family as a great businessperson as he did this by taking risks in a time of great economic opportunity. He teaches his daughter to take risks, “spend money to make money,” and assume a great idea will always be profitable. His daughter may follow or reject her father’s advice, and her success will depend on whether she faces an economic boom or recession.

In both cases, the parent passes on an emotional view of the world (the emotional process), which is taught each generation from parent to child, the smallest possible “unit” of family (the nuclear unit). Reactions to this process can range from open conflict, to physical or emotional problems in one family member, to reactive distancing (see below). Problems with family members may include things like substance abuse, irresponsibility, depression….

The Family Projection Process

This is an extension of The Nuclear Family Emotional Process in many ways. The family member who “has” the “problem” is triangulated and serves to stabilize a dyad in the family.

Thus, the son who rejects his mother’s pessimistic view may find his mother and sister become closer, as they agree that he is immature and irresponsible. The more they share this view with him, the more it makes him feel excluded and shapes how he sees himself. He may act in accord with this view and behave more and more irresponsibly. He may reject it, constantly trying to “prove” himself to be mature and responsible, but failing to gain his family’s approval because they do not attribute his successes to his own abilities (“He was so lucky that his company had a job opening when he applied…” or “It’s a good thing the loan officer felt sorry for him because he couldn’t have managed it without that loan…”). He might turn to substance abuse as he becomes more and more irresponsible, or as he struggles with never meeting his family’s expectations.
Similarly, the daughter who faces harsh economic times and is more fiscally conservative than her father is seen by the parents as too rigid and dull. They join together to worry that she’ll never be happily married. She might accept this role and become a workaholic who has only superficial relationships, or reject it and take wild risks that fail. In the end, she may become depressed as she works more and more, or as she fails to live up to her father’s reputation as a creative and successful business person.

The family member who serves as the “screen” upon which the family “projects” this story will have great trouble differentiating. It will be hard for the son or daughter above to hold their own opinions and values, maintain their emotional strength, and make their own choices freely despite the family’s view of them.

The Multigenerational Transmission Process

This process entails the way family emotional processes are transferred and maintained over the generations. This captures how the whole family joins in The Family Projection Process, for example, by reinforcing the beliefs of the family. As the family continues this pattern over generations, the also refer back to previous generations (“He’s just like his Uncle Albert – he was always irresponsible too” or “She’s just like your cousin Jenny – she was divorced four times.”).

Sibling Position

Bowen stressed sibling order, believing that each child had a place in the family hierarchy, and thus was more or less likely to fit some projections. The oldest sibling was more likely to be seen as overly responsible and mature, and the youngest as overly irresponsible and immature for example.

Think of the oldest sibling who grows up and partners with a person who was also an oldest sibling. They may be drawn to each other because both believe the other is mature and responsible.
Alternately, an oldest sibling might have a relationship with someone who was a youngest sibling. When one partner behaves a certain way, the other might think “This is exactly how my older/younger sibling used to act.”

Emotional Cutoff

This refers to an extreme response to The Family Projection Process. This entails a complete or almost-complete separation from the family. The person will have little, if any, contact, and may look and feel completely independent from the family. However, people who cut off their family are more likely to repeat the emotional and behavioral patterns they were taught.

In some cases, they model the same values and coping patterns in their adult family that they were taught in their childhood family without realizing it. They do not have another internal model for how families live, and so it is very hard to “do something different.” Thus, some parents from emotionally constrained families may resent how they were raised, but they do not know how to be “emotionally free” and raise a family as they believe other families would.
In other cases, they consciously attempt to be very different as parents and partners; however, they fail to realize the adaptive characteristics of their family and role models, as well as the compensatory roles played in a complex family. Thus, some parents from emotionally constrained childhood families might discover ways to be “emotionally unrestrained” in their adult families, but may not recognize some of the problems associated with being so emotionally unrestrained, or the benefits of being emotionally constrained in some cases. Because of this, Bowen believed that people tend to seek out partners who are at about the same level of individuation.

Societal Emotional Processes

These processes are social expectations about racial and class groups, the behaviors for each gender, the nature of sexual orientation… and their effect on the family. In many ways, this is like The Family Projection Process scaled up to the level of a society as a whole. Families that deal with prejudice, discrimination, and persecution must pass on to their children the ways they learned to survive these factors. The coping practices of the parents and extended family may lead to more or less adaptive emotional health for the family and its members.

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 neighborhood to a very different neighborhood, 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.

Goals of Therapy

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.

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.