Tuesday, April 16, 2013

What I Am Working on/What's Working on Me Today


The following excerpt from:  Terror and Societal Regression

After a national trauma, there are a number of signs of "large group" regression.  (I will not here go into some of the characteristics of what constitutes a large group; it relates to elements that I have referred to in the past as our tribal nature; see also here.)  The panel chair, Vamik Volkan, Professor Emeritus of Psychiatry and founder of the Center for the Study of the Mind and Human Interaction at the University of Virginia and Emeritus Training and Supervising Analyst of the Washington Psychoanalytic Institute, described 14 major symptoms of large-group regression:
1) Rallying around the leader.
2) Losing individuality.
3) Severe splitting. This can occur as a polarity between "us" and "them" or within society.
4) Massive, shared introjections and projections, such as societal paranoia.  This phenomenon was seen in Enver Hoxha's Albania, where something like slave labor was used to build over seventy-five hundred bunkers in anticipation of an attack that never came.
5) A shared narcissistic preoccupation.  An example is the grandiose historical view taken by Iraq that it is the cradle of civilization.
6) Magical thinking, blurring of reality, and new or modified societal patterns.  The customary "kidnapping" of brides in South Ossetia is an instance of this last.  What under normal conditions is a playful cultural norm whereby the girl is symbolically kidnapped and married has become under conditions of societal regression, far more aggressive; today's "brides" are kidnapped, tortured, and raped.
7) Inability to mourn or difficulty in mourning whereby a large group becomes a society of perennial mourners and the use of "linking objects" is recognized and institutionalized....  Volkan (1981) has described how perennial mourners ... keep the mourning process externalized and incomplete.
8) Reactivation of "chosen glories" pertaining to the history of a large group's past.  This was seen in Baathist Iraq, where Saddam Hussein tried to identify himself with Saladin.... this history was incorporated into his battle cry to defeat the U.S., the new infidels.
9) Reactivation of a "chosen trauma" whereby a large group unconsciously "chooses" to make a shared mental representation of an event that caused it terrible losses, helplessness, humiliation, and victimization....Slobodan Milosevic exemplified this phenomenon in his reactivation of the shared memory of the Battle of Kosovo in 1389, in which the Serbian hero, Prince Lazar, was killed.
10) Dehumanization.  Exemplified by the Nazis, this is a two-step process.  Step one is identifying undesirable humans; step two is turning them into nonhumans, as in the Hutus' degradation of the Tutsis, referred to as cafrads, or insects.  Interestingly, the Tutsis were also called the "Jews" of Rwanda.
11) Border Psychology, in which borders become shared psychological skins.
12) The narcissism of minor differences.
13) Ruining of basic trust.  This was seen in Nazi child-rearing practices and in the elementary schools of Enver Hoxha's Albania, where students were brainwashed into pledging their allegiance to the leader and were rewarded for spying on and betraying family members who expressed any doubt or opposition to the ruler.
14) Heightened importance of the leader's personality.  When a large group is regressed, the personality organization of the leader becomes extremely influential, as he or she can tame or inflame the regression.  Contrast Slobodan Milosevic's use of violence and terror with Nelson Mandela's use of nonviolent means.

http://shrinkwrapped.blogs.com/blog/2006/09/terror_and_soci.html

Sunday, April 14, 2013

Forever 21: Dealing With America’s Fear of Aging and Death


Societies often regress over generations just as individuals making up any emotional unit.  A regression in society is manifest in a complex interweaving of forces.  Increasing anxiety in any emotional system creates an energy forcing a downward spiral.  As the anxiety that starts the regression forces the togetherness and overrides individuality, a focus on “rights” rather than “responsibility” becomes the new normal (Bowen, 2005).  The more each person focuses on his rights, the less he is aware of responsibility to others.  Next, the emotional distancing progresses to a state of emotional and proximal cutoff.  The multigenerational emotional process leads to institutionalizing aging and death, which, in turn, exacerbates an intrinsic human emotion: fear of aging and death. Denial (Gilbert, 2006, p. 102) of human limits such as mortality lead younger generations to a delusional mindset labeled “forever 21.”


       “When the anxiety in a system increases, people tend to do more of what they have always done, creating a vicious cycle (Gilbert, 2006, p. 110).”  Bowen Family Systems theory views the family as an emotional unit.  The family of origin has a strong emotional and genetic effect on the limbic-HPA system “in particular, the research in these areas indicates that behavioral interactions in the maternal-offspring relationship can influence the neuroendocrine[1] and behavioral development and adaptiveness of individuals (Noone, 2008).”  In other words, each generation passes to the next its anxiety, individuation, and the level of ability to recover from adverse circumstances as well as genetic traits.  Bowen Family Systems theory postulates this same principle applies to national and international emotional units, also known as the emotional process in society (Bowen, 1985).  Over time, America has regressed emotionally as a society and the fear of ageing and death are some of the symptoms of the regression.  The regression includes a growing inability to legislate from a thinking, rather than emotional, stance and its repercussions is one of many reactive behaviors leading to more emotionally driven legislation ad infinitum.

       The sixty-four-year-old Dolly Parton is an excellent display of anxious reaction attributable to the regressive state of the emotional process in America over the last five generations.  The fear of ageing and death is a symptom of the underling anxiety driving the emotions toward a downward spiral.  The obsession for plastic surgery Dolly exhibits, some might say flaunts, is the outward expression of the inward emotional cutoff between generations (Murray Bowen, 1988, p. 242).  Two years ago, in a review of her performance, the writer unwittingly noted another telling symptom:  

At 62, she's part-grandmother (she riffed on her poor eyesight and mortality), part-cougar (she ogled a dancing beefcake), and her sharp quips had the audience roaring with laughter (Rytlewski, 2008).

 

It is important to note that Dolly and her husband, Carl, did not have children but did rear the five youngest of her mother’s twelve children. 

       An emotional distancing between generations in America, the generation gap, is a unique reality and part of our heritage as a “frontier nation.”  It is likely that her need to appear forever young is an indicator of a lack of differentiation of self.  Typically, it is a symptom of a child emotionally fused with her mother and the plastic surgery serves the purpose of binding her anxiety.  She was born on the leading edge of the generation born in the forties, the baby boomers, resulting from the World War, another expression of emotional process in society.   

       The daily reality of a chaplain in a United Methodist Retirement home presents another example of the emotional regression of society.  A few weeks into the chaplain’s new ministry in the continuing care retirement community one female patient was not expected to live.  The two daughters were notified.  At that time, one week before Thanksgiving in 2008, the two children were too busy to be with their parents for this nodal event.  The first daughter explained, with no apparent regret, that her son’s wedding was scheduled in another state and she would try to get to her parents in a couple of weeks.  The second daughter said it was not possible to travel across several states to her mother in North Carolina before Thanksgiving but she would be sure to call her dad to comfort him.  The patient died and the ninety-four-year-old husband refused to leave his apartment until the daughters came to help him.  This reaction to death is another way to distance emotionally in an attempt to avoid their multigenerational emotional fusion (Clinton, 2006).  Both cases, Dolly and the end of life patient, appear to be very different on the surface.  Bowen Family Systems Theory is a way of thinking about, and observation of, family and societal emotional units.  Bowen theory is a way of thinking about and understanding the family’s emotional process.

       The basic building block of any emotional unit is the triangle.  The dyad, or two-person relationship, is unstable and therefore cannot handle emotional intensity for a sustained period of time.  A third person, agency, or object is triangled, enticed into the relationship physically and/or emotionally, in an attempt to bind the anxiety (Friedman, 1985, p. 153).  In the first case, Dolly, plastic surgery is the solution of choice to relieve the anxiety (Gilbert R. M., 2008, p. 125).  The family of origin has firmly established a pattern of choice for triangulating to bind the anxiety over several generations.  Emotions occur at a subconscious level.  Feelings are a label for when the person observes the emotions.  The binding most often occurs at an emotional level and it is possible to learn how to discern, to bring into awareness, the underlying emotional energy driving decisions and choices.  The ability to observe self and increase individuation is a skill that can be learned (Brugger, 2009, p. 5) with the help of a coach.

       Over time the triangle, or triangles, become overwhelmed with emotional energy and again must triangle out forming interlocking triangles.  These might include the society and her institutions, for example rest homes and elder care, in an attempt to provide a quick fix for the defined problem rather than addressing the anxiety creating the undesirable circumstances.  The next presenting symptom of a lack of differentiation of self that has expanded to the ever-increasing interlocking triangles is a need for a means to pay for the institution needed when families no longer are willing or have the perception of being unable to care for their own.  The resulting national healthcare is yet another quick fix and indicator of continuing societal regression.  

     Where did this process begin in this new experiment called America? Why is America commonly known as an experiment in nation building?  What are the roots of the emotional cutoff (Titelman, 2003) that has facilitated the separation of generations to the extent that mortality is considered by Americans as unnatural?  Is there any correlation to abandoning the former multigenerational housing common to other nations?  Consider the evidence.

     America is a nation of immigrants that not so long ago had an expanse of land and great frontiers for each succeeding generation to homestead.  In the beginning, she was a largely agricultural nation and the abundance of land did not prevent a diversity of ethnic generations from sharing ageing and death in animals and humans.  Before supermarkets, death was also a part of daily living due to hunting and preserving food for the typical family.  Industrialization and increasing population slowly displaced the agricultural economy.  Today’s children are isolated from the ageing process.  It is the natural outcome of daycare and other societal intuitions replacing family care giving.  In today’s American society, each cohort has an institution.  Moreover, the various factions each have an advocacy organization to insure all the other groups with special interests respect their rights.  This, in turn fosters emotional distancing as well as cutoff.

       America is still a melting pot of diverse nationalities.  When a society regresses, scapegoating[2] becomes the process of choice for binding anxiety on a national level.

"Young people in the United States live their lives variously as young Asian American women, as working-class Latino youth, as young Blacks or young whites, as young Southerners, as rural middle-class youth, as young Puerto Ricans, as queer youth, and so on. This fragmentation facilitates both a multiplicity of youth cultures and a wide range of hybrid identities. 

       In addition, estimates show that there is a growing racial/ethnic divergence between America’s elderly population and younger age groups, creating a new kind of generation gap (Krayewski, 2009).”

 

American society has accepted the fallacy of the elderly as the defined patient in need of highly specialized and expensive medical care.  The result is over simplistic political slogans as one party advocates killing grandma and another sees the government as the ultimate solution to every cohort’s perceived need.  The unfortunate reality is an unsustainable demand for resources (Gilbert R. M., 2008, p. 137). The elderly have become the scapegoats that bind societal anxiety.  This same process has enabled the young adults and their parents in American society to accept the forever 21 fallacy. 


 


Bowen, M. (1985). Family Therapy in Clinical Practice. Lanham: Rowman & Littlefield.

Bowen, M. (2005). Theory & Practice. Georgetown Family Center. Washington: Georgetown Family Center.

Brugger, E. C. (2009). Psychology and Christian Anthropology. EDIFICATION Journal of the Society for Christian Psychology , 3 (1).

Clinton, T. (2006). Why You Do the Things You Do: The Secret to Healthy Relationships. Wake Forest, NC: Integrity Publishers.

Friedman, E. H. (1985). Generation to Generation: Family Process in Church and Synagogue. New York: The Guilford Press.

Gilbert, R. M. (2008). The Cornerstone Concept: In Leadership, In Life. Falls Church: Leading Systems Press.

Gilbert, R. (2006). The Eight Concepts of Bowen Theory. Falls Church: Leading Systems.

Krayewski, K. (2009, January 25). Modern American Youth Crisis. Retrieved October 26, 2010, from suite101.com: http://www.suite101.com/content/modern-american-youth-crisis-a91994

Murray Bowen, M. E. (1988). Family Evaluation. New York: W. W. Norton & Company.

Noone, R. J. (2008). The Multigenerational Transmission Process and the Neurobiology of Attachment and Stress Reactivity. Family Systems: A Journal of Natural Systems Thinking in Psychatry and the Sciences , 8, 21-34.

Rytlewski, E. (2008, November 18). expressmilwaukee.com. Retrieved October 26, 2010, from Dolly Parton at the Riverside Theatre: http://www.expressmilwaukee.com/article-4533-dolly-parton-a-the-riverside-theater.html

Titelman, P. (Ed.). (1998). Clinical Applications of Bowen Family Theory. Binghamton: The Hayworth Press.

Titelman, P. (Ed.). (2003). Emotional Cutoff: Bowen Family Theory Perspectives. New York: The Hayworth Clinical Practice Press.

 

 



[1] The author has a personal bias due to a rare neuroendocrine cancer and participation in an NIH study for causality: http://www.clinicaltrials.gov/ct2/show/NCT00646022?term=carcinoid&rank=2.
[2] Scapegoating is the projection of anxiety in an attempt to avoid/bind/relieve discomfort.

TRIANGLES: The Bible, Bowen and Me


 
  
 
Ann Long
Pinehurst Chapter of the College of Pastoral Supervision and Psychotherapy
Saturday, September 18, 2009




Long before most of you came to the College of Pastoral Supervision and Psychotherapy, at some point in the journey we call life and ministry, the question had been asked and answered:
         
“What is your guiding theory?”
 
The answer, for me, is:
“Bowen Family Systems.”
 
This morning I will be focusing on one of the nine concepts of Bowen theory[1]. When the anxiety level in any relationship (a dyad) becomes uncomfortable, the one with the highest level of discomfort will use a third person to bind the anxiety, to lessen the anxiety by sharing it with another. The third person, or object, is added to the emotional field and we now have a triangle. The triangle is the basic building block of all emotional systems. (Bowen M. , 1985, p. 373)
 
My guiding principles are theological and my primary source is the Bible. Therefore, all of Bowen theory is viewed through the lens of Armenian theology.  It has been my experience that the two are very compatible and I note here that Bowen grew up in a small town in Tennessee where social life was centered on the local Presbyterian church.
 
That said, let’s start with a dyad. I (A) have a conversation with (B) and B’s anxiety rises. B now has two choices. B can choose to be transparent and express the feelings associated with the anxiety to A.  Conversely, B could choose not to discuss it. When the second option is exercised, either consciously or subconsciously, we have what Bowen labels emotional cutoff.
 

 
 A ___________ B  
 
 
The anxiety will compel B to triangle. It may be immediately or at some point later in time. The pattern for how, when and where the triangles function is established in the family of origin. (Richardson, 2004) How the triangles themselves function is best described by Game Theory. (Bowen K. a., 1988)
 






Now suppose that C’s anxiety becomes unmanageable and C goes to D. How many persons are now in my emotional field; how many potential triangles?  C is upset and in a blaming position. The conversation goes something like “Ain’t It Awful.” (Berne, 1964, pp. 110-112)  This is done so as to insure the comments are overheard by a third person (Bowen K. a., 1988, p. 137).  How many persons are in my emotional system? How many potential triangles?  E is a responsible person who alerts A that the games have begun.  This is illustrated and referred to as interlocking triangles. Note the fact that the triangles multiply exponentially. (Kephart, 1950)
 
 

 
 
Meanwhile, C has a chance encounter with me. This conversation is an expression of the outsider. It goes something like: “B said that you have a relationship with her that you do not have with me. I feel that I should be a part of that system because yadda yadda.” The emotional cutoff that occurred in the original dyad was the result of hurt feelings (narcissistic wounding to the sense of self which increases the pathology/anxiety/symptoms in the system) and the anxiety has spread system-wide[2]. I now have multiple choices to navigate the emotional unit.
 
How does Bowen Family Systems Theory guide me in the dyad?
·       It is not personal; it is a natural outcome of ambient anxiety. (Gilbert, 2006, p. 6)
·       Do not blame or assign motive.
·       Remain calm and in a research position[3].
·       Accept responsibility for my role in the system.
·       Stay connected to all peoples in the system.
 
How does the Bible guide me? What does it have to say about my relationship with B?
·       If my brother/sister in Christ is cutoff and I ignore the situation, God will not bless my ministry. 
·       It is my responsibility to go to him/her.

 23"Therefore, if you are offering your gift at the altar and there remember that your brother has something against you, 24leave your gift there in front of the altar. First go and be reconciled to your brother; then come and offer your gift. [Matthew 5:23-24 (New International Version)]



If B chooses to maintain the emotional cutoff (Titelman, 2003), how does theory guide me?
·       Detriangle. (Bowen K. a., 1988, p. 157) 
·       Stay connected to all persons in the emotional field.
 
What does the Bible have to say?
·       Go to B a second time with other saint(s).
·       If B continues to cutoff, take it to the church body.
·       If B continues to cutoff s/he becomes the outsider.

 15"If your brother sins against you go and show him his fault, just between the two of you. If he listens to you, you have won your brother over. 16But if he will not listen, take one or two others along, so that 'every matter may be established by the testimony of two or three witnesses.' 17If he refuses to listen to them, tell it to the church; and if he refuses to listen even to the church, treat him as you would a pagan or a tax collector.[(Matthew 18:15-17 (New International Version)]

 
 
CONCLUSION
As we close this discussion on triangles, it is apparent that the concept is not a simple one. The possibilities and functions are numerous but predictable. Our guiding principles help us to keep our subjective opinions and inherent tendency to judge and project an assumed motive to a minimum level. Triangles are not good or bad. Triangles just are. When we comprehend this premise, we begin to see triangles in our emotional field as they are instead of the feelings invoked by them.  This basic understanding enables us to become more mature, individuated as persons, and leaders.

One word of caution is indicated here. In his personal correspondence Murry Bowen said that it is wise to practice the theory within our families of origin before using the concepts in the workplace. Otherwise one might expect to be terminated. (Boyd, p. 17)
 
 
 
 

POTENTIAL RELATIONSHIPS WITHIN GROUPS

 

 

Number of persons                                                                                     Potential relationships

 

               2                                                                                                                           1

 

               3                                                                                                                           6

 

               4                                                                                                                         25

 

               5                                                                                                                         90

 

               6                                                                                                                        301

 

               7                                                                                                                        966

 

 

 

(Wilmot, 1980)




[1] The nine concepts are: 1) the nuclear family emotional system 2) the differentiation of self scale 3) triangles 4) cutoff 5) family projection process 6) mutigenerational transmission process 7) sibling position 8) emotional process in society 9) the supernatural.
[2] PR = 3N – 2N +1 + 1 where PR is the number of potential relationships, and N is the number of persons in the group.   Good citation…                                 
                    2
[3] The research position is based on gathering as accurate set of facts as possible, and not on the perception that it is all my fault, or there is something wrong with me, an all or nothing type of thinking, though feelings are given a great deal of attention.

Friday, March 1, 2013

A Family Concept of Schizophrenia



The multidisciplinary approach to schizophrenia yields more favorable outcomes than psychotherapy alone.  Various antipsychotic drug therapies have precipitated research yielding biological and physical explanations for the illness.  The multigenerational emotional and genetic influence on the limbic-HPA system and neuropeptides exert a strong influence on the possibility of the expression of any genetic predisposition.


Schizophrenia and Family Systems
Introduction
Last week this writer thought she was engaged in a conversation with a mentally disabled twenty-year-old female[1].  Suddenly, the young woman turned and said, “I’m schizophrenic[2].  Are you afraid of me?”  Further, into the conversation it became clear she was functioning well below the level achieved prior to the onset of her disorder.  She had dropped out of nursing school and was currently living in her fifth group home.  She was visibly upset when someone nearby spoke her name to someone on the telephone.  The young woman also related the experience of hearing voices; her speech pattern was awkward and not easy to follow.  Flexing her left arm to demonstrate its jerky motion, she explained why she was trying another medication and searching desperately for symptom relief[3].  Through the large windows of the room, the bus from the group home was visible as it came into the parking lot.  It was time to say “Goodbye.”
“Today, as they have been for centuries, the years from 18 to 25 is prime time for hard physical work, athletic achievement, and reproduction (Berger, 2008, p. 447).”  What will life be like for her?  What might have been her fate, and that of so many others suffering from mental disorders, if she had been born hundreds, or even thousands of years ago?
The Disorder in its Historical Context
In the Stone Age, trephination[4] (Comer, 2011, p. 7) was the cure of choice.  In Greek and Roman civilizations, the protocol was a quiet lifestyle, a diet of vegetables, exercise, celibacy, and even bleeding in an attempt to relieve the symptoms.  In the Middle Ages, the clergy cast out demons responsible for abnormal behavior.  Had she been born in Europe in the 1500s, perhaps, the local parish support system would enable her to remain home with her family.  In the sixteenth century, asylums[5] (Comer, 2011, p. 9) housed the mentally ill.  In the 1800s, state-run hospitals were in vogue.  The one in North Carolina bears the name of the impetus of this movement, Dorothea Dix.  The nineteenth century ushered in reform and moral treatment.  “Between 1907 and 1945 45,000 Americans were sterilized under eugenic sterilization laws; 21,000 of them were in state mental hospitals (Comer, 2011, p. 11).”  Public mental hospitals soon became warehouses for the mentally ill.  “By the early twentieth century, psychoanalytic theory and treatment were widely accepted throughout the Western world (Comer, 2011, p. 12).”
From 1954 to 1959, Murray Bowen worked at the National Institutes of Mental Health and studied the origin and development of schizophrenia (Bowen, 2004, p. 45).  First, he studied the mother-child relationship.  Later he studied whole families in an in-patient setting.  At that time, he adhered to Sigmund Freud’s theory of psychoanalysis[6].  It was two decades later that he pioneered Bowen Family Systems theory[7].
Current research as to the Cause of Schizophrenia
“[R]esearchers have been far more successful in identifying the biological influences than the psychological and sociocultural ones (Comer, 2011, p. 389).”  The diathesis-stress view posits a person must first have a predisposition to a disorder and then be subjected to immediate psychological stress in order to develop the disorder (Comer, 2011, pp. G-4).  Today’s knowledge of the neurobiology of attachment and stress are consistent with Bowen theory.  “When the anxiety in a system increases, people tend to do more of what they have always done, creating a vicious cycle (Gilbert R. , 2006, p. 110).”  Bowen Family Systems theory views the family as an emotional unit.  The family of origin has a strong emotional and genetic effect on the limbic-HPA system, “in particular, the research in these areas indicates that behavioral interactions in the maternal-offspring relationship can influence the neuroendocrine[8] and behavioral development and adaptiveness of individuals (Noone, 2008).”  In other words, each generation passes to the next its anxiety, individuation, and the level of ability to recover from adverse circumstances as well as genetic traits.
Oxytocin and vasopressin are among the more influential neuropeptides and hormones involved in attachment.  The experience of the parent-offspring relationship has been found to play a part in the genetic expression of oxytocin (Noone, 2008, 29). Thusly, current research supports the observation that the family plays a central role in in determining an individual’s responsiveness to the social environment.  Biological factors combined with stress are needed for schizophrenia expression.
Treatment Approaches
The preferred first line of treatment is one of the many antipsychotic drugs.  As many as eighty-five percent experience improvement of symptoms while taking the most currently developed atypical antipsychotic drugs (Comer, 2011, p. 379).  The conversation with a young woman mentioned earlier illustrates the difficulties of drug therapies.  Unfortunately, had she been African American, she would be less likely to have been prescribed the atypical antipsychotic therapy (Corey, 2009, p. 378).  “No matter how compelling the evidence for biological causation may be, a strictly biological approach to the treatment of psychological disorders is a mistake more often than not (Comer, 2011, p. 389).”  Each approach has some valid points, but the primary assumptions underlying the understanding of the human psyche is contradictory (Enright, 2009, p. 19).Therefore, a multidiscipline approach is preferable, according to modern thinking.
If treatment on an outpatient basis fails, short-term hospitalization may be necessary.  Aftercare may include partial hospitalization, semihospital, or residential care.  These combinations increase their effectiveness when combined with psychotherapy.  One approach would seek to change how the schizophrenic reacts to his/her hallucinatory experiences and thereby gain control and reduce the delusional ideas.  Family therapy has the potential to create a healthier support system and reduce the chance of relapse.  Social therapy will offer practical advice, aiding in his day-to day needs such as housing, work, decisions, and social skills and making sure he is taking his medication.  For example, the conversation with the young woman took place while she was volunteering in a United Methodist continuing care retirement community as a part of her social training.
Research as the Prevention of the Illness
Currently early intervention is the only recourse.  Universal approaches include educational programs about mental illness that are planned for implementation in this decade.  Some therapists are prescribing low doses of antipsychotic drugs to some patients deemed high-risk (Preventing Schizophrenia - Risk Reduction Approaches, 2004).  Studies are currently in progress addressing risk reduction.  The National Institutes of Health is the only United States study found in researching for this paper.
Prevention, based on current knowledge, is far beyond our grasp and good healthcare from conception (Comer, 2011, p. 369) to midlife is currently the focus.  Genetic factors are indicative of risk, however less than 50% of the genetically predisposed will develop schizophrenia (Comer, 2011, p. 365).  Given these limitations, the multigenerational concept is likely to become the focus of preventive study (Noone, 2008, 31).
Cross-cultural Issues
Bowen Family Systems[9] finds strong validation in the statistical facts[10] concerning schizophrenia occurrence and outcomes among minority and global populations.  More than twice as many African Americans are diagnosed with the disorder but, as stated earlier, this population is less likely to be prescribed the most effective drug therapy.  They are also overrepresented in state institutions.  The emotional process in society explains these phenomena.  Minority populations are more likely to live in poverty, live with family emotional pressures, crowded conditions, and limited access to adequate health care (from conception to the grave).   
Interestingly, the World Health Organization statistics indicate access to good healthcare may not be the determining factor biological views tout.  Developing countries tend to have better recovery rates and less need for drug therapy, correlating with strong family and social support systems.  Minority populations are less likely to project blame onto the schizophrenic than Western populations.  Sociocultural theorists believe the diagnosis, or “label,” heightens and exacerbates symptomology and global statistics support this premise.  The nuclear family emotional systems of various cultural traditions have a strong influence on which of the biologically predisposed will develop symptoms.
A Christian Worldview
The ninth concept of Bowen Family Systems is of utmost importance to the Christian.  “A hallmark strength of mental health practice involves engaging in the observation of relational patterns within and between persons, families, and larger cultural systems (Thurston, 2009, p. 17).”  The history of mental illness treatments provides ample evidence faith systems and beliefs about the supernatural can both undermine and support the well-being of its members and the larger society.  A major tenet of the faith is “love God by serving others.”  Jesus best describes the Christian worldview:
36 Naked, and ye clothed me: I was sick, and ye visited me: I was in prison, and ye came unto me.37 Then shall the righteous answer him, saying, Lord, when saw we thee an hungred, and fed thee? or thirsty, and gave thee drink?38  When saw we thee a stranger, and took thee in? or naked, and clothed thee?39  Or when saw we thee sick, or in prison, and came unto thee?40 And the King shall answer and say unto them, Verily I say unto you, Inasmuch as ye have done it unto one of the least of these my brethren, ye have done it unto me.  Matt 25:36-40 (KJV)
The cause is man’s fallen condition (Gen. 3) and the treatment includes a holistic approach to mental health.  Our faith informs the understanding of behavioral sciences and knowledge of the various theories informs our faith  (Thurston, 2009).  Faith in Jesus Christ runs counter to the scientific assumption that reality is fundamentally physical (Talbot, 2009, p. 29).
Summary
Currently risk reduction research is underway for schizophrenia.  The causes, and therefore preventions, of the illness remains largely a mystery.  Preventative research is in the distant future, indicating the multigenerational concept of Bowen Family Systems theory may well turn out to be the key to prevention.  If so, Christian psychology will prove to be the most successful avenue for prevention and treatment for schizophrenics like the young woman volunteering in the United Methodist Retirement Home.
The strong correlations between genetic and emotional factors indicate a multifaceted approach is appropriate.  The atypical antipsychotic drugs developed in recent years show promise, improving symptomology eight-five percent of the time.   When combined with the community approach the care receiver is more likely to enjoy remission of the disease.

References
Preventing Schizophrenia - Risk Reduction Approaches. (2004). Retrieved July 1, 2011, from schizophrenia.com: http://www.schizophrenia.com/prevention.htm
Berger, K. S. (2008). The Developing Person: Through the Lifespan. New York: Worth Publishers.
Bowen, M. (2004). Family Therapy in Clinical Practice. Lanham: Rowman & Littlefield .
Comer, R. J. (2011). Fundamentals of Abnormal Psychology. New York: Worth Publishers.
Corey, G. (2009). Theory and Practice of Counseling and Psychotherapy. Belmont: CENGAGE.
Enright, R. D. (2009). Can We Scientifically Test Psychological Models which Contradict Each Other? EDIFICATION Journal of the Society for Christian Psychology, 19-20.
Gilbert, R. (2006). The Eight Concepts of Bowen Theory. Falls Church: Leading Systems.
Noone, R. J. (2008). The Multigenerational Transmission Process and the Neurobiology of Attachment and Stress Reactivity. Family Systems: A Journal of Natural Systems Thinking in Psychiatry and the Sciences, 8, 21-34.
Talbot, M. R. (2009). Countering Naturalism. EDIFICATION Journal of the Society for Christian Psychology, 29-33.
Thurston, A. B. (2009). Resisting a Separatist Position as a "Distinctively Christian Psychology". EDIFICATION: Journal of the Society for Christian Psychology, 16-18.



[1] Formal thought disorders can make conversations difficult (Comer, 2011, p. 360).
[2]Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia: 1) at least two of the following symptoms, each present for a significant portion of time during a one-month period: (a) delusions.  (b) Hallucinations.  (c) Disorganized speech.  (d) Grossly disorganized or catatonic behavior. (e) Negative symptoms.  2) Functioning markedly below the level achieved prior to onset.  3) Continuous signs of the disturbance for at least six months, at least one month of which includes symptoms in full and active form.
[3]Tardive dyskinesia: late appearing movement disorder, usually manifests after the patient has taken the drug for more than a year (Comer, 2011, p. 379).
[4] Trephination: A stone instrument is used to remove a section of the skull, presumably to release evil spirits.
[5] Most became virtual prisons (Comer, 2011, pp. G-1).
[6] Psychoanalysis: The theory or treatment of abnormal mental functioning that emphasizes unconscious psychological forces as the cause of psychopathology (Comer, 2011, p. 13).
[7] Family systems theory: A theory that views the family as a system of interacting parts and proposes that members interact in consistent ways and operate by unstated rules (Comer, 2011, pp. G-6).
[8] The author has a personal bias due to a rare neuroendocrine cancer and participation in an NIH study for causality: http://www.clinicaltrials.gov/ct2/show/NCT00646022?term=carcinoid&rank=2.
[9]The nine concepts are: 1) the nuclear family emotional system 2) the differentiation of self scale 3) triangles 4) cutoff 5) family projection process 6) mutigenerational transmission process 7) sibling position 8) emotional process in society 9) the supernatural
[10] All statistical evidence cited in this section is from the Comer textbook, pages 371-373.

NOTES

"Since the beginning of our family study, I have come to regard schizophrenia as a process that requires three or more generations to develop." "The somatic reciprocation often includes definite physical pathology." ~ Murray Bowen

Blood samples taken after just one week of getting fewer than six hours of sleep a night showed changes to more than 700 genes due to sleep deprivation alone, according to the study. Researchers don't entirely understand the role of each of these genes and what the changes may mean, Bloomberg reported, but at least some affect our inflammatory, immune and stress responses, researchers noted. http://www.huffingtonpost.com/2013/02/26/sleep-deprivation-genes_n_2766341.html?icid=maing-grid7%7Cmain5%7Cdl21%7Csec3_lnk2%26pLid%3D276414


We show that one wk of insufficient sleep alters gene expression in human blood cells, reduces the amplitude of circadian rhythms in gene expression, and intensifies the effects of subsequent acute total sleep loss on gene expression. http://www.pnas.org/content/early/2013/02/20/1217154110 


"Our results suggest that voltage-gated calcium signaling, and, more broadly, calcium-channel activity, could be an important biological process in psychiatric disorders," they argued.
The calcium-channel gene CACNA1C has been previously linked to bipolar disorder, schizophrenia, and major depressive disorder, they wrote, as well as to Timothy syndrome, a developmental disorder that can include autism.  http://abcnews.go.com/Health/autism-depression-genetically-linked/story?id=18617381 

Autism, attention deficit-hyperactivity disorder (ADHD), bipolar disorder, major depressive disorder, and schizophrenia share common genetic underpinnings -- despite differences in symptoms and course of disease, researchers discovered.  http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/37584