Bowen's Transgenerational Model
Observations of appearance and behavior
J. is of a normal weight and height for her age, she is 5’3 for 130lbs. Since she checked in, J. is not wearing any type of make up. Her hair is clean; she had died it in the past in a red tone. She does not blow dry it. J. has long artificial nails that she likes to play with during session having them click together. Her nail polish is well taken care of. As per the Women’s Home policy, J. is wearing business casual outfits. Her outfit is neat and free of wear and tear. J. is always wearing a pair of trousers. J.’s style is not as feminine as some others resident, but is appropriate for her age and for the season. J.’s like to wear colorful t-shirts with motifs.
J.’s affect in session or in group is …show more content…
guarded and angry. She frowns, she is tensed. It happened that she cried during her first session together and all the anger and tension was gone. She did not appear guarded anymore. It was like a deflated balloon. When I see her more relaxed in the hallway, communicating with others she appears gentle a good listener ready to follow the rules, serious.
Throughout our different interviews her attention was sufficient and her concentration was adequate. Her memory was average. She recognizes that she is experiencing difficulty, which demonstrate concrete thinking. She is oriented x4. Her judgment proves that she is able to come to appropriate conclusion. She also expressed what sounds as unrealistic expectations regarding happiness. Her pattern of thinking is coherent and logical. J.’s flow of speech is normal. Her flow of speech reflects her anger and frustration. J. was open during our first session. Her motivation for change is her kids. She wants to be able to care for her children. She wants to be stronger and have a happy, healthy life. J. demonstrated a good eye contact.
History and context J. comes from a “healthy” family, “family together”. She described her father has a strong hard worker. He was taking care of his family until he passed away of cancer and J. had a good relationship with him. J. shared that her mother would drink on occasion when J. was growing up and that she really realized that her mother was using cocaine and drinking in her early twenties. She described her mother as being distant. She was not nurturing and prone to discipline. J. has two brothers and two sisters and she is the fourth kid of the family. She is not in contact anymore with her oldest brother and her oldest sister. Both of those siblings are having substance abuse issues (drug and alcohol). J.’s second older sister is supportive of her. She is not really part of J.’s support system having eight kids of her own. J.’s little brother is incarcerated but she remains in contact with him. J. left her parents’ home after her dad passed away when she was 17. I do not have information about the details but looking at the numbers J. got pregnant that same year with her oldest son. I do not have information regarding her son’s dad except that he was abusive. Her son left her house two years ago and asked to live with his dad. He is currently 18. They are still in contact even though she mentioned that she would like to better their relationship and described it as currently shallow. She is now married but separated from her current husband. J.’s husband has been in and out of jail throught the last 15 years they have been together. She shared that she does not want to share the responsibilities as they used to “80/20” next time he will be out (in two years from now). J. mentioned that she took care of him and helped him recover from his addiction. J. shared that she has tensed relationship with her mother in laws. J. discussed the fact that her mother in law is trying to separate J.’s husband from her. It sounds like they never got along. J. and her husband have two kids together, a soon to be one year old and a height year old. They are now living with their paternal grandmother, J.’s in-laws. J. expressed that she is really close to her daughter, she makes her laugh. J. shared that she does not feel isolated when she has her kids with her. J.’s last child is two. She had her with another man while her husband was in prison. After her husband or in laws ran a DNA test, it confirmed that she was not his daughter. J. said that her husband said to his mother that it is the same for him and that he would take care of her but her mother refused to care for her and surrender her to CPS. It is not clear on the status of J.’s right on that child. Her biological paternal grandmother is adopting her daughter and J. can still see her. J. also mentioned that two years ago her spouse got a year in jail for physical abuse and that she was a domestic violence survivor.
J. has been diagnosed with major depressive disorder and is currently taking Prozac for it. She is also diagnosed with severe alcohol use and severe stimulant use (amphetamine). Finally, she has been diagnosed with other specified trauma and stressor related (PTSD by history).
Attempt case conceptualization
The core problem from the client perspective is her depression. J. shared that her depression could be an obstacle in her recovery and it has been a trigger in the past.
From my perspective I think there are different roots to her situation. Her depression is one thing that we need to consider but more than that J. has been the “hero” in her family, taking care of others while mom was not able to. She is still in that pattern and does not notice that she has no support system to support her and care for her. I think condition of worth must be examined too, J. has been in two known abusive relationships reflecting her co-dependency and as she expressed her fear of rejection. Finally, I believe we need to address the grief for her dad and how she relates to it. Guilt is another feeling pretty common in our setting so more information would be needed to consider it as part of the issue or not.
The theoretical approach that I think would work well here is Bowen’s Transgenerational model.
The transgenerational model is a family therapy approach created by Murray Bowen. Bowen saw the family as an emotional unit with network of interlocking relationships. Bowen thought that therapist need to current family patterns that are embedded in resolved issues in the family of origin. When problems remain unsettled, they persist and repeat across generations. For this case even though I am not doing family therapy, I believe that there are problems that ae transgenerational the first one being J.’s addiction. In this theory there are eight interlocking theoretical concepts: differenciation of self, triangles, nuclear family emotional system, family projection process, emotional cutoff, multigenerational transmission process, sibling position, and societal regression. I see the differenciation of self as an important part here. It sounds as if she is sacrificing her individuality to please others such as her husband, maybe her mother and/or father growing up. The differenciation can also be seen with the family of her husband. J. mentioned that she would like to give access to her mother in law to her progress at the Women’s Home. I think she wants to please her mother in law in order to have access to her children. She has poor boundaries. She stated that she feels rejected by her mother in law even though she has been caring for her and had done every effort to fit in her standards. In our first session, J. talked a lot about her parents in law because they are currently taking care of two of her children. Through what she said I notice a triangulation between her mother in law, her husband and herself. I am not sure who is the identified patient. Regarding the nuclear family emotional system, Bowen thought that people choose mates with a level of differenciation equivalent to their own and that they will produce a family with the same characteristic. I can sense
that with the oldest generation, meaning J. and her husband and their respective parents. From my current understanding her parents in laws were in an overt, chronic, unresolved marital conflict. I am not sure about her parents. Because I have net with J. in individual therapy only once this is based a lot on assumptions but J. is no longer in tough with two of her older siblings and she described her relationship with her mother as strained thus can imagine that there must be some sort of emotional cut off going on here. Regarding the sibling position, it is interesting to note that even though J. is the fourth child in her family she was the one in charge. She took the role of the hero caring for her brother and father.
I am planning on doing a genogram with J.. I think it will help her examine the different pattern that exists in her family but also with her parents in law. Working at differenciating J. from others will help her with her codependency and with her substance abuse. People with a high level of differenciation can feel, think and take actions on their own despite external pressures to fall in line. She will be more autonomous.
My feelings
I like working with J.. I did not sense transference on her side. For my countertransference, I need to pay attention to the triangulation that is going on with her mother in law as I am experiencing the same. I also believe that her differenciation level is somewhat close to mine.
J. is of a normal weight and height for her age, she is 5’3 for 130lbs. Since she checked in, J. is not wearing any type of make up. Her hair is clean; she had died it in the past in a red tone. She does not blow dry it. J. has long artificial nails that she likes to play with during session having them click together. Her nail polish is well taken care of. As per the Women’s Home policy, J. is wearing business casual outfits. Her outfit is neat and free of wear and tear. J. is always wearing a pair of trousers. J.’s style is not as feminine as some others resident, but is appropriate for her age and for the season. J.’s like to wear colorful t-shirts with motifs.
J.’s affect in session or in group is …show more content…
guarded and angry. She frowns, she is tensed. It happened that she cried during her first session together and all the anger and tension was gone. She did not appear guarded anymore. It was like a deflated balloon. When I see her more relaxed in the hallway, communicating with others she appears gentle a good listener ready to follow the rules, serious.
Throughout our different interviews her attention was sufficient and her concentration was adequate. Her memory was average. She recognizes that she is experiencing difficulty, which demonstrate concrete thinking. She is oriented x4. Her judgment proves that she is able to come to appropriate conclusion. She also expressed what sounds as unrealistic expectations regarding happiness. Her pattern of thinking is coherent and logical. J.’s flow of speech is normal. Her flow of speech reflects her anger and frustration. J. was open during our first session. Her motivation for change is her kids. She wants to be able to care for her children. She wants to be stronger and have a happy, healthy life. J. demonstrated a good eye contact.
History and context J. comes from a “healthy” family, “family together”. She described her father has a strong hard worker. He was taking care of his family until he passed away of cancer and J. had a good relationship with him. J. shared that her mother would drink on occasion when J. was growing up and that she really realized that her mother was using cocaine and drinking in her early twenties. She described her mother as being distant. She was not nurturing and prone to discipline. J. has two brothers and two sisters and she is the fourth kid of the family. She is not in contact anymore with her oldest brother and her oldest sister. Both of those siblings are having substance abuse issues (drug and alcohol). J.’s second older sister is supportive of her. She is not really part of J.’s support system having eight kids of her own. J.’s little brother is incarcerated but she remains in contact with him. J. left her parents’ home after her dad passed away when she was 17. I do not have information about the details but looking at the numbers J. got pregnant that same year with her oldest son. I do not have information regarding her son’s dad except that he was abusive. Her son left her house two years ago and asked to live with his dad. He is currently 18. They are still in contact even though she mentioned that she would like to better their relationship and described it as currently shallow. She is now married but separated from her current husband. J.’s husband has been in and out of jail throught the last 15 years they have been together. She shared that she does not want to share the responsibilities as they used to “80/20” next time he will be out (in two years from now). J. mentioned that she took care of him and helped him recover from his addiction. J. shared that she has tensed relationship with her mother in laws. J. discussed the fact that her mother in law is trying to separate J.’s husband from her. It sounds like they never got along. J. and her husband have two kids together, a soon to be one year old and a height year old. They are now living with their paternal grandmother, J.’s in-laws. J. expressed that she is really close to her daughter, she makes her laugh. J. shared that she does not feel isolated when she has her kids with her. J.’s last child is two. She had her with another man while her husband was in prison. After her husband or in laws ran a DNA test, it confirmed that she was not his daughter. J. said that her husband said to his mother that it is the same for him and that he would take care of her but her mother refused to care for her and surrender her to CPS. It is not clear on the status of J.’s right on that child. Her biological paternal grandmother is adopting her daughter and J. can still see her. J. also mentioned that two years ago her spouse got a year in jail for physical abuse and that she was a domestic violence survivor.
J. has been diagnosed with major depressive disorder and is currently taking Prozac for it. She is also diagnosed with severe alcohol use and severe stimulant use (amphetamine). Finally, she has been diagnosed with other specified trauma and stressor related (PTSD by history).
Attempt case conceptualization
The core problem from the client perspective is her depression. J. shared that her depression could be an obstacle in her recovery and it has been a trigger in the past.
From my perspective I think there are different roots to her situation. Her depression is one thing that we need to consider but more than that J. has been the “hero” in her family, taking care of others while mom was not able to. She is still in that pattern and does not notice that she has no support system to support her and care for her. I think condition of worth must be examined too, J. has been in two known abusive relationships reflecting her co-dependency and as she expressed her fear of rejection. Finally, I believe we need to address the grief for her dad and how she relates to it. Guilt is another feeling pretty common in our setting so more information would be needed to consider it as part of the issue or not.
The theoretical approach that I think would work well here is Bowen’s Transgenerational model.
The transgenerational model is a family therapy approach created by Murray Bowen. Bowen saw the family as an emotional unit with network of interlocking relationships. Bowen thought that therapist need to current family patterns that are embedded in resolved issues in the family of origin. When problems remain unsettled, they persist and repeat across generations. For this case even though I am not doing family therapy, I believe that there are problems that ae transgenerational the first one being J.’s addiction. In this theory there are eight interlocking theoretical concepts: differenciation of self, triangles, nuclear family emotional system, family projection process, emotional cutoff, multigenerational transmission process, sibling position, and societal regression. I see the differenciation of self as an important part here. It sounds as if she is sacrificing her individuality to please others such as her husband, maybe her mother and/or father growing up. The differenciation can also be seen with the family of her husband. J. mentioned that she would like to give access to her mother in law to her progress at the Women’s Home. I think she wants to please her mother in law in order to have access to her children. She has poor boundaries. She stated that she feels rejected by her mother in law even though she has been caring for her and had done every effort to fit in her standards. In our first session, J. talked a lot about her parents in law because they are currently taking care of two of her children. Through what she said I notice a triangulation between her mother in law, her husband and herself. I am not sure who is the identified patient. Regarding the nuclear family emotional system, Bowen thought that people choose mates with a level of differenciation equivalent to their own and that they will produce a family with the same characteristic. I can sense
that with the oldest generation, meaning J. and her husband and their respective parents. From my current understanding her parents in laws were in an overt, chronic, unresolved marital conflict. I am not sure about her parents. Because I have net with J. in individual therapy only once this is based a lot on assumptions but J. is no longer in tough with two of her older siblings and she described her relationship with her mother as strained thus can imagine that there must be some sort of emotional cut off going on here. Regarding the sibling position, it is interesting to note that even though J. is the fourth child in her family she was the one in charge. She took the role of the hero caring for her brother and father.
I am planning on doing a genogram with J.. I think it will help her examine the different pattern that exists in her family but also with her parents in law. Working at differenciating J. from others will help her with her codependency and with her substance abuse. People with a high level of differenciation can feel, think and take actions on their own despite external pressures to fall in line. She will be more autonomous.
My feelings
I like working with J.. I did not sense transference on her side. For my countertransference, I need to pay attention to the triangulation that is going on with her mother in law as I am experiencing the same. I also believe that her differenciation level is somewhat close to mine.