Bowenian Family Therapy: History and Effectiveness

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Bowenian Family Therapy: History and Effectiveness

THC Editorial Team November 13, 2022
A Venetian Family Portrait Group, after 1750, Pietro Antonio Novelli, The Metropolitan Museum of Art (article on Bowenian family therapy)
A Venetian Family Portrait Group, after 1750, Pietro Antonio Novelli, The Metropolitan Museum of Art


Bowenian family therapy is a form of family therapy that helps people decrease anxiety and improve their relationships by addressing the family system and dynamics. This approach can be used with families, couples, or individuals to help improve communication, familial relationships, and coping skills.

What Is Bowenian Family Therapy?

Bowenian family therapy is a psychotherapeutic approach used to help people resolve familial conflicts by addressing challenges within their families. This approach was developed by Murray Bowen, M.D., a psychiatrist who worked for the National Institute of Mental Health (NIMH).

Bowen believed that two forces, togetherness, and individuality, when out of balance, can lead to dysfunction in relationships. People whose families have too much togetherness in their relationships can struggle with individuality. At the same time, those whose families have too much individuality can end up with too much distance from each other. Bowenian family therapy strives to balance these two forces to help families function more effectively. Bowenian family therapy also addresses intergenerational issues and several other aspects that affect a family’s functioning.

Background/History of Bowenian Family Therapy

Bowen’s family systems theory, also known as Bowen’s theory, was one of the foundational theories of the functioning of family systems.1 Bowen grew up in a large family and was interested in the impact of family relationships on mental health and well-being.

Bowen’s work involved studying adults with schizophrenia. He initially believed that the disorder began with an anxious, unhealthy attachment in childhood between the patient and their mother.

He then began studying unhealthy relationships between parents and eventually exploring unhealthy relationships between generations of family members, including grandparents, parents, and children. Bowen often approached therapy through the lens of at least three family generations.

Bowen developed the theory that family behavioral patterns persist through multiple generations through his work, allowing children to learn problematic behaviors from earlier generations and have similar conflicts within their own families. Bowen believed that a family’s history forms a template that informs the experiences and values of each successive generation.

Through his work at the NIMH with hospitalized patients with schizophrenia and their relationships with their families, Bowen found that the mothers’ and clients’ influence on each other was much stronger than psychologists and psychiatrists had previously realized. He also found that the influences didn’t involve the mothers alone; instead, they involved the entire family.2 He subsequently conceptualized eight interlocking factors to explain how families function and develop as a unit. The eight concepts of Bowen theory are:3

  • Triangles: refers to a three-person relationship system, such as a couple with a child. This triad can help stabilize a system but does not assist in ultimately resolving conflict.
  • Differentiation of self: refers to the development of a robust and separate sense of self, which can result in a healthier adjustment and increased flexibility and resilience.
  • Nuclear family emotional process: refers to four relationship patterns that govern family dysfunction: marital conflict, dysfunction in a spouse, impairment in a child or children, and emotional distance.
  • Family projection process: refers primarily to the transmission of emotional states (generally problems) from parents to children.
  • Multigenerational transmission process: refers to the relational and genetic transmission of information that shapes individuals through multiple generations.
  • Emotional cutoff: refers to individuals reducing or cutting off emotional contact with family members with whom they have unresolved issues.
  • Sibling position: refers to the impact of birth position on personality traits.
  • Societal emotional processes: refers to the impact of emotional systems on whole societies.

Bowenian family therapy aims to improve communication between family members and help each member develop autonomy while breaking harmful behavioral patterns. It uses an intergenerational approach to identify problematic patterns and healthy communication techniques to promote healthy relationships and boundaries.

How Does It Work?

Bowenian family therapy can treat a whole family, a couple, an individual, or other portions of the family. Its practitioners don’t use a specific set of tools but instead use multiple techniques, including constructing family genograms (i.e., diagrams of family relationships) and questioning family members to learn about their relationships and interactions.

The primary aims of Bowenian therapy are (1) to reduce anxiety by promoting clients’ awareness of the functioning of emotions and emotional systems and (2) to increase differentiation from family members by helping clients make changes within themselves instead of others.1

Clients might be given tasks to learn more about their family history and, to do so, might be asked to write letters to distant family members. When a family comes to therapy, they often identify one family member as the person with the problem. A therapist might begin by accepting this notion and then employ multiple techniques to assist every family member with accepting responsibility for the problem. One such technique involves family members providing help to the person identified as having the trouble so they can “get better.”

During treatment, a therapist might work to reframe the presenting issue as a multigenerational family problem caused by factors beyond the family’s control. The therapist will focus on the family’s overall well-being rather than just the problem that the family initially presented. The therapist might then work with family members to react more calmly to one another to reduce emotional turmoil. The therapist might encourage differentiation with couples, which means developing a healthy degree of individuality and autonomy. This strengthens the family unit’s emotional health while helping each member better manage their level of anxiety. The therapist might help families reestablish relationships with family members who have been cut off and work to build relationships with family members with whom they have conflicts so they can separate from their families healthfully.

Bowenian family therapists attempt to reduce anxiety, promote understanding, and facilitate healthful change. The therapist develops relationships with each family member and encourages them to build stronger relationships with one another. During Bowenian family therapy sessions, open conflict between family members is not accepted.

The Potential Benefits of Bowenian Family Therapy

Families undergoing conflict or experiencing communication problems might benefit from Bowenian family therapy. This approach might also help individuals reduce stress and anxiety, particularly those who believe their family dynamics negatively impact their mental health.

Bowenian family therapy might also help couples reduce conflict and improve communication by identifying how they have been affected by their family history. Some potential benefits of Bowenian family therapy include the following:

  • reduced anxiety symptoms
  • greater insight into behavioral choices
  • improved coping skills
  • improved communication and better conflict-resolution skills
  • healthier and often stronger relationships
  • establishment of healthy boundaries
  • more self-awareness about why people make the choices they do
  • increased forgiveness
  • increased empathy

The Effectiveness of Bowenian Family Therapy

The effectiveness of Bowenian family therapy needs further exploration by the scientific community. However, a few studies have indicated that it might be effective for treating several issues, including anxiety, bullying behaviors, and others, and may help facilitate family reunification and improve empathy among family members.

A 2001 article that reviewed eight studies on Bowenian theory concepts found that several Bowenian family therapy concepts were supported empirically, including the effects of differentiation of self, fusion, and triangulation.4

In a recent study involving an adult male addicted to gaming and exhibiting bullying behaviors, researchers found that a combination of Bowenian family therapy and MRI (Mental Research Institute) family therapy resulted in marked improvements in several areas. After treatment, the man improved his family relationships, communication skills, behaviors, coping skills, and perception.5

Another study found that Bowenian family therapy effectively treated couples who experienced boredom in which one spouse had extramarital relationships. The researchers found that couples who underwent Bowenian family therapy showed decreased boredom within their relationships and greater forgiveness.6

One study found that Bowenian family therapy can increase empathy and happiness in couples by improving understanding and communication skills.7

A 2010 study involving 213 graduate university students found that greater levels of differentiation of self can facilitate forgiveness in individuals and promote well-being.8

Another study examined the use of Bowenian family therapy and its effect on the ability of individual family members to differentiate themselves. The researchers found that the participants showed statistically significant improvements in self-differentiation, taking positions, and emotional reactivity. However, they did not show improvements in their fusion (lack of healthy differentiation and sufficient space) with others or in being emotionally cut off from others.9

Researchers have also found that the self-differentiation techniques used in Bowenian family therapy might lead to reduced anxiety symptoms.10 Finally, Bowenian family therapy has been found to encourage family reunification after children have been removed from the family by helping parents to identify and break abusive familial patterns.11

Summary/Key Takeaways

Bowenian family therapy might help individuals and families to resolve conflicts and problematic behaviors that have affected their relationships for generations. This approach might benefit people who believe their family situations have impacted their mental health and overall well-being. However, more research needs to be completed to determine the effectiveness of this approach.


  1. Brown, J. (1999). Bowen family systems: Theory and practice: Illustration and critique. Australian and New Zealand Journal of Family Therapy, 20(2), 94–103.
  2. Kerr, M. E., Bowen, M., & Kerr, M. E. (1988). Family evaluation. WW Norton & Company.
  3. The Bowen Center for the Study of the Family. (n.d.). Learn about Bowen theory. Retrieved September 11, 2022, from
  4. Charles, R. (2001). Is there any empirical support for Bowen's concepts of differentiation of self, triangulation, and fusion? American Journal of Family Therapy, 29(4), 279–292.
  5. Yu, J.-H., & Park, T.-Y. (2016). Family therapy for an adult child experiencing bullying and game addiction: An application of Bowenian and MRI theories. Contemporary Family Therapy: An International Journal, 38(3), 318–327.
  6. Mofassali, R. H., & Hassan, T. (2016). Investigating the effectiveness of Bowenian family therapy in boredom and forgiveness of individuals affected by extramarital relationships of the spouse. International Journal of Pharmaceutical Research & Allied Sciences, (SI), 1–12.
  7. Amini, O., & Naser Shariati, M. A. (2021). The effectiveness of Bowen’s style family therapy on increasing the happiness and empathy marital of couples referring to Isfahan Counseling Center. Journal of Human Relations Studies, 1(3), 23–31.
  8. Sandage, S. J., & Jankowski, P. J. (2010). Forgiveness, spiritual instability, mental health symptoms, and well-being: Mediator effects of differentiation of self. Psychology of Religion and Spirituality, 2(3), 168–180.
  9. Messina, K. C., Kolbert, J. B., Bundick, M. J., Crothers, L. M., & Strano, D. A. (2018). The impact of counseling on Bowen’s differentiation of self. The Family Journal, 26(2), 150–155.
  10. Thomas, R., Shelley-Tremblay, J., & Joanning, H. (2021). Anxiety explains self-differentiation: Implications for Bowenian approaches to marriage and family therapy. The American Journal of Family Therapy, 49(5), 534–549.
  11. Thompson, H. M., Wojciak, A. S., & Cooley M. E. (2019). Family-based approach to the child welfare system: An integration of Bowen family theory concepts. Journal of Family Social Work, 22(3), 231–252.

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