The Family Movement, Bowen Theory, and Theoretical Medicine: A View from the 21st Century

Important changes have occurred in the family movement in the United States since it emerged in the mid‐1950s. Psychiatry supported the movement in its early years, but that changed as psychiatry abandoned the biopsychosocial model and adopted the biological paradigm through the 1970s. This development pushed family and other therapies to the periphery of the discipline. Medicine is dominated by the biological paradigm and cause‐and‐effect thinking. The roots of the medical model go back to Pasteur. In contrast, psychiatry in the United States had been dominated through the 20 th century by psychoanalytic thinking, which rendered the discipline a step‐child to medicine. This and other factors pushed psychiatry to get biological. The change generated a ‘failure of nerve’ in the family movement, abandoning the role of the family in schizophrenia in the face of psychiatry's assertion that all serious mental illnesses had nothing to do with the family. Other important changes separating the family movement from psychiatry occurred as well. Bowen theory is anchored in biology and evolution, but it is not a biological paradigm. Maintaining solid connections to the scientific disciplines are important for keeping the theory an open system. The recent emergence of systems biology and systems medicine could challenge psychiatry's allegiance to the biological paradigm and bring family systems theory centre stage in the discipline. These new disciplines may also arrive at a systems theory of the individual that can be integrated with family theory, powering a paradigm shift in medicine as a whole.