Overview of Bowen Family Systems Theory

Transcript

I'm Dr Michael Kerr family psychiatrist and this recording is going to be about an overview of Bowen family systems theory okay so this is the title slide of course a broad overview of Bowen family systems theory and what I'm presenting is a radically new understanding of how relationships work if you look at this cartoon the wife is saying stop yelling at me and the husband on the right of course is saying stop ignoring me and their daughter in the middle is saying stop fighting so the first section I call Natural systems thinking so the core of this presentation is the application of systems thinking to human behavior with the exception of people who have tried to extend General System Theory and cybernetics to human behavior the bow and family systems theory that is the basis of this short talk is the first application of systems thinking that came from the direct study of a living system namely the Human family system so this a with an arrow to B and this is intended to symbolize cause and effect thinking event be occurs because an antecedent event a occurred a has called caused B this is an important way of thinking and highly useful in many areas such as science however it is inadequate for addressing the complexity of Human Relationships so here is a clinical example of cause and effect thinking Jim the husband says to his wife I feel depressed because you would rather work in your garden then be with me this statement is typically delivered accompanied by a sadl looking face and slumping shoulders his assertion implies that her actions cause him to be depressed so this is a different way of thinking about it you see the arrows going in both directions so this symbolizes a more complex picture of what is happening it symbolizes a reciprocal interaction Jim's wife Mary says it upsets me to be around you when you act depressed and complain about not getting enough attention I Retreat to my garden in response systems thinking describes how each spouse changes in response to a process that both unwittingly help create and sustain the Red Arrows symbolize that this is an anxiety driven process and the ab thing below it is indic Ates two anxious people they co-create the process co-create the process and corresponding changes in one another the whole is greater than the sum of its parts the husband's Communications moods and behaviors trigger a withdrawal response by his wife and her W withdrawal response triggers a depressed mood in the husband husband each contributes equally to an emotional process that alters each other's moods and behaviors the term emotional process refers to the flow of emotions between people each person's emotions not only reflect their internal States but also function to change each other's internal States and ass associate Associated actions in human beings the process is med mediated primarily by auditory and visual stimuli it is nonsense to blame one another because they both help create changes in each other to which both react blaming the other amounts to blaming oneself if we go back to our friends on the title slide what is key to understand is how each person is thinking about this type of interaction if their each thinking cause and effect he blames his yelling on her ignoring him and she blames her ignoring him on his yelling neither wants to give in if either partner can apply systems thinking he or she can work to change self without feeling they are giving in the daughter will obviously derive benefit from their more mature Behavior a key assumption here is that A System's view of relationships is a better description of reality than a cause and effect view the task is for people to gain more objectivity about an emotional process progress results from developing a new way of thinking and translating that into a new way of being it takes a leader to start the process rolling but it does not always have to be the same person leading my task as a family systems therapist is to stay objective about what people say and often act out in front of me ask questions that reflect that objectivity and way of thinking and thus help them educate themselves to an alternative way of understanding their relationship when a person can act on the new way of thinking he or she is being more of a self in the relationship this means he or she can be more reflective and consider a long-term view he or she does less automatic reacting and acting to relieve the anxiety of the moment it may seem easy to make this shift in thinking but it is not cause and effect thinking is a powerful default mode when situations carry some emotional veilance it is much easier to think systems about the cosmos than one's own family a quote from Jonathan height reasoning has evolved not to help us find truth but to help us engage in arguments persuasion and manipulation in the context of discussions with others confirmation bias is a builtin feature of the argumentative mind Jim feels that if Mary were more attentive he would not feel depressed which is true Mary feels if he did not so depressed she would not feel overwhelmed and want the distance which is also true both spouses are caught in a process similar to a Chinese finger trap each is equally reactive to the other spouse it takes two to tango most people play lip service to this being true but it is difficult to live it the shift from causal thinking to observing emotional process and one's part in it generates a state of equinity that produces almost instant changes in interactive process and its consequent effects on the moods and behaviors of both people both often compare it to a breath of fresh air is probably the right spot in this presentation to let a certain cat out of the bag many people are prone to disagree with this assumption in Bowen Theory but it has been implied by everything I have presented thus far people select Marriage Partners and friends who match their own level of emotional maturity or what Bowen Theory terms differentiation of self are there exceptions nowhere nearly as many as people claim if you Embrace this assump it is much easier to apply systems thinking to relationships causing effect thinking ask why why does the other treat me this way maybe he has abandonment issues he or she commitment issues bonding anger or bipolar issues cause and effect thinking sees the explanation for a person's action with within that individual systems thinking does not act ask why it focuses on how what when and where systems thinking describes functional facts about relationship interactions in the Jim and Mary story it is a functional fact that if the husband says things that blame Mary she retreats in reaction it is a functional fact that if she Retreats he makes more blaming comments functional facts are easy to observe once the Observer is thinking systems speculations about why Jim makes blaming remarks are of little value and unnecessary second part social cues and the role of chronic an xiety Charles Darwin even when we are alone how often do we think with pain and pleasure of what others think of us or their imagined approbation or disapprobation and this all follows from sympathy a fundamental element of the social instincts I call this next two slides The Four Horsemen of the Apocalypse the original version Conquest war war famine and death and now I introduce attention approval expectations and distress as the Four Horsemen of the Apocalypse so for example in a well differentiated relationship it's characterized by high level self-regulation there is a low reactivity to The Four Horsemen attention approval expectations and distress on both sides in a poorly differentiated relationship with which I show with dots around the square in the circle instead of a solid line there's a very high react ity to OT attention approval expectations and distress and the associated uncertainty that's true on both sides and that's poorly differentiated relationship these types of reactivity transcend personality characteristics they are common to all human beings a bit about evolution in the emotional system so you see picture there of a human family a naked moat colony colony in the upper rightand corner a b colony in the lower left and a chimpanzee Colony what do these pictures have in common they're all naturally occurring systems living systems are Fountains of energy and activity Bowen Theory assumes that the driving forces of this energy and activity reside in the emotional system the emotional system of homo sapiens and of all other species have been shaped by their long philogenetic histories the emotional systems of all the species on the phenetic tree are not comp composed of identical biological systems and mediated by identical communication signals however there there are likely more common denominators among the seemingly disperate emotional systems of the Myriad speci species on the planet than is generally thought Bowen Theory uses the term emotional more broadly than in common usage simple unicellular creature such as bacteria do not have a brain but they are capable of adaptive Behavior the intracellular systems that support and motivate adaptive Behavior are part of the bacterial emotional system Bowen theory conceptualizes that an emotional system was part of living systems long before what people commonly consider as emotions became became part of emotional systems the flow of emotional forces through a family system is an invisible process you infer their presence by their impact on the emotional functioning of family members observing the impact of emotional forces or the emotional field of family members is emphatically mind expanding I'm going to give a Illustrated clinical vignette there's a family with the on the starting from the left the father as you move to the right the oldest son then the mother and then down below are the two other siblings and this family hypothetical family lives in Peoria Illinois he's a successful small business owner she's a nurse and Homemaker and she has always said to herself I always felt guilty that I left him meaning her oldest son to go back to school when he was just two years old now he the oldest son is a college grad he has a good job and he's living in New York City now for two years the 23-year-old oldest son complains that he does not like to visit his parents because they still treat him like a child it's like I never left home he laments there's the arrow to the oldest son again Dr K that's me asks do you act like a child he replies vigorously yes and that is what I hate most about going home to Poria from New York City this point the young man thinks his parents cause him to act like a child he has not reflected on his highly sensitized emotional reactions to his parents facial expressions tones of voice and other nonverbal cues is not just what they say but that is in the mix of course too furthermore he has not thought much about what his parents react to in his own behavior and demeanor I show there the three red arrows between the Father the oldest son and the mother and their interactive process emotions flow between the three people particularly when they are in physical contact but it can happen on the phone or on Skype as well in a what is called a triangle pattern the threesome creates an emot field that regulates the emotional functioning of each of them anxiety drives the process the process is activated by the high level of emotional reactivity each person has to the other no victims here as described earlier each person reacts to attention approval expectations and distress in others the level of reactivity in this parental triangle is an unresolved Legacy from the years of the son growing up in the family it is also a legacy of what the parents never resolved with their own parents emotionally driven relationship interactions transmit down the generations of every family note well a useful P perspective for people to develop if they are trying to change such a process is that the past does not cause the problem in the present the father mother and son repeatedly recreate the problem in the present correspondently changing the process that unfolds in the present is a high road to resolving issues with the past as the earlier example of the depressed husband and his distancing wife it is impossible to discern when this particular chapter of an old process began the son has planned an obligatory visit home and has been anxious about it for weeks the mother has likely been excited about seeing a son she wishes she could see more of the father worries about having another visit that does not meet expectations particularly for his wife all three people are primed in their emotional reactivity prior to the visit whether aware of it or not a huge source of human chronic anxiety is anticipating situations for which you lack the confidence that you can deal with them to your satisfaction many many of these situations have to do with relationships inside and outside the family Poria airport the parents equally eagerly meet their son at the airport it is a crisp March day in Poria so you see the Father the the mother and the oldest son coming together in that triangle pattern the mother greets her son warmly then says why don't you have a coat on you must be cold the sun bristles and I show anxiety arising him him which will drive reactivity he bristles at this comment the father stiffens as well but supports his wife yes your mother is right so he's anxious too the sun feels hovered over not treated as adult as an adult his Dem P gets subdued anxious and sensitive about his parents thinking he can't make good decisions now more anxious too the mother asks are you sure you feel all right you don't seem like yourself more anxious too the father says to his wife he'll be fine there you go the mother thinks minimizing my worries so now you can see all three people are stirred up with more anxiety the sun is thinking well I'll only be here for two days then mercifully back home in New York City in Bowen Theory we call this a regression in system functioning driven by chronic anxiety commonly the mother's worry and hovering are viewed as the problem but but by the Sun and the Father the father walks on eggshells with the mother knowing how easily upset she can get about signs she interprets his unhappiness in her three kids particularly this oldest boy he tries to do what it takes to keep her happy the son is often angry that his father mostly seems to take his mother's side the son has the same deep desire as his father to please his mother to keep her happy it's easier that way the blame the mother is not the blame she is one of three equal participants in an automatic emotional system process each has difficulty maintaining a self in the Triangle an important lesson from this vignette that applies to a lot of people is that the mother's guilt about going back to school when her their son was 2 years old fueled much of her overprotectiveness she feared that he had been traumatized by her action her putting her son in daycare at an early age is not the problem his core problem was the difficulty developing a self in the ongoing anxiety-ridden relationship process with the parents human beings are sufficiently steeped in individual cause and effect thinking that is very difficult to shift to A System's view it requires letting go of individual thinking gaining an understanding of the emotional system and the concepts in Bowen Theory begins with Evolution the human emotional system is the outcome of an evolutionary process that extends deep into the history of Life the fundamental forces and patterns that operate in all human families are anchored in the emotional system the human emotional system has evolved far more sophistication than the emotional systems of less complex life forms but the large cerebral cortex and elaborate feeling systems of human beings retain retain critically important connections with parts of the brain that evolved long before the emergence of hominoids even long before vertebrates so neuroscientists study the emotional system that exists within the brain of individuals and it's depicted here as the Primitive B brain in the lower left corner uh is involved with self-preservation and aggression the intermediate brain on the upper left is called the lyic system and that is a significant part of emotions and to the right upper right the rational brain the neocortex that can accomplish intellectual tasks so but also to important to emphasize extensive connections exist between the emotional system and both the higher brain and brain stem these connections make subjectivity part of the emotional system as well as all functions throughout the body and I show the arrows there of connection B and Theory incorporates Neuroscience research but extends the concept of the emotional system to an individual's important relationship systems the brain has regulatory process process is built into it to regulate its functioning but the relationship system regulates the brains of each member as well the relationship system can regulate the functioning of each family member's genes so here depicting it the communication mediated through the five senses hearing and vision being the two primary ones and arrows going back and forth between all these individuals say in a family unit so the emotional system motivates Behavior but if you study the relationship this is the way to see the way it's expressed the triangle is called in Bowen Theory the molecule of an emotional system this quote has always tickled my fancy a D functional family is any family with more than one person in it and that's written by Mary Carr who's written several books about examining her family so what is it about human nature that creates the core dilemma of Human Relationships there's a powerful need for emotional closeness and also an allergy to too much of it it makes a twers system inherently unstable it's solved with a triangle two insiders and an outsider kind of the we they phenomenon so looking at this family again I've made several resence references to the parental triangle in the clinical vignette the triangle is one of four patterns of emotional functioning described by Bowen Theory the triangle is so basic it is referred to as the molecule of an emotional system it is the smallest stable relationship system in that anxiety generated in a family or other system can shift around the three relationships another number of facets play out in triangles but the most basic one is two people reducing tensions in their relationship by focusing on a third two parents say on a son the problem is that it impairs the functioning of the third so you see symbolized there the parents have anxiety from the way they're interacting with one another and then project that anxiety to the Sun by focusing more on the sun if the son is a child if the third is a child he develops less self and is quite vulnerable to chronic anxiety his emotional braries are not good so this comes from rard Kipling's first stanza of a a poem called we and then father mother and me sister and Auntie say all people like us are we and everyone else is they and they live over the sea while we live over the way but would you believe it they look at us we as only a sort of they so the calming effect of affiliation in this way can Trump empathy for Outsiders a political process embedded in an emotional process so again you have the powerful need for emotional closeness an allergy to too much of it it makes the twers system inherently unstable it's solved with a triangle two insiders and an outsider the we they phenomenon the higher the basic levels of differ differentiation the more adaptive people are in managing this instinctually rooted dilemma the lower the basic levels of differentiation the greater likelihood of polarization conflict and clinical dysfunction quick review of the patterns of emotional functioning and system de symptom development there are four patterns of emotional functioning described in the theory the triangle dominant subordinate interactions emotional conflict and emotional distance and these are all anchored in biological processes so the patterns operate in All Families across all cultures they are anchored in the emotional system but but also have feeling and psychological component if chronic anxiety elevates sufficiently in a family system it intensifies the activity of one or more patterns that governs where clinical problems surface in a family system on the left it's played out in marital conflict in the in the middle the wife is the dominant one the husband is more adaptive and vulnerable to absorbing chronic anxiety in their relationship through these dominant subordinate interactions that generate anxiety that can then fuel symptoms or it can be as we've been describing earlier it can manifest by focusing on a child that can stabilize the parents relationship but impair the child that's the triangle so anxiety is bound or compartmentalized in one part of the system presumably to preserve the stability of the system as a whole the process can stabilize a family for many years but symptoms will likely emerge eventually such as when it is time for the most involved child to move on into the Adult World his or her Lack of self manifests in anxiety in the young adult and an anxiety in the family the buildup of chronic anxiety can drag the family functioning down one of the most the father of modern medicine Sir William Osler and you can see he bridged the the 19th and 20th centuries emotions acting through the brain can affect the nervous system functioning hormone levels and immunological responses thereby changing a person's susceptibility to a host of organic ills a mountain of research has confirmed this idea of a mindbody connection since osler's time this is not to say that relationships and a person's particular position and a relationship system cause illness disturbances in relationships and a person's position in a system renders that person more vulnerable to physical mental or social symptoms but many other factors play important roles in whether or not someone develops an illness for example genetic predispositions but genetic predispositions by themselves are usually not causal I asked this question is it this simple is Bowen Theory reductionistic medical and psychiatric diagn noes emerge in the context of a relationship system process meaning that diagnoses are actually symptoms of a relationship process not causes symptoms the family member most vulnerable to developing systems is the one making the most adjustments in his or her internal functioning to keep the system in harmony that person is vulnerable to feeling overwhelmed isolated and out of control he or she has lost self in this process such emotions fuel a chronic stress response that can trigger organ and tissue dysfunction part six is differentiation of self fact-based knowledge exists about the type of behaviors that promote cohesion cooperation and productivity and good health in Families versus the type of behavior that promotes fragmentations lack of cooperation lack of pro productivity and poor health it boils down to the degree to which people are able to distinguish between the feeling process which is rooted deeply in the brain and the intellectual process people vary on a Continuum in this ability so Bowen Theory calls this differentiation or the degree of integration of the self an integrated response is one and formed by both objective thinking and feelings it is not a merging of thinking and feeling but it is more like a Cooperative team the theory postulates two opposing B basic life forces one is a build-in gr growth Force toward individuality and the differentiation of a separate self and the other and equally intense emotional closeness differentiation of self is roughly roughly equivalent to emotional maturity one way to describe emotional maturity is the ability to be present and accounted for to be in good emotional contact with important others in important relationship systems particularly during challenging or stressful times the person can re in the temptation to withdraw and also can respect the emotional boundaries of other others people violate emotional boundaries by intruding into the life space of others such as by giving into others immature expectations and demands or imposing one's will on others in subtle and not so subtle ways the ability to have mature connections with others depends on having a well-developed self the less self people have the more difficult it is not to violate the emotional boundaries of others or not to permit others to violate your own emotional boundaries bow and the describes there's Murray Bowen of course two main variables in Bowen three one is the degree of anxiety and the other is this degree of integration of self differentiation describes a property of the individual so for example I've Circle that female in the left leftish side of the diagram with a solid line indicating that she has a pretty good solid self compared to the others so anxiety describes a property of the emotional field so anxiety is very contagious around the family this redness depicts the uh emotional feel getting more anxious but the person there for a while being able to withstand that but then their boundaries her boundaries decline she gets sucked into it too so that's a decline in functional level of differentiation but if she can get her act together and pull up and not get caught in all this relationship process it can pull the system up so the basics of relationship transmission during uh a family with raising kids you have a non-ac you can have a non non- anxious investment and more mature interactions with say a firstborn son Who develops therefore more self and to the right an anxious investment less mature interactions and that individual uh develops less solid self so parents easily describe this difference in the kids something variation very common but sees it as caused by differences in the children that they react to not that they're part of it so the one who with has more self can also be more gold directed and the one who has less self is has more of an obligatory relationship orientation hard to get free of reacting so the left one has more self the right one has less self symbolized there so people are attracted as to spouses at the same basic level so there's a a well differentiated male and below it a a poorly differentiated male and they attract and goodness knows all the factors that go into this attraction uh spouses of equal levels of differentiation of self so thus better differentiated spouses tend on average to raise somewhat more differentiated children with sibling variation then do less differentiated spouses with sibling variation so this just illustrates the family diagram being multi-generational systems it's a multigenerational emotional system like an organism here only four generations but it can be extended farther than that and what can happen is over the course of this process it can create individuals that are well differentiated and individuals that are poorly differentiated aest Continuum so this is just my own family system one that I studied with with great benefit and um I have had a brother who's dead now but uh it was an intense focus of family anxiety he's the one with the dashes around him uh and a big thick Arrow between my mother and that brother and the mother was married for the first time before and divorced so that's my first half sibling and then comes my brother Billy who was eventually diagnosed to have schizophrenia uh which I don't think is really all that useful of diagnosis the next child died in child well near child birth 10 days and Highland menbrane disease and there's a a third brother and myself last each of us Freer in the family system to for form more of a a self so Murray Bowen the originator of Bowen family systems theory let me just give you a little touch of that he began his uh St um psychiatric career at the meninger clinic after World War II and serving in World War II and he was there for eight years 46 to 54 then he went to the National Institutes of mental health for five years to to conduct a family study project and then he moved on to the Georgetown University School of Medicine Department of Psychiatry and was there from 1959 until his death a final thought we human beings have a lot less autonomy om in our emotional functioning than we generally like to think most people know this to be true but it's hard to accept thank you for listening