FEST Writing Group

I presented this at the spring meeting and am writing it up for a book chapter. I’m interested in what makes sense to readers and what doesn’t. Laura

From the perspective of Bowen theory with the focus on the family as an emotional unit, it appears that people are often less affected by life events like death than they are by the reactions of their family that follow. My first aim today is to propose that when there is a death in the family, relationship patterns of the family system produce a mix of trajectories of loss and resilience for its members, and that the family system is an important factor mediating trajectories of loss. A death in the family changes relationship patterns in certain ways, which can intensify emotional pressures on some family members more than others, with consequences for how each family member fares over time.

My second aim is to illustrate how the clinical approach of coaching a family leader to differentiate a self from the family system can moderate the relationship patterns making room for the recovery for those impaired by them who might otherwise remain chronic. When a family leader achieves more differentiation of self from the family emotional system, this moderates the chronic relationship patterns and reduces pressure on those negatively affected. By moderating the patterns, a family member who differentiates self from that can make recovery possible for those who struggle with prolonged emotional reactions to loss as result of the being caught in the patterns.

This is a graph of research findings from an article by research psychologist, George Bonanno, on the trajectories of loss and resilience, that is, the adjustment or failure to adjust back to the baseline level of well being before a death or potentially traumatic event such as violent and life threatening events and the death of close friends or family. The horizontal lines show trajectories of disruption in normal functioning during the 2 year period following a loss or potential trauma such as violent or life threatening occurences or the death of close friends or relatives. The line lowest on the graph shows most people follow a trajectory of resilience after loss and don’t experience more than short disruptions in normal functioning. As you go up the graph, the trajectories reflect   a smaller percentage of people who become symptomatic, but they recover. And at the top, the trajectories show the smallest percentage of people who, sometimes in a delayed reaction, become chronically impaired.

I’d hypothesize that a graph of trajectories of loss and resilience within a family following a loss in the family should look about the same. That is, on average, within a family, there would be a mix of individual trajectories of resilience and loss. Most family members would be resilient, a smaller number would have symptoms and recover, and few would have prolonged and chronic symptomatic adjustments in reaction to a death.

When there is a death in the family if the mix of trajectories of loss and resilience graph similarly to the trajectories of unrelated subjects, that suggests that the family emotional system is playing an important part in the research findings on the mix of trajectories of loss and resilience

Death affects individuals within the family differently, Bowen theory would predict, depending on one’s position within the family and how it shifts following the death. Shifts in relationships after death can move a family member into a position of increased vulnerability to clinical levels of impairment by way of changes in patterns that distribute emotional distress and functional levels of self in the family. Some more than others in a family, become subject to pressures to yield self up and become a problem focus for others..

There are four patterns of the family emotional system that Bowen theory describes that structure relationships in the absence of differentiation of self, and they are conflict, distance, the adaptive spouse who gives in to the dominant one, and parents transferring distress to a child. These patterns are instinctively triggered by real and imagined threats and they stabilize the relationships and family members in them. These relationship patterns have their roots in behavioral biology, having much in common with basic behavioral repertoires of threatened animals such as fight or flight, roll over and subordinate, or dominant coalitions ganging up on those down the social hierarchy.

One pattern is conflict between two spouses fighting to hold onto self. Neither one giving in to the other or able to be adaptive while remaining intensely engaged with one another.The children are unaffected by patterns between the parents as long as they are not triangled into the parent’s relationship.

The 2^nd pattern is emotional distance between spouses who avoid conflict or subordinating self by disengaging from the other.

Each family has a kind of baseline fingerprint of how they use the four patterns – Some families use mostly one pattern and other families use a mix of all four.

.The last two patterns involve someone losing self to the system.

The 3^rd pattern shows an adaptive husband (the square) subordinating self to the emotionally dominant wife to maintain harmony. The adaptive spouse is said to “lose self”, while the other one gains a higher level of functional self in the transactions. The relationship becomes conflictual when the adaptive one quits giving in.  The one who repeatedly gives up self to the other is vulnerable to developing clinical symptoms, as is the child who is the object of the fourth pattern of managing undifferentiation, the family projection process.

The 4th pattern is the family projection process in which emotional focus on a child preserves marital togetherness and negatively impacts the development of a solid self in the child. In the family projection process, the child is triangled into the parental relationship and becomes an emotional focus for the parents who unwittingly constrain the development of a resilient self in the child. It is this pattern that is most characteristic of the family I’ll be talking about in the clinical example and in which the projection process worked very much like the way Bowen described it , pp. 381, FTICP,as a process that begins with anxiety in the mother. The child responds anxiously to the mother, which (the mother) misperceives as a problem in the child.” “The father usually plays a support role as 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 anxious parental effort goes into sympathetic, solicitous, overprotective energy, directed more by parental anxiety than by reality needs of the child. It establishes a pattern of infantilizing the child, who gradually becomes more impaired.” “People impaired by the projection process….“do less well with life”, and, “… have lower levels of differentiation than their siblings….”

The Family System produces different trajectories of loss for different members of the same family by way of the relationship patterns and, Shifts in the family patterns following death determine who in the family will have the most emotional difficulty following the loss.

Shifting now to the clinical approach based on differentiation of self – Since higher levels of differentiation of self in a family moderate use of relationship patterns, a family leader who can differentiate self from the family patterns improves the chances for recovery for the ones most impaired by them following death and loss.

This is a family with three young adult children at the time their oldest son died in an automobile accident, at age 28. The son who died had had a rocky path as a young adult. The trajectories following the loss went like this: The younger son at 25 was engaged and embarking on a teaching career at the time of his brother’s death. He found his brother’s death hard, but he continued on his life course and kept contact with his parents – his is the resilient trajectory. For the parents, their son’s death activated the pattern of emotional distance– they didn’t want to upset each other by talking about their son or their reactions to his death. Their functioning went down for a while but they recovered. The youngest daughter, age 23,in her last year of college, had a prolonged disruption of her functioning following her brother’s death. She finally recovered following the resolution of the family projection process focused on her, based on her mother’s efforts to get out of the family projection pattern.

This family’s reaction to death intensified the patterns that characterized their baseline functioning (shown above): some distance in the marriage but mostly, the family projection process. On this family diagram the higher numbers and more intense colors reflect how much each family member was affected by the patterns before the son’s death. Both the son who died and the youngest daughter had been the focus of the parental anxiety. The most intense focus was on the son at the time of his death. The parents had big expectations who was well behaved and did well in school in his early years. He developed a marijuana smoking and drinking problem late in high school and did not finish college after three tries finally moving to Alaska to work in the seasonal canneries and towards starting a kelping business. before he died.

The emotional focus on the daughter reflected that she was special in to her mother because she was a girl, but the mother felt stressed by having three children, it seemed like one child too many. The mother says the role of mother became too important to her, as a way to prove that she was okay.   She saw her daughter as more needy than the others, as someone who needed to be protected from emotional upsets.

It did not seem that the daughter was struggling before her brother’s death. She was immature but moving along in college. The daughter was close with her oldest brother; they were often confidants feeling like outsiders in the family together. There had been some sexual encounter between the brother and sister that had been acknowledged between them before the death that they agreed to talk about sometime which didn’t happen before the death.

After the son died, the anxious focus shifted mostly to the daughter. She had become more positive toward her parents but she began having panic attacks 6 months after the son’s death. The daughter began treatment with a therapist who became very important, but about 6 or 7 months into therapy she was depressed enough to see a psychiatrist and began medication. Her depression continued to intensify over the following year and she entered a therapy group recommended by her therapist for women sexually abused by their fathers because of the sexual encounter with her oldest brother. Influenced by the group, the daughter accused her father of sexual abuse: No one in the family believed the accusation was based in reality. The daughter cut off for awhile.

In another 6 months or so the daughter’s relationship with her therapist went negative and she made a suicidal gesture in the therapist’s bathroom and shortly after made a serious attempt at suicide. She remained suicidal and unstable for about 18 months.

At this point the mother intensified her effort to work towards separating herself out from the family projection process. She communicated to all her belief that the daughter’s emotional difficulties were based in a family problem. Her daughter seemed able to stay connected to mother around this idea while tolerating the fact that the mother had said did not believe her father had abused her. She also said did not believe that she was lying, or making it up.

In her family of origin, with her own parents who felt sorry for her, the mother objected to the pattern of anxious focus and feeling sorry for everyone. The anxious focus on her own daughter was   a repetition of the chronic anxious focus her parents always had on her older sister. The mother took the position that her parents’ treating her sister and her daughter as poor things, made them feel and act like poor things.

In this relationship with her mother of being respected but not indulged, the daughter stabilized. The father came to an understanding based on learning about recovered memory therapies gone wrong. But the son and his wife remained angry because of her accusations of their father. They did not want her to be at family holidays and acted as if she did not exist. The mother did not go along with the cutoff. She brought her daughter up in conversations and declared holidays were for everyone in the family. She even decided to make the daughter and son co-trustees of the estate, which the professionals warn against with siblings in conflict, but this move motivated the son and his wife to get along with the daughter. Contact and good will was restored to brother and sister more like what had been before their brother’s death.   It’s hard to do this mother’s effort justice in this short presentation. But she separated herself from the family projection process to a significant degree, and the family’s blame and rejection of the daughter was moderated. The mother did not go along with the blaming or cutoffs and the family emerged intact and the daughter recovered. This took some years

.The example shows in particular how the family will use existing patterns until they are overloaded and symptoms emerge. I think we could do research studies tracking shifts in family patterns following death to contribute to understanding the mix of trajectories of loss and resilience.

The case is also an example of a family member achieving more differentiation from the family patterns – which moderates them – and reduces relationship pressure on the impinged and impaired members. This can moderate the trajectory of loss for those losing self and overwhelmed in the patterns.