by Michael E. Kerr
W. W. Norton, 2019
Review by Roy Sugarman, PhD on Jun 18th 2019
Most of us trained in the late 70's and early 80's would have encountered General Systems Theory and the Family Therapy movement that emerged, partly as a reflex response to the individual focus on pathology begun by Freud. Some, like myself, wrote critiques in our Master's theses of the idea of Freudian biological determinism from the family therapy perspective, or even from the Feminist view in my case. Family therapy saw the patient as a presenting patient, presenting the family or systemic pathology to the public eye, as an identified patient rather than a person with purely intrapsychic issues. Each person and each context is seen as a system, and so pathology arises with an ecosystem, as more than one system interacts with another, forming such an ecosystem. Informing these theorists was the work of Jay Hayley, Gregory Bateson, Milton Erickson, and others, now still influential perhaps in emerging therapies such as ACT. Maturana and Varela and others introduced autopoiesis and other post-modernist ideas, so you can see how fertile a field of ideas this became.
Murray Bowen was one of these theorists. As the election of a Republican President has shown, we are emotional creatures, our decisions defying logic in many cases, and confusing pollsters in UK, USA and recently in Australia. Bowen was one of the first to see families as emotional systems and applying second-order feedback mechanics to such systems, self-regulating and responding in non-linear fashion. A does not only cause B to change, but in doing so causes itself to change, and widespread systemic alterations and reciprocal adaptations to stimuli or changes that acted as stimuli. Bowen set out to establish a science of human behavior.
This book in these times (he died in 1990 but his last comprehensive theoretical paper was published in 1976) requires that modern readers be introduced not only to Bowen's theories and approach, but also to General Systems Theory. In its simplest terms, a man withdraws from his spouse's perceived communications, and she asserts her communications are in response to his withdrawal, and so on, explaining circular causality rather than the A causes B approach, as if behavior were billiard balls. In reality, neither is to be seen as causing the other, but the mutual behaviors evolve in a mutually regulating systems, which could be closed, open or something in-between, such as occurs in nature in the visual system for instance. The germ theory of medicine did not hold in such thinking if applied to human behavior, but even so led to the emergence of biopsychosocial approaches to human disease: social capital for instance has a large role to play in patterns of infection or mortality, physical or emotional. Individual psychopathology thus cannot be seen as a default problem of self, but of self in interaction with other systems, both internal and external.
Emotional systems, akin to bacterial and other older systems, lend themselves to study with the difficulty that emerged when we first studied wind for instance: we couldn't see it, but we could measure the force it could wield and how it interacted with more obviously tangible systemic elements. Given the present subsumes the past, it is better to resolve the systemic elements that recreate the problematic interactions in the here and now, and thus take care of the influence of the past in the here and now. Also fundamental to Bowen's work is the concept of the stability of a triangulated relationship compared to a more unstable bilateral one. This would be again to a bipod being more unstable than a tripod in metaphorical terms. In similar ways, we all prefer to be calibrated in terms of distance and closeness between the scores of 3-7 on a 0-10 scale. Too close is stifling, too distant is neglectful, so there is an optimum. These are some of the prerequisite criteria for Bowen as he describes truly differentiated people and those who are less so, thinking of autonomy and so on. Concerns here can be resolved by a triangulation, referred to as the smallest molecule of an emotional system.
All of Bowen's work draws on the idea of four patterns of interaction, of which triangles are just one. These patterns can determine which of the family's members become the identified patient. Paradoxically, if a family actively operates to avoid a particular element of behavior from emerging, these attempts may in reality create the systems in which such behavior might emerge, not be suppressed. For example, trying to enforce autonomy might result in anxiety that evokes dependence. At this point, the reader will notice that all the chapters are heavily populated with explanatory diagrams, as befits a systemic explanation, and there are more than 70 of them in this book, also including one here that changes some of Bowen's original terms.
Speaking of his original terms, the concept of differentiation of self that I alluded to is one of the core outputs of the family system, with success, or lack of it, namely undifferentiated members. This defines the chances of robust development of the individual within the family system. Thinking of the individual as individual, as per Freudian formulations, makes it nigh impossible to understand the concept of differentiation. Bowen is explained here as the awareness of a human that we possess both thoughts and emotions/feelings and discriminate between them as well as weight one or the other in the hope thoughts will dominate the outcome, informed by the feelings of what happens in Damasio terms. Ambivalence will interfere with this process if poorly differentiated in terms of sense of self.
Hence, values become an important part of choices, as they do in ACT, and the discrepancy created by such dissonance informs motivation to change. Poorly differentiated people will again be dominated by the need for instant gratification and thus lack grit. The right balance between intellectual and emotional drivers is thus a recipe for the optimally differentiated person, and dependent on family dynamics. This might be exacerbated in a multigenerational family for instance, given more options for the dynamics in the vertical vs horizontal integration of such a family's power dynamics and emotional expression. This can lead to a pseudo-self or a solid-self, depending. In the former, the ability to fool oneself is paramount, pretending to be something one is not, and the discussions across these and the next few pages might be the most important in the book in explaining the details of Bowen's thinking.
The following three chapters address the three concepts of emotional regression, emotional objectivity, and emotional programming, using terms used elsewhere, but used by Bowen to link to evolutionary growth in both humans and other species. Wryly, the author refers to a quote by Roger Payne: "The human brain is the most unsuccessful adaptation ever to appear in the history of life on earth, what we call intelligence may only be a form of vandalism, just mischief on a grand scale". By regression, he means a return to a former or less developed state, as a starting definition, but he means that if anxiety will come to dominate the presentation, within a relational system, the system is then dominated by the more emotional and less thoughtful reactive ways of interacting, which of course refer to an older evolutionary set. The status quo is thus no longer a more advanced set of complex behaviors, and thus can be said to be regressed. Again, this is a reciprocal set of actions and behaviors within a dyad or larger. Complimentary, or dominant-adaptive interactions are older in terms of evolution, considered more primitive than say a more symmetrical collaboration in the family, emotions colliding with intellect and thus disruptive.
In this section there is a rather fascinating analogy drawn from a study of a colony of wasps, that can be equated with what Bowen is saying here, as pragmatic values return when the emotional aesthetics of the wasp politics are resolved.
The concept of relatedness in modern terms is also applicable here as in the quote from Wilson which demonstrates what happens when we move away from associations with the familiar and develop prejudices against those who appear, emotionally, distant and different. Tribalism, in Bowen terms, has deeper roots though, as explained here, again in terms of evolution. Individuality or group identity trade-offs should depend on the exigencies of the moment. Both of these life-forces are required if a relational system is to operate smoothly, and there is no hierarchy here: things go wrong when thinking and feeling collide. Dogmatic views arrive from a slavish adherence to poorly differentiated views, as in the pseudo-self, and open discussion about which values might apply refer to a rather more functional relationship in which the solid-self reigns. Here, he uses the example of seeing your mother out of duty, which she might see as favorably motivated, whereas seeking out her wise counsel etc might be a more functionally differentiated, individuated approach to valuing time with her.
Context however makes Bowen theory rather hard to apply efficiently, and he studies the Fourth President (Madison) closely, as together with other Presidents and Prime Ministers (Roosevelt, Churchill, and one could say Trump), and ponders the misfit between their clearly differentiated personal and professional lives, one not mirroring the other. If the intellectual system functions best when not hindered by the emotional system, and men such as Madison, confronted with a difficult stepson and wife's interaction, despite his differentiated professional skills, left a poor legacy in that regard, his wife finishing her life in poverty thanks to a poorly differentiated son that she doted on.
The author had discussions with Bowen about individuality-togetherness balance, and emotional regression. Bowen convinced him not to lead with that conflicted statement, in order to not mislead the reading population, and so he relegated it to chapter three in one of his first books. Here, it has evolved to chapter 7. The core idea as I noted it above concerns relatedness, for instance choosing a partner with the same or similar level of differentiation, a Bowen core value. As anxiety comes into play across time, the similarity may disappear, and discrepancy emerges. This has been observed, but at the same time, if the relationship collapses, such discrepancies may wane again, as in the analogy of the paper wasps above. In Bowen terms this may include the borrowing and trading of the pseudo-self, with returns policies dominating after breakup, with the dominant-deferential complementarity dying out when the anxiety is removed by distance. A child being present and then leaving home may play into the triangulation of the dynamic, again a key Bowen component. The James Madison example above examines this in detail for instance, as the wife and stepson undo Madison's usually intellectual pattern of function by continuing to interact as enmeshed-ly as they did. Here, the parents over-functioned and the son under-functioned in private and then public life. The death of her first husband and one son to disease would have had another profound effect on Mrs Madison's life prior to and with Madison. Once more, some complex choreography is simplified by diagrams as mentioned before. A vignette about the distance and closeness choreography is given to help explain things. In essence, the systems theoretical view of reciprocity of causality is played out in a relationship, with psychophysiological responses emerging from the strong anxiety generated by a relationship, with triangulation giving some positive effects as the observing system points out the self-regulating interconnectedness of the protagonists' complaints. Change in one element results in change in the other.
The second of the three chapters covers emotional objectivity, a capacity which is key for working toward a science of human relationships, which is both the author's and Bowen's goal. Higher objectivity, e.g. I am anxious, not because of things, but inherently, leads to a better 'self' which avoids labels like I am a perfectionist and hence anxious, and secondly, assigning to it the correct values in terms of the interaction with others, given this is a systems theory, not a theory of individual pathology or traits in isolation. Functional facts and functional positioning are described here as key parts to objectivity. This means avoiding diagnosing oneself and in essence referring to the logic of emotion, rather than rationality. Position on the other hand refers to placement in a system according to the relationship one has with others, e.g. being over-tuned to someone else's distress and then being the designated fixer, and you can see the complementarity of that relationship.
This short chapter leads to the third, namely emotional programming. This, alongside genetic transmission is the process that delivers information across generations in a family. Continuing on a past theme, the author delivers that emotional programming occurs in the context of the interplay between the counterbalancing life forces of individuality and togetherness in parent-offspring relationships, affecting self-regulation and the intensity of the emotional programming as it varies. Another past theme is that of family projection (Chapter Four) which is interrelated here. Hence, with all this, Bowen theory does not view anxiety as a psychiatric disorder.
Alongside with the degree of integration of self (differentiation of self), anxiety is one of the key areas of variability in Bowen Theory, and although distinct, are considered interlocking. Anxiety is usually internal in most theories, but although this is true here, it is also true in Bowen's view that anxiety is a form of action in relationships as it plays out there. So anxiety at the perceived pulling away of another person in a relationship may trigger the unwanted behavior, increasing the sense of anxious loss in the first person as the triggered person pulls away.
Coming back to intergenerational transmission, a multigenerational family is seen as an organism, a living and evolving system in terms of increasing variation in the emotional functioning of generations across time, varying adaptive functioning. Examination of these generations indicates that every family has high and dysfunctioning branches and is predictable rather than random. The author uses family diagrams, often complex, to decipher these systemic patterns.
I mentioned position earlier, and a chapter is now devoted to sibling position. Studying over 3,000 families, Tolman's work informed Bowen, who readily adopted this body of work on 11 different sibling profiles into his family systems theories. These include for instance the oldest brother of brother(s) or the oldest brother of sister(s), amongst others. I am for instance the youngest brother of a sister, and I should marry the oldest sister of brother(s)….and I did. My daughter, the youngest sister of sister(s), should marry someone who is the older brother of sister(s) but that is not given as that profile's best choice, so she is presumably up the creek without a paddle in Tolman terms. Nevertheless, as with horoscopes, the Tolman thumbnails do have some face validity in their descriptions as a useful heuristic. I am not the only one who smirks with some incredulity at Tolman's formulations, and Kerr explains this by going against the fatalistic critique: he says that emotions were not, until recently, regarded as possible objects for study, in a scientific fashion at least. Aristotle didn't help much with his view on the rationality of humankind, but with the ascendency of the 45th President and the reversal of much of the rational gains on topics such as abortion in the USA, as well as the clear appeal of Republican mentality over Democratic rationality for at least half the nation, and the rise of emotion-driven voting and nationalistic directions politically worldwide, it seems studies of emotion-driven rationality will move forward, if the climate doesn't swamp us all. I am not sure of many psychologists who believe we are entirely rational at all, and certainly Dan Ariely and other economists would deny we are, especially as Kerr notes, when it comes to automatic responses that are amygdala-mediated in the first few 100 milliseconds of perception. Confirmation bias would be one of those processes.
One of the last processes Bowen added was the concept of emotional cutoff. Whilst there is a need for emotional closeness, there is also an aversion to too much of it. Cutoff refers to the process of leaving home as an adult, and the distance between generations as it plays out (think generation gap, for instance how the younger world is responding to perceived climate change). This gap might need to be bridged in family therapy, as cutoff of the family of origin would make the current family appear insular. For instance, a myth about relationships or marriage that denies the origins of such inferences in the family of origin makes it difficult for the current generation to see the flaws inherent perhaps in applying this in the here and now. Growing away is different to breaking away with minimal contact. A family emotional process also has greater utility in societies: I mentioned climate here, and so even Bowen interacted with the EPA on how people reacted to environmental problems in 1972. As with Trump and Fox News, it seems that virulent propaganda is being used to stir emotional reactivity in his conservative base, cementing unity or what we call emotional fusion in Bowen terms, and inciting the base to reject or even cleanse society of other tribes such as immigrants, a key target of Nationalistic elements in society. Such psychological processes are key factors that drive social regressions, more than just an emotional process. Anti-Semitism is on the rise, even though we are only 74 years adrift of the German death and labor camps, hence the term regression in Bowen terms referring to an emotional-psychological return to earlier, less intellectual states. Perhaps this explains why base supporters of such Nationalism are less likely to have a university education and a sense of more rational thinking over emotionally-appealing but rather less than factual concerns expressed by populist leaders. People may sense the emotional underpinnings of false beliefs that can drive such society regressions, but still remain vulnerable to succumbing to emotion-triggering rhetoric. Emotionality fuels the descent of political and economic systems into regressed dysfunction. Keith Stanovich refers to 'dysrationalia' where one is capable of wisdom, but commonly falls short of it. In this way, the change in society reflected a shift in society towards more permissive parenting, which was then seen to foster externalized or acting out manifestations, hence more personality issues rather than neurotic ones, or so the theory goes. Again, Kerr uses diagrams, much like the ones of feet demonstrating choreography, to show the distance and closeness moves of the triadic relationships and how for instance a judge in court might fit into this to and fro. He refers in detail here to the formulations of Barzun, and especially a commentary on the unrest of the '60's as an emanation from the over devotion and over protection of schools, unruly teens and then unsure administrators at the college level. In similar vein, Kerr refers to the current emotional regression in the USA, giving the polarization of Congress into extreme bipartisanship as an example. And then there is the story of the finches on the Galapagos islands….high levels of stimulation led to a loss of impulse control.
To summarize: societal regression depends on more decisions are taken to allay the anxiety of the moment, more cause and effect thinking emerges, a greater focus on rights to the exclusion of responsibility, and finally a decrease in the overall level of responsibility. There is no such thing as a free lunch.
Core concepts having been covered in part one, part two covers the process of differentiation. The task here, especially for every therapist, is to differentiate the self from the family of origin, so that even though connected, still remain outside the emotionality or family emotional field. One is thus in contact with, but outside of, the family emotional system, outside the flow of family emotional forces that regulate the family system. This differentiation process depends on six ingredients that are crucial to the success of functioning as more of 'self' in that context. Observe and think about emotional process; discriminate between thinking and feeling; recognize the impact of anxiety on functioning; engage emotionally difficult situations; maintain more of a 'self' with others and engage in theoretical thinking and scientific enquiry. From these formulations, he engages in personal vignettes of the process of differentiation. In his journey, he saw he had inherited the strengths of the family, his brother the weaknesses, and the family emotional field was a treacherous one that he navigated with Bowen. He refers to this more closely in the closing chapter of the book.
He goes on to examine a clinical example of the process of differentiation, firstly from an example, and then the theory, method and technique of the process, the last chapter of part two. Since intense feelings can override fact-guided thinking, the differentiation of a sense of self is critical to the Bowen technique. Part three begins with applying Bowen Theory to families in the public eye, coming after his discussion of how Bowen would teach using a live family, and also head off disruptive and unhelpful contact with the audience to the live therapies. Here he talks about the Unabomber, the Sandy Hook Shooter, Gary Gilmore who murdered two men, and John Nash, of Beautiful Mind fame who recovered from Schizophrenia without medication or therapy, and a chapter is devoted to each.
After nearly 4000 words, I hope I have given over a flavor of the Bowen Theory book as defined by the passion for it of Michael Kerr. Trained as a family therapist as I was, and with a master's degree that combines systems theory with feminism in family violence, I was steeped in family therapy theory, a movement as such, from the first day of training in the 80's. It involves a fairly complex rethink in thinking about things. The pragmatics of communication, the process of change, and most importantly, the origins of what we might call pathology. More importantly, this is a meta-view, to thinking about thinking, to becoming part of an ecosystem when joining with the multiple systems that make up a family, or a business. Recall perhaps that the Milan School of therapy became authors of a book on the hidden games of organizations and wrote of paradox and contra-paradox in Schizophrenia and Anorexia in families. Paul Dell, Gregory Bateson (Margaret Mead's husband), Peggy Penn, Jay Haley (reprised in ACT formulations in therapy), Milton Erickson (ditto) were all part of our learnings, and more. But the amazing contribution of Bowen was to set out to establish a science of human behaviour, as the ACT and other therapists have done, and also challenge the prevailing view of what constitutes pathology and recovery, in the tradition of the identified patient in family therapy.
In this regard, as with ACT for instance, both psychiatric (e.g. Schizophrenia) and medical illness (e.g. melanoma as he identifies in the book) will interplay with the emotional-based systemic stressors of a family, or a society, and be exacerbated. As with Bateson's fireside chats, Bowen's coaching of the first generation of family therapists resonated beyond his day, and Kerr is revealing what that meant to a generation that may not have heard of them. Welcome back.
© 2019 Roy Sugarman
Roy Sugarman PhD, Clinical Psychologist and Clinical Neuropsychologist, Director: Applied Neuroscience in Performance Innovation, Team EXOS, Phoenix AZ