Murray Bowen, MD (1/31/1913-10/9/1990)

Happy 99th Birthday to Murray Bowen, MD (1913-1990)

On this anniversary of his birthday, I wanted to acknowledge my gratitude for being able to have a relationship with Dr. Bowen for the last fourteen years of his life.  I had both the opportunity to study Bowen theory and to watch and interact with Dr. Bowen.  Towards the end of his life Dr. Bowen gave his theory to the world to do with as we might. The theory is a gift to us and people are free to interpret it as they choose.  The theory contains as impersonal as possible observations about how Bowen saw human behavior.  (I have added a time line of the development of the theory at the end of this piece.

People read his book, watch his videos and find there is a different way to think about the human condition.  Bowen enabled us to see how it is we are so very sensitive to one another. How we are often being hurt by or hurting the ones we love the most.  Bowen pointed to the difficult ways of becoming more of a self. He would joke about having to give up love and approval. As you will see below I consider my relationship with Dr. Bowen a challenging gift, enabling me to observe and question just how relationships function.

One of Bowen’s fundamental contributions was his understanding of the complexities of relationships that are imbedded in an ancient emotional system. A gift from our primordial ancestors,  the emotional system, among other functions, promotes the shifting of anxiety from one member to another.  Some claim this is the origin of power and scapegoating in social units. Bowen did not use these kinds of words because he preferred biological explanations for human behavior.

Relationship alliances are often beyond words to explain and understand.  Plus there are painful, exasperating limits in communicating any deep understanding of one another, but hopefully that doesn’t stop us from making the effort to tell our more personal “story”. Bowen was a complex man with many different kinds of relationships.  If you read his letters to people you will find a constant and very personal effort to describe relationship binds.  There are probably a thousand different views of the man and perhaps just as many of his theory.

Bowen’s book, Family Therapy In Clinical Practice (FTCP), presents his observations of emotional process in his and others families.   It takes time to deeply understand and appreciate his very different description of the human condition that Bowen offers as contrasted to the “conventional wisdom” of the time.   The following are a few snippets and stories about Bowen that I thought about around his birthday.

Murray Bowen, M.D, was my mentor and I was his apprentice. In an effort to learn all there was to know about families I found a job in a psychiatric hospital, read about and was fortunately able to meet Bowen.  I was intrigued by Bowen’s ideas and motivated to learn more to get myself out of personal problems.” The motivation was to get myself out of personal problems.  My problems were not that different than most people face, including but not limited to the family reaction to death and the surrounding chaos that ensued.  One thing I knew even before meeting Dr. Bowen was that I had been trained from birth on to look after others and that I was not up to the job.

After reading Bowen’s work, meeting him and signing up for his courses, I noticed that he had a strange way of dealing with people. They would speak positively to him and he would push them away.  Once he saw me watching him and came over and pointed out a few couples to me and asked me,  “Who’s in charge?  “What is it costing them to get along with each other?”  I couldn’t answer as to the cost but I could see one person seemed to be more “in charge”.

By observing Bowen I saw a very different way to interact with people. After reading Bowen’s early paper, On the Differentiation of Self, (FTCP: Pages 468- 528), I understood his focus on becoming a better observer which leads to the eventual ability to separate a self while staying connected.   Bowen wrote “I believe that that the family therapist usually has the same problems in his own family that are present in families he sees professionally, and that he has a responsibility to define himself in his own family if he is to function adequately in his professional work.”   (FTCP: Page 468) What could make more common sense?

Bowen’s paper was written three years after he made a professional presentation on his effort to be a more separate individual and relate to each individual in his family.  The family of a family therapist as he noted has many of the same emotional mechanisms that are present in any family: superficial relationships, projection, triangling and cut-off to name just a few.  Therefore his plan was to use his family story as a way to illustrate the differences between actions based on his theoretical understanding of the emotional system vs. that of other theories like psychoanalysis. In essence he was also prepared to separate from the family of family therapists as he had done in his own family. One example of how he did this was when Dr. Carl Whitaker was asked to comment on Bowen’s presentation and he said “… Dr. Bowen, I wish I were your brother!”  Dr. Bowen’s response: “Ackerman is.” (FTCP: Page 524)

Bowen went on to say, “Differentiation begins when one family member begins to more clearly define and openly state his own inner life principles and convictions.” ( FTCP: Page) 437 “An anxious group is one in which members of the group are isolated from each other and communication between members is in underground gossip. Anything that improves communication will reduce the tension, as an initial step to more defined efforts to modify the system.” (FTCP: Page 436 )

Being more defined can take years. It can take a long time to be confident in self’s observations and beliefs when others oppose your actions.   Differentiation is a hard process because people are stuck in relationship habits that sustain distance and conflict.  When one person changes, people object but eventually it helps the system reorganize. With a differentiated head, there is no pressure on others to change but there is internal pressure to stand for your own perceptions and beliefs.  The greatest challenge is to observe others without one’s own bias, preconceived ideas, feelings, and the gossip in the system.  Being objective about others is a work out. It does not come naturally. Reacting to others and to differences comes naturally.

Often people can hear a few things that make sense about separating out a more mature self from the automatic ways we react to one another.  People would say, “Dr. Bowen what you said makes so much sense.”  And Bowen would respond, “Use it if you like, but it could mess up your little old head.”

A southern man, Bowen had a twinkle in his eye and a way of using both thinking and emotion to push and challenge one and all with whom he came in contact.  The paradox, the interruptions, the confusion and the bottom-line: you are responsible for how you use me, and I will be responsible for challenging you. Everyone was fair game, everyone a new research project. That is how I see him still.

Bowen knew how to convey a different viewpoint about the confusion we all have.  He was an advocate of life-long learning. By telling people they were risking it all in falling into pretend thinking, and seeking love and approval, he alienated some.  He used to say  “I go and give a talk and 49% of the people think I am crazy, 49% think its interesting and never give it another thought and 2% want to know more.  Of the 2%, half give up along the way. “

People would say,  “Dr. Bowen I need to take your course so I can get a certificate so I can make it in the world out there.”   He would laugh and say,  “Good luck to you,” and advise they go elsewhere.   He picked up on ways of challenging people to think for self.

If you had the courage to speak to him then you could expect a million questions from him like how come you function the way you do? Who got you to think this or that way? How much were you “snookered” by your own unexamined beliefs and the people who claimed to love you? How did you know your compass worked? What do you do to get along with your boss? What made you choose those shoes or that dress?

If you could take the heat then you might get to listen to the homespun tales from his life in Waverly, Tennessee, his time in medical school, the Army, and what he saw and learned at Menninger as he slowly discovered he needed a better theory about how humans functioned.   If you stuck around you might get interested in science or physiology or germs or cancer or your own functioning or why you felt the need to save or quit your marriage, your kids or even the world.

Somehow Bowen was able to always see life as a fantastic puzzle.  He would come to meetings saying he was ready to die, and then start telling us about some insight he gained from the shuttle launch or a football game or his fascination with the jumping genes, or the social behavior of chimps.  All  this and more appeared to be ways of both keeping his mind going and keeping his own intellectual space in the group.  If you said stuff he thought was silly he would pound the table. He might dismiss your effort.  He might say you will make it in another lifetime.  He manifested a genuine curiosity in understanding how living systems functioned.  For most of his  life and still today,  Bowen theory is ignored by the dominant “medical model” and psychiatry, therefore professionally he was isolated and marginalized and was “messed with” by his peers, including those who became disciples and those who dismissed him and his theory.

As one who made mistake after mistake but still dared to speak to him I was able to learn a great deal and he learned something as well or so he said.  This is how Bowen was.  He would interrupt my way of thinking and being, challenging and watching to see if I recovered.

Bowen was constantly looking at the part he played in relationships.  Below is a personal communication from Catherin Rakow about her research on Bowen’s original papers at the National Institute of Mental Health.

“Bowen thought he played some part in all problems.   This goes back to his Menninger years.  It was one of the observations of people in a regressed state.   They hear a casual comment as a command or directive, they can get symptomatic in an unpredictable environment, and any thing close to

mothering can set off symptoms.   Bowen’s “A Psychological Formulation of Schizophrenia” article lays this out including how he used these observations to manage himself.”   

 

One person working to be a bit more separate in a social system is best seen in this observation by Stanley Milgram, who noted the following.   “With numbing regularity good people were seen to knuckle under to the demands of authority and perform actions that were callous and severe. Those, who are in everyday life are responsible and decent, were seduced by the trappings of authority, by the control of their perceptions, and by the uncritical acceptance of the experimenter’s definition of the situation, into performing harsh acts.

 

It may be that we are puppets—puppets controlled by the strings of society. But at least we are puppets with perception, with awareness. And perhaps our awareness is the first step to our liberation.”

There are many steps in becoming a more aware person.  One way to grow a stronger self is to see what it takes for any of us to be more separate with those in our own family.  To be more separate implies that each person is a bit more responsible for self.

When there is less blaming and confusion, people are able to be more objective, less reactive, and to see more about how problems come to be over the generations, and how to change one’s part in the system. In this way the system changes.   One person at a time begins to alter the way he/she sees the problem.

It is in our families that we have the opportunity to learn and understand social pressure and take on the challenges of defining a self.   In becoming more objective and aware of how we participate in social systems, we may even be able to see that we are not that different from ants or gibbons.  We all influence others, and are influenced by others.   Dr. Bowen saw how courageous individuals can alter the reactivity in relationships, altering lives and leading to deeper understanding of one another and of the life force itself. These are the gifts he left for all of us to find.

Andrea Schara with Dr. Bowen,  September 1985 Milwaukee

photo by Kathy Mcabe

TIMELINE FOR DEVELOPMENT OF BOWEN THEORY :

Prepared by Catherine M. Rakow, MSW

January 28, 2012

Sept. 1937  Bowen finishes four years of medical school at University of Tennessee.[1]

1946             Menninger School of Psychiatry opens and Bowen begins work at Menninger.

1940’s          “The most important change in the 1940’s was a solitary effort to create a more scientific theory of human adaptation.”[2]

1947             ”In about 1947, a library study was started to discover how each professional discipline had used science in its basic formulations.”[3]

1948-1954     “in addition to the other programs, a form of anaclitic therapy was started for a series of severely impaired patients whose families lived at a distance.  Theoretically, schizophrenia was considered the result of maternal deprivation in infancy and early childhood… From this experience came new psychotherapeutic principles and techniques used in the effort to resolve the symbiotic attachments, and in the other psychotherapy programs.  The difficulty in resolving the symbiotic attachments led to a new approach, the final step in this eight-year evolutionary process.  The final stage was to discourage intense relationships with any family member, to leave the intensity of the process within the family, and to relate peripherally and supportively to various members of the family unit.”[4]

1948             Bowen becomes a candidate in psychoanalysis.[5]

1949-1954 “Beginning in about 1949 I began an informal research study in which I began seeing multiple members of the same family (patient had schizophrenia) in individual psychotherapy.”[6]

1951             “Began Jan 1951-invited mother to come for extended visit-spend all day with patient…Experience led to suggestion that a section of hospital be set aside for mother and other relatives to live in hospital with patient.[7]

By 1952       Bowen had begun to include some fathers in his study but the main focus was on the mother/child symbiosis.

July 1953     NIMH Clinical Center opened.[8]

1954             “In 1954, the hypothesis from the previous work was incorporated into a formal research study in which schizophrenic patients and their mothers lived ‘in residence’ on a psychiatric research ward.  Each patient and each mother had individual psychotherapy.”[9]

Dec. 1954    ‑‑”project to check belief that presence of the mother is beneficial to the treatment of schizophrenia”[10]

1954‑1959 “First important nodal point in the development of the theory…research study…”  “live‑in project source of a wealth of new facts about schizophrenia.[11]

1955             Live-in project–“…led to the development of a method of family therapy.”11

With admission of whole families—parents required to be responsible for patient.

“The effort to investigate the three generation idea began in 1955 with the statement of our consultant, Dr. Lewis Hill that it requires three generations for schizophrenia to develop.”[12]

Feb. 1955    Bowen writes saying he is “itching to try a different kind of ward communication system.  For instance one could begin by never having a meeting between staff members in which patients were not invited or welcome.”

August 1955          “discussing the plans for also including fathers in our ‘mother-daughter’ studies in schizophrenia”.^[13]  By August 9 the patient group meeting is operating.

Sept.  1955 “Beneath the social organization, man is still an animal with basic patterns shared with or evolved from lower forms…“… science, which is really the conversion of the unknown to the known” [14]

Dec. 1955    –“A shift from seeing schizophrenia as a process between mother and patient or as an illness within the patient influenced by the mother to an orientation of seeing schizophrenia as the manifestation of a distraught family that becomes focused in one individual.”[15]

1955‑1956 “…in order to deal with this wealth of new clues, I revived my background thinking from the 1940’s about the use of discrepant thinking models, and also the ‘far out’ hunches about the biological ‘animal in man.’”[16]

January 1956         “The (unit) meetings were adapted to family therapy immediately after admission of the first father, mother, patient family.”  ^[17] After six months there was no doubt but the family therapy would be continued.

June 56         “…we have used the term ‘family psychotherapy’ for this method in which all family members attend all the family meetings together, and which is designed as a method to replace individual psychotherapy.”[18]

1956             “informal outpatient studies of less severe forms of emotional illness”[19]

“It was the comparison of the intense patterns in schizophrenia with the less intense patterns in others that eventually became the basis for the theory.“19

“By 1956, I knew within me, that the theory contained the necessary variables to become an accepted science in the future.”[20]

After 1956  “After 1956, my main effort was to conceptualize the research findings in terms that would be understood by theorists who knew biology and evolution.”[21]

March 1957            “the first national meeting for papers devoted to the family.”[22]  “.In my paper I referred to the ‘family psychotherapy’ used in my research since late 1955.  I believe that may have been the first time the term was used in a national meeting.”^[23]

August1957           Extensive three generation family history on second family admitted to the research compiled into family diagram.

Sept. 1958  “The major work of the section during the year has focused on two main areas.  One is the area of ‘the family as a unit’ and the other is ‘family psychotherapy.’…After working at this problem for three years, we have been going in the direction of some kind of a system that deals with the ‘function’’of a person in the family rather than the static situation implied with our present diagnostic labels.”[24]

June 1959   Family live-in project terminated.

1959             “moved to Georgetown University Medical Center, where the main focus was on less severe emotional problems”.

1959‑1962 “detailed multi‑generational research was carried out with a few families,                                           including one case in considerable detail going back more than 300 years.”[25]

During 1960’s       “there were increasing comments about emotional patterns in society being the same as the emotional patterns we had come to know so well in families…The connecting link came much closer for me in the period.”

After 1961   “..the concept of ‘sibling position’ was used with every family after 1961.”[26]

about 61-62           “…I began to perfect the concept of ‘triangles’ so well that the concept could be used predictably in the clinical situation…People behave the same in a triangle whether they are in the family or outside the             family….Now I could know predictably that emotional patterns in larger social and work systems followed identical patterns as those in the family situation but a trustworthy connecting link with society was still missing.  The use of the term ‘systems’ which began in the early 1960’s was a help in seeing the specific ways that smaller systems fitted into larger and larger systems and the ways the smaller system could influence the larger, and the obverse.”[27]

1960‑1965 “…the six interlocking concepts of Family Systems Theory were developed in detail.”25

Late 1960’s            “In the late 1960’s I began to shift toward the term SYSTEMS THERAPY which is more accurate theoretically than either Family Psychotherapy or Family Therapy, but more inconsistent with the concept ‘therapy.’”[28]

1974             Societal emotional process added as new concept to the total theory.[29]

1974             “…changed the name of this theory to Bowen Family Systems Theory or…Bowen Theory.”29

1975             Emotional cut-off added as a new concept to the theory.