In the Best Interests of the Children

In the Best Interests of the Children

Problems with a “Child-Focused” Approach

What would it take to sit with one’s own anxiety
rather than passing it along to someone else?

How often do we as parents make projects out of our children when we’d be better off making projects of our relationships and ourselves? In “We Don’t Need Your Help, But Will You Please Fix Our Children,” Jenny Brown described a “common presentation in child and adolescent mental health, where the parents are concerned for their children but are also keen not to open their own ‘can of worms’ (ANZJFT Vol.29 No.2 pp. 61-69 When it’s too difficult for parents to grow themselves up, they try to fix their children instead. What if the best way we can help our children is working on ourselves more, and worrying about them less?

Bowen defined the family projection process as “the primary way parents transmit their emotional problems to a child.” This process often starts prior to birth, and many times prior to conception, or attempts at same. The projection process follows three steps: scanning, diagnosing, and treating:

(1) The parent focuses on a child out of fear that something is wrong with the child;

(2) The parent interprets the child’s behavior as confirming the fear;

(3) The parent treats the child as if something is really wrong with the child.

If the parents subsequently embark on a holy grail quest for a psychiatric diagnosis, the process expands to:

(1) thinking about the child as having a problem;

(2) diagnosing the child as ill;

(3) treating the child as a “patient.”

Ronald B. Cohen, MD of discusses the best approach to therapy for children.This mode of thinking often results in the parents abdicating their responsibility for the child, and turning it over to the medical-pharmaceutical-industrial complex. When a clinician accepts responsibility for treating “the illness” in “the patient” without investigating the extended family web of relationships, a therapist triangle is created. This interlocks with the archetypical “primary parental triangle” which involves an increasing emotional distance between the parents, one or both parents becoming over-responsible for the child, and the child’s behavior functioning to help calm the parental anxiety and stabilize their relationship.

  • The more anxious parents are to “fix” their child, the worse the child does.
  • The more intense the search for a “diagnosis,” the worse the child does.
  • The greater the child focus of the parents, the more likely is the child to be treated under the medical model, which leads to increased and persistent pressure for the child to maintain the “sick role.”
  • The more that both parents and therapists focus on the child as a strategy to minimize the family’s anxiety, the lower the child’s level of functioning.

So what is the yellow brick road, the way out of this emotional morass? Since there’s no place like home, it consists of helping parents become curious researchers “about their role in anxious family patterns” in their family of origin, their extended historical family, and their family of procreation (see Jenny Brown above). Parental “taking care of self” allows space for the child to develop her/his mastery of emotional distress and physical and psychological discomfort.

Family therapy based on Bowen Family Systems Theory will help increase planful thinking and decrease emotional reactivity, allowing one or both parents to truly act “In the Best Interests of the Children,” regardless of who does or does not participate. It only takes one. Why not you?

Please share your thoughts, feelings and experiences about the best interests of your family in the “Leave a Reply” box below. I look forward to hearing what’s on your mind. If you found this post helpful, please don’t keep it a secret. You are encouraged to click on the buttons in the second to the right hand column at the bottom of the page and share this article with your own networks. To request more information please click here. Looking forward to continuing the conversation.

Ronald B Cohen, MD, PC Ronald B. Cohen, MD
Bowen Family Systems Coach
1 Barstow Road, Suite P-10
Great Neck, NY 11021
(516) 466-7530

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  1. Eutelyn Allen on August 23, 2014 at 2:07 am said:

    This is extremely helpful for both professionals dealing with clients’ and their parental issues as well as us practitioners trying to raise our own children.

    The “helping parents become curious researchers” link is quite informative. As parents we are all a little guilty of “over parenting” and “fixing” our children, only to realize later that our actions were not necessarily “in the best interest of the child,” but often out of a parent’s guilt, Pride, embarrassment, competitiveness or need to live vicariously through one’s child.

    This article is a great exposure of the issue.

    • Ronald B Cohen, MD on August 24, 2014 at 9:43 pm said:

      Hi Eutelyn,

      Spot on. In response to your first sentence the most distinctive aspect of Murray Bowen’s “family systems theory of emotional functioning”, for practitioners, is its emphases on the primacy of the therapist defining his/her self more clearly in the extended family they grew up in. Observing one’s functioning in important relationships provides the necessary foundation for effectiveness in the practice of Bowen Family Systems Theory Coaching. In many training programs, including the one I completed at Family Institute of Westchester, study and work on the family therapist’s own extended family is a mandatory part of clinical training. I have written about “My Journey of Professional Self-Differentiation” and described the benefit to mental health professionals of studying the history of, and differentiating within their own families of origin.

      It is an issue of both personal and professional ethics to continuously work on development of our own “solid self”. For this reason, I developed a program to help therapists and other mental health practitioners learn about the benefits of Bowen Family Systems Theory (BFST) Coaching in their professional lives. My next blog post, The Clinician as a “Solid Self”: An Issue of Personal and Professional Ethics further expands on these thoughts.


      — Ron

      • Kathy Hardie-Williams, M.Ed, MS, NCC, MFT, LPC on August 25, 2014 at 5:52 am said:

        Hi Ron…can you say more about the program you developed and how to access it?



        • Ronald B Cohen, MD on September 4, 2014 at 1:39 pm said:

          Hi Kathy,

          I’d start with my most recent blog post,The Clinician as a “Solid Self”.

          I’m officially calling the program Bowen Family Systems Theory (BFST)
          Coaching & Training for Mental Health Professionals:
          A Process for Becoming a More Effective Clinician.

          Executive Summary: How knowledge of BFST can be helpful no matter whom the client is!

          Herein a brief summary of the logistics:
          Training in Bowen Family Systems Theory (BFST) Coaching consists of three overlapping and interrelated undertakings:
          (1) Learning the fundamental theoretical underpinnings
          (2) Work on Self-differentiation in one’s extended family of origin
          (3) Supervision of clinical work.
          The second task is fundamental, as the best way to “learn Bowen” is to “do Bowen.” Your specific program will be developed collaboratively.
          What I will do:
          (1) Teach
          (2) Coach
          (3) Provide Feedback
          What you will do:
          (1) Commit to doing the work in the context of your real-life relationships with your flesh-and-blood extended family members
          (2) Learn to manage your anxiety
          (3) Be Planful and Proactive
          Schedules and fees – specific details to be discussed:
          (1) Frequency of interactions may vary from weekly to monthly and progress to quarterly or yearly “check-ups”
          (2) The more work you do on your own, the less expensive the process becomes

          I’ll forward more specifics. Hope this helps.


          — Ron

  2. Kathy Hardie-Williams, M.Ed, MS, NCC, MFT, LPC on August 25, 2014 at 5:45 am said:

    Ron! First….. Hello, it’s been a while. I hope you have had a great summer.

    Your timing for this could not be better for me. I can tell you from both personal (yes, I did this to my child) and professional (when the parents bring in the child as the ‘identified patient’) experience that you are so right! That being said, this is especially comforting for me right now in my personal life. My son’s father almost died about three weeks ago; they have been estranged for 12 years. I won’t go into all the details (it would become a book instead of blog post:>), but his father’s wife has had a great influence on the situation. When his father was in the hospital, my son was ‘banned’ from seeing him. His father did not have much of a say in the matter given that he was in a coma. I found myself processing that ‘this may be the way it ends’ and that my son may not be able to say goodbye (in person) to his father. Oh my! I was a MESS over that. Actually, I think I was more upset about the situation than my son (that isn’t to say he doesn’t care about his dad; he’s probably better at differentiating from the dynamic than I am). After some therapy myself, A LOT of processing, accepting what is, and letting go, I realized how much I have projected on to my son around this scenario. It’s comforting to hear that it is in our children’s best interest not to worry about them given that I have found it so difficult to reconcile my son’s father ‘cutting him off’. I’m not sure how any mother gets around the pain of that other than working on differentiation, working on ACCEPTANCE OF WHAT IS, and letting go. If I can continue to frame my worry about my son as ‘not in his best interest’ or something I am projecting on to him, it will be easier (I believe) to move forward (for both my son and I). So, thank you!

    • Ronald B Cohen, MD on September 4, 2014 at 11:50 pm said:

      Hi Kathy,

      You are quite welcome. And thank you for your kind and supportive thoughts, and your courage in sharing intimate aspects of your personal journey.

      From an as yet unpublished article with the working title, Three Steps to a Healthier You: Turning theory into practice,

      Words of a Chasidic Rabbi on his deathbed as related by a Protestant Minister

      When I was young, I set out to change the world.
      When I grew a little older I perceived that this was too ambitious
      so I set out to change my state.
      This too I realized as I grew older was too ambitious
      so I set out to change my town.
      When I realized I could not even do this,
      I tried to change my family.
      Now as an old man I know
      that I should have started by changing myself.
      If I had started with myself
      maybe then I would have succeeded in changing my family,
      the town, or even the state –
      and who knows maybe even the world!


      — Ron

  3. Avrum on August 25, 2014 at 8:58 pm said:

    Shared this one with colleagues and friends. Thanks Ron.

    • Ronald B Cohen, MD on August 26, 2014 at 5:57 pm said:

      Hi Avrum,

      Thank You. I am both humbled and honored by your request. Please feel free to forward to your colleagues and friends. I’d appreciate hearing the responses that you get. You might also suggest that anyone who would like further help and understanding contact me directly or view my blog & website to learn more.


      — Ron

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