From the Archives

Chronic Anxiety and balancing self in relationships

Chronic Anxiety in Physical Illness

By chronic anxiety, From the Archives

From the Archives – Chronic Anxiety in Physical Illness

Dr. Bowen spoke at a conference on cancer in 1978 about his thinking of how a disease like cancer could develop. It was quite different thinking at the time. He started by making the point that most psychiatrists (which he was) talked about families as systems or the family as a unit, but didn’t really operate from a systems perspective. “I seriously doubt if even the most experienced family researcher, therapist, can think and act systems more than a fraction of the time.”

Your Stress is my Reactivity

He was clear that stress is a stimulus (a stressor stresses the organism) and anxiety is the response. Anxiety is the emotional reactivity to real or imagined stress or threat. But more importantly, he observed that person B would respond to a threat to person A. This is a key finding for understanding the family as a unit: stress on one creates responses in others. He also observed that anxiety is infectious. Your response (anxiety) to stress (a stimulus) to me ends up creating my response of … anxiety!

Reactions to Illness

Dr. Bowen also noticed that individuals react more to the real or perceived degree of threat that an illness poses than to the type of illness itself. This makes sense from the perspective of “emotional reactiveness to a real or imagined threat.” The implication of this is that how individuals think about an illness can be part of the problem a disease presents. Dr. Bowen grew to see disease as a dysfunction of the family unit based on how anxiety spread and grew in a family. The other aspect of seeing illnesses as dysfunction is that we can view things along a continuum which allows for different levels of reactions to what might appear to be similar stressors.

“An automatic reaction of the organism is to get free of the pain of anxiety. We avoid the things that make us anxious.”

Dr. Bowen 

Chronic Anxiety

“It is sustained or chronic anxiety that is most useful in determining the level of differentiation of self. If anxiety is sufficiently low, almost any organism can appear normal in the sense that it is symptom-free. When anxiety increases and remains chronic for a certain period, the organism develops tension, either within itself or in the relationship system, and the tension results in symptoms or dysfunction or sickness. The tension may result in physiological symptoms or physical illness, in emotional dysfunction, in social illness characterized by impulsiveness or withdrawal, or by social misbehaviour.” (1)

“Leaves anxiety high enough and long enough, and a symptom will emerge from the weakest area of the individual.”

Dr. Bowen

Level of Differentiation of Self

One’s level of differentiation and level of chronic anxiety are closely related. Lower levels of differentiation will generally result in greater levels of perceived threats, which generate anxiety. This will be more chronic, depending on one’s level of differentiation. For example, this sensitivity operates in relationships and can also result in a chronic level of vigilance toward others. Since it’s normal not to want to feel discomfort, one will do things to adapt and have the discomfort reduced. But since one’s level of differentiation isn’t changing, the source of the tension doesn’t go away. The individual can only work at constantly trying to ‘adapt.’ Bring in more stress, and the adapting can become dysfunctional or manifest as a physical symptom emerging “from the weakest area of the individual.”

Emotion Programming and Genetics

Almost 50 years ago, Dr. Bowen believed genes would not be the obvious source of illnesses. For one reason, we have too many genes, and they work as a system. But that doesn’t mean we don’t have vulnerabilities from our genetic makeup. He also talked about “emotional programming” that comes out of our multi-generational past. Here’s an analogy. If the body is a car, and the self is the driver, then drivers that are overreactive will tend to have more accidents, and the weakest part of their car will break down first. The more “functional” the driver, the longer, on average, the car will last.

So chronic anxiety, the chronic response to perceived threats, is related to one’s level of differentiation. Combine this with how I can pick up on others’ chronic stress, and they can pick up on mine. Then add that chronic stress is a factor in almost any illness and how one responds to illness. Thus, working to define myself in my relationships is not only good for my health, but it’s also good for the health of the system.

I invite you to observe how stressors and anxiety operate in your systems.

Thank you for your interest in family systems.

Dave Galloway

A transcript of the recording is here.

Learn more about Bowen family systems theory here.

Dr. Kerr’s article in the Atlantic on Chronic Anxiety is here.

(1) Bowen, Murray; Bowen, Murray. Family Therapy in Clinical Practice (pp. 361-362). Jason Aronson, Inc.. Kindle Edition.

Family Projection Process – From the Archive

By family projection, From the Archives

Family Projection Process

The family projection process is one of eight concepts that make up Bowen theory. Dr. Bowen believed that there were enough observations from his research and clinical work that it warranted being a separate concept. It is important to remember that this is just one of eight concepts and other ideas that make up a system’s way of thinking about human behaviour. Dr. Bowen wondered how levels of differentiation get transmitted from one generation to the next. While he didn’t like the term projection, he couldn’t come up with a better one.

What’s actually being projected is the level of differentiation of the parents into the next generation. In day-to-day family life, it shows up as an over-focus on one or more children, driven by the level of anxiety in the parents. Often, the parent’s relationship is not great, and the projection process compensates for that.

Every child belongs to a unique family.

If you think about anxiety levels, stressors, nodal events, and sibling position, every child is born into a different family. One of the benefits of better contact with siblings is that one learns that siblings often have very different beliefs about the family they grew up in. Walter Toman’s work documented the profiles of sibling positions. Dr. Bowen thought it was so significant and accurate that he incorporated it into the theory. All these factors mean that the parents and other family members will experience each child differently. They will see and communicate in some fashion aspects of the differences they perceive. This is part of the process that resulted in a greater focus on one child.

The projection experiment 

Dr. Bowen, with some cohorts, experimented with the idea of projection at a square dance one evening. He would go up to an ordinarily good dancer and make a comment, “are they feeling okay? Your dancing looks different”. The cohorts would do the same kind of thing. By the end of the night, these people would comment on not dancing well. They would do the opposite with “poor” dancers and watch them get more confident. This change in attitude and behaviour happened in one evening. Imagine what can happen over an extended period in a family.

The projection process occurs in different ways.

The family projection process can happen with various family members. But usually, it is the most vulnerable one. It can take the form of a blamer and one who accepts the blame. Or the process of one who is “helpful” and one who “accepts help.” It’s a relationship process. In a set of experiments with rodents, Dr. Calhoun found that any group would produce a “scapegoated” individual. When he put a number of “scapegoats” into one group, that group produced a “super scapegoat.” The super scapegoat allowed the other mice to look more functional than they really were. The idea is that the individual, perceived as the most vulnerable, gets undo attention. This trains that individual to be more helpless, as it were.

Anxiety can fuel family projection.

Two major natural processes can lead to parents “projecting” or transmitting their level of differentiation onto their children. The process can limit the development of autonomy in the child, thus limiting their level of differentiation. Stressors and anxiety will exacerbate the process. This does not happen with one particular event. It happens in all families because it is a natural process. Parents of infants naturally and appropriately focus on their infant’s well-being. It is natural for the bond or relationship between a child and parent to feel very good. So it can be hard not to, in Bowen’s words, “get on their back” to do good for them when the child is older and trying to be more autonomous. Dr. Bowen observed that this “getting on the back” of a child was not helpful because it impeded the child from becoming more responsible for themselves on their own.

Project up and 0ut, not down and in.

Dr. Bowen observed that individuals who had better contact with as many family members as possible would have less intense family projection. Conversely, parents that were cut off from family would have more intense projection processes. A system with more viable connections would diminish the anxiety that usually drives the process. Another way Dr. Bowen discusses this is “get off the child’s back.” It is one’s anxiety that can create an unhelpful focus on how a child is doing. But it’s not our children’s job to take care of our anxiety by trying to be the way we want them to be. The natural process for any species is for offspring to become independent, functional adults. Too much “caring” can interfere with this process. A person doesn’t become a responsible adult unless they truly understand that it is up to them to be a responsible adult. I believe they learn this by making mistakes and realizing that their irresponsibility doesn’t work for them. It’s hard to watch sometimes, but growing up isn’t child’s play.

Can you notice when your anxiousness or discomfort gets you focused on another versus handling yourself? I invite you to experiment by observing what happens with yourself when you get more stressed or anxious.

Thank you for your interest in family systems.

Dave Galloway

Learn more about Bowen family systems theory here.

Watch this video for a full discussion on family projection here.