November 30, 2007

Victoria Harrison has been a colleague of mine since 1977. She has made a serious effort to bring the ideas based in Bowen Theory to the world. Houston, now her home town, has become one of the important centers for the expansion of Bowen theory.

See WWW.CSNSF.ORG  

Victoria has followed the developing story of the adventures with my younger brother, Drew.  She saw the family organism undergo an incredible change and asked me to write up an article about the remarkable recovery Drew had from a manic depressive episode.  

Her journal, Family Systems Forum, is a well regarded quarterly publication in its 9^th year of publication. Here you will find articles addressing various applications of Bowen theory, from the scientific to the personal, by a wide variety of authors.   

People can get more information about the kind of articles it includes on the Archives. Here they will also find a subscription form you can download.   Following is Victoria’s summery of my article.  I have included the theoretical part, but left out the personal story, as one way to entice people to subscribe to the newsletter. Enjoy….

Andrea Schara describes “Family Emotional Process and the Big Picture” in an article published in Family Systems Forum, Fall 2007. 

This is a powerful personal report of her family’s experience with serious psychiatric symptoms and the recovery, that using Bowen theory makes possible.   This family story has important implications for a society that has come to rely on medication and hospitalization as the only known methods for dealing with the disruption of psychiatric symptoms.   

The author brings over 30 years of wide ranging scholarship, study in neuroscience, neurofeedback practice and work with Bowen theory to approach the challenges in her own family.   The principles described in this account of how she and the family were able to contribute toward her brother’s recovery from psychiatric hospitalization and deterioration, have broad applications.   

Andrea Schara describes the difference it can make when one family member can both see the forest and know each tree well enough to find their way. She illustrates how Bowen theory, a theoretical map of the family forest, was essential in guiding her way. You can subscribe to Family Systems Forum and receive the current issue at WWW.CSNSF.ORG. 

A one year subscription is $25.    

Family Emotional Process and the Big Picture

Andrea M. Schara, LCSWA 

Reprinted from Family Systems Forum, a publication of the Center for the Study of Natural Systems and the Family, Volume 9, Number 3, Fall 2007 

It is one thing to consider a broad picture of mental health.  It is an entirely different matter when a close family member is diagnosed with a mental illness.  When the latter happens, the pressure is on for action: What am I going to do now?   

What can you do if you cannot see both the forest and the tree?  Seeing the forest but not knowing the tree is a broad view but partially blind.  Seeing the tree without knowing the forest lacks perspective.  One without the other does not make for a systems view.  This paper will present both a broad and a personal look at a bipolar diagnosis in one family. 

Mental Illness Oversimplified 

Mental illness can be over-simplified as the inability of one person to “fit in” with a family or a society’s expectation of normal behavior.  Animals, including pets, can behave in strange ways.  “Diagnosing” pets or people is said to lead to proper treatment.  After all, we need to know what to do about the “condition.”  Here we see the pressure exerted by the forest for trees to grow properly.  A tree must bend to the conventional wisdom. But what if diagnosing people adds to the problem? 

Diagnosing in itself suggests that one is the sick tree, and the other not-so-sick trees need to help the sick one.  The family is split, as is society.  Mental illness is not a small problem when 27% of the population is said to have a mental illness or an addiction problem. More than two million Americans have been diagnosed with bipolar disorder.  (U.S. Surgeon General)

Despite research and costly drug treatments, many questions remain as to the long-term efficacy of all treatments.  While diagnosis of bipolar illness has increased tremendously, especially in children, the prognosis remains very guarded. (Archives of General Psychiatry)  

If we consider what benefit this kind of illness might bestow on families or society, we are taking a different position and opening different possibilities.  Bipolar people often have a very creative streak and are contributors to society.  In a family, with rules and regulations for proper and acceptable behavior, there may not be enough room for a person to be creative without being somehow too different. A person who is different can draw negative attention. 

The research of John Gottman and others shows that too much negativity destroys relationships.   That one person in a family or a social group often draws more negative attention is just the way nature organized us.  We have testimony from Jack Calhoun’s mice that scapegoating comes naturally.  One or two absorb the problem-focus, while the others are freer to go about their more ordinary lives. One person’s absorbing more of the problems may benefit the larger group.

Researchers like Dalton Conley elaborate on the dynamics of differentials in family functioning. Families appear to have an automatic away of “knowing” how much to invest in which of their children. Wealthier families seem able to mitigate some the effect of this general tendency to treat children differently.  Looking at the big picture, we can see that many forces operate out of awareness to put more negative pressure on some children. 

The child can, of course, adapt to the pressure.  Some do so in most interesting ways.

Let’s take hallucinations, as these are often the challenge that leads people to put their loved ones into hospitals, often as part of a manic episode. 

Hallucinations

Research suggests that at some distant time hallucinations were useful for society.  Researchers, including Julian Jaynes and Al Sheflen, have discovered both brain functions and historical reasons for their presence.  Jaynes notes the presence in very early written materials of the word “we” and the length of time it took for the word “I” to develop.

In prehistoric tribal society, there was no “I” statement. There is no record of the use of the word “I” until Homer’s Odyssey (c. 800-600 BC).  One possible explanation, Jaynes hypothesizes, is that disruption in the chain of command was a threat to society. 

In those early eons, humans may have been more socially organized, like ants.  Jaynes postulates that early societies were very oriented to command and control.  This operating posture left traces in the brain.  When deaths or loss occurred, when times were tight, as happens during war, families and societies were required to operate more as a “we.”

When geographical disruptions, deaths or separations occurred, hallucinations became more evident in the population. They provided a way to imagine staying connected to the needed voice of authority.  People could “imagine” what needed to be done.  T

he well being of society was facilitated by the ability to “imagine” how the “other” would direct one when the “other” was gone. 

We currently see that the occurrence of schizophrenia increases when children leave home and try to function independently.  Jaynes offers evidence that more democratic societies and families are far more capable of promoting the emergence of the “I.”  

Families with more anxiety and uncertainty would have more difficulty allowing for the development of a more separate individual.  One might be able to imagine how, in our own time, the disturbance generated by the death of a family leader could set off a very old pattern in a social group and in the brain.

This is not to rule out other social and viral disruptions that may be part of a cascade leading to “mental illness” in one person in a family. My focus is that disturbance in relationships can also lead to regression. One could say that the brain and behavior of persons are disrupted, and they “act” as people did in earlier times. 

Hallucinations may be one way to adapt to the loss of meaningful relationships. 

A Personal Story

Explanations are soothing, but do they help when someone close to you has a mental break down? 

………………………………………… Please subscribe to this issues to read all of the story. 

WWW.CSNSF.ORG.   

After-Care Plan

Finally, we were able to develop a plan to get Drew out of the state hospital.  Margie wrote a letter, which I helped her compose, to the hospital director, detailing Drew’s lack of progress and our concern about his regression, drug treatment and fear of dying as his father had.

We also drew up a plan for a two-week after-care program at my cousin Liz’s home. 

We hired people to be with Drew, as he could fall and hurt himself. He was to see a local MD to rule out Parkinson’s disease and see a local therapist, untrained in Bowen theory but a friend of my cousins. He was also to have polarity therapy (a combination of massage and acupuncture using the energy centers of the body), breathing and yoga classes. 

After his reaction to the anti-psychotic drugs and his fear at being in the hospital, Drew’s shaking made it difficult for him to sit and relax. 

For the first two days, he was a shadow of his former self. Unable to hold his head up and make eye contact, he just shook.  Over two weeks, he radically altered his functioning for the better. 

My goals were to: 

·        Diminish my own fear and figure out how to relate to him to make him smile.

·        Keep the group surrounding Drew focused on not knowing and observing. 

I bought a journal to write down observations of all our interactions with Drew. I asked each person to write down what seemed to work, as none of us knew which of the things we were going to try might make a difference. 

I used the idea of three A’s to monitor how he was doing in regard to his affect, loose associations and his ambivalence.  

The first day I put him on WWW.ZENGAR.COM  neurofeedback equipment, he had a moment when he stopped shaking for the first time in four months.

I immediately went out and bought a video camera to tape this process and learn more of what was happening.  In the first five days after his release from the hospital, Drew did seven neurofeedback sessions, building on sessions he had had once a month from May to August. 

Initially, he could manage only ten minutes on the equipment.  We also kept asking Drew if he could stop the shaking.  This gave him the idea that he had the ability to focus and take charge of his life little by little. 

I used humor and paradox to bring up such fearful issues as dying in the state hospital.  Then we would relax with neurofeedback.  Finally, Drew realized he could gain control over his fear and shaking. 

Drew was surrounded by family and friends on a beautiful farm, but we also set limits.  He had to take a shower every day.  We encouraged him to walk, draw, rest and take vitamins with a protein shake. His wife also did neurofeedback each day and was able to alter her way of telling Drew what to do. 

Liz had set up appointments to offer Drew other kinds of help. One of her friends did a forty-minute session of polarity therapy with him.  During the time on the table, he did not shake. Another woman came with a guitar, and they sang.  A

ll in all, we had fun and it paid off.

Changes in Extended Family

Many people in my father’s family were able to visit and support Drew.  This was a major change in family patterns.  Five family members offered money to help support Drew until he got on disability. People who had been afraid of persons in a manic episode began to have confidence and make better contact with Drew.

I think that my work over years to be a calmer individual and in better contact with people in my family helped to create an environment in which change could occur.  Changes happened both in the family and in Drew, for which I am grateful and amazed. 

 What made the difference? 

·        Being with his family, undoubtedly the biggest factor.

·        Reorganizing his brain using neurofeedback  training.

·        Setting limits and working with him to restore his cognitive and affective functioning. 

Summary 

We have been deep into the forest to see how one tree makes it through a lightning storm.  Every forest is slightly different – the songs that are sung, the food, the dance, the fights, the silliness.  There are many variations of the struggle to relate to others as well as possible.  Coming into “good enough emotional contact” is an adventure.   

There is no answer in command and control. 

There is some answer in telling your story about life as you see it. People will make what they will of the neurofeedback and the family, but few can argue how amazing it is when the impossible becomes possible.  

This story is one of hope and possibility which lives in any social group. It is in relationships that the possibility for transformation exists.  

References

Archives of General Psychiatry,  February 2006.

Bowen, Murray.  Family Therapy in Clinical Practice (Northvale, NJ: Aronson, 1985).

Calhoun, John.  “Population Density and Social Pathology.”  Scientific American, 1962.

Conley, Dalton.  The Pecking Order: Which Siblings Succeed and Why.  New York: Knopf, 2005.

Gottman, John.  gottman.com/research/.

Jaynes, Julian.  The Origins of Consciousness in the Bicameral Mind.  New York: Houghton Mifflin, 2000.

Sheflin, Al.  Levels of Schizophrenia.  1981.

U.S. Surgeon General. surgeongeneral.gov/library/mentalhealth/chapter2/sec7.html