Everyone is impacted by their family in many different ways, and every family is different. This is a concept that is often used to help patients understand themselves, their behavior, and their mental health in psychotherapy. One way that therapists come to understand the patient’s family and to help the patient understand their family is with genograms.
Genograms are a visual representation of the patient’s family tree, which includes indicators of the unique and complex relationships between family members and the patient. In this blog, we’ll discuss how genograms work and how they are used in psychotherapy.
Genograms in Systemic Family Therapy
Genograms are most often used in Systemic Family Therapy. Systemic Family Therapy, or Family Systems Therapy, is a therapy that treats the entire family and helps them to understand and improve their interactions with each other. By mapping out the family dynamic, therapists can get a sense of:
- Differentiations of self amongst the family
- Multigenerational transmission of differentiations of self
- Emotional processes
- Family projection processes
- Emotional cutoffs
- Psuedomutability
- Sibling positions
- Societal emotional processes
Genograms in Individual Therapy
Genograms can also be used in individual therapy to help therapists get an understanding of the patient. They help therapists place the big picture events that their patients face in a historical context. They may organize how patients relate to their family members and different generations of their families, assess the function or dysfunction of the family, and identify patterns and themes.
How Genograms Are Mapped
The therapist maps the genogram by getting information from the patient. This can be done during the intake appointment or during some of the first therapy sessions. In creating a genogram, there is a reversal of roles through family therapy. The patient becomes the expert — an expert in their family dynamic. Their therapist is the learner. This allows patients to see how they contribute to their own mental healthcare and may help to set them at ease.
The therapist will ask questions about each member of the family, as well as their relationships with each other and to the patient (in the case of individual therapy). They will ask about any significant family events or childhood experiences. They may also map out other support systems or “constellations.” They may ask about the history of mental health conditions or trauma in the family.
Some things that they’ll consider when creating genograms include:
- Historical clues
- History of illness, physical and mental
- Secrets uncovered as therapy goes on
- Resilience to highlight
- Untimely deaths
Essentially, the therapist will create hypotheses based on their understanding of your family and check those hypotheses with you until they come to a thorough understanding. There may be certain molds that oldest siblings often fall into, for instance, but everyone has different relationships with those archetypes. As therapy goes on, the therapist can better understand that — and therefore better know how to care for you.
They will use symbols over the course of the genogram to map out the family relationships. They may denote marriages or committed relationships, children or miscarriages, ages and deaths, and illnesses. These symbols serve as a shorthand that helps the therapist to express all the complexities of the family dynamic in a limited space.
When creating genograms, flexibility is encouraged. The genogram may change over the course of therapy, as the therapist gets to know you better.
Interested in developing a genogram with your therapist? You don’t have to be in systemic family therapy to broach the topic. Our skilled and compassionate clinicians at Rivia Mind are experienced working with genograms and ready to help when you need it. Contact us today to learn more or to find a provider.
