Bowen Theory and the Social Determinants of Schizophrenia
Abstract
This paper covers different aspects of schizophrenia, including how it may be a good example of Bowen’s theory of emotional process and variation in differentiation of self. Schizophrenia tends toward the low end of differentiation of self, and much can be learned from individuals and their families. My study of schizophrenia includes reading of science papers that contribute to its understanding, as well as observations I have made in my own family and as a social worker for many years with individuals with schizophrenia and their families. Here are the major sections of the paper:
Introduction: What are we talking about when we talk about schizophrenia?
Part I Steve Cole on the social regulation of genetic expression.
Part II Social Work with schizophrenia.
Part III Murray Bowen on schizophrenia.
Part IV Family background of schizophrenia, role of my grandmother.
Part V Putting it together.
PART IV Putting it together
• Schizophrenia may be understood as one of the symptoms of a low level of differentiation in which the individual is regulated more by the social group, or family, than by self.
• Lower levels of differentiation are linked to giving up autonomous functioning in order to function for the larger family group in order to manage an emotional problem in the family.
• The human evolved, probably similar to other social species, to make use of one or more of its members, for that member to function more for the benefit of the group rather than for self.
Low differentiation of self occurs to the degree that an individual’s life course is determined and regulated by the needs of the group.
The lower the differentiation of an individual, the greater his sensitivity to being regulated by the family rather than by himself. How does an individual develop heightened sensitivity? A guess is that the emotional system made up of triangles pressures him to give up self and programs him over time to have the increased sensitivity. While the heightened sensitivity limits the development of the individual, it functions for the overall benefit of the group. The sensitivity to approval or rejection is what makes it possible for the individual who gives up self in a family to be controlled or regulated by the family.
Schizophrenia is an interesting case of an individual absorbing stress at the level of the family group. I have observed the development of schizophrenia in an individual at a time of great urgency and crisis in a family. Schizophrenia can absorb an enormous amount of anxiety and stress in a family, as the rest of the family projects their own emotional immaturity onto the family member with schizophrenia, or any individual who lacks self. There are instances when individuals with schizophrenia may recover during periods of relative calm in the family, though the individual is unlikely to reach potential, and may revert to active schizophrenia when the family experiences increased stress.
Abstract
This paper covers different aspects of schizophrenia, including how it may be a good example of Bowen’s theory of emotional process and variation in differentiation of self. Schizophrenia tends toward the low end of differentiation of self, and much can be learned from individuals and their families. My study of schizophrenia includes reading of science papers that contribute to its understanding, as well as observations I have made in my own family and as a social worker for many years with individuals with schizophrenia and their families. Here are the major sections of the paper:
Introduction: What are we talking about when we talk about schizophrenia?
Part I Steve Cole on the social regulation of genetic expression.
Part II Social Work with schizophrenia.
Part III Murray Bowen on schizophrenia.
Part IV Family background of schizophrenia, role of my grandmother.
Part V Putting it together.
PART IV Putting it together
• Schizophrenia may be understood as one of the symptoms of a low level of differentiation in which the individual is regulated more by the social group, or family, than by self.
• Lower levels of differentiation are linked to giving up autonomous functioning in order to function for the larger family group in order to manage an emotional problem in the family.
• The human evolved, probably similar to other social species, to make use of one or more of its members, for that member to function more for the benefit of the group rather than for self.
Low differentiation of self occurs to the degree that an individual’s life course is determined and regulated by the needs of the group.
The lower the differentiation of an individual, the greater his sensitivity to being regulated by the family rather than by himself. How does an individual develop heightened sensitivity? A guess is that the emotional system made up of triangles pressures him to give up self and programs him over time to have the increased sensitivity. While the heightened sensitivity limits the development of the individual, it functions for the overall benefit of the group. The sensitivity to approval or rejection is what makes it possible for the individual who gives up self in a family to be controlled or regulated by the family.
Schizophrenia is an interesting case of an individual absorbing stress at the level of the family group. I have observed the development of schizophrenia in an individual at a time of great urgency and crisis in a family. Schizophrenia can absorb an enormous amount of anxiety and stress in a family, as the rest of the family projects their own emotional immaturity onto the family member with schizophrenia, or any individual who lacks self. There are instances when individuals with schizophrenia may recover during periods of relative calm in the family, though the individual is unlikely to reach potential, and may revert to active schizophrenia when the family experiences increased stress.
Laurie,
I see that you are on your way to writing a comprehensive study of schizophrenia, encompassing many sources and perspectives. One difficulty that I have in understanding it is how the family/group benefits from the impairment of the member. My experience with schizophrenia is much less than yours, buts I see the cost to families with severely disabled members as great or greater than any benefits. The stresses, the caretaking demands, the grief, the chronicity–may bring out the resourcefulness of the family but also test the limits of resources. The illness to some extent puts the family in the position of being controlled and regulated by the ill member. Maybe the costs are just easier to see than the benefits. Is the benefit mostly the increased maturity that other family members may gain from the experience? This is a part of Bowen theory that I have not ever understood. It suggests that the projection of anxiety to one person is almost inevitable so that one person can carry a great proportion of the total family anxiety. I welome your thoughts, Laurie. I think your article will bring a deeper understanding of the mystery of schizophrenia.
Ask Mike Kerr about the benefits of having a schizophrenic sibling.
Stephanie,
Thank you for your comments and questions here. Your comment is one of the kinds that I especially appreciate because it is challenging. And, as a result of your comment, I plan to add something about it to address the issue you raise when I write the longer article. Yes, you are obviously right about the grief, guilt, etc. It doesn’t feel good to have a family member or other loved one suffering terribly, and schizophrenia is only one example. What I am trying to describe is more about a lack of self or a lack of differentiation of self in an individual in a family. When an individual develops with a lack of self, that individual functions more to relieve an emotional problem in the family. Like a child who becomes a parent’s confidant. Or a child who tries to live out the idealization foisted on her. That child grows up more sensitive to the emotional cues of the system vs being guided by self. The parents are limited as we all are and tend to automatically do what makes them comfortable, which inevitably moves the stress in the family more towards the individual who lacks self the most. I agree with what you say, and it’s not so simple to say that the parents or family as a whole are happier if their child or loved one is ill. Of course I will feel unhappy. But I also am not willing or able to accept the discomfort of taking an outside position in a triangle, to accept the stress of standing alone on a family issue, so I keep unawarely doing things that foist the stress onto that one. I keep encouraging the dependency. I keep trying to make him love me, etc etc. Stephanie, thank you again for your comment and question. My response is inadequate!
Laurie
The idea that schizophrenia absorbs family stress and is adaptive at the group level is so fascinating. We grew up with mom’s best friend “Aunt” Barb” and her son, my friend Chris. When Chris developed schizophrenia B’s life was changed. It was certainly a a life project. One can never know how happy B would’ve been without Chris. Would she have died young? Or been happier? This is an open question. I knew many schizophrenics in my 15 years in community mental health, and so often enjoyed talking with them, and watching them go. I believe in humility about Bowen’s propositions- including that symptoms absorb group stress. We don’t have a pile of scientific evidence. Also, the projection process is only one mechanism.I guess there is a great variation in how DOS plays out in families. The degree of influence likely varies.
Thanks, Erik,
Yes, I hear your point about the importance of humility, and that the theory has not been proven. From my own experience, I can see it both ways. One way is that I have seen the facts of the theory in my own family and other families, and deeply within myself and my own family. On the other side is the awareness of the good luck I had to find Bowen theory when I wasn’t looking for it. And it gave me great benefit, gradually, over a long period of time, 50 years. It only makes sense that it would be a challenge for me to be entirely objective about the theory. I will keep working on that. As Dr Bowen might say, it’s worth working on.
Laurie