Back in the dark ages, in 1956 before family systems theory was a thought, Dr. Bowen was observing families at NIMH and asking his staff to describe what the families were doing. There was to be no diagnosing, “just the facts m’am”, e.g. who walks in the room and who leaves, etc., little things like that. Over time he began to make more sense of what he was seeing. Something was going on in the minds of both the staff and the family members that automatically led to labeling and blaming others. The staff would say the patients were problems. The parents would say the child was the problem. Both looked at ways to fix the problems in the others without looking at how they might have the resources themselves to deal with the problems. This is the family projection process at work and current research demonstrates that this “other focus” still goes on today but is not seen as part of what Bowen identified as the family projection process.[1]

In family after family, Bowen saw over and over again this family projection process. He observed and described three automatic steps that ended up with one person “being the problem”: “(1) thinking of the triadic one as sick, (2) diagnosing the triadic one and designating him “patient” and (3) treating the “patient” as a sick person.”[2]

Although this was written 59 years ago we see the exact same process occurring in families and in mental health clinics today. For example, people are worried about children who are bullies. They want to know how we can decrease bullying.  “Something is wrong with that child”, they say. “We’ve got to fix him or her.” Worry and upset and trying to fix and help people plus a tendency to be “other focused” are the mainstays of love. The most common concern in families is the one in which a mother is “worried” about her children and/or her husband. This is part of a natural process that becomes counter productive.

Can understanding how family projection works in society and in the mental health field give us any advantage? Remember, this knowledge has been around for almost sixty years now and doesn’t seem to have been influential on the societal level.

A system’s view seems lost in the intense focus on fixing the person that has the problem.

“A bully has a mindset” (think individual therapy).

“A bully has a mindset and is surrounded by relationships” (think family systems).

In family systems theory each individual in the system has a mind set which in some way can inhibit or reinforce the bully’s mindset and behavior. In a broad look at the system we see that under increasing anxiety/stress people tend to look for a “cause” and a “quick fix”.  This is “the blame game”, when people tend to project worry and blame onto others.

When people focus on a bully and try to fix him or her, they are often missing the system’s automatic response to anxiety.   They fail to see or understand how they are replicating the family projection process: focus on one person as the problem, diagnosis and fix them or bully them into behaving properly as long as the system is able to do that.

Mindsets range from an overall tendency to be “other focused” to more “self focused”. The “other focus” leads to problems in relationships that can only be solved by “fixing” the other.  The mindsets of people in families are varied depending on the kinds of problems the families have run into over the generations. How flexible are people in switching from an “other focus” on the problem person to a “self focus”? (One caveat: people can be self-focused on what is wrong with self. This can also lead to symptoms.)

Once people have a basic understanding of the automatic nature of projection, more thoughtful, mature questions can arise: “What can I do to understand and deal with the problem which I see in others? If I am playing some small part, can I alter that by changing what I am thinking or doing?”

In some families, the automatic response is that the bully is the “impossible” one. The family reactions fall along a continuum. At one end, family members can be over involved and react by yelling and punishing or being bullies themselves. Some families are full of frustration and/or anger and “encourage” young people to act out the parental frustration towards society. The family of the Boston bombers would fall into this category. There are families at the other extreme where there is a total lack of relationship to one another: no one in the family monitors or cares about the bully’s behavior. That person has been written off. Here the lack of a connected relationship can frustrate and drive people crazy. What keeps people from engaging bullies in conversations?

Family systems theory looks at the system with a long-term approach, enabling family members to see the advantages of continuing the conversation with so called impossible people. One person begins the effort to reengage and then one by one others alter their mindsets and the way they relate to others. The out of control bully might simply be out of meaning-filled relationships. In the majority of families there are usually one or two people who are more capable of seeing their own negative mindset and who are able to alter the way they think and interact with others.

History: Family systems therapy was found to be effective for long-term change back in the fifties, about the time new drugs were discovered that could alter behavior.  And at the same time, treating the family relationship system by coaching the stronger members of the family was seen by the prevailing medical system as too complex, too confusing regarding billing and too far from the prevailing medical model to be easily understandable. Therefore the medical model has continued to foster the family projection process when it comes to mental health.

Family systems therapy does away with diagnosing, blaming and fixing one person. The coach enables clients to develop an understanding of the processes that underlie symptoms in individuals in the family and in so doing goes against the “conventional wisdom” or medical model in psychiatry and psychology today.  Even family therapists in order to be paid have, in fact, been bullied into diagnosing individuals in order to receive payment from insurance companies and to comply with the current medical model.

Reactions to Systems Thinking: Unfortunately, training stronger people in the family to alter their mindsets was and continues to be seen by the medical establishment and other organizations as “blaming” family members, rather than offering greater variety and opportunity for both cognitive and relationship changes to take place.

Coaching: A family systems coach promotes family members’ ability to observe the system and then learn to challenge the family projection process. Questions arise as to how people might relate differently to the individual who is the identified bully.  Change in the family begins as one person begins to take responsibility for altering his or her part in the family problem. Such individuals are no longer other focused.   Now they are more thoughtfully self-focused, working to alter their part in the relationship system.

As family members are coached to be able to see the system, they are more able to relate differently to the individuals who are having issues.  Over time changes in one person’s thinking and behavior begins to impact the entire system.  Small changes in how people think and act can and both interrupt and repair the relationship system.

Change is measured not only in how people behave and think but also in the quantity and quality of relationships in both the nuclear and extended family system.

There are many different ways to alter the emotional system.  For example, if a bully comes from a family where parents are scared of their own child, or are too distant and/or bully the child, these behaviors reinforce the bullying behavior of the child.  Parents are better able to change the long-term relationship with the child when they are in more open emotional contact with their larger family system.

Stronger family relationships with extended family members enable individuals to be more confident about their ideas and opinions.  People can practice standing alone and saying what they will or will not do with family members. This practice of talking with extended family members can then alter the automatic responses to the child, and allow parents to move into a better relationship with more open communication with each other and with the child. Changes in parents increase the likelihood that any behavioral change in a child will be long lasting.

The beauty of family systems theory is that once someone sees the family as an emotional system (automatically regulating the behaviors of its members), the upsetting behavior of others becomes less personal and more interesting to understand and interrupt.

Problems in a child can motivate parents to learn theory and to see the automatic nature of systems and the four ways anxiety is distributed: distance, conflict, reciprocal relationships and family projection. Once people get too worried or anxious these mechanisms distribute anxiety to the individuals in the system.

Once people understand anxiety will be distributed to the most vulnerable (and ultimately to everyone in the system), they can rise to the challenge and be more self defined and take on the family anxiety.  The beauty of family systems theory is that anyone who is important to a system can alter the system by changing self and how he or she participates in the system.

It is possible for parents and teachers to control their own reactivity and to be curious and relate in a non-anxious way to those who say things like: “I feel like beating you up”, or “I do not feel like talking to you” or “I don’t feel like working”, or “give me more money”, etc.

If one person can say “I am glad you’re not listening to and acting on your feelings and that you are talking to me about how you feel” then something this simple can be a first step in allowing a child to see how to separate feelings from thinking. Sometimes it’s hard for people to see just what they are doing to self and others.

Bullies and those involved with them are able to gradually understand the reciprocal nature of their behavior and how it is impacting others. Initially people react and that gives the bully “positive” feedback. The bully is winning. But when one person refuses to be bullied and holds the bully accountable, everything begins to change. A parent can say, “If you continue to act disrespectfully then I will take the car away.” They do not have to get mad and get upset. An upset parent has lost control. The immaturity of the bully has become one with the parents’ immaturity.

If parents can control their emotional reactivity then often other people will find that control of self, interesting. This can motivate people to increase self-control and begin to mindfully relate to others. As one person begins to change self, that person will gradually impact the larger system.

Awareness of the automatic and reactive nature of our family and friendship systems allows us to interrupt and challenge old patterns and to be more of a responsible self in relating to others.

Families are way more complicated than a game of chess. It takes time and effort to recognize the formation of various patterns and what you might do to make more of an impact. Think about how long it takes to deeply understand our families? The family’s rules have never been written down or made explicit and doing so is up to each person.  We began by observing relationships and then defining self as to what one will or will not do. For those willing to take the higher road to a stronger, better defined self, family systems thinking reveals what one is up against in changing self.

Case: The mother of five grown children is concerned about how her husband is interacting with the youngest son. The four older sisters are married and not involved in the family business. But the son has struggled due to a learning disability and is constantly asking his father for money. He is threatening his father that if he does not get money he will have to declare bankruptcy and move to a different state, among other things.

Is this son bullying his father for money? The son has been in various financial ventures with the father. None of these ventures have been profitable and this triggers a lot of worry about the future for the parents. Their financial stability is in question and the son has not been able to make it on his own. The father works and the mother worries.

Worry about the son’s performance has flowed through the parent’s relationship. The mother feels sorry for the son and wonders if her past wish to get the father to support the son has made for trouble and what she can do now? She is worried about telling the son the possible complications they have in their own lives. It might be too much for him.

I can feel this woman’s pain and threat so I asked how people in the family have helped each other over the generations?

Each of them has a tradition of lending money to others and/or worries about having enough money in their old age. In the past generations people have had to sell their homes as they aged and this is a frightening possibility. In addition one of her grandfathers committed suicide after a financial failure.

These are the questions I posed to this mother. They were designed to challenge emotional thinking and the family projection process.

Are you taking sides with people in your family?

Are you challenging people to think for self?

What is the emotional system?

How does it direct you?

Is it possible that each person is being controlled by the emotional system and the mutigenerational fears about money?

Is it possible that even if people are dead they might still be influencing people? For example, could the memory of your grandfather’s suicide make you more worried about money, and then you might give in to your son or your husband?

Who is the hardest person to listen to, your son or your husband?

How hard is it to listen to either of them talk about their problems without taking action (or taking sides)?

When do you seem to give in to either your husband or your son?

What is the most difficult thing to talk to your son or your husband about?

Can you calmly talk to your husband/son as to the facts and/or the anxiety?

How much practice would it take to be more open with your son and your husband? Which one of them would be easier for you to be open with

Is it possible that your son/husband finds people who are willing to take care of them and that person might be you?

If you worry about either of them are you helping or hurting the situation?

Can your worry and upset impact their functioning?

What would you say is your part in your husband/son not standing up on their own?

Have they figured out how to borrow self from you at a low interest rate?

The focus is always on questions. There are no interpretations in the usual sense and only an occasional statement about past experiences with other families that might be considered an interpretation. About a fourth of the comments by the therapist are designed to detriangle the situation when a family member invokes the emotional process in a session. Bowen, Murray (1993-12-01). Family Therapy in Clinical Practice (p. 225).

General ideas that I shared with the mother: I told her I would focus on trying to be low-key and a little humorous and talk about over and under functioning without using those words. I would say softer things to my son like, “A lot of women, including me, really seem to love you. Does that make it hard for you to find your own way with all of us thinking you’re so cute. Honestly I’m just not sure if it’s a blessing or a curse to be so adorable. I have every confidence that you’ll find your way through all of this and figure out what’s really important to you, and what you want to do. And in the meantime you might as well just enjoy all these women thinking you’re so fabulous. Your Dad has put up with all this gooey love stuff for a long time and I am not sure if it has helped him either?”

I certainly would discipline myself not to get worried about either of them. I would do two or three push-ups every time I found myself thinking about whether not he should get a job, or money will be given for no good reason.

What do you think would happen if you told your husband and son that you were doing push-ups every time you found yourself thinking about what either of them should and ought to be doing?

Summary: One-way the family projection process works is that when any of us gets “other focused” or down on self, we can back down in relationship to others. We begin to back out of relationships instead of thinking carefully about how to engage in relationships.   The head of one person begins to worry about the other person and the first thing you know thinking can get pretty fixed. The family emotional process automatically shifts the focus from one person to another until it finally sticks on one and that would be the one that has the major symptoms.

Once you recognize how the system is influencing you and you see it in the way your own head works, then one thing you can do about it is to lighten up, speak about things in a way that doesn’t spread too much worry, that is funny and silly and kind of ridiculous but still tells the truth without making the truth a burden. Anxiety can be used to make more creative changes in the system when you’re curious and ready to take on the automatic nature of the family emotional process.

Optimally, the teaching communications come when the family tension system is low and they are presented in a way that does not involve the therapist in the family emotional system. Many comments are made from the “I” position, in which the therapist presents his views, beliefs, and operating principles in such a way that they can be accepted or rejected by the family. The therapist has much knowledge that can help the family find solutions. The goal is to find a neutral way to present the knowledge. The following framework has been successful in most situations: I have some experience from work with other families that you may find helpful in planning a course of action. If any of the ideas make sense and if you can incorporate and use them as your own ideas, there is a fair chance your effort will succeed.   Bowen, Murray (1993-12-01). Family Therapy in Clinical Practice (pp. 231-232). Jason Aronson, Inc. Kindle Edition. Jason Aronson, Inc. Kindle Edition.

[1] The relationship of case managers’ expressed emotion to clients’ outcomes Solomon P¹, Alexander L, Uhl S. Expressed emotion (EE) has been studied in families of a relative with schizophrenia as well as other psychiatric disorders; and high EE (hostile, critical, and overinvolved) families have been found to be strongly related to relapse among their relatives. EE has been assessed on a limited basis among non-familial care providers and determined that providers can also have high EE which results in poor quality of life and negative consequences for their clients. Soc Psychiatry Psychiatr Epidemiol. 2010 Feb;45(2):165-74. doi: 10.1007/s00127-009-0051-3. Epub 2009 Apr 16

[2] Bowen, Murray (1993-12-01). Family Therapy in Clinical Practice (pp. 131-132). Jason Aronson, Inc. Kindle Edition