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Bowenian Family Therapy
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  • 1. Bowenian Family TherapyOverview of CE Course Created by Eric Lyden, M.A., M.F.T for Practical CE Seminars To complete the full CE course, visit: www.practicalceseminars.com
  • 2. OBJECTIVES• Explore the fundamentaltenets, assessmentissues, goals and interventionsofBowenian Family Therapy.• Discuss the usefulness ofBowenian Family Therapy inactual practice, especially inthe context of managed care. Practical CE Seminars
  • 3. FUNDAMENTAL TENETS• Works well with individuals, couples and families• Longer term approach• Depth-oriented approach• Bowen advocated for at least 4 years of therapy although aspects of Bowen’s approach can be applied in 5 or 10 sessions Practical CE Seminars
  • 4. FUNDAMENTAL TENETS• Bowen would use a Genogram, which was an assessment tooland a treatment tool•You can integrate interventions from other theories, as long asthey serve to meet the primary goal of Bowenian theory• So, if you do an experiential technique, explain how that wouldwork to raise your client’s level of self-differentiation, the longterm goal of Bowen therapy Practical CE Seminars
  • 5. FUNDAMENTAL TENETS• Bowen was not as interested in labels, especially indiagnostic labels.• He believed that by alleviating the anxiety in thesystem, by raising the differentiation, that thesymptomology itself within the system would be alleviatedas well. Practical CE Seminars
  • 6. MURRY BOWEN•Medical doctor• Trained as an analyst during his studies with hospitalizedschizophrenics in the 40’s and 50’s• He integrated many aspects of systems theory• Extended Family Systems Therapy, which he developed, is really aresult of his psychodynamic training and elements of original systemstheory• As a therapist he acted as a coach and an educator, which is areflection of his process Practical CE Seminars
  • 7. ASSESSMENT, GOALS AND INTERVENTIONS• Assessment = how you diagnoseaccording to your theory• Goals = what you want toaccomplish (always start with verbs, e.g., Raise the level of self-differentiation)• Interventions = techniques used to accomplish the goals (e.g., Genogram) Practical CE Seminars
  • 8. ASSESSMENT ISSUESBowen’s assessment issues = his way of describing a situation, a family, and thedynamics within a family 1. He took an extensive family history by interviewing each member of the family 2. He constructed a detailed Genogram. (Depending on the family, he might even have them each construct their own Genograms.) 3. The Genogram is the primary means of gathering information. This is a family tree, constructed by the client(s), which goes back three generations and highlights names and pertinent information, as well as dysfunction that could be repeating itself generationally. Practical CE Seminars
  • 9. BOWEN’S INTERLOCKING CONCEPTS These are the core issues that form the basis of this theory 1. Self-Differentiation 2. Emotional Triangles 3. Nuclear Family Emotional System 4. Family Projective Process 5. Emotional Cut-off 6. Multigenerational Transmission Process 7. Societal Regression 8. Sibling Position Practical CE Seminars
  • 10. SELF-DIFFERENTIATION• It is the ability to separate thoughts and feelings• This can be both an interpersonal as well as an inter-psychicprocess• Differentiation is the ability to take a more neutral position• With higher differentiation, if a person says something toyou, you are able to hold that thought as a cognition and notallow it to turn to a feeling• Every other concept in Bowenian Family Therapy basicallygets back to self-differentiation Differentiation-of-self scale 0 25 50 75 100 Fusion Self-Differentiation Practical CE Seminars
  • 11. FUSION• The lower the individuals level of differentiation, the greater the likelihood that he/she will be unable to differentiate him/herself from other family members• This causes him or her to become "fused" with the emotions that dominate other family members• When an entire family is fused it is called an undifferentiated family “ego mass.”• This is a term used by Bowen to describe the emotional "stuck-togetherness" of families that have inadequate interpersonal boundaries Practical CE Seminars
  • 12. EMOTIONAL REACTIVITY• When people don’t RESPOND, they REACT• The lower a person’s level of self-differentiation, thegreater their likelihood to be emotionally reactive Practical CE Seminars
  • 13. EMOTIONAL TRIANGLES• Bowen thought of family groupings of three individuals as the“molecules” or “building blocks” of the family • Emotional triangles develop their own rules • Bowen also believed that the more one person tried to change two other people, or one person and his or her habit, the more that person reinforced the relationship Practical CE Seminars
  • 14. NUCLEAR FAMILY EMOTIONAL SYSTEM• A family’s coping mechanisms• Or the means it has to deal with tension and instability• Some of these means are dysfunctional, such as poorcommunication between spouses or triangulation of achild Practical CE Seminars
  • 15. FAMILY PROJECTIVE PROCESS• A chronic process of triangulation of the mostvulnerable child• This may be the youngest child, the weakest oreven the oldest• This process creates a lowerlevel of differentiation in thetargeted child Practical CE Seminars
  • 16. EMOTIONAL CUTOFF• A stage of “pseudo-differentiation”• A person may appear to bedifferentiated but actually has manyunresolved issues and difficultyseparating thoughts and feelings• A person does not have to be physically cutoff from his or her family of origin to be emotionally cutoff Practical CE Seminars
  • 17. MULTIGENERATIONAL TRANSMISION PROCESS • Bowen believed that family dysfunction is passed on generationally • Lower levels of differentiation are therefore created by the multigenerational transmission process • An individual with a certain level of differentiation seeks out a spouse with a similar level of differentiation•They have children with lower levels of differentiation, and then they havechildren with lower levels of differentiation, etc.• Bowen originally stated that it took three generations to create a schizophrenic; later he changed that to ten generations and he expanded that to other pathologies Practical CE Seminars
  • 18. SOCIETAL REGRESSION• Bowen also referred to thisas the “process of society”• He hypothesized that thesame principles that apply tothe emotional system withinthe family can be applied tosociety at large. Practical CE Seminars
  • 19. SIBLING POSITION• Bowen borrowed the term “sibling position profile” fromWalter Toman (1961)• Toman spoke of how spouses deal with issues according tohow they dealt with their siblings• There are “typical” behaviors that areexpressed by individuals according totheir sibling position• The child who is a part of the familyprojective process is alwaysinfantilized, regardless of sibling position Practical CE Seminars
  • 20. NUCLEAR FAMILY SYSTEM• Bowen believed that most families sought help whendysfunction surfaced in one or more of the three mainstress areas of the nuclear family system: 1) Marital conflict 2) Dysfunction in a spouse, or 3) Dysfunction in a child Practical CE Seminars
  • 21. Marital Conflict1. Results from one spouse showing more passivity under pressure than the other. This spouse is typically more dependent and often more symptomatic, and is called “overadaptive.”2. The other spouse is referred to as “overfunctional.” This spouse is often unaware that the other is symptomatic, is higher functioning and has a higher level of self-differentiation.3. Together, this relationship has been referred to as a “dysfunctional reciprocal relationship.” (Other forms of dysfunctional reciprocal relationships include overadequate/ underadequate, passive/aggressive and distancer/pursuer.)4. This can lead to fusion. Practical CE Seminars
  • 22. UNDIFFERENTIATED FAMILY EGO MASS• A conglomerate emotionaloneness that exists in all levelsof intensity•These relationships arecyclical, in that they can shiftfrom anxiety, or a state wherethe members are repellingeach other, to extremecloseness Practical CE Seminars
  • 23. TRIANGLES • Triangles are often used to “balance” the undifferentiated ego mass • Bowen described the triangle as the “basic building block” of the family • In essence, two family members recruit a third one to “siphon off” their anxiety onto Practical CE Seminars
  • 24. ROLE OF THE THERAPIST-11. The therapist is neutral, encouraging the family members to speak through the therapist rather than to each other. He or she is a coach, in that he teaches “differentiation moves,” or ways for the client to maintain his or her own state of neutrality. And finally the therapist acts as an educator by continually teaching the family about family systems dynamics. Practical CE Seminars
  • 25. ROLE OF A THERAPIST-22. Thinking in terms of the system and not theemotionality or the content is important, which meansthat the therapist must have a high degree ofdifferentiation. The therapist must be high functioning inthe sense that he or she can separate thoughts fromfeelings and manage emotionalreactivity. In addition, he or shemust have a healthy separationfrom his or her family of origin. Practical CE Seminars
  • 26. ROLE OF A THERAPIST-33. The therapist is a coach and aneducator, teaching the clients about family systemsdynamic, differentiation and the multigenerationaltransmission process. Teaching is a critical elementof Bowenian family therapyand the role of educator isimportant to the successof the approach. Practical CE Seminars
  • 27. GOALS-SHORT TERM1. Bowen uses the Genogram to gather information and offer insight into patterns of multigenerational relationships Practical CE Seminars
  • 28. GOALS-INTERMEDIATE1. Increase the level of self-differentiation of each family member2. Reduce emotional reactivity3. Help each family member detriangulate from his or her family of origin4. To “detriangle” pre-established three person systems in steps Practical CE Seminars
  • 29. GOALS - LONG-TERM1. Self-differentiation and the development of solid self2. Transition client from therapy to other environment and educate them that differentiation is a lifelong process3. Aid client in bridging his or her emotional cutoffs without being pulled back into repeating old patterns in relationship Practical CE Seminars
  • 30. INTERVENTIONS- EARLY STAGE1. Genogram2. Begin to discuss generational patterns3. Lessen emotional reactivity4. Objectivity Practical CE Seminars
  • 31. INTERVENTIONS- MIDDLE STAGE1. Coaching2. Therapeutic Triangles3. Taking “I position” stands4. Marital psychotherapy5. Individual therapy Practical CE Seminars
  • 32. INTERVENTIONS- LATE STAGE1. Education is important throughouttherapy, but in the final stage it can helpthe clients with transition. It’s importantto emphasize that differentiation is alifelong process.2. Reaffirming that differentiation isa lifelong process and that the clienthas gain a deeper understanding ofhim- or herself that facilitate his or herability to continue the process. Practical CE Seminars
  • 33. Summary Bowenian Family Therapy can be used with individuals, couples or families It is a long-term therapeutic approach Differentiation, or the ability to separate thoughts from feelings both intra-psychically and inter-personally, is the core concept of Bowenian Family Therapy When working with couples, Bowen would always have each individual talk “through” him, rather than “to” each other The primary “intervention” in Bowenian Family Therapy is the Genogram Therapy is complete when each member of the family has successfully raised his or her level of differentiation Practical CE Seminars
  • 34. To Learn More about Bowen Family therapy andearn CE credits visit us at: Practical CE Seminars practicalceseminars@holmangroup.com Practical CE Seminars