23 Mar 2015
Murray Bowen was born in Waverly, Tennessee, at January 31, 1913. He was the oldest of Jess Sewell Bowen's and Maggie May Luff Bowen's five children. He earned B.S. degree from the University of Tennessee, Knoxville in 1934, and MD from the University of Tennessee Medical School in Memphis in 1937. He was then an internship at Bellevue Hospital in New York City in 1938 and at Grasslands Hospital in Valhalla, New York 1939-41. In addition, Murray Bowen also following medical training, and so Murray Bowen served five years of active duty with the Army during World War II, 1941-46, with the Major rank. After military service, he accepted for a fellowship in surgery at Mayo Clinic. Changing interests of the surgery to psychiatry Bowen is the impact of his wartime experiences. (The Bowen Center, n.d.)
In 1946, he got psychiatric training at the Menninger Foundation in Topeka, Kansas. After which he widened the staff there until 1954. Then he got a unique research project for five years with the involvement of families with an adult schizophrenia. Bowen was the first director of the Family Division at the National Institute of Mental Health (NIMH) from 1954-1960. He has been credited as being one of those rare human beings who had a genuinely new idea. He had the courage to go against the psychiatric and societal mainstream, to stand up for what he believed about human behavior. Thanks to his efforts the world has been rewarded with a new theory of human behavior, one with the potential to replace Freudian theory with a radically new method of psychotherapy based on the new theory. He died October 9, 1990, but Bowen family theory is alive and growing. (The Bowen Center, n.d.)
Development Bowen's family system theory
Dr. Bowen began to experiment with bringing the family into contact with the patient. He also began to experiment with having professionals spend time with patients in an effort to modify relationships. Many times Bowen stated that he learned the most from dealing with people who were labeled schizophrenic. In making sense of the challenges these people faced, Bowen learned to be a master of paradox. Bowen had altered the psychoanalytic relationship to one of coaching family members, willing to work on changing self in important relationships. This person was usually not the patient but rather an important family member, therefore the beginning of the ideas, which lead to the development of family psychotherapy. (The Bowen Center, n.d.)
Bowen theory uses biological terms to explain human behavior. This is an effort to allow for the exchange of information with all other areas of knowledge. There are many specialties from anthropology to sociobiology, which are interested in the growth and development of individuals who are a part of social systems. Humans are as vulnerable as other social animals in regard to the maintenance of healthy relationships over the generations. Bowen family theory development is heavily influenced by the development of family history as well. (The Bowen Center, n.d.)
Bowen's family system theory is one theory commonly used in family mental health nursing. This theory views the nuclear family as part of the multigenerational extended family and theories that pattern of relating tend repeat themselves over generation. The theory does not "pathologize" families but, rather, encourages individuals to see their families in positive ways. Family members are guided to acknowledge that parents and relatives "did the best with what they hat" (Brown, 1991, as cited in Moriarty & Brennan, 2005)
The main assumption in this theory is that chronic anxiety is underlying basis for dysfunction. Human have coping mechanisms to deal with decreases levels of anxiety. When anxiety increase, tension will be develops. When a person's emotions and intellect are operating separately, that person will have more success in coping with tension. As emotions and intellect become fused, there is less integration of self. Differentiation of self is the cornerstone of Bowen's theory. (Bowen, 1985, as cited in Zieglar, 2005).
The purposes of therapy Bowen's theory are reducing anxiety and improve the symptoms that arise, and increase the participation members of family in adaptation of family as a system. The theory consists of eight mayor concepts that address anxiety and emotional processes (Bowen, 1985, as cited in Zieglar, 2005).
Differentiation of self
Bowen (1985, as cited Zieglar, 2005) differentiation of self has three elements. The first is interpsychic element, describes the emotional "stuck togetherness" in families. In mature families, individual members don't become involved in emotional fusion with each other. However, in undifferentiated families, members become emotionally fused with each other.
The second element of differentiation concerns the intrapsychic level of differentiation between emotions and intellect. This differentiation occurs on continuum ranging from low to high, and may vary from time to time. Those on the high end of the continuum will be able to establish autonomous and independent live from their family origin. The differentiated person has intellectual and emotional systems that function separately. This individual makes decisions base on intellect and is apt to have fewer problems than individuals who are highly fused. Those with low levels of differentiated are dominated by emotions, are unable to differentiate facts from feelings, are relationship oriented, and make decisions based on feelings.
The third element of differentiation concerns the intrapsychic level of self-maturity. Bowen identified a solid-self and pseudo-self. The solid-self as "made up of clearly defined belief, opinions, convictions, and life principle". This solid-self is stable and can be changed from within the self, while the pseudo-self is acquired from others, is created by emotional pressures, is unstable, and can be changed by external forces.
A triangle is "the smallest stable relationship system. A two person system may be stable as long as it is calm, but when anxiety increases it immediately involves the most vulnerable other person to become a triangle" (Bowen, 1985, as cited in Zieglar, 2005).
The smaller two-person system may function satisfactorily until tension causes one or both of the individuals to feel discomfort. To relieve the tension, the another person will be added to the system, forming a triangle. The twosome in the relationship will work to maintain the togetherness with one of the twosome (Bowen, 1985, as cited in Zieglar, 2005).
FatherAbsence of Triangle
Figure 1. Diagram representating triangling, a concept of Bowen's theory of family functioning. (Source: Weger & Alexander, 1999).
The family projection process
This concept is describes how parents transmit their emotional problems for children. Couples who are not able to be bound by its strong commitment as a parent it will create anxiety for their children. These events were being manifested as a triangular relationship father-mother-child. This triangle is commonly located at the various levels of varying intensity on the relationship between parents and children. Children usually become the target chosen for various reasons. It is very dangerous to emotional stability and ability of the child. (Bowen, 1985, as cited in Zieglar, 2005).
The nuclear family emotional system
The nuclear family emotional system is defined as "the patterns of emotional functioning in a family in a single generation. Certain basic pattern between the father, mother, and children are replicas of the past generations and will repeated in the generations to follow" (Bowen, 1985, as cited in Zieglar, 2005).
This concept describes 4 relationship patterns that manage anxiety, marital conflict, dysfunction in one spouse, impairment of one or more children, emotional distance that govern where problems develop in a family. Generally open relationship during the courtship, most individuals chooses mates with the same degree of difference. If the low-level differences that arise during the assessment in this case is the courtship it will most likely appear in future issues. (Bowen, 1985, as cited in Zieglar, 2005).
The multigenerational transmission process
It is a way of interactional patterns that is transferred from one generation to another. So it is an ongoing part of a process of natural / nature of an entire generation. Attitudes, values, beliefs, behaviors and interaction patterns obtained from parent to child through the entire of life. (Bowen, 1985, as cited in Zieglar, 2005).
Bowen uses this technique to help illustrate the difference in position between the family and the possibility of a direct family projection process. One position held by the family will influence the development of a family that can be predicted from the characteristics of the profile. (Bowen, 1985, as cited in Zieglar, 2005).
Termination of an emotionally is dysfunctional family that took place between the original due to entanglement that occurs with the formation of a new family. In an emotional disconnection is usually easy to do if the disconnection between children and parents live in places that were located close together while the children who lived far from the emotional disconnection are a very difficult thing to do. (Bowen, 1985, as cited in Zieglar, 2005).
This concept describes how the emotional system governs behavior on a societal level, similar to that within a family, which promotes both progressive and regressive periods in a society. (Bowen, 1985, as cited in Zieglar, 2005).
Relational eight mayor concepts related to each other
The concepts in Bowen's Theory are interlocking and cyclical in nature. A person's level of differentiation is developed in the environment of the nuclear family. When there is impairment in the nuclear family emotional system, it is likely that at least some members of family will exhibit low levels differentiation. The level of differentiation is also influenced by the birth order (sibling position) of an individual. The patterns of emotional functioning in single generation (the nuclear family) are the passed on to future generations (multigenerational transmission process). (Bowen, 1985, as cited in Zieglar, 2005).
Two people of similar level of differentiation meet and married. At this point, the nuclear family is created. This two person system may be stable as long as there are few stressors in the relationship. As the stressors increase in the couple's, so anxiety increases too. When anxiety reaches a certain level, the two-person system triangles in the most readily available third person. Frequently, this third person is a child in the family.
As triangling occurs, the family projection process also occurs. One of the parents, generally the mother, projects anxiety to the triangle child, who in turn has increased anxiety levels in response to the mother's anxiety. This situation results inn unresolved emotional attachment, which eventually leads to emotional cutoff. (Bowen, 1985, as cited in Zieglar, 2005).
Application to practice in family
Application of Bowen theory in family nursing is to give a substantial contribution, especially in the family nursing process. The process starts from the assessment, diagnosis, planning, implementation and evaluation. (Zieglar, 2005) Focus the assessment is the family as a system. This means that assessment data should include the family of origin. It can be known through the genogram, because the genogram is an assessment tool that enhances communication and intervention strategies in a client note. The implementation of nursing is usually done with counseling. (Puskar, K & Nerone, M, 1996)
Bowen theory is not suitable to be applied to families whose patologize, because of the main assumption in this theory is that chronic anxiety is underlying basis for dysfunction. (Brown, 1991, as cited in Moriarty & Brennan, 2005)
Some researchers have used Bowen's family system theory
According to Nochols and Schwartz (1995, as cited in Zieglar, 2005), Bowen's theory on family system is the most thorough and thoughtful one used in family therapy. However, some have questioned the amount of research support for this theory.
Charles (2001, as cited in Zieglar, 2005) reviewed eight researches articles publish in the 1990s in wich Bowen's concept were tested. In 2000 until 2010 more than eight researches to publish. One of research is claiming that several of the theory's concepts are defined at odds with female development; Knudson-Martin (2002) reconceptualizes and expands Bowen theory to rectify these perceived shortcomings.
Bowen's assumption that couples with the same level of differentiation marry was not supported. His specific theories of sibling position and triangulation also received little empirical support. Research on multigenerational transmission has generally ignored Bowen's theoretical perspective, and more research needs to test Bowen's claim that his theory is universal. In addition, researchers still need to examine the effect of differentiation on child functioning, physical health problems, and adaptability. (Miller, Anderson, .& Keala, 2004)
The limitation this theory is not suitable to be applied to families whose patologize family. (Brown, 1991, as cited in Moriarty & Brennan, 2005)
Significance of theory
The significance of Bowen family systems theory of human care lies in her concern by metaparadigm proposition in nursing which focus on health and nursing to make family not dysfunctional or can decrease anxiety, by nursing process. Because the major concept is human that has built-in mechanisms to deal low levels of anxiety. (Bowen 1985, as cited in Zieglar, 2005).
This theory is consistently discussed the development of family dynamics in which each family find the problems to be overcome. Each family will experience eight concepts of this theory, because the family as a system. The changes in any member of the family will affect other family members. (Bowen, 1985, as cited in Zieglar, 2005).
This theory clearly explains the eight concepts with example case and it will be easier to understand if has real experiences.
Testability and Empirical Adequacy
This concept can be observed at any developmental family, but difficult to measured because Bowen theory privileges individuality and ignores many of the positive aspects of togetherness. (Knudson-Martin, 2002)
The applications of this theory is difficult for nurse, because the implementation this theory with counseling therapy. Nurse must be able to apply counseling technique. Bowen's theory is difficult to apply in my proposal thesis, because Bowen's theory just in the dysfunctional family, and not pathologize family. (Brown, 1991, as cited in Moriarty & Brennan, 2005).
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