Host Lorrie Appleton, LCSW:
Welcome to Social Work Talks. I'm your host, Lorrie Appleton. This episode of Social Work Talks is brought to you by Project ID. So listeners, imagine this scene, you're sitting in your clinical office when a call comes in, a wife initiates the call while her husband listens alongside her. Their adult children have not spoken to them in over a year. The parents have pleaded, cajoled, and apologized for all past transgressions hoping they can make amends. This scenario is not uncommon. Two siblings who no longer speak to each other, grandparents who cannot tolerate how their children treat them, or children who decide they can no longer endure the pain and anguish of disappointment, family disengagement and emotional splinters or trending upward for a variety of reasons. Our featured presenter will offer us insight into understanding the dynamics associated with family cutoffs and how generations can be impacted by this phenomenon.
Margaret Otto LCSW is a licensed clinical social worker with a full-time practice in the Kansas City area. She's been practicing social work since 1989 and specializes in Bowen Family Systems Theory. Margaret is a highly experienced professional who has extensive understanding working with individuals and their families. Margaret is the co-founder and director of KC Center for Family and Organizational Systems. The KC Center began practicing in 1996. Margaret teaches and trains other therapists, family, medical residents, clergy and business owners. She's presented at local, national and international conferences. Gosh, Margaret, what do you do during your free time? Not enough. Well, welcome to the show, Margaret. So before we jump into the case, I'd like to know a little bit more about you. Can you tell us how and why you became a social worker?
Margaret Otto, LCSW:
That's a great question. I've really enjoyed my field. I've never had that Sunday night dread. Oh, I've got to go to work the next day. And when I think back of it, I lived in Detroit in the sixties during the Detroit riots, and I was at Girl Scout Camp and the riots hit, and so kids were getting messages from families and everybody came in my tent. And I remember being confused a little bit then about why is everybody in my tent? But I think it just speaks to family process at an early age. And there it is. Everybody's in my tent. I didn't know a way to think about it then, but it makes perfect sense. I ended up with a master's in social work, then I went into medicine and then went from medicine to mental health in 89. So it's been a great run.
Host Lorrie Appleton, LCSW:
Yeah, it sure makes sense to me because I mean, in family systems, everybody's in your tent, right? Yes. In more ways than in more ways. And we'll get to that later. That's right. Oh gosh. So as your practice evolved, you were interested in Bowen Family Systems theory. Can you tell us more about the theory and how you utilized it in your practice?
Margaret Otto, LCSW:
Yeah. I was really fortunate in graduate school at Wash U, we had whole semesters on theories. Not two weeks, a whole semester. I didn't have anything on Bowen Family Systems theory. But after that I went to Menninger and did some training there and got more interested and heard Dr. Bowen speak early in Leavenworth. And it just made perfect sense to me. It just was one of those theories that just hit me and people will describe this, it just makes sense. So then I went out and studied with him shortly before his death, and then Mike, Kurt took the realm and I've been at it ever since.
Host Lorrie Appleton, LCSW:
Right. So you learned from Dr. Bowen and Dr. Kerr, and then from there you've seen that it makes sense in your clinical practice?
Margaret Otto, LCSW:
Yes, I applied it. I try to apply it as it's human, as the rest of 'em, but as everybody, but try to apply it every hour and not only to my clinical case, but to my own family too, because it doesn't make sense to ask clients to do something you haven't tried or haven't made an effort at. So these are universal issues and challenges and yeah, I've been very happy with my statistics clinically. I used to keep track of them, my suicide rates, hospitalization rates, et cetera. And then I quit doing it because I was so satisfied with it.
Host Lorrie Appleton, LCSW:
Oh, that's great. That's good to know. So let's take a minute to revisit our case study. The parents are reporting that they have not spoken to their adult children and grandchildren for over a year. From the parent's perspective, they were cut off. So oftentimes they're blindsided. They don't understand just stereotypically, they don't understand where everybody went and why this is happening. And so what happens in relationships where cutoffs occur?
Margaret Otto, LCSW:
Well, every family has a version of this. It's just how much Bowen theory talks about universal processes. So people will experience tension in relationships. They can feel guilty, they can feel like they've been treated like a child, they can feel disapproved of, nobody understands me, nobody approves of me. And these tensions develop in relationships over generations and then they have to be coped with. And Boeing created eight original concepts of how family processes work. I actually wrote them down, I always figure, I'll forget one. So triangles, differentiation of self, nuclear family emotional process, the family projection process, multi-generational and cutoff was one of them. Sibling physician societal regression. And then Dr. Kerr added uni disease concept. And over time the core concepts have become anxiety and differentiation. So anyway, when you get all of these processes happening in families, the tension mounts up. And one way that people cope with tension is they cut off where they distance. And cutoff is a term used to describe between generation contact, they cut off between the generations. Parents don't talk to their children or their grandchildren. Distancing is a different concept. Everybody. I mean, my gosh, who hasn't gone to movie and gotten a two and a half hour vacation? I mean distancing through work or drinking or all the variables is different than cutoff and cutoffs when generations lose contact or cutoff to manage the tension.
Host Lorrie Appleton, LCSW:
Right? Well, there's a lot to learn there for each one of those perspectives. And we're going to talk a bit more about that later in the podcast. And so we'll return to our topic after we pause for a commercial break. Listeners will be right back.
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Host Lorrie Appleton, LCSW:
And we're back. We're back with the great Margaret Otto. I would say the human. Margaret Otto, human. Margaret Otto. Of course, of course. Everybody. So we were talking about cutoffs. We were talking about distancing. There is also this dynamic that occurs around pressure to reconcile. I mean, it is almost like housewives of Beverly Hills. The whole family comes into play and they're talking to each other and they're all fired up about what the family members should do and it can be really painful and cause further trauma. What are some strategies you might use to assist the whole family?
Margaret Otto, LCSW:
Well, I mean, like I mentioned, it's true in every family. And I'll talk some about the cutoffs in my own family, my efforts with that. But families can get together and they can be sort of peace of grief families. It looks great, everybody's polite, but there can be a big undercurrent under it that's pretty uptight. Or families can dissolve into yelling, screaming matches, door slamming and all of that. Either style of families. There's the tension to deal with. And I think part of it is beginning process. It's not to see it in cause and effect, thinking the kids didn't cause the cutoff. I didn't cause the cutoff. My grandmother didn't cause the cutoff that it sort of evolved over time. And then the winds or the streams of emotional process sweep up individuals and take 'em downstream and sometimes further than they want. When I ask families in here or individuals to work a lot with individuals, but I, there's usually a desire to connect and return to better times, but there's no roadmap sorted to do that. Sometimes not. That seems to be more of the exception.
So I don't know if you want to throw anything in about that. I can describe the cutoff in my own family. This is some of my own early work that I did, but it's a multi generational process. But I guess one point, instead of cause and effect thinking A created B, it's at least two people, more likely three people to solve a problem. One of the ideas is in order to solve a problem, you got to think in threes at least three people. And sometimes that's really hard to see, Lori. I mean, if you're fighting with your husband or fighting with a kid, I mean, what in the heck? Who is the third person? I mean really it does not feel that way or seen that way or somebody doesn't pick up the phone again. It doesn't seem like there's a third party involved. But if you can get to the top of the stadium and look at it, it's a much different view than being on the field. It's a much different view. And then it gives you more of a roadmap to get more freedom to move around the family however you want. And I just think that's really important to be liberated or free like that, to move anywhere you want.
Host Lorrie Appleton, LCSW:
So often there's a lot of people in the room, even though there are not a lot of people in the room, you set it up so that people understand that it's not just you. There are three people, at least in the room
Margaret Otto, LCSW:
At least. And individually, I'll do individual consultations and they bring in their tribe with them. And I'll draw, I can't see my marker board, but I'll draw the whole emotional system that they're, the context that they live in because nobody, humans are social species. We're all connected. And that level of connection determines the individual as much as the individual determines impacts the system. So I'll draw it out. And that's the beginning. I think beginning, I've seen it in a broader context, all the multi-variable processes that happen that in fact the individual versus it's somebody's fault. I say this often that cause and effect thinking is some of the nastiest in the mental health world. You have to either blame somebody else or blame yourself. Neither one of those that is just awful. I mean, it's your fault or my fault. I mean what? So to have a systems perspective is a way to get out of that kind of entrapment and see it as more of the way it really is versus A created B or B created a, and then it just goes back and forth, defend, move, counter, move, whatever.
Host Lorrie Appleton, LCSW:
And aren't cutoffs intergenerational. If you ask the family. Do you know about if your parents have had any cutoffs or your grandparents have had any cutoffs that you see that there's a connection that they're cutoff somewhere earlier on that then have followed through to the client that you're seeing?
Margaret Otto, LCSW:
Yeah, I'll just talk a little bit about my own family. My grandparents' generation, it's my maternal grandparents. One marriage, solid marriage, didn't look like any overt challenges in the marriage. Two children, oldest sister, youngest sister, and my mother was the youngest and her sister, the oldest. And has typical in nuclear families, one kid gets a little more of the projection process. So one kid gets a little more of the focus and this universal it, it's just is. Sometimes it's mild. Okay, not a big deal. And other times it's pretty heavy. So in that family, the oldest sister, my aunt, my mother's older sister got the label as more the black hat. And my mother got the label of more the good hat, the white hat. So okay, that family tools down the pike and it's very functional and grandfather's successful kids graduate, they marry. But over time the emotional process starts come up in a stronger way and sort of an erosive process. So then when my grandfather dies first, my grandmother dies second and she leaves the inheritance in a different manner to the two girls. So because of the difference in the will. So classic, I mean, how many times have you heard this story, Laurie? Well, and listeners. Listeners, this is not new. This is not new. This is just 1 0 1 family process. Okay, fine. So then the sisters don't speak because they weren't quite treated the same. So then I come along, I'm the middle of three and I graduate and get raised and not in a peace of grief family. And then I get married, I'm getting married, and I'm like, now why don't I talk to my aunt, what is up with that? Because I have memories. When I was little, it was great. She could work on an engine just like anybody, any man, she could make the best pot of chili. I had no beef with her. And I'm like, wow. And then I had started just at the beginning, the bowing theory, just mening. I did a female functioning class. Then I went to Georgetown and I'm like just at the very beginning. And then I realized it was really an issue between my mother and I was riding her tail once. I mean she didn't speak, so why would I speak? I hadn't really thought about, well, why am I locked at the hip? Why am I doing that? So I, I got married and I invited everybody to the wedding because I cut off on both my parents' side. Both my father didn't talk to his brother much, and my mother didn't talk to her sister much. I invited everybody. And then I had my
Host Lorrie Appleton, LCSW:
Older, you said social worker again.
Margaret Otto, LCSW:
Well, I just started to think different. Now why would I just rubber stamp this to, I mean, it wasn't my beef. Why would I just rubber stamp this? So then fast forward, I have a child. And then in that period of time, my mother got sick, terminally ill. And I thought, again, why is this, why am I not connected to that family? I mean, I had cousins I knew. And so I told my family I was going to contact her. Well, it didn't go over great. Let's just say that my father told me absolutely not. I should not do that. I contacted my cousin. My cousin said, you're going to kill. I was going to kill my aunt if I contacted her. Right?
Host Lorrie Appleton, LCSW:
No pressure, no pressure, no pressure.
Margaret Otto, LCSW:
And I'm like, I just like nobody was for it. Don't do it. Don't do it. Don't do it.
Host Lorrie Appleton, LCSW:
Leave things alone.
Margaret Otto, LCSW:
Leave it as be, don't. It's a peace of grief. Family don't create a fuss up. So of course controversially, I decided, I told my cousin that I was going to call her and she could give her 24 hour notice so that if there was a health problem, we could get around that. And so I called my aunt the next day and it was fine. It was just like we'd never talked. And did it make a difference? That much difference to everybody else? I don't know so much, but it made a difference for me. I was able to contact them, stayed in touch, still in touch with that family. I'm not going to ride somebody else's tailwind if I don't have the same beef. My aunt and my mother did contact prior to her death. Did it make a huge difference? I don't know. They visited, it was fine. It was fine. It wasn't any big hallelujah, moment. There was no big consequence out of it except for me. And then I got more freedom to move in the family I wanted. So I don't know if you have thoughts or questions about that, but that's a very classic, classic story,
Host Lorrie Appleton, LCSW:
Right? Well, first of all, thank you so much for sharing your story. And I can't see the listeners, but I can imagine that they're leaning forward, that there's an understanding. And one of the things that you talked about going back to our title of the podcast is should I stay or should I go? Your family was saying don't touch it, leave it alone, don't do anything about it. And you said, no, I want to look at this legacy and I want to look at this intergenerational stuff that I have nothing to do with and I think I want to look into this. And that's what happened from that. That's amazing.
Margaret Otto, LCSW:
Well, they're probably all leaning forward saying, don't do it. Don't do it. What's the matter with you? I mean, it's sort of an outlier position. Why would you? And it may make sense in some families not to, it might be too disruptive, it could be too fragile.
This thing about getting neutral and getting objective about emotional process. But the idea is if there's a cutoff, sometimes I think of families this way, and it's probably a weird therapist brain that's been exposed to bone theory, but I think it's like tributaries of water, all the connections, all the evolution of relationships over time. And if you cut them off, like my parents cut basically two families off to a certain extent, not total. They'd see their family. My father would see his mother once a year. So it wasn't total cutoff, but you decrease the flow of connection. Well, it's got to go somewhere. The water's got to go somewhere. And so then there's a shift of symptoms. If there's a cutoff in one area, it can create a shift in symptoms to another area, a marriage, the kids' family somewhere. It's got to go somewhere. And all of us have an immature reactive side and tension will up somewhere. So it really doesn't, in a way it short term, it solves a problem. I can understand why my mother and her sister didn't talk. I mean, why would you want to after that slap in the face, right? I mean, but on the other hand, symptoms were popping up elsewhere. And so that's part of the dilemma I think. How do you, what's worth it and what's not.
Host Lorrie Appleton, LCSW:
Well, that's a great image. It's a really great image. One of the things that you talked about that I want to follow up on is reunification is not always the best solution. What you did was you invited your family in, even though it was suggested, leave it alone. On the other hand, reunification may be a choice that makes the most sense. So how do you maintain your neutrality while helping the client determine their best path forward?
Margaret Otto, LCSW:
Yeah, I mean there's a lot to it. I mean, this is family after family hour, after hour. What is contact about what type of contact? Sometimes I tell families, well, I mean I'm a mother and half nieces and nephews and all that, great nieces and nephew, but I don't know how to unr a baby. So I'll just say
Host Lorrie Appleton, LCSW:
That's just brilliant.
Margaret Otto, LCSW:
You may not want to talk to 'em, but you still have a baby. I don't know how to unbirth a baby. So you may not want to deal with your sister or your brother or your cousin or whoever, but I don't know. You still are a cousin. You still are a brother or a sister. And then they usually laugh. And I laugh too, like I don't know how to undo it. But what to do with it is a challenge. And generally when families do decide to undertake something, they do it carefully, carefully with coaching. They don't go in on a weekend and blow it up. It's careful. And with coaching and purposeful, maybe it starts with birthday card or the other common threat is that if you don't do what I want, mom, you're not going to see my grandkids. That's a pretty common triangle too, right? I mean, I'm talking same triangle in my family, just working differently.
Host Lorrie Appleton, LCSW:
Well, that's our case study right there. Yeah.
Margaret Otto, LCSW:
If I disapprove, if you get my disapproval, there's this potential threat. You are not going to see the grandkids, so you have to go belly up to me. So you can see the grandkids,
Host Lorrie Appleton, LCSW:
Right,
Margaret Otto, LCSW:
Pressure to give in or accommodate or go into no self position to, I call it ghost in yourself, not taking a position and then avoiding the threat. And yet there's consequences down the line to that.
Host Lorrie Appleton, LCSW:
Right? What about, you've been talking about systems theory and many of the people listening don't do systems theory. They see individuals and it's hard for them to see the whole system. They're thinking more about the individual. So can people who are hearing about family issues, can they help their individual clients?
Margaret Otto, LCSW:
Yeah, I mean, the thing that's crazy in a way to me is that when anybody starts to talk, doesn't matter if it's a client in therapy or a neighbor or a consultation or a doctor or they individuals will talk it. They come in talking systems, they come my neighbor's talking systems. It's a natural system theory. People are talking it all the time. They're describing it. And sometimes it's missed because the mindset is trained in a different way, might be trained more individual and not hear so much what people are saying. But if you listen to what people are describing, well, here's an example. I'll give you another example. I had two, this is old times, two doctors that referred to in the same clinic. One doctor referred to me a lot, the other doctor didn't matter what happened. I could not get a referral, I could not understand it. Why do you think the one doctor didn't refer to me? Now, if we had everybody listening, I could hear all their guesses. How do you think those two doctors got along? And I'm like, oh, I knew that. They told me that I didn't hear it.
Host Lorrie Appleton, LCSW:
So the triangle,
Margaret Otto, LCSW:
Yeah, one's going to refer a bunch to me. The other I'm never going to get a referral from in the same clinic. I don't get along. They don't see it the same. Okay, that's one of the processes. The other is my end of it. What do I do with that? But anyway, I mean people will describe it and they talk it. And then if you're trained in an individual way, sometimes it's missed because you can't really hear it. You're applying a different perspective on the individual. And I honestly don't care what it is. What I do care about is when I do presentations and did one for NASW not too long ago, but I always say, this is my most important slide in my PowerPoint. How you think about a problem determines what you do with it.
So if you think medically, you'll be thinking medicine. If you think psychoanalytically, you'll be thinking one way. If you think attachment theory, it's another, my beef is when people don't know the theory, they're working off. I don't care what it is. Any of 'em can be founded on research and have interesting things in 'em. I think Bowen Family Assistance Theory is the most comprehensive, but I think it's important to know what leg you're standing on when you're providing services. But I don't care which one it's, but how you think about it's going to determine what you do about it.
Host Lorrie Appleton, LCSW:
Right. Well, let's make a little bit of a shift, but still talking about systems theory. Because I was coming into this podcast and it occurred to me that this is such a timely opportunity to do this topic because our country is splintered right now. And a system is a system. So whether it's working individually, whether it's working with couples, whether it's working with families, organizations, now our whole country is splintered and struggling. And so what people do when we're struggling in pain oftentimes is reach out. And yet when I think of Dr. Bowen, I think that much of his work was reaching in. And I wonder if you have any thoughts about that. We could certainly use your perspective.
Margaret Otto, LCSW:
Yeah, I remember I just studied under him at the end of his life, and I remember we had some meetings in his home and I remember his office and it had so many books from other fields. He was all about learning what was going on in other fields. And he talked about the internal world and made the theory applied to the individual world and the relationship network around the individual. But his focus was so much on other fields. And then my career continu that at the Bowen Center in Georgetown and continued that at the Bowen Theory Academy. I have had many a scientists come and speak here. And it's always so interesting that the scientist starts in one end, they don't know the other person's perspective, and then they just almost march together and then they end up on BTA did a conference on cancer with Marta Bert's work, philosophy of cancer, and here's Dr. Kerr, and they just end up connecting.
So I think the science of human behavior is really important. And to get back to where your focus, one of the original concepts was societal regression, and Bowen described that as a primary concept in the late fifties, early sixties. And where people are, it's like tribalism against each other instead of connecting with each other and also getting more and more permissive over time. So how do you do that? I mean, how do you continue to relate and connect to humans no matter what their religious orientation is? Their political orientation. Humans are humans. They all have families. We're all in the same species and not get into a form of tribalism. You want tribal. Tribal, which is always a pressure, always a pressure. So anyway, I'm rambling on. One other thing I'll think about. I'll throw in Laurie and then see I'm talking too much. Usually I talk too much on Fridays, but today I'm talking too much maybe on a Monday.
I think one of the laments at Dr. Bowen's end of his life and then her continued, and I think everybody in the field can see that there's, what is it that's so hard about focusing on oneself? What is so hard about that? What does it truly take for somebody to get interested in their own part of the problem? Now, mind you, I say part because it's not causing effect. It's not blame. There's three people involved. You'd have a third of it, right? You have a third. You have a part to play. It's not responsible for it's a part. And then when people can figure that part, whether it's on a three neighbors or how they're interacting religiously or politically, then they have the freedom to do something about it. But I think that people get allergic to so into cause and effect. They think they're going to be blamed the family. It's the farthest thing from it. What are you going to do? Go call up my great-great grandmother and say, why did you marry him? I mean, when I draw it out, how many people, there's always 10 or more. So the lament of what does it take for people to get really interested in themselves and becomes more self-responsible?
And that's in some ways what everybody's working on at some level.
Host Lorrie Appleton, LCSW:
Well, that's really helpful. As we begin to wind down, one of the things I take from that is that just like families are generational over time, that our society is generational over time. And in the moment it feels like it does. If you are, let's say these parents go back to the case study and you feel like this is an event, it's happening right now, it's painful, it's a crisis. And yet if you look spread it out and you take a bleacher's perspective and you look at the family, then you can see that there is a continuum. And so that relates to society right now. And so I find that really interesting and very helpful, and I think our listeners will as well. Do you have anything that you want to add to that? This has been so useful.
Margaret Otto, LCSW:
Humans are made to do hard things. Humans can manage a great deal of discomfort and get the twitch out of it, so to speak. Bowen used to say, leave the twitch at the door, but they can get the twitch out of it and they can manage a great deal of discomfort. And people are made to do hard things. And sometimes I think humans forget about that, about themselves, that they can do it. They can do something hard because we're made for it. My gosh. I mean, the humans have populated for better or worse, the entire earth. They can live in anywhere, the saher to the Arctic. Now, we could talk about other dynamics or other consequences of that, but humans are made to do hard things and sometimes they, I think forget that to be more self-responsible is freedom. And it gives, just like my little effort with my aunt got me freedom so I could go and visit where I wanted to.
I had the freedom in the family to go where I wanted and nothing really blocked it at that point. Now, did my family move up on the scale of differentiation to some high point? No. I've always said that I was about a 32, maybe at 34, but it was useful for me even though it was hard. And there are other hard things, but you get a gain for your effort. Maybe not short term. Short term. I'm thinking my aunt's going to have a heart attack. If I call her, she might die. Maybe they're right, maybe they're right. Maybe I shouldn't call her. But long-term is much different.
Host Lorrie Appleton, LCSW:
Thank you so much. Thank you for helping us understand the complexities associated with family splintering. There's so many different ways to look at this, and so we really appreciate all that you've shared today. And thank you listeners for tuning into this episode of Social Work Talks. For more information about Margaret and the KC Center from Family and Organizational Systems, go to www.kcfamilysystems.org. Listeners, you can find more information about Margaret and our topic in the show notes section of social work talks. Anything else you want to say before we close, Margaret?
Margaret Otto, LCSW:
No, it's been fun. I'm just working on myself. I don't know about helping others, but just keep trying to lend a hand and work on own issues, and I've enjoyed it, Lorrie. It's fun. It's a great field. And actually social work started with families. The origin of social work at Whole House was with families, so I think it's a lot of fun and be glad to discuss it anytime or with anybody else that's interested.
Host Lorrie Appleton, LCSW:
Well, thank you so much. And listeners, thank you for listening.
Producer:
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