Bringing Systems Thinking to Life

Expanding the Horizons for Bowen Family Systems Theory

Ona Cohn Bregman, Charles M. White

• Publisher: Routledge
• Year: 2011
• ISBN:
  9781136905025
• Edition: 1
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

In a single volume, Bringing Systems Thinking to Life: Expanding the Horizons for Bowen Family Systems Theory presents the extraordinary diversity and breadth of Bowen theory applications that address human functioning in various relationship systems across a broad spectrum of professions, disciplines, cultures, and nations.Providing three chapters of never-before-published material by Dr. Bowen, the book also demonstrates the transcendent nature and versatility of Bowen theory-based social assessment and its extension into fields of study and practice far beyond the original psychiatric context in which it was first formulated including social work, psychology, nursing, education, literary studies, pastoral care and counseling, sociology, business and management, leadership studies, distance learning, ecological science, and evolutionary biology.Providing ample evidence that Bowen theory has joined that elite class of theories that have enjoyed broad application to social phenomena while lending credibility to the claim that Bowen theory is one of the previous and current centuries' most significant social-behavioral theories.More than a "resource manual" for Bowen theory enthusiasts, this book helps put a new great theory on the intellectual landscape.

II Established Domains for Systems Thinking and Bowen Theory

DOI: 10.4324/9780203842348-9

The therapy movement is a big thing these days. All I do know is that people in the professions rush in and start doing family therapy. And they're more interested in how you do it. They're more interested in developing a cookbook way of doing it than developing a way of thinking about it. I believe this has to do with a human characteristic. I think the human is on the reluctant side to learn something that does not have some immediate usefulness, and that's called “therapy.” Now your ability as a family therapist, and this comes from my own experience, will be many times better if you can think of this in theoretical terms, rather than cookbook, gun-barrel terms.

Murray Bowen, MD, October 1984 Minnesota Institute of Family Dynamics, Minneapolis, MN

Murray Bowen had an unrelenting conviction that theory was the most important foundation for psychiatry, family therapy, and other practice areas. Therefore, absent some theoretical rationale, he would reject technique-based, how-to, and recipe approaches to practice in favor of a thoughtful, theory-grounded, open-systems perspective on the human condition and the process of change. This section presents a sample of applications in professional practice areas in which Bowen family systems theory has been used for decades— mental health, social services education, faith communities, business, and leadership development.

8 Learners Without Teachers: The Simultaneous Learning About Self- Functioning and Bowen Theory by Supervisor, Staff, Interns, and Clients in an Outpatient Program

CHARLES M. WHITE

DOI: 10.4324/9780203842348-10

This chapter details how the author's consistent focus on learning for self served as the creative force behind a 4-year effort to develop two mental health–substance abuse outpatient programs based on Bowen family systems theory—a 27-hour-per-week day program and a 12-hour-per-week evening program. The author, who served as the program coordinator and supervisor, illustrates how aspects of his own differentiation of self trajectory were represented in program components and protocols. Principles of Bowen theory were infused into the program components in which the supervisor and all staff, interns, and clients participated. When these Bowen theory principles were consistently lived and emphasized by the supervisor and the staff, they functioned as catalysts for creating an emotional atmosphere in which simultaneous and re ciprocal learning could occur for all program participants (i.e., supervisor, staff, interns, and clients) regardless of their place or role in the agency or program hierarchies.

One specific principle that was consistently lived and that permeated all aspects of the program was that each staff person, intern, and client assume complete responsibility for his or her own life, learning, symptoms, and behavior. From the program's onset, the supervisor and the staff shared the observation that the staff, interns, and clients who adopted this “assume-responsibility-for-self” behavioral stance Often reported developing more objective and factual understandings of their multigenerational family emotional process and tended to engage in more thoughtful actions aimed at increasing their degrees of differentiation of self. They also reported greater overall success in symptom, behavior, and life management.

Agency Context for the Simultaneous Learning Curriculum

Bowen theory places considerable emphasis on individuals, including supervisors and coaches, engaging in a continuous effort to increase their own levels of differentiation of self in their nuclear and extended families of origin. For serious students of the theory, this effort is deemed an essential prerequisite and corequisite to any attempt to communicate Bowen theory to others. The curriculum for learning about self-functioning and Bowen theory detailed in this chapter incorporates this emphasis by having the supervisor's continuous effort to increase his level of differentiation of self as the principal function behind the learning-for-self curriculum.

The department and agency context for this curriculum was the outpatient department of a Community Mental Health Center in central New Jersey. The programmatic contexts for the curriculum were two intensive outpatient programs (called intensive outpatient services, or IOS): a three-phase, 18- to 22-week day service and a three-phase, 18- to 22-week evening service. Descriptive flyers detailing service hours and components were provided to all clients and client referral sources. Service clients were coping with or recovering from both substance use and mental health-related symptoms, hence the name dual-recovery IOS.

Clients physiologically dependent on one or more substances (typically daily substance users who had developed clinically significant tolerances to those substances) first completed medically supervised inpatient substance detoxification before referral to the day or evening dual-recovery IOS. Clients who were actively psychotic, suicidal, homicidal, severely depressed, manic, or anxious typically completed short-term voluntary or involuntary inpatient psychiatric hospitalizations before their referral. Clients discharged from detoxification or hospitalizations on psychotropic medications were immediately referred to the Community Mental Health Center's Medication Clinic for consults and medication monitoring from a staff psychiatrist or clinical nurse practitioner at the onset of their service participation.

A continuous rotation of five 2nd-year clinical master of social work (MSW) or master of arts (MA) in psychology graduate student interns was essential to the day-to-day service operations. Beginning at two different times during the year—MSWs in September and psychology MAs in March—the internships lasted approximately 7 months, with the first and last 2 internship weeks devoted to being trained by outgoing interns and training incoming interns in various service responsibilities and protocols. The supervisor, whose agency title of coordinator made him the dual-recovery IOS's functional leader, designed and facilitated the services with a focus on learning for self—not on trying to impart or teach anything to the staff, interns, or clients. In contrast to this learning-for-self agenda, the agency's agenda was to pay the author (as coordinator) a salary based on his output to others: providing treatment to dual-recovery IOS clients, supervising staff, and teaching interns. Although these agendas may appear incompatible, the author contends that this apparent incompatibility can be resolved when the supervisor's theoretical and practice orientation is Bowen theory.

The author's experience with Bowen theory over 25 years has convinced him that his differentiation of self effort is (a) absolutely essential to his becoming a progressively more effective supervisor and coach with staff, interns, and clients and (b) qualitatively the same as that in which staff, interns, and clients engage as they seek to increase their levels of differentiation of self in their nuclear and extended families. One result of combining the perspectives of learning for self and qualitatively-the-same differentiation efforts was that the supervisor would naturally and routinely use his own family diagram and refer to his own family emotional process during his interactions with service participants. Although the intent behind these family references was to facilitate the supervisor developing a more objective and factual understanding of his family emotional process and self-functioning in a multigenerational context (not to teach anything), these family references did have a useful by-product—providing the staff, interns, and clients with a perpetual case study that simultaneously facilitated the recognition and under standing of family emotional processes while illustrating aspects of Bowen theory.

In addition, the supervisor was continually reading the prevailing emotional atmospheres for the staff, intern, and client relationship systems. His intent in maintaining awareness of these emotional climates was not to facilitate changes in the dual-recovery IOS components or structures, but rather to provide another vehicle for his effort to become more objective and factual about his multigenerational family emotional process and self-functioning. The link between the supervisor's monitoring the agency's emotional climates and his effort to become a more differentiated self in relation to his family played out as follows: (a) Emotional storms among the staff, intern, and client systems were usually indicators that the supervisor had not been clearly Defining self in areas critical to service operations; (b) the supervisor's lack of clear stances typically resulted in an observable increase in confusion and indecisiveness among the staff and interns coupled with a decrease in morale; followed by (c) the clients responding in a manner similar to that of the staff and intern systems, Often coupled with an observable increase in acting out, substance use relapse, or other reactive behaviors directed toward self, other clients, interns, staff, supervisor, or service structures and guidelines.

These reactive system responses usually motivated the supervisor to focus on developing clearer, more consistent, less ambivalent, and less reactive stances from which to lead and supervise the services, which eventually brought him back to examining unclear stances in the context of his functioning in his nuclear and extended families. This process led him to greater objectivity about his functioning in his family and ultimately moved him to adopt clearer, more defined leadership positions from which to oversee the service programming and personnel. The staff, intern, and client system emotional storms Often subsided as the supervisor successfully implemented these more clearly defined leadership stances.

The services afforded the supervisor, staff, interns, and clients with several learning-for-self opportunities each week through a curriculum loosely organized under two developmental domains: (a) grounding self in Bowen theory, and (b) understanding one's family emotional process and self-functioning in a multigenerational context. Many of these learning-for-self experiences were embedded in the service weekly schedules and involved the supevisor, staff, interns, and clients. Other learning-for-self experiences, such as the 2.5-hours-per-week Supervisor, Staff, and Intern Family-of-Origin Exploration Supervision and the 1.5-hours-per-week Clinical Team Meeting, involved the supervisor and one, some, or all of the staff and interns; such meetings were usually held at times when the services were not in session.

Grounding Self in Bowen Theory

General Resources for Learning Bowen Theory

The author finds continually grounding himself in Bowen theory basics instrumental to his developing a more objective and factual understanding of his multigenerational family emotional process and his effort to increase his level of differentiation of self in his nuclear and extended families of origin. His more concentrated Bowen theory learning experiences have included participating in postgraduate training programs, symposia, seminars, conferences, and workshops at the Princeton Family Center for Education in Princeton, New Jersey, and at the Bowen Center for the Study of the Family in Washington, DC; giving presentations on Bowen theory at universities and to the community at large; and using his PhD coursework opportunities to research and write about aspects of Bowen theory (e.g., writing this chapter).

The author also engages in more routine activities to ground himself in Bowen theory basics, such as investing time in reading and rereading the primary texts on Bowen theory, supplemental texts and book chapters that synopsize or focus on specific aspects or applications of Bowen theory, and journal and magazine articles that summarize Bowen theory or explore its relationship to natural systems thinking. In recent years, the author has used a few Internet resources: The Bowen Center for the Study of the Family (http://www.thebowencenter.org/) and the Western Pennsylvania Family Center (http://www.wpfc.net/) Web sites, in particular, offer extensive resources and Web-based opportunities.

Family Systems Theory Education Presentations

Most of the supervisor's regular Bowen theory–grounding experiences were embedded in the dual-recovery IOS weekly schedules. The most substantial of these experiences was the audience-participatory Family Systems Theory Education Presentation (1–1.5 hours per session) that he or a senior staff person facilitated one to three times a week uninterrupted for almost 4 years. The presentation curriculum covered the theory's eight basic concepts and foundational postulates through a 10-presentation series. Staff members, interns, clients, family members, and friends attending the presentations each received a packet of readings and excerpts from central Bowen theory works to enhance their knowledge of the 10 presentation topics.

By choice, facilitators used no presentation notes or outlines, although key points were illustrated through overhead transparencies (e.g., Bowen theory quotes, family diagrams, cartoons, artwork photographs, and nature photographs with animal researcher captions), a three-generation “family mobile,” and occasionally short video segments. Not using written notes or outlines thoroughly exercised the facilitators’ abilities to draw on their internalized knowledge of Bowen theory while simultaneously honing their capacity to use conversa tional language to talk about the theory. The advantage to facilitators in using simple transparencies, family mobiles, video segments, and unscripted conversational language to provide a synopsis each week of a specific theory topic was that it tended to stimulate audience participation. The barrage of questions and comments from the audience of staff, interns, clients, family, and friends greatly enhanced the potency and theory-grounding potential of these presentations for the facilitators.

Ideally, the 10 presentations were conducted over a 10-week span so that clients graduating from service Phase 2 (typically 8–10 weeks) had the opportunity to hear most or all of them and participate in the discussions. The occasional to-be-announced presentation had a more in-depth participant discussion with additional illustrative video segments about the previous week's topic. Because each service ran 18–22 weeks, a client's family and friends had the opportunity to participate in approximately two complete cycles of the 10 presentations if invited by the client to the once-a-week evening programming for the entire time that the client was in either service.

Bowen Family Systems Theory Video and Seminar Series

A second substantial Bowen theory–grounding experience for the supervisor, which simultaneously exposed staff and interns to the theory, was the Bowen Family Systems Theory Video and Seminar Series. For the video part, half-hour video segments detailing aspects of Bowen theory or using case studies to illustrate the theory were followed by supervisor-facilitated half-hour discussions with the staff and intern participants. Held weekly year-round, the videos were organized to capitalize on thematic similarities between each week's segment topic and the Family Systems Theory Education Presentation topic. The thematic similarities promoted more robust dialogue among participants in both the series and the education discussions, increasing the theory-grounding potential of both weekly discussions for the supervisor.

Starting in September and again in March, the series featured foundational Bowen theory DVDs and videotapes from Bowen's The Basic Series (Georgetown Family Center, 1980) and Kerr's Bowen Family Systems Theory and Its Applications series (Bowen Center for the Study of the Family, 2004). These videos provided participants with an introduction to the theory's postulates ...

Table of contents

• Cover Page
• Half Title Page
• Series Page
• Epigraph
• Title Page
• Copyright Page
• Dedication
• Table Of Contents
• Foreword
• Preface
• Acknowledgments
• Editors
• Contributors
• Section I Theoretical Considerations in Learning Systems Thinking and Bowen Theory
• Section II Established Domains for Systems Thinking and Bowen Theory
• Section III New Horizons for Systems Thinking and Bowen Theory
• Appendix: Bowen Theory Training Centers and Contributor Organizations
• Index