Bowen Family Theory and Case Study

Bowen Family Theory and Case Study

John R. Stafford II

Brandman University

Abstract

Bowen family systems theory emphasizes the individual human behaviors that contribute to the overall family dynamic. By asserting eight different concepts, Bowen theory aids therapists to determine potential critical areas of practices that influence the complex emotional interactions of individual family members that in turn, affects the overall health of the household.  Bowenian therapists, however, do not seek to provide solutions to the problems, but instead provide the family members with the insight needed to make proper conclusions of the problem, and use their thinking skills to bring forth an appropriate resolution.

Keywords:  Bowen Family Systems, Bowenian Theory, Family Therapy, Family Systems Theory

Bowen Systems Theory

Dr. Murray Bowen (1913-1990) surmised that sociocultural experiences influence and shape perceptions of self and family interactions, and how personal relationships are affected by two primary factors of individuality and togetherness (Bowen Family Therapy, n.d.; Nichols, 2013). Dr. Bowen’s theory of human behavior focuses on all the members of the family as a single emotional unit, meaning that the intense emotional connection between the family members directly influences the mental function of the household as a whole (Kerr, 2000).

Bowen’s theory of change is quite simplistic. Meaning, if individuals within a family structure are emotionally intertwined, it will require changes in the mental and emotional process of the family structure to modify the person, and vice-versa. From a behaviorist perspective, the behaviors and emotions of the family impede or enhance the actions of each member of the household, and in turn, the actions of the individual affect family homeostasis. However, Bowen employs a neutral position of family/therapist interactions where the therapist takes a neutral role in assisting the family in working through the solution on their own by asking open questions and encouraging open dialog to lead to solutions.

Eight Concepts of Bowen Family Systems Theory

A key component of Dr. Bowen’s theory included eight concepts that integrate personal feelings and behaviors associated with family issues like marital problems, communication between parents and children, sibling relationships, and external family members. Although these concepts provide unique insight into a particular family member’s behaviors, it is fair to note that one or more concepts may apply to each family member, and often include more than one person (Kerr, 2000).

Triangles

The triangle concept describes a three-person relationship and is considered a core component of a larger emotional system. Triangles can involve three members of the immediate family, or a combination of immediate family members and individuals outside the household like a friend or relative (Kerr, 2000; Nichols, 2003).

Differentiation of Self

The core foundation of Bowen’s theory asserts that individual family members develop the capacity to think independently, act with flexibility and reason when faced with everyday issues (Nichols, 2003). In contrast, undifferentiated family members tend to become more emotional, become more reactive to problems and are less likely to recognize their autonomy within the family structure (Nichols, 2003).

Nuclear Family Emotional Process

The nuclear family emotional process describes four patterns in a family relationship that influence problems that develop within the family unit. Although individual perceptions of relationships change these trends, the underlying forces causing the problems play a significant role in the family emotional process (Kerr, 2000; Nichols, 2003).

Marital Conflict

Martial conflict arises when tensions within the family increase. This increase in pressure results in one or more of the spouses to externalize anxiety and place emphasis on what the other person is doing and attempt to control his or her partner, resulting in resistance from the receiving partner (Kerr, 2000; Nichols, 2003).

Singular Spousal Dysfunction

In contrast to marital conflict, dysfunction also occurs when one partner applies pressure on the other to react or think in a particular manner, and the receiving partner acquiesces to those pressures. Although this process can result in preserving harmony between spouses, it results in the pressured spouse to feel less comfortable with having his or her integrity and control subverted (Kerr, 2000; Nichols, 2003).

Impairment of children

A family with one or more impaired child suffer additional stressors like excessive worrying, becoming overly protective, and heightened anxiety levels between the parents and other siblings. Additionally, the impaired child may need extra care, which places additional responsibility on the parents, and a feeling of preferential treatment from the child’s siblings. The impaired child is also more likely to have inhibited self-differentiation and may experience problems in various social activities (Kerr, 2000; Nichols, 2003).

Emotional Distance

When issues in a relationship become overwhelming or repetitive in nature, a common reaction is for one partner become distant and sometimes isolated from other members of the family. Emotional distance occurs under different circumstances. Issues that intensify emotions in the family dynamic, or one person absorbing more anxiety than other family members may help the family function normally, but at the expense of one or more family members (Kerr, 2000; Nichols, 2003).

Family Projection Process

It is important to understand that children are susceptible to, and inherit many traits, behaviors, and come mental conditions from their parents. Familial projection occurs when one or more parents project their problems to one or more children in the family. Projection usually results in the child experiencing issues like a heightened need for attention and approval, a tendency to take responsibility for others actions or emotions, and impulsive behavioral patterns (Kerr, 2000; Nichols, 2003). Additionally, the parents may develop reinforcing behaviors like placing additional focus on the child, misinterpreting the child’s actions for a more serious issue and treating the child as if there were more serious behavioral or mental problems (Kerr, 2000; Nichols, 2003).

Multigenerational Transmission Process

A concern for any family unit is how generational differences influence the overall health of the family unit and the ability for family members to adapt to changes that naturally occur in the familial lifespan. Multigenerational transference is a process where older generations, parents, and grandparents, influence children during developmental stages. Although some of these transferences occur consciously through teaching and training, others occur on an unconscious level. Emotional reactions and behavioral patterns are, in many situations, a direct result of parental actions, attitude, and mood patterns (Kerr, 2000; Nichols, 2003). Additionally, family units may experience additional multigenerational stressors when an older family member like a grandparent moves into the home. The effects of multigenerational transmission manifest in the child’s development, and typically reinforce future patterns like mate selection, inhibited or increased differentiation of self, and emotional stability (Bowenian Family Therapy, n.d.; Kerr, 2000).

 Emotional Cutoff

Unresolved emotional issues with various family members may produce consequences of estrangement in an attempt to reduce the amount of emotional conflict. While it is not uncommon for family members to sever relationships with family members they have an unhealthy relationship with, this is not a cure for the underlying problem, and in fact, may result in additional challenges within the family unit.  (Kerr, 2000; Nichols, 2003). Some important causes of emotional cutoff are a child expressing his or her sexuality, religious or political differences, and lifestyle choices that parents disapprove of and are unwilling to accept (Kerr, 2000).

 Sibling Position

The Bowenian concept of sibling position is based largely on the research of psychologist Walter Toman (1920-2003) which surmised that siblings mature based on their position within the family structure. Toman, and consequently Bowen, asserted that the positioning of a sibling directly influences individual behavioral and temperament traits as they mature into adulthood. For instance, the oldest child may naturally adopt a leadership role, whereas a middle child may adopt behaviors of both the older and younger siblings, and younger siblings may become more reliant on either the older or middle sibling (Kerr, 2000). Sibling position roles are also subject to parental influence. If one or both parents place heightened levels of anxiety on the oldest child, he or she may, in fact, become more submissive, or disinterested in a leadership role because of the stress initiated by the parents. In contrast, the middle or youngest child may assert more of a dominant role in this situation, resulting in new conflict amongst the siblings (Kerr, 2000).

 Societal Emotional Process

Although Bowenian Family Systems Theory emphasizes the treatment of families, the eight concepts also apply to non-familial environments. Each concept is applicable in corporate and social environments and provides insight into how individual reactions, attitudes, and emotions affect other people during everyday encounters (Kerr, 2000). Considering the validity that what happens at home affects how we react to situations outside the home, societal emotional process explains how psychological systems control individual and group behaviors on a societal level (Kerr, 2000).

The Family Diagram

Bowen developed the family diagram to represent the family as a living organism and multigenerational emotional process. A therapist will use the family chart as a tool to outline the family lineage and identify important behavioral issues, traumatic family events, or important life events that could influence the family’s current dysfunction, or dysfunction of a particular individual within the family structure (Kerr, 2000; Nichols, 2003).

Family Assessment in Counseling
Family counseling does not only occur when there is trouble in the home. Some people decide to engage a professional before marriage to aid in the assimilation process (Wilmoth & Smyser, 2010), while others may choose to hire a therapist to prepare for an upcoming birth of their first child (Ghanbaripanah & Sharif Mustafa, 2012). Although the myriad of reasons ranges in intensity, the outcome is to seek professional assistance to help resolve the issue at hand. Regardless of the reasons a client seeks help, the therapist must develop a thorough understanding of the people and issue[s] involved (Boughner, Hayes, Bubenzer, & West, 1994; Ghanbaripanah & Sharif Mustafa, 2012).
Because there are different disciplines or methods of family counseling, the initial evaluation is standardized with three primary instruments; self-report, observational, and diagrammatic method (Ghanbaripanah & Sharif Mustafa, 2012). However, these three instruments are vague descriptors of the variety of tools which fall under them, and professionals are left to determine which set of tools is best suited for both the therapist and the client[s] (Ghanbaripanah & Sharif Mustafa, 2012).

Developing a Treatment Plan

After a successful assessment, a treatment plan will be required to assist the client[s] in achieving a satisfactory resolution to the problems (Hutchinson, Casper, Harris, Orcutt, & Trejo, 2008). A successful treatment plan should engage the client[s] in treatment (Hutchinson, et al., 2008). The plan should act as a collaborative, creative, and client-driven activity roadmap developed by the therapist and the client[s] that creates an alliance between the client[s] and the counselor (Hutchinson, et al., 2008). A primary aspect of a successful treatment plan is to include coherent problem statements and the creation of actionable goals that are individualized to the client[s] and the underlying issues (Hutchinson, et al., 2008).

Case Study

Kristen and her family experience multiple dysfunctions in the home that stem from a variety of multigenerational aspects, family triangles, sibling positioning, and family process issues. As a child, Kristen grew up in an abusive household. Her father, an alcoholic was abusive. Although it is not clear if he was abusive to his wife and daughter, it is safe to assume he was. Problems with the father resulted in an alliance triangle between Kristen and her mother, Juana, and her father, George. In this situation, the triangle would be the mother focusing her attention and emotions towards the child because of the neglect and abuse received from the father. The household problems would also create a multigenerational problem where both Kristen and her mother had unresolved attachments to the symptoms of the alcoholic father and the family triangle. These issues further complicate the current relationship between Kristen and Juana and enhance Juana’s attachment to the oldest son, Ronnie.
There is also sufficient information that reflects on Kristen’s unresolved issues influenced her past marital choices. Kristen stated that her first husband and Ronnie’s father was also an abusive alcoholic. However, her current husband Tony is the opposite and breaks the behavioral mold of her past. Furthermore, Juana’s unresolved issues with George, combined with Ronnie sharing similar behavioral traits to George have manifested in Juana emotionally projecting an unhealthy and overly-protective relationship with Ronnie that inhibits differentiation and enhances troubles between other family members; here we discover the second triangle. The second triangle is between Kristen, Juana, and Ronnie, and fueled by the problems between Kristen and Juana, which acts as an enabler for Juana to become intertwined with Ronnie.

Kristen’s concerns about Ronnie’s behaviors stem from his occasional aggressiveness, most likely fueled by Juana’s attention, and Kristen’s projection of unresolved past family experiences. Although there is minor discussion surrounding some other family members, there is enough data to extrapolate the third triangle, which would include Tony, Kristen, and the middle-placed daughter, Brittany. The triangle is a result of problems between Kristen and Tony, which results in Tony and Brittany spending more time together that with other family members. Over time this triangle will most likely impede Brittany’s ability to differentiate herself adequately from her father, and manifest as a disassociative pattern between Brittany and the rest of the family.

While it is fair to note that a fourth triangle involving Kristen and Tanya is apparent, there could be multiple third-party causations, and lack of more accurate information would lead to speculation. However, noting that Tony is more withdrawn, quiet, and reserved and that Kristen and Tony have experienced problems with Juana, there is an indication that Tony would be the third factor in this equation. Exacerbating the problems is the oldest daughter Sophie. Sophie displays a high level of dissociation and emotional cut-off from the family. Sophie’s dissociative behavior is likely a result of sibling positioning as the oldest daughter and second oldest child, combined with Ronnie’s aggressive behavior, problems between Juana and Kristen, and the triangles that exist between her parents and other siblings.

Treatment Plan Considerations

The treatment plan should be designed to emphasize a combination of continued therapy for the family to help improve family structure, communication, and homeostasis. Progress will be measured by milestones to show areas of improvement, or identify areas still in need of improvement. The plan is implemented in phases that allow the family time to explore the issues and come to conclusions with minimal guidance from the therapist. The first step of implementation should be therapy sessions to help the family talk, hear each other, and discover solutions. The second stage is to help the family identify and break old routines that may enhance anxiety in the home and to encourage changing interaction patterns between family members. The final stage would include a reduction and progression towards ending therapy once family homeostasis improves. There are areas where specific family members may seek additional counseling to address unresolved issues.

Family therapy sessions should continue to help the family members identify communication and active listening opportunities to aid in disarming argumentative postures, feelings of not being heard, and improving relations between family members. Continued counseling will also assist family members to identify existing triangles, multigenerational transfers, and sibling placement issues. As the family begins to discover these issues through open communication, they will start to define solutions for them.  Juana and Kristen may desire to seek additional counseling to recognize and resolve past issues that influence current tensions. Also, Juana, Kristen, and Tony should be encouraged to spend equal time with the children, and the family should be invited to change the family routine to foster more interaction and togetherness, and potentially start to change associative behaviors of “favorites” between family elders and children.

Tony and Kristen should be encouraged to spend time together as a couple to restructure and redefine their roles as less adversarial and reactive to active and communicative. Reestablishing the bond and cohesiveness of the marital couple will have a dramatic impact on the overall family structure. The children should be encouraged to spend time together as siblings, which should help identify areas of commonality and interest; a concert or movies perhaps. These activities should reduce triangular interactions that currently exist, promote a healthier home life, and increase healthy differentiation pattern development.

Treatment Plan

Recipient Information

Name: Family X – Vignette
Date: 02/01/2017
Problem/Symptom
See above Assessment


Long Term Goal: Improve family structure, communication, and interactions

Short Term Goals/Objectives

1. Continued family counseling to help family recognize communication and other problem areas
2. Juana and Kristen seek additional counseling for past issues
3. Break old routines
4. Encourage family members to spend more time in groups and as a family
5. Reduce therapy sessions

Milestones

1. Family arguing and contention begins to balance. Communication improves
2. Past issues become resolved. Mother and daughter are talking more openly. Fighting reduces.
3. Breaking old routines introduces exploration as a family.
4. Reduces existing family triangles. Helps family members find commonalities. Notable reestablishment of family structure.
5. As the family structure, communications, and interactions improve, a reduction in therapy sessions will show significant progress.

References

Boughner, S. R., Hayes, S. F., Bubenzer, D. L., & West, J. D. (1994). Use Of Standardized Assessment Instruments By Marital And Family Therapists: A Survey. Journal of Marital and Family Therapy,20(1), 69-75. doi:10.1111/j.1752-0606.1994.tb01013.x

Bowenian Family Therapy. (n.d.). Retrieved January 28, 2017, from http://www.psychpage.com/learning/library/counseling/bowen.html

Ghanbaripanah, A., & Sharif Mustaffa, M. (2012). The Review of Assessment in Family Counseling. International Journal of Fundamental Psychology & Social Sciences,2(2), 32-35. Retrieved February 01, 2017, from http://fundamentaljournals.org/ijfpss/downloads/15-Afsan%20300412.pdf

Hutchinson, M., Casper, P., Harris, J., Orcutt, J., & Trejo, M. (2008, July 31). THE CLINICIAN’S GUIDE TO WRITING TREATMENT PLANS AND PROGRESS NOTES [PDF].

Kerr, M. E. (2000). One Families Story: A Primer on Bowen Theory. Retrieved January 26, 2017, from http://www.thebowencenter.org/theory/

Nichols, M. P. (2013). Family Therapy: Concepts and Methods (10th ed.). Boston: Pearson.

Wilmoth, J., & Smyser, S. (2010). Use of Premarital Assessment Questionnaires by Clergy in Marriage Preparation. Journal of Couple & Relationship Therapy,9(3), 252-267. doi:10.1080/15332691.2010.491783