The therapist should be alert to communication and behaviors that indicate a lack of differentiation. Differentiation or differentiation of the self is a major construct in Bowen's Family Systems theory, which is the seminal family-of-origin theory. Differentiation is defined by the development of the self within the family's relational context. "Bowen proposed that 'The interplay of individuality and togetherness is important in every relationship in which people have emotional significance to one another' (Kerr & Bowen, 1988, p. 64). An important indicator of differentiation within the context of the family of origin is emotional reactivity. Bowen (1978) suggested that those with lower levels of differentiation would be highly influenced by the emotional process in the system and be unable to make choices about their behavior. He suggested that this emotional reactivity came in several forms: defend self, counter-attack and withdraw. Of importance here is the perceived lack of choice about behaviors. Individuals with lower levels of differentiation react to situations rather than step back from the situation and consider options" (Bartle-Haring et al., 2007, page 54).
Differentiation of the self occurs in the balancing between the individual's need for togetherness or connection and need for independence or autonomy. The individual seeks to develop an autonomous sense of self, while keeping intimacy with first his or her caregivers, the family, and subsequently other new valued relationships. To be successfully differentiated, an individual needs to be able to self-regulate his or her emotions, reason thoughtfully through challenging circumstances, and be not be overwhelmed with his or her feelings. Such individuals are more introspective and insightful and can take responsibility for thoughts and feelings, while valuing intimacy and connection with others. A poorly differentiated individual gets very activated by other people's emotional intensity, as well as being emotionally reactive in general in his or her own process. Such an individual tends to engage in fusion with or emotional cutoff from others when under stress or experiencing overwhelming anxiety (Skowron, 2004, page 447). A case is made that higher levels of differentiation lead to higher relationship and life functioning across cultures.
"Research conducted with samples of White European Americans has corroborated Bowen's (1978) assertions that individuals who are more differentiated enjoy better personal adjustment, fewer psychological and physical health problems (Harvey, Curry, & Bray, 1991; Skowron & Friedlander, 1998), and are better problem solvers (Murdock & Gore, 2004). In addition, well-differentiated adults seem to cope better with stress (Skowron, Wester, & Azen, 2004) and develop healthier, more satisfying relationships with others (Kosek, 1998; Skowron, 2000). In contrast, few studies have directly examined relations between differentiation of self and personal adjustment within diverse ethnic cultural groups. One notable exception involved a study conducted in the Philippines in which Tuason and Friedlander (2000) found support for the cross-cultural applicability of Bowen theory in a sample of 306 Filipino adults. Specifically, theoretically expected links were observed between greater differentiation scores and lower anxiety and general symptomatology scores. Contrary to the authors' predictions that self-assertion in relationships would predict maladjustment in this collectivist, family-oriented culture, greater ability to take 'I' positions in relationships predicted lower levels of anxiety and better adjustment, as proposed by Bowen theory. However, results of structural equation modeling found only partial support for Bowen's (1978) multigenerational transmission hypothesis, namely that similar levels of differentiation of self are present across multiple generations of a family. In another cross-cultural investigation conducted in Taiwan (Yang, 1999), family differentiation was found to predict greater self-esteem and interpersonal competence and lower depression among young adult women, and greater self-esteem among young adult men" (Skowron, 2004, page 448).
Greater differentiation of self among people of color predicted greater psychological adjustment and social problem-solving skills. Those with the most positive psychological adjustment had the lowest tendencies to be emotionally cut off. They were more connected to significant individuals including family. People of color who could engage in self-directed behavior and own their thoughts and feelings reported that they had better social skills for problem solving. "Although the relationship between differentiation of self and personal adjustment was observed in a diverse sample of ethnic minority adults, these findings lend initial support to the cross-cultural relevance of Bowen family systems theory and support a growing body of literature (e.g., Campbell, Adams, & Dobson, 1984; Grotevant & Cooper, 1985; Kenny & Perez, 1996; Tuason & Friedlander, 2000) demonstrating that a capacity for self-definition and relatedness, together, is associated with health and maturity among individuals from ethnic minority cultural groups" (Skowron, 2004, page 453). In addition, greater differentiation did not adversely correlate with a sense of belonging to the ethnic group. "People of color who reported more positive attitudes toward, and stronger ties with, their own ethnic group were less emotionally cut off in their relationships with family and significant others." The balance between autonomy and connectiveness appears to be best when both characteristics are strongest. Individuality and togetherness appear to be mutually supportive.
Some examples presented in this book make specific reference to ethnicity or cultural back ground while others do not. Many relationships or couples were discussed without specific reference to ethnicity and culture because their experiences are common across various populations. Laura who could be of any ethnicity was fused with her mother, and at risk to fuse with her daughter. Christine who emotionally reacted so intensely to her husband sitting on her antique chairs tended to fuse with her partner. She responded as if she were being molested again. Her defining "cultural" experience was of being sexually abused. She had difficulty separating herself from him and her childhood trauma from current events. Fusion was expressed in her expectation that he would automatically know how and why she felt that it was so "wrong" for him to do that "to" her. It may be hypothesized that someone from an oppressive society whose community has suffered ethnic or religious discrimination may be similarly sensitized and reactive as Christine was to her partner. Therapy for Laura and for Christine in their respective relationships needed to help them differentiate from the old dynamics. Anxiety about rejection and abuse needed to be soothed in a less fused dynamic with better boundaries between each of them and their respective husbands. In their relationship, George dealt with his anxiety about intimacy and rejection by cutting off emotionally from Laura. While George and his father Herbert's defining cultural experiences were of being upper class, their dynamics are relevant across class distinctions. Therapy for George would include getting him, even when anxious to risk and practice staying emotionally present and connected with Laura rather than blaming her. Eliminating or reducing his tendency to cut and run with an intellectualized excuse would be a goal of therapy.
Hoang (2005) says that, "I see differentiation evidenced in the way each partner focuses less on blaming or criticising the other. Instead, they face more about themselves, and wonder what it was about them that has led them to feel and act the way they do. To some extent, they may start to see the relationship as a particular part of their lives, rather than as their whole life" (page 69-70). Hoang notes how the therapist may recognize increased differentiation when he or she hear comments that suggest an individual can recognize a partner's behaviors as having been molded by his or her family-of-origin or culture, as opposed to being a disrespectful personal response to him or her. With greater differentiation, a person is more able to recognize his or her own intense reaction to the other. Different theories may use various terms to convey similar strategies and goals for clients to differentiate. "Psychoanalytic and object relations models emphasize increasing individuation, whereas attachment and family systems theories predict that some optimal moderate balance of separation and connection yields the most healthy adjustment. Adult attachment models help explain the origin of differences in the specific point at which a given individual might define his optimal balance. Feminist 'self-in-relation' models describe gender differences and predict that for women, an optimal blend of individuation and continuing relatedness is necessary, whereas men who received traditional masculine socialization may value increasing degrees of separation" (Haws and Mallinckrodt, 1998, page 197).
Bowen tried to coach each partner to differentiate from each other and from their respective family of origin by de-triangulating. In family therapy with children, focus is on the couple as the parents to free children from the parents' emotional involvement with each other. If both partners do not come to therapy, Bowen would choose to work with the more differentiated partner if available. This family therapy or couple therapy without all members of the family or couple is based on the premise that increased differentiation in one person would activate change for everyone, increasing potential differentiation among rest of the family. Specifically, "Very often, the therapeutic intervention is to coach the over-functioning spouse to be less over-functioning, enabling the under-functioning spouse to function at a higher level" (Farmer & Geller, 2005, page 71-71). On a practical level, this strategy is often necessary with one partner more invested and ready to engage in couple therapy. While the therapist often prefers both partners involved from the beginning of therapy that focuses on relationship issues, many times one partner is reluctant if not outright opposed to participating in couple therapy. While theoretically arguable, the therapist may find that one partner in therapy addressing relationship issues is often highly predictive of the couple not resolving issues and/or eventually separating. The therapist working with the ostensibly more differentiated partner only has the reputation and perspective of the other partner that the client presents. Without a contrary or alternative voice, the therapist is left only the present client's story. With the natural tendency to empathize and commiserate with the client, the therapist is at risk for reinforcing the negativity of the client… who may or may not actually be more differentiated. How would the therapist know without having met the other partner?
Jeanina instigated therapy without her husband. She told extensive and disturbing stories of his neglectful and emotional abusive behavior. One story revolved around a disagreement about shopping that deteriorated into him becoming enraged and verbally and profanely abusing her. The theme of the story was how he ignored her requests and was selfish. When she asked to be respected, he flew into an intimidating rage. The therapist processed her fear and worked with her around how her experiences with her rage-aholic father were related. Therapy explored safety issues and education about the cycle of domestic violence as well as consideration whether alcohol was a relevant contribution to the rage. After two months of weekly sessions with her alone, her husband agreed to come to therapy. Couple therapy had always been her desire and the intent of therapy. The therapist framed the therapy based on working with the couple even though initially only Jeanina came. She had started with individual sessions because he was not yet willing to participate. Now he was ready. Rey was very frustrated and was willing to take a chance couple therapy might be helpful. Boundary issues about including Rey into what had been couple's focused but individual therapy functionally were discussed. The therapist proposed that everything that Jeanina had discussed in the earlier sessions were considered appropriate for the new sessions since it was always intended to be couple therapy. Jeanina enthusiastically agreed. As the therapy proceeded, the big fight over the disagreement about shopping was brought up. As the argument preceding Rey yelling profanity at Jeanina was examined, Rey revealed that he had been exhausted and unable to participate positively in their discussion. He said that they had agreed previously to allow for time out when one or the other could not participate in a productive manner. He had excused himself despite Jeanina's demand to keep talking. Rey had changed, washed up, and gone to bed. He said he was so tired that he fell asleep immediately. He was asleep about 45 minutes, when Jeanina came into the bedroom and threw a glass of water on his face. That was when then he screamed and cursed at her. The therapist asked her to confirm this element of the story that she had previously omitted. Her ashen face and silence verified the scenario.
The intensity of pain and accrued outrage for injustice (largely from prior to their relationship) that Jeanina experienced left her self-righteous and defensive. She triangulated her prior abuse experiences into her and Rey's relationship that lead to her presenting to the therapist a set of circumstances consistent with her lack of differentiation. Her revelations to the therapist reflected her intensely held life mythology as the aggrieved victim to the horrific intimate partner. Unfortunately, her story did not reflect reality as they both had experienced it. The therapist should remain vigilant when seeing only the individual (rather than the couple) who complains about a relationship may not be the most differentiated member of the couple. In this case, further work uncovered significant borderline issues for Jeanina that defined and colored her experiences. Getting all the members of the family system present may allow the therapist to ascertain the fluctuating identities of protagonists and antagonists in the dynamics.
The specific approach and intervention in therapy can vary not just according to theoretical orientation but the therapist's clinical style. Bowen proposed long-term work, which aims to enhance self-differentiation in clients. He tended to have an individual client visit the family after coaching him or her on how to differentiate him or herself from the emotional system of the family. After getting family history and working out an agenda of unfinished business for the session, the therapist may also have a family session with the actual family of the client. Such therapy can be very immediate and intense, offering opportunity to take action to change family dynamics. In couple therapy, bringing in the family may not happen until there has been ample time spent on learning about partners learning about each respective family-of-origin. Hoang (2005) describes Freeman's strategy with couples and family-of-origin work. "Freeman (1992) distinguishes different phases of family of origin therapy with couples. In the initial phase and the first half of the middle phase, he places more attention on self and partners getting to know each other's family of origin and how it shapes them. Clients' parents would only be invited in the later middle phase, when appropriate, for example, 'to learn more about the complexity of the family' (1992: 210). Freeman involves extended family members in therapy primarily in order to break an impasse in clients' progress" (page 66).
A therapist may use family-of-origin principles with an individual client without ever intending to bring in or have the client process directly with his or her family. This may be a practical issue when family-of-origin members have already passed away. Moreover, direct processing with otherwise available members from the family-of-origin may be counter-therapeutic. In some situations, a client who attempts to process directly with his or her family-of-origin may anticipate positive and receptive responses and be sorely disappointed. In fact, the client may be re-traumatized as parents and/or family members may be too rigid, be in denial, or otherwise emotionally or psychologically unable to participate in a healthy manner. In other words, the individual psychological or emotional dysfunction of one or more parents or family members that was harmful in the family-of-origin for the client as a child may persist years and decades later. The assumption that the client and family members can now process in a more emotionally connected, psychologically empowered, and adult manner may be waylaid by personality disorders that have aged without mellowing or by addictions still in full force. The client that hopes for kindness, understanding, and empathy that was missing in childhood from family members may find it still absent in adulthood. A naïve client or one that has been encouraged by the therapist to return to the parent that rejected or shamed him or her in childhood may be devastated to be rejected and shamed again.
The therapist should work with the client to determine what the parent or family member may be capable of doing. If there are personality disorders and addictions in particular, direct interaction for re-processing or resolving old issues may not be recommended- perhaps, discouraged. The therapist should also check what the client is hoping for or seeking from the parent or family member. It may be something: compassion, ownership, responsibility, kindness, and so forth that the parent or family member is incapable of giving in response. The fact of the client's still needing or seeking confirmation or validation from emotionally incapable parents or family members may be most evident of his or her lack of differentiation. Differentiation may thus be realized when the client no longer requires or seeks approval from those who were and still are incapable of giving approval. As such, the therapist and client, including in couple and family therapy might work towards differentiation in session and in life away from the family-of-origin.