CHARLES M. WHITE

This chapter details how the author’s consistent focus on learning for self served as the creative force behind a 4-year effort to develop two men-tal health–substance abuse outpatient programs based on Bowen family systems theory—a 27-hour-per-week day program and a 12-hour-per-week evening program. The author, who served as the program coordina-tor and supervisor, illustrates how aspects of his own differentiation of self trajectory were represented in program components and protocols.

Principles of Bowen theory were infused into the program components in which the supervisor and all staff, interns, and clients participated. When these Bowen theory principles were consistently lived and emphasized by the supervisor and the staff, they functioned as catalysts for creating an emotional atmosphere in which simultaneous and re ciprocal learning could occur for all program participants (i.e., supervisor, staff, interns, and clients) regardless of their place or role in the agency or program hierarchies.

One specifi c principle that was consistently lived and that permeated all aspects of the program was that each staff person, intern, and client assume complete responsibility for his or her own life, learning, symptoms, and behavior. From the program’s onset, the supervisor and the staff shared the observation that the staff , interns, and clients who adopted this “assume-responsibility-for-self” behavioral stance oft en reported developing more objective and factual understandings of their multigenerational family emo-tional process and tended to engage in more thoughtful actions aimed at increasing their degrees of diff erentiation of self. Th ey also reported greater overall success in symptom, behav ior, and life management.

Agency Context for the Simultaneous Learning Curriculum

Bowen theory places considerable emphasis on individuals, including supervi-sors and coaches, engaging in a continuous eff ort to increase their own levels of diff erentiation of self in their nuclear and extended families of origin. For serious students of the theory, this eff ort is deemed an essential prerequisite and corequisite to any attempt to communicate Bowen theory to others. Th e curriculum for learning about self-functioning and Bowen theory detailed in this chapter incorporates this emphasis by having the supervisor’s continuous eff ort to increase his level of diff erentiation of self as the principal function behind the learning-for-self curriculum.

Th e department and agency context for this curriculum was the outpatient department of a Community Mental Health Center in central New Jersey.

Th e programmatic contexts for the curriculum were two intensive outpa-tient programs (called intensive outpaoutpa-tient services, or IOS): a three-phase, 18- to 22-week day service and a three-phase, 18- to 22-week evening service.

Descriptive fl yers detailing service hours and components were provided to all clients and client referral sources. Service clients were coping with or recover-ing from both substance use and mental health-related symptoms, hence the name dual-recovery IOS.

Clients physiologically dependent on one or more substances (typically daily substance users who had developed clinically signifi cant tolerances to those substances) fi rst completed medically supervised inpatient substance detoxifi cation before referral to the day or evening dual-recovery IOS. Clients who were actively psychotic, suicidal, homicidal, severely depressed, manic, or anxious typically completed short-term volun tary or involuntary inpatient psychiatric hospitalizations before their referral. Clients discharged from detoxifi cation or hospitalizations on psychotropic medications were imme-diately referred to the Community Mental Health Center’s Medication Clinic for consults and medica tion monitoring from a staff psychiatrist or clinical nurse practitioner at the onset of their service participation.

A continuous rotation of fi ve 2nd-year clinical master of social work (MSW) or master of arts (MA) in psychology graduate student interns was essential to the day-to-day service operations. Beginning at two diff erent times during the year—MSWs in September and psychology MAs in March—the intern-ships lasted approximately 7 months, with the fi rst and last 2 internship weeks devoted to being trained by outgoing interns and training incoming interns in various service responsibilities and protocols. Th e supervisor, whose agency title of coordinator made him the dual-recovery IOS’s functional leader, designed and facilitated the services with a focus on learning for self—not on trying to impart or teach anything to the staff , interns, or clients. In contrast to this learning-for-self agenda, the agency’s agenda was to pay the author (as coordinator) a salary based on his output to others: providing treatment to

dual-recovery IOS clients, supervising staff , and teaching interns. Although these agendas may appear incompatible, the author contends that this appar-ent incompatibility can be resolved when the supervisor’s theoretical and practice orientation is Bowen theory.

Th e author’s experience with Bowen theory over 25 years has convinced him that his diff erentiation of self eff ort is (a) absolutely essential to his becoming a progressively more eff ective supervisor and coach with staff , interns, and clients and (b) qualitatively the same as that in which staff , interns, and clients engage as they seek to increase their levels of diff erentia-tion of self in their nuclear and extended families. One result of combining the perspectives of learning for self and qualitatively-the-same diff erentia-tion eff orts was that the supervisor would naturally and routinely use his own family diagram and refer to his own family emotional process during his interactions with service participants. Although the intent behind these family references was to facilitate the supervisor developing a more objec-tive and factual understanding of his family emotional process and functioning in a multigenerational context (not to teach anything), these family references did have a useful by-product—providing the staff , interns, and clients with a perpetual case study that simultaneously facilitated the recognition and under standing of family emotional processes while illus-trating aspects of Bowen theory.

In addition, the supervisor was continually reading the prevailing emo-tional atmospheres for the staff , intern, and client relationship systems. His intent in maintaining awareness of these emotional climates was not to facilitate changes in the dual-recovery IOS components or structures, but rather to provide another vehicle for his eff ort to become more objective and factual about his multigenerational family emotional process and functioning. Th e link between the supervisor’s monitoring the agency’s emo-tional climates and his eff ort to become a more diff erentiated self in relation to his family played out as follows: (a) Emotional storms among the staff , intern, and client systems were usually indicators that the supervisor had not been clearly defi ning self in areas critical to service operations; (b) the supervisor’s lack of clear stances typically resulted in an observable increase in confusion and indecisiveness among the staff and interns coupled with a decrease in morale; followed by (c) the clients responding in a manner similar to that of the staff and intern systems, oft en coupled with an observ-able increase in acting out, substance use relapse, or other reactive behaviors directed toward self, other clients, interns, staff , supervisor, or service struc-tures and guidelines.

Th ese reactive system responses usually motivated the supervisor to focus on developing clearer, more consistent, less ambivalent, and less reac-tive stances from which to lead and supervise the services, which eventu-ally brought him back to examining unclear stances in the context of his

functioning in his nuclear and extended families. Th is process led him to greater objectivity about his functioning in his family and ultimately moved him to adopt clearer, more defi ned leadership positions from which to oversee the service programming and personnel. Th e staff , intern, and client system emotional storms oft en subsided as the supervisor successfully implemented these more clearly defi ned leadership stances.

Th e services aff orded the supervisor, staff , interns, and clients with several learning-for-self opportunities each week through a curriculum loosely orga-nized under two developmental domains: (a) grounding self in Bowen theory, and (b) understanding one’s family emotional process and self-functioning in a multigenerational context. Many of these learning-for-self experiences were embedded in the service weekly schedules and involved the supevisor, staff , interns, and clients. Other learning-for-self experiences, such as the 2.5-hours-per-week Supervisor, Staff , and Intern Family-of-Origin Exploration Supervision and the 1.5-hours-per-week Clinical Team Meeting, involved the supervisor and one, some, or all of the staff and interns; such meetings were usually held at times when the services were not in session.

Grounding Self in Bowen Th eory

General Resources for Learning Bowen Theory

Th e author fi nds continually grounding himself in Bowen theory basics instrumental to his developing a more objective and factual understanding of his multigenerational family emotional process and his eff ort to increase his level of diff erentiation of self in his nuclear and extended families of ori-gin. His more concentrated Bowen theory learning experiences have included participating in postgraduate training programs, symposia, seminars, con-ferences, and workshops at the Princeton Family Center for Education in Princeton, New Jersey, and at the Bowen Center for the Study of the Family in Washington, DC; giving presentations on Bowen theory at universities and to the community at large; and using his PhD coursework opportuni-ties to research and write about aspects of Bowen theory (e.g., writing this chapter).

Th e author also engages in more routine activities to ground himself in Bowen theory basics, such as investing time in reading and rereading the primary texts on Bowen theory, supplemental texts and book chapters that synopsize or focus on specifi c aspects or applications of Bowen theory, and journal and magazine articles that summarize Bowen theory or explore its relationship to natural systems thinking. In recent years, the author has used a few Internet resources: Th e Bowen Center for the Study of the Family (http://

www.thebowencenter.org/) and the Western Pennsylvania Family Center (http://www.wpfc.net/) Web sites, in particular, off er extensive resources and Web-based opportunities.

Family Systems Theory Education Presentations

Most of the supervisor’s regular Bowen theory–grounding experiences were embedded in the dual-recovery IOS weekly schedules. Th e most substantial of these experiences was the audience-participatory Family Systems Th eory Education Presentation (1–1.5 hours per session) that he or a senior staff per-son facilitated one to three times a week uninterrupted for almost 4 years.

Th e presentation curriculum covered the theory’s eight basic concepts and foundational postulates through a 10-presentation series. Staff members, interns, clients, family members, and friends attending the presentations each received a packet of readings and excerpts from central Bowen theory works to enhance their knowledge of the 10 presentation topics.

By choice, facilitators used no presentation notes or outlines, although key points were illustrated through overhead transparencies (e.g., Bowen theory quotes, family diagrams, cartoons, artwork photographs, and nature photo-graphs with animal researcher captions), a three-generation “family mobile,”

and occasionally short video segments. Not using written notes or outlines thoroughly exercised the facilitators’ abilities to draw on their internalized knowledge of Bowen theory while simultaneously honing their capacity to use conversa tional language to talk about the theory. Th e advantage to facili-tators in using simple transparencies, family mobiles, video segments, and unscripted conversational language to provide a synopsis each week of a spe-cifi c theory topic was that it tended to stimulate audience participation. Th e barrage of questions and comments from the audience of staff , interns, cli-ents, family, and friends greatly enhanced the potency and theory-grounding potential of these presentations for the facilitators.

Ideally, the 10 presentations were conducted over a 10-week span so that clients graduating from service Phase 2 (typically 8–10 weeks) had the oppor-tunity to hear most or all of them and participate in the discussions. Th e occasional to-be-announced presentation had a more in-depth participant dis-cussion with additional illustrative video segments about the previous week’s topic. Because each service ran 18–22 weeks, a client’s family and friends had the opportunity to participate in approximately two complete cycles of the 10 presentations if invited by the client to the once-a-week evening programming for the entire time that the client was in either service.

Bowen Family Systems Theory Video and Seminar Series

A second substantial Bowen theory–grounding experience for the supervi-sor, which simultaneously exposed staff and interns to the theory, was the Bowen Family Systems Th eory Video and Seminar Series. For the video part, half-hour video segments detailing aspects of Bowen theory or using case studies to illustrate the theory were followed by supervisor-facilitated half-hour discussions with the staff and intern participants. Held weekly

year-round, the videos were organized to capitalize on thematic similari-ties between each week’s segment topic and the Family Systems Th eory Education Presentation topic. Th e thematic similarities promoted more robust dialogue among participants in both the series and the education discussions, increasing the theory-grounding potential of both weekly dis-cussions for the supervisor.

Starting in September and again in March, the series featured founda-tional Bowen theory DVDs and videotapes from Bowen’s Th e Basic Series (Georgetown Family Center, 1980) and Kerr’s Bowen Family Systems Th eory and Its Applications series (Bowen Center for the Study of the Family, 2004).

Th ese videos provided participants with an introduction to the theory’s pos-tulates and eight basic concepts. Showing these videos in the fall and spring provided incoming interns with a Bowen theory overview at the outset of their internships, and this early exposure to theory basics promoted more focused and thoughtful exchanges among the supervisor, staff , and interns during series discussions, with this dialogue quality typically lasting for the duration of the students’ internships. For the supervisor, one benefi t in re-viewing these foundational videos was having his basic understanding of Bowen theory recalibrated through repeat exposure to some of Bowen’s and Kerr’s thinking on the theory’s central concepts. Many of these foundational videos were also shown in 1-hour segments to the day Phase 1 (typically 4–5 weeks) clients dur-ing their once-weekly Family Systems Th eory Video.

Aft er the foundational Bowen theory videos, advanced theory clarifi ca-tion DVDs and videotapes were shown during the early winter and summer months. Used for this sequence were selections from the Bowen/Kerr Interview Series (Georgetown Family Center, 1987), which features Kerr interviewing Bowen on aspects of the theory that many people fi nd diffi cult to understand.

Aft er these advanced theory segments, the fi nal few winter and summer weeks featured a sequence of illustrative case study DVDs and videotapes. Segments were selected from a number of sources: clinically oriented client interviews with commentaries, animal research and nature fi lms, documentaries and independent short fi lms, select episodes from television series, illustrative fea-ture fi lm segments, and even short animation fi lms.

By viewing these illustrative case studies aft er the foundational and advanced theory segments, series participants could then observe the case studies through the theoretical lenses they had constructed from the Bowen theory knowledge they had acquired in part through the preceding theory segments. Th us, the discussion sessions became a venue for participants to hone their theoretical lenses and learn how to synthesize and integrate their Bowen theory knowledge with their family emotional process observations.

Taking family emotional process markers displayed in the case studies, par-ticipants proceeded to formulate, articulate, and evaluate systemic hypoth-eses based on those observations and Bowen theory. Many of these illustrative

case study videos were also shown to the evening service clients during the extra half hour scheduled for that service’s Family Systems Th eory Education Presentation, aff ording the supervisor an additional opportunity each week to further hone his theoretical lens.

For the seminar part of the series, the bimonthly full-day Princeton Family Center for Education seminars and annual conferences provided the super-visor, staff , and interns with a more concentrated and in-depth exposure to Bowen theory, as presented by some of the theory’s foremost experts. For the supervisor, the principal Bowen theory–grounding benefi t gleaned from these expert-facili tated, theoretically precise seminars and conferences was that they served to further recalibrate his basic understanding of Bowen the-ory. A secondary benefi t to the supervisor, which came through the staff and interns attending these seminars and conferences, was a sustained increase in the overall quality of thoughtful, Bowen theory–based dialogue off ered by the supervisor, staff , and interns during both the weekly series and the educa-tion discussions. Th is increased quality in the theoretical exchanges served to greatly enhance the Bowen theory–grounding potential of both weekly dis-cussions for the author.

Family Emotional Process Video and Case Studies Forum (Fridays and Mondays)

Th e illustrative case study videos mentioned earlier were all shown in 1-hour segments to the day service Phase 1 and 2 clients (typically 8–10 weeks) dur-ing their twice-weekly Family Emotional Process Video. When an edited-for-length feature fi lm was used as an illustrative case study, the fi rst half of the movie was shown on Friday morning and the second half was shown on the ensuing Monday morning. All participants at both morning sessions received photocopies of a family diagram detail ing what was known of the case study’s nuclear and extended families and a page of open-ended questions (e.g., who, what, when, where, and how questions) formulated from a careful case study viewing and designed to stimulate participants’ factual understandings of the family while promoting family emotional process pattern recognition.

Th e case studies were also sequenced to create a thematic match between each Friday’s Family Emotional Process Video and the Family Systems Th eory Education Presentation topic. Th is thematic matching greatly enriched the education discussions by encouraging the participants to rapidly formulate, articulate, and evaluate systemic hypotheses generated from their newly acquired Bowen theory topical knowledge and their case study family emo-tional process observations from earlier in the day. Th is discussion enrichment then surged through the rest of the Friday service day, promoting thoughtful, integrative, and energetic Bowen theory–based exchanges among the super-visor, staff , interns, and client participants of the accompanying half-hour Family Emotional Process Case Studies Forum.

Th ese supervisor- or staff -facilitated twice-weekly forums provided the supervisor, staff , interns, and day service clients with a venue in which to vigorously discuss the Friday–Monday illustrative case study. Th e case study family diagram and open-ended questions became the forum discussions fodder, providing participants with opportunities to recognize what was objectively known about the case study family from the video segments and family diagram and to identify observable family emotional process markers.

With their growing knowledge of Bowen theory, forum participants pro-ceeded to formulate, articulate, and evaluate systemic hypotheses based

With their growing knowledge of Bowen theory, forum participants pro-ceeded to formulate, articulate, and evaluate systemic hypotheses based