Theory in The Practice

CHAPTER 3
Theory in the Practice of

Psychotherapy
Murray Bowen, M.D.
There are striking discrepancies between theory and practice in psychother-

apy. The therapist's theoretical assumptions about the nature and origin of
emotional illness serve as a blueprint that guides his thinking and actions
during psychotherapy. This has always been so, even though "theory" and "
therapeutic method" have not always been clearly defined. Primitive medi-
cine men who believed that emotional illness was the result of evil spirits
had some kind of theoretical notions about the evil spirits that guided their
therapeutic method as they attempted to free the person of the spirits. I
believe that theory is important now even though it might be difficult to
define the specific connections between theory and practice.
I have spent almost three decades on clinical research in psychotherapy.

A major part of my effort has gone toward clarifying theory and also toward
developing therapeutic approaches consistent with the theory. I did this in
the belief it would add to knowledge and provide better structure for
research. A secondary gain has been an improvement in the predictability
and outcome of therapy as the therapeutic method has come into closer
proximity with the theory. Here I shall first present ideas about the lack of
clarity between theory and practice in all kinds of psychotherapy; in the
second section I will deal specifically with family therapy. In discussing my
own Family Systems theory, certain parts will be presented almost as previ-
ously published (1,2). Other parts will be modified slightly, and some new
concepts will be added.
42
Bowen 43
BACKGROUND TO THEORY IN PSYCHOTHERAPY
Twentieth-century psychotherapy probably has its origin in Freud, who

developed a completely new theory about the nature and origin of emotional
illness. Before him, mental illness was generally considered the result of
some unidentified brain pathology, based on the structured model used by
medicine to conceptualize all disease. Freud introduced the new dimension
of functional illness which dealt with the function of the mind, rather than
brain pathology. His theory was derived largely from patients as they
remembered details of early life experiences and as they communicated this
detail in the context of an intense emotional relationship with the analyst.
In the course of the analysis it was discovered that the patients improved,
and that the patient's relationship with the analyst went through definite,
predictable stages toward a better life adjustment. Freud and the early
analysts made two monumental contributions. One was a new theory about
the origin and nature of emotional illness. The other was the first clearly
defined theory about the transference relationship and the therapeutic value
of a talking relationship. Although counseling and "talking about prob-
lems" may have existed before, it was psychoanalysis that gave conceptual
structure to the "therapeutic relationship," and that gave birth to the
profession of psychotherapy.
Few events in history have influenced man's thinking more than psycho-
analysis. This new knowledge about human behavior was gradually incor-
porated into psychiatry, psychology, sociology, anthropology, and the other
professional disciplines that deal with human behavior, and into poetry,
novels, plays, and other artistic works. Psychoanalytic concepts came to be
regarded as basic truths. Along with the acceptance there were some long
term complications in the integration of psychoanalysis with other knowl-
edge. Freud had been trained as a neurologist. He was clear that he was
operating with theoretical assumptions, and that his concepts had no logical
connection with medicine or the accepted sciences. His concept of "psycho"
pathology, patterned after medicine, left us with a conceptual dilemma not
yet resolved. He searched for a conceptual connection with medicine, but
never found it. Meanwhile, he used inconsistent models to conceptualize his
other findings. His broad knowledge of literature and the arts served as
other models. A striking example was the oedipal conflict, which came from
literature. His models accurately portrayed his clinical observations and
represented a microcosm of human nature; nonetheless, his theoretical
concepts came from discrepant sources. This made it difficult for his succes-
sors to think in concepts synonymous with medicine or the accepted
sciences. In essence, he conceptualized a revolutionary new body of knowl-
edge about human functioning that came to exist in its own compartment,
without logical connection with medicine or any of the accepted sciences.
44 Theory in the Practice of Psychotherapy
The knowledge was popularized by the social sciences and the artistic
world, but few of the concepts found their way into the more basic sciences.
This further separated psychoanalysis from the sciences.
There have been some clear evolutionary developments in psycho-
analytic theory and practice during the twentieth century. Successors to
Freud have been more disciples than scientists. They lost contact with the
fact that his theory is based on theoretical assumption, and they have tended
to regard it as established fact. The more it is considered to be fact, the less
it has been possible to question the theoretical base on which it rests. Very
early the disciples began to disagree with certain details of the theory (
predictable in human relationship systems), and to develop different "theo-
ries," concepts, and "schools of thought" based on the differences. They
have made such an issue over "differences" that they have lost sight of the
fact that they all follow Freud's broad assumptions. The different branches
of the tree spend their lives debating the proclaimed "differences," unaware
that all spring from the same basic roots. As time passes and the number
of branches increase, so do the differences.
The number of differences about the therapeutic relationship are even

greater. Freud defined a basic theory about the therapeutic relationship.
Beyond that, each practitioner is on his own in developing methods and
techniques for applying the theory. There is more flexibility for developing "
differences" about therapeutic method and techniques than about theory.
Psychoanalysts maintain a strict interpretation of the "transference," which
is considered to be different from the popular notion of the therapeutic
relationship. There are differences, but the focus on differences obscures the
common denominators. Group therapy is a good illustration of the trend.
It sprang primarily from theory about the therapeutic relationship, and
secondarily from basic psychoanalytic theory about the nature of emotional
illness. The growing multitudes of mental health professionals who use all
the different theories and therapies still follow two of the basic concepts of
psychoanalysis. One is that emotional illness is developed in relationship
with others. The second is that the therapeutic relationship is the universal "
treatment" for emotional illness.
There are other evolutionary trends that illustrate the separation of

theory and practice. It has to do with psychological research. The basic
sciences have long been critical of psychoanalysis and psychological theory
as nonscientific and based on shifting hypotheses that defy critical scientific
study. There is validity to this criticism. The psychoanalysts and psycholo-
gists have countered that the field is different, and the same rules do not
apply. They have coined the term social "sciences," and much research has
gone into proving that they are scientific. There is some support for the
proposition that social sciences are scientific. The major change has been
in the development of the scientific method designed to study random and
Bowen 45
discrepant data in a scientific way. If the scientific method is pursued long
enough, it should eventually produce the data and facts that are acceptable
to the basic sciences. This has not occurred. The debate has gone through
the century with the psychologists accepting psychoanalytic assumptions as
fact and believing that the scientific method makes the field into a science,
while workers in the basic sciences are still unconvinced. This is where
research in the mental health field is today. The directors of research and
experts who control the funds for research are schooled in the scientific
method, which tends to perpetuate fixed postures. My own position on this
is that, "There is no way to chi square a feeling and make it qualify as a
scientific fact." This is based on the belief that human behavior is a part of
all nature, so that it is as knowable and predictable and reproducible as
other phenomena in nature; but I believe that research should be directed
at making theoretical contact with other fields, rather than applying the
scientific method to subjective human data. This has been a long-term
conflict I have had with research in mental illness. To summarize, I believe
that research in emotional illness has helped to contribute to the separation
of theory and practice, and to the notion that psychological theory is based
on proven fact.
There are trends in the training of mental health professionals that

support the separation of theory and practice. Early in the twentieth cen-
tury the popularity of psychoanalysis was increasing, but overall, psy-
chiatry, and also the public, was still negative about it. By the 1940s and
1950s, psychoanalytic theory had become the predominant theory. By that
time the psychoanalysts had developed so many superficial "differences"
among themselves that the new trainees of the 1940s and 1950s were con-
fronted with a spectrum of different "theories" all based on basic psycho-
analytic concepts. They learned psychoanalytic theory as proven fact and
the therapeutic relationship as the treatment for emotional illness. The
trainees from that period are now the senior teachers in the field. The
number of superficial "differences" have increased. Starting in the 1950s
and increasing into the 1960s, we have heard much antipsychoanalytic talk
by people who use basic psychoanalytic concepts in theory and practice. In
the present era we have the "eclectic," who tells us that there is no single
theory adequate for all situations and he chooses the best parts of all the
theories to best fit the clinical situation of the moment.
I believe that all the differences belong within the basic framework of
psychoanalysis, and that the eclectic shifting may be more for the needs of
therapist than the patient. The average training programs for mental health
professionals contain a few didactic lectures on theory appended to the basic
training An overwhelming amount of time goes to tutorial training, which
emphasizes the therapeutic relationship, learning about one's own emo-
tional problems, and the management of self in relation to the patient. This
produces professionals who are oriented around the therapeutic relation-

ship, who assume they know the nature and origin of emotional illness, who
are unable to question the theoretical base on which the field rests, and who
assume the therapeutic relationship is the basic treatment for emotional
problems. Society, insurance companies, and the licensing bodies have come
to accept this theoretical and therapeutic position, and have become more
lenient about providing payment for psychotherapeutic services. Counse-
lors, teachers, police, courts, and all the social agencies that deal with
human problems have also come to accept the basic assumptions about
theory and therapy.
Mental health professionals relate to theory in a spectrum. At one
extreme are the few who are serious students of theory. A larger group can
state theoretical positions in detail, but they have developed therapeutic
approaches discrepant with the theory. A still larger group treats theory as
proven fact. These last are similar to the medicine men who knew that
illness was caused by evil spirits. Professional expertise becomes a matter
of finding more ingenious techniques for externalizing the bad spirits. At
the other extreme are the therapists who contend there is no such thing as
theory, that theoretical efforts are post hoc explanations for the therapist's
intuitive actions in the therapeutic relationship, and that the best therapy
is possible when the therapist learns to be a "real self ' in relation to the
patient.
In presenting these ideas about the separation of theory and therapy in

the mental health professions, I have inevitably overstated to clarify the
issues. I believe that psychoanalytic theory, which includes the theory of the
transference and talking therapy, is still the one major theory to explain the
nature and origin of emotional illness, and that the numerous different
theories are based more on minor differences than on differences with basic
concepts. I believe Freud's use of discrepant theoretical models helped
make psychoanalysis into a compartmentalized body of knowledge that
prevented successors from finding conceptual bridges with the more ac-
cepted sciences. Psychoanalysis attracted followers who were more disciples
than scholars and scientists. It has evolved into more of a dogma or religion
than a science, with its own "scientific" method to help perpetuate the
cycle. I believe it has enough new knowledge to be part of the sciences, but
the professionals who practice psychoanalysis have evolved into an emotional
ingroup, like a family or a religion. Members of an emotional ingroup
devote energy to defining their "differences" with each other and defending
dogma that needs no defense. They are so caught up with the ingroup
process that they cannot generate new knowledge from within, nor permit
the admission of knowledge from without that might threaten the dogma.
The result has been a splintering and resplintering, with a new generation
of eclectics who attempt to survive the splintering with their eclecticism.
Bowen 47
THE THERAPEUTIC RELATIONSHIP IN BROADER PERSPECTIVE
Family research has identified some characteristics of emotional systems

that put the therapeutic relationship into broader perspective. An emotional
system is usually the family, but it can be a larger work group or a social
group. The major characteristic to be examined here is that the successful
introduction of a significant other person into an anxious or disturbed rela-
tionship system has the capacity to modify relationships within the system.
There is another characteristic of opposite emotional forces, which is that
the higher the level of tension or anxiety within an emotional system, the
more the members of the system tend to withdraw from outside relation-
ships and to compartmentalize themselves with each other. There are a
number of variables that revolve around the characteristic in focus. The first
variables have to do with the significant other. Other variables have to do
with what is meant by successful introduction. Other variables have to do
with the introduction of the significant other and how long he remains a
member of the system. Still other variables have to do with what it means
to modify a system. I have chosen the term modify in order to avoid the
use of change, which has come to have so many different meanings in
psychotherapy.
An individually oriented psychotherapist is a common significant other.

If he can manage a viable and moderately intense therapeutic relationship
with the patient, and the patient remains in viable contact with the
family, it can calm and modify relationships within the family. It is as
though the therapeutic relationship drains the tension from the family and
the family can appear to be different. When the therapist and patient
become more intensely involved with each other, the patient withdraws
from emotional contact with the family and the family becomes more
disturbed. Therapists have intuitive ways of dealing with this situation.
Some choose to intensify the relationship into a therapeutic alliance, and to
encourage the patient to challenge the family. Others are content with a
supportive relationship. There are a number of other outside relationships
that can accomplish the same thing. A significant new relationship with a
friend, minister, or teacher can be effective if the right conditions are met. The
right degree of an outside sexual relationship can calm a family as much as
individual psychotherapy. When the affair is kept at the right emotional
level, the family system can be calm and blind to evidences of the affair.
The moment the outside affair becomes emotionally overinvested, it tends to
alienate the involved person from the family and increase tension within
the family. At this point the other spouse becomes a suspicious detective,
alert to all the evidence previously ignored. This phenomenon, which has
to do with the balance of relationships in a family, applies to a broad
spectrum of relationships.
A set of variables revolve around the qualities that go into a significant

other relationship. One variable deals with the importance of the family
member to the rest of the family. The family would respond quickly to the
outside emotional involvement of an important family member who is
relating actively to the others. It would respond slowly to a withdrawn and
inactive family member unless the outside relationship was fairly intense.
The most important variable has to do with the assumed, assigned, or actual
importance of the significant other person. At one extreme is the significant
other who assumes or is assigned magical or supernatural importance. This
includes voodoo experts, leaders of cults, great healers, and charismatic
leaders of spiritual movements. The significant other can pretend to repre-
sent the diety and to have supernatural power. He pleads for the other to "
believe in me, trust me, have confidence in me." The assuming of great
importance and the assigning of importance is usually a bilateral operation,
but there probably could be situations in which the importance is largely
assigned, and significant other goes along with it. These relationships oper-
ate on high emotionality and minimal reality. When successful, the change
can come rapidly or with instantaneous conversion.
At the other extreme are the situations in which the evaluation of the
significant other is based largely on reality, with little pretense, and with
little of the intense relationship phenomenon. The principal ingredient is
knowledge or skill. Examples of this might be a genetic counselor, an estate
planner, or a successful professor who has the ability to inspire students in
his subject, more through knowledge than relationship. In between these
two extremes are relationships with healers, ministers, counselors, physi-
cians, therapists of all kinds, and people in the helping professions who
either assume or are assigned an importance they do not have. The assum-
ing and assigning of importance is clearest in its extreme forms in which
the pretending of importance is sufficiently grotesque for anyone to notice.
Actually, the assigning and assuming of importance, or unimportance, is
present to some degree in all relationships, and present enough to be detect-
able in most relationships on careful observation. A clear example is a love
relationship in which each has an overvalued image of the other. It is also
easy to recognize the change in a person who is in love. Overall, the degree
of assigning and assuming overimportance in the therapeutic relationship
is on the high side. Psychoanalysis has subtle techniques to encourage the
development of a transference, which is then dealt with in the therapy.
Other methods do even more of this, and efforts to correct the distortion
are even less.
Another set of variables revolve around the way the significant other is
introduced into the system. At one extreme, the significant other pleads,
exhorts, advertises, evangelizes, and makes promises of the great things if
he is invited in. At the other extreme, the significant other enters the system
only on unsolicited invitation and with a contract either verbal or written
Bowen 49
that comes closer to defining the reality of the situation. The rest fall
somewhere between these two extremes. Other variables have to do with the
length of time the significant other is involved in the system. The successful
involvement depends on whether or not the relationship works. This in-
volves the family member devoting a reasonable amount of thinking-feeling
energy to the relationship without becoming too emotionally preoccupied.
An important set of variables revolves around what it means to modify
relationships within the family. I avoid using change here because of the
loose way this word is used within the profession. Some speak of an emo-
tional conversion, a shift in mood, a shift in attitude, or a shift from feeling
sad to happy as being "change" or emotional "growth." The word growth
has been so misused during the past decade, that it has become meaningless.
In contrast, other people do not consider change to have taken place with-
out basic, documentable, structural alteration in the underlying situation
that gave rise to the symptoms. Between these two lie all the other manifes-
tations of change. It is common for mental health professionals to consider
the disappearance of symptoms as evidence of change.
The more the relationship with the significant other person is endowed
with high emotionality, messianic qualities, exaggerated promises, and
evangelism, the more the change can be sudden and magical, and the less
likely it is to be long term. The lower the emotionality and the more the
relationship deals in reality, the more likely the change is to come slowly
and to be solid and long lasting. There is some degree of emotionality in
any relationship, especially in the helping professions where the principal
ingredient is services rather than materials, but it is also present around
those who deal in materials, such as supersalesmen. The emotionality can
exist around the charismatic person who attracts the assignment of impor-
tance from others. Emotionality may be hard to evaluate with public figures
who attain their positions from superior skill and knowledge, in which
emotionality is low, and who then operate on reputation, in which assigned
importance is high. The doctor-patient relationship encompasses a wide
range of emotionality. At one extreme it can be almost all service and little
relationship, and at the other extreme the emotional component is high. The
physician who operates with a posture which says, "Have no fear, the
doctor is here," is assuming great importance, and also using it to calm
anxiety. The physician who says, "If doctors could only be half as important
as their patients think they are," is operating with awareness and less
assumption of importance. Emotionality is sufficiently high in medicine that
the placebo effect is routinely built into responsible research to check the
emotional factor.
Psychotherapy is a service that deals in a higher level of emotionality

than the average doctor-patient relationship. The level of assumed and
assigned importance is on the high side. The well-trained therapist has
techniques to encourage the patient to assign him an overimportance which

he interprets to the patient as part of the therapy. He is aware of transfer-
ence "cures," and of the unhealthy aspects of countertransference when he
becomes emotionally overinvolved with the patient. He may have operating
rules to govern the right kind of therapeutic relationship: trying to match
the patient with the therapist's personality, avoiding working with a patient
he does not "like," or recommending a male or female therapist for particu-
lar kinds of problems. The psychotherapist does not get into emotionality
that is in the spiritual range, but he deals constantly in a high level of
emotionality. The well-trained therapist does well with these emotional
forces, but the rapidly enlarging field of psychotherapy includes many who
do not have this expertise. The training of therapists may involve the
selection of trainees who have the right personality for a good "therapeutic
relationship." The level of emotionality in the field makes it difficult to
evaluate the results of psychotherapy.
I go into this much detail about the therapeutic relationship because

concepts about the therapeutic relationship and the notion that psychother-
apy is the treatment for emotional illness are basic teachings in the training
of mental health professionals. The orientation is probably greater for non-
medical people who do not have to learn the medical part of psychiatry.
Mental health professionals are so indoctrinated in these basic concepts
they have difficulty hearing another way of thinking. That is why my own
theory is incomprehensible to those who cannot think through their early
basic teaching and practice. Early in my professional career I was a serious
student of the therapeutic relationship. In the psychotherapy of schizophre-
nia much effort went into eliminating the assumed and assigned importance
from the therapeutic relationship. The more I was successful at this, the
more I could get good results after others had failed. It was usual for others
to consider these good results as related to some undefined personality
characteristic in me, or to coincidence. A good result could be followed by
a comment such as, "Some schizophrenics come out of their regression
automatically." Successfully managing the transference in schizophrenia
made it easy to automatically manage the milder transference in the neu-
roses. The change to family research provided a new dimension for dealing
with the therapeutic relationship. It became theoretically possible to leave
the intensity of the relationship between the original family members, and
bypass some of the time-consuming detail. I began to work toward avoiding
the transference. When I started to talk about "staying out of the transfer-
ence," the usual response was, "You don't mean you stay out of the trans-
ference; you mean you handle it well." That is, my statement was countered
by another even more dogmatic, and pursuit of the issue only resulted in
polarized emotional debate.
The prevailing opinion of therapists who operate with the therapeutic

Bowen 57
relationship is that I handle the transference well. However, a therapist with
knowledge of the facts inherent in systems theory, and especially a knowl-
edge of triangles (discussed below) can deal largely in reality and facts and
eliminate much of the emotional process that usually goes into a transfer-
ence. Indeed, it is possible to routinely reproduce an operational version of
the same expertise in a good percentage of professional trainees. This is in
contrast to usual training methods in which the result of training depends
more on the intuitive and intangible qualities in the trainee than on knowl-
edge. One never reaches the point of not being vulnerable to automatically
falling back into the emotionality of transference. I still use mechanisms to
reduce the assumed and assigned overimportance that can get into any
relationship. When one acquires a reputation in any field, one also acquires
an aura of assigned overimportance that goes beyond reality. Among the
ways I have dealt with this is by charging average fees, which helps avoid
the emotional pitfalls inherent in charging high fees. The therapeutic effort
is so different from conventional therapy that I have developed other terms
to refer to the therapy process; for instance I speak of "supervising" the
effort the family makes on its own behalf, and "coaching" a family member
in working with his own family. It is accurate to say there is some emotion-
ality in any relationship, but it is also accurate to say that the emotionality
can be reduced to a low level through knowledge about emotional systems.
THE THERAPEUTIC RELATIONSHIP IN FAMILY THERAPY
The separation between theory and therapy in most family therapy is

far greater than with individual therapy. The vast majority of family thera-
pists started from a previous orientation in individual or group therapy.
Their family therapy descends almost directly from group therapy, which
came out of psychoanalytic theory with an emphasis on the theory of the
transference. Group therapy led to far more differences in method and
technique than individual therapy, and family therapy lends itself to more
differences than group therapy. I have referred to this as the "unstructured
state of chaos" in family therapy.
Family therapists deal with the therapeutic relationship in a variety of

ways. Some great family therapists, who were adept at dealing with transfer-
ence in individual or group therapy, continue their adeptness in family
therapy. They use psychoanalytic theory for thinking about problems in the
individual, and transference theory for thinking about relationships. There
are those who speak of "getting into and getting out of ' intense relation-
ships with individual family members. They are confident in their skill and
ability to operate freely within the family. They operate more on intuition
than any special body of knowledge. Their therapy is difficult for trainees
to imitate and reproduce. Most therapists use some version of group therapy
in their effort to keep relationships "spread out" and manageable. Another
group uses cotherapists, usually of the opposite sex; their rationale is
derived from psychoanalytic theory that this provides a male-female model
for the family. The cotherapist functions to keep some degree of objectivity
when the other therapist becomes emotionally entangled in the family.
Others use a team approach in which an entire mental health team meets
with a family or group of families in a problem-focused group therapy
method. The team, or "therapeutic group," is composed of members of the
various mental health professions. The team-group meetings are commonly
used for "training" inexperienced professional people who learn by partici-
pation in the team meetings, and who can rather quickly gain the status of "
family therapist." Trainees begin by observing, following which they are
encouraged to become part of the group by expressing their "feelings" in
the therapy meetings. These are people who have never had much training
in theory, or in the emotional discipline of learning the intricacies of trans-
ference and countertransference. Theory is usually not explicit, but the
implicit format conveys that emotional illness is the product of suppressed
feeling and poor communication, that treatment is the free expression of
feelings and open communication, and that a competent therapist is one
who can facilitate the process. Family therapy has also attracted therapists
who were never successful at individual therapy, but who find a place in one
of the numerous kinds of group therapy methods being used in family
therapy. These admitted overstatements convey some idea of the many
kinds of family therapy methods and techniques that are in use.
Group therapy has long acted as though it did not have a theory. I
believe the reasons for this are that family therapy for the most part is a
decendant of group therapy, that family therapy has started variations in
method and technique that were not possible in group therapy, and that the
separation between theory and practice is greater in family therapy than any
of the other therapies. All these circumstances may account for the fact that
few family therapists have much awareness of theory.
My approach differs from the mainstream of family therapy. I have

learned more about the intricacies of the therapeutic relationship from
family research than from psychoanalysis or the psychotherapy of schizo-
phrenia. Most of this was learned from the study of triangles. The automatic
emotional responsiveness that operates constantly in all relationships is the
same as the therapeutic relationship. As soon as a vulnerable outside person
comes into viable emotional contact with the family, he becomes part of it,
no matter how much he protests the opposite. The emotional system oper-
ates through all five senses, and most often through visual and auditory
stimuli. In addition, there is a sixth sense that can include extrasensory
Bowen 53
perception. All living things learn to process this data very early and to use
it in relation to others. In addition, the human has a sophisticated verbal
language which is as often used to deny the automatic emotional process
as to confirm it. I believe the automatic emotional process is far more
important in establishing and maintaining relationships than verbal lan-
guage. The concept of triangles provides a way of reading the automatic
emotional responsiveness so as to control one's own automatic emotional
participation in the emotional process. This control I have called detrian-
gling. No one ever stays outside, but a knowledge of triangles makes it
possible to get outside on one's own initiative while staying emotionally in
contact with the family. Most important, family members can learn to
observe themselves and their families, and to control themselves while on
stage with the family without having to withdraw. A family member who
is motivated to learn and control his own responsiveness can influence
relationships in the entire family system.
The effort of being outside the family emotional system, or remaining

workably objective in an intense emotional field, has many applications.
Family relationships are remarkably different when an outsider is intro-
duced into the system. A disturbed family is always looking for a vulnerable
outsider. It would be healtheir if they worked it out among themselves, but
the emotional process reaches out for others. For a quarter of a century
there has been a debate in family research about ways to do objective
observations of the family, free from outside influences. Well-known re-
search investigators such as Erving Goffman and Jules Henry have insisted
that objective observations be made in the family's native habitat, the home,
by a neutral observer. Based on my experience with emotional systems, I
am sure any such observers were fused with the family as soon as they
entered the home, that the family automatically became different, and that
their belief they were being objective was erroneous. Complete objectivity
is impossible; but I believe the best version of objectivity is possible with
significant others who know triangles. There was a recently publicized
movie-television study of a family done by a movie crew who went into the
home to film the family as it really was. From my viewpoint, the movie crew
automatically became a significant other which helped propel the parents
toward divorce. This situation might have found another triangle that
would have served the same triangle force.
THEORY IN THE DEVELOPMENT OF FAMILY THERAPY
The family movement in psychiatry was started in the mid-1950s by

several different psychiatrists who worked independently for several years
before they began to hear about each other. I have described my version of
that in other papers (1, 2, 6). Among those who started with family research
on schizophrenia was Lidz and his group at Johns Hopkins and Yale (7),
Jackson and his group in Palo Alto (3), and Bowen and his group in
Bethesda (4, 8). The psychoanalytic principle of protecting the privacy of
the patient-therapist relationship may account for the family movement's
remaining underground for some years. There were strict rules against the
therapist's contaminating the transference by seeing other members of the
same family: the early family work was done privately, probably to avoid
critical colleagues who might consider this irresponsible until it was legiti-
mized in the name of research. I began formal research in 1954 after several
years of preliminary work. During 1955 and 1956 we each began to hear
about the others and to meet. Ackerman had been thinking and working
toward family concepts in social service agencies and clinics (9). Bell, who
remained separate from the group for some years, had a different beginning.
His first paper was written some seven or eight years after he started (10).
There were others mentioned in the earlier summaries.
For me, 1955 to 1956 was a period of elation and enthusiasm. Observing
entire families living together on a research ward provided a completely new
order of clinical data never before recorded in the literature. Only those who
were there could appreciate the impact of the new observations on psy-
chiatry. Other family researchers were observing the same things, but were
using different conceptual models to describe their findings. Why had these
findings, now so commonplace, been obscured in previous observations? I
believe two factors to account for this observational blindness. One was a
shift in the observing lens from the individual to the family. The other is
man's failure to see what is in front of him unless it fits his theoretical frame
of reference. Before Darwin, man considered the earth to have been created
as it appeared before his eyes. He had stumbled over the bones of prehistoric
animals for centuries without seeing them, until Darwin's theory permitted
him to begin seeing what had been there all the time.
For years I had pondered the discrepancies in psychoanalytic theory

without finding new clues. Now I had a wealth of new clues that could lead
to a completely different theory about emotional illness. Jackson was the
other of the early workers who shared the theoretical potential. Lidz was
more established in his psychoanalytic practice than Jackson and I, and he
was more interested in an accurate description of his findings than in theory.
Ackerman was also established in psychoanalytic practice and training, and
his interest lay in developing therapy and not theory. I had built a method
of individual therapy into my research design for studying the families.
Within six months there was evidence that some method of therapy for
family members together was indicated. I had never heard of family
therapy. Against the strong theoretical and clinical admonitions of the time,
Bowen 55
I followed the dictates of the research evidence and after much careful
planning started my first method of family psychotherapy. Later, I heard
that others had also thought of family therapy. Jackson had been approach-
ing on one level and Ackerman was approaching on another. In 1956 I
heard that Bell had been doing something called family therapy, but I did
not meet him until 1958.
J'he first family sectional a, mationa1 meeting was organized by Spiegel-
at the American Q.rthczpsyychiatricmeeting_in,Chicagain March, Ig57. He
,
was Chairman of the Committee on the Family of the Group for the
Advancement of Psychiatry and he had just heard about the family work
in progress. That was a small and quiet meeting. There were papers on
research by Spiegel, Mendell, Lidz, and Bowen. In my paper I referred to
the "family psychOtherapy" used in my research since late 1955. I believe
that may have been the first time the term was used in a national meeting.
However it happened, I would date the family therapy explosion to March,
1957. In May, 1957, there was a family section at the American Psychiatric
meeting, also in Chicago. In the two months since the previous meeting,
there had been an increasing fervor about family therapy. Ackerman was
secretary of the meeting, and Jackson was also present. Family ideas gener-
ated there led to Jackson's book, The Etiology of Schizophrenia, finally
published in 1960 (4). At the national meetings in 1958, the family sessions
were dominated by dozens of new therapists eager to report their family
therapy of the past year. That was the beginning of the family therapy that
was quite different from the family research of previous years. The new
people, attracted by the idea of family therapy, had been developing empiri-
cal methods and techniques based on the psychoanalytic theory of individ-
ual and group psychotherapy. The family research and the theoretical
thinking that gave birth to family therapy were lost in the rush.
The rush into family therapy in 1957 and 1958 produced a wild kind
of therapy which I called a "healthy, unstructured state of chaos." There
were almost as many different methods and techniques as there were new
therapists. I considered the trend healthy in the belief the new therapists
would discover the discrepancies in conventional theory, and that the con-
ceptual dilemma posed by family therapy would lead to new concepts and
ultimately to a new theory. This did not occur. I did not realize the degree
of therapeutic zeal that makes psychiatrists oblivious to theory Family
therapy became a therapeutic method engrafted onto the basic concepts of
psychoanalysis, and especially the theory of the transference. New thera-
pists tended toward therapeutic evangelism, and they trained generations
of new therapists who also tended toward simplistic views of the human
dilemma and family therapy as a panacea for treatment. Family therapy not
only inherited the vagueness and lack of theoretical clarity from conven-
tional psychiatry, but it added new dimensions of its own. The number of
minor differences and schools of thought are greater in family therapy than
in individual therapy, and it now has its own group of eclectics who solve
the problem through eclecticism.
Jackson and I were the only two from the original family researchers
with a significant interest in theory. Jackson's group included Bateson,
Haley, and Weakland. They began with a simple communication model of
human relationships, but soon expanded the concept to include the total of
human interaction in the concept. By the time Jackson died in 1968, he had
moved toward a rather sophisticated systems model. I believe my theory
had a sounder base to connect it with an instinctual motor; Jackson was
operating more on phenomenology, but he was moving toward a distinctly
different theory. One can only guess where he would have emerged had he
lived.
In the past decade, there has been the slow emergence of a few new
theoretical trends. It is not possible to stay on a broad conceptual level and
do justice to the work of individuals, and at this point it is not possible to
do more than survey the field in broad concepts. The notion of systems
theory started gaining popularity in the mid-1960s, but the the use of
systems in psychiatry is still in a primitive state. On one level, it is no more
than the use of one word to replace another. On another level, it has the
same meaning as a transportation system or circulatory system. On a more
sophisticated level, it refers to a relationship system, which is a system in
human behavior. On a broad level, people believe that "system" is derived
from general systems theory, which is a system of thinking about existing
knowledge. In my opinion, the attempt to apply general systems theory to
psychiatry, as psychiatry is presently conceptualized, is equivalent to the
effort to apply the scientific method to psychoanalysis. It has a potential,
longterm gain if things work out right. However, the slow emergence of
something that goes in a systems direction is one of the new evolutions in
the family field. There have been some fascinating innovations in concepts
that still retain much basic psychoanalytic theory. Among these is Paul's
concept (11) concerning unresolved grief reactions which has a therapeutic
method that fits the theoretical concept, and effectively taps the basic emo-
tional process. Boszormenyi-Nagy is one of the theoretical scholars in the
field (12). He has a rather complete set of theoretical abstractions that may
one day provide a theoretical bridge between psychoanalysis and a different
family theory. One of the more unique new orientations is Minuchin's (13).
He carefully avoids the complex concepts of theory, but he uses the term
Structural Family Therapy for a therapeutic method designed to change the
family through modification of the feedback system in relationships. His
focus is more on therapy than on theory.
Bowen 57
FAMILY SYSTEMS THEORY
The evolution of my own theoretical thinking began in the decade before

I started family research. There were many questions concerning generally
accepted explanations about emotional illness. Efforts to find logical an-
swers resulted in more unanswerable questions. One simple example is the
notion that mental illness is the result of maternal deprivation. The idea
seemed to fit the clinical case of the moment, but not the large number of
normal people who, as far as could be determined, had been exposed to
more maternal deprivation than those who were sick. There was also the
issue of the schizophrenogenic mother. There were detailed descriptions of
schizophrenogenic parents, but little to explain how the same parents could
have other children who were not only normal, but who appeared supernor-
mal. There were lesser discrepancies in popular hypotheses that linked
emotional symptoms to a single traumatic event in the past. This again
appeared logical in specific cases, but did not explain the large number of
people who had suffered trauma without developing symptoms. There was
a tendency to create special hypotheses for individual cases. The whole body
of diagnostic nomenclature was based on symptom description, except for
the small percentage of cases in which symptoms could be connected to
actual pathology. Psychiatry acted as if it knew the answers, but it had not
been able to develop diagnoses consistent with etiology. Psychoanalytic
theory tended to define emotional illness as the product of a process between
parents and child in a single generation, and there was little to explain how
severe problems could be created so rapidly. The basic sciences were critical
of psychiatric explanations that eluded scientific study. If the body of
knowledge was reasonably factual, why could we not be more scientific
about it? There were assumptions that emotional illness was the product of
forces of socialization, even though the same basic emotional illness was
present in all cultures. Most of the assumptions considered emotional illness
as specific to humans, when there was evidence that a similar process was
also present in lower forms of life. These and many other questions led me
to extensive reading in evolution, biology, and the natural sciences as part
of a search for clues that could lead to a broader theoretical frame of
reference. My hunch was that emotional illness comes from that part of man
that he shares with the lower forms of life.
My initial family research was based on an extension of theoretical

formulations about the mother-child symbiosis. The hypothesis considered
emotional illness in the child to be a product of a less severe problem in the
mother. The hypothesis described the balancing forces that kept the rela-
tionship in equilibrium. It was a good example of what is now called a
system. Very quickly it became apparent that the mother-child relationship
was a dependent fragment of the larger family unit. The research design was
modified for fathers and normal siblings to live on the ward with mothers
and the schizophrenic patients. This resulted in a completely new order of
observations. Other researchers were observing the same things, but they
were using a variety of different models to conceptualize findings, including
models from psychoanalysis, psychology, mythology, physics, chemistry,
and mathematics. There were some common denominators that clustered
around the stuck togetherness, bonds, binds, and interlocking of family
members with each other. There were other concepts for the balancing
forces, such as complementarity, reciprocity, magnetic fields, and hydraulic
and electrical forces. Accurate as each concept might be descriptively, the
investigators were using discrepant models.
Early in the research, I made some decisions based on previous thinking
about theory. Family research was producing a completely new order of
observations. There was a wealth of new theoretical clues. On the premise
that psychiatry might eventually become a recognized science, perhaps a
generation or two in the future, and being aware of the past conceptual
problems of psychoanalysis, I chose to use only concepts that would be
consistent with a recognized science. This was done in the hope that inves-
tigators of the future would more easily be able to see connections between
human behavior and the accepted sciences than we can. I therefore chose
to use concepts that would be consistent with biology and the natural
sciences. It was easy to think in terms of the familiar concepts of chemistry,
physics, and mathematics, but I carefully excluded all concepts that dealt
with inanimate things, and studied the literature for concepts synonymous
with biology—that is, I used biological concepts to describe human behav-
ior. The concept of symbiosis, originally from psychiatry, would have been
discarded except for its use in biology where the word has a specific mean-
ing. The concept of differentiation was chosen because it has specific mean-
ings in the biological sciences. When we speak of the "differentiation of
self," we mean a process similar to the differentiation of cells from each
other. The same applies to the term fusion. Instinctual is used exactly
as it is used in biology, rather than in the restricted, special meaning of its
use in psychoanalysis. There are a few minor exceptions to this overall
plan, which will be mentioned later. In the period when I was reading
biology, a close psychoanalyst friend advised me to give up "holistic"
thinking before I got "too far out."
Another longterm plan was directed at the research staff, and was based
on the notion that the clues for important discoveries are right in front of
our eyes, if we can only develop the ability to see what we have never seen
before. Research observers can see only what they have been trained to see
through their theoretical orientations. The research staff had been trained
in psychoanalysis, and they tended to see confirmation or extensions of
psychoanalysis. On the premise there was far more to be seen if they could
Bowen 59
get beyond their theoretical blindness, I devised a plan to help us all open
our eyes to new observations. One longterm exercise required investigators
to avoid the use of conventional psychiatric terminology and to replace it
with simple descriptive words. It was quite an exercise to use simple lan-
guage instead of terms such as "schizophrenic-obsessive-compulsive-
depressed-hysterical-patient." The overall goal was to help observers clear
their heads of pre-existing ideas and see in a new way. Although much of
this could be classified as an exercise or a game in semantics, it did contrib-
ute to a broader viewpoint. The research team developed a new language.
Then came the complications of communication with colleagues, and the
necessity of translating our new language back into terminology others
could understand. It was awkward to use ten words to describe "a patient,"
when everyone else knew the correct meaning of "patient." We were criti-
cized for coining new terms when old ones would be better, but during the
exercise we had discovered the degree to which well-trained professional
people use the same terms differently, while assuming that everyone under-
stands them the same way.
The core of my theory has to do with the degree to which people are
able to distinguish between the feeling process and the intellectual process.
Early in the research, we found that the parents of schizophrenic people,
who appear on the surface to function well, have difficulty distinguishing
between the subjective feeling process and the more objective thinking
process. This is most marked in a close personal relationship. This led to
investigation of the same phenomenon in all levels of families from the most
impaired, to normal, to the highest functioning people we could find. We
found that there are differences between the ways feelings and intellect are
either fused or differentiated from each other, and this led us to develop the
concept of differentiation of self. People with the greatest fusion between
feeling and thinking function the poorest. They inherit a high percentage
of life's problems. Those with the most ability to distinguish between feeling
and thinking, or who have the most differentiation of self, have the most
flexibility and adaptability in coping with life stresses, and the most freedom
from problems of all kinds. Other people fall between the two extremes,
both in the interplay between feeling and thinking and in their life adjust-
ments.
Feeling and emotion are used almost synonymously in popular usage

and also in the literature. Also, little distinction is made between the subjec-
tivity of truth and the objectivity of fact. The lower the level of differentia-
tion, the more a person is not able to distinguish between the two. The
literature does not clearly distinguish between philosophy, belief opinion,
conviction, and impression. Lacking guidelines from the literature, we used
dictionary definitions to clarify these for our theoretical purposes.
The theoretical assumption considers emotional illness to be a disorder
of the emotional system, an intimate part of man's phylogenetic past which
he shares with all lower forms of life, and which is governed by the same
laws that govern all living things. The literature refers to emotions as much
more than states of contentment, agitation, fear, weeping, and laughing,
although it also refers to these states in the lower forms of life—contentment
after feeding, sleep, and mating, and states of agitation in fight, flight, and
the search for food. For the purposes of this theory, the emotional system
is considered to include all the above functions, plus all the automatic
functions that govern the autonomic nervous system, and to be synonymous
with instinct that governs the life process in all living things. The term
emotional illness is used to replace former terms, such as mental illness and
psychological illness. Emotional illness is considered a deep process involv-
ing the basic life process of the organism.
The intellectual system is a function of the cerebral cortex which ap-

peared last in man's evolutionary development, and is the main difference
between man and the lower forms of life. The cerebral cortex involves the
ability to think, reason, and reflect, and enables man to govern his life, in
certain areas, according to logic, intellect, and reason. The more
experience I have had, the more I am convinced that far more of life is
governed by automatic emotional forces than man is willing to acknowledge.
The feeling system is postulated as a link between the emotional and
intellectual systems through which certain emotional states are represented in
conscious awareness. Man's brain is part of his protoplasmic totality.
Through the function of his brain, he has learned many of the secrets of the
universe; he has also learned to create technology to modify his environment,
and to gain control over most of the lower forms of life. Man has done less
well in using his brain to study his own emotional functioning.
Much of the early family research was done with schizophrenia. Since
the clinical observations from those studies had not been previously de-
scribed in the literature, it was first thought that the relationship patterns
were typical of schizophrenia. Then it was discovered that the very same
patterns were also present in families with neurotic level problems, and even
in normal families. Gradually, it became clear that the relationship patterns,
so clear in families with schizophrenia, were present in all people to some
degree and that the intensity of the patterns being observed was related
more to the anxiety of the moment than the severity of the emotional illness
being studied. This fact about the early days of family research conveys
some notion of the state of psychological theory twenty years ago that is
not appreciated by those who were not part of the scene at that time. The
family studies in schizophrenia were so important that they stimulated
several research studies of normal families in the late 1950s and early 1960s.
The influence of the schizophrenia research on family therapy was so impor-
tant that family therapy was still being considered to be a form of therapy
Bowen 67
for schizophrenia as much as ten years after the family movement started.
The results of the early studies on normal families might be summarized
by saying that the patterns originally thought to be typical of schizophrenia
are present in all families some of the time and in some families most of the
time.
My work toward a different theory began as soon as the relationship
patterns were seen to repeat over and over, and we had achieved some
notion about the conditions under which they repeated. The early papers
were devoted mostly to clinical description of the patterns. By 1957, the
relationship patterns in the nuclear family were sufficiently defined that I
was willing to call a major paper, "A Family Concept of Schizophrenia."
Jackson, who was reasonably accurate in his use of the word theory, had
coauthored a paper in 1956 called, "Toward a Theory of Schizophrenia"
(3). He urged me to use the term theory in the 1957 paper, which was finally
published in 1960 (4), but I refused on the basis that it was no more than
a concept in a much larger field, and I wanted to avoid using theory for a
partial theory or a concept. The situation in the late 1950s was an absolute
delight for me. It satisfied my theoretical curiosity that schizophrenia and
the psychoses were part of the same continuum with neurotic problems, and
that the differences between schizophrenia and the neuroses were quantita-
tive rather than qualitative. Psychoanalysis and the other theoretical sys-
tems viewed psychosis as the product of one emotional process, and the
neuroses as the product of another emotional process. Even today a
majority of people in psychiatry probably still hold the viewpoint that
schizophrenia and the neuroses are qualitatively different. It is usual for
mental health professionals to speak of schizophrenia as one thing, and the
neuroses as another type of problem; they also still speak of "normal"
families. However, I know they are all part of the total human dimension,
all the way from the lowest possible level of human functioning to the
highest. I believe that those who assume a difference between schizophrenia,
the neuroses, and the normal are operating from basic psychoanalytic the-
ory without being specifically aware of it, and that they base the difference
on therapeutic response rather than on systems theory. I believe psychiatry
will some day come to see all these conditions as parts of the same con-
tinuum.
The main part of this family systems theory evolved rather rapidly
over a period of about six years, between 1957 and 1963. No one part was
first. A concept about the nuclear family emotional system and another about
the family projection process had both been started in the early
descriptive papers. They were both reasonably clear by the time it was
possible to compare the patterns in schizophrenia with the total range of
human problems. The notion that all human problems exist on a single
continuum gave rise by the early 1960s, to the concept of.differentiation of
self. The notion
of triaiigles, one of the basic concepts in the total theory, had been started
in 1957 when it was called the "interdependent triad." The concept was
sufficiently developed to be used in therapy by about 1961. The concept of
multigenerational transmission process started as a research hypothesis as
early as 1955, but the research that brought it to reasonable clarification had
to wait till 1959 to 1960, when there was a larger volume of families for
study. The concept oKibling position had been poorly defined since the late
1950s, but it had to Wait until Toman's Family Constellation (14) in 1961
provided structure. By 1963, these six interlocking concepts were suffi-
ciently defined that I was willing to put all six together into family systems
theory, which satisfied a fairly strict definition of theory. It was not included
in Intensive Family Therapy by Nagy and Framo (5), which was published
in 1965, because they had specifically asked for a chapter on schizophrenia.
The six concepts were finally published as a coherent, theoretical system in
1966 (1). After 1966, there were numerous changes in therapy, but the
theory as presented in 1966 has remained very much as it is today, with
some extensionsAnd refinements. Finally, in 1975, two new concepts were
added. The first-,-'he emotional cutoff, was merely a refinement and a new
emphasis of former theoretical principles. The last and eighth concept,
societal regression, had been rather well defined by 1972, and was finally
added as a separate concept in 1975. Also, the name family systems theory
was formally changed to the Bowen theory in 1975.
Any relationship with balancing forces and counterforces in constant

operation is a system. The notion of dynamics is simply not adequate to
describe the idea of a system. By 1963, when the six interlocking concepts
were defined, I was using the concept of system as a shorthand way to
describe the complex balancing of family relationships. This idea was finally
presented in some detail in the 1966 paper on theory. By the mid-1960s, the
term systems was being used more frequently; some therapists picked it up
from my writings, and others picked it up from general systems theory,
which was first defined in the 1930s. In the past decade, the term has become
popularized and overused to the point of being meaningless. Family systems
theory has been confused with general systems theory, which has a much
broader frame of reference and no specific application to emotional func-
tioning. It is very difficult to apply general systems concepts to emotional
functioning except in a broad, general way. My family systems theory is a
specific theory about the functional facts of emotional functioning.
It is grossly inaccurate to consider family systems theory as synonymous

with general systems, although it is accurate to think of family systems
theory as somehow fitting into the broad framework of general systems
theory. There are those who believe family systems theory was developed
from general systems theory, in spite of my explanations to the contrary.
At the time my theory was developed, I knew nothing about general systems
Bowen 63
theory. Back in the 1940s, I attended one lecture by Bertalanffy, which I
did not understand, and another by Norbert Wiener which was perhaps a
little more understandable. Both dealt in systems of thinking. The degree
to which I heard something in those lectures that influenced my later
thinking is debatable. In those years, I was strongly influenced by reading
and lectures in aspects of evolution, biology, the balance of nature, and the
natural sciences. I was trying to view man as a part of nature rather than
separate from nature. It is likely that my systems orientation was patterned
after the systems in nature, and unlikely that systems of thinking played any
part in the theory. However it developed, family systems theory as I have
defined it is a specific theory about human relationship functioning that has
now become confused with general systems theory and the popular, non-
specific use of the word systems. I have long opposed the use of proper
names in terminology, but in order to denote the specificity that is built into
this family systems theory, I am now calling it the Bowen theory.
Emotionality, feelings, and subjectivity are the principal commodities

which the theoretician has to conceptualize, which the researcher has to
organize into some kind of structure, and which the clinician has to deal
with in his practice. It is difficult to find verifiable facts in the world of
subjectivity. Conventional psychiatric theory focuses on the why of human
behavior. All members of the mental health professions are familiar with
why explanations. The search for why reasons has been part of man's cause
and effect thinking since he became a thinking being. Once the researcher
starts asking why, he is confronted by a complex mass of variables. It was
the search for reliable facts about emotional functioning that led toward
systems thinking early in the family research. From this effort came a
method of separating the functional facts from the subjectivity of emotional
systems. Systems thinking focused on what happened, and how, when, and
where it happened, insofar as these observations could be based on observa-
ble facts. The method carefully avoids why explanations and the discrepant
reasoning that follows. Some fairly efficient formulas were developed for
converting subjectivity into observable and verifiable research facts. For
example, one such formula might be, "That man dreams is a scientific fact,
but what he dreams is not necessarily a fact," or, "That man talks is a
scientific fact, but what he says is not necessarily factual." The same for-
mula can be applied to almost the whole range of subjective concepts, such
as, "That man thinks (or feels) is a scientific fact, but what he thinks (or
feels) is not necessarily factual." The formula is a little more difficult to
apply in the intense feeling states, such as love and hate, but as long as the
researcher stays on the facts of loving and hating and avoids the content
of these intense emotions, he is working toward systems thinking
The effort to focus on the functional facts of relationship systems is a

difficult and disciplined task. It is easy to lose sight of the fact and become
emotionally involved in the content of the communication. The main reason

for making this effort was for research purposes. The main concepts in the
Bowen theory were developed from the functional facts of relationship
systems. In this disciplined research effort, it was discovered that a method
of therapy based on the functional facts was superior to conventional
therapy. It is so difficult for most therapists to shift from conventional
therapy to this method of family systems therapy that no one ever achieves
more than partial success at it. When anxiety is high, even the most disci-
plined systems thinker will automatically revert to cause and effect thinking
and why explanations. However, it is possible for therapists to keep perfect-
ing their ability to think in systems concepts. The more I have been able
to shift to thinking systems, the better my therapy has become. The shift
to systems thinking requires the therapist to give up many of his old con-
cepts. A recent exchange with a therapist involved in psychoanalytic re-
search illustrates the dilemma in making such a shift. He said he could hear
the notion of trying to find facts in subjectivity, but he simply could not give
up the therapeutic contributions of dreams and analyzing the unconscious.
I replied that I could respect his conviction if he could respect mine about
the ultimate advantage of a total systems approach. A major advantage of
systems theory and systems therapy is that it offers options not previously
available. The young professional has the choice of continuing conventional
theory and therapy, or of incorporating a few systems concepts, or of trying
to go all the way toward systems thinking. I believe a few systems concepts
are better than none.
The Bowen theory contains no ideas that have not been a part of human
experience through the centuries. The theory operates on an order of facts
so simple and obvious that everyone knew them all the time. The uniqueness
of the theory has to do with the facts that are included, and the concepts
that are specifically excluded. Said in another way, the theory listens to a
distant drumbeat that people have always heard. This distant drumbeat is
often obscured by the noisy insistence of the foreground drumbeat, but it
is always there, and it tells its own clear story to those who can tune out
the noise and keep focused on the distant drumbeat. The Bowen theory
specifically excludes certain items from individual theory that are equiva-
lent to the foreground drumbeat. The concepts we learned in individual
theory all have their accuracy within one frame of reference, but they tend
to nullify the unique effectiveness of the simple story told by a broad systems
perspective. The Bowen theory is very simple to those who can hear, and
the simple approach to therapy is determined by the theory.
_iwen 65
THE BOWEN THEORY
The Bowen theory involves Jw.0 main variables. One is the degree of
anxiety, and the other is the degree of integration of self. There are several
variables having to do with anxiety or emotional tension. Among these are
intensity, duration, and different kinds of anxiety. There are far more vari-
ables that have to do with the level of integration of the differentiation of
self. This is the principal subject of this theory. All organisms are reasonably
adaptable to acute anxiety. The organism has built-in mechanisms to deal
with short bursts of anxiety. It is sustained or chronic anxiety that is most
useful in determining-the differentiation Otself.TfaniietY siiffiCiently low,
almost any organism can appear normal in the sense that it is symptom free.
When anxiety increases and remains chronic for a certain period, the orga-
nism develops tension, either within itself or in the relationship system, and
the tension results in symptoms or dysfunction or sickness. The tension may
result in physiological symptoms or physical illness, in emotional dysfunc-
tion, in social illness characterized by impulsiveness or withdrawal, or by
social misbehavior. There is also the phenomenon of the infectiousness of
anxiety, through which anxiety can spread rapidly through the family, or
through society. There is a kind of average level of differentiation for the
family which has certain minor levels of difference in individuals within the
family. I shall leave it to the reader to keep in mind there is always the
variable of the degree of chronic anxiety which can result in anyone appear-
ing normal at one level of anxiety, and abnormal at another higher level.
Three of the theory's eight.concepts apply to overall characteristics of

the family The other five focus on details within certain areas of the family
) Differentiation of Self This concept is a cornerstone of the theory, and

d my discussion becomes repetitive, I beg the reader's indulgence. The
concept defines people according to the degree of fusion, or differentiation,
between emotional and intellectual functioning. This characteristic is so
universal it can be used as a way of categorizing all people on a single
continuum. At the low extreme are those whose emotions and intellect are
so fused that their lives are dominated by the automatic emotional system.
Whatever intellect they have is dominated by the emotional system. These
are the people who are less flexible, less adaptable, and more emotionally
dependent on those about them. They are easily stressed into dysfunction,
and it is difficult for them to recover from dysfunction. They inherit a high
percentage of all human problems. At the other extreme are those who are
more differentiated. It is impossible for there to be more than relative
separation between emotional and intellectual functioning, but those whose
intellectual functioning can retain relative autonomy in periods of stress are
more flexible, more adaptable, and more independent of the emotionality
about them. They cope better with life stresses, their life courses are more
66 Theory in the Practice of Psychotherak.
orderly and successful, and they are remarkably free of human problems.
In between the two extremes is an infinite number of mixes between emo-
tional and intellectual functioning.
The concept eliminates the concept of normal, which psychiatry has
never successfully defined. It is not possible to define normal when the thing
to be measured is constantly changing. Operationally, psychiatry has called
people normal when they are free of emotional symptoms and behavior is
within average range. The concept of differentiation has no direct connec-
tion with the presence or absence of symptoms. People with the most fusion
have most of the human problems, and those with the most differentiation,
the fewest; but there can be people with intense fusion who manage to keep
their relationships in balance, who are never subjected to severe stress, who
never develop symptoms, and who appear normal. However, their life
adjustments are tenuous, and, if they are stressed into dysfunction, the
impairment can be chronic or permanent. There are also fairly well-differen-
tiated people who can be stressed into dysfunction, but they recover rapidly.
At the fusion end of the spectrum, the intellect is so flooded by emotion-

ality that the total life course is determined by the emotional process and
by what "feels right," rather than by beliefs or opinions. The intellect exists
as an appendage of the feeling system. It may function reasonably well in
mathematics or physics, or in impersonal areas, but on personal subjects its
functioning is controlled by the emotions. The emotional system is hypothe-
sized to be part of the instinctual forces that govern automatic functions.
The human is adept at explanations to emphasize that he is different from
lower forms of life, and at denying his relation with nature. The emotional
system operates with predictable, knowable stimuli that govern the instinc-
tual behavior in all forms of life. The more a life is governed by the
emotional system, the more it follows the course of all instinctual behavior,
in spite of intellectualized explanations to the contrary. At higher levels of
differentiation, the function of the emotional and intellectual systems are
more clearly distinguishable. There are the same automatic emotional
forces that govern instinctual behavior, but intellect is sufficiently autono-
mous for logical reasoning and decisions based on thinking. When I first
began to present this concept, I used the term undifferentiated family ego
mass to describe the emotional stuck-togetherness in families. Although
this phrase was an assemblage of words from conventional theory, and thus
did not conform to the plan to use concepts consistent with biology, it fairly
accurately described emotional fusion. I used it for a few years because more
people were able to hear the concept when it was put into words they
understood.
As I began to present the concept of a well-differentiated person as one

whose intellect could function separately from the emotional system, it was
common for mental health professionals to hear the intellectual system as
Bowen 67
equivalent to intellectuality which is used as a defense against emotionality

in psychiatric patients. The most common criticism was that a differentiated
person appeared to be cold, distant, rigid, and nonfeeling. It is difficult for
professional people to grasp the notion of differentiation when they have
spent their working lives believing that the free expression of feelings repre-
sents a high level of functioning and intellectualization represents an un-
healthy defense against it. A poorly differentiated person is trapped within
a feeling world. His effort to gain the comfort of emotional closeness can
increase the fusion, which can increase his alienation from others. There
is a lifelong effort to get the emotional life into livable equilibrium. A
segment of these emotionally trapped people use random, inconsistent,
intellectual- sounding verbalization to explain away their plight. A more
differentiated person can participate freely in the emotional sphere without
the fear of becoming too fused with others. He is also free to shift to calm,
logical reasoning for decisions that govern his life. The logical intellectual
process is quite different from the inconsistent, intellectualized verbalizations
of the emotionally fused person.
In earlier papers, I presented this as a Differentiation of Self Scale." I

did that to convey the idea that people have all gradations of differentiation
of self, and that people at one level have remarkably different life styles from
those at other levels. Schematically, I presented a scale from 0 to 100, with
0 representing the lowest possible level of human functioning and 100
representing a hypothetical notion of perfection to which man might evolve
if his evolutionary change goes in that direction. I wanted a spectrum broad
enough to cover all possible degrees of human functioning. To clarify the
fact that people are different from each other in terms of emotional-intellec-
tual functioning, I did profiles of people in the 0 to 25, the 25 to 50, the 50
to 75, and the 75 to 100 ranges. Those profiles are still amazingly accurate
ten years later. In that first paper, I also presented the notion of functional
levels of differentiation that can shift from moment to moment, or remain
fairly constant for most of a life. Some of the major variables that govern
the shifting were presented as a way of clarifying the concept and categoriz-
ing the apparent complexity of human functioning into a more knowable
framework. The schematic framework and the use of the term scale resulted
in hundreds of letters requesting copies of "the scale." Most who wrote had
not grasped the concept nor the variables that govern the functional levels
of differentiations. The letters slowed down my effort to develop a more
definite scale that could be used clinically. The theoretical concept is most
important. It eliminates the barriers between schizophrenia, neurosis, and
normal; it also transcends categories such as genius, social class, and cultur-
al-ethnic differences. It applies to all human forms of life. It might even
apply to subhuman forms if we only knew enough. Knowledge of the
concept permits the easy development of all kinds of research instruments,
but to attempt to use the scale without knowledge of the concept can result
in chaos.
Another important part of the differentiation of self has to do with the
levels of solid self and pseudo self in a person. In periods of emotional
-
intimacy, two pseudo-selfs will fuse into each other, one losing self to the
other, who gains self. The solid self does not participate in the fusion
phenomenon. The solid self says, "This is who I am, what I believe, what
I stand for, and what I will do or will not do," in a given situation. The
solid self is made up of clearly defined beliefs, opinions, convictions, and life
principles. These are incorporated into self from one's own life experiences,
by a process of intellectual reasoning and the careful consideration of the
alternatives involved in the choice. In making the choice, one becomes
responsible for self and the consequences. Each belief and life principle is
consistent with all the others, and self will take action on the principles even
in situations of high anxiety and duress.
The pseudo-self is created by emotional pressure, and it can be modified

by emotional pressure. Every emotional unit, whether it be the family or
the total of society, exerts pressure on group members to conform to the
ideals and principles of the group. The pseudo-self is composed of a vast
assortment of principles, beliefs, philosophies, and knowledge acquired be-
cause it is required or considered right by the group. Since the principles
are acquired under pressure, they are random and inconsistent with one
another, without the individual's being aware of the discrepancy. Pseudo-
self is appended onto the self, in contrast to solid self which is incorporated
into self after careful, logical reasoning. The pseudo-self is a "pretend" self.
It was acquired to conform to the environment, and it contains discrepant
and assorted principles that pretend to be in emotional harmony with a
variety of social groups, institutions, businesses, political parties, and reli-
gious groups, without self s being aware that the groups are inconsistent
with each other. The joining of groups is motivated more by the relationship
system than the principle involved. The person may "feel" there is some-
thing wrong with some of the groups, but he is not intellectually aware. The
solid self is intellectually aware of the inconsistency between the groups and
the decision to join or reject membership is an intellectual process based on
careful weighing of the advantages and disadvantages.
The pseudo-self is an actor and can be many different selfs. The list of
pretends is extensive. He can pretend to be more important or less impor-
tant, stronger or weaker, or more attractive, or less attractive than is realis-
tic. It is easy for most people to detect gross examples of pretense, but there
is enough of the impostor in all of us so that it is difficult to detect lesser
degrees of the impostor in others. On the other hand, a good actor can
appear so much for real that it can be difficult for the actor or for others
without detailed knowledge of how emotional systems function to know the
Bowen 69
dividing line between solid self and pseudo-self. This also applies to thera-
pists, mental health professionals, and researchers who may attempt to
estimate the level of differentiation in themselves or in others. The level of
solid self is stable. The pseudo-self is unstable, and it responds to a variety
of social pressures and stimuli. The pseudo-self was acquired at the behest
of the relationship system, and it is negotiable in the relationship system.
Based on my experience with this concept, I believe that the level of solid
self is lower, and of the pseudo-self is much higher in all of us than most
are aware. It is the pseudo-self that is involved in fusion and the many ways
of giving, receiving, lending, borrowing, trading, and exchanging of self. In
any exchange, one gives up a little self to the other, who gains an equal
amount. The best example is a love relationship when each is trying to be
the way the other wants self to be, and each in turn makes demands on the
other to be different. This is pretending and trading in pseudo-self. In a
marriage, two pseudo-selfs fuse into a we-ness in which one becomes the
dOminant decision maker or the most active in taking initiative for the
we-ness. The dominant one gains self at the expense of the other, who loses
it. The adaptive one may volunteer to give up self to the dominant one, who
accepts it; or the exchange may be worked out after bargaining. The more
that the spouses can alternate these roles, the healthier the marriage. The
exchanging of selfs may be on a short or longterm basis. The borrowing and
trading of selfs may take place automatically in a work group in which the
emotional process ends up with one employee in the one-down or deselfed,
position, while the others gain self. This exchanging of pseudo-self is an
automatic emotional process that occurs as people manipulate each other
in subtle life postures. The exchanges can be brief—for instance, criticism
that makes one feel bad for a few days; or it can be a longterm process in
which the adaptive spouse becomes so deselfed, he or she is no longer able
to make decisions and collapses in selfless dysfunction—psychosis or
chronic physical illness. These mechanisms are much less intense in better
levels of differentiation or when anxiety is low, but the process of people
losing and gaining self in an emotional network is so complex and the degree
of shifts so great that it is impossible to estimate functional levels of differen-
tiation except from following a life pattern over long periods.
Profile of Low Levels of Differentiation. This is the group I previously

described as 0 to 25, the lowest level of differentiation. The emotional fusion
is so intense that the variables extend beyond the undifferentiated family ego
mass into the undifferentiated societal ego mass The intricacies of fusion
and differentiation are much clearer in people with moderate levels of fusion
in whom the various processes are more easily defined. There are some
striking overall characteristics of the low levels of differentiation. People at
the lowest level live in a feeling-dominated world in which it is impossible
to distinguish feeling from fact. They are totally relationship oriented. So
much energy goes into seeking love and approval and keeping the relation-
ship in some kind of harmony, there is no energy for life-directed goals.
Failing to achieve approval, they can spend their lives in withdrawal or
fighting the relationship system from which they fail to win approval.
Intellectual functioning is so submerged that they cannot say, "I think that
. . ." or, "I believe. . . ." Instead, they say, "I feel that . . ." when it would
be accurate to express an opinion or belief. They consider it truthful and
sincere to say, "I feel," and false and insincere to express an opinion from
themselves. Important life decisions are made on the basis of what feels
right. They spend their lives in a day-to-day struggle to keep the relationship
system in balance, or in an effort to achieve some degree of comfort and
freedom from anxiety. They are incapable of making longterm goals except
in vague general terms, such as, "I want to be successful, or happy, or have
a good job, or have security." They grow up as dependent appendages of
their parents, following which they seek other equally dependent relation-
ships in which they can borrow enough strength to function. A no-self
person who is adept at pleasing his boss may make a better employee than
one who has a self. This group is made up of people preoccupied with
keeping their dependent relationships in harmony, people who have failed
and who go from one symptomatic crisis to another, and people who have
given up in the futile effort to adapt. At the lowest level are those who
cannot live outside the protective walls of an institution. This group inherits
a major portion of the world's serious health, financial, and social problems.
Life adjustments are tenuous at best, and when they fall into dysfunction,
the illness or "bad luck" can be chronic or permanent. They tend to be
satisfied with the result if a therapy effort brings a modicum of comfort.
Profile of Moderate Levels of Differentiation of Self This is the group

previously presented as 25 to 50. There is some beginning differentiation
between the emotional and intellectual systems, with most of the self ex-
pressed as pseudo-self. Lives are still guided by the emotional system, but
the life styles are more flexible than the lower levels of differentiation. The
flexibility provides a better view of the interplay between emotionality and
intellect. When anxiety is low, functioning can resemble good levels of
differentiation. When anxiety is high, functioning can resemble that of low
levels of differentiation. Lives are relationship oriented, and major life
energy goes to loving and being loved, and seeking approval from others.
Feelings are more openly expressed than in lower-level people. Life energy
is directed more to what others think and to winning friends and approval
than to goal-directed activity. Self-esteem is dependent on others. It can
soar to heights with a compliment or be crushed by criticism. Success in
school is oriented more to learning the system and to pleasing the teacher
than to the primary goal of learning. Success in business or in social life
depends more on pleasing the boss or the social leader, and more on who
Bowen 77
one knows and gaining relationship status than in the inherent value of their
work. Their pseudo-selves are assembled from an assortment of discrepant
principles, beliefs, philosophies, and ideologies that are used in pretend
postures to blend with different relationship systems. Lacking solid self,
they habitually use, "I feel that . . ." when expressing their pseudo-self
philosophies; they avoid, "I think," or "I believe," positions by using an-
other person or body of knowledge as their authority when making state-
ments. Lacking a solid self-conviction about the world's knowledge, they
use pseudo-self statements, such as, "The rule says .. ." or "Science has
proved . . ." taking information out of context to make their points. They
may have enough free-functioning intellect to have mastered academic
knowledge about impersonal things; they use this knowledge in the relation-
ship system. However, intellect about personal matters is lacking, and their
personal lives are in chaos.
The pseudo-self may be a conforming disciple who pretends to be in

harmony with a particular philosophy or set of principles, or, when frus-
trated, he can assume the opposite posture as a rebel or revolutionary
person. The rebel is lacking a self of his own. His pseudo-self posture is
merely the exact opposite of the majority viewpoint. The revolutionary
person is against the prevailing system, but he has nothing to offer in its
place. The sameness of polarized opposites in emotional situations has led
me to define revolution as a convulsion that prevents change. It is relation-
ship-oriented energy that goes back and forth on the same points, the issue
on each side being determined by the position of the other; neither is capable
of a position not determined by the other.
People in the moderate range of differentiation have the most intense

versions of overt feeling. The relationship orientation makes them sensitive
to others and to the direct action expression of feelings. They are in a
lifelong quest for the ideal relationship with emotional closeness to others
and direct, open communication of feelings. In their overt emotional depen-
dence on others, they are sensitized to reading the moods, expressions, and
postures of the other, and to responding openly with direct expression of
feeling or impulsive action. They are in a lifelong pursuit of the ideal close
relationship. When closeness is achieved, it increases the emotional fusion
to which they react with distance and alienation, which can then stimulate
another closeness cycle. Failing to achieve closeness, they may go to with-
drawal and depression, or to pursuit of closeness in another relationship.
Symptoms and human problems erupt when the relationship system is
unbalanced. People in this group develop a high percentage of human
problems, including the full range of physical illness, emotional illness, and
social dysfunctions. Their emotional illness includes neurotic-level internal-
ized problems, depression, and behavior and character disorder type prob-
lems; they get involved in the increasing use of alcohol and drugs to relieve
the anxiety of the moment. Their social disorders include all levels of
impulsive and irresponsible behavior.
Profile of Moderate to Good Differentiation of Self. This is the group in
the 50 to 75 range. These are the people with enough basic differentiation
between the emotional and intellectual systems for the two systems to
function alongside each other as a cooperative team. The intellectual system
is sufficiently developed so that it can hold its own and function autono-
mously without being dominated by the emotional system when anxiety
increases. In people below 50, the emotional system tells the intellectual
system what to think and say, and which decisions to make in critical
situations. The intellect is a pretend intellect. The emotional system permits
the intellect to go off into a corner and think about distant things as long
as it does not interfere in joint decisions that affect the total life course.
Above 50, the intellectual system is sufficiently developed to begin making
a few decisions of its own. It has learned that the emotional system runs
an effective life course in most areas of functioning, but in critical situations
the automatic emotional decisions create longterm complications for the
total organism. The intellect learns that it requires a bit of discipline to
overrule the emotional system, but the longterm gain is worth the effort.
People above 50 have developed a reasonable level of solid self on most of
the essential issues in life. In periods of calm, they have employed logical
reasoning to develop beliefs, principles, and convictions that they use to
overrule the emotional system in situations of anxiety and panic. Differen-
tiation between the emotions and the intellect exists in subtle gradations.
People at the lower part of this group are those who know there is a better
way; but intellect is poorly formed, and they end up following life courses
similar to those below 50.
People in the upper part of this group are those in which there is more
solid self. Persons with a functional intellectual system are no longer a
prisoner of the emotional-feeling world. They are able to live more freely
and to have more satisfying emotional lives within the emotional system.
They can participate fully in emotional events knowing that they can extri-
cate themselves with logical reasoning when the need arises. There may be
periods of laxness in which they permit the automatic pilot of the emotional
system to have full control, but when trouble develops they can take over,
calm the anxiety, and avoid a life crisis. People with better levels of differen-
tiation are less relationship directed and more able to follow independent
life goals. They are not unaware of the relationship system, but their life
courses can be determined more from within themselves than from what
others think. They are more clear about the differences between emotion
and intellect, and they are better able to state their own convictions and
beliefs calmly without attacking the beliefs of others or without having to
defend their own. They are better able to accurately evaluate themselves in
Bowen 73
relation to others without the pretend postures that result in overvaluing
or undervaluing themselves. They marry spouses with equal levels of differ-
entiation. The life-style of a spouse at another level would be sufficiently
different to be considered emotionally incompatible. The marriage is a
functioning partnership. The spouses can enjoy the full range of emotional
intimacy without either being deselfed by the other. They can be autono-
mous selfs together or alone. The wife is able to function more fully as a
female and the husband more fully as a male without either having to debate
the advantages or disadvantages of biological and social roles. Spouses who
are more differentiated can permit their children to grow and develop their
own autonomous selfs without undue anxiety or without trying to fashion
their children in their own images. The spouses and the children are each
more responsible for themselves, and do not have to blame others for
failures or credit anyone else for their successes. People with better levels
of differentiation are able to function well with other people, or alone, as
the situation may require. Their lives are more orderly, they are able to cope
successfully with a broader range of human situations, and they are remark-
ably free from the full range of human problems.
In previous papers I have described a level of 75 to 100, which is more

hypothetical than real, and which conveys an erroneous impression of the
human phenomenon to concretistic thinkers who are searching for another
instrument to measure human functioning. Rather than pursue the hypoth-
esis about the upper extremes of differentiation, I shall instead make some
general comments about differentiation. A common mistake is to equate the
better differentiated person with a "rugged individualist." I consider rugged
individualism to be exaggerated pretend posture of a person struggling
against emotional fusion. The differentiated person is always aware of oth-
ers and the relationship system around him There are so many forces and
counterforces and details in differentiation that one has to get a broad
panoramic view of the total human phenomenon in order to be able to see
differentiation. Once it is possible to see the phenomenon, there it is, operat-
ing in full view, right in front of our eyes. Once it is possible to see the
phenomenon, it is then possible to apply the concept to hundreds of differ-
ent human situations. To try to apply it without knowing it is an exercise
in futility.
The therapy based on differentiation is no longer therapy in the usual

sense. The therapy is as different from the conventional therapy as the
theory is different from conventional theory. The overall goal is to help
individual family members to rise up out of the emotional togetherness that
binds us all. The instinctual force toward differentiation is built into the
organism, just as are the emotional forces that oppose it. The goal is to help
the motivated family member to take a microscopic step toward a better
level of differentiation, in spite of the togetherness forces that oppose. When
one family member can finally master this, then other family members
automatically take similar steps. The togetherness forces are so strong in
maintaining the status quo that any small step toward differentiation is met
with vigorous disapproval of the group. This is the point at which a thera-
pist or guide can be most helpful. Without help, the differentiating one will
fall back into the togetherness to get emotional harmony for the moment.
Conventional therapy is designed to resolve, or talk out, conflict. This does
accomplish the goal of reducing the conflict of that moment, but it can also
rob the individual of his budding effort to achieve a bit more differentiation
from the family togetherness. There are many pitfalls in the effort toward
differentiation. If the individual attempts it without some conviction of his
own, he is blindly following the advice of his therapist and is caught in a
self-defeating togetherness with the therapist. I believe that the level of
differentiation of a person is largely determined by the time he leaves the
parental family and he attempts a life of his own. Thereafter, he tends to
replicate the life-style from the parental family in all future relationships.
It is not possible ever to make more than minor changes in one's basic level
of self; but from clinical experience I can say it is possible to make slow
changes, and each small change results in the new world of a different
life-style. As I see it now, the critical stage is passed when the individual
can begin to know the difference between emotional functioning and intel-
lectual functioning, and when he has developed ways for using the knowl-
edge for solving future problems in a lifelong effort on his own. It is difficult
to assess differentiation during calm periods in a life. Clinically, I make
estimates from the average functional level of self as it operates through
periods of stress and calm. The real test of the stability of differentiation
comes when the person is again subjected to chronic severe stress.
It is reasonably accurate to compare the functioning of the emotional

and intellectual systems to the structure and function of the brain. I con-
ceive of one brain center that controls emotions and another that controls
intellectual functions. The fusion suggests centers that are side by side with
some degree of fusion, or grown togetherness. Anatomically, it would be
more accurate to think of the two as being connected by nerve tracts. In
poorly functioning people, the two centers are intimately fused, with the
emotional center having almost total dominance over the intellectual cen-
ter. In better functioning people, there is more functional separateness
between the centers. The more the separateness between the centers, the
more the intellectual center is able to block, or screen out, a spectrum of
stimuli from the emotional center, and to function autonomously. The
screening process, which might be biochemical, operates best when anxiety
is low. The emotional center controls the autonomic nervous system and all
other automatic functions. The intellectual center is the seat of intellect and
reasoning. The emotional center handles the myriads of sensory stimuli
Bowen 75
from the digestive, circulatory, respiratory, and all the other organ systems
within the body, as well as stimuli from all the sensing organs that perceive
the environment and relationships with others. In periods of calm, when the
emotional center is receiving fewer stimuli from its sensing network, the
intellectual center is more free to function autonomously. When the emo-
tional center is flooded by stimuli, there is little intellectual functioning that
is not governed by the emotional center. In some areas, the intellect operates
in the service of the emotional center.
There are many clinical examples that illustrate emotional dominance
over the intellect in determining a life course. The intellectual center is
either appended to, or is directed by, the emotional center. In the various
psychotic and neurotic states, the intellect is either obliterated or distorted
by emotionality. There may be an occasional situation in which there is an
island of reasonably intact intellectual activity, such as in the psychotic
person with a computer mind. In the various neurotic states the intellect
is directed by emotionality. There is the intellectualizing person whose
apparent intellect is directed by the emotional process. There are the behav-
ior problems in which automatic impulsive action is directed by emotional-
ity, and the intellect attempts to explain or justify it after the action. This
can vary from childish misbehavior to criminal action. The parents and the
social system ask why, pretending there is a logical answer. The organism
responds with an instant excuse that appears most acceptable to self and
others. In the same category falls the mass of emotional center-dominated
behavior that is often called self-destructive. This behavior is designed to
relieve anxiety of the moment, and the impulse for immediate relief over-
rules awareness of longterm complications. It is at its worst in alcohol and
drug abuse. There are situations in which the intellect aids emotionally-
directed behavior—as, for instance, intellectual planning that helps emo-
tionally directed crime. A large group of people choose their philosophies
and ideologies because of emotional system pressure. In another group, a
section of the intellect functions well on impersonal subjects; they can be
brilliant academically, while their emotionally-directed personal lives are
chaotic. Even in people who exhibit some degree of separation between
emotion and intellect, and in whom the intellect can hold its own with the
emotional system in certain areas most of the time, there are periods of
chronic stress in which the emotional system is dominant.
Triangles. I began work on this basic concept in 1955. By 1956 the

research group was thinking and talking about "triads." As the concept
evolved, it came to include much more than the meaning of the conven-
tional term triad, and we therefore had a problem communicating with
those who assumed they knew the meaning of triad. I chose triangle in order
to convey that this concept has specific meaning beyond that implied in
triad. The theory states that the triangle, a three-person emotional configu-
ration, is the molecule or the basic building block of any emotional system,
whether it is in the family or any other group. The triangle is the smallest
stable relationship system. A two-person system may be stable as long
as it is calm, but when anxiety increases, it immediately involves the most
vulnerable other person to become a triangle. When tension in the triangle
is too great for the threesome, it involves others to become a series of
interlocking triangles.
In periods of calm, the triangle is made up of a comfortably close
twosome and a less comfortable outsider. The twosome works to preserve
the togetherness, lest one become uncomfortable and form a better together-
ness elsewhere. The outsider seeks to form a togetherness with one of the
twosome, and there are numerous well-known moves to accomplish this.
The emotional forces within the triangle are constantly in motion from
moment to moment, even in periods of calm. Moderate tension states in the
twosome are characteristically felt by one, while the other is oblivious. It
is the uncomfortable one who initiates a new equilibrium toward more
comfortable togetherness for self.
In periods of stress, the outside position is the most comfortable and

most desired position. In stress, each works to get the outside position to
escape tension in the twosome. When it is not possible to shift forces in the
triangle, one of the involved twosome triangles in a fourth person, leaving
the former third person aside for reinvolvement later. The emotional forces
duplicate the exact patterns in the new triangle. Over time, the emotional
forces continue to move from one active triangle to another, finally remain-
ing mostly in one triangle as long as the total system is fairly calm.
When tensions are very high in families and available family triangles
are exhausted, the family system triangles in people from outside the family,
such as police and social agencies. A successful externalization of the ten-
sion occurs when outside workers are in conflict about the family while the
family is calmer. In emotional systems such as an office staff, the tensions
between the two highest administrators can be triangled and retriangled
until conflict is acted out between two who are low in the administrative
hierarchy. Administrators often settle this conflict by firing or removing one
of the conflictual twosome, after which the conflict erupts in another two-
some.
A triangle in moderate tension characteristically has two comfortable

sides and one side in conflict. Since patterns repeat and repeat in a triangle,
the people come to have fixed roles in relation to each other. The best
example of this is the father-mother-child triangle. Patterns vary, but one
of the most common is basic tension between the parents, with the father's
gaining the outside position—often being called passive, weak, and distant —
leaving the conflict between mother and child. The mother—often called
aggressive, dominating, and castrating—wins over the child, who moves
Bowen 77
another step toward chronic functional impairment. This pattern is de-

scribed as the family projection process. Families replay the same triangular
game over and over for years, as though the winner were in doubt, but the
final result is always the same. Over the years the child accepts the always-
lose outcome more easily, even to volunteering for this position. A variation
is the pattern in which the father finally attacks the mother, leaving the
child in the outside position. This child then learns the techniques of gaining
the outside position by playing the parents off against each other.
Each of the structured patterns in triangles is available for predictable
moves and predictable outcomes in families and social systems. A knowl-
edge of triangles provides a far more exact way of understanding the father-
mother-child triangle than do the traditional oedipal-complex explanations.
Triangles provide several times more flexibility in dealing with such prob-
lems therapeutically.
Knowledge of triangles helps provide the theoretical perspective be-
tween individual therapy and this method of family therapy. An emotion-
ally involved relationship is unavoidable in the average two-person, patient-
therapist relationship. Theoretically, family therapy provides a situation in
which intense relationships can remain within the family and the therapist
can be relatively outside the emotional complex. This is a good theoretical
premise that is hard to achieve in practice. Without some special effort, it
is easy for the family to wrap itself around the therapist emotionally, install
the therapist in an all-important position, hold the therapist responsible for
success or failure, and passively wait for the therapist to change the family.
I have already discussed ways other therapists have dealt with the therapeu-
tic relationship, as well as my continuing effort to operate from outside the
family emotional system. Initially that included making the family members
responsible for each other, avoiding the family tendency to assign impor-
tance to me, and promising no benefits except from the family's own effort
to learn about itself and change itself. Most important was a longterm effort
to attain and maintain emotional neutrality with individual family mem-
bers. There are many subtleties to this. Beyond this effort, it was knowledge
of triangles that provided the important breakthrough in the effort to stay
outside the emotional complex.
One experience, above all others, was important in learning about trian-
gles. That was a period in which much of my family therapy was with both
parents and behavior problem adolescent child. It was possible to see the
workings of the triangle between parents and child in microscopic detail.
The more I could stay outside the triangle, the more clearly it was possible
to see the family emotional system as it operated on well-defined emotional
circuits between father, mother, and child. Therapeutically, the family did
not change its original patterns. The passive father became less passive, the
aggressive mother less aggressive, and the symptomatic child would become
asymptomatic. The average, motivated family would continue for 30 to 40
weekly appointments and terminate with great praise for the "good result."
In my opinion, the family had not changed, but I had learned a lot about
triangles. It was possible to observe a family and know the next move in
the family before it occurred.
From the knowledge of triangles, I hypothesized the situation would be
different by excluding the child and limiting the therapy to the two parents
and the therapist. Rather than dealing in generalities about staying out of
the family emotional system, I was then armed with specific knowledge
about the parents' triangling moves to involve the therapist. Therapeu-
tically, the results were far superior to anything before that time. This has
remained the one basic therapeutic method since the early 1960's. On a
broad theoretical-therapeutic level, if the therapist can stay in viable emo-
tional contact with the two most significant family members, usually the
two parents or two spouses, and he can be relatively outside the emotional
activity in this central triangle, the age-old fusion between the family mem-
bers will slowly begin to resolve, and all other family members will au-
tomatically change in relation to the two parents in the home setting. This
is basic theory and basic method. The process can proceed regardless of
content or subject matter discussed. The critical issue is the emotional
reactiveness between the spouses, and the ability of the therapist to keep self
relatively detriangled from the emotionality. The process can proceed with
any third person who can keep self detriangled, but it would be difficult to
find such an outside relationship. The method is as successful as other
methods in short-term crisis situations. In the early years, I was active in
engaging the family emotionally in consultations and short-term crisis
situations. A calm, low-keyed, detriangling approach is more effective with
a single appointment or with many.
Nuclear Family Emotional System. This concept describes the patterns

of emotional functioning in a family in a single generation. Certain basic
patterns between the father, mother, and children are replicas of the past
generations and will be repeated in the generations to follow. There are
several rather clear variables that determine the way the family functions
in the present generation, which can be measured and validated by direct
observation. From a careful history, in connection with knowledge of the
details in the present generation, it is possible to do a rather remarkable
reconstruction of the way the process operated in past generations. From
knowledge about the transmission of family patterns over multiple genera-
tions, it is possible to project the same process into future generations, and,
within limits, do some reasonably accurate predictions about future genera-
tions. No one person lives long enough to check the accuracy of predictions
into the future, but there is enough detailed knowledge about some families
in history to do a reasonable check on the predictive process. Based on
Bowen 79
experience in family research, the predictions of ten to twenty years ago

have been rather accurate.
The beginning of a nuclear family, in the average situation, is a mar-
riage. There are exceptions to this, just as there have always been excep-
tions, which is all part of the total theory. The basic process in exceptional
situations is similar to the more chaotic pattern in poorly differentiated
people. The two spouses begin a marriage with life-style patterns and levels
of differentiation developed in their families of origin. Mating, marriage,
and reproduction are governed to a significant degree by emotional-instinc-
tual forces. The way the spouses handle them in dating and courtship and
in timing and planning the marriage provides one of the best views of the
level of differentiation of the spouses. The lower the level of differentiation,
the greater the potential problems for the future. People pick spouses who
have the same levels of differentiation. Most spouses can have the closest
and most open relationships in their adult lives during courtship. The fusion
of the two pseudo-selfs into a common self occurs at the time they commit
themselves to each other permanently, whether it be the time of engage-
ment, the wedding itself, or the time they establish their first home together.
It is common for living together relationships to be harmonious, and for
fusion symptoms to develop when they finally get married. It is as if the
fusion does not develop as long as they still have an option to terminate the
relationship.
The lower the level of differentiation, the more intense the emotional
fusion of marriage. One spouse becomes more the dominant decision maker
for the common self, while the other adapts to the situation. This is one of
the best examples in the borrowing and trading of self in a close relationship.
One may assume the dominant role and force the other to be adaptive, or
one may assume the adaptive role and force the other to be dominant. Both
may try for the dominant role, which results in conflict; or both may try
for the adaptive role, which results in decision paralysis. The dominant one
gains self at the expense of the more adaptive one, who loses self. More
differentiated spouses have lesser degrees of fusion, and fewer of the com-
plications. The dominant and adaptive positions are not directly related to
the sex of the spouse. They are determined by the position that each had
in their families of origin. From my experience, there are as many dominant
females as males, and as many adaptive males as females. These characteris-
tics played a major role in their original choice of each other as partners.
The fusion results in anxiety for one or both of the spouses. There is a
spectrum of ways spouses deal with fusion symptoms. The most universal
mechanism is emotional distance from each other. It is present in all mar-
riages to some degree, and in a high percentage of marriages to a major
degree.
Other than the emotional distance, there are three major areas in which
the amount of undifferentiation in the marriage comes to be manifested in
symptoms. The three areas are marital conflict; sickness or dysfunction in
one spouse; and projection of the problems to children. It is as if there is
a quantitative amount of undifferentiation to be absorbed in the nuclear
family, which may be focused largely in one area or distributed in varying
amounts to all three areas. The various patterns for handling the undifferen-
tiation comes from patterns in their families of origin, and the variables
involved in the mix in the common self. Following are general characteris-
tics of each of the three areas.
Marital Conflict. The basic pattern in conflictual marriages is one in
which neither gives in to the other or in which neither is capable of an
adaptive role. These marriages are intense in the amount of emotional
energy each invests in the other. The energy may be thinking or action
energy, either positive or negative, but the self of each is focused mostly on
the other. The relationship cycles through periods of intense closeness,
conflict that provides a period of emotional distance, and making up, which
starts another cycle of intense closeness. Conflictual spouses probably have
the most overtly intense of all relationships. The intensity of the anger and
negative feeling in the conflict is as intense as the positive feeling. They are
thinking of each other even when they are distant. Marital conflict does not
in itself harm children. There are marriages in which most of the undifferen-
tiation goes into marital conflict. The spouses are so invested in each other
that the children are largely outside the emotional process. When marital
conflict and projection of the problem to children are both present, it is the
projection process that is hurtful to children. The quantitative amount of
marital conflict that is present reduces the amount of undifferentiation
that is focused elsewhere.
Dysfunction in One Spouse. This is the result when a significant amount

of undifferentiation is absorbed in the adaptive posture of one spouse. The
pseudo-self of the adaptive one merges into the pseudo-self of the dominant
one, who assumes more and more responsibility for the twosome. The
degree of adaptiveness in one spouse is determined from the longterm
functioning posture of each to the other, rather than from verbal reports.
Each does some adapting to the other, and it is usual for each to believe
that he or she gives in more than the other. The one who functions for long
periods in the adaptive position gradually loses the ability to function and
make decisions for self. At that point, it requires no more than a moderate
increase in stress to trigger the adaptive one into dysfunction, which can be
physical illness, emotional illness, or social illness, such as drinking, acting
out, and irresponsible behavior. These illnesses tend to become chronic, and
they are hard to reverse.
The pattern of the overfunctioning spouse in relation to the underfunc-

tioning spouse exists in all degrees of intensity. It can exist as an episodic
Bowen 87
phenomenon in families who use a mixture of all three mechanisms. When
used as the principal means of controlling undifferentiation, the illnesses can
be chronic and most difficult to reverse. The sick or invalided one is too
impaired to begin to regain function with an overfunctioning spouse on
whom he or she is dependent. This mechanism is amazingly effective in
absorbing the undifferentiation. The only disadvantage is the dysfunction
in one, which is compensated for by the other spouse. The children can be
almost unaffected by having one dysfunctional parent as long as there is
someone else to function instead. The main problem in the children is
inheriting a life pattern as caretaker of the sick parent, which will project
into the future. These marriages are enduring. Chronic illness and invali-
dism, whether physical or emotional, can be the only manisfestation of the
intensity of the undifferentiation. The underfunctioning one is grateful for
the care and attention, and the overfunctioning one does not complain.
Divorce is almost impossible in these marriages unless the dysfunction is
also mixed with marital conflict. There have been families in which the
overfunctioning one has died unexpectedly and the disabled one has miracu-
lously regained functioning. If there is a subsequent marriage, it follows the
pattern of the previous one.
Impairment of One or More Children. This is the pattern in which

parents operate as a we-ness to project the undifferentiation to one or more
children. This mechanism is so important in the total human problem it has
been described as a separate concept, the family projection process.
There are two main variables that govern the intensity of this process
in the nuclear family. The first is the degree of the emotional isolation, or
cutoff, from the extended family, or from others important in the relation-
ship system. I will discuss this below. The second important variable has
to do with the level of anxiety. Any of the symptoms in the nuclear family,
whether they be marital conflict, dysfunction in a spouse, or symptoms in
a child, are less intense when anxiety is low and more intense when anxiety
is high. Some of the most important family therapy efforts are directed at
decreasing anxiety and opening the relationship cutoff.
Family Projection Process. The process through which parental un-
differentiation impairs one or more children operates within the father-
mother-child triangle. It revolves around the mother, who is the key figure
in reproduction and who is usually the principal caretaker for the infant.
It results in primary emotional impairment of the child; or, it can superim-
pose itself on some defect or on some chronic physical illness or disability.
It exists in all gradations of intensity, from those in which impairment is
minimal to those in which the child is seriously impaired for life. The
process is so universal it is present to some degree in all families
A composite of families with moderately severe versions of the projec-
tion process will provide the best view of the way the process works. It is
as if there is a definite amount of undifferentiation to be absorbed by marital
conflict, sickness in a spouse, and projection to the children. The amount
absorbed in conflict or sickness in a spouse reduces the amount that will be
directed to the children. There are a few families in which most of the
undifferentiation goes into marital conflict, essentially none to sickness
in a spouse, and relatively small amounts to the children. The most striking
examples of this have been in families with autistic, or severely impaired,
children in which there is little marital conflict, both spouses are healthy,
and the full weight on the undifferentiation is directed to a single, maximally
impaired child. I have never seen a family in which there was not some
projection to a child. Most families use a combination of all three mech-
anisms. The more the problem shifts from one area to another, the less
chance the process will be crippling in any single area.
There are definite patterns in the way the undifferentiation is distributed

to children. It focuses first on one child. If the amount is too great for that
child, the process will select others for lesser degrees of involvement. There
are families in which the amount of undifferentiation is so great it can
seriously impair most of the children, and leave one or two relatively out
of the emotional process. There is so much disorder and chaos in these
families, it is difficult to see the orderly steps in the process. I have never
seen a family in which children were equally involved in the family emo-
tional process. There may be some exceptions to the process described here,
but the overall patterns are clear, and the theory accounts for the excep-
tions. There are suggestions about the way children become the objects of
the projection process. On a simplistic level, it is related to the degree of
emotional turn on or turn off (both equal in emotional systems terms) the
mother feels for the child. This is an automatic emotional process that is
not changed by acting the opposite. On a more specific level, it is related
to the level of undifferentiation in the parents, the amount of anxiety at the
time of conception and birth, and the orientation of the parents toward
marriage and children.
The early thoughts about marriage and children are more prominent in
the female than the male. They begin to take an orderly form before adoles-
cence. A female who thinks primarily of the husband she will marry tends
to have marriages in which she focuses most of her emotional energy on the
husband, and he focuses on her, and symptoms tend to focus more in
marital conflict and sickness in a spouse. Those females whose early
thoughts and fantasies go more to the children they will have than the man
they will marry, tend to become the mothers of impaired children. The
process can be so intense in some women that the husband is incidental to
the process. Spouses from lower levels of differentiation are less specific
about marriage and children. The children selected for the family projection
process are those conceived and born during stress in the mother's life; the
Bowen 83
first child, the oldest son or oldest daughter, an only child of either sex, one
who is emotionally special to the mother, or one the mother believes to be
special to the father. Among common special children are only children, an
oldest child, a single child of one sex among several of the opposite sex,
or a child with some defect. Also important are the special children who were
fretful, colicky, rigid, and nonresponsive to the mother from the beginning.
The amount of initial special emotional investment in such children is great.
A good percentage of mothers have a basic preference for boys or girls,
depending upon their orientation in the family of origin. It is impossible for
mothers to have equal emotional investment in any two children, no matter
how much they try to protest equality for all.
On a more detailed level, the projection process revolves around mater-
nal instinct, and the way anxiety permits it to function during reproduction
and the infancy of the child. The father usually plays a support role to the
projection process. He is sensitive to the mother's anxiety, and he tends to
support her view and help her implement her anxious efforts at mothering.
The process begins with anxiety in the mother. The child responds anx-
iously to mother, which she misperceives as a problem in the child. The
anxious parental effort goes into sympathetic, solicitous, overprotective
energy, which is directed more by the mother's anxiety than the reality
needs of the child. It establishes a pattern of infantilizing the child, who
gradually becomes more impaired and more demanding. Once the process
has started, it can be motivated either by anxiety in the mother, or anxiety
in the child. In the average situation, there may be symptomatic episodes
at stressful periods during childhood, which gradually increase to major
symptoms during or after adolescence; intense emotional fusion between
mother and child may exist in which the mother-child relationship remains
in positive, symptom-free equilibrium until the adolescent period, when the
child attempts to function on his own. At that point, the child's relationship
with the mother, or with both parents, can become negative and the child
develop severe symptoms. The more intense forms of the mother-child
fusion may remain relatively asymptomatic until young adulthood and the
child can collapse in psychosis when he attempts to function away from the
parents.
The basic pattern of the family projection is the same, except for minor
variations in form and intensity, whether the eventual impairment in the
child be one that leads to serious lifelong dysfunction, or one that never
develops serious symptoms and is never diagnosed. The greatest number of
people impaired by the projection process are those who do less well with
life and who have lower levels of differentiation than their siblings, and who
may go for a few generations before producing a child who becomes seri-
ously impaired symptomatically. This theory considers schizophrenia to be
the product of several generations of increasing symptomatic impairment,
with lower and lower levels of differentiation, until there is a generation that
produces schizophrenia. In clinical work, we have come to use the term
the triangled child to refer to the one who was the main focus of the family
projection process. Almost every family has one child who was more trian-
gled than the others, and whose life adjustment is less good than the others.
In doing multigenerational family histories, it is relatively easy to estimate
the family projection process and identify the triangled child by securing
historical data about the life adjustments of each sibling.
Emotional Cutoff. This concept was added to the theory in 1975 after
having been a poorly defined extension of other concepts for several years.
It was accorded the status of a separate concept to include details not stated
elsewhere, and to have a separate concept for emotional process between the
generations. The life pattern of cutoffs is determined by the way people
handle their unresolved emotional attachments to their parents. All people
have some degree of unresolved emotional attachment to their parents. The
lower the level of differentiation, the more intense the unresolved attach-
ment. The concept deals with the way people separate themselves from the
past in order to start their lives in the present generation. Much thought
went into the selection of a term to best describe this process of separation,
isolation, withdrawal, running away, or denying the importance of the
parental family. However much cutoff may sound like informal slang, I
could find no other term as accurate for describing the process. The thera-
peutic effort is to convert the cutoff into an orderly differentiation of a self
from the extended family.
The degree of unresolved emotional attachment to the parents is equiva-

lent to the degree of undifferentiation that must somehow be handled in the
person's own life and in future generations. The unresolved attachment is
handled by the intrapsychic process of denial and isolation of self while
living close to the parents; or by physically running away; or by a combina-
tion of emotional isolation and physical distance. The more intense the
cutoff with the past, the more likely the individual to have an exaggerated
version of his parental family problem in his own marriage, and the more
likely his own children to do a more intense cutoff with him in the next
generation. There are many variations in the intensity of this basic process
and in the way the cutoff is handled.
The person who runs away from his family of origin is as emotionally
dependent as the one who never leaves home. They both need emotional
closeness, but they are allergic to it. The one who remains on the scene and
handles the attachment by intrapsychic mechanisms tends to have some
degree of supportive contact with the parents, to have a less intense overall
process, and to develop more internalized symptoms under stress, such as
physical illness and depression. An exaggerated version of this is the
severely impaired person who can collapse into psychosis, isolating himself
Bowen 85
intrapsychically while living with the parents. The one who runs away
geographically is more inclined to impulsive behavior. He tends to see the
problem as being in the parents and running away as a method of gaining
independence from the parents. The more intense the cutoff, the more he
is vulnerable to duplicating the pattern with the parents with the first
available other person. He can get into an impulsive marriage. When prob-
lems develop in the marriage, he tends also to run away from that. He can
continue through multiple marriages, and finally resort to more temporary
living together relationships. Exaggerated versions of this occur in relation-
ship nomads, vagabonds, and hermits who either have superficial relation-
ships or give up and live alone.
In recent years, as the age-old cutoff process became more pronounced

as a result of societal anxiety, the emotional cutoff has been called the
generation gap. The higher the level of anxiety, the greater the degree of
generation gap in poorly differentiated people. There has been an increase
in the percentage of those who run away, and who become involved in living
together arrangements and communal living situations. These substitute
families are very unstable. They are made up of people who ran away from
their own families; when tension builds up in the substitute family, they
cutoff from that and move on to another. Under the best conditions, the
substitute family and outside relationships are poor substitutes for original
families.
There are all gradations of the emotional cutoff. An average family

situation in our society today is one in which people maintain a distant and
formal relationship with the families of origin, returning home for duty
visits at infrequent intervals. The more a nuclear family maintains some
kind of viable emotional contact with the past generations, the more orderly
and asymptomatic the life process in both generations. Compare two fami-
lies with identical levels of differentiation. One family remains in contact
with the parental family and remains relatively free of symptoms for life,
and the level of differentiation does not change much in the next generation.
The other family cuts off with the past, develops symptoms and dysfunction,
and a lower level of differentiation in the succeeding generation. The symp-
tomatic nuclear family that is emotionally cut off from the family of origin
can get into cyclical, longterm family therapy without improvement. If one
or both parents can re-establish emotional contact with their families of
origin, the anxiety level subsides, the symptoms become softer and more
manageable, and family therapy can become productive. Merely telling a
family to go back to the family of origin is of little help. Some people are
very anxious about returning to their families. Without systems coaching,
they can make the problem worse. Others can return, continue the same
emotional isolation they used when they were in the family, and accomplish
nothing. Techniques for helping families to re-establish contact have been
sufficiently developed so that it is now a family therapy method in its own
right. This differentiation of a self in one's own family has been presented
in another paper (15). It is based on the experience that a spouse who can
do a reasonable job at differentiating self in his parental family will have
accomplished more than if he was involved in regular family therapy with
self and his spouse.
Multigenerational Transmission Process. The family projection process
continues through multiple generations. In any nuclear family, there is one
child who is the primary object of the family projection process. This child
emerges with a lower level of differentiation than the parents and does less
well in life. Other children, who are minimally involved with the parents,
emerge with about the same levels of differentiation as the parents. Those
who grow up relatively outside the family emotional process develop better
levels of differentiation than the parents. If we follow the most impaired
child through successive generations, we will see one line of descent produc-
ing individuals with lower and lower levels of differentiation. The process
may go rapidly a few generations, remain static for a generation or so, and
then speed up again. Once I said it required at least three generations to
produce a child so impaired he would collapse into schizophrenia. That was
based on the notion of a starting point with fairly good surface functioning
and a process that proceeded at maximum speed through the generations.
However, since I now know the process can slow down or stay static a
generation or two, I would now say that it would require perhaps eight to
ten generations to produce the level of impairment that goes with schizo-
phrenia. This is the process that produces the poorly functioning people
who make up most of the lower social classes. If a family encounters severe
stress in perhaps the fifth or sixth generation of a ten-generation
process, it may produce a social failure who is less impaired than the
schizophrenic person. The degree of impairment in schizophrenia comes
from those poorly differentiated people who are able to keep the relationship
system in relatively symptom-free equilibrium for several more
generations.
If we followed the line through the children who emerge with about the
same levels of differentiation, we see a remarkable consistency of family
functioning through the generations. History speaks of family traditions,
family ideals, and so on. If we follow the multigenerational lineage of those
who emerge with higher levels of differentiation, we will see a line of highly
functioning and very successful people. A family at a highest level of differ-
entiation can have one child who starts down the scale. A family at the
lowest level can have a child who starts up the scale. Many years ago I
described schizophrenia from a phenomenological standpoint as a natural
process that helps to keep the race strong. The weakness from the family
is fixed in one person who is less likely to marry and reproduce and more
likely to die young.
Bowen 87
Sibling Position. This concept is an adaptation of Toman's work on the
personality profiles of each sibling position. His first book in 1961 (14) was
remarkably close to the direction of some of my research. He had worked
from an individual frame of reference and only with normal families, but
he had ordered his data in a way no one else had done, and it was easy to
incorporate them into the differentiation of self and the family projection
process. His basic thesis is that important personality characteristics fit with
the sibling position in which a person grew up. His ten basic sibling profiles
automatically permit one to know the profile of any sibling position, and,
all things being equal, to have a whole body of presumptive knowledge
about anyone. His ideas provided a new dimension toward understanding
how a particular child is chosen as the object of the family projection
process. The degree to which a personality profile fits with normal
provides a way to understand the level of differentiation and the direction
of the projection process from generation to generation. For instance, if an
oldest turns out to be more like a youngest, that is strong evidence that
he was the most triangled child. If an oldest is an autocrat, that is strong
evidence of a moderate level of impaired functioning. An oldest who
functions calmly and responsibly is good evidence of a better level of
differentiation. The use of Toman's profiles, together with differentiation
and projection, make it possible to assemble reliable presumptive
personality profiles on people in past generations on whom verifiable facts
are missing. Knowing the degree to which people fit the profiles provides
predictive data about how spouses will handle the mix in a marriage, and
how they will handle their effort in family therapy. Based on my research
and therapy, I believe that no single piece of data is more important than
knowing the sibling position of people in the present and past generations.
Societal Regression. This eighth and last of the concepts in the Bowen
theory was first defined in 1972, and formally added to the theory in 1975.
I have always been interested in understanding societal problems, but the
tendency of psychiatrists and social scientists to make sweeping generaliza-
tions from a minimal number of specific facts resulted in my interest's
remaining peripheral except for personal reading. Family research added a
new order of facts about human functioning, but I avoided the seductive
urge to generalize from them. In the 1960s, there was growing evidence that
the emotional problem in society was similar to the emotional problem in
the family. The triangle exists in all relationships, and that was a small clue.
In 1972 the Environmental Protection Agency invited me to do a paper on
human reaction to environmental problems. I anticipated doing a paper on
assorted facts acquired from years of experience with people relating to
larger societal issues. That paper led to a year of research, and a return to
old files for confirmation of data. Finally I identified a link between the
family and society that was sufficiently trustworthy for me to extend the
basic theory about the family into the larger societal arena. The link had
to do, first, with the delinquent teenaged youngster, who is a responsibility
for both the parents and society, and secondly, with changes in the way the
parents and the agents of society deal with the same problem.
It has not yet been possible to write this up in detail, but the overall
structure of the concept was presented in outline form in 1974 (16). The
concept states that when a family is subjected to chronic, sustained anxiety,
the family begins to lose contact with its intellectually determined princi-
ples, and to resort more and more to emotionally determined decisions to
allay the anxiety of the moment. The results of the process are symptoms
and eventually regression to a lower level of functioning. The societal
concept postulates that the same process is evolving in society; that we are
in a period of increasing chronic societal anxiety; that society responds to
this with emotionally determined decisions to allay the anxiety of the mo-
ment; that this results in symptoms of dysfunction; that the efforts to relieve
the symptoms result in more emotional band aid legislation, which increases
the problem; and that the cycle keeps repeating, just as the family goes
through similar cycles to the states we call emotional illness. In the early
years of my interest in societal problems, I thought that all societies go
through good periods and bad, that they always go through a rise and fall,
and that the cyclical phenomenon of the 1950s was part of another cycle.
As societal unrest appeared to move toward intensification of the problems
through the 1960s, I began to look for ways to explain the chronic anxiety.
I was looking for concepts consistent with man as an instinctual being,
rather than man as a social being. My current postulation considers the
chronic anxiety as the product of the population explosion, decreasing
supplies of food and raw materials necessary to maintain man's way of life
on earth, and the pollution of the environment which is slowly threatening
the balance of life necessary for human survival.
This concept proceeds in logical steps from the family to larger and
larger social groups, to the total of society. It is too complex for detailed
presentation here. I outline it here to indicate that the theoretical concepts
of the Bowen theory do permit logical extension into a beginning theory
about society as an emotional system.
SUMMARY
Most members of the mental health professions have little interest in,
or awareness of, theory about the nature of emotional illness. I have devel-
oped a family systems theory of emotional functioning. For some ten
years I have been trying to present the theory as clearly as it is possible
for me
Bowen 89
to define it. Only a small percentage of people are really able to hear it. In
the early years, I considered most of the problem to be my difficulty in
communicating the ideas in ways others could hear. As the years have
passed, I have come to consider that the major difficulty is the inability of
People to detach themselves sufficiently from conventional theory to be able
to hear systems concepts. In each presentation, I learn a little more about
which points people fail to hear. I have devoted almost half of this presenta-
tion to some broad background issues which I hoped would set the stage
for people to hear more than they had heard before, and to clarify some of
the issues between my family systems theory and general systems
theory. I have never been happy about my efforts to present my own
theory. I
can be perfectly clear in my own mind, but there is always the problem of
restating it so others can hear. If it gets too brief, people hear the theory
as too static and too simplistic. If I try to fill out the concepts with more
detail, it tends to get wordy and repetitive. Ultimately, I hope to present
it so that each theoretical concept is illustrated with a clinical example, but
that is a long and complex book. I believe that some systems theory will
provide a bright new promise for comprehending emotional illness.
Whether the ultimate systems theory is this one or another remains to be
seen. After some twenty years of experience with this theory, I have great
confidence in it. It does mean that the therapist must keep the whole
spectrum of variables in his head at once; but, after some experience,
knowing the variables well enough to know when one is out of balance
becomes automatic.
REFERENCES
1. M. Bowen. "The Use of Family Theory in Clinical Practice," Comprehensive

Psychiatry, 7(1966), 345-74.
2. "Family Therapy and Family Group Therapy," in H. Kaplan and B.
Sadock (eds.). Comprehensive Group Psychotherapy. New York: Williams and
Wilkins, 1971.
3. G. Bateson, D.D. Jackson, J. Haley, and J.H. Weakland. "Toward a Theory of
Schizophrenia," Behavioral Science, 1 (1956), 251.
4. M. Bowen. "A Family Concept of Schizophrenia," in D. Jackson (ed.). The
Etiology of Schizophrenia. New York: Basic Books, 1960, 346.
5 "Family Psychotherapy with Schizophrenia in the Hospital and Private
Practice," in I. Boszormenyi-Nagy and J. Framo (eds.). Intensive Family
Therapy. New York: Harper and Row, 1965, 213.
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CHAPTER 3

Theory in the Practice of

There are striking discrepancies between theory and practice in psychother-

I have spent almost three decades on clinical research in psychotherapy.

Twentieth-century psychotherapy probably has its origin in Freud, who

The number of differences about the therapeutic relationship are even

There are other evolutionary trends that illustrate the separation of

There are trends in the training of mental health professionals that

produces professionals who are oriented around the therapeutic relation-

In presenting these ideas about the separation of theory and therapy in

Family research has identified some characteristics of emotional systems

An individually oriented psychotherapist is a common significant other.

A set of variables revolve around the qualities that go into a significant

Psychotherapy is a service that deals in a higher level of emotionality

techniques to encourage the patient to assign him an overimportance which

I go into this much detail about the therapeutic relationship because

The prevailing opinion of therapists who operate with the therapeutic

THE THERAPEUTIC RELATIONSHIP IN FAMILY THERAPY

The separation between theory and therapy in most family therapy is

Family therapists deal with the therapeutic relationship in a variety of

My approach differs from the mainstream of family therapy. I have

The effort of being outside the family emotional system, or remaining

THEORY IN THE DEVELOPMENT OF FAMILY THERAPY

The family movement in psychiatry was started in the mid-1950s by

For years I had pondered the discrepancies in psychoanalytic theory

The evolution of my own theoretical thinking began in the decade before

My initial family research was based on an extension of theoretical

Feeling and emotion are used almost synonymously in popular usage

The intellectual system is a function of the cerebral cortex which ap-

Any relationship with balancing forces and counterforces in constant

It is grossly inaccurate to consider family systems theory as synonymous

Emotionality, feelings, and subjectivity are the principal commodities

The effort to focus on the functional facts of relationship systems is a

emotionally involved in the content of the communication. The main reason

Three of the theory's eight.concepts apply to overall characteristics of

) Differentiation of Self This concept is a cornerstone of the theory, and

At the fusion end of the spectrum, the intellect is so flooded by emotion-

As I began to present the concept of a well-differentiated person as one

equivalent to intellectuality which is used as a defense against emotionality

In earlier papers, I presented this as a Differentiation of Self Scale." I

The pseudo-self is created by emotional pressure, and it can be modified

Profile of Low Levels of Differentiation. This is the group I previously

Profile of Moderate Levels of Differentiation of Self This is the group

The pseudo-self may be a conforming disciple who pretends to be in

People in the moderate range of differentiation have the most intense

In previous papers I have described a level of 75 to 100, which is more

The therapy based on differentiation is no longer therapy in the usual

It is reasonably accurate to compare the functioning of the emotional

Triangles. I began work on this basic concept in 1955. By 1956 the

In periods of stress, the outside position is the most comfortable and

A triangle in moderate tension characteristically has two comfortable

another step toward chronic functional impairment. This pattern is de-

Nuclear Family Emotional System. This concept describes the patterns

experience in family research, the predictions of ten to twenty years ago

Dysfunction in One Spouse. This is the result when a significant amount

The pattern of the overfunctioning spouse in relation to the underfunc-

Impairment of One or More Children. This is the pattern in which

There are definite patterns in the way the undifferentiation is distributed

The degree of unresolved emotional attachment to the parents is equiva-