Refection’s from FSI 2015 conference on addictions.

By Susan Hamilton.

I know now, as an individual and as a clinician, that one of the great strengths of Bowen theory is to take such survival-driven adaptations out of individual pathology and make of them something more scientific, more objective, more INTERESTING, more plastic.

Fifty percent of our attention on ourselves, fifty percent on the client – Murray Bowen’s wise advice to the clinician.  The recent FSI conference on Addictions and the Family System prompted me to reflect on my own addiction to food, and my eight years’ participation in a marriage in which my then husband played out the end game of twenty three years of debilitating drinking.  I did some more thinking about how these experiences of mine flowed from the coping strategies used by several generations in my highly anxious and fused family.  Recent genealogical work has underlined the multigenerational force of the various destructive ways in which family members have tried to regulate themselves.

I was struck too by Anne McKnight’s comment that “each of us faces the problem of an automatic response that we need to manage” One of mine is my compulsion to find ‘self’ through “helping”, another legacy of my place within my family of origin.

These reflections gave particular relevance to the work of two researchers foregrounded at the Conference.  First was Suomi’s experiments that connected alcohol use in Macaques with early rearing experience.  The second, Stephen Cohen’s observation that “Human beings have a deep need to bond and form connections it’s how we get our satisfaction.  If we can’t connect with with each other, we will connect with anything we can find – the whirr of a roulette wheel or the prick of a syringe.  We should stop talking about addiction altogether, and instead call it “bonding”.  A heroin addict has bonded with heroin because she couldn’t bond as fully with anything else.  So the opposite of addiction is not sobriety.  It is human connection.”

In my clinical work, I’ve found the drawing and exploring of birth family genograms very useful.  (I’m indebted to Dan Paper who, on day 2 of the conference, set out his own process for genogram construction).  In my experience, genograms have the potential to depersonalise and normalise many things:  memory and attention difficulties, triggered behaviours and their causes, the necessary slowness of the insight/accomplishment trajectory, other family members’ behaviours towards self, the links between self regulation and other behavioural change and the reciprocal nature of these (focus and be calmer, be calmer and focus) and that the early and enduring absence of connection and presence is at the heart of many current seemingly intransigent behaviours.  Genograms have proven particularly effective with couples, where they have the capacity to shift repetitive patterns of high emotionality, other focus and blame into curiosity and movement.

I have been seeing a heterosexual couple.  Over the first three sessions each member had difficulty in moderating the other focus and blaming that’d confirmed the stuckness of a victim position for both.  It began to be clear to me that neither, to varying degrees, could manage self sufficiently to become thoughtful about the process and therefore a little more accountable for self.  I shared my thinking with them and suggested some individual work prior to returning as a couple might be more useful.

The man, let’s call him A, quickly came alone.  He had been the more symptomatic of the two.  He is a religious man, with a pornography-addiction, and anger management challenges.  He self-reported verbally abusing his partner and children.  He saw these behaviours as “sins” and, when not externalising, attached deep shame to them.

We sat together constructing and reflecting upon a genogram that included his paternal line over four generations.  We found alcohol, porn and gambling addiction in men and women throughout.  A showed a great interest in the Brain map that hangs in my room as we talked about the neurobiological changes of addiction elucidated by a number of speakers at the conference.  I mentioned Prof John Saunders observation that “in addiction the reward system is reset in a profound and enduring way…it takes a long time to reset”

I recall now another speaker saying, “Looking at someone’s place in the family system is looking at strengths:  it’s looking at the person not their symptoms.”  Perhaps this provides an explanation for which happened next in A’s session.  There was a long silence.  Then he sighed and said, “We’ve moved right out of the moral dimension here, haven’t we, Susan?”  The relief from shame became palpable in the room.  We were in the new country of “This is.” NOT of “I am and I should not be!”

“There are no victims or victors in hell,” someone wise once remarked.  But for the emotive language, it might have been Murray Bowen…

A had moved himself onto a new pathway – the discovery of how he might make a stronger hand of poor cards and play a better game in the long work of connecting with his wife and children.

Just as his family emotional system over many generations and its members’ various reactivity to it had formed A, so in the same way and through the same processes my experience in my family began own almost irresistible impulse to “help”.

I know now, as an individual and as a clinician, that one of the great strengths of Bowen theory is to take such survival-driven adaptations out of individual pathology and make of them something more scientific, more objective, more INTERESTING, more plastic.

This is allowing A and me some creative space – from his and my need for him to make that seductive “flight into health.”

Susan is a member of the FSI graduate Group and is a recommended supervisor coach for members of our Certificate program. Click here to read more about her Edgecliff practice. Photo credit: Fresh Perspectives