Family Health Services
What difference does Bowen Theory make?
Most family therapy explains symptoms as a product of pathology, either in the person or in the family. The process of diagnosing the problem or the person as the problem limits the options for change. This thinking leads to support in dealing with the symptom or the problem or to a focus on removing or altering “the pathology.”
Bowen theory considers symptoms of any kind to be the product of reactions associated with efforts to adapt to changes that are a challenge for people. When people can develop a more factual and objective perspective about the situation and the symptoms and recognize some of the reactions stirred, they can begin to see more choices they can make in changing reactions that play a part in symptoms.
When one person in a family or organization goes about this process, it sets in motion a beneficial ripple effect. Bowen noted that a non-symptomatic family member, particularly a parent, can make a bigger difference in improving the health of the family than the person who has the symptoms often can. I too observe this again and again in clinical practice based on Bowen theory. I will never forget the first time!
A mother brought her son who was referred by his pediatrician for stomach aches & migraine headaches. They started when the boy was 12 and happened mostly at school, often during basketball practice. The boy, I’ll call him, Derek, was on the biofeedback equipment measuring his skin sweat response, his fingertip temperature, and his muscle tension. All these are measures of tension and anxiety reactions. He looked at ease while he talked about school and sports.
When I began to talk to his mother about her worries about her son, he got all the classic reactions. His sweat response soared and his skin temperature dropped. Then I asked his mother about her own family and whether anyone had experienced an injury or accident in their young teens. Oh my.
Mother, Mrs. D, talked about the day that her mother left her in charge of her five siblings. She was 18. The boys sneaked out to swim in a farm pond. Her youngest brother drowned. He was 13. While she was talking about her own family and the facts of life and death there, Derek’s physical reactions returned to active but at ease. He was sad for his mother, but he no longer reacted as if the emotions was his own.
This mother worked with me for about a year to develop a broader perspective on her own family experiences and to change the degree to which she took on all of the responsibility for her siblings in adult life. She talked to her aunts about the early days of the family and what was going on in her own mother’s life. When it came time to plan their aging grandmother’s birthday party, Mrs. D declined to do it all herself, as would have been expected. She let people know what she would be able to do and what she would not be able to do. She left the invitations to her aunt and to her mother, who, after a slow start, took responsibility for more of the party.
During this year, Derek had no more stomach aches and migraines at school. Five years later, I spoke to Mrs. D and learned that Derek had done well. He graduated high school and was leaving home for college that fall.
There are so many examples of changes people accomplish when they can gain a broader more factual view of anxiety factors and reactions that play a part in symptoms, whatever they be. It does require that someone take responsibility for their own reactions and do their part differently.
Why is it so difficult to do that? To see what one can change and do it?
Many aspects of symptom development make it difficult. How we see the problem is one obstacle. You know the old joke…
We look for our keys where the light is brightest… not where we lost them.
The focus on feelings as the way to understand reactivity makes it more difficult. Most reactivity goes on without any feeling attached. We can only feel a small amount. People can learn to see far more of their reactivity and its connections to symptoms when they can “see it” for themselves. Biofeedback and neurofeedback measures can help. People train themselves to be better more accurate observers of self and of others. It is a learning process.
Our brains are built to operate “on automatic” without much self-awareness, particularly when anxiety is high. We tend to focus on one thing and miss everything else that has an impact.
Habits of reacting occur quickly, whether they are biological like adrenalin or whether they are behaviors, like avoiding conversation and hiding out in front of the TV. We all participate in reciprocal chain reactions that are familiar, innocent and ordinary for the most part.
Symptoms are often the first sign that habits are not working well. Symptoms provoke some people to make the special effort to change… the way they see the situation and the way that they are reacting.
This sounds too simple. I return to my first comment. No one knows enough.
What is so important about science in therapy?
If someone can observe the impact of her reactions on others and recognize her responsiveness to the reactions of others, it is possible to develop more control over those reactions, for the good of one and the good of all.