Posts Tagged ‘Anger Management Issues’

Dr. Cunningham often hears couples come to marriage counseling and relationship counseling with issues related to anger. Each partner often begins couples counseling with a wish for the therapist to “fix” the other.  Counseling aims to help each partner increase their capacity to visualize their own part in the dance. This increased self-responsility to at once be true to expressing your feelings to your intimate other and, still, to decrease blaming him/her is an overarching goal of most psychotherapy within my model, no matter what the presenting problems.

In his book entitled TO A DANCING GOD: NOTES OF A SPIRITUAL TRAVELER, Sam Keen has a dialogue with anger (pp. 114-119).  Anger says, “If you doubt that I am the companion of love, remember the ecstasy of the reconciliation that comes after fighting. After a good expression of clean anger, lovers have established the integrity of their separateness, and they may come together without fearing that either will be eradicated by the act of love. If you can’t fight, you can’t love.”

Interestingly, this quote from Keen has been backed up by specific research in the field. John Gottman’s research disspelled a prevalent myth about marriage. He found that fighting is not predictive of divorce. If couples are engaged with one another and learn principles of “fair” fighting, learning more effective ways to resolve conflict can, in fact, lead the way to deepening relational growth. Notably, important work by John Gottman identified lethal forms of communication between partners that were predictive of divorce and he called them the four “Horsemen of the Apocalypse” (stonewalling, criticism, contempt, and defensiveness). He found that these communication patterns in relationships were dangerous to holding relationships on a course of stability and longevity.

Thus, Keen’s quote is backed up by Gottman’s empirical findings.  Anger that is not expressed or held back may be classified as a kind of stonewalling. So-called happy couples may be ignoring or hiding the anger that exists within and between them. Marital partners who are more able to express anger in a timely, reflective, and respectful manner, especially with a Gottman technique that he referrs to as “soft startups,”  may be more adept at repair attempts and thus are more likely to stay together in a more fulfilling way.

Anger has to be a respected member of the partnership. If not, the couple may not be genuine with themselves or with each other. Furthermore, anger unrecognized or in disguise may be more dangerous than when it is out in the open and dischargeable. Hidden anger can lead to sudden disruptions, including failure in the marriage, a damaged sex life, domestic violence, and anxious child-rearing that may even lead to child abuse. When unconscious and unexpressed anger festers, it grows and becomes regressively more primitive.

If one considers the tasks of loving from the perspective of  Bowen Family Systems Theory, lovers must also be able to establish the integrity of their separateness if they are to remain connected as effective marital partners. If partners are fused too tightly, they will not be able to come together without fearing eradication by the other. Bowen would wholeheartedly agree with Keen that lovers who can cleanly express their anger are likely to be more engaged lovers. Lovers must have a bottom line and be differentiated enough to not “cave in” or accommodate to another just because they fear losing the relationship if they do not give in. Those who can make a move for “self” are also able to freely choose to make a move for “other” instead of just going along, with resentment following closely behind. They are able to be at choice about when they wish to be separate and when they wish to be connected while, at the same, they have a greater capacity to respect a differing need for closeness and/or distance at various times in their partner.

Makeup sex often occurs without a clear resolution to existing problems. It occurs because the couple just gets tired of fighting and feeling all the  negative energy and want to restore the illusion that they are really doing ok without necessarily doing the work to get there. In my view, an accurate description of problems brought to therapy always addresses the reciprocity between a couple and one’s ability to identify or visualize one’s own part in a dynamic. The “automatic” impulse is to focus on what is wrong with other instead of working to see what one’s own part may be and then moving toward changing it. Part of the work in “fair” fighting, from my perspective, then,  is the capacity to “step up” and see what you can do to shift the unhelpful dynamic that led to the fight. Makeup sex can feel goodin the moment, but may be a mere escape from taking responsibility on your end to make things better in the longterm. Makeup sex that does not include each partner’s effort to change can feel euphoric, but without the promise of future increased connectedness. Some people have compared the feeling to getting high on cocaine.

The more you love, the more susceptible you are to being hurt. When a person is hurt, the natural response is anger in some form or other. While anger is a painful emotion, it also brings wakefulness, alertness, and, if it does not burn out of control, can even lead to clearer thinking and action about one’s own functioning in relation to important others. Anger is an emotion creeping into many of our expressions. Problems are tackled, obstacles are attacked, roadblocks are smashed, fears are conquered, and skills are mastered. I believe that it is not enough to be angry about some things.  If you can be aware of your anger, express it with an eye to including in your expression what you have done to trigger such anger-provoking behavior in another, and fight fairly, then you will discover that you can love better and not be in a state of chronic festering resentment Anger needs to be expressed and recognized as an integral part of life and living. At one time or another, it  is part of being transparent to a significant other. Being emotionally “naked” with another is difficult;  the process of this effort describes the challenges in the journey toward increasing transparency. As David Schnarch noted in his book entitled PASSIONATE MARRIAGE, this capacity to increase transparency can lead to what he refers to as ” wall socket sex.”  Certainly, the expression of anger in a nonblaming manner with an eye to what one has done to trigger the other to behave in ways that inspire anger is a helpful, systemic approach to conflict resolution. To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.Cunninghamtherapy.com or call 619 9906203 for a complimentary phone consultation.


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“Anger is a signal, and one worth listening to.” Harriet Lerner

Dr. Barbara Cunningham, licensed marriage and family therapist in San Diego, CA, sees many couples who complain that chronic anger has eaten away at their relationship or marriage over time. What follows are some of  her thoughts on how negative feelings can cut into relational quality.

Anger is an emotion that can erode an individual’s quality of life and play havoc with the dynamic in one’s most important relationships. In my clinical practice, I see many couples who complain that anger has infected their relationship satisfaction. The roller coaster quality of living with someone who has trouble managing his/her anger can be devastating. At http://www.Cunninghamtherapy.com, Dr. Cunningham works on helping people learn new tools and apply new principles to their relationships that can help them lead calmer, more satisfying lives. 

Dr. Cunningham, for example, emphasizes that it is important to be clear about one’s bottom line. What will you do and what won’t you do for the other person? Consider your “yes-es” as carefully as you consider your “no’s.” If you accommodate and give in again and again, over time, resentment toward your partner may build. Then as normal day-to-day stresses of life accumulate, a person with anger management problems may explode and hurt those he or she loves deeply.

A person with anger management problems needs to learn that they can shape their world rather than being at the mercy of outside forces. They need to increase their sense that they can become the CEO of their own life instead of exerting energy upon trying to control others. If a person can become aware of triggers that make them say yes when they really want to say no (or conversely, make them say no when they really want to say yes), they will know where they stop and the other begins.

People who work on developing this type of “emotional muscle” will not be quite as governed by the responses of others. This simple yet difficult self-management skill can help curb resentment toward an important other. When one works on managing one’s own boundaries more carefully, it can help to control the risk of festering and growing resentment and anger. Such an effort can empower people to become long distance runners in the art of intimacy. Dr. Cunningham sees individuals and couples for relationship counseling on issues of all kinds. To learn more, visit her web site at http://www.cunninghamtherapy.com or call for a complimentary phone consultation at 619 9906203.

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Roberta M. Gilbert, M.D.  wisely observed that “Consistently responsible parents, attentive to their principles, their adult relationships, and connected to their youngsters, rear responsible children” (Connecting wth Our Children: Guiding Principles for Parents in a Troubled World, p. 36).  In marriages that are characterized by chronic conflict and/or increasing distance,  the odds increase that the children may become less and less responsible as they become increasingly symptomatic witnessing their emotionally immature parents bicker and battle in front of them. The children of warring husbands and wives can often get “caught” in the maelstrom of marital difficulties. Indeed, it is extremely challenging for children to witness fight after fight…to experience the consistent chill in the air…the ongoing and escalating tension between parents thick enough to be cut with a knife. The wounds that  are inflicted upon children as emotionally immature  parents continue their struggles with one another and move toward divorce are deep, longlasting, and can leave a multigenerational legacy. Children are often terrified as they watch their parents yell, trade sarcastic jabs,  and, ultimately, move toward the process of divorce.

Andrea Maloney-Schara defines divorce as “really just a legal agreement that grants some physical or emotional distance to two people who no longer understand each other.” What follows is a listing of some key ways to help your child survive your divorce:

As a mature and principled parent,  never allow your child to witness your rage at the other parent. To demean a child’s other parent is to diminish their own sense of self. Their sense of identity is, in large part, determined by how they view their parents. Do not allow this view to be tarnished by talking in a derogatory manner about their mother or father. Do not cast a net that allows your child to get “caught” emotionally in the bucket of troubles between the two adults.

Just as divorces can be chaotic, ugly, and drawnout, divorce can also be achieved in a calm, cooperative and reasonable way. As parents who are choosing to divorce, know that it is time to work diligently on increasing your emotional maturity. Edward Beal, author of Adult Children of Divorce, reports that it is not divorce that makes as much of a difference with children as the manner in which the mother and father divorce and the way the family reorganizes itself in the aftermath of the divorce. Do it conscientiously, carefully, and with as much self-regulation as possible. Get help with counseling to go through this process with as much integrity and maturity as you can muster!

Divorcing parents do better to avoid cutting off from one another and retaining an effective co-parenting relationship that is more than merely civil. This can be a challenge as well as an opportunity in the hard work of increasing one’s emotional maturity. This higher functioning in the face of challenge benefits all people involved. Create as positive a relationship as possible with your ex-spouse!

Never ask your child to be a message carrier between you and your ex. This places the child in the uncomfortable position of being caught in a triangle between the two of you and should be avoided at all costs!

Never discuss your ex to your child. Your child wants to be loyal to both of you.

Make it safe for your child to talk about unhappy, angry, confused or uncomfortable feelings about the divorce. You can encourage such discussions with young children with books such as Dinosaur Divorce. There are numerous books for older children with the theme of divorce. Shared reading can open a dialogue about emotions. Normalize, normalize, normalize!

Remember, you get but one opportunity to raise your child-there are no do-overs when it comes to responsible parenting. Be guided by principles that allow your child to see two people who may not have been able to make it as spouses, but who can and do work effectively and caringly as co-parents.

To learn more about Dr. Cunningham’s model of practice, visit her website at http://www.Cunninghamtherapy.com or call 619 990-6203 for a complimentary telephone consultation.

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Random House Webster’s Dictionary
defines “defensiveness” as “sensitive to the act of criticism.” In his book entitledWhat Predicts Divorce?” John Gottman describes four types of communication that he labels the Four Horsemen of the Apocolypse. According to him, these styles of communication are not helpful and can be predictive of divorce. One of the four horsemen is defensiveness. When a partner is defensive, he or she may also saying, “I am more interested in protecting myself than caring about what you are thinking or feeling in the context of this problematic situation.”  Things can proceed downhill from there between the sparring partners.

In order to avoid provoking defensiveness in your partner, you may want to try some new self-management strategies:

1. Avoid blaming or criticizing your partner. The more your partner hears judgment and criticalness, the more he or she will place their energy into a counterattack or self-defense.

2. Try to assume a more neutral posture. Ask questions to gather information rather than to accuse. Your goal is to understand more accurately and objectively what the other person really means or believes to be the case. Remember that to make assumptions is to pose as if you have an ability to mind read (no one does!).

3. Verify what you think you heard in a tentative way that reflects your genuine effort to “get it right.” If you notice your partner’s body language, for example, conflicts with their words, notice it and ask about it. Do not let your own voice tone or body language conflict with your verbal request to understand where your partner is coming from.

4. Avoid using hyperbole-for example, do not use words such as “never” or “always.” Such “all or nothing” language serves to provoke defensiveness instead of promoting understanding. Try to stick to facts. Instead of saying, “You never want to spend time with just the two of us, ” say, “The last four times I initiated an activity for just the two of us, you said you didn’t want to do it.”

5. Listen to the “meta-content” or the message underneath the defensive or hostile statements. For example, if your partner says, “Back off! I am doing all that I can,” he may be feeling unappreciated or needing acknowledgement for his sincere efforts. When we work toward an understanding of a person’s underlying emotions and needs, it is much easier to demonstrate respect for what the other person is up against or what our own part has been in the context of problems in the relationship.

Trying to change how we communicate in our marriage or in our relationship can lead to a more harmonious union that supports the growth of one another as a result of resolving impasses. To learn more about Dr. Cunningham’s model of practice, visit her at http://www.Cunninghamtherapy.com

Dr. Cunningham practices marriage counseling and relationship counseling in the heart of Mission Valley. She offers complimentary telephone consultations at 619 9906203. It takes courage to embark upon a journey of individual counseling or couples counseling. Make a move to begin such a  journey today!

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See full size image Relationship counseling and marriage counseling are offered with both daytime and evening hours in the heart of San Diego by Dr. Barbara Cunningham, a licensed marriage and family therapist with her doctorate in marriage and family therapy. In her practice with couples and individuals, she offers people the opportunity to maximize their potential in the context of their relationships. Following is a list of ten tips to improve your relationship functioning:

1. See if you can identify a repetitive cycle that is not useful in your relationship. For example, you may be a pursuer while your partner distances. Of you may overfunction while your partner underfunctions.

2. Try to see if you can identify your part in how this stuck dynamic continues and change it up!

3. Keep your eye on what IS working in the relationship and notice it, both internally and in vocalizing it to your partner.

4. Go on regular and, at least, weekly date nights. Take turns planning and executing the date night–making “surprise” a key element for your partner.

5. In the words of Ghandi, be the change you wish to see.

6. Choose your words carefully, taking special care to avoid blame, criticalness, contemptuousness, or stonewalling (Thanks, John Gottman).

7. Practice self care. The more you model that you love yourself, the more loveable you become!

8. Be a self. Know where you stop and he/she begins. Be willing to risk disapproval in the service of keeping connected and engaged. Just choose your words in a way that will minimize a defensive reaction in your partner. Make your statements from an “I” perspective instead of “You should/shouldn’t” perspective.

9. Play with your partner!

10. Work WITH your partner. Be more interested in being connected rather than in being right!

To learn more about Dr. Cunningham’s model of practice and how relationship counseling can be useful, visit her website at http://www.Cunninghamtherapy.com

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“The truth is that our finest moments are most likely to occur when we are feeling deeply uncomfortable, unhappy, or unfulfilled. For it is only is such moments, propelled by our discomfort, that we are likely to step out of our ruts and start searching for different ways or truer answers.” M. Scott Peck

We all experience times in our lives when our problems seem overwhelming. In earlier eras, there was a social stigma to seeking counseling. But over the past forty years or so, it is becoming increasingly clear that counseling is a treatment that everyone can benefit from at one time or another in one’s life. To seek counseling is to address one’s problems, conflicts and relationship difficulties directly. Counseling is an effort that is inherently relational. The counseling relationship is itself a place to practice being honest with self and with other. Counseling is a courageous move. It can be empowering for the individual and his/her relationship. If you are having problems either individually or in your relationship, why not begin the new year by seeking counseling? It may put you on a different path that will lead you toward increasing clarity and fulfillment. For affordable relationship counseling, call 619 9906203 for a complimentary consultation or visit http://www.Cunninghamtherapy.com for some free tips and information about Dr. Cunningham’s model of practice.

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 Alcoholism & Substance Abuse in Diverse Populations – Second Edition

I am excited to report that the academic textbook for which I wrote a chapter is finally released. Edited by my former dissertation chair and her husband, I am proud to have written chapter 13 entitled: A Family Systems Treatment for the Impaired Physician. The book, edited by Gary W. Lawson and Ann W. Lawson, is entitled Alcoholism and Substance Abuse in Diverse Populations, second edition. To learn more about me and my model of practice, visit me at http://www.Cunninghamtherapy.com or call for a complimentary phone consultation at 619 9906203.

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Role of the Therapist (Typical Intervention Techniques and Process Used in Sessions)

Bowen family systems theory is unique in its emphasis upon the self-development of the therapist.  Thus, I continually work on an increasingly healthy separation from my own family of origin in a way that I still remain connected. 

Friedman (1991) points out that “Bowen has consistently maintained that it is hard for the patient to mature beyond the maturity level of the therapist, no matter how good his or her technique” (p. 138).  In fact, Friedman explains that “In Bowen theory, the differentiation of the therapist is the technique” (p. 138).  One cannot possibly be a Bowen therapist merely by reading about it or taking workshops (Kerr, 1981).  The therapist must go through an emotional transformation, which happens experientially after continued exposure to revisiting one’s family of origin while applying the complex ideas of the theory.  Work with one’s family of origin and work with a supervisor is a central part of the therapist’s development.  Similarly, psychoanalysts must first complete their own psychoanalysis with a supervising analyst, before they are deemed competent to analyze clients.

It is important to maintain a non-anxious presence.  To be objective and to promote differentiation in others is directly related to the being of the therapist, not to his/her technical skills (Friedman, 1991).  To be able to think in terms of the system and not the emotionality or content requires a high level of differentiation.  I push myself to work continually at separating my thoughts from feelings and knowing where I stop and my client begins.

I am warm, respectful, engaging, and matter of fact in asking questions.  I maintain a collaborative atmosphere in all stages of treatment.  The process of gathering family facts is, in itself, collaborative and inherently conducive to reducing anxiety.  Additionally, the types of questions asked move the client toward a deepening appreciation for pattern and process.  In a sense, I assume the role of researcher and am always curious.  One question leads to another, and the calmer I am, the more I can call on my best thinking to expand the line of questioning into broadening perspectives.  Eventually, clients begin to see replicating patterns from past to present and connections between events in their nuclear families and family of origin legacies.

I encourage family members to speak through me rather than to each other.  By remaining a non-anxious presence in a triangle, I can induce a change in the relationship of the other two that would not occur if the same things were said in the absence of the therapist.

In my work with couples, I work to identify and reflect back repetitive, dysfunctional cycles of interaction early in treatment.  For example, I want to identify patterns such as distancer/pursuer, overfunction/underfunction, or withdrawer/blamer.  Initial progress is facilitated if the couple becomes aware of their pattern early in treatment and works toward interrupting it.

There are times when I depart from The Bowen method of having a couple talk through me.  For example, in the early phases of marital therapy, I believe that it is important to assess a couple’s ability to talk to one another about sensitive material.  To assess their ability to connect with one another, I may ask them to turn to one another and repeat important things to the other that they have just said to me.  I watch their verbal and nonverbal styles of communication carefully.  As treatment continues, I use the same method to heighten important material.  I encourage communication in which one assumes responsibility for oneself, whether it is about expressing wishes for space or connection. 

I am a coach, in that I teach differentiation moves, or ways that the client can increase his/her neutrality, especially in hot triangles.  I also act as an educator in teaching the family about family systems dynamics.  Often, I diagram or illustrate BFST concepts on a white board to increase clients’ ability to think about their processes in a systemic way.  Homework may include relevant readings and letter writing assignments, which may or may not be mailed.  Clients may be asked to journal and/or generate questions to ask their extended family members.  Photograph albums and videos brought to session touch the past, adding a rich layer of experience to the treatment and also enhancing the joining effort of the therapist.  This material may also aid in the effort to bridge cutoff, resolve attachment, or make contact with the deceased.  Socratic questions that highlight process over content challenge the client to engage his/her cognitive process. 

Kerr and Bowen (1988) encourage therapists to use humor and playfulness where appropriate, but warn that the maturity and differentiation of the therapist is critical to communicating that what is taken so seriously by the family can be seen in a humorous light.  The client is honored as the expert on his/her own family and is often asked questions that lead him/her to take responsibility for his/her part in a family problem.  A helpful guideline is that within the session, I work on making myself “small.”  Such an effort means that I have succeeded in being a non-anxious presence who does not overfunction for the client.

To learn more about this model of therapy practice, visit Dr. Cunningham’s web site at http://www.Cunninghamtherapy.com. Dr. Cunningham, whose practice is conveniently located in the heart of San Diego, specializes in treating individuals and couples.

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Often, couples come into therapy looking for the therapist to fix their partner. They want their partner to say and do things to make them feel as if they are loved and valued. Every one wants to feel loved and valued. However, sometimes we go about getting the love we want in a backwards way.

Mistakenly, many people think love needs to be proven by action. Instead of getting busy loving, many people are checking to see if they are getting the love they want. These misguided couples may be hypervigilant in looking to see whether their partner has done something wrong, or they are hypercritical of everything the partner says or does not say to them about their value or their attractiveness or anything else. This is the wrong approach!

I tell my clients to think of love as an action, as a verb. Erich Fromm, in his classic entitled THE ART OF LOVING, points out that love is an art. He asserts that to truly love, one must possess maturity, self-knowledge and courage. What this looks like in real life varies. However, one facet of this behavior is to be able to hear difficult material from your partner without clobbering him or her for being authentic. It is in being transparent–in being able to be naked emotionally when one wants to be “seen”–that wall socket connections to important others can be made. Love is a developmental triumph. It takes self-discipline, creativity, and courage. As Katherine Hepburn once said, “Love has nothing to do with what you are expecting to get–only with what you are expecting to give–which is everything.” To learn more about my model of practice, visit me at http://www.Cunninghamtherapy.com or call 619 99906203 for a complimentary phone consultation.

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Initial assessment must evaluate for the presence of any safety issues.  For example, if significant depression is part of the presenting picture, I routinely assess for suicidal ideation, and, if present, evaluate the lethality of the threat.  Symptoms may require a medical evaluation to rule out serious physical problems.  Elder abuse, child abuse, neglect, and domestic violence must be addressed if relevant in initial assessment protocols.

From a life cycle perspective, I want to “. . . track family patterns over time, noting particularly those transitions at which families tend to be more vulnerable because of the necessary readjustments in relationships. . . . Problems are most likely to appear when there is an interruption or dislocation in the family life cycle, whether because an untimely death, a chronic illness, a divorce, or a migration forces family members to separate or because a family is unable to launch a child or tolerate the entry of a new in-law grandchild” (McGoldrick, 1995, p. 31).   It is important to be aware of the typical triangles and issues at each stage of family life (McGoldrick & Carter, 2001).  

From the perspective of my model of practice at http://www.Cunninghamtherapy.com, which is heavily informed by Bowen Family Systems Therapy, outcome is viewed very differently from other theories. A small change in one person may significantly change his/her life course, and such a small change cannot be implemented without therapy that may last several years.  Also, a small change in one person may not be reflected in the family system for three or more generations.  Kerr and Bowen (1988) state that “The more generations of a family included in an assessment, the greater will be the divergence in functioning. . .  Given sufficient generations, every family will produce people from the extreme of remarkably high functioning to schizophrenia” (p. 221).   Kerr and Bowen clarify that “. . .  the most extreme forms of manic-depression, alcoholism, and obsessive-compulsive neurosis, for example, develop over the course of at least several generations. . . . Most distinctions between diagnostic categories may eventually be discarded in favor of a continuum ranging from mild occasional depression to chronic psychosis. . . so saying that the intensity of symptoms is generations deep does not necessarily mean that the actual symptoms have been present in preceding generations.  It means that basic levels of differentiation are generations deep” (p. 241). 

It is important to understand that all people diagnosed with a specific disorder are not the same emotionally (Kerr & Bowen, 1988).  As Kerr and Bowen explain, “There may be an inherited predispositon (genetic or otherwise) to [a disease like] manic-depression, but all people who have such symptoms are not equally adaptive. Those with low levels of differentiation have lives that are usually unstable in most aspects. . . those with higher levels of differentiation may have only one or two [episodes] in a lifetime. . . . The age of onset, severity and impairment of life functioning associated with all psychiatric diagnoses can be understood in the context of the multigenerational emotional process” (pp. 240-41).   Some instances involve a combination of markedly impaired adaptiveness and fairly minimal life stress and produce a psychosis.  In other instances, a combination of strong adaptiveness and extreme life stress can precipitate a psychosis.   Kerr and Bowen explain that “Whether the potential for psychosis is actually part of everyone is difficult to determine. . . because there are so many other ways people manage anxiety.  For example, there may be learned or genetically based psychological as well as biological tendencies that determine that a given individual will, when under stress, develop serious physical or social symptoms rather than emotional ones.  This does not mean that the potential for psychosis is absent. . . . It just means he manages his anxiety, even when under extreme stress, in a different way” (p. 240). 

The Bowen therapist is concerned with assessing intensity in relationship.  Papero (1990) describes an intense interaction as “. . . one in which strong feeling states are produced and very rapidly transmitted among the participants to the exchange. . . . Intense anxiety is a strong fear of real or imagined events.  The more intense an interaction, the greater the likelihood that individuals involved will behave automatically, that is in response to the emotional system with the intellectual system being overriden” (p. 41).  Such automatic behavior is viewed as reactivity. 

Since Bowen family systems is based in natural systems rather than cybernetic systems, the focus in not on homeostasis so much as it is focused on reciprocity.  Thus, if one person’s functioning declines, another person’s functioning may rise. As such, it is possible, for example, that one sibling’s success may predict another sibling’s failure.  Similarly, if an overfunctioning spouse decreases his/her functioning, the underfunctioning spouse should improve.

Kerr and Bowen (1988) state, “It is the basic level of differentiation that is largely determined by the degree of emotional separation a person achieves from his family of origin. . . basic level is fairly well established by the time a child reaches adolescence and usually remains fixed for life, although unusual life experiences or a structured effort to increase basic level at a point later in life can lead to some change in it” (p.98).  A given sibling will have a slightly greater or lesser amount of differentiation than his/her parents. 

As opposed to basic differentiation, functional differentiation is dependent on the relationship process.  As such, people with very different basic levels can, under favorable circumstances, have similar functional levels (Kerr & Bowen, 1988).  Related to functional differentiation is the concept of pseudo-self, which refers to “. . . knowledge and beliefs acquired from others that are incorporated by the intellect and are negotiable in relationships with others.  Pseudo-self is created by emotional pressure and can be modified by emotional pressure” (Kerr & Bowen, 1988).

  Kerr and Bowen (1988) explain, “Assessment of the basic level of differentiation of a multigenerational family is one component of the assessment of basic level of differentiation of an individual.  A second component is the impression about the individual’s awareness of the  self in relationship.  Change can occur when people apply their will to their own self-differentiation rather than trying to will others to change.  In this way, one can change one’s position in his/her family system.

Bowen (1978) did not consider the interpretation of transference as the way to change. Instead, Bowen thought that “. . . the therapist should try to stay out of the transference as much as possible by functioning in a detriangled manner that kept it fulminating within the family in front of him” (Friedman, 1991, p. 154).  I agree, and coach clients to resolve transference directly with family members, especially within their primary triangles.  In clients’ one-to-one meetings with siblings and parents, the effort is to develop an adult-to-adult relationship with each individual family member.  By taking problems back to their original sources, the client is on a direct route to altering the etiological factors giving rise to current problems.  Through revisiting one’s position, especially in his/her primary triangle, and by reviewing childhood distortions, the client’s perceptions become more realistic.  In this way, family cutoffs can be repaired and fused positions can be shifted, which diminishes family anxiety.  It is in this context that the client can change from a focus on others to a focus on self-in-relation.

Bowen (Kerr & Bowen, 1988) believed that the process of change takes time.  Change is not equated with symptom relief or even feeling better, but with an increase in the level of differentiation of the family.  Long-term therapy increases the depth with which the client addresses multigenerational processes (Friedman, 1991), and this requires a commitment to therapy that may last several years.  Change occurs outside of therapy, as the Bowen coach sends clients back to work with their families of origin.

To affect change in the system, I work with the person most motivated to change, who often is the overfunctioner.  The goal of the work with this person is to develop a differentiated leader, one who can lead the family in a way that will have a positive effect on all members.

Horizontal and vertical stressors challenge the system in varying degrees, depending on the level of differentiation in the individual and in the family.  By raising levels of differentiation, more flexible and adaptive responses to change can increase Bowen, 1978).

Marked upward or downward changes in differentiation from one generation to the next are uncommon.  Each sibling may have a little bit more or a little bit less differentiation than may his/her parents.  Children that are focused upon more heavily are not as differentiated as those left freer to grow and develop (Kerr & Bowen, 1988).  Thus, the position of each sibling in his/her family of origin may be more or less fortunate, leading to small but varying differentiation in lines of the family.  Much as it takes several variables all lined up correctly to spawn a hurricane, so it is with negative outcomes in the human being and his/her family system.  If only one variable is changed, it can prevent the storm that might otherwise have occurred.

 Bowen (1978) bypassed the marital fusion of the nuclear family in favor of focusing on at least three generations of the extended family (Titelman, 1987).  Bowen (1978) concluded that “. . . families in which the focus is on the differentiation of self in the families of origin automatically make as much or more progress in working out the relationship system with spouses and children as families seen in formal family therapy in which there is a principal focus on the interdependence in the marriage” (p. 545).

I believe that people are doing the best they can with the tools that they have at any given time.  I also view the principles of psychic determinism (Freud, 1924; Brenner, 1973) and evolution as complementary.  One thing follows naturally from another. To attend to the evolving process between people while at the same time analyzing the evolving process within people is the heart and soul of my theory of change.

To learn more about my model of practice and pick up some free tips just by visiting the web site, visit me at http://www.Cunninghamtherapy.com or call 619 9906203 for a complimentary phone consultation!

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