My Journey of Professional Self-Differentiation

“Remember that if you haven’t worked on differentiation yourself
in your own family, you will probably be prone to misjudge
the intensity of systemic reaction to your client’s moves.”

– Betty Carter & Monica McGoldrick

 Why I am NOT that kind of Psychiatrist

Ronald B. Cohen's Professional JourneyI have been asked, on numerous occasions, some variation of “How does a Board-Certified Psychiatrist become a Bowen Family Systems Coach?” So here it goes.

Once upon a time, psychiatrists actually talked to their patients. One questioner added, “I had assumed that ALL psychiatrists were psychoanalytic,” and indeed, once upon a time, that was also true.

And then, through a perfect storm of bizarre circumstances, including the advent of “Biological Reductionism” and the “economically driven practice of automatically dividing treatment,” we arrived at the era of “Better Living Through Chemistry” and the ascendency of “The Problem of the Psychopharmacologist.”

As they more and more ceded psychotherapy to psychologists, social workers and other mental health clinicians, many, if not most psychiatrists signed on to the 15 minute medication check where they ended up seeing incredibly large numbers of people for very short periods of time, and becoming somewhat mechanical prescription writers. I became increasingly disenchanted with the direction that the profession of Psychiatry was going in and ultimately it became completely unsatisfying.

So what can a poor boy do, but to play in a rock and roll band? Fortunately, in my case I had a guide and mentor who had previously experienced similar disillusionment to help me proceed through the process of professional self-differentiation. John W Jacobs, MD, originally a supervisor of mine during my psychiatric residency, and currently an esteemed senior colleague, had gone through the process himself, coached by Betty Carter at The Family Institute of Westchester, and became a Bowen Family Systems Coach. John suggested that I contact Elliot Rosen, the then current director of The Family Institute of Westchester, and the rest, as they say, is history.

Ronald B. Cohen's Professional JourneyAll trainees at Family Institute of Westchester are coached in a process affectionately know as “Therapist’s Own Family (TOF)”. One of the most distinctive aspects of Murray Bowen’s Family Systems Theory is its emphasis on work in the therapist’s own family of origin to strengthen the therapist’s level of self-differentiation.

For me, it was a yeoman’s task. The number of siblings in my grandparents’ generation ranged from four to ten, representing multiple cultures and ethnicities, and producing enough aunts, uncles, first, second, third and multiply removed cousins to last a lifetime of research and (re-) connection. I was able to track a half dozen siblings of my great-grandparents as well. They originated mostly from Eastern Europe, Hungary, Roumania, Russia and Ukraine. My five-generation genogram covered nearly all of one wall in my home office.

With such a large extended family I have just about one of everything:

  • Denizens of Miami Beach and hotel managers, bankrupt former owners of department stores and mattress wholesalers, dairy farmers, fruit & vegetable wholesalers, and push cart vendors, associates of organized crime and fugitives from justice, a spy, capitalists and card carrying communists, spendthrifts and penny pinchers, truck drivers, parking garage owners and newspaper editors, a Talmudic scholar and a confidant of the Birthright founders, ne’er-do-wells and overachievers, the inventor of the GPS, physicians and attorneys, real estate brokers and engineers, a suicide or two, compulsive gamblers and con-men, a rambunctious aunt with a pink Cadillac, an organic farmer and a candy store owner

  • Alcoholics and individuals, sometimes entire families, with chemical dependence, some in recovery and some who never made it, deaths from overdose and traumatic brain injury from a motor vehicle accident perhaps while under the influence

  • Chronic and life-shortening medical illnesses of multiple varieties, childhood brain tumors and healthy nonagenarians, malaria and other tropical diseases

  • Untimely deaths of children, parents and spouses, resulting in orphans, step and half siblings, victims of the influenza pandemic and survivors of polio

  • In-marriages and out-marriages, separations, divorces both amicable and highly conflicted, remarriages up to three, the marriage of a brother-in-law and a sister-in-law following the death of their respective first spouses, a bigamist

  • A couple without children, an only child and a family of six, unplanned pregnancies and adoptions, abortions, miscarriages and a sudden infant death, affairs and a consanguineous union

  • Members of the armed forces and combat casualties, paratroopers and fighter pilots, SeeBees, a Navy Petty Officer and a Green Beret

  • Severe and persistent psychiatric illnesses, autism and eating disorders

  • Abandonments and disinheritances, cut-offs and estrangements

  • Lesbians and gay men both in the closet and out

  • And the repetitive, never-ending conversations about the cemetery plot

Ronald B. Cohen's Professional JourneyFamily members have lived along the northeast corridor from Boston to Washington, DC, upstate New York and the Bronx, Northern and Southern California, the Midwest including Detroit, Chicago, Cleveland and St. Louis, northern New England, the Southeast and Florida, Nevada and Arizona, a summer house in Wyoming, and Shanghai.

Consequently I’ve experienced the anxiety and avoidance, the emotional impasses and seemingly immovable triangles, and the negative reactivity and pushback of working on self-differentiation in my own family of origin. I’ve benefited greatly in learning to take responsibility for my behavior and emotional well-being by developing the necessary power and control to depend on my own efforts and resources to make changes in my family of origin and manage both their and my own emotional reactivity.

Following completion of the post-graduate core training program at The Family Institute of Westchester, and with John’s ongoing coaching, I have conscientiously and steadfastly worked to define a new professional self, from one based on the Diagnostic and Statistical Manual of Mental Disorders (DSM) medical model to that of a humanistic and non-pathologizing Bowen Family Systems Coach.

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Bowen Family Systems Coaching

Bowen Family Systems Coaching with Ronald B Cohen, MD is the treatment of choice for complicated relationship problems and intergenerational conflicts. Include the whole family in resolving and improving what is going on right NOW! When the entire family works to make the difficult journey together, the results are almost magical.
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If you are experiencing family relationship problems and distress, don’t treat all therapists alike. Look for a Family Therapist who has had specific training, is comfortable with emotional intensity and will offer clear direction to help resolve identified problems. Ronald B. Cohen, MD works with the whole family in a manner that can save you time and be more cost effective than equal doses of individual therapy.
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I offer both individual coaching and a consultation group to help facilitate the acquisition and further development of knowledge and expertise in Bowen Family Systems Theory and Coaching for the enhancement of clinical efficacy, productivity and satisfaction. If this is something you want to do professionally, and especially if you have not had significant training and experience in working with family dynamics and relationships, then experiential learning by doing is the best way to go.
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