TRANSGENERATIONAL FAMILY THERAPIES Çilen UĞURAL

Transgenerational approaches to family therapy have grown out of the work of such pioneers as Murray Bowen, Ivan Boszormenyi-Nagy, James Framo, Norman Paul, and Donald Williamson. These theorists share the belief that; present day problems are related to issue in a person’s family of origin. Although their theories and practice may differ, all agree that the royal road to problem resolution involves working with more than one generation in therapy.

A common misconception is that these models espouse a linear approach, in which people’s problems are “caused by their families of origin”. In fact, all of these are larger systems models that view problems as being maintained in ongoing patterns that span generations.

MURRAY BOWEN Bowen conducted clinical studies at the National Institute of Mental Health (NIMH) in which entire families lived on a psychiatric ward with their family members. He noticed the patients and their parents acted in predictable interactional patterns. Anxiety could often be transmitted from one family member to another, and even to other staff members working on the unit. In fact, a family’s anxiety often subsided as various members of the unit staff began to take on the anxiety for them. These observations led Bowen to develop a systems concept for schizophrenia and other disorders.

Bowen’s ideas evolved through his attempt to bridge the dichotomy between the social and the biological sciences. He developed a model that moves beyond explaining how families resolve problems to a broadscale theory that attempts to explain humanity’s relationship to other natural systems. A core assumption of Bowen Systems Theory is that; families and other natural systems respond in organized, patterned behaviors. This instinctual organizing into repetitive patterns is called the emotional system.

Bowen coined the term “differentiation” to address the lifelong process individuals go through to define the self within the family emotional system. Individuals with low levels of differentiation respond in patterned behaviors learned within their families of origin. Those more differentiated individuals are capable of more independent thought and feelings. Differentiation is both an individual and a family phenomenon. Low levels of family differentiation are often maintained in families through the process of emotional cutoff.

Triangles are the basic building blocks of an emotional system and serve to connect individuals to each other. As anxiety builds between two members of a family, a third individual is involved to stabilize the relationship or bind the anxiety. Triangles and emotionality may be passed down from generation to generation. This is called the multigenerational transmission process. Those children most triangled into parental anxiety have lower levels of differentiation than their siblings.

A critical goal of Bowen Therapy is to help individuals differentiate from their family’s emotional “togetherness”. This is accomplished through teaching individuals about family triangles and coaching them to stay outside of them. Bowen found that helping adult family members differentiate from their own families of origin often has surprisingly positive effects on the patients’ relationships with their spouse and children. His findings have led to the use of family-of-origin procedures as the treatment of choice for most family problems.

KEY CONCEPTS Differentiation of self: One’s emotional and intellectual systems are distinguishable. Differentiation of Self Scale: One’s degree of undifferentiation (no self) is directly correlated with one’s degree of emotional fusion into a common self with others. Emotional cutoff: In the process of separation, isolation, withdrawal, running away, or denying the importance of one’s parental family, dealing with unresolved attachment may be problematic.

Emotional System: Kerr and Bowen believe that all natural systems respond in a patterned, reactive manner. Entitlement: This is the amount of merit a person accrues for behaving in an ethical manner with others. Family Projection Process: According to Bowen, this process in which parents may project part of their immaturity onto one or more of their children. The child who is the object of the projection develops the lowest level of differentiation of self and is more likely to be symptomatic in the future.

Ladger: An accumulation of the accounts of what has been given and what is owed. Legacy: Legacy is a specific configuration of expectations that originate, not from the merit of the parents, but simply from the universal implication of being born of parents. There is a chain of destiny anchored in every parent-child relationship. Loyality: Internalized expectations, injunctions, and obligations in relation to one’s family of origin have powerful interpersonal influences. “What to an outsider may seem like irrational or pathological behavior may, in fact, conform to a basic family loyalty.”

Multigenerational Transmission Process: This is a pattern that develops over several generations, in which children grow up and marry partners with similar levels of differentiation to themselves. Nuclear Family Emotional System: Parental undifferentiation may produce; (1) marital conflict, (2) dysfunction in a spouse, (3) projection to one or more children. Personal Authority in the Family System: When an individual has personal authority, he or she is in charge of his or her own thoughts and opinions, acts freely and responsibly, and maintains appropriate social connection with others.

Relational Ethics: Life is a chain of interlocking consequences between the generation. The behavior of an individual is both rooted in the past and has the ability to affect future generations. Because of this, individuals are ethically responsible for the consequences of their behaviors. Sibling Position: Sibling position is useful in understanding how a particular child is chosen as the object of the family projection process. Societal Regression: What is needed is better differentiation between emotion and intellect, allowing more constructive societal decision to be made. Triangle: A three-person system, the smallest stable relationship system.

KEY CLINICAL SKILLS Coaching: Role in supervising patients and trainees in the process of differentiation of self. The actual work is done by the patient, and the learning comes as the patient works toward his or her goal outside the therapy session. Cross-Confrontation and Self-Confrontation: Clients reactions to the stressor stimuli are aduio or videotaped and are later played back to them as a type of self-confrontation. Detriangling: An individual keeps him or herself outside the emotional field of two others.

Exoneration: A process by which the therapist attempts to help the client see the positive intent and intergenerational loyalty issues behind the behavior of members of previous generations. Genogram: A written symbolic diagram of the family system, the genogram is not unlike a “family tree”. Multidirected Partiality: Therapists keep channels open among all family members and that all solutions serve the best interests of everyone.

Operational mourning: Norman Paul states that “ there is a direct relationship between the maladaptive response to the death of a loved one and the fixity of symbolic relationships within the family. Person-to-person Relationships: Two family members relate personally to each other about each other; they do not talk about others (triangling) and do not talk about impersonal issues.

TRANSGENERATIONAL FAMILY THERAPIES Çilen UĞURAL