23 Mar 2015
The concept of family therapy is perceived as a form of psychotherapy involving all the members of the nuclear family. Family therapy should be conducted by a team of therapists or at least a pair. In many situations the team should consist of a man and a woman so as to treat gender related issues used as a role model to the members of the family in question. The family therapy models are based on psychodynamic principles or behaviors while others are based on family systems theories which regard a family as a unit of treatment, as a whole while emphasizing on such values as communication patterns as opposed to traits and relationships (Medical Psychology, 2009, p. 1).
The history of Murray Bowen interest in psychiatry as a physician dates back to 2nd world War. After the War Bowen became trained and worked at the Menninger Clinic at Kansas: Topeka which is very famous; founded by two brothers who were practitioners of psychoanalytic technique in psychiatry. Bowen had a feeling of confusion as well trapped at the Menninger dynamics. The particular issue that gave him distress was the manner in which the two brothers and the employees were involving patients and other employees in "crazy making" interactions. He realized that he was in a position to think of the problem in the clinic while traveling but could become dysfunctional immediately he reported back to work. He discovered that the families of schizophrenic patients who were victims of the War communicated in disturbed manner. The patient's symptoms were noted to rise or fall dependent on the tension between the parents (Medical Psychology, 2009, p. 1).
Bowen came to a realization that he could be able to think more clearly of his own family of origin dynamics in those times that he spent away form his family of origin. He discovered that family members had a tendency to complain to him of other family's members without talking directly to the persons about the problem. He came to a realization that he could be in a position to think more clearly of what was happening when not communicating with any of the family members encountering more difficulties when communication with the complainant (Medical Psychology, 2009, p. 1).
It's based on these observations that he set a course towards deliberately changing his own ways of interacting with his family. In a speech he delivered in a professional meeting he disclosed his endeavor in the family approach breaking therapist tradition of never disclosing own family information and published a paper that became very famous on his family of origin known as 'Framo' in 1972 (Medical Psychology, 2009, p. 1).
Bowen theorized that people who are mentally ill were caught in the pattern of their families' fusion or undifferentiated ego mass to an extent that they are symptoms careers for the illness of the entire family rather than characterologically flawed ill. Bowen would hospitalize the entire family so that he could treat the emotional problem rather than offer treatment to the individual (Medical Psychology, 2009, p. 1).
The key concepts in the in Bowen's family psychodynamics included:
Differentiated self; the concept of differentiation of self refers to an individual's ability to maintain strong sense of self while still maintaining strong connectivity with a strong emotional system. A person is able to differentiate what one thinks and feels as separated from system dynamics whereby an individual is able to think and act on his/ her own opinion with no influence from the family members influence; acting on personal judgment. Such a person can have other peoples' opinions and advice but make an independent decision. Bowen notes that differentiation of the self in a family dynamic as opposed to an individual characteristic. The process is observable through friendship, family or work. A person should get to a level of differentiating emotions from thoughts (Nichols & Schwartz, 2001, p. 140).
Fusion; is the opposite of self differentiation where Bowen noted that all people endeavor to balance intimacy from autonomy. Without autonomy one may not be able to think for him/herself. This leads to easily being swayed by other people's opinions and feelings emanating from the natural tendency to feel connected and have intimacy with others. On the other hand there is a feeling of anxiety when we start losing our autonomy hence an attempt to develop a separate self. Bowen hence argues that most of behaviors are the rational attempts to balance between the separateness and the natural togetherness. The fusion of anxiety leads to emotionality and reactivity under stress (Titelman, 1998, p. 21).
Triangulation: Bowen pointed out that emotionally significant relationships are shadowed by third parties who may include; relatives, workmates and the work itself, objects and memories. He noted that relationships are dynamics where there are cycles of closeness of distance whereby triangles may develop during distance times. In a situation where one person undergoes through more distress he/she is likely to identify another person elsewhere so as to have an ally. Sometimes the significant other may offer help when they sense conflict (Nichols & Schwartz, 2001, p. 137).
The role of counselor in the process of development of psychodynamic approaches within family systems therapy as presented by Bowen revolves around the goals of therapy. One of the major goals of this therapy is to reduce anxiety as one increases differentiation of self. It's incumbent for the councilor first to note the problem in the patient and help the client first accept that they have a problem. Any healing process will emanate from admitting that indeed the problem exists (Nichols & Schwartz, 2001, p. 137-171).
The councilor has a role to use his/her experience in tracing the family pattern. As Bowen argues a client is symptom carrier for the entire nuclear family and hence an attempt to treat the patient without treating the entire family will be just cooling the problem for sometime for the root of the problem is not identified; tracing the family pattern helps the councilor to understand the core of the problem so as to offer cure to the sickness rather than to the symptoms. The counselor will do this through paying attention to patterns of emotional reactivity and paying attention to the structures that includes interlocking triangles (Nichols & Schwartz, 2001, p. 137-171).
The counselor should endeavor to create a connection with the family members while working on their levels of anxiety and emotional arousals in the entire system. He/she should also define parameters of central symptomatic triangles. The therapist should remain free of emotional entanglement so that he will not feel stuck. He should coach the client in that the client will cultivate responses. He should be clear to the client of what he feels, not giving confusing sentiments (Nichols & Schwartz, 2001, p. 137-171).
The role of a client in the Bowen's model to the development of psychodynamic approaches within family systems therapy facilitates the treatment process. The greatest role of a client is to show cooperation in the therapy process, as mach as a counselor may have the relevant experience, the success of this therapy is dependent on the client. Since the councilor takes the role of a 'couch' the client will have to obey the couch to get over the problem. He should answer the questions directed to him/her truthfully. The client should create conducive environment that will enable the counselor to offer the necessary help. For example in the tracing of the family patterns a therapist can not be able to do it without the assistance of the client. This calls for trust and openness on the part of the client towards the counselor (Williamson, 2002, p, 115- 117).
The client will have to accept that they have a problem and realize the need for securing solution. The client should be keen to listen to the instructions commit themselves to the healing process by comply with and implement all the instructions to the letter. The client should have readjustment of the mind. If he/she has always believed that he can only make a decision based on what others especially family members say, then such calls for an absolute turn to making decisions based on own personality (Williamson, 2002, p. 115- 117).
Advantages and limitations of Bowen's family therapy
This model on family therapy is one of the most distinctive models for its in-depth approach an evaluation of the family beyond the symptoms in the present. The focus which it takes in the on the emotional process over individuals or generations differentiation in their systematic context does offer a therapist a multi level view which has been reserved for psychodynamic therapies (Corey, 2005, p. 421-424).
The approach is able to pay attention to the emotional interaction of the therapist as well as that of their client. This process expects that in one way or the other a therapist's life applies to the therapy process in one way or the other. In this way the therapist is able to remain Meta to the client's family system (Corey, 2005, p. 421-424).
Research has identified family therapy system as having several advantages. Its principles have been used by many therapists in family settings. The approach has an advantage of broadening the perception of a therapist through incorporation of the family system theory in therapy process. It provides a practitioner with a holistic perception of the problem in question and hence easily come up with treatment measures (SPB, 2007, para. 4).
It also has strength in relation to developing a solution to a problem in that it takes into account the congregation as a whole. It considers a family as a living organism which is continually affected by all the elements that comprise the whole (Prest & Protinskey, 1993, 352-360). Hence it provides a global view of an individual with a problem and his/her social constructs; it may offer a more exhaustive therapy in light of this (Carr, 2006, p. 56).
Some of the limitations that that have been outlined in relation to Bowens model include: therapist have identified that it's not always possible to integrate the entire family into the treatment process; even though if a therapist is able to change an individual to fit into the system, he/she will play a key role in bringing the entire family into the healing process. Bowen's family therapy model is found to ignore many of the positive roles of family's togetherness and may be malfunctioned to an individual from collective cultures.
Critique to Bowen's approach
Bowen's model of family theory has not escaped the eyes of rational criticism on its approach to the concept of family therapy; several of Bowen's therapists have acknowledged that wider focus on the approach by Bowen can be a drawback since many clients are focusing only on addressing symptoms relief n nuclear family. They argue that the symptom reduction approach by Bowen is perceived just a groundwork from which families are free to proceed to less anxiously to working on de-triangling and enhanced levels of differentiation. In this lies a clear risk of discrepancies in client and therapist purposes (Kerr & Bowen, 1988, p. 395).
The approach has been criticized as having paid too much attention on mother's contribution in the symptom development in children. "Some evidence to the allegation can be found by scanning the index to Kerr and Bowen (1988). In the two theorists publications 'fathers' do not affirm a category yet 'mothers' are referenced in relation to families of schizophrenics, levels of differentiation in the child, and their role in triangles" (Kerr & Bowen, 1988, p. 395).
They have been criticized as having failed to contextualize maternal behavior. Patriarchal supposition regarding male / female roles along with family organization are not recognized or critiqued, leaving women susceptible to having their socially approved roles pathologised.Â Women are readily labeled as 'over fretful, and their vigorous, relational role in families too effortlessly labeled as 'undifferentiated'.Â There is no puzzlement of societal norms that can be seen to '[school] females into undifferentiating by teaching them always to put others' needs first' (Corey, 2005, p. 421-424).
Bowen has been recorded as being among the first people to pioneer the network of family relationships. His family system therapy has a very comprehensive view of human behavior and relationships (Nichols & Schwartz, 2001, p. 317). In his theoretical formulations he talked about differentiation of self, triangulation, nuclear family emotional process, family projection process, and Multigenerational Transmission Process. Â
Basically family therapy system represents a hypothesis which perceives a family as an emotional unit which employs system thinking in the description of a complex interaction within that unit. The model has been utilized by many therapists in transforming marriages and family's life. It has clearly showed the connection between an individuals problem to role of the family in extrapolating of the problem. The model attempts to explain the need of individuals in a family setting developing individuality. The model has profoundly showed the effect of each others thought feelings and action to an individual. It uses systematic thinking n describing complex interaction of a family that is considered as an emotional unit. The theory is based on the principle of interconnectivity and reactivity in a family's emotional setting.
The model observes a clients problematic behavior as serving a function for the family. The individual problematic behavior may also serve as a family's inability in productivity.teh maladaptive behavior may be a manifestation of dysfunctional patters that have been passed down from one generation to another (Corey, 2001, p. 384-451).
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