Effectiveness of Self-differentiation Training Based on Bowen’s Approach on Positive Feeling Towards Spouse in Married Women in Isfahan in 2019

Received: 24 June 2021 Accepted: 2 September 202

because it flourishes your forces in a way unique to yourself, and is more constructive because it frees you from the need for suppressing your emotions or wasting your energy and empowers you by familiarizing you with the nature of your emotions (8). Beck(2011), in a study in unmarried adults or those with failed marriages, showed that these people have a general tendency toward problematic beliefs and maladaptive emotions (9). also there is a significant relationship between marital satisfaction with communication beliefs and irrational expectations of couples (10). Studies show that many factors influence "skillful social interactions", "effectiveness: and "popularity,"; but the role of positive feelings and emotions is of great importance in this regard (11). Furthermore, one of the factors investigated during the investigation of marital satisfaction couples' mental wellbeing is the level of self-differentiation of each partner in their married life and its effect on their relationship (12).
Self-differentiation is the most important aspect of Bowen's theory (13). Bowen is one of the most well-known theorists regarding families and is the finder of family system theory (14). According to Bowen, the level of self-differentiation in each person shows one's ability to differentiate emotional and logical processes. In other words, one's level of success in planning and having specific values and beliefs, especially during stressful situations without having one's behavior guided by emotional signals received from others, indicates one's level of self-differentiation (15). People with low levels of self-differentiation are controlled by involuntary emotional reactions and often show inefficient behavior even at low levels of anxiety caused by marital problems. In the theory of family systems, the key to the mental wellbeing of an individual is having access to both feelings of belonging to family and selfdifferentiation. In Bowen's approach, family therapy is carried out in two stages, including evaluation interview, generational mapping, and therapeutic intervention (16,17) Bowen's family therapy doesn't care about the current clinical problem and instead follows two treatment goals: first, decreasing the stressors and symptoms and increasing the levels of selfdifferentiation in family members to increase their compatibly (18). Therefore, according to Bowen's theory, increasing the levels of self-differentiation is the main tool. This is because people with high self-differentiation are self-guided, meaning that they understand their thoughts and emotions, express themselves, and feel no need for following other's unreasonable expectations. This means that these individuals don't lose control in highly emotional and unexpected situations, reducing the chance for wrong decisions and instead deciding through logic and thinking (19). Based on these facts and the effect of increased self-differentiation and couples' abilities for separation of thoughts and emotions on improving the quality of marital life and due to the lack of previous studies on the effectiveness of Bowen's self-differentiation on positive feelings toward one's spouse, the main aim of this study is to "Study the Effectiveness of Self-differentiation Training Based on Bowen's Approach on Positive Feeling Towards Spouse in Women in Isfahan".

Methods
This study is carried out using an experimental design approach with pretest-posttest and control group. In this study, self-differentiation training therapy using Bowen's approach was used as the independent variable, and positive feelings toward the spouse were used as the dependent variable. The study's statistical population included all married women visiting consolation centers in the city of Isfahan in 2019. Sampling was carried out using voluntary sampling. In order to determine the sample size, due to the lack of cooperation of many eligible individuals, the minimum acceptable volume was used according to Delavar (2015), which considers 30 subjects as an acceptable number of samples in experimental research (21).
It should be noted that sampling in experimental and non-experimental research has a relatively different implication. In experimental research, you try to create different communities in a homogeneous subgroup from the beginning by applying different experimental measures. The purpose of sampling here is to make sure that all subjects belong to the same community before being exposed to the experimental design (22). To this end, volunteer married women were interviewed regarding inclusion criteria, and in case of having all inclusion criteria, the volunteers were invited to participate in the pretest. Among these, 30 individuals with scores lower than average or below the cutoff point were selected, and 15 of these women were randomly assigned to the control group, and 15 others were assigned to the experiment group.
The training was carried out in eight sessions and was held once per week for 90 minutes each as group sessions (the training was carried out as a workshop, and after each session, assignments were given to the participants in order to help them understand their own problems). The summary of training sessions is presented in table 1. The Control group did not participate in the training session and was instead placed on the waiting list for future marriage enrichment sessions. Finally, after the last session, participants in both control and experiment groups participated in the post-test.
Data gathering in this study was carried out using the demographic & Positive Feeling Questionnaire (PFQ). The first part of this questionnaire measures demographic details such as age, education, marriage length, and the number of children. The main positive feeling questionnaire was first introduced by O'leary (20) in a therapy clinic affiliated with New York State University. This tool includes 17 items that are designed to measure positive feelings and love toward one's spouse. This scale can be used to measure the effect of touch, loneliness or being with a spouse, kissing, and cuddling with one's spouse.
This questionnaire is divided in two sections scored using Likert's scale. The first section includes 8 items that ask the participants to score their general emotions toward their spouse in the last few months from 1 (severely negative emotions) to 7 (severely positive emotions). The second section includes 9 items scored from 1 to 7 by the participants based on their emotions. The total store of "Positive Feeling toward spouse Questionnaire" is easily calculated as the sum of all scores. This questionnaire has a Cronbach's Alpha coefficient of 0.94 which shows great reliability.
The validity of the "Positive Feeling toward spouse Questionnaire" was investigated by comparing its results with the results of "Marital Adjustment Test", "Navaran Communication Scale", Beck Depression Inventory", Couples scores regarding marital commitment and the score of their positive behavior; all of which indicated very high validity. This questionnaire was converted to Persian by Mazaheri and Pouretemad (1380) using translation and retranslation approach and includes items regarding emotions toward spouse (or fiancé). The introduction to the questionnaire states that "please answer each item based on your emotions in recent months. Select the score or rank which indicates your own real emotions, not the emotion you must or want to have toward your spouse" (23). In the present study, Cronbach's alpha coefficient was equal to 0.91, which indicates that the collected data have good reliability.
After gathering the pretest and post-test results, data analysis was carried out using descriptive and inferential statistical methods. Mean and standard deviation were used at the descriptive level, while covariance analysis was used at the inferential level using SPSS-24 software.

Results
The total number of participants was 30 individuals, 15 of which were placed in the experiment group and 15 in the control group, with both groups participating in pretest and post-test. Based on the demographic information, the mean age of the participants was 32.67 years, with a standard deviation of 4.17 years. In the control group, the highest percentage belonged to age groups of 26 to 30 and 36 to 40 for 13.3% each, while the age group with the highest percentage in the experiment group was 20 to 25 with a frequency of 16.7%. A total of 20% of the participants had a high school diploma, 33.3% had an associate degree, 33.3% had Bachelor's degree, and 13.3% had a master's degree or Ph.D. The mean length of marriage for the sample was 6.49 years, with a standard deviation of 2.81. Among the participants, 30% had no children, 36.7% had 1 or 2 children, 16.7% had 3 or 4 children, and 16.7R of the participants had five or more children. Table 2 shows the descriptive results of the current study, including the mean and standard deviation of pretest and post-test scores obtained using PFQ for control and experiment groups. According to the positive feeling questionnaire results, the mean score for the experiment group was 56.33 for the pretest and 60.86 for the post-test (Table 2).
At the inferential level, covariance analysis was used to investigate the effectiveness of selfdifferentiation training using Bowen's approach on positive feelings of women toward their husbands in the city of Isfahan. In order to use the analysis of covariance, it is necessary to observe some conditions such as the normal form of data distribution, homogeneity of variance between groups, lack of significant relationship between the covariate and independent variables, and a significant relationship between the covariate and dependent variables. (24).
First, the Shapiro -Wilk test was used to confirm the normal data distribution for pretest and post-test. The results showed that data distribution is based on the normal distribution (P>0.05), and the requirement for covariance analysis is met. In order to investigate the assumption of homogenous variances, the Levene test was used. The results were not significant (P>0.05), which confirmed the zero hypotheses for the Levene test regarding homogeneity between covariant and dependent groups. Furthermore, the results of covariance analyses of regression slope and lack of comparison significance showed that the zero hypotheses regarding lack of equality between regression slopes was not confirmed, which means the equity of regression slope in the results is confirmed. Also, to examine the relationship between the covariate variable and the dependent variable, the Pearson correlation coefficient was used, equal to 0.43, which was significant at the error level of 0.05.
In the next step, covariance (ANCOVA) test was used to investigate the research hypothesis regarding the effectiveness of self-differentiation training based on Bowen's approach for improving the positive feelings of married women toward their spouse in the city Isfahan. The values of the F statistic for the group source were significant at P<0.05, which shows that the training has been effective in improving the positive feelings of women toward their spouses. Based on eta coefficients, it can be said that 18% of the changes in positive feelings of married women toward their spouses can be explained based on selfdifferentiation training using Bowen's approach. Furthermore, test power confirms the sufficiency of data volume. Based on these results, the research hypothesis regarding the effectiveness of Bowen's self-differentiation training on increasing the positive feelings of married women in Isfahan toward their spouse was confirmed (Table 3).

Discussion
This study aimed to investigate the role of selfdifferentiation training based on Bowen's approach in positive feelings towards husbands in women. The results showed that this training has been effective in improving women's positive feelings towards their husbands.
In the review of previous literature related to the hypotheses of the current study, no direct studies on the direct effects of Bowen's self-differentiation training on positive feelings toward one's spouse were discovered. However, since selfdifferentiation is a process indicating personal independence at emotional and mental levels, helping people in independent decision-making and use of logic, positive emotions, and closeness, the results obtained in the current study are close to the results obtained by Ghabishani et al., and Nabawi et al. studies which investigated the effect of family therapy with emphasis on Bowen's family system on loving styles and closeness in women (18,19,23). Neuensch wander showed that self-differentiation is related to avoidance, attachment anxiety, and closeness feedback (28).
Jenkins also investigated the effects of Bowen's self-differentiation on Erikson's psychological development stages and concluded that selfdifferentiation levels have a positive correlation with psychological development (29). Gandy showed that training in reducing problems and self-differentiation in adults effectively improves closeness in couples (30). The results of the study by Bagher Nia showed that self-concept and positive feelings toward spouse are effective in improving marital satisfaction (31). Khalegh Khah et al., in their study, discovered that self-regulation couple therapy could be a useful program for improving the level of marital satisfaction and positive feelings toward spouse (32). Furthermore, in their study, Hassaan Abadi et al. showed that the emotional-centered approach effectively increases positive feelings toward spouses in people with extramarital relations (33,34).
Regarding the current study results, it can be said that the main requirement for a lasting marital relation and a healthy family is positive feelings of couples toward each other, their commitment, closeness, loyalty, trust, and certainty (7). Selfdifferentiation, which is the basis of Bowen's theory, shows that people have reached a level of emotional maturity that allows them to interact with their original family without reacting subconsciously and emotionally under various circumstances. In other words, people are selfdifferentiated when emotional and security needs cannot force them to lose or limit their individuality to receive love and acceptance from others. Having emotional maturity allows people to be skilled in understanding, managing, and expressing and receiving emotions and use this skill to improve closeness in their interpersonal relations and prevent the cooling of relationships (15). Therefore, emotional maturity and having the ability to understand and express emotions in women participating in the therapy sessions resulted in their improved ability at interacting with their spouse, prevented them from worrying about losing the other side's approval, and made them aware of their own needs and their importance and helped them to act and make decisions based on logic and thoughts. Therefore, it is expected for self-differentiation training to improve participants' skills and assertiveness. Emotional cutoff describes the separation and isolation from the family of origin in order to [ DOI: 10.18502/jchr.v10i3.7278 ] escape from conflict. Bowen states that running away from the family of origin is a sign of emotional dependence, which also causes vulnerability (13). Struggling to manage emotional problems with family members displays itself as a cutoff, which is the origin of unresolved attachment. Having an unresolved emotional attachment to their parents is a major issue for the differentiation of self (28). Bowen believes that when poorly differentiated individuals experience intense anxiety in the family, they are inclined to cut off emotional contacts within the family. Emotional cutoffs are usually transferred from the past generation to future generations, and they repeat. When there is cutoff with the past, it is likely also to have marital conflict, withdrawal, and emotional cutoff with the children.
For this reason, having family cutoff with the previous generation leads to dysfunction in the family and poorly differentiated people (9,29). This training uses practical assignments during sessions, effective communication skills, and correct emotional relations to increase positive feelings toward the spouse. This helped participants to keep their connections to others while also maintaining their definition of self (outside and inside the relationship). This resulted in experiencing increased interpersonal communication skills and reduced mental strain. Bowen (1976) explains that well-differentiated individuals make their decisions using their logical thoughts. In their emotional life, they can experience intimacy and achieve closeness without fusion. They are able to deal with conflict, rejection, and separation (28). Dion also showed that Bowen's self-differentiation therapy is effective in emotional reactions and emotional cutoff (37). Self-differentiation training not only helps people to manage their emotions but helps couples to satisfy the emotional needs of each other through suitable emotional reactions and helps them experience positive feelings through their shared experiences, and creates a safe and desirable environment. Before this training intervention, women hadn't received proper selfdifferentiation training and showed negative emotional reactions in stressful situations. The reason for this behavior is the mixing of logic and emotions in stressful situations and the "prioritization of feelings," which are among negative emotions due to their stressful sources.
After participating in this training program, women were enabled to self-regulate their emotional responses and were more capable of creating close and emotional relations. This type of close relationship is formed based on individual "self" situation and their positive emotional responses. Since having a "self" equals having personal beliefs and opinions in one's life and since self-differentiated people have strong senses of self or a more powerful self, they are less likely to change their opinions and behavior to satisfy others. Furthermore, one's "self" situation is related to their ability to maintain self-confidence in relations without fusion with others. As a result, these individuals avoid strong emotional responses under pressure or at sensitive times and act with more dominance. This results in higher tolerance for others' mistakes and higher evaluation of personal differences, turning them into more forgiving individuals (21). As a result, these women attempt to have more love, closeness, and understanding in relations with their spouse and receive more positive feelings, which is the same as the results presented by Nabawi et al. (23).
On the other hand, emotions take over logic in emotional responses, and personal decisions are made based on emotional responses. The severity and method of response to the outside and inside stimuli depends on this emotional response. Since this type of strong emotional response along with a strong self (self-differentiation) results in commitment, sensitivity, generosity, understanding, closeness, loyalty, responsibility, trust, and certain between couples, Bowen's selfdifferentiation therapy is successful in increasing positive feelings toward spouse and therefore improving the health of the family. These results are similar to the studies conducted by Gandy and Dion (28,33).
One of the challenges of this study was lack of follow-up studies due to implementation problems, limiting this study's ability to predict the long-term effects of this therapy method on positive feelings toward one's spouse. Furthermore, due to lack of male participants in the study, the role of husbands in the intervention and the effect of selfdifferentiation in husbands was not investigated which was another limitation of this study. Furthermore, due to limitations and given the multigenerational nature of Bowen's therapy approach, we suggest that future studies ask at least two generations (such as grandparents, family members, and husbands) to be present during therapy sessions. Regarding the sample size of the current study, it is suggested that more expansive studies with a larger number of participants be carried out and for the results obtained using this therapy method to be compared to the results of other therapy approaches.

Conclusion
Bowen's therapy's main aim is to reduce chronic anxiety through awareness of family emotional system, increased self-differentiation levels, and concentration on changing self instead of changing others. In general, when faced with a problem, self-differentiation training is considered to be a suitable therapy approach because differentiation is an indicator of personal independence at emotional and logical levels.
During this training, people learn to make independent decisions and have positive feelings toward their spouse based on logic and control of their emotions.
This approach can be used to solve various marital problems effectively. Therefore, given the effectiveness of Bowen's self-differentiation training in increasing positive feelings toward the spouse, this approach can be used in educational and consolation centers.