Where Now Family…… Therapy?


One day an email arrived at The Murray Bowen Archives Project, TMBAP,  http://www.murraybowenarchives.org asking if someone would please write an article for the American Association for Marriage and Family therapy magazine, AAMFT.

https://www.aamft.org/iMIS15/AAMFT/Content/FTM/Family_Therapy_Magazine.aspx

The request from Kim Bryce, the senior editor, was to discuss the foundations of the field from the viewpoint of where family therapy is today compared to its early roots.

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Photo by Andrea Schara 1978

Questions were: how did Bowen impacted the field, what aspects of his model are still in use today, and what interventions or approaches came from Bowen’s original work? Basically, how did he help shape what the field is today?

In addition, what would the founders think of the way Marriage and Family Therapy is practiced today. Has the field grown in a way that the pioneers would have expected or have we strayed far from the early visions of Family Therapy?

What an opportunity!

I quickly volunteered to write an article. My main idea was to have different individuals represent where they had taken Bowen’s ideas in order to draw attention to the importance of differences.  This might be one way to communicate thoughtfully about the differences in the field of mental health that persist and undermine progress today.

As in many fields tribal boundaries are set up by the different approaches to serious problems.  These differences can create divisions as to how we think about and treat emotional problems.  People can object to the word “emotional” and insist that you refer to mental health, and so it goes.

 The roots of family therapy go back to the early family researchers who began to clarify a system view of human behavior, after WW II. Mental health was the main casualty veterans suffered from after the war. In the 1950s, congress funded the National Institute of Mental Health. One of the initial researchers, Murray Bowen, M.D. was hired to research schizophrenia in the family.  Enough evidence had been found to implicate family dynamics and to warrant further study. At the same time, new drugs appeared, which treated the individual and reduced symptoms, but did not alter the social system around the person. And here we have mostly been ever since.

Bowen went in a far different direction from his early training in psychoanalysis. Instead of the individual being the focus, the basic unit of emotional functioning he saw as residing in the multigenerational family system.  Known as family system theory, Bowen connected human behavior to biology and evolution rather than to Freud’s use of metaphors and Greek myths.  Family systems theory became a small part of a larger field of marriage and family therapy. Bowen was the only one to develop a theory of individual functioning within the larger multigenerational family.  His focus was more on coaching one person to become the family leader thereby altering the family system.  This did not appeal to insurance companies.

Since the fifties, the numbers of professional interested in the family has increased yet the focus of main stream mental health remains on the individual.  This should not be too shocking since this is the direction that the family as an emotional unit takes. The family unit tends to worry about or blame one person thereby missing the system.  One person often has far more social pressure or neglect than others.  Just how the family unit manages anxiety, is not a part of conventional individual based psychotherapy.

Today the American Psychiatric Association has about 36,000 members. The American Psychological Association has about 77,000 members. The American Association for Marriage and Family Therapy (AAMFT) represent 50,000 marriage and family therapists, possibly there may be a couple of thousand individuals who have been trained in Family systems theory.

Below you can explore the different directions a few individuals have taken to move family systems theory along. I deeply appreciate those who had the time to write up where they have taken the ideas from Bowen’s original work.

Overview:

Bowen, an oldest son of five, was a born observer of human behavior. Growing up in Waverley, Tennessee, his parents ran the local mortuary, allowing him to observe how families function after a death. After WW II, he saw many psychological wounds and became interested in psychiatry training at Menninger.

Taking careful notes on the impact relationships had on behavior, he saw how relationship shifts changed how people thought and acted. Selected as the first family researcher on schizophrenia at NIMH in 1956, he hospitalized several families for observation, asking the staff to discuss the relationship issues they, the staff had. The families could listen in and all records were open.  This research structure required the staff to focus on the strength of families and not to diagnose and tell others what to do, but to focus on self’s part in any problem. This coaching method enables family members to become more responsible and decreases the fusion between people.

Bowen based his theory in evolution and said he had merely pointed in a direction. The human family is part of evolution.   It has its reasons to survive just as the individual does. This opens the door to the unequal distribution of anxiety in social groups.  We have evolved to act for the benefit of the group, especially when under social pressure. Our feelings and thinking are always interacting but not always informing us accurately because there are hidden influences, blindsiding us.

The field of family therapy still credits Bowen for introducing the family diagram, the ideas around transmission of problems into future generations, triangles, sibling position and emotional cut off.  More difficult are the ideas that 1) the family is an emotional unit governing the behavior of its members; and 2) that differentiation is a way for motivated individuals to define a problem, take a position and get outside the emotional system, while staying in contact with others, thereby allowing the system itself to change.

There is a large national and international network of people who are interested in Bowen theory. Possibly the best way to understand where Bowen Theory has gone in the years since Bowen death in 1990 is to see where people have taken the theory.

Laurie Lassiter: In recent years, there has been more and more interaction between Bowen theory and the life sciences.  In addition, scientific discoveries suggest avenues for evidence for the theory, including in areas of neuroscience, animal behavior, and epigenetics.   One of the most important issues for the theory is its predictability.  Once trained in the theory, it is fairly easy to see in retrospect how family influences our productivity; relationships, including those outside the family; our physical health; and our overall well-being.  Once research breaks through to demonstrate the ability of the theory to predict the future–how the family determines the individual life course within limits–Bowen theory will gain mainstream interest.  In some ways, the current time, without the pressure of popularity, may be an especially rich period of development of the theory.  People who encounter the theory and seriously apply it to their own lives are often amazed at its power.  The theory makes possible a lifelong effort, as there is always something to work on, to increase differentiation of self, as relationships with others become more open, more free, more long-lasting, and more enjoyable.

Laurie Lassiter is in private practice, author of articles on Bowen theory, including:  2011 “Others,” in Chimeras and Consciousness. Ed. Lynn Margulis. MIT Press: an effort to communicate Bowen family systems theory to biologists.

2007 “The Regulatory Function of Triangles,” in Triangles: Bowen Family Systems Perspectives. Ed. Peter Titelman. Haworth Press.

Currently transcribing tapes of individuals’ sessions with Dr. Bowen to be edited for a book on his coaching.  Present at conferences, webcasts, working on several writing projects including her Triangle Hypothesis.  She organizes two online writing groups on Bowen theory, including FEST, a four-times-a-year opportunity to submit and read writing, and a Lunch Hour writing group.

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Photo by Andrea Schara – In keeping with Bowen’s turn toward evolution here is a photo of Bowen and Paul MacLean.  The triune brain is a model of the evolution of the vertebrate forebrain and behavior, proposed by the American physician and neuroscientist Paul D. MacLean. MacLean originally formulated his model in the 1960s and propounded it at length in his 1990 book The Triune Brain in Evolution.

Laura Havstad, Ph.D., I continue to lead Programs in Bowen Theory in Sonoma County in it’s 28th year.  We have a training seminar for mental health professionals, consultants, and clergy and educational conferences for professionals and the community on Bowen theory and it’s applications regarding current topics in biology, clinical science and practice, and emotional process in society. Along with leaders of other programs in Bowen theory I participate in a national network that meets twice a year in which more than a dozen leaders of similar programs work towards the advancement of Bowen theory.  I am working on papers for publication on a reliable method and a parsimonious framework for looking at shifts in the family emotional system as they affect the functioning and chronic anxiety of family members and changes in their symptoms. The goal is to contribute the ability to assess and control for the family system effects in clinical research occurring in the mainstream of the clinical sciences.   The same framework will serve as an organizing structure for developing a knowledge base of family systems data to be developed for family system researchers, particularly for those with hypotheses based in Bowen theory, in conjunction with the Princeton Family Center.  I am publishing a paper in a volume edited by Peter Titleman and Sydney Reed on Death and Loss in the Family making a connection between the trajectories of resilience that emerged out of the research of George Bonnano and his associates, and the shifts in the family system, as Bowen theory predicts following death and loss as anxiety is redistributed in the family system.

Victoria Harrison, LMFT, uses the concepts in Bowen theory and the methodology described in Bowen’s writing and teaching to work with individuals and families where symptoms impact health and reproduction.  Her research and writing focuses on the family emotional system as part of evolution, the biological nature of family relationships, and the difference Bowen theory makes in psychotherapy practice.  One person alters self and the system changes.  This is a completely different method for reducing symptoms in a multigenerational system.  She serves on the faculty of The Bowen Center and directs Center for the Study of Natural Systems and the Family in Houston, Texas where she also maintains a clinical practice using biofeedback and neurofeedback for self-regulation in family systems psychotherapy.  She teaches nation-wide and internationally.  Her articles can be found in Family Systems Forum, the journal Family Systems and in other medical and mental health publications.

This is year four of an Observations of Change research project documenting changes in anxious physiology and patterns in the family associated with one person’s work on differentiation of self, the process of psychotherapy based in Bowen theory.   Fifteen participants from the Bowen Center Postgraduate Training program take measures of muscle tension, adrenalin levels, sympathetic nervous system activity, brain waves and cortisol four times a year while describing and dating the steps toward differentiation of self that they take.

Preliminary observations are that A) anxiety increases as people plan to contact family and handle themselves differently in triangles throughout the family and B) anxiety decreases and evidence of thoughtfulness increases over time with sustained effort.  The changes in physiological reactions and patterns of interaction, associated with decreasing symptoms within the family, indicate reversibility of the impact of epigenetic influences over the generations and adversity in one’s own lifetime.

Mkerr M Bowen Jack Calhoun.jpgMichael Kerr, Murray Bowen, and Jack Calhoun

John B. Calhoun (May 11, 1917 – September 7, 1995) was an American ethologist and behavioral researcher noted for his studies of population density and its effects on behavior (at NIMH). He claimed that the bleak effects of overpopulation on rodents were a grim model for the future of the human race. During his studies, Calhoun coined the term “behavioral sink” to describe aberrant behaviors in overcrowded population density situations and “beautiful ones” to describe passive individuals who withdrew from all social interaction. His work gained world recognition. He spoke at conferences around the world and his opinion was sought by groups as diverse as NASA and the District of Columbia’s Panel on overcrowding in local jails. Calhoun’s rat studies were used as a basis in the development of Edward T. Hall‘s 1966 proxemics theories.

Taking the High Road by James B. Smith, MS, Director, Western Pennsylvania Family Center, Pittsburgh, PA: We live at a time in human history that psychiatrist Murray Bowen described as a time of “societal regression”.  Human functioning is guided more by subjectivity, opinion and feeling than fact.  Observable facts are commonly exchanged for other more comfortable “facts” at the drop of a hat, in marriages, families, at all levels of society, and at all points on the political spectrum, allowing individuals to gain comfort in relationships at the expense of what is real in the issues and decisions at hand. I discovered Bowen theory 48 years ago in my first professional job as a state hospital psychologist, finding it to be the most accurate description of human functioning that I had ever come across. I still find that to be true. I have used it to guide the entirety of my subsequent personal and professional life. I have found it to be equally at home in my work with those living in or having grown up in North America, South America, Asia, Africa and Europe. I have found universal validity of the singular focus In Bowen theory on making the effort to become more emotionally mature.  An African colleague put it this way: “What Zambia needs most is more differentiation of self”. On the last page of his just published “Churchill and Orwell: The Fight for Freedom”, journalist Thomas Ricks writes: “The fundamental driver of Western civilization is the agreement that objective reality exists, that people of goodwill can perceive it and that other people will change their views when presented with the facts of the matter.” I have come to believe that the journey toward becoming more emotionally mature is the high road to realizing this, not only in the West, but worldwide. With more people taking to this high road the current course of societal regression may tilt to societal progression.

Andrea Schara, LCSWA: In 1976 while working as an alcoholism counselor at a psychiatric hospital I met Murray Bowen, MD. In the talk, he noted that alcoholism would decrease if you could figure out how to “de-twitch” rats. I wanted to know how to do this and was accepted in the post graduate program at the Georgetown University Family Center, despite having only two years of college. Four years later, 1980, I was hired as the audio-visual coordinator and videotaped his work with families, staff and faculty, believing that in the future there would be more interest in his effort to use science as the base for a theory which gives a broad look at understanding human behavior from an evolutionary viewpoint. From 1985 to 1995 I organized a pilot program for individuals in families with HIV/AIDS. This project considered how motivated individuals could altered their family relationships, impacting the immune systems of the HIV/AIDS patients. I used biofeedback and now neurofeedback to “de-twitch” or reduce anxiety which increases the ability integrate thinking and feeling. People who altered family relationships lived longer than predicted by T cell counts. This will be a chapter in a book on death edited by Peter Titleman and Sydney Reed on Death and Loss in the Family. I spearheaded the donation of 15 years of Bowen’s clinical videotapes with two families to the National Library of Medicine (NLM) .  NLM researchers have access to all Bowen’s videos, letters and papers.  As a founding member of The Murray Bowen Archives Project, I have worked with its Board of Directors to make Bowen’s work accessible to the public via the web.  Oral interviews and videotapes of Bowen are available on the Archives web site. the faculty of the Georgetown Family Center, 1993 – 2011 and am currently on the faculty of Navigating Systems DC, providing learning opportunities for consultants who serve family businesses or members of wealthy families. How to communicate useful ideas around the process of differentiation of self is covered in my book: Your Mindful Compass: Breakthrough strategies for navigating life/work relationships in any social jungle.

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Andrea Schara with Murray Bowen, MD at Walter Reed Army Hospital 1986