Abstract: Bowen theory and the social determinants of health in schizophrenia
Posted by Laurie Lassiter
Bowen theory and the social determinants of health in schizophrenia
For the past 10 years I’ve been curious about the social determinants of health accompanied by changes in genetic expression being researched by Steve Cole and other scientists linked to him.
He and others (2023) are beginning to explore the social determinants of health in schizophrenia. This presentation compares and contrasts the work of these scientists and the theory of Murray Bowen in the understanding of schizophrenia.
Bowen, page 45, “A Family Concept of Schizophrenia,” Family Therapy in Clinical Practice.
“The schizophrenic psychosis of the patient is, in my opinion, a symptom manifestation of an active process that involves the entire family. The family unit is regarded as a single organism and the patient is seen as that part of the family organism through which the overt symptoms of psychosis are expressed.”
“The emotional system of the family is made up of interlocking triangles.”
Here is the citation of the article by Steve Cole and others. One point they maintain is that by examining the social determinants of health they are moving beyond seeing the problem as located within the individual.
“Review of Major Social Determinants of Health in Schizophrenia-Spectrum Psychotic Disorders: III. Biology”
Dilip V Jeste, Dolores Malaspina, Kara Bagot, Deanna M Barch, Steve Cole, Faith Dickerson, Amanda Dilmore, Charles L Ford, Nicole R Karcher, Joan Luby,
Tarek Rajji, Adrián A Pinto-Tomas, Larry J Young.
Schizophrenia Bulletin, Volume 49, Issue 4, July 2023, Pages 867–880.
Social determinants of health (SDoHs) are defined as nonmedical factors that significantly affect health and longevity.
The social determinants of health these scientists consider include: early life adversity, poverty, discrimination including racism, migration, disadvantaged neighborhoods, low socioeconomic status, and food insecurity. They include processes of epigenetics, allostatic load, accelerated aging with inflammation, and effects on the microbiome, in the context of biological and psychological factors.
Murray Bowen has described how schizophrenia may develop in the human family, based on his NIH research, as well as outpatient cases. Schizophrenia is recently being addressed as a larger societal issue. I think it is a rich subject to examine from the perspective of Bowen theory, as well as the view of scientists who study the social determinants of health.
Go Steve Cole! Wonderful how these presenters at the Bowen Center inspire.
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Laurie,
This is a great springboard for describing what Bowen theory can add to understanding social determinants of health. How would you describe the emotional system and levels of differentiation of self in a way that Steve Cole and Larry Young might understand as useful? Victoria
Laurie,
Good beginning for a difficult topic. Thanks for bringing to my attention to the big Steve Cole et al. article. I agree with and found helpful most of the article, especially all the material on social epigenetic processes.
However, there is a big group of variables missing. One which I included in my Symposium presentation. Family features and family interaction variables. These mostly came from research done 1950-2000. Like genetics, sociological, and environmental variables, these are partial predictors of schizophrenia, which work together with these additional partial predictors.
Jim Edd
Speaking of partial variables, I’ve been wondering how much DOS explains? For schizophrenia or any symptom? Thoughts? A rough %? Is that even possible to estimate since self effects gene expression, resilience and on and on.
“This presentation compares and contrasts the work of these scientists and the theory of Murray Bowen in the understanding of schizophrenia.”
I will follow this with interest.
Laurie,
It looks like Murray Bowen and Steve Cole and his group are coming to similar conclusions from different starting points, Bowen from his view of schizophrenia as a product of the family emotional process over generations, and Cole from an individual perspective and now realizing that there are broader social variables involved. As I think Jim Edd is suggesting, Cole is not distinguishing the family influence from the overall societal factors. As Bob Noone has pointed out, many researchers in neuroscience and evolutionary biology skip from the individual to the societal level and miss seeing the family. As Victoria points out, bringing Bowen’s work to the attention of Cole and associates would make for an interesting and possibly fruitful exchange. A step toward consilience!