Murray Bowen

Murray Bowen, M.D., (13 January 1913, Waverly, Tennessee - 9 October  1990) was an American psychiatrist and a professor in Psychiatry at the Georgetown University. Bowen was among the pioneers of family therapy and founders of systemic therapy. Beginning in the 1950s, he developed a systems theory of the family.

Life
Murray Bowen was born in 1913 as oldest of five and grew up in the small town of Waverly, Tennessee, where his father was the mayor for some time. Bowen got his B.S. in 1934 at the University of Tennessee in Knoxville. He received his MD in 1937 at the Medical School of the University of Tennessee Medical School in Memphis. After that he had his internships at the Bellevue Hospital in New York City in 1938 and at the Grasslands Hospital, Valhalla, New York from 1939 to 1941. From 1941 to 1946 he had his military training followed by five years of active duty with Army in the United States and Europe. During the war his interest changed from surgery to psychiatry. While observing the soldiers he decided that mental illness was a more pressing and worthwhile goal. After his military service he had been accepted for fellowship in surgery at Mayo Clinic. But in 1946 he started at the Menninger Foundation in Topeka, Kansas as fellow in psychiatry and personal psychoanalysis. This psychiatric training and experience lasted here until 1954.

From 1954 to 1959 Bowen worked in the National Institute of Mental Health, Bethesda, Maryland he started developing the now known Bowen Theory. In that time family therapy was still only a by-product of theory. Bowen did first research on live-in parents with one adult schizophrenic child, which he thought could provided a dimension for all children. After defining the field of family therapy he started integrated concepts with the new theory. None of this had previously been described in the literature, and was being connected with Freudian theory. What began the first year became known nationally in about two years. From 1959 to 1990 he worked at the Georgetown University Medical Center in Washington DC as clinical professor at the department of Psychiatry, and later as director of Family Programs and founder of a Family Center. He had a half-time research and teaching appointment. His research focussed on human life rather than symptomatic cubicles. Through association with medicine, knowledge has been extended to every medical specialty, and even the prodromal states that precede medical diagnoses. For Bowen each concept was extended, and woven into physical, emotional, and social illness. As long as psychiatry exists to diagnose and treat emotional illness, its potential is limited. This new work went beyond another family systems theory. His aimed on a theory that eventually would replace Freudian thinking.

Beside this research and teaching Bowen had other faculty appointments and consultantships. He was visiting professor in a variety of medical schools, for example at the University of Maryland from 1956 to 1963 and at the Medical College of Virginia of Richmond from 1964 to 1978. He was life fellow at the American Psychiatric Association and at the American Orthopsychiatric Association, and life member at the Group for the Advancement of Psychiatry. He was at the American Board of Psychiatry and Neurology in 1961 and first president at the American Family Therapy Association,

Murray Bowen got different awards and recognitions, and among them.
 * 1978-1982, Originator and First President, American Family Therapy Association.
 * 1985 June, Alumnus of the Year, Menninger Foundation.
 * 1985 December, Faculty, Evolution of Psychotherapy Conference, Erickson Foundation, Phoenix,
 * 1986 June, Graduation Speaker, Menninger School of Psychiatry,
 * 1986, Governor’s Certificate, Tennessee Homecoming ‘86, Knoxville.
 * 1986 October, Distinguished Alumnus Award, University of Tennessee-Knoxville.

Bowen remained active and interested in family therapy his entire life. It is said that his theory is one of the purest ideas that family therapy has created. He was the first president of the American Family Therapy Association from 1978 to 1982. He died of lung cancer in 1990.

Work
Many people believe that growing up in this small town is what gave Murray Bowen his foundation for his family therapy theories. He believed that the family was an emotional unit that was made up of individuals who had their own thoughts and needs.

Bowen studied the psychoanalysis for several years at the Menninger Foundation in Topeka, Kansas. While at the Menninger clinic he studied schizophrenic patients and discovered a unique relationship between the patients and their mothers. This relationship led to his concept of differentiation of self which is autonomy from others and separation of thoughts from feelings. From there he moved on to National Institute of Mental Health in 1954 where he began work on expanding the mother – child relationship to include fathers and thus sparking the idea of triangulation. He believed that the triangle was the smallest unit in a relationship. The idea of a triangle is that one diverts a conflict between two people by involving a third. In 1959 he moved to Georgetown University Medical Center and began more extensive work on family systems and how they relate to one another during therapy. He believed that family members adopt certain types of behavior based on their place in the family.

He obtained a great deal of information while at Georgetown, including the need to make a hard effort to remain an objective party. He first attempted to have sessions with families and staff on the assumption that togetherness and open communication would be therapeutic. His staff began to become pulled in different directions and the same effect carried through when he attempted these multifamily meetings alone. He decided that families needed to be met with one at a time. During this time he also coined the term "emotional cutoff". Emotional cutoff refers to the mechanisms people use to counter anxiety from unresolved issues with family. To avoid these sensitive topics, individuals will move away, rarely go home, and use tactics like diverting a topic.

His final large contribution was that of his own personal discovery; the idea of differentiation. He determined that this is best accomplished by having individual relationships with parents, and family members. It is valuable to differentiate oneself from family and will be complete when one is no longer pulled into triangles and does not become emotionally reactive.

Bowen felt that problems within the family unit stem from a multigenerational transmission process whereby levels of differentiation among family members become progressively lower from one generation to the next. He developed an extended family systems therapy with the goal to increase individual family members level of differentiation.

Interlocking concepts
Bowen summarized his theory using eight interlocking concepts
 * Differentiation of Self (the most important concept)
 * Nuclear Family Emotional System
 * Triangulation
 * Family Projection Process
 * Multigenerational Transmission Process
 * Emotional Cutoff
 * Sibling Position
 * Societal Emotional Process

Differentiation of Self
Differentiation of self refers to one's ability to separate one's own intellectual and emotional functioning from that of the family. Bowen spoke of people functioning on a single continuum or scale. Individuals with "low differentiation" are more likely to become fused with predominant family emotions. (A related concept is that of an undifferentiated ego mass, which is a term used to describe a family unit whose members possess low differentiation and therefore are emotionally fused.) Those with "low differentiation" depend on others' approval and acceptance. They either conform themselves to others in order to please them, or they attempt to force others to conform to themselves. They are thus more vulnerable to stress and they struggle more to adjust to life changes.

To have a well-differentiated "self" is an ideal that no one realizes perfectly. They recognize that they need others, but they depend less on other's acceptance and approval. They do not merely adopt the attitude of those around them but acquire their principles thoughtfully. These help them decide important family and social issues, and resist the feelings of the moment. Thus, despite conflict, criticism, and rejection they can stay calm and clear headed enough to distinguish thinking rooted in a careful assessment of the facts from thinking clouded by emotion. What they decide and say matches what they do. When they act in the best interests of the group, they choose thoughtfully, not because they are caving in to relationship pressures. Confident in their own thinking, they can either support another's view without becoming wishy-washy or reject another's view without becoming hostile.

Triangulation
In family systems theory, whenever two people have problems with each other, one or both will "triangle in" a third member. Bowen emphasized people respond to anxiety between each other by shifting the focus to a third person, triangulation. In a triangle, two are on the inside and one is on the outside. For example, rather than talk with her husband about and deal with her frustration with him, a new mother might preoccupy herself with her new child. In this case, the wife diminishes her anxiety by ignoring its source (the relationship between her and her husband); the husband is on the outside and the wife and child are on the inside.

Similarly, in the same situation, instead of talking with his wife about their marriage and dealing with his frustration with her, the husband might spend more time at work instead. He would thus be making work as the inside relationship excluding his wife.

In either example, though anxiety is reduced, neither husband or wife resolve the source of their anxiety.

Triangles usually have two individuals or entities in conflict, and another entity or individual uninvolved with the conflict is brought in. When tension is not high the relationship between the first two individuals is desirable. The two original people of the relationship or conflict are the inside positions of the triangle. The insiders bond when they prefer each other, but in the case of conflict, another entity or individual (the outsider) is brought in by one of the first individuals in effort to either diffuse and avoid the situation or team up against the other insider (see paragraph discussing high levels of tension). The insiders may actively exclude the outsider when tensions are not low between the insiders. Being excluded may provoke intense feelings of rejection and the outsider works to get closer to one of the insiders.

Like musical chairs, the positions are not fixed. If mild to moderate tension develops between the insiders, the most uncomfortable insider will move closer an outsider. The remaining original insider then switches places with the outsider. The excluded insider becomes the new outsider and the original outsider is now an insider. Predictably, the new outsider may move to restore closeness with one of the current insiders.

At a high level of tension, the outside position becomes the most desirable. If the insiders conflict severely, one insider opts for the outside position by getting the current outsider to fight with the other insider. If the maneuvering insider succeeds, he gains the more comfortable position of watching the other two people fight. When the tension and conflict subside, the outsider will try to regain an inside position.

Emotional Cutoff
Emotional cutoff refers to the mechanisms people use to reduce anxiety from their unresolved emotional issues with parents, siblings, and other members from the family of origin. To avoid sensitive issues, they either move away from their families and rarely go home; or, if they remain in physical contact with their families, to avoid sensitive issues, they use silence or divert the conversation. Though cutoff may diminish their immediate anxiety, these unresolved problems contaminate other relationships, especially when those relationships are stressed.

The opposite of an emotional cut-off is an open relationship. It is a very effective way to reduce a family's over-all anxiety. Continued low anxiety permits motivated family members to begin the slow steps to better differentiation. Bowen wrote, "It might be difficult for such a family [that has severe cut-offs] to begin more emotional contact with the extended family, but any effort toward reducing the cut-off with the extended family will soften the intensity of the family problem, reduce the symptoms, and make any kind of therapy far more productive."

Publications
Bowen wrote about fifty papers, book chapters, and monographs based on new theory of human behavior. Some important publications where:
 * 1966, The Use of Family Theory in Clinical Practice.
 * 1974, Toward the Differentiation of Self in One's Family of Origin.
 * 1978, Family Therapy in Clinical Practice, Northvale, NJ: Jason Aronson Inc., 1978.

Publciations about Bowen

 * Michael E. Kerr, Evaluation: An Approach Based on Bowen Theory, p 4-6.
 * Roberta M. Gilbert, Extraordinary Relationships: A New Way of Thing About Human Interactions, Minneapolis, MN: Chronimed Publishing, 1992.