Godmindfamily, Chapter 3

Chapter 3: Introduction to Bowen Family Systems Theory (BFST)

The best prior framework for thinking about the family is Murray Bowen’s Family Systems Theory, written about and developed by his protégé, Michael Kerr. Murray Bowen was born in 1913 as the oldest of five siblings. He served as a doctor in the Second World War and shifted his interest to psychiatry. After the war, he pioneered family therapy and family systems theory, which was developed through his work at the National Institutes of Health in Bethesda, Maryland. He conducted experiments on families with one schizophrenic child in a clinical environment, which informed his theory. We will take Bowen Theory as our starting point for an analysis of the family.

These are the core concepts of Bowen Theory, including extensions and clarifications made by Kerr.

1.     Emotional Fusion, Overfunctioning and Underfunctioning. From observing families in a clinical context, Bowen noticed that there was a tendency to emotional fusion. That is, the tendency for family members to merge with each other emotionally, to feel each other’s feelings and become highly anxious, moody, melodramatic and reactive to one another. This can occur in romantic relationships, parent-child relationships, sibling relationships and even intense friendships. In cases of emotional fusion, there is a lack of boundaries that sacrifices the independence of family members as individuals. Often one member in a fused pairing overfunctions and the other underfunctions. That is, one person does most of the work, domestic chores or decision-making and the other does nothing or very little. Though it may appear the underfunctioner is the more dependent, in reality, Bowen realised that both individuals are dependent on each other.[i] Of course, take any two people and it is unlikely they will do the exact same amount of work, but in a fused pairing the overfunctioning and underfunctioning are pronounced. Bowen believed that the human desire for togetherness (fusion) was counterbalanced by a competing desire for individuality (differentiation). According to Bowen, the consequences of emotional fusion are either cutoff (see item number 7), dysfunctional behaviour, symptoms, or bringing a third person into the conflict (the formation of a triangle).

2.     Triangles. A triangle is a relationship system involving three people. Bowen regarded the triangle as the basic emotional building block of society. He believed that a triangle was more stable than a two-person system because unlike a dyad, it can tolerate more tension without involving an extra person. Triangles usually mean that one person is the ‘third wheel’ or odd one out in the outside position, with two closer insiders. But tensions between the two insiders can result in shifting allegiances, whereby the outsider becomes the insider and one of the previous insiders becomes the new outsider.[ii] Bowen believed the outside position was associated with a build-up of anxiety because of the social exclusion, but acknowledged that when the insiders argue, the outside position can actually be something of a haven of tranquillity. An example of a dysfunctional triangle is two insider parents focusing excessively on an outsider child, which can cause rebellion or sickness in the child.

3.     Differentiation of Self. This was Bowen’s main concept, and solution, to family-related anxiety. Differentiation was basically Bowen’s measure of how emotionally mature people are, the extent to which they are influenced by others, and by their own emotions. Indeed, there are two components of differentiation: differentiation of self from others and differentiation of the intellectual system from the emotional system. A poorly differentiated person is highly emotionally reactive to others and becomes easily stressed out. This can manifest in running away from conflict (including ghosting), or in melodramatic and overly emotional behaviour. I.e. being a drama queen. Bowen believed that people with low self-differentiation were more liable to illnesses. A well differentiated person is able to remain calm and objective and maintain their own values and beliefs in the face of outside pressure, while staying connected to others. Bowen believed that people had a basic differentiation level, derived from their genes, family history, childhood and adolescence, that was relatively fixed and difficult to improve upon. He did however allow that one’s functional level of differentiation – how one behaves in relationships – was more context-dependent and capable of development, but within limits. Family Systems Theory and family therapy aims to improve patients’ self-differentiation (SD) to ameliorate family dysfunction. The chief mechanism for doing this is to increase the awareness in the individual, or better yet, the entire family, of the functioning of the family as an emotional unit, bringing about a higher level of emotional objectivity in the system (or at least part of it) and for behaviour to change constructively as a result of these insights. Bowen’s family therapy is thus a kind of ‘knowledge therapy’, like Sarno’s work. Bowen and Kerr believed it was possible to score people’s differentiation level on a scale from 0 to 100, based on qualitative observations of how individuals function emotionally within the family.[iii] Bowen posited that people could be highly competent at work and yet be low differentiation at home. It is possible to achieve great or important things with medium to poor self-differentiation – look at Steve Jobs, infamous for his overbearing personality and temper tantrums, who nonetheless designed the architecture of 21^st century consumer technology.[iv]

4.     Nuclear Family Emotional Process – describes four basic patterns that determine where problems emerge in a family: martial conflict (spouses focusing on each other’s shortcomings, especially as responsibilities mount), dysfunction in a spouse (the submissive spouse yields too much self-control to the dominant, which Bowen believed may result in dysfunction or symptoms), impairment of one or more children (when both parents focus their anxiety excessively on a child, this undercuts the child’s differentiation), and emotional distance (people distance from each other to reduce the intensity of the relationship, without actually solving anything).

5.     Family Projection Process – whereby parents unconsciously transmit their emotional problems and anxieties onto their children, often by focusing on them excessively, mollycoddling them or worrying that the child has a problem, which causes the child to act in ways that confirm that belief. This can actually create real problems, illness and low differentiation in the child via the power of SFP’s (including IFP’s).

6.     Multigenerational Transmission Process – how levels of differentiation and problems are passed down through the generations of a family, often leading to a deterioration in levels of differentiation over time. This occurs via the family projection process and Bowen believed it could affect factors like physical health and marital stability in descendants.

7.     Emotional Cutoff – a means of handling the tension and unresolved emotional issues in relationships with parents, siblings or partners by cutting oneself off from them. This can be achieved by moving away, visiting rarely, or remaining in occasional or frequent contact with the family but avoiding sensitive topics. Emotional cutoff does not resolve a relationship problem, and people who cut themselves off risk carrying the issue over from their family of origin to their new family (e.g. recreating parental issues with a spouse or child).

8.     Sibling Position. Bowen derived this idea from Walter Toman. The basic concept is that birth order influences people’s personalities in more or less predictable ways. For example, Bowen believed that an oldest sibling tended toward leadership positions, while younger siblings tended to be followers or rebels. Bowen also believed that the sibling positions of a couple determined their compatibility.[v]

9.     Societal Emotional Process – posits that the anxiety and emotional issues that beset families also affect communities and nations, which effectively function as large scale families. Bowen and Kerr observed that governments can also mollycoddle their citizens via excessive welfare and benefits, and that during periods of national stress – war, recession etc. – the systemic anxiety of the country increases, sometimes leading to irrational collective behaviour. Bowen believed that ever since World War Two, American society entered a regressive pattern, and the differentiation level began to decline, the symptoms of which included an increase in crime, collective anxiety, divorce, drug abuse, insolvencies and an increased, harmful focus on children and their problems. Bowen acknowledged that it is harder for families to function well in periods of social regression, like the one we are currently in. As always, he believed more differentiation of self was the answer: the ability to maintain a clear sense of self and avoid fusion with a decaying society.[vi] More on this later.

10.  Chronic Anxiety. There is a difference between acute and chronic anxiety. Acute anxiety is a reaction to immediate threats, which are sometimes real. Chronic anxiety, according to Bowen, is generated within the relationship system based on largely perceived dangers. Bowen and Kerr conceptualized chronic anxiety as the main problem afflicting human beings and systems including families, organisations and societies, positing that it caused everything from domestic arguments and dysfunctional behaviours (including addictions, infidelity, delinquency, etc.) to physical symptoms. Bowen posited that people with low differentiation had higher chronic anxiety. He thought anxiety could be lowered by increased differentiation resulting from successful family therapy, but only to a point.

11.  Unidisease. Michael Kerr extended Bowen Theory with his concept of unidisease. The basic concept of unidisease as outlined by Kerr, is that chronic anxiety generated within the family system causes all diseases, from cancer to psoriasis, via physiological mechanisms such as inflammation.[vii] Though Kerr acknowledged the link between trauma (including adverse childhood events) and disease, he explained that both phenomena were effects of the same basic cause: low differentiation of self within the family.[viii] Bowen and Kerr often observed that schizophrenics were very dependent on their mothers and believed that the cause of the schizophrenia was the emotional fusion in the mother-child relationship and dysfunction in the family.[ix] Kerr believed that more highly differentiated individuals were less susceptible to illness than poorly differentiated ones.

12.  Systems Thinking Versus Individual Causes. It is important to note that Bowen and Kerr did not seek to assign blame to any one individual, but rather, they perceived that dysfunction arose as a consequence of the family as a system. They believed that some people were simply dealt bad cards as a result of their family history, and that in certain cases, only limited progress could be made as a result of the multigenerational transmission process. Bowen thought that family members were so intensely connected, that a change in one person often caused a change in another family member. For example, when Elaine presses her husband Tim to open up to her and spend more time with her, Tim withdraws. Both Elaine’s neediness and Tim’s avoidance contribute to the relationship dysfunction. Bowen saw human family systems as being essentially similar to animal systems, because he believed humans had evolved from animals and that all natural systems are similarly interconnected.[x]

13.  Supernatural Phenomena. This last part of Bowen’s Theory was the least developed, receiving just a few mentions by Bowen and one short chapter at the end of Bowen Theory’s Secrets, written by Michael Kerr. Bowen observed the miraculous healings at Lourdes and other instances of amazing healing from physical and psychological maladies and hypothesised that the recipient’s faith that they would recover was an important factor in their recoveries. Kerr pointed out the empirically verified healing power of the placebo effect in support of this idea.[xi]

Bowen Theory: The Evidence

Bowen Theory has received a decent amount of empirical validation, if you are into that kind of boring stuff. The theory partially emerged out of Bowen’s clinical observations of families with a schizophrenic child.[xii] The concept of self-differentiation is correlated with better relationships, lower anxiety and psychological health in empirical studies.[xiii] Bowen preferred a qualitative measure of SD, factoring in a multigenerational analysis of the family, observations of how the subject responds to emotional pressure (whether they resort to fusion or cutoff) and how well they can calmly state what they believe without becoming defensive (which he called ‘I position’). In modern empirical studies, SD is measured quantitatively, on the basis of self-report questionnaires such as the Differentiation of Self Inventory (DSI), which seek to assess emotional reactivity, ‘I’ position, emotional cutoff, and fusion with others.[xiv] There was also a study in Iran which showed that couples receiving 8 sessions of Bowen Therapy had less marital conflict than the control group.[xv] Bowen’s contention that couples with similar levels of differentiation get married is not supported by the evidence.[xvi] Of course, scientific evidence should be taken with more than a grain of salt, for reasons that will be given later in the book.

[i] Kerr, Michael. Bowen Theory’s Secrets: Understanding the Hidden Life of Families.

[ii] https://www.thebowencenter.org/triangles

[iii] Kerr, M. 2019. Bowen Theory’s Secrets: Revealing the Hidden Life of Families. W.W. Norton & co.

[iv] Isaacson, W. 2011. Steve Jobs: The Exclusive Biography. Abacus.

[v] Kerr, M. 2019. Bowen Theory’s Secrets: Revealing the Hidden Life of Families. W.W. Norton & co.

[vi] https://www.thebowencenter.org/societal-emotional-process#:~:text=Each%20concept%20in%20Bowen%20theory,governs%20behavior%20in%20whole%20societies.

[vii] Kerr, M. 2019. Bowen Theory’s Secrets: Revealing the Hidden Life of Families. W.W. Norton & co.

[viii] Ibid.

[ix] Ibid.

[x] Kerr, M. Bowen, M. 1988. Family Evaluation.

[xi] Kerr, M. 2019. Bowen Theory’s Secrets: Revealing the Hidden Life of Families. W.W. Norton & co.

[xii] Bowen, M. 1993. Family Therapy in Clinical Practice. Jason Aaronson Inc.

[xiii] Mozas-Alonso etal. 2022 (Mar). PLos One. https://pmc.ncbi.nlm.nih.gov/articles/PMC8942213/#:~:text=Several%20studies%20have%20found%20that,between%20DoS%20and%20parenting%20styles.

[xiv] Skowron, Friedlander 1998. Differentiation of Self Inventory. APA Psyctests. https://psycnet.apa.org/doiLanding?doi=10.1037%2Ft02883-000

[xv] Yektalab, S et al. 2016. Efficacy of Bowen Theory on Marital Conflict in the Family Nursing Practice: A Randomized Controlled Trial.

[xvi] Miller et al 2004. Is Bowen theory valid? A review of basic research. J Martial Fam Ther. https://pubmed.ncbi.nlm.nih.gov/15532253/#:~:text=Bowen's%20assumption%20that%20couples%20with,also%20received%20little%20empirical%20support.