Jenny Brown interviews our Conference Speakers from our upcoming Annual Conference:

Elizabeth A. Skowron, Ph.D.

Margaret (Peg) Donley MSW

Bowen Family Systems Clinical Seminars Kansas City

Awarded 2013 Bowen centre Pollie Caskie research scholarship for: The Neurobiology of Family Relationship Processes.

Unravelling the Complexity of Child Focus

As our conference is approaching I was keen to dig a little into the thinking of our key note presenters about systems thinking and parenting.  Just this morning I was listening to a radio news program that mentioned 2 pieces of research that were relevant to our conference topic – “unraveling the complexity of child focus”.  One was a study showing the dramatic increase in the cost of raising children.  What particularly engaged me was the comment that most of this was due to parents spending more on non essential items such electronic games and purchasing the right kind of clothing to assist their child fit in with their peer group.   Another area of study referred to data suggesting the value of including parents in the treatment of their child/teen’s anorexia.  There was discussion about a predominate view over recent times that parents were a hindrance to their child’s recovery. It seems the tables are now turning to acknowledge the important resource a parent can be in their child’s battle to overcome such a debilitating set of symptoms.   I thought about how there is much evidence and interest in the role of parents and the anxieties they are up against.  At the same time there seems to be much confusion about the processes at work behind this.  Our speaker’s reflections reveal how a natural systems theory understands the predictable yet complex interplay of family and societal processes behind parent anxieties and professional confusion about how to best engage the parents of the children they are working with.   See what you think of our speaker’s reflections and how they shed light on this complexity:

Jenny brown interviews our 2 key note conference speakers Margaret Donley MSW and Elizabeth Skowron PhD .

Jenny:  Margaret, our sub-title for the conference is stolen from an article of yours with this name: Unraveling the Complexity of Child Focus, published in Family Systems, 2003. It has been such a helpful piece at our centre in clarifying a number of recognizable patterns of sensitivity between each parent and their children.  This article reveals your effort over decades of clinical practice to observe and describe nuances of family emotional process.

In writing this piece, what was behind your choice of the word “complexity”? –  As opposed to process or patterns?

Margaret: I wanted to convey that there are many variables that go into the development of symptoms in children.   The two dominant perspectives suggest that symptoms result from either, (1) poor parenting (often code for bad mothering) or, (2) a random genetic process, largely outside people’s control.  For example, if a mother appears anxious or critical, people think the problems in the child are due to the mother.  If the parents appear loving and caring, people conclude that the problems must be due to a genetic process (this is particularly true when a child has been adopted).    In contrast, I believe that emotional problems in children are deeply embedded in chronic anxiety and a multigenerational process that transcend the actions of any one individual.    What I know for sure is that parents, and the extended family, can influence the process to some degree.  This alone can help parents move out of helplessness/hopelessness towards a process where they can begin to be more thoughtful about the challenges they face.   The clinical tape I am going to present at the conference reflects the effort of one parent who was able to influence the emotional process in her family over time.  Her child had fairly severe problems that required hospitalization and medication.  Now, 6 years later, the child is in a great university and doing very well.

Margaret can you share a few thoughts about what you think is important for clinicians in respecting complexity in understanding and working with child focused families?

Parents often feel they are to blame for the problems in their kids; that it is their fault their child is not doing well.  Or, in some cases like divorce, one parent wants to blame the other parent (“John is having problems because his father doesn’t care about him”).  Or, it is a genetic process (“John is having problems with drinking because my father was an alcoholic” – or, “his birth mother was an addict.”  It is important that the therapist adopts a neutral perspective – one that does not feel sorry for people, or secretly blame one parent.  The ability for the clinician to stay curious, to ask thought provoking questions, can be a significant contribution to a family in distress.    Clinical work based on theory is the best way I know to keep your head above water in a clinical hour.  Given that we evolved with a social brain, it is a workout to not get caught in the emotional process of a family.  The clinician can best serve his/her clients by being a consultant and helping them step back and to become more thoughtful about the challenges they face.  In this way, a clinician can truly become a resource to the family over time.

Jenny: Elizabeth, in your research exploring the concept of differentiation of self, what is some of the thinking it has opened up about parenting?

 Elizabeth : I have spent two decades now on efforts to understand differentiation of self.  My initial work focused on operationalizing differentiation and testing basic tenets of Bowen theory and over time I began to get curious about Bowen’s proposition that differentiation is expressed on a biological level, in the functioning of the autonomic nervous system as well as central brain regions.  With support from the National Institutes of Health, we have been exploring how autonomic regulation is associated with differentiation of self in the context of family interactions.  In short, our findings suggest that differentiation of self, both in observed behavior and at a physiological level appear to shape how parents are able to interact with their young children.  Particularly among the highest risk parents—those involved with Child Welfare Services for physical abuse or serious neglect of their children—parents who are more emotionally and physiologically reactive are less able to support their child’s independence and are more likely to control and manage their child in strict and critical ways.  Further, ‘getting it right’ is not essential for good parenting.  Rather in line with other published research, another of our studies suggests that while positive interactions with parents are important for children’s healthy development, the experience of brief ruptures and successful repairs in the relation actually support children’s abilities to manage and regulate their own behavior.   

Jenny: What are the challenges and implications of researching a continuum concept as opposed to a typology? 

I find the continuum of differentiation of self to be a particularly useful concept in my work, and inherently more useful than typologies of health and disorder.  Likewise, the field is increasingly questioning the utility of typologies such as those represented in the DSM for understand mental health and dysfunction.  Recent efforts undertaken at the National Institutes for Health are moving in the direction of thinking about dimensional approaches to understanding mental health that will help us to better understand mechanisms that underlie various classifications of disorder.  Those dimensions currently under consideration include Cognitive Systems, Social Process Systems, and Arousal/Regulatory Systems, for which I believe that Bowen’s theory offers considerable insights  In short, I believe that efforts to understand human experience along a continuum of functioning that span from neurons to families and neighborhoods, will provide us the greatest insights into healthy development and functioning.

Jenny: A question to both-A seasoned Bowen family systems clinician and researcher at a conference together – Any thoughts on what you think this combination might contribute to our thinking and learning?

Margaret: Having a clinician and researcher together in one conference is a great combination.  Dr. Skowron brings a research perspective to understanding the details in the interplay between parents and their children.  She has a gift for making research user friendly and relevant to clinical work.  And, her work in ferreting out the details of differentiation of self has been a real contribution.  In my opinion, the best clinical work is guided by theory – where assumptions have been researched and validated.  The last decade has seen a greater focus on therapists learning technique, with an emphasis on short term solutions.  This contributes to clinicians often not knowing what they are doing with people, and clients not knowing exactly what they are working on.  Keeping an eye on research can be daunting for clinicians; especially for those who tend to avoid the natural sciences as being irrelevant to working in the trenches with real people.  Hopefully, Dr. Skowron and I can show the value inherent in how research can contribute to solid clinical work.

Elizabeth: The field of family therapy is unique in that it originated in the 1950s out of the efforts of researchers and clinicians to forge a new way of thinking about individuals from within a family context.  Family therapy began as a result of research efforts to understand family communication patterns and emotional processes in the context of schizophrenia and substance abuse (e.g., Bateson et al.; Bowen; Nagy; and others).  The development of new clinical approaches to working with families then followed from these efforts, and was informed by research findings.    As a researcher and clinician, I am delighted by the unique origins of the field of family therapy, and I value the dialectic between research and practice.  I currently focus my professional efforts in this space between.    I believe the best research questions are informed and shaped by rich clinical theory and careful study of skilled clinicians, and conversely, that clinical practice can be enriched by good research.   Family therapy has a rich history of bringing together both research and clinical practice in a joint effort to move the field forward—with research findings informing practice and clinical theory enriching the quality of research that is conducted.   I am excited to share the conference stage together with Peg Donley, a highly skilled clinician, expert in Bowen theory, and colleague in our research group at the Bowen Center for the Study of the Family.

Jenny: Thanks for sharing your thinking and giving us a taste of what’s  in store at our  upcoming conference .