NU672 Unit 7 Genogram and Bowen Formulation Example

A Door Slammed Every Evening at Six: A Three-Generation Genogram and Bowen Formulation for a 16-Year-Old's Anger Outbursts

[Student Name]

Purdue University Global

NU672: PMHNP Psychotherapy for Individuals, Groups, and Families Clinical

Unit 7 Genogram and Formulation

[Instructor Name]

[Date]

The family is composite; names, ages and dates are bracketed. The genogram is given in text form.

The Referral

Jordan [M.], [16], was referred by his school counselor after he punched a locker and was suspended for [two] days. At home he has had outbursts most evenings since [January]: shouting, slamming doors and, twice, breaking things. The outbursts usually begin within an hour of his father's return from work. His mother, Dana, [44], has begun meeting her husband, Greg, [47], at the door to tell him "not to set him off." Jordan's sister, Mia, [12], spends evenings in her room. Jordan says his father "treats me like I'm nothing." Greg says Jordan is "out of control and his mother lets him get away with it."

The Genogram in Text

Generation one, paternal side: Greg's father, Walt [M.], [74], a retired millworker with alcohol use disorder, described as explosive when drinking; Greg's mother, Ruth, died in [2012] of breast cancer. Greg has not spoken with his father since Ruth's funeral, a cutoff of about [12] years. Greg's older brother, [Ray], lives [two] hours away and has limited contact with everyone.

Generation one, maternal side: Dana's parents, Frank and Lois [P.], [72] and [70], married [50] years, live [ten] minutes away. Dana speaks to her mother every day and describes her as her "best friend." Lois has a history of anxiety and was often ill during Dana's childhood; Dana, the eldest, helped care for her younger siblings.

Generation two: Greg and Dana, married [19] years. Dana describes the marriage as "fine except for the fighting about Jordan." Greg works long hours as a warehouse manager.

Generation three: Jordan, [16], and Mia, [12].

Relationship lines: close and overinvolved between Dana and Lois; close and protective between Dana and Jordan; conflictual between Greg and Jordan; distant between Greg and Dana; cutoff between Greg and Walt.

The Bowen Formulation

Bowen family systems theory describes the family as an emotional unit in which individual symptoms can reflect patterns in the whole system. Four of its concepts carry the formulation.

1. Triangles. When tension between two people rises, a third is drawn in to reduce it. Here, tension between Greg and Dana is not addressed directly; it runs through Jordan. Dana aligns with Jordan against Greg's criticism, Greg criticizes Jordan and, through him, Dana's parenting.

2. Emotional cutoff. Greg manages his unresolved relationship with his father by having no contact. Bowen theory predicts that a cutoff does not resolve the underlying emotion but carries it into new relationships. Greg describes his father as "never satisfied," and Jordan uses the same words about Greg.

3. Differentiation of self. Differentiation is the ability to stay connected to others while keeping one's own thinking and feelings. Dana's daily reliance on her mother and her role as a caretaker in childhood suggest lower differentiation; her anxiety rises when Jordan is upset, and she acts to calm him rather than letting father and son work things out.

4. Multigenerational transmission. Patterns repeat across generations: an explosive father in generation one, a critical father in generation two, an explosive son in generation three; a caretaking eldest daughter in generation two who now caretakes her son.

What the Symptom Accomplishes

Jordan's outbursts keep his parents from facing each other: every evening's argument is about him, and none of it is about the distance in their marriage. The outbursts also keep Dana close to Jordan and give Greg a target for the frustration he cannot direct at his own father. For Jordan, the outbursts are painful, but they bring his mother's protection and keep his father's attention on him, even if negatively. In Bowen's terms, the symptom stabilizes the system at the cost of the child.

How Well Supported Is This Formulation?

Bowen theory is influential in family therapy, but its concepts have uneven research support. A review of basic research found empirical support for the link between differentiation of self and chronic anxiety, marital satisfaction and psychological distress, but little support for Bowen's specific theories of triangulation and sibling position, and noted that research on multigenerational transmission had largely not tested Bowen's own version (Miller et al., 2004). Differentiation can be measured with a validated self-report scale, the Differentiation of Self Inventory (Skowron & Friedlander, 1998).

This means the formulation's strongest element, that lower differentiation relates to Dana's anxiety and the couple's distress, has the best support. The triangle, although it fits the family's evening pattern, is a clinical interpretation rather than a tested finding. The formulation should be treated as a working hypothesis that guides questions and interventions, not as a fact about the family.

How the Family Responded to the Genogram

The genogram was drawn with the family in the second session, with Jordan present for the first half. When the line between Greg and his father was drawn as a cutoff, Greg said, "That's got nothing to do with this." Later in the same session he said, without prompting, that his father used to wait for him at the door "to see what mood he was in." Dana was quiet when her daily calls with her mother were drawn as an overinvolved line, and then laughed and said her husband had been saying that for years. Jordan said little but asked to take a photo of the drawing. These reactions do not confirm the formulation, but they suggest the family found parts of it recognizable, which is a useful starting point for treatment.

Implications for Treatment

1. Assess safety first: the two incidents of breaking things and the locker punch call for a clear safety plan, including what each parent will do if an outburst escalates.

2. Interrupt the triangle: ask Dana to stop meeting Greg at the door, and support Greg and Jordan to have one short, structured conversation each week with Dana not present.

3. Address the couple directly: offer Greg and Dana sessions about their relationship, framed as supporting Jordan.

4. Invite Greg to explore his relationship with his father, at his own pace, since the cutoff appears to shape how he responds to his son.

5. Measure: ask both parents to complete the Differentiation of Self Inventory at intake and after [12] sessions, and track the frequency of outbursts weekly.

The genogram itself is a tool for this work. McGoldrick and colleagues describe genograms as a way to engage families in seeing patterns across generations (McGoldrick et al., 2020). Showing the family the repeated patterns may help them see Jordan's anger as part of a family story rather than as his problem alone.

References

McGoldrick, M., Gerson, R., & Petry, S. (2020). Genograms: Assessment and treatment (4th ed.). W. W. Norton.

Miller, R. B., Anderson, S., & Keala, D. K. (2004). Is Bowen theory valid? A review of basic research. Journal of Marital and Family Therapy, 30(4), 453-466. https://doi.org/10.1111/j.1752-0606.2004.tb01255.x

Skowron, E. A., & Friedlander, M. L. (1998). The Differentiation of Self Inventory: Development and initial validation. Journal of Counseling Psychology, 45(3), 235-246. https://doi.org/10.1037/0022-0167.45.3.235