Handbook of bowen family systems theory and research methods mignonette n keller, robert j noone, routledge, 2020 scan

Handbook of Bowen Family SystemsTheory and Research Methods The Handbook of Bowen Family Systems Theory and Research Methods presents innovative approaches on a range of issues inherent

“One of the important contributions of Keller and Noone’s volume of collected studies from theperspective of Bowen Theory is its focus on concepts in family systems theory and related con-structs in the wider multidisciplinary research literature The authors of these studies are deeplyconversant with Bowen theory and its potential as an integrative theory to guide research andpractice This is a project that aims to carry forth Bowen’s most ambitious goal for his familysystems theory, that of moving towards a science of human behavior.”

Laura Havstad, Ph.D., director, Programs in Bowen Theory, Northern California

“Diverse perspectives of empirical research are necessary to address the complexities of research

in family systems Reciprocal influences of individuals and families, families and communities,and communities and culture require a consistent theoretical grounding for approaching mean-ingful questions Launched from Bowen family systems theory, Keller and Noone have assembled

a knowledgeable group of scholars and practitioners to address important concerns of familyresearch for an invaluable resource for family systems researchers It is an important text for thoseseeking to design and interpret systems research.”

David S Hargrove, Ph.D., is professor emeritus at the University of Mississippi,Oxford, MS, where he served as chairperson of the Department of Psychology,interim chair of the Department of Modern Languages and interim chair of the

Department of Exercise Science

“The Bowen family systems theory field will advance as a natural science when the ideas areapplied and systematically researched by many professionals in varyingfields of study This bookhas collected the research and explorations of seasoned experts in ourfield, investigating ways ofadvancing the theory and its applications The effort to research families as an emotional system

is daunting and complex This collection of works documents how many authors and researchershave undertaken the challenge It will be a valued resource in my library.”

Walter Howard Smith, Jr., Ph.D., is a trustee of the Casey Family Programs Foundationbased in Seattle, WA He is the retired Deputy Director and Clinical Director at theAllegheny County Department of Human Services in Pittsburgh, PA, where heserved as Deputy Director of the Office of Children, Youth, and Family Services

He is a licensed psychologist in private practice

Handbook of Bowen Family Systems

Theory and Research Methods

The Handbook of Bowen Family Systems Theory and Research Methods presents innovative approaches

on a range of issues inherent in family research and discusses the links between theory, datacollection, and data analysis based on Bowen family systems theory

This multi-authored volume discusses core issues within family systems theory, including iety, stress, emotional cutoff, differentiation of self, multigenerational transmission process, andnuclear family emotional process Chapters also examine related constructs in the research litera-ture such as adaptation, resilience, social support, social networks, and intergenerational familyrelations Readers will be able to view theoretical and methodological issues from the perspective

anx-of Bowen theory and develop a clearer knowledge anx-of ways to navigate the challenges faced whenstudying individual, familial, and societal problems

An essential resource for clinicians and researchers in the social and natural sciences, the book of Bowen Family Systems Theory and Research Methods provides a comprehensive frameworkfor understanding the application of Bowen theory to family practice and family research.Mignonette N Keller, Ph.D., is faculty at the Bowen Center for the Study of the Family inWashington, D.C., and former assistant professor in the School of Social Work at HowardUniversity, Washington, D.C She received her doctorate from Howard University, Washington,D.C., master’s from the University of Chicago, Chicago, IL, and postgraduate training atGeorgetown University School of Medicine, Washington, D.C

Hand-Robert J Noone, Ph.D., is faculty at the Center for Family Consultation, Evanston, IL, andthe Bowen Center for the Study of the Family in Washington, D.C He is the editor of thejournal Family Systems and co-editor of The Family Emotional System (2015) He received hisdoctorate from the University of Illinois at Chicago and postgraduate training at GeorgetownUniversity Medical Center in Washington, D.C

Handbook of Bowen Family Systems Theory and Research Methods

A Systems Model for Family Research

Edited by Mignonette N Keller and Robert J Noone

First published 2020

by Routledge

52 Vanderbilt Avenue, New York, NY 10017

and by Routledge

2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN

Routledge is an imprint of the Taylor & Francis Group, an informa business

© 2020 Taylor & Francis

The right of Mignonette N Keller and Robert J Noone to be identi fied as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988 All rights reserved No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers.

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Library of Congress Cataloging-in-Publication Data

A catalog record for this title has been requested

Mignonette N Keller and C Margaret Hall

John F Butler

Daniel V Papero

PART II

PART III

Mechanisms Influencing Family Functioning: Stress/Anxiety,

7 Stress, Chronic Anxiety, and Symptom Development: A Family

12 Cutoff and Self-Functioning in Three Generations of Families with

19 The Multigenerational Transmission Process and Family Functioning 278 Mignonette N Keller

PART V

20 Anthropological Contributions to the Study of the Human Family 301 Joanne Bowen

Phyllis W Sharps

Yvonne Bronner, Paul Archibald, Ian Lindong, and Barbara Laymon

Clancie Mavello Wilson

PART VI

24 Extension of Bowen Theory to Include Natural Systems of Human Societies

Patricia A Comella

C Margaret Hall

Appendix A: Cuto ff and Self-Functioning in Three Generations of Families and

Washington, D.C., and a former assistant professor in the School of Social Work at HowardUniversity, Washington, D.C Her writing and research interests include theoretical and meth-odological issues in family research related to factors influencing family functioning; a systemsmodel for family research; and the family diagram as a reliable assessment instrument for empiricalresearch She received funding from the Center of Research on Minority Health at the NationalInstitutes of Health for her study of alcohol dependence and the family based in the HowardUniversity Alcohol Research Center The Howard University Faculty Research Award Programsprovided funding for her multigenerational study of factors influencing family functioning

Dr Keller holds a doctorate in sociology from Howard University, Washington, D.C., a master’sdegree in social service administration from the University of Chicago, Chicago, IL, and shecompleted postgraduate training at the Georgetown University School of Medicine, Washington,D.C., in family theory, family psychotherapy, and family research

Evanston, IL, where he maintains a practice in psychotherapy He is the editor of the journalFamily Systems and a faculty member at the Bowen Center for the Study of the Family in Wash-ington, D.C Along with Dr Daniel V Papero, Dr Noone is editor and contributor to therecently published book The Family Emotional System: An Integrative Concept for Theory, Science,and Practice (2015) and author of published articles and book chapters on Bowen family systemstheory and psychotherapy A practicing family therapist for more than 40 years, he received hisdoctorate from the University of Illinois at Chicago and his postgraduate training in family sys-tems therapy at Georgetown University School of Medicine in Washington, D.C

x

Paul Archibald, Ph.D., is an assistant professor in the Department of Social Work at the College

of Staten Island, City University of New York Staten Island, New York, and a former assistantprofessor in the School of Social Work at Morgan State University His research interests includeviolence, trauma, depression, and substance abuse He has several publications in professionaljournals related to substance abuse, depression, and black males

of William and Mary in Williamsburg, VA She is also the Executive Director of the MurrayBowen Archives Project in the History of Medicine Division of the National Library of Medi-cine, a nonprofit organization dedicated to the preservation and dissemination of the MurrayBowen Archives Dr Bowen is the author of numerous scientific publications in professionaljournals and book chapters

Community Health and Policy at Morgan State University in Baltimore, MD She has conductedresearch on breast feeding, obesity, and healthy lifestyles and served as the principal investigator

of the Nutritional Assessment of the Maryland School Child Study Dr Bronner is the author ofnumerous publications in professional journals and book chapters

Washington, D.C She coordinates the Internship Program and Research Committee and serves

on the editorial board of the Family Systems Journal She has a family therapy practice in EllicottCity, MD Her research interests include adoptive families, family projection process, withinfamily variability, emotional cutoff, and research from a systems perspective

John F Butler, Ph.D., is in private practice at Rose Street Mental Health Care in Wichita Falls,

TX He is editor of the Origins of Family Psychotherapy: The National Institute Mental Health FamilyStudies Project and the author of several professional articles on family theory and psychotherapy

Carrie E Collier, Ph.D., is a faculty member at the Bowen Center for the Study of the Family inWashington, D.C She is the Director of the online program for studies in Bowen family systemstheory at the Bowen Center She is also an adjunct faculty member in the Department of Coun-seling and Human Development at George Washington University, Washington, D.C Herresearch interests include research methodology that captures family systems variables and devisingand testing a family unit functioning scale to be used in clinical and research studies She main-tains a clinical practice in Washington, D.C., at the Bowen Family Center

xi

Patricia A Comella, J.D., is a faculty member at the Bowen Center for the Study of the Family

in Washington, D.C She is currently a self-employed, independent consultant Prior to herretirement, she was employed as a Senior Foreign Affair Officer, Office of Nuclear Energy

Affairs, at the U.S Department of State in Washington, D.C She has published numerous icles related to Bowen theory

B.C., a pastoral counseling center that uses Bowen theory as its primary approach to counseling,training, education, and research He is a member of the faculty of the Bowen Center for theStudy of the Family in Washington, D.C., and author of professional articles and book chapters

on family theory and psychotherapy

Washing-ton, D.C., where she was a member of the full-time faculty from 1970 to 2018 She chaired thedepartment of sociology in 1976–1980 and 1983–1989 and directed Women’s Studies from 1993

to 1996 Dr Hall specialized in theory construction in clinical sociology, with particular attention

to social intelligence and social sources of personal and social identify Her research interviewsaddress primarily family, religion, or belief systems, gender, the emotional bases of social intelli-gence, and individual and social behavior She used observations, life histories, and content ana-lyses as research methodologies in her work on theory construction Dr Hall publishedextensively including journal articles, book chapters, and books

and the Family in Houston, TX She is also senior faculty at the Bowen Center for the Study ofthe Family in Washington, D.C She is in private practice based in Bowen theory and uses bio-feedback and neurofeedback for the study of reactivity She conducts research on physiologicalreactivity in the family and its impact on health and reproduction She is the author of severaljournal articles and book chapters

Murray Bowen as Director of the Georgetown Family Center in 1990 He is the founding editor

of Family Systems: A Journal of Natural Systems Thinking in Psychiatry and the Sciences and served aseditor from 1994 to 2014 He is the co-author with Murray Bowen of Family Evaluation: AnApproach Based on Bowen Theory He recently published Bowen Theory’s Secrets: Revealing theHidden Life of Families (2019) Dr Kerr has written numerous journal articles and book chaptersrelated to Bowen theory

conducting a longitudinal, multigenerational family research study that began in 1994 This studyhas explored how the following variables influence variation in nuclear family functioning: viableemotional contact versus cutoff with the multigenerational family, stress in the multigenerationalfamily, symptomology in the multigenerational family, reactivity in the primary triangle, familyprojection, and goal direction of the husband and wife He has also examined nuclear familyemotional processes being passed on to the next generation He has published numerous articles

in scientific journals and book chapters regarding his findings related to various aspects of Bowentheory

confer-ences and webcasts on Bowen theory regularly Her past mentors are Murray Bowen and the

Contributors

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evolutionary biologist Lynn Margulis, with whom she associated until the latter’s death in 2011.She has written several articles and book chapters on Bowen theory, with particular interest inthe relationship of the triangle to differentiation of self She applied Bowen theory to socialorganisms representing early life and she has emphasized the evolutionary heritage of Homo sapi-ens Her current interest is in the research potential of discoveries in the social regulation of gen-etic expression as it relates to Bowen theory.

Washington, D.C She is also the Lead Analyst for the National Association of County and CityHealth Officials, the nonprofit representing local health departments across America Her researchbackground includes an interest in long-term care policy, maternal and child health, managed careorganization, population health and epidemiology, community health assessment, and social deter-minants of health Dr Laymon is interested in the ninth concept in Bowen theory, the supernaturalphenomenon, and plans to conduct research on systems thinking in religion and spirituality

Policy at Morgan State University in Baltimore, MD He concurrently serves director and investigator roles in federally sponsored programs in the university His research interest includetechnology in health care services delivery and program effectiveness evaluation He has taughtbiomedical courses in pathophysiology in the Nursing program, in addition to Epidemiology andBiological Basis of Public Health in the Public Health graduate program

Washington, D.C She has been the Director since 2011 and served on the faculty since 1992.Her clinical and research interests include death in the family, addiction, epigenetics, and ethics

Dr McKnight has numerous publications in professional journals and book chapters related toBowen theory She maintains a clinical practice in Washington, D.C., and Arlington, VA

Family in Washington, D.C He is the author of Bowen Family Systems Theory and the co-editor

of The Family Emotional System with Dr Robert Noone, in addition to having written journalarticles and book chapters He lectures both nationally and internationally on the Bowen theoryand maintains a clinical practice in Washington, D.C

Baltimore, MD., where she also serves as the Associate Dean of Community and Global grams and holds the Elsie M Lawler Chair As Associate Dean for community programs andinitiatives, she directs three health and wellness centers operated by the Johns Hopkins School ofNursing Her scholarly expertise and interests include perinatal health, domestic violence, parent-ing, women’s health, domestic violence, and infant mortality Dr Sharps has numerous scientificpublications in professional journals and has written book chapters

a nonprofit organization committed to addressing the needs of youth and families Her researchinterests include identifying more effective ways to educate and aggressively involve parents inthe process; better understanding of cultural differences and how these differences impact learn-ing; as well as research to bridge the gap between home and school Dr Wilson is the author ofseveral articles in professional journals and book chapters

Contributors

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This is a book about Bowen theory and research, so I will frame current research on Bowen theory

in the context of Murray Bowen’s key discoveries Most readers are likely aware that Bowen is theoriginator of Bowen family systems theory He and his collaborators developed the theory based onobservational research in many settings over several decades Early in Bowen’s research in the secondhalf of the 1940s at the Menninger Clinic, he concluded that Freud’s psychoanalytic theory wasplagued with enough subjectivity that it would never be accepted by the sciences This realizationmotivated Bowen to read extensively in the sciences and other disciplines to determine what would

be necessary to develop a theory of human behavior that would meet the criteria of the acceptedsciences The background research convinced Bowen that such a theory could be developed.Bowen’s observational research settings prior to the first publication of the new theory in 1966included eight years at Menninger’s, five years at the National Institute of Mental Health(NIMH), and five years at the Georgetown University School of Medicine’s Department ofPsychiatry The theory that emerged from that research was an emphatic departure from psycho-analytic theory Its two most innovative aspects were applying systems thinking to describehuman behavior and grounding the theory in Homo sapiens being a product of evolution Notsurprisingly, the major obstacle to applying systems thinking is cause-and-effect thinking Cause-and-effect thinking in the form of psychopathology existing within the patient causing neuroticand psychotic disorders was at the core of Freudian theory

Bowen was a maverick from the time he arrived in the fall of 1959 in the Georgetown Department

of Psychiatry, a psychoanalytically oriented program Like other departments around the country, itwas easier for them to accept family therapy than it was to accept a family theory that was out of stepwith psychoanalytic theory Despite being out of step with other members of the department, Bowenwas able to establish family programs at Georgetown for the psychiatric residents and mental healthprofessionals in the community The new method of therapy spawned by the new theory was builtaround the process of differentiation of self This concept both explained variation in human emo-tional functioning and provided a blueprint for raising one’s level of differentiation

A key piece of research at Menninger’s was facilitated by Bowen breaking from standard chiatric practice and meeting with members of his inpatients’ families In doing so, he observedhow powerfully affected emotionally the patients were by their families, especially their mothers,and vice versa The traditional practice of insulating the doctor–patient transference relationshipfrom contamination by interaction with the family had allowed the intensity of family–patientinteractions tofly under the radar This family–patient emotional intensity was evident no matterwhat the patient’s diagnosis

psy-One particular study that Bowen conducted with a schizophrenic patient at Menninger’sallowed an actively psychotic patient to regress The key was allowing the patient to get worsewithout nervously intervening As expected, as the patient regressed, and his symptoms worsened,

xiv

but, after a period of time, his psychotic symptoms unexpectedly disappeared The patient related

to the research staff much like a normal child

This observation challenged a psychoanalytic theory contention that schizophrenic people had neverformed an attachment to their mothers during early development However, Bowen and his team sawthat they were indeed capable of forming an attachment, but that ability had been buried under thepsychosis This conclusionfit with the intense reactivity Bowen was observing between adult patientsand their family members at Menninger’s I interpret these observations to indicate a high level of anx-iety that schizophrenic patients experience in their social interactions, especially with family This cantrigger a powerful impulse to withdraw, both behaviorally and into psychotic thinking

The term symbiosis was in the psychiatric literature at that point in the early 1950s Bowenadopted the term to describe what he was observing between the inpatients and their familymembers It appeared that the normal early symbiotic mother–child attachment had neverresolved He decided to study mother–adult offspring symbiosis and chose to conduct the studywith mothers and their adult schizophrenic offspring, but he could have studied symbiosis withany severe dysfunction He departed Menninger’s for the NIMH to set up the symbiosis study

on an inpatient research ward in 1954

The study began with three mothers and their young adult schizophrenic offspring Onemother–daughter pair agreed to live on the ward full-time; the other two pairs spent most oftheir waking hours there The research ward was located in the National Institutes of HealthClinical Center Despite his early observations at Menninger’s, Bowen was still using psychoana-lytic thinking when the study began This was reflected in his conceptualizing the unresolvedsymbiosis as being the result of “interlocking psychopathologies.” As part of the study, he pro-vided individual psychotherapy for the mother and the schizophrenic offspring The purpose was

to define the specific psychopathologies of both people with the expectation that this therapeuticprocess might enable them to separate into two people

Two very important research observations had occurred by the end of the first year of thestudy Thefirst was that the unresolved symbiosis was more intense than had been recognized atMenninger’s, and neither mother nor offspring was motivated to change it Bowen interpretedthe obstacle to change as“loss of each other equals death.” He described it as a fusion of feelingstates between the two people The second observation was equally if not more important:fathers were part of the problem Fathers visited the research ward frequently enough for researchobservations to be made about them, too

Observing fathers led to the conceptualization that the mother–adult offspring symbiosis was

a fragment of the larger family group Families function as emotional units Family members arelinked by a powerful emotional interdependence that is associated with exceptionally highreactivity to each other Other family pioneers also conceptualized the family as an“organism,”but Bowen was the only one to anchor the emotional process in a human emotional system thathad been shaped by billions of years of evolution

At this juncture, the study morphed from a study of symbiosis to a study of the family Familygroups that included a father, a mother, schizophrenic offspring, and “normal” sibling were nowadmitted to the project The patient’s symptoms were viewed as part of a dynamic processinvolving the entire family

What made the Family Study Project unique was that Bowen and the research team wereobserving family interactions directly Learning what was unfolding in the families was notdependent on just listening to the subjective reports of family members All of the staff madecareful notes of their observations Despite being housed on a research ward, it was a reasonablynaturalistic setting in that the staff worked not to intrude into family tensions and conflicts Thiswas not an easy task because family members often tried to get staff members involved A study

of seven outpatient families paralleled Bowen’s research ward studies

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Bowen characterized the perspective the research team gained from the Family Study Project

as equivalent to moving from watching a football game from the vantage point of the sideline tothe very top row of the stadium This allowed previously unobserved broad patterns of move-ment of the players on the field to come into view As Bowen and his team observed familiesover a long period, he decided that the term“function” was preferable to “role” or even person-ality trait Function is a moreflexible term in that it can accommodate family members’ function-ing in a variety of ways that result from the nature of their reciprocal functioning with others.For example, a schizophrenic patient may severely under-function when interacting with hisover-functioning parents, but under-function less when relating to a sibling or someone outsidethe family Marked contrasts in functioning were frequently observed in how family membersfunctioned in a work setting versus in the family setting For example, a father might functionwith more sureness and decisiveness in his work setting than in the family setting A commonfamily pattern was a passive father, a more active mother, and helpless and immature schizo-phrenic offspring These patterns were not fixed in stone but could vary with changingcircumstances

An extremely important observation concerned the “normal” siblings of the schizophrenicpatient Bowen would later refer to this as varying levels of “differentiation of self” in the sib-lings The child with the most intense attachment to mother since early in life, and extendinginto adult life as an unresolved symbiosis, inherits more of the parents’ immaturities or weak-nesses than their strengths The less involved sibling, growing up in a different and less anxious

“parental triangle,” inherits more of the parents’ maturities or strengths

The association Bowen made with degree of unresolved attachment to family, such as the ation between siblings and overall life functioning, challenges the still commonly held view thatvarious types of abuse, physical and emotional neglect, having a mentally ill or substance-abusingparent, parental separation and divorce, and domestic violence place children at risk for later lifeproblems such as heart disease, strokes, diabetes, cancer, emphysema, and Alzheimer’s Suchoccurrences correlate with later life problems, but Bowen’s theory describes a “hidden” layer offamily system forces and patterns operating underneath abuse, trauma, and neglect that are more

vari-influential on a child’s outcome This underneath layer, which reflects a low level of family tioning (undifferentiation), affects how much “self” a child develops It can explain why two sib-lings exposed to the same trauma and deprivation can turn out very differently Trauma, abuse,and neglect are not good things to happen to a child, but they are symptomatic of a more insidi-ous process

func-It was common in the family movement to refer to the identified patient, the most tional of a sibling group, as a “scapegoat.” This term risks conveying that the child is a victim.The child is not a victim if you apply systems thinking to recognize that the mother–child rela-tionship is a reciprocal interaction For example, a child acting like a baby can calm the mother’sanxiety The child does it automatically because he or she is rewarded with a calmer mother.The mother is calmed by viewing the source of her anxiety as outside herself, in the child, andministering to the needy child also helps her feel competent The focus of both parents on thechild’s functional helplessness can distract the parents from potential tensions between themselvesand thus stabilize their relationship Bowen and the research team assessed the parents’ maturitylevels to be just a little higher than those in the child Their problems are typically hidden bytheir over-functioning, making them appear more mature than they really are

dysfunc-This non-victim perspective on a child does not relieve parents of their responsibility in familytherapy to take the lead in changing family process The child is an equal participant in thefamily process but is in too dependent of a position to take responsibility for leading change inthe family Parents benefit greatly from a therapist who can discern that whatever negative

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experiences are playing out in the family, they do not result from a lack of love or involvementbut from too much anxiety-driven involvement.

Bowen viewed the family with a psychotic member as functionally helpless, an anxious ism, without a leader Interestingly, he did not think the family members were truly helpless, butfunctionally helpless in relationship to each other A pervasive passivity exists in poorly differenti-ated families, although it may be punctuated with overly controlling and aggressive behaviors.The helplessness is also accentuated by years of seeking answers outside themselves and by themental health professionals consulted taking responsibility for diagnosing andfixing the patient

organ-A brief description of change in one family at NIMH will highlight the processes justdescribed Bowen developed his first method of family therapy at the NIMH, a method hereferred to as family group therapy All family members were present for the sessions In this caseexample, the mother and adult schizophrenic daughter’s relationship was often tense and conflict-ual The mother over-functioned, and the daughter under-functioned, in the reciprocity Thefather, highly reactive to his wife’s anxiety, tended to support her view that the basic problemwas in the daughter With the help of therapy, the father began to see how anxious he wasabout his wife’s anxiety and how it clouded his thinking about how things were playing out inthe family As a result of his developing a little more objective view of the family dynamics, hechanged by no longer going along with his wife’s pleadings to support her anxiety-driven focus

on the child In response, the wife had an emotional meltdown of her own, pleading desperatelywith the husband to support her with the daughter The mother was feeling angry, abandoned,and especially helpless The husband held his ground in face of her pressure He was not angry athis wife, just calmer and a little surer of himself To his amazement, his stance eventually had

a calming effect on his wife, which then helped her resist her daughter’s anxious pleadings thatthe mother do what was typical for her when the daughter was feeling helpless and distressed.The mother would take over andfix the problem Of course, this accomplished only a short-term solution Now, with the mother not doing her usual thing, the daughter put stronger pres-sure on her mother to solve her problem by acting more psychotic The mother held the line,and the daughter picked up her functioning What I have just described is one of the many ver-sions of“family emotional process” that Bowen and the research team were observing The pro-cessflows through a family in predictable ways, with often-predictable results

When the Family Study Project ended in 1959, Bowen moved to Georgetown UniversitySchool of Medicine, Department of Psychiatry The inpatient studies were over, but his theoret-ical thinking and numerous innovations of the therapyflourished there An important observationfrom outpatient studies at Georgetown was confirmation that the same patterns in families withschizophrenia occurred in better differentiated or more maturely functioning families, but withless intensity Work at Georgetown alsofleshed out an idea that began at NIMH The idea wasthat the high degree of intensity of unresolved emotional attachment between a mother and adultdysfunctional child reflected the outcome of gradually increasing degrees of unresolved emotionalattachment over many generations The idea eventually became a concept in Bowen theory: themultigenerational transmission process

Bowen considered another development at Georgetown one of the most important: diation of self in one’s own family As an alternative to lying on a couch for many years, with some

fferenti-“coaching help,” people could apply Bowen theory to the real world of their own families to work

on whatever degrees of unresolved attachment they had with them Bowen suggested that, forfamily therapists to be effective in their work, they had a particular responsibility to do this.Besides continuing developments in theory and therapy, family programs Bowen developed atGeorgetown enabled interested psychiatric residents and other mental health professionals in thecommunity to learn about Bowen theory and therapy An annual symposium on family began in

1965, a postgraduate training program began in 1969, and the Georgetown University Family

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Center opened its doors in 1975 All those activities continue to this day Bowen’s book of lected papers was published in 1978.

col-In the late 1980s, a new psychiatry department chair was especially unaccepting of Bowen’sideas being so out of step with the still psychoanalytic base of the department The chair’s atti-tude, along with Bowen’s health having been in decline for several years, led to GeorgetownUniversity severing ties with the Center in the summer of 1990 It could be that the departmentthought the Family Center would fall apart without Bowen because it assumed the Center wasBowen based, not theory based Bowen was a strong leader, but the theory had been transmittedsuccessfully to many others who would continue to develop it Bowen died in October 1990,but the family faculty that been assembled over many decades continued the Center’s programs

as a not-for-profit, 501(c)(3) organization in an off-campus location near the one it had occupiedfor many years

Bowen’s principal guidance in reference to the future of Bowen theory and its many tions (to non-family as well as family systems) for those that would follow him, both at theFamily Center, Inc (a.k.a Bowen Center for the Study of the Family as of the mid-1990s) and

applica-at the myriad Bowen theory-oriented sites thapplica-at had sprung up around the country and overseas,was to keep Bowen theory an open system by maintaining viable contact with the sciences andother relevant disciplines The theory needed to be continuously exposed to new facts emergingfrom other disciplines that would either support or contradict it Failure to do so would renderthe theory vulnerable to becoming a closed system, a dogma A mantra of the Bowen network isthat theory can be changed by facts alone, not by personal opinion Through the efforts of manypeople in many places, the viable contact continues

I have provided this background on the history of the development of Bowen theory toemphasize the theory’s unique position in intellectual history Using systems thinking to combinefacts about human behavior from many disciplines, especially family research, with facts abouthuman beings as a product of evolution is a genuinely new idea The theory is not well estab-lished in the public consciousness at present, but I believe history will treat it kindly This book

is about research that attempts to support and extend this idea, but an obstacle exists to ance of the theory

accept-The recently emerging field of systems medicine highlights some of the obstacles Bowentheory researchers face Systems medicine is an interdisciplinaryfield that looks at the systems ofthe body as an integrated whole Like a family system, the components of a body system interact

to create something that could not be predicted by just studying its individual components

In systems medicine, the research effort is to elucidate the pathways in a network that regulatethe components of that network, and how networks interact with other networks in the body as

a whole The ultimate goal is a better understanding of states of wellness and disease An ant component of the work in systems biology and systems medicine is computational biology ormathematical modeling

import-In a family system, it is difficult to quantify the communication signals that regulate the tioning of family members When the Georgetown University Family Center was just gettingunderway, Bowen invited the research chair of the medical school to a meeting that includedBowen and his faculty Prior to the meeting, the chair had been provided with two collections

func-of papers that had been presented at conferences related to Bowen theory The first thing theresearch chair said was,“I read these papers, but there are no numbers here Where are the num-bers?” This comment made quite an impression on me, and I think it highlights obstacles thatBowen theory researchers face A mathematical model is not reality; it is an attempt to matchnatural phenomena with equations that can then be used to make predictions about natural phe-nomena Mathematical models can be honed to fit reality If a mathematical structure is a goodmodel of whatever reality is being addressed, it lends a certain credibility to the research No one

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has yet developed mathematical modeling for a family relationship system, but that does notmean it cannot be done.

An absence of mathematical models is not a reason for family researchers to get defensive

A useful perspective on this issue has been provided by a young systems biologist, James Valcourt

He compares the current state of systems medicine to the state of knowledge at the timeJohannes Kepler defined the laws of planetary motion Kepler described what was happening,even developing mathematical formulas about the phenomenon, but he could not account for itbeing the way it is Valcourt suggests it is necessary for systems medicine to get to the time ofNewton Newton conceptualized gravitational forces that could predict everything Keplerdescribed I interpret Valcourt’s point to be that systems medicine would benefit greatly from

a theory developed from all the factual information it is collecting A theory would enhancefuture research

Bowen described myriad functional facts of family interactions gleaned from extensive tional research Within a relatively short period of time he was able to construct a theory fromthose facts He did this without any numbers I suggest that Bowen was like a Kepler-Newton.This does not mean that computational biology does not have a place in Bowen theory research,but the existence of family theory places Bowen theory research in a unique place that is differentfrom where systems medicine is today

observa-Observational research depends on overcoming what Bowen termed “observational blindness”

or what others refer to as“inattentional blindness.” Both phrases describe a psychological processthat results in an individual failing to perceive an unexpected stimulus that is in plain sight Ittook the application of systems thinking to get beyond the observational blindness generated byindividual psychopathological thinking and to see how patterns of interaction revealed by systemsthinking regulated the functioning and behaviors of individual family members

Bowen made a quantum leap Dysfunction in one family member is a symptom of

a disturbance in the family relationship system The equivalent for systems medicine, if I aminterpreting the current state of that field correctly, would be shifting from the view that

a disease causes a disturbance in an organism’s homeostasis to the view that dysfunction in anorgan or tissue is symptomatic of a disturbance in the organism homeostasis It would be

a quantum leap for systems medicine to view disease in this way

All of us who became serious students of Bowen theory had to prove the theory to selves Bowen got us interested in the ideas, but everyone has his or her own research to do

our-No mathematical formulas exist about families to provide credibility Proving the theory tooneself is part of the process of differentiation of self It involves becoming acquainted withsystems thinking and having the motivation (and courage) to apply it in one’s own family It

is observational research on one’s personal life, recognizing previously unseen patterns, thentaking actions based on this new way of seeing what is unfolding The actions are aimed atchanging self, not others

Next comes the problem of assessing any progress that has been made How to assess, let alonequantify, progress in oneself and progress in a complex family system is difficult at present.People fall back on self-observation and observations of the relationship system Both assessmentsare vulnerable to contamination by subjectivity It is easy to fool oneself into thinking one hasmade more progress than one has actually made The research systems biologists and systemsmedicine people are using will likely be of help to Bowen theory researchers over time Forexample, systems biology may be able to quantify levels of chronic anxiety in individuals andfamily units to a degree that is not currently possible To do this, systems biology would have toinclude the impact of stress on the networks being studied

The authors of the chapters in this book are serious students of Bowen theory Each comes upwith his or her own creative way of approaching research, either to document the accuracy of

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Bowen theory’s predictions and/or to extend the theoretical concepts I hope the background

I have described conveys something about the challenges they face in studying a complex systemsuch as the human family I commend and admire their efforts I suspect I will end my career bysaying what Bowen often said,“I know within me that the theory is accurate.” This, of course,proves nothing

Michael E Kerr, MD

July 2019Islesboro, Maine

Foreword

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This multi-authored volume provides a framework for examining principles of the research cess through the lens of Bowen family systems theory This publication discusses the linksbetween theory, data collection, and data analysis from a systems perspective The authors of thechapters discuss the core concepts within family systems theory, developed from the study ofthe human family, with emphasis on strategies for addressing theoretical and methodologicalissues inherent in family research

pro-This book also provides a framework for acquiring new knowledge and expanding the standing of both theory and research methods in family research This is accomplished through

under-an in-depth discussion of recurring theoretical under-and methodological issues encountered in familyresearch In addition, examples are provided that illustrate the application of Bowen family sys-tems theory in empirical family studies

The seminal work by Dr Murray Bowen, Family Therapy in Clinical Practice, published in

1978, provides an in-depth discussion of family systems theory and its early development.Many have written notable publications based on Bowen family systems theory, which tend

to have a clinical focus They significantly expanded the theoretical knowledge and an standing of issues related to the clinical application of Bowen theory However, a greaterfocus on the expansion of family research to ensure its viability and contribution to futuregenerations of clinicians and researchers in the social and natural sciences involved in familyresearch is needed

under-The purpose of each chapter is outlined below

Chapter 1: The Role of Theory in Family Research

In the search for knowledge about human behavior and the human family, theory andresearch methods are interdependent and complementary Both are important in familyresearch because they are critical to the collaborative search for science Science is

a systematic and logical approach for gaining knowledge and an increased understanding ofthe predictability of human life in the universe through the testing and analysis of observableand measurable facts This chapter examines the role of Bowen theory in the researchprocess

Chapter 2: The Origins of Family Research

We are fortunate today to have many sources related to Dr Murray Bowen’s National Institute ofMental Health (NIMH) Family Study Project 1954–1959 This chapter has several purposes First, asother sources provide comprehensive details about Bowen’s project, the emphasis of this chapter is

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on the research methodologies of the project, which have not been discussed consistently as much ashave other aspects of the project This chapter also reviews some seminal results of the project.

Chapter 3: Developing a Systems Model for Family Assessment

Since the publication of Michael Kerr’s outline of a procedure for assessing family functioning,several attempts have been made to use the outline to develop a model for family assessment.Although these efforts have been informative, no clear model has emerged and been tested In

2011–12, the NIMH began development of the Research Domain Criteria (RDoC), a researchframework for studying the full range of human behavior from normal to abnormal based onbiology, behavior, and context The RDoC moves away from the categorical classification model

of the DSM to a dimensional or continuum model

The RDoC use of dimensions led the author to consider a new approach to family assessment that

differed from the Kerr model Beginning with Bowen’s conceptualization of the family as a system andhis focus on the functioning of that system as it faced adaptive challenges and accompanying anxiety andstress, it becomes possible to develop a dimensional model of family system functioning That modelincludesfive dimensions, each ranging from optimal to dysfunctional: resourcefulness, tension manage-ment, connectedness and integration, systems thinking, and goal structure At present, the work remains

a proposed schema for evaluation, not a validated instrument, which will require further testing

Chapter 4: Bowen Theory: A Systems Model for Family Research

A systems model for family research based on Bowen family systems theory is proposed The purpose

of family systems theory is to observe the facts of functioning in human relationships The facts can

be observed to repeat consistently across generations The Bowen theory focuses on“what happenedand how, when, and where it happened.” The assumptions and theoretical principles within Bowentheory provide the framework for further understanding family functioning and advancing knowledgethrough empirical research When using the scientific method, the replication and affirmation of find-ings based on the theoretical formulations of Bowen theory will demonstrate the potential of the con-ceptual framework as a viable approach for family research

Chapter 5: Data Collection and Family Research

This chapter discusses the family diagram, a theory-driven assessment instrument, based on theformulations of Bowen family systems theory The assessment procedure is designed to systemat-ically collect factual family data (who, what, when, and where) on all family members that pro-vide a multigenerational diagrammatic description of the relationships and emotional patterns inthe nuclear and extended family system The chapter provides strategies for making the familydiagram a reliable assessment instrument for empirical research

Chapter 6: Data Analysis and Family Research

The family data used in family research, which is based on Bowen family systems theory,

differs from conventional clinical and social science family data For example, Bowen theoryconsistently focuses on assessing and measuring functioning differences in family dependenciesand relationships Consequently, conventional ways of measuring family exchanges—throughgender, race, social class, or religious beliefs—are often essentially discounted Furthermore,reliability and validity are deliberately sought through use of innovative techniques such asfamily diagrams and life histories Thus, adequate primary and secondary family data are

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collected by quantitative and qualitative research methods that allow researchers to alize Bowen theory’s concepts.

operation-Chapter 7: Stress, Chronic Anxiety, and Symptom Development:

A Family Systems Perspective

A wealth of research evidence over the past several decades supports the relationshipbetween stressful life events and health This evidence has contributed to an understanding

of how stress and the response of individuals to stress are significant factors in the ment of physical, emotional, and behavioral symptoms Knowledge about the neuroendo-crine systems involved in the physiological stress response and their influence on variousother systems has shed light on how the response to stress can contribute to a wide range

develop-of symptoms Bowen theory describes how such processes within individuals are regulated

physio-Chapter 9: Human Stress Genomics and Bowen Theory: Potential

for Future Research

Murray Bowen theorized that the human-interaction phenomena described in his theory couldeventually be identified and measured at the cellular level, as well as at the psychological/relation-ship level An emergingfield of human social genomics, based in changes in genetic expression

in response to social stress, has the potential to offer evidence of Bowen theory on the level ofmolecular physiology There is broad congruence between Bowen theory and social genomics inidentifying three major factors that contribute to human functioning: (1) degree of sensitivity tosocial regulation, which Bowen saw as an aspect of his concept of differentiation of self; (2) the

effects of one’s position in the social group in determining health, illness, and well-being; and (3)the consequences of social stress, or anxiety, from intimate, family relationships to the level ofsociety

Chapter 10: Use of Differentiation of Self in Family Research

This chapter describes the multifaceted concept of differentiation of self and reviews and evaluatesways in which the concept has been operationalized for family research Other concepts such asresilience, coping, adaptation, and self-esteem will be examined for possible relevance to research

on differentiation of self

Chapter 11: Emotional Cutoff

Emotional cutoff is one of the eight concepts of Bowen theory, a family systems theory oped by Murray Bowen based on viewing the family as an emotional unit Emotional cutoff is

devel-Preface

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the distancing of a relationship, physically or emotionally, in reaction to tension or anxiety Therelationship might appear as distant or “not important,” but cutoff signifies that effort is beingexpended to isolate oneself from someone with whom one has an intense bond and strongreactivity One reaction to intense fusion is to sever the relationship to gain more autonomy oremotional breathing space Bowen observed that cutting off only intensified the fusion in otherrelationships, resulting in vulnerability to new symptoms Concepts such as social support andsocial network will be examined for their relevance to research on emotional cutoff.

Chapter 12: Cutoff and Self-Functioning in Three Generations of

Families with Substance Abusing Teenagers

Cutoff is one concept of Bowen family systems theory that addresses emotional cutoff or physicaldistancing as a way of handling unresolved attachment between generations of a family The pull-ing away of the child from the parent or the extrusion of the child by the parents is a means toresolve tension in the relationship However, the cutoff also prevents a resolution of the difficul-ties, which may impact on the child in their subsequent relationships, nuclear family, and parentalfunctioning This chapter will describe thefindings in a research study conducted with sixty fam-ilies who were referred to a mental health center for a substance-abuse evaluation of a teenager

Chapter 13: Within Family Variability: Intergenerational Cutoff and

Family Projection in an Adopted Family

Research on within family variability has provided an exhaustive exploration of the multiple tors that contribute to why children in the same family turn out differently This chapter willbriefly review these research findings and describe a family systems view of the subject Familysystems theory, specifically Bowen theory, offers a broad view of variability in human functioningthat includes family variables such as emotional cutoff between generations and family projectionprocess, where the parental anxiety is focused on the children to varying degrees The aforemen-tioned concepts will be elucidated in a long-term case study of a single parent family with twochildren, one birth child and one child by adoption The family emotional process has variablelong-term consequences for each child

fac-Chapter 14: Nuclear Family Emotional Process

The concept of the nuclear family system describes both the interdependent functioning of thefamily unit and the interactional patterns involved as family members adapt to one another and

to the environment Defined as an emotional system, family processes are viewed as largely matic and, for the most part, operating outside the awareness of the members This chapter willdiscuss the nuclear family system as an adaptive system and describe the mechanisms or processesfamilies utilize in the effort to maintain stability Implications for research will also be discussed

auto-Chapter 15: The Primary Triangle and Variation in Family Functioning

The triangle, a concept in Bowen theory, is the emotional context in the family system thatshapes the human over the course of life This longitudinal study explores the influence of thefamily of origin primary triangle on fifty-one couples’ reproductive functioning over ten years.The quantitative analysis identifies associations between reproduction and three variables: distanceversus openness in the family of origin, the degree of inside and outside positions in the primarytriangle, and the degree of projection as expressed in worry

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Chapter 16: Family Emotional System and the African American

accur-Chapter 17: Multigenerational Transmission Process

Differences in how well individuals cope with their circumstances over their life course entailgenetic, epigenetic, physiological, psychological, relationship, and environmental variables, whichinteract over the course of their development One of the hypotheses derived from thefive-yearNIMH study of the family by Murray Bowen was that family interactions and emotional process

in the family unit, which govern varying degrees of maturity attained by children, also shapevariation in the range of maturity levels attained in the next generation With further study andthe development of the concept of differentiation of self, this observation was refined into theformal concept of the multigenerational transmission process This chapter discusses the conceptand some of the research in the neurosciences and epigenetics, which both provide support forthe concept

Chapter 18: The Multigenerational Transmission of Family Unit

Functioning

Bowen theory hypothesizes that a nuclear family’s level of functioning is influenced by the ity or functioning of previous generations This longitudinal study tests this hypothesis withfifty-one newly developing nuclear families and their multigenerational families Family functioningwas measured using a composite of physical, emotional, social, and marital symptoms of thefamily members of current and previous generations The quantitative analysis supported thehypothesis In a correlation analysis of thefirst five years of this twenty-year study, multigener-ational functioning, especially nuclear family of origin functioning, was associated with nuclearfamily functioning

stabil-Chapter 19: The Multigenerational Transmission Process and Family

Functioning

The multigenerational transmission process is a concept within Bowen family systems theory thatdescribes the variability in the functioning among family members ranging from the most favor-able to the most dysfunctional Some segments move toward a higher level of functioning, whileother segments move toward a lower level of functioning Family members differ in functioning,and multigenerational trends in functioning reflect an orderly, predictable process that connectsthe functioning of family members within and across generations This chapter explores theextent to which family systems theory provides the most useful framework for identifying andevaluating factors that influence the variability in functioning among family member in thefamily study spanning nine generations

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Chapter 20: Anthropological Contributions to the Study of the

Human Family

This chapter extends Murray Bowen’s concept of societal emotional process by incorporating thefamily–land relationship into his theory Bowen understood that the forces driving emotionalregression in the family and society were resource-based, and he postulated overpopulation andscarcity of resources could be sufficient to produce societal-level regression At the same time, herecognized that the forces were far more complex and he remarked that other disciplines had

a better knowledge base than he did He hoped future generations would be able to expand hisconcept

Chapter 21: Bowen Theory Integrated into Nursing

This chapter describes the practice of, and scientific foundations for, nursing Nursing family ories are described, including how Bowen family systems theory has been integrated into thenursing theories The chapter also includes selected examples of integration and application ofBowen theory concepts and strategies used to guide nursing practice and nursing research Thechapter concludes with a discussion of implications for Bowen family systems theory and nursingresearch

the-Chapter 22: The Family: A Public Health Approach

This chapter sets forth the World Health Organization (WHO) and the Department ofHealth and Human Services (DHHS) vision of “Health for All” as the collective goal, whilerecognizing the mental disease burden that families and communities will have to absorb asour population ages and lives longer Public health facilities and the mental health workforceare not likely to be adequate to manage the level of dementia and Alzheimer’s they will face.Therefore, the stigma that mental health has in the community, when public health evidenceabout intervention and prevention strategies that use life course frameworks is examined, will

be discussed Bowen family systems theory will be discussed as an alternative for expandingthe strategies for addressing the challenges in the public health arena

Chapter 23: The Family and Academic Achievement

This chapter focuses on families’ support networks and their impact on children’s ment Research indicates that a social support network brings about improved academic per-formance by children from families enduring prolonged or multiple stressors Given suchsupport, parents more effectively focus on reinforcement of the child’s home-learning envir-onment More explicitly, Coleman indicates that social support provides strength for parentsand children to draw upon during difficult times: for example, when encountering emotional

achieve-or financial hardship, or problems with schoolwork, teachers, or peers Edmunds points outthat social support is a useful community intervention strategy for African American and His-panic American children living in poverty This chapter explores reconnections between par-ents’ social support networks and children’s academic achievement

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Chapter 24: Extension of Bowen Theory to Include Natural Systems

of Human Societies and Their Sustaining Environments

Murray Bowen’s odyssey toward a science of the human lasted nearly 50 years He explored thehuman as an instinctual animal with a“marvelous” brain until death claimed him on October 9,

1990 Although he did not reach his goal of constructing “a total human theory from scientificfacts alone,” he left a rich intellectual legacy to guide future explorers of the human condition intheir quests toward that science, fashioning a natural systems theory designed tofit precisely withthe principles of evolution and the human as an evolutionary being This chapter presents theauthor’s understanding of how to use his guide to extending The Bowen Theory to encompasshuman societies and their sustaining environments

Chapter 25: Future Directions of Family Research

Bowen family systems theory approaches research from many levels of analysis and interpretation.The author considers micro- and macro-trends of family interdependence together, as well asseparately, and Bowen’s concept of emotional process in society helps us understand how familiesare influenced by societies and vice versa This makes us more aware of what we take for grantedabout family and research challenges, so that we make new emphases, according to observed pre-dictabilities in families Bowen’s interest in biological sources of family reactivity may further ourquests tofind linkages between science, nature, the environment, and families Also, clearing ourminds of conventional thinking challenges some of us to try to solve the future massive globalproblems

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Many individuals have made significant contributions that have enabled us to complete this researchhandbook However, foremost recognition is due to our families Mignonette Keller wishes to acknow-ledge the members of her nuclear and extended family system, including her husband, Royce, son,Joseph, and extended family for a legacy of leadership, achievement, and courage Robert Noonewould like to acknowledge the previous generations for all they have contributed to his life

We are deeply indebted to the authors from the network of Bowen theory scholars and theacademicians in the social and natural sciences who graciously consented to lend their expertise

to writing chapters for the original research handbook based on Bowen family systems theoryand research methods The cadre of scholars included in this publication will be among theresearchers providing leadership in the quest for a science of human behavior

Expressions of deep gratitude are extended to Dr Murray Bowen for his foresight in providing thefoundation and direction for future generations of family researchers Through his groundbreakingresearch, a new formal theory was developed based on the human family, with a goal of movingtoward a science of human behavior The assumptions, theoretical principles, and constructs withinBowen theory provide the framework for advancing the knowledge of human behavior throughempirical research Research and the ongoing development of the theory will determine the viability

of Bowen family systems theory as an approach for the study of the family and human behavior.Without a doubt, Bowen’s revolutionary vision of developing a science of human behavior will

influence the direction of family research for decades The future of family research now depends onserious students of Bowen theory to continue the course that he initiated through the conceptualiza-tion of a science of human behavior using family systems theory as the springboard

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Mignonette N Keller and Robert J Noone

Bowen family systems theory represents a scientific study of human behavior, with emphasis onthe family Murray Bowen was deeply committed to the development of a science of humanbehavior His commitment to scientific theory and research was critical to the development ofBowen family systems theory, also known as Bowen theory The family as characterized byBowen is a natural system influenced by the laws that govern all living things As a naturalsystem, the family has predictable patterns of growth, adaptation, and change throughout the lifecourse responding to life events (i.e., birth, death, marriage, divorce, separation, health, and ill-ness) over generations (Bowen, 1978; Kerr & Bowen, 1988)

Bowen spent years observing and evaluating family interactions, specifically related to familydynamics within the family relationship system, in varying family configurations (Butler, 2013)

He developed the concepts for Bowen theory following years of intensive observation of familyinteractions in empirical investigations In so doing, he observed family interactions that revealed

an orderly and predictable process of recurring patterns

Through the study of the human family, a coherent theory was developed regarding thehighly influential nature of the family relationship process on individual functioning WhenBowen (1978) examined the relationship system of the family, he moved from thinking interms of a collection of relatively autonomous individuals toward thinking in terms of thegroup as an emotional unit Bowen observed that psychological functioning and physio-logical functioning are regulated more by family relationships than previously thought, andthat an individual’s functioning does not merit the degree of autonomy suggested in theliterature

Historical Background of Family Research

For decades, a wide range of sociological and psychological theories have dominated the familyresearchfield Several theories that have had a major influence in family research are interactionisttheory, exchange theory, social systems theory, cybernetics, and general system theory Five the-ories that have had less influence are behaviorism, developmental theory, ecosystems, conflicttheory, and phenomenology A number of peripheral theories that have had limited influence onfamily research include game theory, field theory, learning theory, situational approach, transac-tional analysis, and structure-functionalism (Holman & Burr, 1980)

1

An examination of some of the literature suggests that many of the theories that have beenutilized over the pastfifty years have been used to investigate various aspects of family function-ing (Hill & Hansen, 1960; Hill, 1964, 1966; Christensen, 1964; Broderick, 1971; Bowen, 1978;Burr et al., 1979a, 1979b; Troll & Bengtson, 1979; Holman & Burr, 1980; Kerr & Bowen,1988; Berado, 1980; Kerr, 1990; Papero, 1990; Boss, Doherty, LaRossa, Schumm, & Steinmetz,1993; Bengtson, Acock, Allen, Dilworth-Anderson, & Klein, 2005; Keller, 2006; Noone, 2008;Butler, 2013; Noone & Papero, 2015) Although many social scientists express the need for

a general family theory for all disciplines that link personality and society, others suggest thatsome theories more effectively explicate specific aspects of family functioning A comprehensivetheory, integrating the anthropological, biological, psychological, and sociological perspectives isrequired to fully understand all facets of family functioning (Adams, 1988; Grotevant & Carlson,1989)

In the 1950s, the family movement in psychiatry significantly contributed to the existingapproaches for studying the family Among the pioneers who contributed to family theory andfamily research were Don Jackson and his colleagues in Palo Alto, California; Murray Bowen andhis colleagues in Bethesda, Maryland; and Lidz and his group at Johns Hopkins and Yale.Bowen and his colleagues (Dysinger & Bowen, 1959) studied the relationship betweenmothers and schizophrenic patients in a seminal research study based at the National Institute ofMental Health (NIMH) The overallfindings of the study resulted in the family being viewed as

a unit that operates as a system Moreover, this study also provided the basis for the development

of the original concepts in Bowen family systems theory Bowen (1980) states the following:Systems theory has the breadth and flexibility to conceptualize the interplay of numerousforces within the family It has the flexibility to comprehend the flow of forces betweenneurophysiology, psycho-pharmacology, and emotionality It is not that one theory is moreaccurate or better Each theory is a different way of looking at the same thing Each person

is an individual, but each is also part of the emotional amalgam of the family and society Itcan explain the human phenomenon all the way from functioning within an individual tofunctioning in society

(p xvi)Family systems theory is a comprehensive theoretical framework that provides the basis for theresearch process, including theoretical conceptualization, data collection, and data analysis Thepurpose of Bowen theory is to observe the facts of functioning in human relationships, whichcan be observed to repeat consistently within and across generations The Bowen theory focuses

on what happened, including how, when, and where it happened (Bowen, 1978) The tions and theoretical principles provide the framework for further understanding family function-ing and advancing knowledge through empirical research When using the scientific process, thereplication and affirmation of findings based on the theoretical formulations of Bowen family sys-tems theory will confirm the potential of the conceptual approach as a viable theory for thedevelopment of knowledge from research in the natural and social sciences

assump-Science and Human Behavior

The development of Bowen theory represents an effort to move toward a science of humanbehavior and the principal basis of its development was the research study at NIMH The prob-lem-solving and predictability elements of the scientific process are also major components of thissystems oriented research Furthermore, Bowen theory articulates an explanation of humanbehavior based on testable, observable, and predictable facts of functioning

Mignonette N Keller and Robert J Noone

2

Evolutionary Theory

From the inception of his work, Murray Bowen’s primary emphasis was directed toward the

“development of a theory that moved toward the sciences.” Bowen states the following:

Science will continue to expand knowledge for the millennium ahead If knowledge aboutthe human ever becomes an accepted science, it can share new knowledge with the acceptedsciences and proceed into the future with the other sciences I support the view that thehuman is as scientific as the other forms of life on the planet, that it will finally be possible

to construct a total human theory from scientific facts alone, and that the feeling elements ofhuman existence will be handled in relationship with other human beings The brain is anevolutionary organ that has been slowly evolving for most of a million years What the brain

is differs from what the brain thinks

(Kerr & Bowen, 1988, p 360)

In developing family systems theory, Bowen states that he selected scientific facts of evolution toreplace traditional Freudian theory “Evolution is a rich body of facts that can be proven andvalidated” (Kerr & Bowen, 1988, p 360) He further suggests that a form of systems theory wasrequired to incorporate the new facts Two kinds of systems theory were in existence in the1940s The theories were general system theory by Ludwig von Bertalanffy and systems theory

by Norbert Wiener General system theory by von Bertalanffy was applied to the human andcontained concepts from mathematics The systems theory developed by Norbert Wiener dealtwith the new technological advances in cybernetics, robotics, and computer science Neither ofthe existing systems theories seemed appropriate for studying the “human as an evolutionarybeing” (p 360) Bowen believed that the use of a theory grounded in mathematics or technol-ogy, which was a product of the human mind, would be insufficient in the quest toward science.Therefore, Bowen developed a natural systems theory, “designed to fit precisely with the prin-ciples of evolution and the human as an evolutionary being” (p 360)

Biology and Natural Sciences

Bowen used biology and related disciplines in natural science to develop the scientific perspectivefor family systems theory With a focus on science, he incorporated a framework for the accuracyand precision needed to develop a theory based on the observation of repeatable interactionalpatterns Moreover, Bowen family systems theory moves further toward validation, theoreticaland methodological development, and prediction when these processes yield reliable behavioraloutcomes resulting from empirical investigations

The systems model of family research is compatible with the scientific method, which isthe process by which science is conducted Both use observable facts to move through the

different phases of the research process The scientific process is a collection of strategies forinvestigating phenomena and attaining and incorporating new information Although the pro-cedures used in science and research are not fixed and may vary somewhat in the variousfields of study, there tends to be overall consistency among the disciplines regarding a set ofgeneral principles that are closely followed in the phases of the research process including: (1)observation, (2) hypothesis formulation and testing, (3) data collection, and (4) data analysis.Naturalistic observations, comparative studies, conceptual clarification and refinement, know-ledge from otherfields, analysis and logic, measurement and quantification, classification, elim-ination of alternative theories, and experimental studies are among other processes involved inscience (Mayr, 1982)

Introduction

3

When combined with research methods, a Bowen theory systems orientation for familyresearch includes: (1) observation– the primary task of the systems oriented researcher and thecore element of science; (2) facts– observable behavior that can be objectively and scientificallyestablished; (3) family diagram– an assessment procedure designed to collect observable and fac-tual data that provide a multigenerational diagrammatic description of the relationships and emo-tional patterns within the nuclear and extended family system; and (4) behavioral markers –observable and factual data that are indicators of the emotional process in the family relationshipsystem: (a) conflict, (b) distance, (c) fusion, (d) triangles, and (e) family impairment (social, emo-tional, or physical).

Moreover, theoretical constructs within Bowen family systems theory that have a basis inrepeated observations include: (1) differentiation of self – describes the range of human function-ing from the highest to the lowest levels; (2) emotional cutoff – describes the manner in whichpeople separate from their past in order to live in the current generation; (3) triangle– describes

a three-person unit as the basic building block of an emotional system; (4) fusion– a process thatdescribes varying degrees of interdependence among family members; (5) family projection pro-cess– describes the manner in which parents transfer their problems to their children; (6) nuclearfamily emotional process – describes the adaptive mechanisms utilized by the family; and (7)multigenerational transmission process – describes the emotional process in succeeding gener-ations (Bowen, 1978; Kerr & Bowen, 1988) The major theoretical concepts outlined in this sec-tion will be discussed in greater depth in later chapters

The Family Emotional System

The observation that family members interacted in a highly integrated manner and that thefamily unit constituted a system became apparent in the early months after the fathers andsiblings began living on the NIMH research unit Relationship patterns not previously seencould now be observed in the families’ daily interactions The interactions in the mother–schizophrenic offspring dyad could now be seen in the context of the reciprocal interactions

of the larger family Bowen had for years been interested in the influence family membershad on individuals with schizophrenia and other severe disorders, not just their mothers, butnow the reciprocal nature of the interactions could be observed day in and day out Hedescribed this experience in writing:

The focus on the family instead of the individual provided a completely different thinkingdimension The previous years of study may havefigured into entire families living on the(research) ward together The study played a monumental part in the research itself and inthe subsequent twenty-five years With the families living together, I could see a completely

different world Years of work suddenly became clear The view faded in and out until

I could control it better It was there when I could think about evolution and science

(Bowen, 2013, p 103)

It became evident that a change in one family member would result in a change in another.Patterned interactions could be observed over and over

Once the family could be observed to function as a system, it became conceptually important to

define what kind of system it was Bowen believed that, if a theory of human behavior were tomove toward science and have the capacity to integrate known facts of science, it would have to bebased in evolution He believed that a theory of the family would have to be consistent with thefacts of biology and the human as an evolved form of life In defining the family as an emotionalsystem he wrote:

Mignonette N Keller and Robert J Noone

4

Man is conceived as the most complex form of life that evolved from the lower forms and isintimately connected with all living things.… Emotional functioning includes the automaticforces that govern protoplasmic life It includes the force that biology defines as instinct,reproduction, the automatic activity controlled by the autonomic nervous system, subjectiveemotional and feeling states, and the forces that govern relationship systems.

(Bowen, 1978, pp 304–305; emphasis added)Bowen theory is a theory not of how the family evolved, but of how the family functions If thetheory were to be consistent with the facts of nature and the human as a part of all life, however,

it had to be consistent with the facts of the evolution of life The consideration of the family as

a product of evolution provides a perspective that can contribute to a more neutral or objectiveview of its functioning Bowen believed that one of the principle obstacles to the development

of a science of human behavior was human subjectivity

It has been possible for the human to gain increasing objectivity about the natural world overthe millennia This effort greatly sped up with the development of science A basic premise inscience is that a reality exists outside of the human mind But observations of nature must neces-sarily be run through our very subjective minds In the strict sense of the term, theory represents

an effort to move beyond that subjectivity As evolutionary biologist E O Wilson (1998) writes:Still, scientific theories are a product of imagination – informed imagination They reachbeyond their grasp to predict the existence of previously unsuspected phenomena They gen-erate hypotheses, disciplined guesses about unexplored topics whose parameters the theorieshelp to define The best theories generate the most fruitful hypotheses, which translatecleanly into questions that can be answered by observation and experiment

That life evolved is a fact accepted in the sciences, and Bowen defined the family as an tional system to base it in evolution He wrote:

emo-Family systems theory is grounded in the assumption that the development of a science ofhuman behavior is possible The human species, despite its unique qualities, is part of all life.The human emotional system is a product of evolution and is assumed to be orchestrated byprinciples that are fundamental to all living systems Much of what we do, feel, and say isanchored in the instinctual nature of man The concept of an emotional system describesthese more automatic aspects of human functioning

(Kerr & Bowen, 1988, p 334)

It is an assumption in Bowen theory that the increased interdependency observable among familymembers is a product of evolution Its evolution led to the highly integrated family emotionalsystem in which members co-regulate each other’s functioning over the course of development,over the life course, and over multiple generations Over the course of evolution, the integration

of family members led to a functional unit with emergent properties that cannot be accounted

Introduction

5

for by the behavior of individuals alone Though culture may influence how aspects of the familyemotional system are expressed, Bowen theory posits that basic underlying emotional processesexist that are basic to all human life.

In defining the human family as an emotional system, Bowen grounded it as an expression of

a process at play from life’s beginning From the earliest forms of microbial life to the most plex and varied forms on the planet today, the emotional system is seen as underlying thehomeostatic and adaptive functioning of all living systems When a family is viewed as an emo-tional system, the individual members of the family can be seen as engaged in an ongoing giveand take that is largely automatic The elaborate brain of humans permits a potential degree ofchoice in behavior, but our evolutionary history is embodied in our lives from top to bottom,from our cellular biochemistry to our relationship interactions Although not writing about thefamily, neuroscientist Antonio Damasio (2018) captures this adaptive give and take among thecomponents of evolved living systems:

com-The principle is always the same: organisms give up something in exchange for somethingthat other organisms can offer them; in the long run this will make their lives more efficientand survival more likely What bacteria, or nucleated cells, or tissues, or organs give up, ingeneral, is independence; what they get in return is access to the “commons,” the goodsthat come from a cooperative arrangement in terms of indispensable nutrients or favorablegeneral conditions, such as access to oxygen or advantages of climate

differences in relation to his theoretical concepts or research methods However, the researchershad to willingly carry the priorities of Bowen theory into their family research In so doing,these individuals became important contributors as family researchers prepared to contribute,through both theory and research methods applications, to the development of Bowen familysystems theory and science Kerr (in Butler, 2013) suggests that the interdisciplinary exchangewith researchers studying human behavior and other forms of life continually subjects the accur-acy of Bowen theory to scrutiny Moreover, he further states that the benefit to date has beenthat,“the myriad of facts emerging from a wide range of disciplines have been consistent withBowen theory” (Butler, 2013, p 6)

As previously stated, biology and other “natural sciences” are among the disciplines thatBowen used to develop the scientific perspective for Bowen family systems theory His survey

of the scientific disciplines and elements contributing to the development of a science ofhuman behavior provided the clarity and regularity needed to support the construction of

a new theory Family systems theory and family research methods move closer to theoreticaland methodological development, and prediction, when these processes yield reliable behav-ioral indicators Bowen theory and research methods provide the context for further under-standing the complexities in family relationships, including family dependence and familyreactivity (Noone, 2008)

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Family systems theory provides a comprehensive framework for integrating the complex,multifaceted range of issues inherent in the study of human behavior, including the anthropo-logical, biological, psychological, and sociological perspectives There are areas within the study

of human behavior that address issues intrinsic in each of these disciplines

Anthropological Perspective

Anthropology is the scientific study of human behavior in groups The basic unit of analysis forthe anthropologist is the social system Anthropologists investigate behaviors that are learned andshared among individuals in specific social groups They systematically seek to identify generalpatterns in human behavior Selltiz, Wrightsman, and Cook (1981) suggest that anthropologistsmake extensive use of observational methods in their research Their work usually includes livingwith the people they are studying and observing on a daily basis The data obtained provide thebasis for testing theoretical propositions and describing existing behavior patterns Anthropologistsalso conduct investigations in classrooms, businesses, and factories Historically, anthropologistshave studied primitive societies; however, in recent years, there has been movement towardurban populations It is conceivable that techniques employed to study other societies can beapplied to study our society

Lewis (1959) utilized an anthropological research design and reporting in his study of fiveMexican families The major focus of the study was the family rather than the community or theindividual The intensive study of the family has several methodological advantages, including: (1)the family lends itself to the holistic approach of anthropology as it is a small social system; (2)the family is a natural unit of study; (3) the study of a culture through an intensive analysis high-lights what institutions mean to individuals; and (4) culture and personality are observed as com-ponents of real-life situations

Family Systems Theory and the Anthropological Perspective

The theories that have contributed most significantly to the development of anthropology include(1) culture theories, (2) structural functionalism, (3) moral economics, (4) ecological approach,and (5) social biology Family systems theory is not among the theories used by anthropologists

in the study of human behavior, although it is compatible with the anthropological perspectiveand germane to the scientific study of the family within society Anthropologist Mark Flinn’s(2006) longitudinal study of families in a remote Carribean village is an example of research thatcontributes to knowledge of the family system

Psychological Perspective

Psychology is the scientific study of the behavior of individuals The basic unit of analysis for thepsychologist is the individual, though social psychology has contributed much to the study ofgroups and organizations The study of the family with emphasis on the individual as the basisfor understanding the collective functioning within the family unit is central to the psychologicalperspective Moreover, the conceptualization of the generational process on individual develop-ment of family members throughout the life cycle is germane to the psychological orientation

Family Systems Theory and the Psychological Perspective

The theories that have contributed most significantly to the development of psychology include(1) behavioristic theories, (2) psychodynamic theories, (3) humanism, (4) cognitive theories, (5)

Introduction

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biological approaches, (6) social theories, and (7) evolutionary approaches Family systems theoryhas not, for the most part, been used by psychologists in the study of individuals, although it iscompatible with the psychological perspective and germane to the scientific study of individualbehavior.

Sociological Perspective

Sociology is the scientific study of people in groups and how interaction shapes their behavior Thebasic unit of analysis for the sociologist is the social system (families, groups, institutions, cultures,etc.) The study of the family with emphasis on the interdependence and interactions among individ-uals within a system is central to the sociological perspective Moreover, the family transmission pro-cess and intergenerational relations pertaining to the relationship process within the family system arecritical to understanding of the functioning of the family unit and the factors influencing the func-tioning among family members Furthermore, the conceptualization of generations of family lineageaccording to age stratification or cohorts in the social system denotes the influence of environmentaland societal factors on family functioning Troll & Bengtson (1979) state:

The generational process within the family simultaneously exerts an influence upon and is

influenced by the generational process in the individual development throughout the course

of life as well as by the succession of age cohorts in the larger society Development of eachindividual in the family lineage as well as changes in the society to which the family belongs,are both intricately related to cross-generational relationships within the family

(p 127)

A cohort refers to the historical time period in which an individual is born For example, eration is given to persons born during specific historical time periods including the French andIndian War, World War I, the Civil War, the Great Depression, World War II, and the VietnamWar These historical time periods are important when external factors are evaluated becausebehavioral characteristics are presumed to be associated with specific time periods

consid-Family Systems Theory and the Sociological Perspective

Current literature suggests that various theories have been employed by sociologists to study thefamily The theories that have been widely used by sociologists to study the family include (1)interactionist theory, (2) exchange theory, (3) systems theory, (4) developmental theory, (5) struc-tural-functionalist theory, (6) conflict theory, (7) learning theory, (8) field theory, (9) situationalapproach, (10) transactional analysis, and (11) phenomenology Family systems theory has not beenamong the theories used by sociologists in the study of the family However, the theory is compat-ible with the sociological perspective and is germane to the scientific study of societal systems

Theoretical Significance of Bowen Family Systems Theory

When considering the contribution of the aforementioned approaches, a major theoretical tage of Bowen family systems theory is that it provides a comprehensive framework for integrat-ing the anthropological, biological, psychological, and sociological perspectives There are areaswithin the study of the family that address issues inherent in the aforementioned disciplines: (1)the investigation of behaviors that are learned and shared among individuals in a specific socialgroup (family) is central to the anthropological perspective; (2) consideration of the family as

advan-a nadvan-aturadvan-al system with predictadvan-able padvan-atterns of growth, advan-adadvan-aptadvan-ation, advan-and chadvan-ange throughout advan-all

Mignonette N Keller and Robert J Noone

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developmental phases is critical to the biological perspective; (3) emphasis on the individual asthe basis for understanding the collective functioning within the family unit is central to the psy-chological perspective; and (4) emphasis on the interdependence and interaction among individ-uals is central to the sociological perspective.

Methodological Significance of Bowen Theory

Theory

Family systems theory is a comprehensive theoretical model that provides the basis for theresearch process including theory, observation, data collection, and data analysis Bowen (1978),Kerr and Bowen (1988), Papero (1990), and Noone and Papero (2015) identified basic assump-tions in family systems theory The theoretical assumptions formulated are as follows: (1) thefamily is a natural system that has predictable patterns of growth, adaptation, and change through-out all developmental stages; (2) relationship patterns are repeated within and across generations;(3) the relationship system in families provides the basis for the transmission of patterns, beliefs,and values; (4) individual functioning is influenced by the emotional process in the family; (5)individual variation in basic adaptiveness is generated in the family; (6) stressful events disturb theequilibrium in families; (7) a three-person system is the building block of a relationship system;and (8) sibling position influences an individual’s personality characteristics

Data Collection

The family diagram is a method of data collection based on Bowen family systems theory It isessential that one understands the principles that govern emotional systems as delineated in familysystems theory in order for the information on the family diagram to be meaningful According

to Bowen (1978), the data collected employing the family diagram reflect the relationship andemotional processes within the family system However, the data will vary widely among familiesbecause of the differences in families regarding the level of differentiation and the management ofanxiety According to Bowen (1978), family historical information is important because, in

150–200 years, an individual is the descendant of 64–128 families of origin Bowen made thefollowing statement regarding the multigenerational family history:

To follow a nuclear family of 200 years from marriage through the addition of each newchild and then follow the life course of each child, provides one with a different view of thehuman phenomenon than is possible from examining the urgency of the present It is easier

to see the same emotional patterns as they operated then, and one can get a sense of tinuity, history and identity that is not otherwise possible

con-(1978, p 492)Kerr and Bowen (1988) postulate that, given adequate generations, most families produce mem-bers with functional extremes in behavior, which can range from extremely stable to extremelyunstable Variables can then be analyzed to assess the life functioning of family members in thenuclear and extended families

unlike more conventional family researchers who focus on gender, social class, or religious beliefs(Bowen, 1955) In addition to the above, an emphasis is placed on the collection of facts of the multi-generational family (i.e., birth order, dates of marriages, divorces, births, deaths, etc., geographic loca-tions, and moves) Moreover, data collection strategies such as multigenerational family diagrams anddetailed oral histories are used by systems oriented researchers because they are consistent with Bowentheory, thereby ensuring the quality of data in describing and explaining patterns in family relationshipsthat can heighten the accuracy of thefindings.

Summary

The discussion in this introduction emphasizes the potential of Bowen family systems theory as

an overarching theoretical framework for use in family research It has been demonstrated thatthe theory is sufficiently developed to withstand rigorous testing throughout the research process.Furthermore, it is comprehensive enough that it can address the multidisciplinary aspects involved

in the study of the family Central to the development of Bowen theory was afive year study byBowen and colleagues at NIMH (Butler, 2013) The study involved the classical research meth-odology of observation, hypothesis formulation and testing, data collection, and data analysis.The theory has continued to be developed in the decades following its original publicationthrough the study of the family, the sciences, and concept clarification It is hoped that the fol-lowing chapters will provide the reader with a sampling of the rich and wide-ranging application

of Bowen theory to the study of the family

References

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Berado, F M (1980) Decade preview: Some trends and directions for family research and theory in the1980s Journal of Marriage and the Family, 42, 723–728

Boss, P G., Doherty, W J., La Rossa, R., Schumm, W R., & Steinmetz, S K (1993) Sourcebook of familytheories and methods: A contextual approach New York: Springer

Bowen, M (1955) Interim Report on Research Project: Influence of the Early Mother–Child Relationship inthe Development of Schizophrenia Murray Bowen Papers Accession 2006–003, Box 4, History of Medi-cine Division, National Library of Medicine, Washington, D.C

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Bowen, M (1980) Foreword In E T Carter & M McGoldrick (Eds.) The family life cycle: A framework forfamily therapy (p xvi) New York: Gardner Press

Bowen, M (2013) Subjectivity, Homo sapiens, and science Family Systems, 9, 101–105

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Hill, R & Hansen, D A (1960) The identification of conceptual frameworks utilized in family study Marriageand Family Living, 22, 299–311.

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of Marriage and the Family, 42, 729–742

Keller, M (2006) A case study: Efforts toward differentiation of self among slaves and their descendants.Family Systems, 7 (2), 103–121

Kerr, M (1990) Cancer and the family emotional system In Goldbery, J G (Ed) Psychotherapeutic treatment ofcancer patients (pp 273–315) New Jersey: Transaction

Kerr, M & Bowen, M (1988) Family evaluation New York: W W Norton

Lewis, O (1959) Five families: Mexican case studies in the culture of poverty New York: Mentor Books

Mayr, E (1982) The growth of biological thought Cambridge, MA: Harvard University Press

Noone, R J (2008) The multigenerational transmission process and the neurobiology of attachment andstress reactivity Family Systems, 8 (Spring), 21–34

Noone, R J & Papero, D V (2015) The family emotional system Lanham, MD: Lexington Books

Papero, D V (1990) Bowen family systems theory Boston: Allyn & Bacon

Selltiz, C., Wrightsman, L., & Cook, S (1981) Research methods in social relations New York: Holt, Rinehart &Winston

Troll, L & Bengtson, V (1979) Generations in the family In Burr, W R., Hill, R., & Reiss, F I (Eds.).Contemporary theories about the family: Research based theories, Volume 1 (pp 127–161) New York: Free Press.Wilson, E O (1998) Consilience: The unity of knowledge New York: Alfred A Knopf

Introduction

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