Table of Contents
Chapter 1 Genograms: Mapping Family Systems 1
What Is a Genogram? 1
Genograms Map Who We Belong To 2
Using a Genogram to Map Family Structure 4
Exploring Families in Social Context 6
Genograms Challenge Individualistic, Linear Thinking and Foster a Family Systems Perspective 6
Genograms Let the Calendar Speak 7
The Context for Assessing Problems: Belonging, Our Multiple Identities, and the Sense of Home 8
Members of a Family Tend to Fit Together as a Functional Whole 12
The History of Genograms 12
The Importance of Agreeing on Genograms Symbols 14
Multiple Applications of Genograms 15
Using Genograms to Depict Larger Societal Patterns 17
Genograms in Medicine and Nursing 19
Tracking the Genogram of Family Therapy 21
Using Genograms to Explore Specific Patterns and for Family Research 26
Toward Future Developments 32
A Caveat 34
Chapter 2 Creating Genograms 35
Timing of Genogram Interviewing 36
Mapping the Family Structure on a Genogram 36
Dealing with Complex Genograms 36
Mapping Key Information with a Limited Number of Symbols 37
Basic Symbols and Their Location on a Genogram 39
Mapping Couple Relationships on Genograms 40
Mapping Children on Genograms 42
Symbols for Addiction and Other Physical or Psychological Disorders 43
Patterns of Functioning 44
Showing Relationships on Genograms 45
Family Relationships and Roles 46
Relationship Questioning 46
Household, Key Information, & Position of Family Members on a Genogram 48
Information Relevant for Each Family Member 49
Building a Genogram 50
Key Patterns to Note on a Genogram 57
Creating Specific Genograms to Explore Issues or to Promote Resilience in a System 61
Contextual Influences May Include: 63
Institutional Affiliations
Physical/Psychological/Spiritual Activities
Support Systems
Business and Governmental Institutions
Values or Interests
Community Connections
Indicating Cultural Background, Education, Occupation, Socio-Economic Situation, Religion & Spirituality on Genograms 63
Exploring Patterns of Functioning, Relationships, and Structure Over the Generations 64
Attending to Missing or "Hidden" Information on Genograms 64
Issues Difficult to Capture on Genograms 65
Chapter 3 The Genogram interview 71
Genogram Interviewing to Engage Families 72
The Family Information Net 73
The Presenting Problem and the Immediate Household 74
The Current Situation 75
The Wider Family Context 76
Resistance in the Genogram Interview 77
Dealing with a Family's Resistance to Doing a Genogram 78
Family's Beliefs About the Problem and About Possible Solutions 79
Diplomatic Inquiry About Basics of Family History and Functioning 79
Socio-Cultural and Religious Background 80
Questioning About Difficult Issues of Cultural and Social Location 86
The Informal Kinship Network 87
Tracking Family Process 88
Difficult Questions About Individual Functioning 88
Setting Priorities for Organizing Genogram Information 91
Essentials of a Brief Genogram Interview 93
Chapter 4 Tracking Family Patterns with Genograms 95
Tracking Balance in the Family Structure, Roles, & Functioning 95
Tracking Relational Patterns and Triangles on Genograms 101
Tracking Families Through the Life Cycle and Critical Life Events 103
Tracking Couples on Genograms: The Joining of Families 106
Genogram Patterns to Track for the Early Parenting Years 107
Tracking the Family with Young Children 108
Genogram Patterns for The Middle Childrearing Years 109
Families at Midlife: Adolescence, Launching, Young Adulthood, Joining as New Couples, and Moving On 109
The Later Chapters of the Life Cycle: Growth, Resiliency, Retrospection, Caretaking, Loss, Grief, and Legacies 110
Tracking Families in Their Ability to Live Beyond Loss 111
Building Family Chronologies 112
Tracking the Family of Erik Erikson: Secrets Over the Life Cycle 112
Tracking Coincidences of Life Events 122
The Buildup of Stressors: Queen Elizabeth's "Annus Horribilis" 122
Tracking Traumatic Coincidental Events: The Example of the Bateson Family 124
Tracking Critical Life Changes, Transitions, and Traumas 126
Tracking Anniversary Reactions 127
Tracking A Family in Historical Time: Social, Economic, and Political Events & Cohort 129
Tracking Social Class, Finances, and Downward Mobility on a Genogram 132
Tracking Migration 135
Tracking Family Caretaking 139
Tracking Specific Themes on a Genogram 142
Tracking Missing Information and Discrepancies 149
Chapter 5 Exploring Family Constellations with Genograms 152
Household Composition 152
Parent-Child Triangles 156
Triangles in Families with Foster or Adopted Children 158
Multigenerational Triangles 159
Family Boundaries: Open and Closed, Insiders and Outsiders 160
Triangles Over Time 162
Remarried Families 165
In Vitro Fertilization 168
Children Raised in Multiple Households 169
Triangles with Pets and Objects 171
Richly Cross-Joined Families 173
Hypotheses About Darwin's Genogram 177
Unusual Family Configurations 180
Children Growing Up in Multiple Families: Foster Care, Adoption, and Orphanage Experiences 185
Adoption Experiences: Steve Jobs 188
Chapter 5 Exploring family Constellations with Genograms 194
Twins 198
Different Roles for Brothers and Sisters 199
The Influence of Loss on Sibling Patterns 203
Oldest Sons and Daughters 205
Middle Children 207
Youngest Children 210
Only Children 212
Sibling Position and Parenting 215
Sibling Relationships in Adult Life 215
Factors That Influence Sibling Constellation 216
Family Constellations Are Not Astrology 222
Chapter 7 Exploring Couple Constellations with Genograms 223
Sibling Position and Coupling 223
Sibling Constellation, Coupling, and Gender 229
Mapping Couple Relationships with Multiple Partners 229
Exploring Couples in the Context of Culture, Time and Place 234
Common Couple Triangles to Look For 243
Divorced and Remarried Families Have A Whole Extra Layer of History and Potential Triangles 245
In-Law and Grandparent Relationships in Remarried Families 249
Putting Couples in Perspective 249
Chapter 8 Exploring Families Through Time and Space with Genograms: The Family Life Cycle 250
Example of Sigmund Freud and His Family 251
The Transition to Parenthood: The Freud Family in 1856 255
The Early Parenthood Years 256
The Middle Childrearing Years 259
The Freud Family at Midlife: Adolescence, Launching, Young Adulthood, Joining as New Couples, and Moving On 261
The Next Generation 266
The Freud Family in Later Life 272
The Great Mandala (Wheel) of Life 275
Chapter 9 Clinical Uses of the Genogram 276
Uncovering Family Secrets: The Carusos 276
Addressing Loss and Trauma 278
Clarifying Family Patterns 279
Refraining and Detoxifying Family Issues 279
Using Genograms to Draw Forth Resilience and to Design Interventions 281
Interventions in Family Medicine 285
Family Patterns, Significant Events, Concurrent Life Stresses, and Cultural Issues 290
How Genogram Information Can Transform Clients' Perceptions of Themselves 295
Genogram Value as a Therapy Tool 297
Chapter 10 Genograms in Medical or Psychiatric Practice, M.D., M.S.P.H. 298
Why Do Genograms as a Physician? 289
Why Not Do Genograms as a Busy Physician? 299
Practical Tips for Doctors Doing Genograms 299
Starting to Do Genograms 300
Pearls from Doing Routine Genograms Over the Years 300
Looking at My Own Family 302
Doing Genograms in the Electronic Medical Record Era 307
Greg and Penny 308
Bob and Nell 311
Larry and Connie 313
Linda, Patrick, and Gino 315
Genograms of Family Medicine/Practice 318
The Joy of Doing Genograms 321
Chapter 11 Family Play Genograms 322
Creating the Genogram Picture 323
The Exercise 323
Using Play Genograms to Invite, Engage, and Enliven The Therapeutic Encounter 325
A Play Genogram Session with Jenny 326
Materials Used for Family Play Genograms 330
Additional Family Play Genogram Exercises 330
Play Genograms for Finding Family Resources 331
Case of Alexis: Child Sexual Abuse in Remarried Family 334
The Nogucis: A Family of Outsiders 337
Appendix 344
The Genogram Map 344
Outline for a Brief Genogram Interview 345
Patterns to Trace on a Genogram 346
