Bowenian Family Therapy

Bowenian Family Therapy
Overview 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

OBJECTIVES

• Explore the fundamental
tenets, assessment
issues, goals and interventions
of
Bowenian Family Therapy.

• Discuss the usefulness of
Bowenian Family Therapy in
actual practice, especially in
the context of managed care.

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

FUNDAMENTAL TENETS
• Bowen would use a Genogram, which was an assessment tool
and a treatment tool

•You can integrate interventions from other theories, as long as
they serve to meet the primary goal of Bowenian theory

• So, if you do an experiential technique, explain how that would
work to raise your client’s level of self-differentiation, the long
term goal of Bowen therapy


FUNDAMENTAL TENETS
• Bowen was not as interested in labels, especially in
diagnostic labels.

• He believed that by alleviating the anxiety in the
system, by raising the differentiation, that the
symptomology itself within the system would be alleviated
as well.


MURRY BOWEN
•Medical doctor

• Trained as an analyst during his studies with hospitalized
schizophrenics in the 40’s and 50’s

• He integrated many aspects of systems theory

• Extended Family Systems Therapy, which he developed, is really a
result of his psychodynamic training and elements of original systems
theory

• As a therapist he acted as a coach and an educator, which is a
reflection of his process


ASSESSMENT, GOALS AND
INTERVENTIONS
• Assessment = how you diagnose
according to your theory

• Goals = what you want to
accomplish
(always start with verbs, e.g., Raise the level of self-
differentiation)

• Interventions = techniques
used to accomplish the
goals (e.g., Genogram)

ASSESSMENT ISSUES
Bowen’s assessment issues = his way of describing a situation, a family, and the
dynamics 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.


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


SELF-DIFFERENTIATION
• It is the ability to separate thoughts and feelings
• This can be both an interpersonal as well as an inter-psychic
process
• Differentiation is the ability to take a more neutral position
• With higher differentiation, if a person says something to
you, you are able to hold that thought as a cognition and not
allow it to turn to a feeling
• Every other concept in Bowenian Family Therapy basically
gets back to self-differentiation

Differentiation-of-self scale

0 25 50 75 100
Fusion Self-Differentiation


FUSION
• The lower the individual's 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


EMOTIONAL REACTIVITY
• When people don’t RESPOND, they REACT

• The lower a person’s level of self-differentiation, the
greater their likelihood to be emotionally reactive


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


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 poor
communication between spouses or triangulation of a
child


FAMILY PROJECTIVE PROCESS

• A chronic process of triangulation of the most
vulnerable child

• This may be the youngest child, the weakest or
even the oldest

• This process creates a lower
level of differentiation in the
targeted child


EMOTIONAL CUTOFF
• A stage of “pseudo-differentiation”

• A person may appear to be
differentiated but actually has many
unresolved issues and difficulty
separating thoughts and feelings

• A person does not have to be
physically cutoff from his or her
family of origin to be emotionally
cutoff

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 have
children 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

SOCIETAL REGRESSION

• Bowen also referred to this
as the “process of society”

• He hypothesized that the
same principles that apply to
the emotional system within
the family can be applied to
society at large.


SIBLING POSITION
• Bowen borrowed the term “sibling position profile” from
Walter Toman (1961)

• Toman spoke of how spouses deal with issues according to
how they dealt with their siblings

• There are “typical” behaviors that are
expressed by individuals according to
their sibling position

• The child who is a part of the family
projective process is always
infantilized, regardless of sibling position

NUCLEAR FAMILY SYSTEM
• Bowen believed that most families sought help when
dysfunction surfaced in one or more of the three main
stress areas of the nuclear family system:

1) Marital conflict

2) Dysfunction in a spouse, or

3) Dysfunction in a child


Marital Conflict
1. 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.


UNDIFFERENTIATED FAMILY EGO
MASS
• A conglomerate emotional
oneness that exists in all levels
of intensity

•These relationships are
cyclical, in that they can shift
from anxiety, or a state where
the members are repelling
each other, to extreme
closeness

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

ROLE OF THE THERAPIST-1
1. 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.


ROLE OF A THERAPIST-2
2. Thinking in terms of the system and not the
emotionality or the content is important, which means
that the therapist must have a high degree of
differentiation. The therapist must be high functioning in
the sense that he or she can separate thoughts from
feelings and manage emotional
reactivity. In addition, he or she
must have a healthy separation
from his or her family of origin.


ROLE OF A THERAPIST-3
3. The therapist is a coach and an
educator, teaching the clients about family systems
dynamic, differentiation and the multigenerational
transmission process. Teaching is a critical element
of Bowenian family therapy
and the role of educator is
important to the success
of the approach.


GOALS-SHORT TERM

1. Bowen uses the Genogram to
gather information and offer
insight into patterns of
multigenerational relationships


GOALS-INTERMEDIATE
1. Increase the level of self-differentiation of
each family member
2. Reduce emotional reactivity
3. Help each family member detriangulate from
his or her family of origin
4. To “detriangle” pre-established three person
systems in steps


GOALS - LONG-TERM
1. Self-differentiation and the development of solid self

2. Transition client from therapy to other environment
and educate them that differentiation is a lifelong
process

3. Aid client in bridging his
or her emotional cutoffs
without being pulled back
into repeating old patterns
in relationship

INTERVENTIONS-
EARLY STAGE
1. Genogram
2. Begin to discuss generational patterns
3. Lessen emotional reactivity
4. Objectivity


INTERVENTIONS-
MIDDLE STAGE

1. Coaching
2. Therapeutic Triangles
3. Taking “I position” stands
4. Marital psychotherapy
5. Individual therapy


INTERVENTIONS-
LATE STAGE
1. Education is important throughout
therapy, but in the final stage it can help
the clients with transition. It’s important
to emphasize that differentiation is a
lifelong process.

2. Reaffirming that differentiation is
a lifelong process and that the client
has gain a deeper understanding of
him- or herself that facilitate his or her
ability to continue the process.


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


To Learn More about Bowen Family therapy and
earn CE credits visit us at:

practicalceseminars@holmangroup.com


Bowenian Family Therapy

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