TEMA 4 Terapia Mea

7/30/2019 TEMA 4 Terapia Mea

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TEMA 4: CUM AM DE LUCRU CU TERAPIA MEA? Terapia transgenerationala Terapia sistemica de familia a lui Murray Bowen

Recomandare Elena:

I. Model folosit impreuna

II. Model recapitulative curs avansat IIIII. Enumerare teze si concept care stau la baza psihoyh meleIV. Obiective generale ale th meleV. Cand e considerate terapia terminata de catre p thVI. Care este procesul th de baza?VII. Enumerare tehn din repertoriu

I. Model folosit impreuna este pentru aborcarea experentiala

I sedinta: evalueaza si intervine

PT evalueaza interactiuni, stiluri de comunicare, defense, concomitent promoveazaschimbarea.

Ex: indeamna la comunicare directa si congruenta

A II-a sedinta si a n-a

PT continua evaluarea si mai ales lucreaza cu comunicarea

Ghidare client : sa-si insuseasca comunicarea congruenta (subliniere intentie pozitiva,

fara reprosuri, si invinuiri, alegere alternative)

PT experimenteaza si creaza noi ocazii pentru a avea experiente noi.

Membrii system au experiente noi, inedite.

Tehnica sculpturiiJoc de rol

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Alegere alternativeCoregrafia

Desen

Identif si reviz convingeri limitative

UmorExpresivitate

O alta sarcina impo a PT in sed a II-a este sa acompanieze familia pentru a depasirecaderile si pentru a descoperi solutii noi, mai potrivite.

Apoi: consolidare si inchidere

DiferenteAutoapreciere

Stima de sine

Unicitate si asemanari.

Problem de rezolvat prin dezvoltare

Retea de sustinere

Orice problema se rezolva prin dezvoltare

Defensa aparte atunci cand se doreste evitarea

II. Cursul avansat II, 23-26.10.2008, Elena

Bagajul therapeutic:

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1. Teorii2. Tehnici3. Atitudini egalitate (terapeutul nu este expert in problema client!)

- Empatie, 5 niveluri- Curiozitate- ? binevoitoare

- Cel care ghideaza- Asertivitate- Reflecting team- co-constructie terapeut-client

4. obiectiv terapie, ales pe baza ipoteze: O principal5. etapele process therapeutic: inceput, mijloc, final/sfarsit6. Inceput: crearea climat de incredere , siguranta, speranta

Confidentialitate processAdaptare limbajClarificariMetacomunicare

ReasigurariTe arati dsponibil , intrebari despre nevoiInformatii clare, sigurantaFocalizare pe resurseRabdare

7. Marcel: culegere de info, personae implicate in problema client, motivarecelorlalte personae, nuante

Combatere rezistente, lasat timpRespect pentru ceea ce spune clientul

8. CADRU9. PRIMA SEDINTA: obiective:

Climat, inceput la telefonIpotezeleDefinire problemaStabilire obiectiveContract therapeutic

- Joining:relativizare granite pentru client- Prezentare, adaptare la client- Regulile

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- Definire problema- Definire asteptari, asteparile se discuta- Negocierea motivatii- Obiective: prin alianta terapeutica, operationale- Contract therapeutic: durata sedinte, interval de timp intre

sedinte, actliber consimtit,

o Enumerare teze si concept care stau la baza psihoyh mele

10.MIJLOCUL TERAPIE: obiective: ajutarea membri families a se exprimeAjutarea membrii families a se inteleagareciprocIncurajare

11.SFASIT TERAPIE: terapeutul observa indeplinirea O iar familia/ clientul nu maiofera material nou

Clientii considera ca au atins obiectivele propuseTh obserrva ca are limitary ce duc la final thModalittai de a inheia th

ce v-a ajutat cel mai mult?Daca ar fi sa continuati ce ati schimba?Discutare motive intrerupere

Atentie la dependent

III. Enumerare teze si concept care stau la baza psihoyh mele

Bowen:

Murray Bowen Among the pioneers of family therapy, Murray Bowen's emphasis

on theory and insight as opposed to action and technique

distinguish his work from the more behaviorally oriented family

therapists (Nichols & Schwartz, 1998. Family Therapy: Concepts

and Methods. 4th ed. Allyn & Bacon). Bowen's therapy is an

outgrowth of psychoanalytic theory and offers the most

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comprehensive view of human behavior and problems of any

approach to family therapy. The core goal underlying the

Bowenian model is differentiation of self, namely, the ability to

remain oneself in the face of group influences, especially the

intense influence of family life. The Bowenian model also

considers the thoughts and feelings of each family member aswell as the larger contextual network of family relationships that

shapes the lie of the family.

Bowen grew up in Waverly, Tennessee, the oldest child of a large

cohesive family. After graduating from medical school and

serving five years in the military, Bowen pursued a career in

psychiatry. He began studying schizophrenia and his strong

background in psychoanalytic training led him to expand his

studies from individual patients to the relationship patterns

between mother and child. From 1946 to 1954, Bowen studied the

symbiotic relationships of mothers and their schizophrenicchildren at the Menninger Clinic in Topeka, Kansas. Here he

developed the concepts of anxious and functional attachment to

describe interactional patterns in the mother-child relationship.

In 1954, Bowen became the first director of the Family Division

at the National Institute of Mental Health (NIMH). He further

broadened his attachment research to include fathers and

developed the concept o triangulation as the central building

block o relationship systems (Nichols & Schwartz, 1998. Family

Therapy: Concepts and Methods. 4th ed. Allyn & Bacon). In his

first year at NIMH, Bowen provided separate therapists for each

individual member of a family, but soon discovered that this

approach fractionated families instead of bringing them together.

As a result, Bowen decided to treat the entire family as a unit, and

became one of the founders of family therapy.

In 1959, Bowen began a thirty-one year career at Georgetown

University's Department of Psychiatry where he refined his model

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of family therapy and trained numerous students, including Phil

Guerin, Michael Kerr, Betty Carter, and Monica McGoldrick, and

gained international recognition for his leadership in the field of

family therapy. He died in October 1990 following a lengthy

illness.

teoria sistemica, ca modalitate de gandiremai putina autonomie emotionala in vietile noastre decat credemcei mai multi sunt reactivi si dependent unul fata de celalaltfamilia, ca o retea de relatii multigenerationala, formeaza interjocul individ-a fiimpreuna , conform unor 6 conceote intreconectate (1966) plus alte doua adaugate in1976: sep emotionala si process emotional societal.

Moniva MGoldrick: etnicitatea: terapie de familie pe baze de

diferente de etnie, norme si valori culturale de diferenta, nun suntfamilii disfct ci diferite in mod legitimate.

Monica McGoldrick, LCSW, PhD (h.c.) Director, Multicultural Family Institute

Teacher, author and family therapist. Books include: The Genogram Journey:

Reconnecting with Your Family (2nd ed, 2011), Re-Visioning Family Therapy (2nd Ed.

2008), The Expanded Family Life Cycle (4th Ed., 2011), Ethnicity & Family Therapy (3rd

Ed., 2005), Genograms Assessment and Intervention (3rd Ed., 2008), Women in

Families, and Living Beyond Loss, (2nd Ed, 2004). Faculty, Psychiatry Dept., RWJ

Medical School, Visiting Professor, Fordham University School of Social Service (1991-

2001). Honorary Doctorate, Smith College School for Social Work(1991). American

Family Therapy Academy Award (1988) for Distinguished Contribution to Family Therapy

Theory & Practice. Formerly: Co-Director, Cultural Competence Training Center for

Central NJ.

Betty Carter

An ardent and articulate feminist, Betty Carter was instrumental

in enriching and popularizing the concept of the family life cycle

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and its value in assessing families. Carter entered the field of

family therapy after being trained as a social worker, and

emphasized the importance of historical antecedents of family

problems and the multigenerational aspects of the life cycle that

extended beyond the nuclear family. Carter further expanded on

the family life cycle concept by considering the stages of divorceand remarriage (Nichols & Schwartz, 1998. Family Therapy:

Concepts and Methods. 4th ed. Allyn & Bacon).

Carter's interest in family therapy was stimulated by taking part in

a family therapy field placement at the Ackerman Institute as part

of her M.S.W. requirements at Hunter College. She quickly

became an avid student of the Bowenian model, and served on the

staff of the Family Studies Section at Albert Einstein College of

Medicine and Bronx State Hospital with Phil Guerin and Monica

McGoldrick. Carter left the Center for Family Learning to

become the founding director of the Family Institute ofWestchester in 1977. Carter served as Codirector of the Women's

Project in Family Therapy with Peggy Papp, Olga Silverstein, and

Marianne Walters, and has been an outspoken leader about the

gender and ethnic inequalities that serve to keep women in

inflexible family roles.

Currently, Carter is an active clinician and specializes in marital

therapy and therapy with remarried couples (Nichols & Schwartz,

1998.Family Therapy: Concepts and Methods. 4th ed. Allyn &

Bacon). Her work with couples focuses on helping her clients to

understand their situation and to address unresolved family

issues. Carter incorporates tasks, such as letter writing, which

serve to intensify and speed up the communication process and

help couples move out of rigid patterns of behavior.doua boweniene feministe

Micheal Kerr

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Michael E. Kerr, MD

Michael E. Kerr, MD succeeded Murray Bowen as Director

of the Georgetown Family Center in 1990, following a close twenty-year

association with him.

Dr. Kerr is the co-author with Murray Bowen ofFamily Evaluation: An Approach

Based on Bowen Theory which

was published by W.W. Norton & Company in 1988. He

has also written many articles and book chapters related to Bowen theory and its

applications. He is the editor ofFamily Systems: A Journal of Natural Systems

Thinking in Psychiatry and the Sciences published by the Georgetown Family

Center.

Dr. Kerrs primary research interests have been the relationship of Bowen theory to

evolutionary theory, the relationship of physical, emotional, and social symptoms tofamily emotional process, and the process of differentiation in clinical work. At an

Annual Family Symposium, he proposed a new concept in Bowen theory called, "the

unidisease." He is developing an article on the unidisease concept for publication.

He speaks frequently around the country at medical schools, universities, meetings of

national organizations, and regional conferences on these and other topics related to

Bowen theory.

He has produced a videotape lecture series on Bowen family systems theory and its

applications, a lecture tape entitled, Why Do Siblings Turn Out So Differently?and a lecture tape called, Towards A Systems Concept of Supernatural

Phenomena: A Status Report.

Contact Information: [email protected]

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Philip Guerin

Student a lui Murray Bowen , ideile sale inovatve au dus la dezviltarea unei sophisticate abordari

clinice in terapia /tratamentul problemelor copiilor, adolescentilor, cuplurilor si indivizilor adulti.

Tinte therapeutice: contextual multigenerational, calmarea zestrii emotionale a mb familiei sidefinirea unor tipare specific de relationare in familie.

Abordarea sistemelor familiale este desinata sa masoare severitatea conflictelor si identificarea

zonelor specific care au nevoie de imbunattaire.1970: director al studiilor de antrenare a familiei la colegiul medical A Einstein si spitalul de stat

Bronx.

Clinician desavarsit, este si autorul unor carti si articole valoroase in domeniul terapiei de familie:

Evaluarea si tratamentul conflictelor maritale. O aborcare in 4 stadii, 1987 si Lucrul cu

triunghiurile din relatii: unul-doi-trei sau abc-ul din psihoterapie , 1996.

1. Diferentierea sinelui

Context emotional DS un grad relative de autonomie

Persoanele diferentiater sunt mai flexibile, mai adaptabile mai autonome.

Au spirit critic.

Mentin un grad de obiectivitate si distanta emotionala.

Persoanele differentiate au un eu mai solid, mai integrat

Deciziile sunt rationale, nu emotionale.

Nediferentiatii sunt mai rigizi, mai dependent emotional de altii, cmpt directionat

pe emotii.Decizii pe baza de emotii nu pe ratiune

Pseudo-eu (self): deciziile luate la perioade diferite de timp sunt incosistente unele

cu altele

Bowen (1976) ps-eu = eu pretins, persoana il poate sinti ca fiind real dar nu este.

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Intreventie th: crestere grad de autonomie, unii fata de altii.

Fuziunea si diferentierea sunt concept f importante in ceea ce priveste ipotezele

trangenerationale si intergenerationale.

Doua personae nediferentiate tind sa se gaseasca sis a fuzioneze.Separarea de famikia de origine si fuziunea sotilor.

2. Process emotional al familiei nucleare

Gama de pattern-uri relationale emotionale din sisteme, dintre parinti si copii.

4 mecanime

- Distanta emotionala

- Conflict marital

- Transmiterea sau proicetarea problemei catre copil: problemele dintre soti si

anxietatea generate tind sa fie evitate prin concentrarea lor pe unul sau maimulti copii. (mama fuzioneaza symbiotic cu unul dintre copii), concomitant

cu distantarea tatalui care este si evitat in acest timp. Copilul fuzionat este cel

mai vulnerabil la dezvoltarea unor smpt.

- Disfunctia intr-un sot: poate devein solid cand sotul disf dezvolta o maladie

fizica sau mentala.

3. Triunghiuri si triangularea; proiecti asupta unui sau mai ulti copii.

Triunghiul este unitatete de baza a intredependentei in sistemul emotional

familial.Bowen spune ca o diada (un system format din doua personae) este stabile atat

timp cat este calma. Apar f stresori care cresc anx si atunci cand atinge un nivel

ridicat o a treia persoana va fi atrasa in campul emotional al celor doi.

Ex; un cvonflict intre soti sotia isi va atrage mama in conflict cu scopul de a-si

reduce anxietatea.

Pot fi latent si sa nu se manifeste decshis, ele fiind cativate in pewr de stress.

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Nivelul de stress sau anx pentru destabilizare diada este in stransa legatura cu

gradul de diferentiere al celor doi.

4. Procesul proiectiv al familiei: nivel de dif parental trece mai departe la unul

sau mai multi copii.Obi, un copil va avea o implicare emotionala crescuta cu unul dintre

parinti.=supraimplicare.

Variatii: parinte ingrijorat excesiv pana la parinte ostil act copilului.

Dinamica deterioreaza caoac copil de a fct efic in context sociale.

Gradul de dif parental si nivelul de stress in familie detemina intensitatea

process proicetiv al fam.

5. Intreruperea sau distantarea emotionala, = fuz dintre generatiiScadee anx asociata cu contactul familial si creaza o probl: izoleaza indivizii care

ar putea beneficia de contact.

Disfunctia se poate asocial cu relatii superficiale, boli fizice, drpresie, cmpt

impulsive.

6. Process de transmitere multigenerationala.

Tendinta de a repeat pattern-uri disfct ale conduitei emotionale in generatii

successive culmineaza cu niveluri scazute de dif e eu-lui pentru anumiti mb ai gen

ai tinere. (Hall, 1981)

7. Pozitia de frate sau sora

Varsta mai mare si distributia pe sexe intre fratii ac generate au o puternica inflasupra cmpt. (Hall, 1981)

8. Procesul emotional al societatii (regresia sociala).

Concept cheie Bowen-procesele (pattern-urile) familiei sunt observabile social si in

modul de intreactiun e social.

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Societatea esueaza cand f stress sunt cronici si face fata la f acuti: Bowen.

Din pricina stressului cronic, atat societatea cat si familia pierd contactul cu

pricipiile sistemului lor intellectual si vor actiona in virtutea sistemului emotional,

cand isi pierd obiectivitatea.

Daca react emotional iti piersi obiectivitatea

Murray Bowens Insights into Family Dynamics*

1. Diferentierea sinelui sau cum sa ai propria ta viata si sa nu te lasi coplesit de

propria familie.

Fortele familiei pentru imoreuna si fortele opuse de a fi separate.

Gradul in care apare dif selfului la un individ reflecta posibilitaeate acestuia de a distinge intre proceul

intelectula sic el emotional. In acste mod dif s este legata de gradul in care individual este in masura ca

actiunile, relatiile si viata sa sunt ghidate de emotii sau ganduri. (ce parte din mine imi conduce viata

mea, emotiile sau creierul , cne este seful emotiile sua gandurile, ratiunea?

Indivizi cu o mare fuziune intre cele doua fct cel mai prost.

Sunt la mila reactiilor emotionale involuntare si tind sa devina disfunct la cle mai mic stress.

In acelasi mod in care nu pot dif emotiile de ratiune acedte persoane au greutate de a se dif de altii si fuz

usor cu emotia dominant in familie.

Acesta este codependenta, efectiv nu poate spune care este dif dintre gandurile si emotiile proprii si cerle

ale latei persoane.

Bowen a introdus conceptual de masa de ago familial nedif , derivate din psihoanaliza pentru a transmite

ideea de familie blocata emotuional impreuna, locul unde conglomeratul de unuicitate exista la divefire

niveluri cde intensiatte. (gradina de variate grade de codepende in familie)

Ex: gradul de relatie de simbioza intre mama si fiu poate reprez cea mai intense vresiune a acestui

concept.

Tatal se detaseaza mai putin intens.

Gradul in care un mb al fam la un miment dat este dire prop cu gradul de impl in are masa de ego

emotional.

Tensiunile emot variza in diverse grade.

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Bowen a definit psihoanalitic variabila masa de ego emotional mai traziu ajunge sa sa def in fuziune dif

(codependenta septaresanatosa.

Penrtu ca cineva sa devina individ independent tb sa devina liber de proble emotion ale familieimde

origine sis a expire un self solid.

Gradul in care oricare mb al fam este implicat in familie la un moment dat depinde de nivelulbazal de

implicare in masa de ego familial.Ctaeodata aceasta apropiere emotionala poate fi atat de intense cam b fm pot sti totul despre restul mb

fam: vise, ganduri, emotii, fantezii etc.

Aceasta intinmiktate poate duce la supra apropiere inconfortabila si in final la respingere mutuala intre

doi memebri: certuri, usi trantite, telefoane trantite etc) .

In cocl in sistemult familiei tensiunile emotionala vraiza cu timpul (cateodata rara alteori rapid) intr-o

serie de aliante si respingeri.

Ccea ce Bowen a caracterizat intiail in termini psihoanalititci masa de ego nediferentiata- a recadrat

mai tarziu in termini de fuziune-diferentire (codependenta-separarae sanatoasa).

Ambii tremeni dovedesc ca maturizarea si self actualizarea necesita cere ca individual sa-si rezlve

atasamewnetle emotiomale din fa de orig .

O persoana cu un sine puternic ( astea sunt opinile mele, asta cred eu, asta sunt ru, asta am sa fac, si asta

nu am sa fac exprima convingeri clasre si bine definite.

O asedmenea persoan nu isi va comptomite self-ul de dragul fericirii maritale, sau sa fie pe placul

parintilor, sau sa-si obt dorintele prn coercitie.

Un lat exemplu este un parinte care nu va enable an addict to continue to use drugs or alcohol.

0 25 50 75 100Undifferentiated Differentiated

Codependent Codependent in recovery

Alcoholic/Addict Alcoholic/addict in recovery

Dysfunctional FunctionalFused/ Enmeshed Self actualized

Unhealthy Healthy

Triggered, evoked, freaking out Rational under stressEmotionally immature Emotionally Mature

Parent/Child relationships Adult/Adult relationships

False Emancipation EmancipationCGAS* 80 or less CGAS 81 or higher

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GAF* 80 or less GAF 81 or higher

(* See page 9 for information on CGAS)

PersoaNLE CU7 UN SCOR SCAZUT SUNT CELE AL CARORO EMOTII SI INTYELECT

SUNT DOMINATE de emotiile celor din jurul lor: ex: copilul meu experimenteaza dificultati tre

sa ma grabexsc sa-l salvez)

Ca o consecinta sunt disfct. Bowen considera ca au un pseudoself, pe care-l poti crede a fi reladar este format din opinii si va,lori ale celollaltyi (codependenta).

Cei care ua un scor la nivel mare sunt mature emotional, deoarece inn periaode de trse intellect si

rationalul fct bune.si pot lua decizii bune independent de emotioanlitaea din jur.

Cele mai multe perssoane sunt la mijlocul scalie cu diferite grade de dif si fuziune.

Scasla elimina nevoia de concept de normalaitate.

Confrom lui Bowen orice nivel de dif reflecta niv de dif din familia sa .

Un nivel moderat catre inalt de dif permite intractiune a cu altii fara teama de fuziune (pierdere asinelui intr-o relatie sau sa devii codependentma enervezi e un semn de pierdere a self-ului.

Flexibilitatea scade proport cu scadrea difernt.Teoria lui Bowen spune ca este in instinctual finite umane de a propulsa sau genera copii capabili

sa dezv. O persoana separate emotionala, capabila sa gandeasca, sa simta si sa actioneze ca un

individ.

In acelasi timp tot insntinctyul face ca persoana sa ramana concetgata emotuional.

Va rezultata al acestor soua forte nimeni nu poate ajunge la separararea emotinala complete de

familia de origine.

Totusi sunt diferente considerabile in modul cum ne separam de familie cat si diferente dintre

gradele de separarea ale copiilor in aceeasi familie.Aceste lucru din urma se datoreaza relatiilor diferite stabilite de parinti cu ficeare copil in parte.

2. Triunghiuri sau cum in loc sa ne maturizam noi insne sa incercam sa sa

arasnjam pe altcineva.

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Cu cat gradul de fuziune intre soti este mai mare cu ata este mai dificil a gaseasca o cale de a-I

staosface pe ambii.

Bowen, 1978, spun ca in acset mom intrevine triangularea, e dificil sa discutam in doi atuncivom dicuta depsre altcineva.

Triunghiul dilueaza anxietatea.

Cata vreme este situati calma SOTII POT FACE SCHIMBURI INTRE EI.

Cand nivelul stabilitatii este ameninttdin cauza supararii sau anxietatii datorate unui stress intrensau din cauza unui stress extern (abuzul de droguri sau de alcoole creaza un stress major).

Cand un anumit nivelul de stress va fi ajuns unul sau ambii parteneri va implica o persoana

vulnerabila. (o persoana cu un eu sanatos nu va fi interesata in drama altei persoane).

Acets triunghi va dilua anxietatea. Daca ea va crets se va triagula o lata p[esdoana de catre

triungh deja existent.

Cu cat familia edste mai fuzionata cu atat eforturile de tr vor fi mai mari.De ex famililiile cu probl de alcool pierd multa vreme sa discute in loc sa treaca la ctiune.

Adica sa se maturizeze si sis a devina fct.

Bowen refers to the triangle as the smallest stable relationship system. By definition,

a two-person system is unstable and forms itself into a three-person system or triad understress, as each partner attempts to create a triangle in order to reduce the increasing tension

of his or her relationship (even partners in healthy marriages seek outside counsel at times).

As more people become involved, the system may become a series of interlocking triangles,

in some cases heightening the very problem the multiple triangulations sought to resolve.For example, a distraught mothers request for help from her husband in dealing with their

son is met with withdrawal from the father. As the mother-son conflict escalates, she

communicates her distress to another son, who proceeds to get into a conflict with hisbrother for upsetting their mother. What began as a mother-son conflict has now erupted

into interlocking conflicts between mother and son, brother and brother, and mother and

father. The alcoholic and drug addicted family often has dozens of involved individuals.Thus triangulation does not always reduce tension. Bowen points out that

triangulation has at least four possible outcomes: (1) a stable twosome can be destabilized

by the addition of a third person (for example, alcoholism, drug addiction); (2) a stable

twosome can be destabilized by the removal of a third person (marital conflict follows after

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an alcoholic, addict or codependent seeks treatment, and thus is no longer available to be

triangulated into their conflict); (3) an unstable twosome can be stabilized by the addition of

a third person (seeing a therapist, recovery); and (4) an unstable twosome can be stabilizedby the removal of a third person (conflict is reduced by setting a boundary and eliminating

an addict/alcoholic from ones life).

To give another familiar example, note that conflict between siblings quickly attracts

a parents attention. Let us assume that the parent has positive feelings toward both childrenwho, at the moment, are in conflict with each other. If the parent can control his or her

emotional responsiveness and manage not to take sides while staying in contact with bothchildren, the emotional intensity between the original twosome, the siblings, will diminish.

(A parallel situation exists when parents quarrel and a child is drawn into the triangle in an

attempt to dilute and thus reduce the strain between the combatants.) Generally speaking,the probability of triangulation within a family is heightened by poor differentiation of

5

family members; conversely, the reliance on triangulation to solve problems helps maintain

the poor differentiation of certain family members. (Substance dependent/codependentfamilies not in recovery always get worse.)

As we discuss later in this chapter when we describe Bowens therapeutic technique,a similar situation exists when a couple visits a marital/family therapist. Following from thetheory, Bowen contends that if the therapist the third person in the system can remain

involved with both spouses without siding with one or the other, the spouses may learn to

view themselves as individual, differentiated selves as well as marital partners. However, ifthe third person loses emotional contact with the spouses, the twosome will proceed to

triangulate with someone else. (If all family members seek recovery then differentiation

occurs. Those who do not seek recovery will find other addicts or codependents to hook up

with.)

3. sistemul emotional al famliei nucleare sau suntem toti captive in ou

Nuclear Family Emotional System orWe Are All Stuck Inside The Egg

Bowen spune ca oamenii isi aleg parteneri cu grade echivalente de dif.

Un cuplu va produce copii asemanatori lor.

Sisatemul emotional al familie nucleare resultat va fi instabil si va cauta variate forme de a

reduce anx/tensiune si de a mentine stabilitatea. (alcoolul, drogurilr si codpenedenta merg f

bine impreuna) Cu cat este mai mare fuziunea in familia nucl cu atat mai mare va fi anx si

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potyentialul de instabil su cu atat mai are predilectia familieimsa caute rezolvare prin

cearat , distantare, sau un partener cu defcinete la vdere sau cu fct compromisa sau

preocupatyi de un copil.

Caest lucru fac cam b sa scada stress prin abuz de subst.

Bowen vede trei pattern posibile la partenerii smpt. In fdam nucleara. Ca fiind produsulfuz intense (niveluri crescute de codependenta) intre parteneri.

Fiece patt se intensifica de anx si can dintens ajunge un parg sufic se dezv diverse forme de

smpt.

Persoana sau relatia care manif smpt este detrem de patt emotionale predom in acel sisitem

fam.

Cele trei patt sunt urmatoarele:

4. Disfct, fizca sau emotionala a unuia dintre parteneri, cateodata

devenita cronica, ca o altrnatriva la a infrunta direct conflictul din

familie;anx generata de fct. Nedif a fiecarui mb al familie este

absorbita disproportional de un parinte smpt.5. Semnificatia clinica , cronica, nu rezolva conflictul marital, in care

cicluri de apropiere departare emotinala apar.; ambele sentiemetele

negative in timpul conflictului si cele positive unul pentru altul din

perioada de apropiere sunt n modelul roller coaster; anxietatea

familieieste absorbita de catresoti.

6. Handicapul fiziologic al unu copil, activeaza focalizarea parentala

asupra disfct coplilului si ignira sau naega propriul lord if scazuta ( e

copilul, prostule!) ;cum copilul devine centru atentiei al familiei,

intensity relatiei parentale este diminuata si anx famn este absrbita

de problema copilui; gradul de dif alcopli cu cat este mai scazut cu

atat mai mare va fi vulenrab lui de a creste in fam anx si deci de acreste disct.

VIII.

.

relationship is diminished, thus the family anxiety is being absorbed in the childs

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Disfunctia unui sot poate lua forma de reciprocitate supra sau sub adecvata, in care un mb al

famlie preia toate rtesponsabilitatile pe cand celalat subfct.

Codeoendentilor permit dependentilor sa sub fct.

Dysfunction in one spouse may take the form of an overadequate-underadequatereciprocity, in which one partner takes on most or even all family responsibilities (earning aliving, caring for the children, cooking, shopping, and so on) while the other plays the

counterpart role of being underresponsible. Codependents enable dependents to underfunction. Fused together, the two-pseudo selves develop an arrangement in which onepartner increasingly underfunctions while the other takes up the slack by assuming

responsibility for them both codependency! When the tilt gets too great the one giving up

more pseudo self for the sake of family harmony becomes vulnerable to physical or

emotional dysfunction chemical dependency, other addictions, illness!In some cases, the pattern intertwines with marital conflict, the under adequate one

(alcoholic) complaining of dominance, inconsiderateness, and so forth from the spouse. Theoveradequate one (codependent) is more comfortable with the arrangement until theunderadequate one complains or becomes so inadequate as to cause difficulties for the

overadequate one. When this occurs, the problem is likely to be seen as belonging to the

unhappy underadequate spouse, rather than as a relationship problem for which both needhelp the alcoholic is the problem, not me!

aproape fiecrae familie are un copil care este mai vulnerabil la fuziune ca celalt si care

poate fi trriangulat intr-un conflict parental.

Orice crest a anx parentale declanseaza un cmpt disfct la scoala, acasa sau ambele.

Ducand la si o mai mare crest a anx parentale.In shimb cmpt copilului devine un handicap, tran format cateodata in un patt de fct scazuta

pe viata.

Sistemul emot al fam nucleare este un fnmen multigenerational.

Indivizii tind sa repete ceea ce au invatat in fam de orig. sis a paseze si la copii lor.

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Pentru Bowen , singura cale reala de a rezolva problem de fam este de a schimba

interactiunea in familiile de origne (semnarii de recuperera, psihoter, educatie )

Doar in acste fel poate inceapa diferentierea si indivizii implicate sa devina mai putini

hiper reactivi la fortele emotionale zdrobitoare din familil sis a dea viitoarelor generatii

posib de a produce fam santatoase.

Individuals tend to repeat in their marital choices and other significant relationships the styleof relating learned in their families of origin, and to pass along similar patterns to their

children. To Bowen, the only effective way to resolve current family problems is to change

the interactions with the families of origin (recovery, psychotherapy, education,

workshops). Only then can differentiation proceed and the individuals involved become

less overreactive to the emotional forces sweeping through the family - and give futuregenerations a better shot at producing functional families.

4. procesul proiectiv al familiei sau hai sa fim de accord ca acest copil este bun sicelalalt ester rau, acesta este destept si celalalt nu este.

Asa cu am observant mai devreme patintii nu raspund n acelasi fel la fiecare dntre

copii desi pretend contrariul. (rolurile tipice in familiile sunt eroul, tapul ispasitor, mascot,

copilul pierdut, copilul patinte, micul ajutor)

Diferenteke dintre cmpt parentale produc diferente semnificative intre cmpt copiilor

si in modul cum fct acestia.

Copii care sunt obiectul focalizarii parentale tind sa dezvolte o mai are fuzionare

decat fratii lor si in consec raman mai vulnerabili la stressful emotional ce are loc in familie.

Cei predispusi la fuziune, copii focus, sun tai sensibili la perturbariincl semnelincipiente.

Bowen crese ca parintii, la randul lor imaturi, selecteaza ca obiect de atentie cel mai

infantile/slab copil, indif de ordineanasterii.

Asta e problema, nu este sigur alcoolismul meu, codependenta, afacerile, jocuriled

enoroc etc)

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Acest process proiectiv lucreaza cu triada mama-tata-copil; trans nedif apare prin traigularea

celui mai vulenrabil copil in relatia parentala.

Bowen subl ca pozitia in fratrie a parintilor in familia de origine este posibila cheie prin care aleg

coplilul urmatoarei generatyii.

Copilul cel mai astast emotional din familie va avea cea mai mica dfer a sinelui si cea mai difcila

separera de familie.Mai mult, Bowen crede ca cu cat e mai mare gradul de nedif a parintlor mai mult se bazeaza pe

procesul proicetiv pentru a stabiliza sistemul si si este mai probabil ca mai multi copii vor fifuzionati.

Acset process al al proectarii sau al transterii nedif parentale cu atat mai devreme cu cat incepe

legarea matrena de copilul mic.

Codepend si depend se poate trans la generatii.

Intensitatea procesulu de proiectie al fam este legata de doi factori: gradul de imaturitate sau

nedif al parntilor, si nivrlul der stress sau anx experimentat de familie.In scenatiul trangulariii copilul raspunde anxios la anxietatea mamei, ea fiind primul ingrijitor, ;

mama devine alarmata la ceea ce ea precepe a find plproblema copilului si devinehiperprotectiva.

In acest fel se stabileste un ciclu in care mamma intantilizeaza copilul (chiar la maturitate, se

numeste activare) care copil, in schib, devine hamdicapat si exigent (devine addict, somer,alcoholic)

Tatal, care este sensibil la anxietatea sotiei, in incercarea de a o calma joaca un rol suportiv si

devine al treile piscior al triunghiului.

Fiind colaboratori , parintii au stabilizat acum realtia lor in jurul unui copli tulburat (tap isp) si aunui proce de perpet a tr familiei.

5. intreruoerea(distantarea emotionala

Sau voi pretend ca nu suntem intr-o relatie

Copii mai putin implicate in procesul p sunt apti de a rezita fuziunii si separab gandirea de

sentimente sau emotia de ratiune si cunosc diferenta dintre ei si altii.cei care sunt mai

mplicati inceraca varii strategii de a atinge maturittea chiar mai devreme.

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Separare geografica, bariere psihologice sau selfdeception ca sunt eloberati de legaturile de

familie din cauza distantei.

Drogurile si alcoolul suntf efic la sepatare , pentru moment.

Bowen considera ca aceasta presupusa libertate un cut-off emotional, un zbor de la probl

eotionale nerezolvate si nu o reala emancipare.

Evitarea atasamentulu poate reprez negarea confl nerez sis a mascheze fuzioneaneexplorata. Cutoff emo reflecta o problema (subl fuziunea dintre generatii), rezolva o

problema (reduce anx asociata cand esti in contact) si creaza o problema (izolarea

oamenilor care ar putea beneficia de un contact mai apropiat.

Cutoff apare mai frecv la familiile in care exista un nivel mare de anx si de dependent

emotionala (drog, alcool abuz si depend-codepend).

Cum ambele cresc si coeziunea fam marite este asteptata conflictul intre mb familiei poate

fi ascuns si deghizat.

Fuziunea ar putea ajunge la un nivel de nesuportat, iar unii mb pot caut o mai mare

distantare, emotionala, sociala, chimica, poate fizica pentru conservarea sinelui.

Cand se impune comunicarea aceasta este superficiala, scurta si neautentica.

Bowen a sugerat ca atunci cand exista cut off emot intre parinti si bunici, atunci

probabilitatea unui cutoff intre parinti si copiii generatiei urmatoare creste

Bowen insista ca adultii tb sa-si resolve atasam emotionale in familiile de origine.

Bowen a descries propria sa lupta pentru difer din familia sa de orgine.

Fara acestlucru, Bowen spune cat h de famlie poate fi traangulatvfara voie in conflictele

familiilor clientilor, ca atunci cand erau copii in propr familii, probabil supraidentif cu un

mb al fam sau proiectand la altii propriile probl nerezolvate.

In gen, th este vulnerabl la efortul familiei clientlui sa reziste schimb s sa pastr hoemostazia

fam.

Th de fam tb sa fie in contact cu sis a fie liber de propria lui intrenalizare a fam in asa fel cat b

nerezolvate din trecut sa nu perturbe terapia cu familia client.

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Iata un exemplu visual: imag ca suneti un purec pe un cal. Iar calul galopeaza spre sud. Tu si cu

un prieten purec va intalniti si impreuna luati decizia schimb traiect cal.

Esti ferm: calule ia-o spre nord. Dupa o vreme realizezi ca directia ramane nemodif. S audni maimulti mb dn familie pt un scop: sa mergi cu calul sper nord.

Din pacate calul nu va lua nicicand in seam apararea unor pureci.

Singura cale in care purecii si pot indeplini dorinta proprie este de a se da jods de pe cal si a o lua

singuri spre nord.Calul in fiece familie este compus din: valorile const si incost, norme, reguli, asteptari.

.in plus am vazut cum slaba dif in mod clar ne ia abilitatea de a lua decizii in viata nostra, pt ca

desesori suntem condusi de emotiile unei late persoane .

Sau in mod incost, suntem de accord sa implinim asteptarile altui mb al fam (aici este o probl sit

u esti asta) Prin urmare, din puct de vedere psihologic, cu exc cazului cand ne faem traba suntem

la mila trectutului nsotru si nu vom fi niciodata autorii vetii noastre.

Putem continua sa fim dependenti de chimicale si nicicand mai avansati dincolo de momentulinceperi folos de subst sau sa suferim o moarte premature si tragica.

Sau codependenta noastra poate sa ne fixeze pe cmpt altuia producand un parinte necrutator inadult si dincolo de si astfel ambii previn de la maturizare si noi insine de la a avea o viata

implinita.

Deci putem fi o victima a celor slab dif si niciodata sda nu depasim etapa sugarului sau sa

decidem sa ne schimbam sau sa luam o decizie sa cautam ajutor sis a ne traim viata.

Ce e sa-ti traoesrti viata? Sau sa ia viata ta?

Ei, acseat este intrebarea pe care o pun cei care dortesc o viata implinita.

. Or

our codependency may cause us to be fixated on anothers behavior causing us to

relentlessly parent them into adulthood and beyond and thereby both prevent them fromever growing up and ourselves from ever having a fulfilling life. Or we may be the victim

of those poorly differentiated souls and never psychologically let go of the breast, or decide

to change, or make a decision to reach out for help, suck it up, and get a life. What is the

necessary work to get a life? This is the question that those who want a full, functional

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cei care isi vor peterec restul vietii raspunzand la inyrebarea asta.

Asta e intreb la care veti rasp fiec dntre voi mereyu mereu.

Doemne da-mi linistea sa accept lucr pe care nu le pot schimba (la fel ca totti ceilalti), da-mi

curajul sa schimb lucr care pot (ca mine insumi) si intelepciunea sa stiu dif dintre mine si o alta

persoana (ce catedata e imposibil)

life and wonderful, fun, and juicy relationships will spend the rest of their lives answering.

This is the question we will be asking each of you to ask yourself over and over.

God, grant me the serenity to accept the things I cannot change (Like anyone else),

The courage to change the things I can (Like myself),

And the wisdom to know the difference between myself and another person (Which

is sometimes impossible).

1 - Emotional Fusion and Differentiation of Self

2 - Triangles

3 - Nuclear Family Emotional System

3 - Nuclear Family Emotional System

In positing the 'nuclear family emotional system', Bowen focuses on the impact of 'undifferentiation'

on the emotional functioning of a single generation family. He asserts that relationship fusion, which

leads to triangling, is the fuel for symptom formation which is manifested in one of three categories.

These are:

a. couple conflict;

b. illness in a spouse;

c. projection of a problem onto one or more children.

Each of these is expanded below.

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3A. COUPLE CONFLICT

The single generation unit usually starts with a dyad - a couple who, according to Bowen, will be at

approximately equal levels of differentiation (ie. both have the same degree of need to be validated

through the relationship). Bowen believed that permission to disagree is one of the most important

contracts between individuals in an intimate relationship (Kerr and Bowen, 1988: 188). In a fusedrelationship, partners interpret the emotional state of the other as their responsibility, and the other's

stated disagreement as a personal affront to them. A typical pattern in such emotionally intense

relationships is a cycle of closeness followed by conflict to create distance, which in turn is followed

by the couple making up and resuming the intense closeness. This pattern is a 'conflictual cocoon'

(Kerr and Bowen, 1988: 192), where anxiety is bound within the conflict cycle without spilling over to

involve children. Bowen suggested the following three ways in which couple conflict can be functional

for a fused relationship, in which 'each person is attempting to become more whole through the other'

(Lederer and Lewis, 1991).

1. Conflict can provide a strong sense of emotional contact with the important other.

2. Conflict can justify people's maintaining a comfortable distance from each other without feeling

guilty about it.

3. Conflict can allow one person to project anxieties they have about themselves onto the other,

thereby preserving their positive view of self (Kerr and Bowen, 1988: 192).

3B. SYMPTOMS IN A SPOUSE

In a fused relationship, where each partner looks to the other's qualities to fit his / her learned

manner of relating to significant others, a pattern of reciprocity can be set in motion that pushes each

spouse's role to opposite extremes. Drawing from his analytic background, Bowen described this

fusion as 'the reciprocal side of each spouse's transference' (Kerr and Bowen, 1988: 170). For

example, what may start as an overly responsible spouse feeling compatible with a more dependent

partner, can escalate to an increasingly controlling spouse with the other giving up any sense of

contributing to the relationship. Both are equally undifferentiated in that they are defining themselves

according to the reactions of the other; however the spouse who makes the most adjustments in the

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self in order to preserve relationship harmony is said by Bowen to be prone to developing symptoms.

The person who gets polarised in the under functioning position is most vulnerable to symptoms of

helplessness such as depression, substance abuse and chronic pain. The over functioning person

might also be the one to develop symptoms, as s/he becomes overburdened by attempts to make

things 'right' for others.

3C. SYMPTOMS IN A CHILD

The third symptom of fusion in a family is when a child develops behavioural or emotional problems.

This comes under Bowen's fourth theoretical concept, the Family Projection Process.

3a. Couple Conflict

3b. Symptoms in a Spouse

3c. Symptoms in a Child

4 - Family Projection Process

5 - Emotional Cutoff

6 - Multi-generational Transmission Process

7 - Sibling Positions

Modelul bowenian al conflictului maritaln modelul bowenian al conflictului marital, ca i n problemele individuale laaduli i copii, exist o influen a sistemului sinelui, sistemul familial extins(familia de

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origine) i sistemul nuclear al cuplului.I. Sistemul sineluiProblemele sinelui pot fi separate n: probleme de dezvoltare, factori depersonalitate, proieciile familiei de origine.1. Problemele de dezvoltare i pentru conflictul marital n particular,problemele de dezvoltare a adultului n conceptualizarea individual i

relaional aproblemelor. Termeni ca vrsta de 30 de ani, criza vrstei de mijloc,menopauzamasculin, sunt bine documentate i descrise de muli cercettori. Evident,schimbrilebrute de identitate, capacitate psihic, carier, poziie social sau soie nciclul vieiiplaseaz un stres sever asupra relaiilor i cer o schimbare neateptat dereguli, roluri iateptri n cursul oricrei csnicii.2

Grigore Ana-Nicoleta, 20112. Factorii de personalitate sunt, probabil, extins studiai de modelulpsihodinamic al terapiei maritale, care descriu paternurile relaionale ntermeniiinterblocarea nevrotic ca n binecunoscutul mariaj obsesiv-isteric.Terapeuii bowenienidescriu acelai tip de indivizi n termenii patternurilor relaionare interactiveca urmritoriorientai emoional sau distanai orientai spre obiect (distanareemoional).Urmritorul emoional este o persoan orientat spre comunicarea

sentimentelor, a crei tendin este de a-i asuma rspunderea pentrumeninerea relaiilor,are un ritm intern i interpersonal care funcioneaz cu dou viteze: vitezmaxim i stop.Un urmritor emoional tinde s fie mai degrab o pasre de noapte dect unmatinal i svalorizeze intruziunea sa n viaa personal a celorlali, precum i a altora nviaa sa. El

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este un tip entuziast, i plac provocrile i aventurile, i asum mai multeriscuri dect estenecesar i are un optimism incurabil. Erorile pe care le comite sunt dedomeniul faptelor,implicrii. Scuzele i faptele explicite vin rapid, n timp ce sfriturile i lurilede rmas bun

sunt foarte grele.Distanatul emoional pe de alt parte este o persoan orientat spre obiectcu o tendin extrem de slab spre a transmite gnduri i emoii personalealtora i a cruiritm este clar i previzibil. El este o persoan matinal, care prefer s nu ise adresezentrebri personale i care va rsplti acest favor adresnd extrem de rarntrebripersoanale. Din punct de vedere temperamental se apropie cu precauie desarcini noi iaventuri i are o doz sntoas de pesimism. Erorile pe care le face sunt de

domeniulomisiunilor. Scuzele apar de obicei greu, n timp ce s abandoneze o sarcine uor,sfriturile i separrile par s cauzeze mai puin suprare i durereemoional.Cel mai apropiat terapeut de terapia bowenian vine cu o teorienoninteracional teorie a personalitii prin scrierile existeniale despre sinen terapiasistemic ale lui Forgarty. El descrie zone sau arii de investiie n individ, caresunt: oamenii,obiectele, adncimea i timpul. Totui la o examinare mai atent,

dimensiunile Oameni,Obiecte i Timp reflect tendine interactive (ex. micarea printre obiecte) ncontextul uneirelaii (ndeprtarea de oameni), doar n dimensiunea Adncime Forgartydescrie ceea cepoate fi considerat eveniment intrapsihic.Forgarty se ocup de dimenisiunea adncimii cel mai elocvent n lucrarea sa

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Pe empatie i apropiere, aici ele descrie dificultile care emerg n relaiicare decurg dinlipsa de dorin a indivizilor sau incapacitatea de a simi termenii experieneisufleteti depustiire, goliciune, pe care Forgarty l vede ca pe un aspect al existeneiumane inevitabil.

Oamenii ns, dect s umple cu acest gol, ncearc s-l umple cu succes,recompensemateriale i n ultimul rnd prin relaii interpersonale. Cum golul este practicimposibil deumplut, cnd nu se ajunge la aceste ateptri nerealiste, distresul emoionalcare emerge esteadesea protejat de relaiile interpersonale, ca i cum satisfacia personal(mplinirea) unuiaeste responsabilitatea celuilalt i nefericirea unuia este vina celuilalt.3Grigore Ana-Nicoleta, 2011

Forgarty pune considerabil accentul pe responsabilitatea personal, proiecii,experiene existeniale, auto-contientizare n evaluarea i terapia cuplului.Acest proces estemai evident n al su ciclu expectaii-alienare, n care progresiv,expectaiile nerealiste cuprivire la so i cstorie, trec prin stadiile dezamgirii, rnirii, tristeii, furieii n finalalienare i izolare.3. Proieciile familiei de origine sunt determinantul major al coninutului(iintensitii) acestor expectane disfuncionale, determin de asemenea multe

dintre atitudini,orientri i concepii care afecteaz comportamentul individului n csnicie.Acest programeste gndit spre a avea loc n mecanismul multigeneraional al procesului deproieciefamilial.n procesul de proiecie familial, membrii familiei sunt investii cu anumite

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caracteristici: serios, iritabil, nerealist i obligaii emoionale: ai grija demama etc de ctrepredecesorii ale cror probleme de relaionare n familie sunt nerezolvate dincauza doliuluiincomplet, loialitii familiale, divoruri sau despriri. Astfel aceti indivizi iesdin familiile

lor de origine n lume i csnicie programai s repun n scen caracteristiciaparinndoamenilor, relaiilor i evenimentelor demult ngropate.De exemplu, un brbat crescut ntr-un triunghi parental tipic, aspru, cu untataextrem de distant i o mama supra-implicat, sufocant (care a renunat s-i mai ajungsoul) poate ajunge la relaii intime adulte cu o alergie emoional laapropiere, care l va faces experimenteze o invazie i o pierdere a independenei i de asemenea cuo atitudine

compensatorie extrem de distant, modelat de tatl su.Tatl distant Mamadistant supra-implicat (sufocant)

Fiuln mod analog, o femeie care a crescut ntr-un triunghi parental tipic, cu untata departe, idealizat i represiv, o mama extrem, care a concurat cu fiicaei pentru dozalimitat de afeciune pe care o aloca tatl, poate ajunge la maturitate cu odependenemoional de brbai distani, pe care l urmeaz, dar pe care niciodat nureuete s-l

ajung i cu o incapacitate de a relaiona cu femei.Tata distant Mama4Grigore Ana-Nicoleta, 2011distant, idealizat supra-implicat, critic

Fiican final, brbaii i femeile cresc ntr-un sistem familial cu frai i surori, iar

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aceast experien de frate est un alt determinant puternic ncomportamentul interpersonal aladultului. Toman a demonstart, de exemplu, c mariajele care suntcomplementare (un fratemai mic al unei surori cstorindu-se cu o sor mai mare a unui frate maimic) au o mai mare

probabilitate de rezisten n timp i de procreare dect mariajelenecomplementare.Aceste piese de afacere neterminat cu prinii, fraii i rudele maindeprtatesunt normale din punct de vedere statistic, dar mai puin dect optime. Cuct acesteprobleme sunt mai intense i cu ct sunt tratate prin distanare i nlturaredin sistemulmarital n care s-au dezvoltat, cu att mai mare este riscul ca acestea s fiereluate n relaiilemaritale i s predispun la suferin.

II. Sistemul familial extinsSeciunea precedent a descris cum creterea ntr-un anumit tip de familiepredispune indivizii, n condiii de stres la recrearea patternurilor relaionalepredictibile insufleirea acestora n moduri disfuncionale predictibile. Oricum, un modelal conflictuluimarital are nevoie s specifice cum aceste patternuri sunt declanate i cemenine evidentadisfuncionare i interaciunea dureroas care caracterizeaz acestepatternuri n conflictulmarital.

O viziunea psihodinamic asupra conflictului marital susine c sub presiunearealitii n convieuirea de zi cu zi, idealizarea figurilor reciproce ale soilorse erodeaz i seinstaureaz deziluzia cu un corespondent nerealist, proiectiv i negativ nsprecellalt so.O viziune structural strategic afirm c schimbrile din ciclul vieii uneifamilii (ex. naterea unui copil) fac interaciunile obinuite ale familieidisfuncionale sau

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regulile nvechite, iar soii se vor afla n conflict pn cnd vor elabora regulinoi, maiapropiate noului context.Viziunea sistemul familial bowenian este c nivelul neateptat de anxietate,modurile de a face fa anxietii i severitatea stersorilor receni reprezintevenimentele

5Grigore Ana-Nicoleta, 2011nodale (care intensific anxietatea ca emoie i proces) n sistemul familialextins din jurulmariajului sunt determinanii majori ai timpului, intensitii i persisteneiconflictuluimarital. De exemplu ntr-un sistem familial cu un grad mare de fuziune,despre care amdiscutat mai sus, nivelul anxietii este extrem de ridicat din cauz cstresorii i tulpinilevieii normale nu sunt tratate n mod eficient. n plus, n astfel de sisteme,

structuriledisfuncionale apar spre a face fa unor nivele neobinuit de ridicate deanxietate cronic.ntre aceste structuri reciproce se afl triangulrile (descrise mai sus),distanarea reactiv(emoional) i strangulrile, n care poriuni din procesul emoional neplcut(ex:dezamgire) sau probleme sufocante (ex: suferine nerezolvate) sunt evitatencetnd s maiconlucreze cu membrii importani ai sistemului familial care reprezintproblemele toxice.

Corespunztor, apropierea reactiv i situaia nclcit, n care anumiiindivizi suntmpiedicai de la o separare normal i o autonomie de funcionare, adeseacompenseaznevoile emoionale n alte relaii care sunt tratate prin distanare reactiv.Reciprocitateaacestor structuri este vizibil n observarea triangulrilor n familie, care suntadesea compuse

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din o strangulare i dou mreje individuale.n plus, pentru astfel de observaii clinice, cercetrile stresului i a boliloraratca interaciunile neateptate cu familia de origine joac un rol semnificativ nsetul psihic desimptome. De exemplu, ct de bine se neleg indivizii cu prinii lor este un

predictorimportant al bolilor legate de stres, iar depresia postpartum este mai comunfemeilor caresunt distanate fizic i emoional de familiile lor extinse sau care au avut undeces recent nfamiliile de origine.Rolul decesului membrilor familiei n depresia postpartum ilustreaz al doileafactor major din familia extins n conflictul marital, numit eveniment saustresor nodal.Evenimentele nodale pot fi recente (conflictul ngrijrii bunicii n vrst) saundeprtate

(disputa pe marginea motenirii bunicului de acum zece ani), instantanee(atacul de cord al6Grigore Ana-Nicoleta, 2011tatlui) sau de termen lung (boala Alzheimer a mamei), pozitive (natereaunui copil) saunegative (moartea unui frate), serioase (ameninarea unui rzboi nuclear)sau blnde (copilulncepe coala cu internat). Evenimentele nodale pot de asemenea s seproduc la nivelindividual (pierderea slujbei), relaional (divorul surorii), al grupului social

(libertateafemeilor), sau la nivelul ntregii societi (criza energetic).Astfel, evenimentele nodale sunt fie fenomene de familie (cstoria, divorul,naterea, moartea etc) producndu-se n sistem sau fenomene non-familiale(angajarea,fenomene sociale) care se strecoar spre membrii familiei din exterior. norice caz,

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evenimentele nodale pot influena suferina marital prin creterea niveluluianxietii nsistemul familial extins., astfel intensificnd paternurile disfuncionale alefamiliei(triangulri, strangulri, situaii nclcite), care crete stresul individual almembrilor familiei

(inclusiv soilor) i n mod simultan descrete irul opiunilor relaiei icoerena potrivitreelei familiale.Mai mult dect att, la un nivel mai mulumitor, natura evenimentelor nodalespecifice poate declana probleme maritale vulnerabile i toxice care nu suntadresate cuivaanume (ex: divorul surorii poate amenina stabilitatea altor mariaje dinsistemul familial).Pe scurt, nlimea frecvenei i severitatea evenimentelor nodale n sistemulfamilial extins i maturitatea emoional sczut (diferenierea i apropierea)a sistemului vor

va natere la anxietate ridicat si la o probabilitate mai mare de apariie asimptomelorindividuale n relaie, incluznd conflictul marital.III. Cuplul/ sistemul familial nuclearn final, surse ale conflictului marital apar din afara relaiei de cuplu i a altorprobleme ale familiei nucleare. Unii dintre aceti factori incluzndincompatibilitatea npoziia dintre frai, ateptri nerealiste i triangulri reciproce reactive(distana-urmrie, pestei sub-funcionare) sunt dificil de izolat decontextele interconectate alesinelui i ale familiei

extinse. Astfel de factori sunt reluai n relaia marital i predispun ladisfuncii n contextstresant.Desigur, chiar dac aceste moteniri complicate i limitri nu sunt prezente,multe compromisuri, negocieri, adaptri i nvturi noi care trebuie sapar ntre doupersoane pentru a putea tri mpreun i probabil s aib copii suntformidabile. Mc Goldrick

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nota:Cstoria cere ca un cuplu s renegocieze mpreun un numr vast deprobleme personale pe care mai nainte le-au definit pentru ei nii sau aufost definite dectre prini lor, incluznd deciziile zilnice, cum ar fi cnd i cum smnnce, doram,

7Grigore Ana-Nicoleta, 2011vorbeasc, fac sex, lupte, reduc tensiunea. Ei trebuie s decid n ceea ceprivetevacanele, amenajarea spaiului, timp i bani. Apoi sunt deciziile de familiedespre ce tradiiii ritualuri trebuie s rein din familia de origine a fiecruia i care suntpartenerii pe carei vor dezvolta pentru ei. Acestea i mii de alte decizii similare nu mai potfideterminateindividual. Ei trebuie s lucreze la compatibilitate pentru ca cei doi s se

potrivesc. Cuplus+ar putea gsi de asemenea n situaia de a renegocia relaiile lor cuprinii, fraii,prietenii i alte rude din perspectiva mariajului lor.Odat ce aceste greuti trec, timpul i noile stadii ale ciclului familial al vieiilovesc cuplul, numeroi parametri ai relaiei maritale pot trece prin stres.Guerin menioneazfuncionarea relaional de ntreinere care poate ceda la stres:comunicarea, schimbul deinformaii, auto-dezvluirea, credibilitatea, i timpul de activitate al relaiei.La modul

general, aceste funcii sunt manifestarea climatului emoional al cuplului,patternuruile demicare (urmrire-distanare, supra i sub- funcionare) i triangulrilecentrale.n general, cnd stresul atinge mariajul (din oricare dintre sistemele descrisemai sus), patternurile tranzacionale care ar putea fi adaptative sau cel puinbenigne, devin

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mai reactive i mai exacerbate, iar disfunciile pot aprea n unele arii alesistemului familial.n sistemul cuplului n care reaciprocitatea reactiv primar este pe axaorizontal deurmrire-distanare, progresia este n general de la urmrire activ ladistan spre distanare

reactiv a urmritorului i urmrire reactiv a distanatorului i a chinreciproc sfrit prindistana fix ntrerupt de ntmpltoare btlii furtunoase. n astfel decupluri , relaiileextramaritale i triangulrile cu copii sunt comune, conducnd la conflictmarital care nuduce nicieri i formeaz copilul simptomatic de mai trziu.Distan UrmrireReciprocitatea distan-urmrireDistan DistanDistanarea reactiv din partea urmritorului

Urmrire Respingere8Grigore Ana-Nicoleta, 2011Urmrire reactiv din partea distanatorului, respingere din parteaurmritoruluiTensiuneDistana fixMuncAventur etcApropiere DistanareDistanare

conflictualTriangulare maritalDistanaretcutDistan apropiereCopil simptomaticTriangularea copilului

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Cuplurile n care tranzacia reactiv primar s-a realizat pe axa vertical asupra i subfuncionriidezvolt adesea simptome la unul dintre soi sau tranzacii ritualizate n jurulabuzului de substane cnd stresul lovete sistemul.Subfunc distan suprafunc

IV. SCOP/OBIECTIVE TERAPIE

The main goal of Bowenian therapy is to reduce chronic anxiety by

1. facilitating awareness of how the emotional system functions; and

2. increasing levels of differentiation, where the focus is on making changes for the self rather

than on trying to change others.

Bowenienii nu incearca sa schimbee oamenii si nici nu sunt interesati de rezolvarea problemelor.

Terapia este o ovazie de a invata mai mult despre ei insisisi despre relatiile lor, in asa fel inact sa-

si poata asum aresponsabilitatea propriilor problem.

Terapeutul ajuta mb fam sa reninte la ideea de vinovatie sis a gasesca greseala pentru a seconfrunta si explora propriilor lor roluri din problema familiei.

Paternul inseamna atentie la process ( pattern de reactivitate emotionala) si la structura (reteaua

intreconectata a triunghiurilor).Procesul therapeutic: Bowen: depinde de abilitatea de a se raporta la familie, fara a se implica

emotional.

Terapeutul are 5 fct principale in tratament:

1. Sa defineasca sis a clrifice realtia dintre soti prin utilizarea genogramei.

2. Sa pastreze eu-l in afara triunghiului sistemului emotional al familiei.

3. Sa invete fct sistemului emotional utilizand pricipiile modelului.4. Sa demo dif prin conducerea eu-lui in cursul terapiei.

5. Sa resolve separarile.

Kerr si Bowen sugereaza utilizarea urmatoarelor intrebari in process:1. Cine a initiat terapia?

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2. Care este simptomul si care este pacientul identificat?

3. Care este familia nucleara al pacientului identficat?

4. Pattern-uti de fct emotionala in fam nucl?5. Ce infl: o incarcatura excesiva de evenimente sau un nivel redus de adaptabilitate?

6. Care este gradul de dif al sinelui din sistemele familiale?

7. Care sunt directiile pentru terapie?

Th face un triunghi nou, unul terapautic.Procesul detriangularii si dif care va schimab profund si permanent sist fam.

Creste capacitatea par de a-si gestiona prorpia anx si de aici vor devein capabili sa se ocupe de

cmpt.

Scopul th maritale este crestere autofocus, scaderea reactivitatii emorionale, modif pattern disf.

Terapia de cuplu se baz pe premiza ca tens in diada se va disipa daca ei raman in contact cu a o

treia persoana (intr-un tr stabil) daca caea persoana ramane neutral si obiectiva ma degraba decatangajata emotional.

Tr th poate rasturna proceul insidious al probl de ment a triangularii. Mai mult schimb in tr vaschimba inyregul system familial.

Terapia cu o persoana se baz pe premiza ca daca o pers din familie realiz un nivel inalt de dif

aceasta va permite celorlalti mb din families a faca acelasi lucru.

1.Imbunatatirea diferentierii eu-lui (Bowen, 1978)

2.Cu o diferentierea crescuta, mb individuali ai familiei sun tai capabili sa tolereze anxietatea sis

a-si acceseze functiile intelectuale.3.Reactivitateae emotionala crescuta si fct intellectual sporita sunt late scopuri atinse de terapia

lui Murray Bowen.

4. comunicarea deschisa in cadrul familiei.5. reducerea comnuicarii iresponsabile, subterana a secretelor si barfelor cu altii.

6. rezolvarea treburilor neterminate cu familia de origine.scop personal al terapeutului:

Anxietate redusa in campul emotional pentru imbunatirea nivelului fct al dif eului si

pentru reducerea simptomelor.

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Imbunatirea nivelului de baza al dif pentru a creste adaptabilitatea persoanei la campurile

emotionale intense. Iolanda Mitrofan

Conditii pentru schimbare cmpt

Crest capac de a distinge dif dintre gandire si simtirre

Mics anxietate si marind focusul pe sine.

Intelegerea si nu actiunea este vehicul schimbare.

Atmosfera siedintelor si pozitia th sunt ambele desemnate sa micsoreze emotionalitatea.

Cheia este neuttralitatea.

Terapia nu cere prezenta intregii familii ci doar a constiintei sale.

Parte a procesului de dif a sinelui este dezv rel pers cu orice mb al familiei. Puterea acesto rlegaturimde famlie poate parea misterioasa in s[ecila pentru cei care nu se gandesc ca bun a lor

stare ar fi dependent cu realatiile din familie.

Freud avea o notiune similara privind nivelul intrapsihic.

In modelul neurolologic al mintii, din Proiect pentru psihologie stiiitifica, Freud spune ca

mintea imatura are putine iesiri ( catehxis) pentru canalizarea energiei psihice si de aici arecapacitate sau flexibilitate scazuta pentru amanare raspuns.

Mintea matura , pe de alta parte, are multe canele de raspuns, care permit flexibilitate mai mare.

Notiunea lui Bowen de crest a retelei emotionale familiale este asemeni model lui Freud, f clara.

VII. Tehnici

Chiar 7 tehnici mai importante ale terapiei sistemice Bowen.

1. Genograma(Guerin, 1972) sau diagrama familiei (Bowen)

Organizare date, in timpul fazei de evaluare, scoate la lumen in timpul process th. Procesele relationale si

triunghiurile cheie.

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2. Triunghirile terapiei procesele relationale conflictuale ale familiei au tr actvate legate de smpt. Cheie in

incercarea de a restabili echil. Familia va incerca sa train th. Este nevoie cat h sa fie liber de reactivitatea

emot familia va icepe sa gas solutii la probl lor. La lucrul cu cupl se pun intre fiecarui sot pt atenuarea

emotiei si a creste obs ai gand obiectiva, a dif emotia de ratiune. Se va face effort pt a incetin suprafct in

diada Ir cel subfct sa se implice

3. Experimente relationale - alterare strc din tr cheie : sa ajute mb fam sa constde procesele sist sis a invete sa

rec propr rol in ele. Fograty, experim pe urmarit urmariti emotionali. Clientii nu se vindeca miraculousemotional c vad ce e cu ei insisi si in rel.

4. Antrenarea: este o latrenativa boweniana penrtu roul de implicare in mai personal si mai emotional comun

celor mai multe forme de terapie.pui intrebari de process pentru a ajuta oamenii sa vada procesel emotionale

ale fam si rol lor.scop: crest intelegerii, crest autoconcentr si legatur mai fct intre mb cheie ai fam.

5. Pozitia eu- pozitie personala, spui ce simti in loc ce fac altii, una dintre cele mai directe cai de a rupe

cercurile de reactivitate emotionala.

6. Terapia de famlie multipla James Framo

7. Povesti de inlocuire - tehnica lui Guerin, care arata filame, casete video si spune povesti penrtru a invata

mb fct sist intr-un mod care minimizeaza defensvitatea acestora.

MODELUL IN PRACTICA CLINICA

Tehnica

Nu este focalizata pe un model ce are descireri specific depsre cum sa structurezi sesiunea

th.

Scopul este cat h sa asistemb fam sa obtina niveluri mai mari de dif, niveluri cu mai putina

vinovatie, reactvitate scazuta, si crestere a responsabilitatii pentru sine in sistemultemotional.

Un aspect important este propriul lucru cu sine al terapeutului cu familia de origine, , roul

central al th in a directiona conversatia, siminima lui focalizare pe copii in procesul th.

Bowen vede trei stadia ale th:

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1. Reducerea anxietatii clientilor despre symptom incurajand-I sa afle cum smpt este

parte dn pattern-ul lor de relatie.

2. Focalizarea asupra clientilor ca problema de self , pentru a creste gradul de dif.

Clientii sunt ajutati sa reziste atractiei fortei impreuna din familie.

3. Clientii adulti de acum, dupa cele doua faze, sunt antrenat sa se dif fata de fam de

origine, asumarea dif care scade automat anx sdi marierea responsabil in familia

nucleara.

Clinical Practice : The Role of the Therapist

The role of the therapist is to connect with a family without becoming emotionally reactive. Emphasis

is given to the therapist maintaining a 'differentiated' stance. This means that the therapist is not

drawn into an over responsible / under responsible reciprocity in attempts to be helpful. A therapist

position of calm and interested investigation is important, so that the family begins to learn about

itself as an emotional system. Bowen instructs therapists to move out of a healing or helping position,

where families passively wait for a cure, 'to getting the family into position to accept responsibility for

its own change' (Bowen, 1971 in Bowen, 1978: 246).

Bowen warns of the problems of therapists losing sight of their part in the system of interactions,

where they may be inducted into a mediating role in a triangle with the family. Hence there is a high

priority given to understanding and making changes within the therapist's own family of origin. In

training, the emphasis is on the trainees' level of differentiation, and not on therapeutic technique.

The therapist's resolution of family of origin issues is reflected in the:

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...ability to be in emotional contact with a difficult, emotionally charged problem and not feel

compelled to preach about what others should do, not rush in to fix the problem and not pretend to

be detached by emotionally insulating oneself (Kerr and Bowen, 1988: 108).

Clinical Practice : Therapist Activity

The therapist is active in directing the therapeutic conversation. Enactments are halted so as to

prevent the escalation of clients' anxiety. Clients are asked to talk directly to the therapist so that

other family members can "listen and 'really hear' without reacting emotionally, for the first time in

their lives together" (Bowen, 1971 in Bowen, 1978: 248). Bowen himself would avoid couple

interaction in the room and concentrate on interviewing one spouse in the presence of the other.

Bowen clearly avoided asking for emotional responses, which he saw as less likely to lead to

differentiation of self, preferring mostly to ask for 'thoughts', 'reactions' and 'impressions' (Bowen,

1971, in Bowen, 1978: 226). He called this activity 'externalizing the thinking of each client in the

presence of the other' (Bowen, 1975 in Bowen, 1978: 314).

Clinical Practice : Children in Bowen's Therapy

A surprising feature of Bowen's family therapy is his tendency to minimise the involvement of

children. While Bowen might include children in the beginning stage of therapy, he would soon

dismiss them, focusing on the adults as the most influential members of a family system (Bowen,

1975 in Bowen, 1978: 298). Excluding a child from therapy responsibility is viewed as a detriangling

manoeuvre. When parents cannot use the child as a 'triangle person' for issues between them, and

the therapist resists taking the replacement role in the triangle, parents can begin differentiating their

respective selves from one other.

Clinical Practice : Family Evaluation

The beginning sessions in Bowenian therapy focus on information gathering in order to form ideas

about the family's emotional processes, which concurrently provides information to family members

about the presenting problem in its systemic context. The presenting problem is tracked through the

history of the nuclear family and into the extended family system. A multigenerational genogram is a

useful tool for recording this information (McGoldrick and Gerson, 1985; Kerr and Bowen, 1988: 306-

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313). The therapist looks for clues about the emotional process of the particular family, including:

patterns of regulating closeness and distance, how anxiety is dealt with in the system, what triangles

get activated, the degree of adaptivity to changes and stressful events, and any signs of emotional

'cutoff'. Information collected is acknowledged to be extremely subjective, especially when extended

family are discussed; but stories about past generations are viewed as useful clues to the roles

people occupy in triangles and the tensions that remain unresolved from their families of origin. If forexample, a member of the extended family is described as 'the rebel', the therapist explores what

events gave rise to this label, who else has occupied this role across the generations and how

triangles formed around family crises involving 'rebellion'. Calming family members' anxiety in the

early stages of therapy might involve helping them to make connections between the development of

symptoms and potent themes in a family's history. Another aim will be to loosen the central triangle

that has formed around, and maintains, the presenting problem. Teaching clients about systems

concepts as they operate in their own family is part of therapy at this stage. This does not mean

attempting to convince people to do things differently but to encourage family members to see

beyond their biases so that it is possible for them to consider each person's part in the family

patterns.

Clinical Practice : Questions that Encourage Differentiation

The therapist asks questions that assume that the adult client can be responsible for his / her

reactiveness to the other. An example would be, "How do you understand the way you seem to take

your child's acting out so personally?" In response to such questions, family members are

encouraged to take an 'I' position where they speak about how they view the problem, without

attacking, or defending against, another family member (Bowen, 1971a in Bowen, 1978: 252;

Goodnow and Lim, 1997). Clients are taught to make personal statements about their thoughts and

feelings in order to facilitate a greater sense of responsibility in a relationship. For example, an

accusatory statement such as, 'You are so selfish to cause this much worry for your parents!', is

shifted to, 'I am really concerned that this might affect your school grades'. The parent is encouraged

to 'own' their worries, rather than to project their anxieties through blaming statements. Developing

such a 'self-focus' is said to be crucial in lowering anxiety and enabling 'person to person'

relationships where each family member can think about the part they play in problematic

interactions.

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Clinical Practice : Creating a Multigenerational Lens

Bowen's multigenerational model goes beyond the view that the past influences the present, to the

view that patterns of relating in the past continue in the present family system (Herz Brown, 1991).

Hence the therapist uses questions to encourage clients to think about the connection between their

present problem and the ways previous generations have dealt with similar relationship issues. Forexample, if the onset of a symptom followed a death in the family, the therapist asks about how grief

has been dealt with in previous generations. Questions seek to uncover family belief systems as well

as the way relationships have shifted in response to loss. Tracking symptoms and exploring related

themes over at least three generations makes it more difficult for individuals to blame one another for

individual deficiencies. As therapist and family members see how patterns repeat over generations, it

is possible to identify the 'automatic' reactions of family members towards each other:

The ability to act on the basis of more awareness of relationship process (not blaming self or others,

but seeing the part each plays) can, if done repeatedly in important relationships, lead to some

reduction in emotional reactivity and chronic anxiety (Kerr and Bowen, 1988: 132).

Clinical Practice : Detriangling

This is probably the central technique in Bowenian therapy. The client is first helped to recognise

both the subtle and the more obvious ways that they are 'triangled' by others, and the ways in which

they attempt to triangle others in their turn. The therapist uses questions to facilitate the family

members' awareness of their roles in family triangles. Simple open ended tracking questions, using

what Herz Brown (1991) terms the four 'Ws' (who, what, when and where) help clients to become

'detectives' in their own interpersonal systems. It is often very difficult for family members to identify

the triangles they participate in, and the sometimes covert ways in which they detour anxiety. Anexample would be a client who was struggling to understand her negativity towards her father. When

questioning included her mother's role in these emotions, the client began to see that her view of her

father was influenced by her position in a triangle. As her mother's ally in this triangle, she viewed her

father as the inadequate husband who left her mother feeling needy.

Once triangles have been identified, family members are helped to plan ways of communicating a

neutral position to others, leaving the dyad to communicate directly with each other. The goal is for a

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family member to find a less reactive position in the face of the other's anxiety. This will require

different stances in different systems, ranging from refusing to discuss the deficiencies of another

behind his/her back, to reversing one's usual reaction in a triangle. For example, when the

predictable pattern in the family system is to keep distance between those who haven't been able to

work out their problems, the therapist helps a family member to plan strategies that shift their usual

role in maintaining the avoidance. The family member might encourage more involvement betweenthe conflictual twosome, or change the subject when invited to discuss the conflict. Reversal is a key

detriangling technique. When for example a family member A complains about how uncaring another

person is, person C reverses the predictable sympathetic response, substituting a casual comment

about how considerate person B seems for not putting demands on A's time and energy. Unlike a

strategic intervention, the goal of any detriangling stance is not to change the other's relationship but

to express one's neutrality about it. A calm and thoughtful neutral stance prevents one from anxiously

reacting to the tension of another relationship by 'taking sides'.

Clinical Practice : Coaching: Family Therapy with an

Individual

Another distinguishing feature of Bowen's model is its validity in working with a single adult. The term

'coaching' describes the work of the therapist giving input and support for adult clients who are

attempting to develop greater differentiation in their families of origin. Clients should feel in charge of

their own change efforts, with the therapist acting as a consultant. Bowen thought that a person's

efforts to be more differentiated would be more productive when the focus shifted away from the

intensity of the nuclear family to the previous generation. The emphasis is on self-directed efforts to

detriangle from family of origin patterns. An individual's efforts can modify a triangle, which in turn

ripples through to change in the whole extended family.

Bowen described 'coaching' as 'family psychotherapy with one family member' (Bowen, 1971 in

Bowen, 1978: 233). This therapy takes on the flavour of teaching, as clients learn about the

predicable patterns of triangles. The therapist supports their efforts in returning to their families to

observe and learn about these patterns. Clients practise controlling their emotional reactivity in their

family and report their struggles and progress in following sessions. During family of origin coaching,

clients use letters, telephone calls, visits and research about previous generations to gain a systemic

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perspective on their family's emotional processes and a sense of their own inheritance of these

patterns. The therapist prepares clients for the anxiety they will encounter if they shift from their

customary roles in their families of origin. Any such changes will inevitably disturb the predictable

balance of family patterns and therefore heighten anxiety and resistance.

Change is viewed as a three step process where:

a. one takes a new position,

b. family members react and

c. the new stance is maintained in the face of pressure to revert to the original position (Herz

Brown, 1991).

Bowen (1978) emphasised that it is what happens in step 'c' that really determines whether change

occurs.

Current Developments

Bowen's model has been adopted and developed by many prominent therapists. Rather than attempt

to summarise all of these developments, I shall focus on the applications of the model by Betty

Carter and Monica McGoldrick which have influenced the practice of the Family Institute of

Westchester in New York and the Family Institute of New Jersey.

Since the early 1980s, the work of Carter, McGoldrick and their colleagues has expanded Bowen's

framework to include attention to the family life cycle (Carter and McGoldrick, 1980, 1988.) As well as

the 'vertical' flow of anxiety through the generations, Carter included an assessment of 'horizontal'stress as families move through various stages of the life cycle. Vertical and horizontal patterns

converge, as multigenerational tensions impact on the ways that life cycle tasks and disruptions are

negotiated. The stress of life cycle changes affects the choice of family of origin issues focused upon

in the current generation. Using a life cycle perspective, symptom development is viewed in the

context of an unresolved adjustment to a life cycle task.

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Acknowledging the significance of gender, race, ethnicity and class on a family's progression through

life cycle stages was an important development in family assessment (eg. McGoldrick, Pearce and

Giordano, 1982; Carter et al., 1988; McGoldrick, Anderson and Walsh, 1988; Herz Brown, 1991).

This much broader focus provides what Carter has called a 'multi-contextual lens'.

These variables are part of the context of the family's 'horizontal' story and underlie the potentthemes of a family's multigenerational legacy. Patterns of gender across the generations are viewed

as powerfully contributing to the roles that people occupy in the family emotional system. The

inclusion of gender sensitivity in a Bowenian framework means that the therapist helps clients to look

not only at patterns of relating over the g

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