1. Bowen Family Systems Therapy Nichols, M. P. & Schwartz, R. C. (2001). Bowen family systems therapy. In M. P. Nichols & R. C. Schwartz, Family therapy: Concepts and methods (5th ed., pp. 137-171). Boston: Allyn and Bacon.

2. Dr. Ronald Werner-Wilson Introduction  Bowen was one of the few early pioneers who paid attention to the larger network of family relationships.  “Bowen family systems therapy has by far the most comprehensive view of human behavior and human problems of any approach to family treatment” (p. 137).

3. Dr. Ronald Werner-Wilson Sketches of Leading Figures  Bowen family systems therapy evolved from psychoanalytic principles and practice.  Bowen was innovative and developed comprehensive ideas.  Bowen was the oldest child from a large family in rural Tennessee.  Many prominent MFTs trained with Bowen, including many feminist therapists such as Betty Carter and Monica McGoldrick.

4. Theoretical Formulations

5. Dr. Ronald Werner-Wilson Differentiation of Self  This is both an intrapsychic and interpersonal concept.  Intrapsychic aspect: ability to separate feeling from thinking. “The differentiated person isn’t a cold fish who only thinks and never feels … he or she is capable of strong emotion and spontaneity, but also capable of the objectivity that comes with the ability to resist the pull of emotional impulses” (p. 140).

6. Dr. Ronald Werner-Wilson Differentiation of Self (cont.)  Interpersonal aspect:  Undifferentiated people react emotionally – positively or negatively – to others.  Undifferentiated people have limited autonomous identity.  Differentiated people are able to take principled stands.  Differentiated people are able to develop intimacy without become reflexively shaped by others.  The process of differentiation promotes personal responsibility.

7. Dr. Ronald Werner-Wilson Triangles  All emotionally significant relationships are shadowed by third parties (including relatives, friends, objects, work, memories).  Relationships are dynamic; there are cycles of closeness of distance. Triangles are likely to develop during times of distance.  In relationships, the partner who experiences the most distress will often connect with someone else as a way to gain an ally.  Sometimes, significant others offer support when they sense anxiety or conflict.

8. Dr. Ronald Werner-Wilson Triangles (cont.)  Triangulation lets off steam, but it freezes conflict in place: “Unburdening yourself to a friend will make you feel better. It will also lessen the likelihood that you’ll engage the problem at its source” (p. 141).  Interlocking triangles are present in systems of more than three.  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 change the relationship of another, the more likely it is that you will reinforce the aspects of the relationship that you want to change.

9. Dr. Ronald Werner-Wilson Nuclear Family Emotional Processes  Undifferentiated people experience difficulty managing anxiety and stress.  Lack of Differentiation X Anxiety = Fusion Between Spouses.  Emotional fusion is unstable. It tends to produce:  overt marital conflict;  reactive emotional distance;  physical or emotional symptoms (usually the more accommodating partner);  projection of problems on to children.

10. Dr. Ronald Werner-Wilson Family Projection Process  Definition: “the process by which parents project part of their immaturity to one or more children” (Bowen, 1978, p. 477).  The child who is the most emotionally attached to parents is likely to be the object of parental projection and, as a result, have lower levels of differentiation (Bowen, 1978).

11. Dr. Ronald Werner-Wilson Multigenerational Transmission Process  This refers to the transmission of a family projection process.  The nature and degree of intensity of emotional responses are passed down from generation to generation (Friedman, 1991).  Levels of differentiation are affected through generations based on levels of differentiation of partners as they marry.

12. Dr. Ronald Werner-Wilson Sibling Position  Belief that personality characteristics are influenced by sibling position. He also believed that family functioning and other variables influenced roles.  Sibling conflict may often be the result of triangular relationships (e.g., coalitions with parents can foster sibling antagonism).

13. Dr. Ronald Werner-Wilson Emotional Cutoff  All people have some degree of unresolved emotional attachment to their parents.  Level of cutoff is influenced by degree of differentiation: there is an attempt to distance by avoiding contact.

14. Dr. Ronald Werner-Wilson Societal Emotional Process  Emotional processes in families influence emotional processes in families.  Social forces (including sexism, racism, poverty) fundamentally influence how families interact with each other.

15. Dr. Ronald Werner-Wilson Normal Family Development  Bowen believed that families varied on a continuum from emotional fusion to differentiation.  Optimal Family Development: thought to take place when  family members are relatively differentiated;  anxiety is low;  parents are in good emotional contact with their own families of origin.  Emotional attachment between spouses often is similar to those from families of origin.  Family development is a process of expansion, contraction, and realignment that supports entry, exit, and development of family members.

16. Dr. Ronald Werner-Wilson Characteristics of Well-adjusted Families (Fogarty, 1976a):  They are balanced and can adapt to change.  Emotional problems are seen as existing in the whole group.  They are connected across generations to all family members.  Minimum use of fusion or distance to solve problems.  Each dyad is capable of dealing with conflict within it.  Differences are tolerated.  There is an awareness of what each person receives from others.

17. Dr. Ronald Werner-Wilson Characteristics of Well-adjusted Families (cont.)  Each person is allowed her/his own emptiness.  Preserving a positive emotional climate is more important than doing what is popular or socially appropriate.  Each member thinks the family is a pretty good place to live.  Members use each other as sources for feedback and learning, not as emotional crutches.

18. Dr. Ronald Werner-Wilson Development of Behavior Disorders  Symptoms develop from stress that exceeds a person’s ability to handle it.  Symptoms are a product of emotional reactivity, acute or chronic.  The ability to deal with stress is influenced by level of differentiation.  Remember, differentiation is not a synonym for maturity.  It reflects both an intrapsychic and interpersonal process. As a result, symptoms also develop when stress exceeds a systems ability to bind or neutralize it.

19. Dr. Ronald Werner-Wilson Goals of Therapy  Trace Family Patterns  Pay attention to processes: patterns of emotional reactivity.  Pay attention to structure: patterns of interlocking triangles.  Goal of therapy: decrease anxiety and increase differentiation of self.  Goals become less specific over time.

20. Dr. Ronald Werner-Wilson Goals of Therapy (cont.)  Guerin’s approach:  Place the presenting problems in multigenerational context by completing a thorough and accurate genogram.  Connect with key family members: work to calm their anxiety and level of emotional arousal so that anxiety throughout the system can be lowered.  Define parameters of the central symptomatic triangle  Feminist approach: address inequality in relationships.

21. Dr. Ronald Werner-Wilson Conditions of Behavior Change  Therapists must be able to tolerate anxiety.  Therapists must practice differentiation and avoid triangulation.  Therapists ask questions to foster self-reflection and direct them to individuals one-at-a-time.  Individuals are encouraged to look for their own role in processes.  Therapy requires an awareness about the entire family (even though it does not need to include the presence of the entire family).  Differentiation requires cultivating a personal relationship with everyone in the extended family.

22. Dr. Ronald Werner-Wilson Techniques  Genogram: family diagram to collect and organize information about the family.  The therapy triangle: therapist should try to remain free of emotional entanglements in order to avoid feel stuck or stalemated.  Relationship experiments: ask clients to try new behaviors and pay attention to the processes.  Coaching: ask process questions designed to help clients cultivate responses.  The “I-Position”: take a personal stance and say what you feel.

23. Dr. Ronald Werner-Wilson Techniques (cont.)  Multiple family therapy: work with multiple couples at once. Observing other couples can be helpful.  Displacement stories: tell stories (or recommend movies) that minimize defensiveness.