>> Marie Bowen's multigenerational family therapy was the first systemic model to be tested through the National Institute of Mental Health. Bowen focused his work on families who had an identified schizophrenic patient. He would often hospitalize the whole family in an effort to both understand the dynamics and patterns that were repeated, often over several generations. Bowen came to believe that triangles in which two people worked against the third or in which a third person was drawn into a problem between two others were at the heart of family difficulties. He also come to believe in the importance of a differentiated self. A differentiated self was evident when an individual in a stressful family situation was able to use reason rather than emotional reactivity. Emotional reactivity results in relationships when people push each other's buttons. Bowen would coach the person in the family who had the greatest potential for differentiation in an effort to help the individual observe what was going on and come to a reasonable assessment and rational response. The same capacity for rational observation is required of the therapist too. The following video segment is based on the case by Philip Gearing. Dr. Bitter works with the family in which the mother feels that her daughter's friend and the friend's mother are bad influences on her child. The father in this family is largely absent or cut off from the family process. Dr Bitter demonstrates how a Bowen therapist might work with triangles in a family and coach the various family members toward a more reasonable solution. >> Dr. Bitter: Oh would help me to get to know the family little better if I could hear who everyone is, who's in it, even perhaps some of the people who aren't here, but are important to you. >> Betty Anne: Well I'm Betty Ian. This is my daughter Alison that I called you back and my husband's Steve. >> Dr. Bitter: I'm just going to make a diagram here as we go along and if you'd like a copy of it at the end of all of this, you're welcome to it. Are there other family members besides the three of you? >> Alison: I've brother John. He is in college for a year and he only comes home on vacations and then there is my grandma, see her a lot. >> Dr. Bitter: Aha. So there is John and then your grandmother. Would that be your mother, Steve or? >> Steve: No mother-in-law, it's Betty Anne's mother. >> Dr. Bitter: Oh it's your mother, okay. Can you tell me a little bit about her? >> Betty Anne: Ah, she's been sick for about a year now. She's got throat cancer. >> Dr. Bitter: Oh, okay. That's a very difficult thing. I'm sorry to hear that. Ah, so John is away at college and your grandmother Alison has throat cancer. Are there other people I should know about? >> Betty Anne: Well I think Samantha and her mother should be sitting here. >> Dr. Bitter: Okay. Can you tell me about that? >> Betty Anne: Samantha is a new friend of Alison. She just moved here few months ago from California. >> Dr. Bitter: Okay. Ah, so what is that like Alison? What does Samantha and her mother to you? >> Alison: I think Samantha and her mom are really cool and you know Samantha, she, she's different and she's interesting. >> Dr. Bitter: Hmm, what like of cool would you say she is? What makes her cool to you? >> Alison: Well, her, her parents don't get all over her for a whole lot of stuff. She has a lot more freedom. >> Dr. Bitter: Uh huh. And how does she do in school and other things like that where, that where you know her in school or just in the block or? >> Alison: She's a straight A student. She's on a varsity volley ball team and she's on the debate team. >> Dr. Bitter: Okay. So it sounds like she's a good friend to you but that you have some, some worries about, about Samantha. >> Betty Anne: Well Samantha's mom lets her hang out [inaudible]at the mall and I don't think she dresses what I consider appropriately. She wears low neck lines and hip hovers and short shorts and dress like that. She draws boys like flies. >> Dr. Bitter: But you know when you called though, I don't remember us talking about that, I remember something about Alison sneaking out, but. >> Steve: Yes she was, won't go to the mall and, and there was an argument between Alison and her mother and there is some four letter words we used. >> Dr. Bitter: Okay. Were, were you there, how you said? >> Steve: No, at work. >> Dr. Bitter: Okay. >> Steve: So I just heard about it later. >> Dr. Bitter: You heard about it later, okay. >> Betty Anne: That's when I sent her to her room and she was gone for hours even after I learned that she was missing, that wasn't in her room like she should be in. And plus she's failing some of her grades. I'm concerned. >> Dr. Bitter: Alison is. >> Betty Anne: Yes. >> Dr. Bitter: Okay. So this seems like there's a lot going on and some of it seems pretty complicated. Steve you mentioned you weren't at home when all of this took place you were at work. Is that right? >> Steve: I sure was, yes. >> Dr. Bitter: Okay. And what you do? >> Steve: I'm a lawyer for Apec Technologies and we're going through some really difficult time. We faced a hostile takeover in it's over the last six months or so I've had to work a tremendous number extra hours. I feel like I've not been able to devote the kind of time I'm used to with Alison. That's kind of bothersome for me but work is just so demanding now. >> Dr. Bitter: So you've been at work a lot and may be not spending as much time with Alison as you're used to? >> Steve: Yes it seems to be the case. >> Dr. Bitter: Okay. Betty Anne you know I don't know if I asked you if you worked outside the home or not. >> Betty Anne: Yes, not near as much as Steve, mine is just part time with a consulting business. >> Dr. Bitter: Okay. >> Betty Anne: It's steady. >> Dr. Bitter: It's pretty steady, okay. How about you Steve thought that I think he wasn't having as much time with Alison as he used to may be losing a bit of touch with her. Did you ever feel like you're losing touch with Alison? >> Betty Anne: Well I love Alison. Sometimes I just, I'm worried and concerned, you know, I want her to be safe. >> Dr. Bitter: Yeah. So what have you thought about possibly doing to help Alison with all of this. >> Betty Anne: Well heard about some Tough Love Groups. Would you suggest that? >> Dr. Bitter: Well I don't have any recommendations to make at this point. I am still trying to get to know everything that's going on, but with Tough Love Groups is one thing that you've looked into you thought may be that might be helpful? Okay. Well may be it'd be helpful to me if I could hear from Alison and see what all of this means to her. >> Alison: Well what means to me? >> Dr. Bitter: Oh I'd be interested in hearing you know whether your, what you're feeling in relation to your mom and dad on this. Also anything about how you might be feeling about your grandmother's situation. >> Alison: I don't mind that they can relate more to John than me and grandma. Grandma loves me just fine. She is easy to get along with and as far as Samantha goes I don't see why they have a problem with her. She is different, yeah. She's had different experiences but that's what makes her great. She, she's different from me that's why I like hanging out with her. I rather leave home to not be with Samantha, period. >> Dr. Bitter: So it's very important to you? >> Alison: Yeah. >> Dr. Bitter: Yeah, you know earlier you, you said that you felt I think something like you were being clamped down on, you generally that kind of happens when parents start to be afraid of things. What do you think your mother might be most afraid of with you? >> Alison: That I'm going to have sex with the entire football team in the back parking lot of the mall. >> Betty Anne: That's for sure. >> Dr. Bitter: So that is one of your fears. >> Betty Anne: One of them. >> Dr. Bitter: Okay. Okay could you tell me little bit about some of the other fears might be. >> Betty Anne: One of my fears is I'm losing her. You know I don't want her to be doing something that she will regret for the rest of her life. >> Dr. Bitter: That sounds like a, a fear that comes from other experience, may be long ago, may be something about what it was like for you when you were an adolescent. How was it like when you were young teenager? >> Betty Anne: Well, I'm sure I had my, you know anxieties and curiosities. >> Dr. Bitter: What was your relationship like with your mom? >> Betty Anne: It was good. I can really talk to my mom. She is my best friend. I never had to lie to her. >> Dr. Bitter: So maybe it's something about you feeling that best friend part is missing in your relationship with Alison? >> Betty Anne: Yes, I'm not near as good as my mother is. >> Alison: Grandma was great. She didn't try to teach you to be a better person, she just loved you. I love her. I don't know what I do without her. >> Betty Anne: I know Alice, she does love you. I just don't know what I would do without her either. >> Steve: I don't know what to say. >> Dr. Bitter: May be its okay Steve not to say anything. This is so it seems to be kind of like a tender moment that two of you are sharing. I think its okay for it to be just between them. [ Pause ] >> Dr. Bitter: Can you say more about what you hope for, for Alison, Betty Anne. >> Betty Anne: I just want her to be safe. You know I want to know where she is at. I don't want to have to worry about her all the time. >> Dr. Bitter: You know that's something that I want for my children too, but it strikes me that it's fairly normal for teenagers to want to spend a lot of time with their friends. I know my own daughter spends an enormous amount of time on the telephone talking and text messaging to her friends. Seems like it's almost more important for her to be connected to her friends at this age and that was, than it is it, to her family. I'm, I'm not completely certain either that it's totally up to as parents to make sure that they're, they're safe. Ally I'm, I'm wondering you've heard your mother's worries and I'm sure your dad wants you to be safe too. I wonder if it'd be possible for you to come up with guidelines for yourself, something that you would think would be fair and reasonable for you. >> Alison: You mean come up with what I can and can't do. >> Dr. Bitter: Yeah, but to do it taking into account what your parents want for you most. They, they want you to be safe, they want you to get a good education. They want you to have a foundation for one day leaving home and having a productive life. If you could take into account their hopes and dreams for you as well as your own, may be you could come up with a, a set of guidelines for yourself that would work. What do you think about that? >> Alison: Yeah, well what if I come up with it and mom doesn't like them or she doesn't think they're enough? >> Dr. Bitter: Well that is a problem. I'm fairly certain that you know almost everything in life has to be negotiated. First step would be to get it all written down on, on paper, to spell out you know what it is that you think would be good about how you would behave when you're away from them, what your comings and goings would be like. I'm guessing that your friend Samantha might even be helpful to you in this. >> Alison: Negotiate? >> Dr. Bitter: Yeah. Negotiation is what people do when they want to work things out. So I don't know who, do you think you would be best at negotiating with, your mom or your dad. >> Betty Anne: Her dad for sure. >> Alison: Dad. >> Dr. Bitter: Dad, okay. So Steve do you accept election as the administrator and negotiator for the parent team. >> Steve: I think I can handle that. >> Dr. Bitter: Okay, great. I, I think that will be something that will be really worthwhile. You know what my hope for you is Betty Anne is that you and Alison could try out a different kind of relationship. I would like to see one in which you got to spend a little more time being the fun parent in this family may be to just spend time together and to have Steve be the person who handles any of the correction that might need to take place so that you can build on some common interest with Alison. What would you think about that? >> Betty Anne: I think it would be great for us to, to spend time together. >> Dr. Bitter: Okay. Oh, do you have a sense of how you would go about that? >> Betty Anne: What do you suggest how, how do I start? >> Dr. Bitter: Well you might, might start by just paying attention to how it goes currently. There must be some times that you have to do some correction advising or some even criticizing, with other times in which you must be doing some supportive and even affectionate kind of interactions. We would want you to do kind of more of the latter and let, let Steve handle the other things that might come up. What do you think? >> Betty Anne: I'm willing to try. >> Alison: Okay. So mom and I have this great time together, but where does that leave me and Samantha? >> Dr. Bitter: Well I would hope that you and Samantha continue to be good friends and I would like to see you spend lots of time together. I think that's the appropriate thing for you to be doing. You know it seems to me that as you described her and I didn't hear your parents disagreeing, there's no drugs involved in this relationship, both of you do pretty well in school and can support each other in that. She brings you a different kind of perspective than you might get in your family. There is you know no particular reason why you would have to get involved in the relationship between your mother and father and I similarly think that there's no reason for either of them to be involved in your relationship with Samantha, I think, that's between you and her. Any more than I would want Samantha and her mother to come between you and your, your parents. So we're really talking about building a, a good relationship of two apples, one between you and Samantha and one between you and your mom, to kind of reconnect what might have been, and lost along the way. >> Alison: So I do get to spend time with Samantha? >> Dr. Bitter: Yes, I think that would be a very good thing to have happen. Steve I'm wondering with all that you have to do whether there's going to be time given your work to actually sit down with Alison and negotiating the guidelines that she'll come up with. >> Steve: Yeah, certainly will be very busy but this sounds very interesting enough, really do believe I can carry it through. >> Dr. Bitter: Okay. And Alison how do you feel? Do you think that you'll be able to do that with your dad? Okay. So I think that we'll see how that goes for a while.