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genogram - DOC

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									    THE GENEOGRAM: THE FAMILY TREE AS A
                 TOOL
I keep six honest serving-men,
(They taught me all I knew)
Their names are What and Where and When
And How and Why and Who.
R. Kipling, Just So Stories

A geneogram is a visual diagram of family relatedness, structure and history. It combines the usual
demographic date such as age, sex and marital status with the dates of important life events such as births,
marriages, divorces, and deaths. The geneogram also graphically represents the skeletal relationship structure of
two or more generations of a family upon which their collisions, patterns, bonds, and the transgenerational
passage of their culture may be superimposed.

Gathering information is only one of the many functions of the geneogram. For example, the geneogram
functions as an educational tool. It can educate the family into an organic view of itself, provide a rationale for
changes in secrecy boundaries between family members, and allows a working blueprint for change to be
explained clearly to the family involved. The process of construction within the session can engage all family
members in a common task, neutralise destructive conflicts temporarily and bridge intergenerational barriers.
The geneogram also allows the therapist a quick and thorough entry into the family's cultural development,
tradition, and belief, enabling the therapist to make sense out of the gestalt of those family members present in
the therapy session. Finally the geneogram provides a neutral task which may relieve the anxiety of a new
therapist when confronting the
<end of page 68>
unknown, possibly hostile or engulfing family.

Construction of the Geneogram
The geneogram may be constructed on a blackboard in the office in the presence of one or more family
members, or it may be drawn by each family member on paper once the symbols used in its construction have
been explained. After having been taught the means of construction of a geneogram family members can be
asked to construct their own diagrams at home. In this way they can gather information from sources in their
family at home to fill in missing data about their family.

                                       Figure 4.1 Key to Geneograms
The symbols used in the construction of a geneogram are shown in Figure 4.1. These simple symbols can be
used to build up a picture of the most complex family structures. A solid line (______) between a circle and a
square indicates along-term union, either a marriage or a longstanding relationship such as common-law
marriage. It is a symbol indicating that heterosexual bonding has been established. A broken line (------)
between a circle and a square indicated a short-term sexual liaison, such as an affair which may be included
because of its importance to the development of the family quandary. A line descending from the union between
a man and a woman, whether a marriage (solid line) or an affair (broken line) indicates the offspring or issue of
that relationship. Children are usually listed in order of birth date from left to right, including miscarriages, and
are joined on a solid horizontal line if they are full siblings. Full names may be written above each of the circles
and squares and ages may be written within them. Marriage dates are written above the union line while dates of
separation and divorce are written immediately below the union line.
<end of page 69>


                               Figure 4.2 Geneogram of a Nuclear Family



http://www.genopro.com/genogram/

http://www.genopro.com/genogram/Sample.aspx

http://www.genopro.com/genogram/emotional-relationships/
Figure 4.2 is a visual representation of a nuclear family. The geneogram at its present stage reveals that Mrs.
Eva Mae (Rees) Smollett, a 54-year old housewife, married a lawyer, Henry James Smollett, on the 29 February
1948. Following a miscarriage in 1950, they produced a daughter in 1954 named Rose Mae, and a son, Ian
Noel, in 1957. Seven years later, in 1963, Eva had an affair with an unnamed man and separated from her
husband. The separation was temporary. So far the geneogram depicts a two-generational family structure
whose fourth-dimensional origin occurred with the marital bond in 1948. That bond was stressed by an affair
and temporary separation in 1963.

Figure 4.3 continues the geneogram construction further back in time and into the extended family including
grandparents, uncles, aunts, and cousins. Arthur Michael Rees, a farmer, and Rose Mae married in 1922. They
had three children, Kevin, Neal and Eva Mae. Their respective ages at the time of the interview were sixty,
fifty-eight and fifty-four. Neither Kevin nor Neal married. Arthur Rees died in 1963 while Rose Mae died in
1967. George Smollett, a lawyer, married his wife, Rose in 1919. They had two children, George Andrew, fifty-
eight, and Henry James. For convenience the convention of listing offspring by date of birth from left to right
has been ignored in order to show the combination of the two families of origin at the time of marriage. The
ages within the circles or squares and the dates of birth give enough
<end of page 70>


<Page 71 is entirely composed of figure 4.3 in Landscape orientiation>
                            Figure 4.3 A geneogram of an Extended Family




<end of page 71>
information to keep the birth order straight. Alternatively, separate diagrams for each side of the family may be
done before combining them. To continue the description of the family shown in Figure 4.3, George Andrew
married and had two daughters whose names and ages were unavailable. Rose Smollett died in 1940 while Rose
Mae Rees died in 1967 from unnamed causes. Arthur Michael Rees died in 1963 from a heart attack, and
George Smollett died in 1957 from unnamed causes.

A comparison of the foregoing diagrams with their written explanations should clarify the usefulness of
drawing out the family structure rather than writing it down. The organised visual display depicts relationships
with an overview lacking in the verbal description.

Up to this point the family diagrammed has been a relatively simple one. There are families whose complexities
can tax the imagination in attempting to record their geneogram. Three of the most common complexities are
reconstituted families, multiple births, and adoption. The geneogram can be of special use in recording
reconstituted families. The therapist can clearly delineate the origin of each of the various children in the family
to himself as well as to the family members who may never have encountered such a factual display of the
structural anomalies in their family.

Figure 4.4 shows all of the previously mentioned complexities in one geneogram. The family is actually a
composite of several families. June and David Rudge were married in 1950 and produced three children, Joan,
and twins Simon and Justin. The twins are represented on a separate vertical line branching into two further
vertical lines. That they are twins should be clear from their single date of birth as well as their equal ages.
David Rudge died in 1955 in a car accident. June remarried in 1960 to Barry Hamblin. Barry had been
previously married from 1958 to Heather who was pregnant with Margaret prior to marriage. On his divorce in
1960, in which June was "the other woman", he remarried to June. Heather remarried in 1965 to Mark Sutcliffe
who was fifteen years older than she. Heather had again been pregnant prior to marriage. She gave birth to John
in 1966 and three years later gave birth to Josie, now a ten-year-old mentally subnormal child. June and Barry
found that they couldn't have children so they adopted Dora in 1970. Mark Sutcliffe adopted his stepdaughter,
Margaret, in 1970. Margaret married in 1978. In this composite family it would be possible to imagine that
Margaret and her husband were referred for marital problems and that Margaret still maintained relationships
with all of her relatives. It should be clear from the geneogram that there are solutions to drawing the most
tangled of family relationships.
<end of page 72>

<Page 73 is entirely composed of Figure 4.4 in landscape orientation>


                                              Figure 4.4 A Complex Reconstituted Family




<end of page 73>


So far my description has been limited to the mechanics of constructing a geneogram. This description has been
necessary in order to convey to the reader the methods of recording, but has not yet dealt with the dynamic
construction process.

The Process of Geneogram Construction
The production of the geneogram is a process in which the family members and the therapist must co-operate.
The process is complex and may involve a lengthy interaction between the family members, the therapist and
the diagram being constructed. It is within that process that the geneogram ceases to be a sterile shorthand of
history and relatedness. It becomes instead a tool used to explore the family quandary, its origins and its
possible solutions.

Diagrams of the geneogram being constructed have been placed at appropriate intervals within the transcript in
order to show its build up throughout the session.

Therapist
      I know that you have been admitted to hospital with a diagnosis of anorexia nervosa but you were
      unable to keep to the regimen and your discharge caused a great deal of discomfort among your family. I
      look at things from a family point of view so you might find things strange at first. I'd like you each to
      tell me how this illness is a problem for you.
      Angry silence).
Brother (George)
      Someone has to say something!
Father (Richard)
      Our problems don't necessarily arise out of Doreen's illness. There were problems simmering beneath
      the surface before that surfaced, erupted and then went back again.
       <end of page 74>
Therapist
       Sometimes problems get buried and come back in different ways.
Father
       That's right. It was unfortunate that when Doreen first developed this I had trouble at work and the
       frustration was taken home. There were lots of changes. I coped with them but I snapped their heads off
       at home.
Therapist
       Can I interrupt for a second. I like to draw diagrams of the families I see on the blackboard. How old are
       you Doreen? (See Figure 4.5)
Sister
       (Doreen)
       Twenty-two
Therapist
       How old are you? What's your name?
Brother
       George
Therapist
       Who were you named after?
Father
       He was named something else but we found they didn't like it in Ireland.
Therapist
       What was that?
Father
       Named Patrick but apparently that's a Catholic name so we changed it.
Therapist
       Your name is?
Mother
       Jillian Victoria.
Therapist
       And your age?
Mother
       Fifty-eight.
Therapist
       And you are...?
Father
       Richard Arthur and I'm fifty-two.
Therapist
       So you are six years older than your husband. George, did you know that you were named Patrick?
Brother
       Yes. But I've never been called it. I have two birth certificates.
Therapist
       Different years?
Father
       No. You can change the name within three months.
Therapist
       I didn't know that. And when were you two born?
Brother
       2 October 1955.
Sister
         8 May 1952

                            Figure 4.5 The Process of Geneogram Construction, I




         <end of page 75>
Therapist
       Now we were talking about...
Father
       How I brought short-temperedness home with me. It's always been a family trait, but the three of us
       have it in a different form than Mick.
Therapist
       Which three? Mick? Who's Mick?

         (Laughter)

Father
       That's the name she's called. That's the Irish part of her.
Mother
       Don't you write that down.
Therapist
       And you are not Irish?
Father
       No. I'm English. I flare and forget. She flares and then she sulks for days.
Sister
         If there's a feud she will go away to her bedroom and sulk. But we'll sit and fume in the sitting room.
Father
       But we tend to forget afterwards. Mick at times will bring things back that have happened in the past
       next time she flares.
Brother
       I'm surprised she can remember them.
Therapist
       I've suddenly realised looking at you in the office and looking at your family geneogram on the board
       how isolated it looks. There are just the four of you. Is that actually true? (See Figure 4.6).
Father
       Well, I mean, let's face it, I have a sister, one sister.
Mother
       Oh dear. You want to put all that down. There won't be room on the board for my side.
Father
       I have one sister and one nephew.
Therapist
       One sister who is married and has a son.
Father
       My nephew is married and has two daughters. The only other relatives I have are two cousins, one in
       Canada and one who lives in Hastings.
Mother
       And you never see any of them.
Therapist
       Your parents are dead?
Father
       Yes. My family were never close unlike Mick's side which is close knit.
Therapist
       Are your family in Ireland or over here? (See Figure 4.7)
Mother
       They are all over the world but mostly in Ireland.
Therapist
       So you are cut off.
Father
       Yes, she's the odd one out. That of course has a bearing on our problems, must have.
Mother
       Yes, and more so now because until these last few years I used to go regularly every year, but since The
       Troubles over there I can't bear to go there. It's awful. I know I ought to go because my father is elderly
       and I want to see him.
         <end of page 76>

         <All of page 77 taken up with figures 4.6 and 4.7 one above another, portrait>


                                        Figure 4.6 The Process of Geneogram Construction, II
Figure 4.7 The Process of Geneogram Construction, III
       <end of page 77>
Therapist
       How about your mother? Is she still alive?
Mother
       No. She died thirteen years ago. But the way things are over there, I look at The Troubles in a different
       way than them and it causes friction. I've lived in England most of my life since the war so I look at it
       from an English point of view. My sister came over with me to join up but she got married instead.
Therapist
       Is that when the two of you met?
Mother
       Yes. We met at a dance. He was passing through on the way to Africa.
Father
       It became a competition. All the blokes were after her and they were on permanent staff and I was in a
       transient unit. She was very popular.
Therapist
       Why was that?
Father
       She was good looking, a good figure and all.
Mother
       Compliments are flying aren't they?
Father
       She was a good dancer. She was good fun, and very sociable in those days.
Mother
      See what you have done to me. Look at me now!
Therapist
      You tend to do it to each other, don't you? That's the trouble with marriage; it ruins great romances.
Mother
      It does. It should be abolished.
Therapist
      We're kind of talking about and around sex really. How has that side of your relationship gone? Its not
      the kind of thing you like to talk about in front of children. I don't want to spread out the lurid details but
      I'm wondering if you two were ever content with the physical side of it.
Mother
      You mean since we were married?
Therapist
      Or before.
Mother
      Oh not before - there wasn't any physical relationship before, only petting and kissing.
Therapist
      But you never had sexual intercourse before you were married?

       (Silence)

Mother
       Oh come on. You may as well be honest, if we are going to bring that up at all. I wouldn't let him.
Therapist
       You mean he tried.
Mother
       Definitely. You might as well be honest.
Father
       Well if we're going to be honest let's be honest. I was pretty pushy back then and I got what I wanted.
Brother
       I can't imagine him every feeling that way. I accept that he probably did but I can't imagine it.
       <end of page 78>
Therapist
       So you don't come across that way to George.
Father
       No. I think I come across on the cold side to them. I'm emotional inside but I strain to control it. It
       comes out most when I'm angry.
Therapist
       But it doesn't come out in other ways like sadness, love or those soft feelings?
Father
       They can answer that better than I can. Doreen can twist me around her little finger.
Brother
       He's tougher with me.
Mother
       You get everything you want, too.
Therapist
       How about you?
Mother
       Oh I don't get anything. I don't. I've stopped asking.

       (Laughter all round)
Therapist
       Does that include sexual relations?
Father
       We stopped it. She didn't want it so we stopped. Three years ago around the time of Doreen's illness.
       Since Mick had the change of life.
Therapist
       So your periods stopped three years ago and Doreen's never started?
Sister
       Mine started and then they stopped when my mother stopped.
Therapist
       So you are going through the menopause with your mother?

       (Roars of laughter)

Doreen
       I don't get hot flushes or anything.
Therapist
       So your relationship must have changed in some way three years ago. Before that did you enjoy your
       relationship?
Mother
       Its not something you want to discuss before your family is it?
Therapist
       No. I'm not saying you should. But what I would like to do is get the two of you on your own so we can
       explore the effects of this change away from the children.
Brother
       I object to being called a child.
Therapist
       Well you are a child to them aren't you?
Father
       No.
Sister
       Of course he is.
Mother
       Oh, he is.
Brother
       Because they are used to treating me as a child they still treat me as a child in many respects, but when I
       go away to University I'm treated as an adult.
Mother
       You ask to be treated like a child sometimes. All children
       <end of page 79>


       do until they get married and go away.

Therapist
       Is that what it was like with you? (See Figure 4.8)
Mother
       Yes. The Paisleys were like that. My parents never interfered after I married.
Therapist
       And who is the dominant one of you two?
Father
       She has to be dominant.
Therapist
         Yes, I should have guessed that because that's the way the sexual side has gone as well.
Father
       She comes from a matriarchal family and has continued to exercise that.
Therapist
       Did you know that when you married?
Mother
       No, well he didn't know it until it was too late.
Therapist
       So there are two big areas of conflict between you two with the kids trapped in between. First is the
       sexual conflict and the second is who controls the family. If you both come from different families,
       brought up in different ways...
Mother
       Yes, his father was just like him. My sister is the only one who lets her husband run the family.
Therapist
       Does being like his father turn you off of him? I mean is that one of the reasons you're not able to be
       close together?
Mother
       No
Therapist
       Does he turn you off?
Mother
       Completely!
Therapist
       Is it that you don't like him any more or are not in love with him any more.
Mother
       Yes, I'm afraid that is it. It's no use beating about the bush saying I do if I don't, is there? I suppose my
       feelings have just gradually worked off over the years.
Therapist
       You have just fallen out of love with him?
Mother
       I don't even like him, I hate him - no I don't wish him harm, I don't hate him.
Father
       She has hated me for thirteen years!
Therapist
       That would be back in 1961. What happened back then other than your mother dying?
Father
       Ah yes, but something happened before her mother died that caused it. She had an affair with another
       man and I turned to someone else myself.
Mother
       Richard had another woman and he wanted to divorce me and take the children as well.
Therapist
       I see. Did you know about this?
Brother
       Yes, but it is only recently that we've been told.
         <end of page 80>
Sister
      I felt before that there had been something like that. I wasn't surprised. I didn't worry, and I don't think
      George thought about it, he was out of the house.
Therapist
      But you two stayed together.
Mother
       Well, he wanted a divorce and he wanted the children and I knew that he couldn't have the children so I
       took them and went to Ireland for a change and I was there for four weeks when my mother died from a
       heart attack. And then Richard came over for the funeral and he asked me to come back and promised
       that things would be different.

                           Figure 4.8 The Process of Geneogram Construction, IV




       <end of page 81>
Therapist
       So here is one of the fundamental arguments.
Father
       I feel that I fulfilled my part of the bargain, that I have but she has not. She has never forgiven me and
       never will.
Therapist
       You two don't have a very good model for marriage do you?
Sister
       But I have to live with it. No wonder I've been depressed almost all my life.
Brother
       But we don't have to follow that model do we?
Sister
       But I can't get out. I mean I'm stuck. I've got nowhere to go. He's alright. He's at University so he's well
       out of it but if I leave I don't know what will happen to them.
Therapist
       Even if you leave you won't stop your way of thinking about them.
Mother
       What can we do about it?
Father
       She'll have to learn to live with it until she conquers this emotional bond she has to live with.
Therapist
       Which bond? (See Figure 4.9)
Father
       The bond which makes you worry even if you weren't there. I've been through it with my parents. My
       sister opted out. She was at nursing school and she got married and opted out completely. And I was
       stuck at home.
Mother
       Well, of course we lived with them for five years after we were married and they were always fighting
       and...
Father
       I was always there and even when we were on our own I still had this worry, this emotional conflict over
       the fight that went on at home between my mother and my father and my sister...
Therapist
       Are you the younger brother?
Father
       Yes. My sister is the same age as my wife. And when my mother died, my father lived for some years
       afterwards. You would never know that they argued because as far as he was concerned the only things
       that existed were the happy times and I wondered then why I fought and battled with them both to keep
       them together.
Therapist
       Its terrible what parents do to their children, isn't it?
Mother
       It is. I don't think people should have any more.
Sister
       No children, no world.
Therapist
       If you didn't have Doreen or if she starves herself to death then you could split?
Father
       You are assuming that we want to split. She might want to split but I don't.
Mother
       That's what we're trying to avoid. Doreen starving to death. As for me leaving where would I go?
       <end of page 82>
Doreen
       They can't agree on anything.
Therapist
       It seems to me that families are composed of different units and it sounds as if your marital, your parent
       unit is the major problem and that you are both reacting in different ways, opposing ways to the
       quandary you're in.
Mother
       You're right. That's exactly it.
Therapist
       And Doreen and George are doing the same thing that you and your sister did with your parents.
Father
       You see, even when my mother died there was conflict between me and my father and my sister over the
       Will and the possessions.
Therapist
       When did she die, your Mom?
Mother
       Twenty-three years ago wasn't it?
Brother
       1951.
Therapist
       So Doreen wasn't born then.
Father
       Doreen was conceived after my mother died because my wife wanted to start a family then.
Mother
       I don't remember that.
Father
       Well, its true. It was your choice.
Therapist
       Rather than his?
Mother
       I wouldn't say rather than his. It was one of the few joint things we made.
Therapist
       See that. No wonder you're stuck. No wonder you can't opt out. How about George? Was he planned?
Mother
       He was planned. He didn't just happen.
Brother
       I'm surprised.
Father
       Ten years after we were married she had him planned. We lost one between Doreen and George, at three
       months.
Therapist
       I didn't know that. How did that affect you?
Mother
       Well, don't forget that the first six years of our married life we lived in two rooms in his father's house
       and that was a very unhappy time for me.
Therapist
       How did you get on with his father?
Mother
       Very, very badly. In fact, for years he never spoke to me and I used to take pills for my stomach all the
       years we stayed in that house. I felt that Richard was happy there with his father and mother and he
       didn't want to move. He had everything and even though it was affecting my health he wouldn't do
       anything about it.
Therapist
       When were you married?
Father
       1945, in August.
Mother
       So in fact we have a very bad start right from the beginning.
       <end of page 83>


                           Figure 4.9 The Process of Geneogram Construction, V
Therapist
       Well, time is moving on and I think we'll have to stop there. I want to see the two of you alone next
       time. I don't know if you have learned anything new today about your parents but if you can...
Father
       They must have. They said they didn't know she was good looking.
Therapist
       ...If you can go away at least remembering that the family quandary has to do with them and not with
       you I think you'll have gained something.
       <end of page 84>
Brother
      I think we dimly realised that before we came.
Therapist
      Yes, well maybe none of the other doctors spelled it out. As I see it Doreen has to learn to be able to opt
      out more while you two have to come to some sort of resolution, and you need someone else to do it
      because you've been at it for several decades without doing it on your own.
Mother
      What will happen to your lovely little picture now. You'll have to rub it out, won't you?
Therapist
      No, I'm going to copy it down on to paper. I'm afraid we haven't spent any time on anorexia. But it didn't
      seem as important.
Mother
      No, we haven't, have we?
Sister
         Thank God.

The Geneogram as a Tool
The history-taking process logically extends to use of the geneogram as an educational aid. The family must be
apprised of the basic premise of family therapy; that the family is an organism. To family members
labelled with an individual illness such as depression, agoraphobia or frigidity, this concept is an alien one
which must be taught. The interlinked structure of a geneogram provides a lucid illustration of the family
organism. The family educational process can then proceed to the transgenerational model of the family
organism possessing the fourth dimension of time. Repetitive patterns which are visible in the geneogram
structure from generation to generation can illustrate this point. In fact, most of the concepts applying to family
therapy can be usefully taught to families using the geneogram which has been drawn on a blackboard in front
of the family during the session.

								
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