Michael Fogarty, MD writing in the 1970’s and working with Philip Guerin, MD, was both clear and elegant in describing his gradual understanding and movement from an individual to a family and systems focus. He was also among the most articulate about what a system and particularly a family system really were. Describing the family systemic view of Murray Bowen, MD, he wrote, Bowen “traced levels of anxiety over three or more generations. He showed how the intensity of this anxiety could rise so high and diffuse among people so widely that one ended up with an undifferentiated family ego mass — a large glop of people so undefined that a feeling in one was experienced as a feeling in the other. He tried to get people to define their "I" positions out of this glop so they could move up the scale of differentiation.”
Mary Sykes Wiley a senior family therapist describes Bowen’s work:
“While Bowen did not invent systems thinking, he was the first to conceptualize the family as a natural system—more like an ant colony or an elephant herd than most people cared to admit—which could only be fully understood in terms of the fluid but predictable processes between members. Such a major part of the official family therapy canon have Bowen's ideas about the family system become, that it is almost impossible to imagine the field without him. He did more than give intellectual legitimacy to the scruffy, make-do empiricism of family therapy. In large part he created the field's intellectual scaffolding, gave it the conceptual structure that distinguishes it as a system of thought and a discipline from all other psychotherapies." Focusing on the clinical work, she continues, "Furthermore, Bowen introduced a highly novel form of family therapy based on one family member's researching and coming to terms with his or her own family of origin. Unlike most family or individual therapists, Bowen conceived personal growth and family interaction as part of an indivisible whole, creating a therapy that involved both the self of the individual and the multiple relations in the family." Notice that she does not mention the larger circles as necessary for understanding either the family or the individual.
"Finally, Bowen gave family therapists a new way to know themselves..." "He transformed the psychoanalytic process of finding yourself into something particularly appropriate for family therapy," says Carl Whitaker. "He showed family therapists a way they could look at themselves and their own lives, analogous to Freud's self-analysis, and bring that awareness into their work." Bowen, alone, made it a critical point that therapists differentiate themselves from their own families before trying to help others do the same.” Separation is so important and taken for granted as a goal and a relevant yardstick."
And Fogarty again: describing dysfunction in a relationship,
“…that the focus is on the other person. What properly belongs in and to the other person? What are the limits of what one can realistically and functionally do for the other person? This has to be done without borrowing self from the other. It is easy for the wife of an "alcoholic" to look good by trying to help him. Ask her what she wants from herself, for herself. She will give you an answer in terms of him, not herself. "I would be happy if he stopped drinking." She is not responsible for his drinking but she is borrowing self from him. As long as he has a "problem," she does not have to look at herself…This then means that we must emphasize the necessity for the other person to be allowed and encouraged to have an "I" position of his own. “
Please notice the non-tribal or anti-tribal emphasis. Tribes more or less disown an "I" position visa a spouse, especially in women.
How can we integrate the following facts and phenomena?
1) The global fact of political, social and family “tribalism”, 2) Bowen’s family systems theory and its emphasis on individuating, 3)northwestern vs southeastern history, and 4) the different geography based views of governance and macroeconomics.
Let’s start with psychotherapy.
Starting in the 1880’s Sigmund Freud, MD, saw patients through an individual pathology lens. That is, he viewed the data relevant to understanding a person as stemming from individual constitution and intimate life experiences. The more these two areas could be explored and articulated for “the patient”, the better our chances of helping that patient. Although there is abundant evidence that he was aware of cultural differences and culture’s affects on people, he never incorporated these effects and their implications on how to help or understand patients clinically or theoretically.
Erich Fromm, a post-Freudian analyst also emphasized the individual but in a more social context. He described different societies and he described different societal “types” or “characters”. He even mentioned a process in which societies seem to create the national character in its citizens that is necessary for the society to survive or prosper.
Harry Stack Sullivan, MD, another societally sensitive analyst focused on dyadic relationships. He was quoted as saying “The mother is the transmission belt of the society” to the children. He wrote an essay titled "The Myth of individuality". Neither Fromm nor Sullivan went into detail nor tried to explain the mechanisms, processes nor methods involved in passing on from one generation to the next, the character traits that form the fabric and engines of a society. What allows the self- induced misery of one generation (alcoholism, drug addiction, compulsive criminality, compulsive greed and materialism, emotional distance and deadness) to find its way into the hearts, minds and psyches of the next with almost twin-like similarities? Will we ever be able to identify, articulate and intervene in these universally observed phenomena? This forum seeks to start that process.
In the post World War II period the “object relations” school of psychiatry again saw the roots of understanding people as lying in the first two years of life and within a dyad framework; this time in early mother–child intimacy. Instead of one “ego, id, superego”, to understand, we now were offered the interaction of two people to unravel: the early child-patient and the “mothering one”. Please read Wikipedia’s description of one such practitioner: James Masterson, MD.
“Most closely associated with the British psychoanalysts Donald Winnicott and Melanie Klein, object relations theory centers on infants' early attachment to their mothers. This attachment is vital, the theory holds — so vital that disruptions can cause psychological disturbances later on. Classical Freudianism roots personality disorders in the Oedipal period, roughly between the ages of 4 and 6. Applying the object relations model, Dr. Masterson placed the roots even farther back, in the pre-oedipal period between the ages of about six and 36 months.
The pre-Oedipal disorders include all the personality disorders by definition, but are much more concerned with the issue of maternal availability. Dr. Masterson argued that these disorders crucially involve the conflict between a person's two "selves": the false self, which the very young child constructs to please the mother, and the real self. The psychotherapy of personality disorders, is an attempt is to put people back in touch with their real selves.”
Starting in the late 1950’s Murray Bowen, MD incorporated a wider “systemic” framework through which to understand the nature of “psychopathology” and “normal” development.
“Before Bowen, early family thinkers like Ackerman and Whitaker "ingeniously tried to stretch psychoanalytic theory to fit around families," says Robert Aylmer, a Bowen student and director of LifeCycle Learning Center in Newton, Massachusetts.
"Bowen was the first to realize you can't translate individual psychoanalytic concepts into the language of families, and the first to see the family as a structure in itself, which had its own wiring." The family, in short, wasn't just a collection of mutually influential but separate psyches living together under the same roof. For Freud, unconscious motivation was the unperceived prime mover of intellectual and emotional life; for Bowen, the submerged ebb and flow of family life, the simultaneous push and pull between family members for both distance and togetherness, was the driving force underlying all human behavior.” (Mary Sykes Reilly)
When viewing data in a systemic framework, all systems, (e.g. families, schools, businesses, cities and cultures) are seen as functioning in ever-expanding concentric circles having an inter-related and mutually influencing non-linear pattern. Systemic thinking was used to understand the functioning of a variety of system types: industries and businesses, schools, cities etc. Bowen applied systems thinking to the individual and the “family of origin”. Understanding the family was seen as the proper database and context in which to “understand” the origins of, and the solutions for, the problems of the “patient”. He repudiated a view that saw the individual patient as the proper item of study. In this context he actually saw the family as being a living, breathing entity that was constantly adapting and modifying itself and its members to establish the universal goals necessary for survival.
Our hypothesis is that, as per Dr. Murray Bowen, all cultures (all individuals and all groups) for the sake of survival, seek stability and balance (Homeostasis). As Bowen formulated, the family is a living breathing organism that responds internally and dynamically to changing circumstances. We believe the same description can be applied to society. In order to function within different socio and political-economic constraints, all civilizations instill certain unique anxiety parameters and markers as well as anxiety antidotes in its family citizens in order to facilitate cultural stability and survival. There is an intense interactive relationship between families and their surrounding societal culture. Families are seen as the mediators between the individual, (his character, style and substance) and that of the surrounding socio-political-economic culture. Using the principles of Family Therapy Systems Theory we seek to draw a series of parallel lines between these two dynamic domains: on one hand the workings of cultural history, macroeconomics and political science, and on the other hand individual development, parenting and adult character and behavior. Between these two domains is "la famiglia." These two parallel lines (an interactive pattern of reciprocity and spiraling mutual influence and reinforcement) are mediated and held in place by this universal institution, the family. We contend that appreciating the interactions of these 3 parallel lines (society, family, individual) has the potential to unlock new conversations, theories, vocabularies and solutions for our pressing global challenges.
To understand societies (and their constituents: families and individuals), historical context must be a consideration. We show that connection and explore its implications.
Examples of some historical facts not previously considered relevant to such a discussion are:
A- the 300-400 year religious wars between Protestants and Catholics in Great Britain
B- over hundreds of years, the repeated invasions, occupations and general exploitation of the south-eastern European countries: Italy, Spain, The Balkans, Greece Romania, Hungary, Russia and other Mediterranean countries by Arabs, Austrians, Turks, Mongols etc
C- the current cultural-polis-economic differences in Central and South American countries depending on the empire by which they were "imperialized" between 1500 and 1960.
D- in Christian Europe, the sequential 800 year denial of dignity and citizenship to Semitic people.
In this regard, we hope to show how these historical facts are directly related to and predictive of:
1) Working clinically with many contemporary globalized patients and families and
2) Training, supervising, motivating and retaining a multi-ethnic, multi-generational workforce
3) Designing and implementing multi-national (Euro, as well as emerging market) macroeconomics and civic policies.
So how does the treatment of mental health patients connect to macroeconomics and industrial management?
The crux of our argument as mentioned, is that there are whole societies that encourage or value differentiation-individuation for individuals (the post-industrial US, Anglo-Saxons and northern Europeans); there are societies in which differentiation and selfhood are discouraged and frowned upon, (many pre-industrial, agrarian, Muslim and Jewish societies) and then there are those cultures that actually monitor and punish individualism and independence from the tribe; such as, but not limited to, ISIS, certain pre-industrial Arab, African and South American sub-cultures, Korean and other Asian cultures. Not coincidentally, those countries favoring individualism usually have more or less democratic governance, value gender equality and contain advanced industrial urban economies, while those favoring tribalism have had mainly agrarian, gender harshness, top-down authoritarian economies and governance. Is that in fact, just a coincidence? We see these differences as current but also historical, going way back. Moreover, these historical east-west differences have inclined a path either towards or away from industrialization and large-scale urbanization. In turn, these "means of production" (agrarian pre-industrial, traditional vs industrial-urban-modernity) have, in a reciprocal and self reinforcing pattern, produced certain national character traits and political institutions that affect family structure and functioning. For Europe's north and the “Anglosphere” (the countries, collectively, where English is the main language), in turn, these differing family structures and evolving national institutions have produced a postindustrial evolving “modernity character” and way of life. In The Premise, a more detailed description-explanation of this unacknowledged societal "tribalism-individualism", "urban-agrarian" and "society-family reciprocality" will follow the course proposal.
We employ principles and assumptions that combine features of Dr. Murray Bowen's Family Therapy Systems Theory to reinterpret history, geography, macroeconomics, sociology, anthropology and societal governance, relying on the works of Frederick Perls, Dr. Alan Macfarlane of Cambridge, Dr. Francis Fukuyama of Stanford, Dr. Edward Banfield of Harvard, Dr. Jerry Mueller of Catholic University of America, Dr. T.M. Luhrmann of Stanford among other historians, anthropologists and economists. In exploring the reciprocity and mutuality of culture and systems I found it impossible to leave out Dr. Bowen's multi-generational (i.e. historical) dimension in family development. To say that individuation of self requires a three generational time frame, as he did, is a way of taking history into account; the stages of one family generation will be different depending on the societal stage it lives in. Also, Dr. Bowen clearly tried to link the three parallel lines of individuals, family and society; to quote from the Washington website, regression in our society would "continue until the repercussions stemming from taking the easy way out on tough issues exceeded the pain associated with acting on a long-term view. " Is it a coincidence that this is exactly the two sided debate among the economies in the northwestern vs southeastern Eurozone? Yes, we are all nurtured, abandoned or engulfed by our family and its triangles, but is the family of the Colonel in the ISIS Army (even though he attended the Sorbonne and Harvard) to be treated with the same approach, strategy, methodology and solutions as a Mayflower English professor at Swarthmore?
Can we understand our patients’ background and treat our patients effectively, without incorporating and becoming intimately familiar with new cultural "large system" concepts such as "the economics of trust", "modernity", "globalization"," anti-modernity", "the anglosphere", "income disparity", "currency union", "currency wars", "economic imperialism", "tribalism" and "post industrialism vs tribalism" "blackmarket economy", "transparency and culture of corruption", "rule of law and law and order", "bicameral gov't ", "capitalism", "prudence", "personal and macroeconomic consequences", "democracy", "dictatorship", "populism", "imperialism", "societal rationalism-emotionalism," ? They are among the concepts from the various "non-therapeutic" social sciences that we believe can be significantly related and clarified, to enhance Dr. Bowen’s pioneering work. Some of these concepts will be illustrated in the multimedia course.
Dr. Bowen assumed a series of ever-larger concentric circles starting with the individual and family and expanding past the extended family to community and to the society as a whole. We hope to reveal those concentric circles and understand them in a new way.