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    The Role of Anxiety

    Q. I have a good life. A loving husband, healthy kids, a nice house and a good job. Sure, we have money problems and family issues, but overall we’re blessed. I even get along with my parents and my brothers and sisters.  But I know I don’t enjoy my life enough. I’ve struggled with depression at times, and am often critical and irritable with my husband and kids. Medication helps a little, but doesn’t solve my problem. I don’t like taking it anyway. I often feel like I’m faking it and just going through the motions. What I really want to do is stay in bed and pull the covers over my head. I must be really messed up, right? Maybe my mother was right and I’m just spoiled because I’m the youngest.

    A. It’s hard to say exactly what’s going on without knowing your specific family history and other details of your life, which we will gather if you come in for therapy, but there are some principles that apply to all of us:

    Individuality and Togetherness

    All people struggle with a tension between the emotional forces for Individuality and Togetherness.  The togetherness force is a biologically rooted life force that pushes individuals to be part of the group. The togetherness force encourages dependence, agreement, following, and harmony.  The togetherness force is always operating in dynamic tension with the force for individuality, “a biologically rooted life force that propels an organism to follow its own directives to be an independent and distinct entity” (Kerr and Bowen, 1988, p. 64).

    More pressure for togetherness often exists than room for individuality. When the forces get out of balance, this contributes to Chronic Anxiety.  In your case, it may be that the pressures of being a wife, mother, homemaker, daughter and employee are making it difficult for you to honor your need to be an individual among your loved ones.  This might explain your desire to separate yourself and “pull the covers” over your head.

    According to Ed Friedman (Friedman, 1999, p. 183):

    Differentiation refers to a direction in life rather than a state of being:

    • Differentiation is the capacity to take a stand in an intense emotional system.
    • Differentiation is saying “I” when others are demanding “we”.
    • Differentiation is containing one’s reactivity to the reactivity of others, which includes the ability to avoid being polarized.
    • Differentiation is maintaining a non-anxious presence in the face of anxious others.
    • Differentiation is knowing where one ends and another begins.
    • Differentiation is being able to cease automatically being one of the system’s emotional dominoes.
    • Differentiation is being clear about one’s own personal values and goals.
    • Differentiation is taking maximum responsibility for one’s own emotional being and destiny rather than blaming others or the context.

    Relationship Patterns

    Q. When we first met, my girlfriend and I could talk about anything. Now I feel like I have to walk on eggshells not to upset her.  It’s gotten so bad I find myself talking more to a woman friend at work than I do with my girlfriend.  A buddy of mine says this is how affairs start and I can see his point. What should I do?

    A. Remember how easy it was to get along in the beginning of your relationship? It seemed like you could talk about anything without fear of being judged. You were excited to see each other, but open and honest about all kinds of personal subjects. Now it’s changed between you. You worry more about saying or doing the wrong thing. And you also find yourself being more critical, more easily irritated by what your partner says and does. Maybe you are the kind of couple who argues, or maybe you avoid each other when you’re upset but either way, sometimes you just wish it was how it was in the beginning of your relationship; fun and easy.

    It is normal for emotional intensity and sensitivity to develop between two people who are physically and emotionally close to one another.  There is always a dynamic tension between the normal human needs for closeness on the one hand, and individuality on the other.  Often, one of you will “carry” more of the need for closeness while your partner “carries” more of the need for separateness; balancing these opposing forces is a challenge for everyone in relationships.

    Because few of us understand the normal relationship process as it happens, we try our best to manage the growing intensity and sensitivity, but end up getting stuck in repetitive, sometimes dysfunctional, patterns. You should recognize your own relationship in one or more of the patterns described below:

    When you decide you are ready for change you can initiate therapy by yourself or with your partner.  If your partner doesn’t want to participate, you can start on your own.  It is likely that when the changes you are making become evident, your loved one will decide to join the process.

    Family Health

    Q. Help!  I am married and have three kids. The middle one, a son, and my daughter, the baby, are doing well. The problem is the oldest.  He’s 14 and has always been difficult. He won’t do chores, gets into trouble at school, talks back, and hangs out with kids his father and I disapprove of.  But the biggest problem is the arguing between him and my husband. They go at it all the time, and have even gotten into fist fights. No one gets hurt, but as my son gets older, I worry what will happen. I tell his dad he’s too hard on the boy, but he won’t listen. Sometimes I think this is related to my husband also being an oldest. He had difficulty getting along with his father. They haven’t talked for the past 12 years. Will that happen to my family? What should I do?

    A. Because there is a lot of anxiety present in your family system it is possible to see several common dynamics at work here:

    Advanced Training for Students and Professionals​

    As a clinical application, Bowen Theory is unlike other disciplines that emphasize therapeutic techniques employed by the clinician to treat the client. Likewise, Bowen Theory doesn’t rely on the therapeutic relationship to provide a healing environment. Instead, Murray Bowen maintained that the clinician’s focus should be on his or her own level of Differentiation of Self as the primary change agent for clients.

    If the therapist is to develop the capacity to stay relatively outside the family emotional system in his clinical work, it is essential that he devote a continuing effort to differentiate his own self from the emotional system of his own family…” (Bowen, 1978, p. 250).

    Lorna offers both individual coaching and advanced training for clinicians based on the small group format developed by Murray Bowen at the Bowen Center for the Study of the Family.

    Contact Lorna regarding special student discounts and for group start dates and other details.

    Are You Worried About How Much You Drink?

    Brittany* is married and has three children. She says about her marriage, “Paul and I get along well with each other. We hardly ever argue. My only real complaint is that I have to do most of the work with the kids and the house. But he’s busy earning a living, so that’s ok, right?” When asked, Brittany also reports mostly happy relationships with her extended family and friends. Her kids are doing well socially and in school. All this makes the fact that Brittany is prone to excessive drinking that much more confusing to her:

    I try to keep it to one or two glasses a night, but a couple of times a week I just overdo it. When I drink too much wine my sleep is disrupted and I feel sluggish the next day. Once in a while I get sick from drinking too much. That’s when I really worry about myself. I don’t think I’m an alcoholic because I go to work every day and I take care of myself with exercise, but I can’t seem to control how much I drink sometimes. I don’t want to quit entirely, but everything I’ve tried to control it-switching to white wine, only drinking on weekends, alternating water and wine-has never worked for more than a few days. Then it’s like some switch turns off in my brain and I give myself permission to go overboard. I tried AA a few years ago but I didn’t like it. I’m not religious and I don’t think abstaining is right for me. They’d say I’m in denial, but I don’t think so. Isn’t there anything that can help someone like me?

    Many people can identify with Brittany’s problem. They report a seeming inability to reliably control how much alcohol they consume. Yet they don’t consider themselves alcoholics and don’t see abstinence as a viable solution.

    Dr. David Sinclair (1943-2015) was an alcoholism researcher working in Finland in the 1970s and 80s. He developed the revolutionary Sinclair Method for the treatment of problem drinking. Unique from all other methods, the Sinclair Method relies on the pairing of a medication with drinking in order to decrease cravings and alcohol use over time. (For detailed information refer to Sinclair, David. The Cure For Alcoholism: The Medically Proven Way to Eliminate Alcohol Addiction. Dallas: BenBella, 2012. Print.)

    Dr. Sinclair used the principles of learning theory to develop his treatment. Based on his research with rats he determined that, like the rats, people don’t need psychotherapy to benefit from medication to manage their drinking. While his method is successful for an amazing 80% of the individuals who adhere to the treatment, it may not be quite that simple. Family systems theory looks at alcohol use/misuse from the perspective of the family system, and takes into account more factors than what is considered in learning theory. People learn to drink, and start misusing alcohol, in the context of their relationship networks. The symptom of excessive alcohol use is embedded in the family system. Removal of that symptom has effects not only on the drinker, but on everyone involved in the drinker’s life. In the long run this should be a positive occurrence, but things may not go that smoothly.

    After Ken started taking Naltrexone for his drinking his consumption went way down, as promised. He felt much better physically, but he didn’t exactly feel happier: “I was more irritable with my wife and kids. Lots of things that didn’t bother me before started to get on my nerves. I realized that no one in my family took me very seriously. In fact, I didn’t take me very seriously! I think a big reason why I drank in the first place was because no one listened to me as a kid and I never expected anyone to listen to me even when I was the husband and father. Counseling helped me to figure that stuff out. Otherwise I don’t know if I would have stuck with Dr. Sinclair’s method. It was hard in the beginning.”

    If you are interested in getting help for your alcohol use, contact Lorna. She works in collaboration with Board Certified psychiatrists to provide state of the art treatment for problem drinking based on the proven benefits of the Sinclair Method and the principles of Family Systems Theory.

    Bowen, M. (1978). Family therapy in clinical practice. New York: J. Aronson.
    Friedman, E. (2007). A Failure of Nerve: Leadership in the Age of the Quick Fix. New York, New York: Church Publishing.

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