Bio & SpecialtyTrianglesFusionDifferentiation Of SelfF.A.Q.Meet the Team

Lorna Hecht

I have maintained a private therapy practice in Mission Valley, San Diego, CA since 1999.

In addition to the in-depth education and experience required by all Marriage and Family Therapists, I have received advanced postgraduate training in Washington, D.C. and San Diego.

As of 2022 I have joined the Board and faculty of the Center for the Study of Natural Systems and the Family in Houston TX. (https://www.csnsf.org/) My responsibilities include assisting with their social media presence and offering coaching and online courses designed to further the study of Bowen theory.

It is my belief that learning about and making contact with the family of origin and the extended family facilitates the ability to identify and modify the part self plays in the patterned behavior of the family. This the cornerstone of any effort to improve one’s quality of life.

Why Bowen Family Systems Therapy

Of all the theories of human behavior I was exposed to in graduate school, the one that resonated the most was Bowen Family Systems Theory. Murray Bowen, M.D. studied families over time and discovered that all families are subject to the same opposing forces of togetherness and independence. Families differ in how well they manage the challenges of life, but every family and every individual struggles with the same basic issues of how to be a member of the group while remaining a distinct individual.

Bowen theory does not provide an easy path for a clinician, focusing as it does on the personal growth, individual responsibility, and maturity of the clinician as the most important factor in successful treatment.

My goal is to continue to deepen my understanding of Bowen Theory for the purposes of enhancing both my personal relationships and my clinical work. I trust that this ongoing effort benefits my clients and my loved ones, now and into the future.

Center for the Study of Natural Systems and the Family Board member and faculty 2022-present
Center for the Study of Natural Systems and the Family Small Group Consultation 2017-present
Bowen Center for the Study of the Family, Washington, D.C. 2012-2015
Southern California Training in Bowen Theory, San Diego, CA, 2009-2015
Clinical member, American Association of Marriage and Family Therapy
Clinical member, California Association of Marriage and Family Therapists

How to get the most out of therapy using Family Systems Theory

It is inevitable that tension will arise between any two people who spend enough time together. The natural reaction is that one or both of them will involve a third person in the relationship. This can be done through gossip, affairs, “venting” to an outsider, joining together to worry about or blame a third person, or hiring someone to intervene in a conflict (therapists, lawyers, consultants, mediators, etc.). This is what Bowen called “triangling,” the purpose of which is to relieve anxiety in the emotional system by providing it with another “circuit” to run. When the simple triangle is no longer able to absorb the anxiety in the system, another triangle will be created. Bowen saw all relationship systems as connected series of interlocking triangles. (Bowen, 1978, p. 161)

At any moment in time participants in the emotional triangle form a two-insiders one-outsider configuration. This insider-outsider formation can shift rapidly. For example, in a simple triangle between a mother, father, and child, the mother and child may be chatting in the kitchen (insider position) while dad watches TV in the den (outsider position). Then Dad comes into the kitchen and asks the child if she’s done her homework, moving the two of them to the inside position and Mom on the outside. If Mom answers Dad for the child, “Yes, she’s done her homework,” then she’s moved herself into the inside position with Dad, putting the child into the outside position. This is a completely ordinary interaction and simply describes the way humans-and probably other animals as well-form and maintain relationships. Learn about the family systems concept of triangles for use in your own life to help you to get the most out of therapy with Lorna.

Emotional Fusion Generates Anxiety in the Family.

“The young adult who runs away from home never to see his parents again may have more basic attachment to his parents than other siblings who continue to live with their parents.” (Bowen, 1978).

Family members are attached to one another through intense emotional bonds, or fusions. The force of the fusion compels individuals to modify their thoughts and behavior in an effort to maintain harmony. It can be this very effort that paradoxically leads to conflict in some cases.

Throughout life, people tend to automatically recreate variations of their original fusions with their parents in new romantic relationships, friendships, work and other settings. It is common for people to try to escape an anxious fusion by maintaining emotional and/or geographical distance. However, that which remains unresolved will be played out in new relationships or with one’s children.

A primary goal of therapy is to heighten awareness about one’s part in relationship fusions, and to determine goals for behaving with more autonomy and thoughtfulness in the face of emotional pressure to revert to the familiar fused postures.

Is It a Thought or Is It a Feeling?

Differentiation of self is defined as your ability to distinguish between your thoughts and feelings in your relationships. Ultimately, the goal of therapy is to increase your level of differentiation. The less well-differentiated you are, the more dependent you will be on the acceptance and approval of others. This dependence will prompt you to either adjust what you think, say, and do to please others or else decide what others should be like and pressure them to conform.

Characteristic of a higher level of differentiation is the willingness and ability to recognize your realistic dependence on others, and the ability to stay calm and clear headed enough in the face of conflict, criticism, and rejection to distinguish thinking based on facts from thinking clouded by emotionality. Thoughtfully acquired principles help guide decision-making about important family and social issues, making you less at the mercy of your feelings of the moment. You can act selflessly, but acting in the best interests of the group is a thoughtful choice, not a reaction to pressure from the group. Confident in your thinking, you can either support another’s view without following blindly or reject another view without making anyone a “bad guy”. This is a lifelong journey, as no one is ever “differentiated”. It’s always a work in progress. The higher your level of differentiation, the fewer the interpersonal difficulties you’ll tend to have, and the easier time you’ll have coping with life’s inevitable challenges. You’ll also find it easier to be intimate with your loved ones because closeness won’t feel like being “swallowed up”.

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.

Do you accept health insurance?

I am a provider for several insurance companies. However, there are many good reasons to pay out of pocket for your sessions:

Privacy. No 3rd party will have access to any details of your treatment or even the fact that you are in treatment.
No diagnosis. All insurers demand a diagnosis for reimbursement.
Insurance companies often put a cap on the number of sessions allowed.

For more about this see my blog post: http://lornahecht.com/2012/04/26/should-i-use-my-health-insurance-to-pay-for-therapy/

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What are your rates?

My rate is $180.00 per session and $130.00 per session for students, interns, and military families. Sessions run 55 minutes.

Unlike many other therapeutic approaches that involve the clinician telling the client how often they should come in, the family systems model maintains that clients are the best judge of the frequency of sessions. In fact, it is thought that more frequent sessions do not lead to faster change. Most of my clients report that coming in twice monthly works very well. Once they know what they want to work on between sessions every four to six weeks become the norm. This is one way to keep therapy costs down.

Another option for interested clients is that I have well qualified pre-licensed associates working under my license and supervision. They also work from a family systems perspective and they offer a sliding fee scale.

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How many sessions will I need?

There is no set answer for this question. Variables include:

Your goals for treatment
How much thought and effort you maintain between sessions
The nature of the issues you are facing

Many people come in to treatment with one particular problem they want to solve. They find relief and take a break from therapy. After thinking things through using family systems theory, some other clients realize that ongoing coaching can be a valuable resource. These are the folks who will continue to come in every month or two to receive guidance about the ongoing challenges that inevitably arise in any complicated life.

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What are your success rates?

Once again, there is no set answer to this question. Most approaches focus solely on symptom resolution in one person, and make that the goal for treatment. Family systems theory takes a holistic view of the family, considering the interplay between every member. The overall goal is to assist clients in their efforts to thoughtfully think through and handle whatever challenges they are facing. Including in this is the reduction of problematic symptoms.

http://lornahecht.com/family-systems-theory-a-holistic-approach-2/
http://lornahecht.com/how-to-get-the-most-out-of-therapy-using-family-systems-theory/

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Is your approach effective?

It is a fact that no one therapeutic approach has been shown to be significantly more effective than any other. Many of the new so-called “evidence based” therapies make great claims about their effectiveness, however, much of the research has been shown to be flawed. The truth is, there are no sure-fire quick fixes to complicated emotional problems and anyone who tells you there are is either uninformed or dishonest.

I suggest reading the information on this website. You can also look through the blog archive and read some of the articles. Schedule an appointment if what you read makes sense to you. There is no commitment and it is important to find a therapist who is a good fit for you.

http://lornahecht.com/8-benefits-of-coaching-with-a-marriage-and-family-therapist-trained-in-bowen-family-systems-theory/
http://lornahecht.com/smart-skeptic-risks-therapeutic-overpromising/

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Do you treat children?

I think my husband and I need couple’s counseling but he won’t come in, what should I do to convince him?

I’m going to make a paradoxical statement here: The purpose of marital counseling is to have individual counseling in the presence of your spouse.

All marriages are made up of an uncountable number of reciprocities. That is, you and your spouse (and others in your relationship triangles,) react to one another over and over again in patterned ways. These patterns can get stuck and, in some cases, dysfunctional. The goal of therapy is to figure out your part in the reciprocities so that you can make modifications. This can be done with your husband present or without him.

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I should be able to figure things out on my own. How can a therapist help?

My mother is emotionally abusive. She’s the one who should be getting counseling, right?

What diagnoses do you specialize in?

There are many therapists who specialize in specific conditions. I do not work that way. Instead, I view all symptoms-physical, emotional, or social-as coming out of a relationship process in the family. The goal is to modify that process, which can lead to a reduction in symptoms.

Personally, I am uncomfortable with the current emphasis on diagnosis. Being able to accurately diagnose a medical condition is essential to treatment. The same principle has been applied to mental disorders which has not turned out to be as effective, and can in many situations make things worse. I think it is far more accurate to look at the functioning of a family system as a whole and to view the symptomatic individual(s) within the context of what is happening between people.

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If you are a family therapist does that mean you only work with the whole family?

I have an individual therapist and she says my husband and I should see someone else for couple’s counseling. Will you see us?

The belief that each individual should have their own therapist, as well as a separate couple’s counselor, comes out of a specific therapeutic philosophy. This may be a valid approach but as I see it there are several disadvantages:

It is more expensive to maintain several therapists.
There is a lot more time spent in therapy, which has not been shown to be more effective.
Different therapists may give contradictory information.
Systems theory maintains that there is no distinction between couple and individual issues; everything exists within the relationship process and context.
Creating more therapeutic triangles may calm the system down in the short run but over time it is more likely for the family to develop a dependence on the therapists, and even to avoid dealing with difficult issues within the family.

While in couple’s therapy you will alternate between individual and joint meetings. This facilitates the ability to learn from your partner’s perspective while allowing space to focus on your individual goals.

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Lorna’ s Approach

Lorna Hecht

Why Bowen Family Systems Therapy

How to get the most out of therapy using Family Systems Theory

Emotional Fusion Generates Anxiety in the Family.

Is It a Thought or Is It a Feeling?

Do you accept health insurance?

What are your rates?

How many sessions will I need?

What are your success rates?

Is your approach effective?

Do you treat children?

I think my husband and I need couple’s counseling but he won’t come in, what should I do to convince him?

I should be able to figure things out on my own. How can a therapist help?

My mother is emotionally abusive. She’s the one who should be getting counseling, right?

What diagnoses do you specialize in?

If you are a family therapist does that mean you only work with the whole family?

I have an individual therapist and she says my husband and I should see someone else for couple’s counseling. Will you see us?

Contact Lorna to Schedule an Appointment

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