On Trying Too Hard to Help

  • May 28, 2020
  • Catherine Rakow, MSW & Carl Jensen, MDiv., MSEd
  • 11 Comments

Is there a therapist alive who has never tried harder to solve a client problem than his or her client?  Dr. Murray Bowen’s family research spoke to this dilemma and led to the surprising conclusion that families asked to simply explore and describe their functioning (“research families”) made more therapeutic gains than those who specifically sought therapeutic help (“therapy families”).  

Recently, fellow WPFC faculty member Carl Jensen, MDiv, MSEd, emailed me (Catherine Rakow, MSW), searching for a Bowen quote on the issue:

To Catherine

I’ve been looking for a Bowen quote for some time and haven’t been able to find it. I recall reading that Dr. Bowen found that research families did better than therapy families.  This was associated with the idea that researchers don’t try to change families, but that therapists often do.  I imagine that the anxiety that goes with being a change agent rather than an observer is related to this.  If Dr. Bowen actually said something like this, I’d love to have the source.  If not, then I’ll just chalk it up to my creatively inaccurate memory

Carl 


Reply to Carl, 

In Bowen’s research at Menninger, he discovered that people who had families involved in their treatment did better than those who did not. Those families received casework support from the social worker, and Bowen saw some of the families too.

At NIMH, where families were involved, Bowen found that research families who were outpatients did better than the in-patient families.  While he tried to structure the ward as free- form as possible and leave decision making within the family, the reality was there were certain requirements of the hospital that made the environment less free than living on their own.

I had not heard or read the piece about “researchers don’t try to change families…..”.  You are actually touching on the origin of differentiation of self there.  When Bowen was doing his research at Menninger, the treatment method at the time was resolving the transference.  After several modifications in treatment, Bowen worked to avoid forming the transference, leaving that in the family. (1951).

Having a neutral other who is present, interested but not moving toward or away from you, was important to the innate development of being more of an individual. That remains the basic treatment method of Bowen theory.

Catherine


Reply to Catherine

Thanks for getting back to me, Catherine.  The piece about “researchers don’t try to change families” was my thought.  Here’s how I put some things together for myself:  

One of the frequent issues with therapy is therapist anxiety to deliver on a contract for change.  This is especially true when therapists are seen as having primary responsibility for results, whether by their organizations, their treatment models, or their personal sense of things.

Although researchers may have their own task-related anxieties, changing the people who are subjects of research normally is not a goal.  As I tried to make sense of what I thought I had read, I thought that research families would benefit from considering the questions of researchers, but would not be burdened by therapist anxiety about change, as families in treatment might be.  

Regardless of where I got this idea, it helped me to remember to take an “observer” position as a coach, to avoid over-responsibility/overfunctioning, and to monitor my own anxiety for results in a process that inherently did involve change in one way or another.  I agree that this relates to your description of what differentiation of self means in practice.

Carl 


Reply to Carl, 

I appreciate how you used your own thinking and were able to find a way to not interfere in clients’ efforts to change.  I hear exactly what you are describing in professionals with whom I have consultation.  There is definitely anxiety in the question about what is helpful and what is expected, and in finding one’s self when “hired” by a family or family member for problem resolution.

Catherine Rakow, MSW & Carl Jensen, MDiv., MSEd

WPFC Faculty Members

 

11 Replies to “On Trying Too Hard to Help”

  1. I really enjoyed the format of this blog post. I appreciated observing how the thinking evolved in the ‘not helping’ posture – for me, it illustrated the very process written about. Thank you!

    1. I’m glad this was useful for you, Allison.

      As a firstborn son of a firstborn son, this has been a long term issue for me. I wonder how birth order relates in one way or another for others who are reading.

    2. Ms. Whitney, I think of this blog as a thoughtful conversation on Bowen theory that invites others to speak alongside the posting. I appreciate your comment on the conversational process representing the clinical process. I didn’t catch that. Catherine Rakow

  2. I thought I remembered the quote Carl was talking about, as I’ve often reminded myself of its underlying principle when working with clients. So I turned to my dog-eared copy of Bowen’s Family Therapy in Clinical Practice and opened it randomly to one of the many sticky-note-tagged pages. Voila! On page 156 Bowen states, “Over the years, ‘research’ families have done better in family psychotherapy than those for whom the primary goal was ‘therapy.’ “

    1. Thanks, Ann for finding the source I was seeking.

      Having much more time simply to observe and think in retirement, my mind frequently has wandered to the idea that those in helping positions can contribute to functional helplessness in those receiving help. As I’ve tried to apply Bowen Theory to my work over the years, I’ve found this idea in the theory to be a significant counterweight to the expectations that I’ve had of myself and that others have had of me.

      Discerning what is and isn’t overfunctioning is an ongoing challenge, at least for me. Maybe ongoing exchanges in the blog will unpack this issue

      1. Rev. Jensen, a good question as to how does sibling position relate to overfunctioning. I’d tend to think of oldest or functional oldest as filling the position of “go to” person in the family if you want something done. That, of course, is an assumption as I think it is more what function one serves in the family. And certainly the question, as I’m reframing it, of acting for another AS IF they can’t figure things out for self or aren’t given the opportunity to do so is a challenge to a parent. Anxiety and perceptions can serve as motive and often anxiety obscures and perceptions are wrong. I have been known to ask my husband to change his filters as he responds to me. And sometimes I’ve asked “Who raised you?” in wondering what any one of my grown children is relaying, While it sounds rather easy to say be present, attentive, engaged but not directive unless asked, I have found it to be much more difficult as a spouse, a parent and a clinician.

      2. I was searching through some of my computer files today and reviewed a transcript of the interview with Dr. Warren Brodey and Mrs. Betty Basamania done when they visited the Center in 2001. Both of these people worked on Dr. Bowen’s NIMH research project 1954-1959. I excerpted a quote from Dr. Brodey that seems relevant to this discussion. So I thought I would add Dr. Brodey’s voice to this discussion. He is speaking about the research families: “So the father was pushing the mother to change, the mother was pushing the child to change, and everybody was pushing each other to change and nobody was changing. And they’re all pushing
        us to change, and we didn’t push them back to change. We said, take responsibility for yourselves. If you change, that’s fine. If you don’t, well you know, we can’t do any better than we’re doing now. If we try and come in and make you change, that won’t make anything change.
        … after I left that work, I realized that I had to change to make, you know, my own family work. So, I mean, there were changes in me that were quite profound after that. So I consider this sort of the beginning of me re-contexting my own life from what I had learned from my parents and challenging it inside myself. I was more able to become what I call a spiritual warrior after that because I was able to fight the battle against what I had been programmed to be as a small child.”
        The video of this interview is available at the Center. It is video 000194, BASAMANIA – BRODEY CONVERSATION PT. 1

  3. I appreciate reading the blog and the conversation it has sparked . I have already read it several times through. Catherine, I appreciate the quote from Dr. Bradley. It speaks directly to my well-developed over-functioning capacity and creates space for me to take a breath. In so doing I can better contain what is automatic in me before responding.

    1. Yes, the great value in pausing, taking a breath, allowing for other possibilities to enter our mind. I am so taken with the idea that being present, available, and attentive to another is a gift to either side of a relationship. It keeps the pressure on self to think, relate and respond. When trying too hard with a family or family member occurs it often leads to either resentment that change in them is not happening or it leads to the family being more dependent on the “expert” clinician. With the first, the family is considered hopeless, maybe I should refer them to someone else while with the latter can lead to even more doing for rather than the activation of their own internal change ideas. It was helpful to me to adopt the reality that what can honestly be offered is time and attention. Humor is a big help when feeling that pull to overdo. Ms. Caffo, thanks for thinking along with me and the others in this discussion.

      1. I’m ending a therapy session With a couple who manifest very high anxiety. We’re minutes over the stopping time and they’re conveying that I’d better come up with something good or else they’ll have significant conflict over the break. I end the session but reverberate with a sense that I should have done something more or better.Bowen’s insight about being a researcher in this situation helps me reconfigure the situation.I suspect this boundary issue would have been less likely to occur if I had been more in the research and less in the thereapy mode. Very helpful blog.

        1. Good point Dr. Dreiss. Any suggestions on how to pick this up in the moment such as what the red flags were that a shift from thinking with others to feeling with others had taken place? I do think once a clinician starts to notice this kind of emotional process then awareness is more likely to come sooner. Your comment brings up another question for me which is assessing real threat from perceived threat. I suppose a sense of threat would have been on both sides, the family’s fears of floundering and your fear of not doing enough. It helps to have a fallback response when one finds one’s self in such a position. Many times in Bowen’s early papers “attitude” is mentioned as crucial to interacting with others. Any more thoughts on a researcher’s attitude in the scenario you described?

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