Introduction
KRISTINE (aged 39) & SUNNY (aged 45) are the clients in the case I will be writing on. For a start, I will construct a 3-generational genogram of Sunny & Kristine’s family. Then I will employ the Bowen’s Systemic Family Therapy to analyse and formulate my systemic hypotheses of Kristine’s family. I will identify certain roles & relationship pattern as well as the interlocking factors in the relationship. Next I will examine the areas of concern so as to discuss them with the couple in my next session with them. Lastly, I will address the difficulties I might encounter in this case & how I will manage them.
Analysis based on Bowen Family System Theory (BFST)
Eight interlocking concepts make up Bowen’s theory. The main goal of Bowenian therapy is to reduce chronic anxiety by facilitating awareness of how the emotional system functions; and increasing levels of differentiation, where the focus is on making changes for the self rather than on trying to change others. (Retrieved on 6 August, 2006 from http://www.thefsi.com.au/papers/bowen_theory/ )
A genogram depicts graphically the relationship in a family with at least a 3-tiered generational diagram. (Nichols & Schwartz, 2001) Constructing a genogram with Sunny & Kristine (Figure A) during the counselling process help them discover the unique pattern of interaction between individuals in the family. As a couple, Sunny & Kristine must renegotiate their relationships with parents & siblings. When Sunny & Kristine begin to understand their family systems, i can invite part or the entire family to be involved in the counselling process.
Triangulations
Triangulation occurs when anxiety in a dyad is increased beyond a comfortable level. This involves a third person in an attempt to achieve some kind of resolution for anxiety. (Brown, 2002) If Kristine is differentiated, she does not need to bring in a third party to reduce tension. Kristine’s decision to medicate Charles with Chinese herbs is largely prejudiced by her mother, Yvette.
The growing emotional & sexual distance in the marriage is balanced by Sunny getting overly involved with Charles’ poor eating habit & asthmatic condition. Spreading the tension can stabilize a system but triangles can contribute significantly to the development of clinical problems as well.
Differentiation
A differentiated person is able to keep his/her emotional system & intellectual/rational system separate. He/she has a strong sense of self, is comfortable with that self, and can make choices based on reasoning rather than emotions. (Brown, 2002) Kristine’s relationship with her parents during childhood & adolescence primarily determine how much `self’ she develops. If Kristine is well-differentiated, she will be able to strike a balance between her feelings & cognition. She will be able to express her emotional-self spontaneously and will not be seeking acceptance & approval all the time.
Deeply fused with her family of origin, the impact her parents have on her functioning is making her control actively the functioning of Sunny & Charles. That explained why she was upset when her brother-in-law did not attend her wedding. Kristine tries to control Sunny’s functioning by arranging lunches & get-together for the latter to win approval & acceptance from his siblings. Kristine’s dependence on Yvette for approval to medicate Charles & her pressure on Sunny to conform is also indicative of a poorly-differentiated self.
Sunny, on the other hand, is confident in his thinking. He is well-differentiated and did not take his brother’s absence from his wedding as a personal attack. He managed to make himself less at the mercy of the feelings of the moment. He seemed clear-headed when he assessed Kristine’s lack of quality time spent to nurture a closer relationship with Charles & ensuring that he eats better.
Nuclear Family Emotional System
The concept of the nuclear family emotional system describes four basic relationship patterns that govern where heightened tensions develop in a family. Bowen (1978) would say that even when the therapist works with a couple, the extended family are very much a part of the process because the couple has to deal with all the emotions, beliefs and images that he or she brought to the current relationship. The four basic relationship patterns are:
Marital conflict - As family tension mounts, Kristine & Sunny become more anxious and they externalize their anxieties into the marital relationship. Each focuses on what is wrong with the other, each tries to control the other, and each resists the other’s efforts at control.
Dysfunction in one spouse - Kristine pressures Sunny to think & act in certain ways.
Impairment of one or more children - Both Kristine & Sunny focus their anxieties on Charles. This may lead to Charles acting out or internalizing family tensions. His reaction to his parents’ emotional over-involvement with him could have led to his immature demands on his parents by way of poor eating habit.
Emotional distance – As Sunny grew critical of Kristine’s functionality, he distanced himself from her to reduce the tension in the relationship. The latter felt isolated when Sunny went ahead to buy a car without getting her involved.
Family Projection Process
The projection process describes the primary way parents transmit emotional problems to a child. Both Sunny & Kristine participate equally in the family projection process, in different ways & its intensity is unrelated to the amount of time they spend with Charles individually. In fact, their marital distance accentuates their individual need for their only child, Charles.
The projection process in Kristine & Sunny’s case follows three steps:
a. Both parents focus on Charles’ poor eating habit & asthmatic condition.
b. Sunny interprets Charles’ intake of potato chips an unhealthy behaviour and is fearful this will lead to deterioration of health condition.
c. Kristine felt that Sunny constantly over-reacted & over-medicated Charles.
Multigenerational Transmission Process (MTP)
The concept of the MTP describes how small differences in the levels of differentiation between parents and their offspring will, over many generations, lead to marked differences in differentiation among the members of a multigenerational family. The information creating these differences is transmitted across generations relationally & genetically
Marcus' habit of showing Kristine off and sending her to expensive school might have been passed on to Kristine as reflected in her handling of Charles. Having used to being basked in the approval of others & coming from a family that fawned over her, Kristine felt Sunny’s disapproval & rejection.
Yvette came from a well-to-do family and Kristine may have modelled after her in lifestyle. She too experienced Yvette as competent and caring. She entrusted Charles to her care & control Playing a large influence in Kristine’s life, Yvette’s over-functioning has promoted Kristine’s under-functioning. The relationship pattern that dominated Yvette’s nuclear family - that of over-involvement with a child is now played out by Kristine with Charles.
Sunny modelled after his thrifty & traditional parents. That explained why he was upset with Kristine’s spending pattern and angered by her disbelief in Chinese medicine.
Emotional Cut-off
The concept of emotional cut-off describes people managing their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them. By cutting off from his family of origin, Sunny is made vulnerable to pressure Kristine & Charles to be certain ways for him so as to meet his needs. The striking parallel now is Sunny is also emotionally distancing himself from Kristine
Sibling Position
Bowen theory incorporates the research of psychologist Walter Toman as a foundation for its concept of sibling position. The basic idea is that people who grow up in the same sibling position predictably have important common characteristics. Sunny & Kristine are both younger in ranking and not complementary (Toman, 1993), & Kristine did not grow up with a sibling of the opposite sex. Growing up, both were focused on by their parents. Sunny was expected to perform academically by his thrifty parents he might have experienced considerable family anxiety that led him to put pressure on himself. This makes Sunny a somewhat demanding leader in his nuclear family. He wants Kristine to function better and that comes across as disapproval to the latter. Kristine grew up dependant on her family doing things for her & approval-seeking.
Societal Emotional Process (SEP)
The concept of SEP describes how the emotional system governs behaviour on a societal level, promoting both progressive & regressive periods in a society. Bowen’s first clue about parallels between familial and societal emotional functioning came from treating families with juvenile delinquents. Two parents intensely focusing on what’s wrong with a child can over time trigger serious rebellion in the child. The child feels controlled and is adept at sensing the uncertainty of their parents’ positions. The current societal regression is characterized by an increased child focus in the culture. With increase in affluence, meeting the material needs of children is easier than meeting their emotional needs. Kristine left Charles to the care & control of domestic helpers instead of nurturing a closer relationship with him. Over time Charles may feel alienation from his parents and their values. A loosening of standards in society will also make it difficult for less differentiated parent like Kristine to hold a line with Charles. Importantly, the constructive direction for Sunny & Kristine to take now would be to work on their marital downslide rather than focusing on improving the future generation.
Areas of Concern
When I meet up with the Sunny & Kristine next, I will explain the main goal & concepts of the Family System Theory with emphasis on self-differentiation & reducing chronic anxiety.
The connectedness and reactivity promoted by Kristine’s doting parents make her family of origin a closely-knitted one. Obviously, Kristine & her sister know who to turn to for immediate support in times of distress. As a result there is less individual autonomy & problem-solving. Hence the only antidote is resolution through differentiation, the process by which Kristine learns to chart her own direction rather than perpetually following the guidelines of her parents & others.
The intense focusing on what’s wrong with Charles can over time trigger serious rebellion in him. Sunny & Kristine have to learn to see Charles as a separate and distinct person to reduce the anxieties chronically.
Difficulties I might Encounter
First and foremost, I must find way to engage Sunny & Kristine if they are to be effective in altering the situation. I will need to `reframe’ their behaviors as `caring’ towards Charles so that they will feel my support & understanding. My focus is to be on the Process rather than Content of the therapy. In a nutshell, I have to put across the Systemic Family Therapy as a way of thinking rather than any specific behaviour. Hopefully that will help them to view themselves as differentiated individuals as well as marital partners.
Another challenge I might encounter is to stay detriangled - “neutral” & detached as in staying emotionally connected with both Sunny & Kristine but not emotionally entangled. partners.
As a change in one person’s functioning is predictably followed by reciprocal changes in the functioning of others. I reckon Kristine’s change will affect her parents & sister in the process, therefore such change has to be initiated at a good pace to avoid arousing unnecessary anxiety.A sample of my dialogue with Kristine may be: (Corey, 2001)
I: What will it be like for you to invite your parents & sister into therapy with you?
K: It’ll be very difficult. My family find Sunny aloof & suspect he is disapproving of them.
I: Who in your family genogram here can you really count on?
K: I think my sister would want to help if she could.
I believe the difficulties & challenges can be overcome once Kristine’s significant others come to grasp the roles they play in the structure & workings in the family system.
(1967 words)
REFERENCES
Nichols, M.P., & Schwartz, R.C. (2001). Family therapy: concepts & methods (5th ed.). Needham Heights, MA: Allyn & Bacon
Brown, J., Brown, C. (2002) Marital Therapy: Concepts and skills for effective practice. Canada: Brooks/Cole.
Bowen, M. (1978). Family therapy in clinical practice. New York: Aronson.
Toman, W. (1993). Family constellation: its effects on personality and social behaviour (4th ed.). New York: Springer Publishing Company
Corey, G. (2001) Theory & Practice of Counseling & Psychotherapy (6th ed.). USA:Brooks/Cole
