How to show multiple marriages on a genogram

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Gathering family information and constructing a genogram should always be part of a more general process of joining, assessing, and helping a family. The information is gathered and organized as family members tell their story. While basic genogram information can be collected in a structured format as part of a medical record, the information should always be treated with respect and gath- ered for a purpose. Sharing a family's history is a sacred relationship, not a mat- ter of technical fact-gathering.

Genogram information can be obtained by interviewing one famlly mem- ber or several. Clearly, getting information from several family members increases reliabil~ty and provides the opportunity to compare perspectives and observe interactions directly. By interviewing several family members, we get many points of vlew, and together these verslons become a whole story.

Since family patterns can be transmitted from one generation to the next, the cllnlc~an should scan the genogram for patterns that have repeated over several generations. Such repetitive pattems occur in functioning, relation- ships, and famlly structure. Recognizing such pattems often helps families avoid repeating unfortunate pattems or transmitting them into the future. Tracking critical events and changes in family functioning allows us to notice anniver- sary reactions, make systemic connections between seeming coincidences, assess the impact of traumatic changes on family functioning, its resources and vulnerability to future stresses, and then try to understand such events in the larger social, economic, and political context. This tracking enables the clini- cian t o seek ways to promote resilience based on past sources of strength and modify adaptive strategies that in the past have proved dysfunctional.

Of course, seeing several family members is not always feasible, and often the genogram interview is used with one person. The time required to complete a genogram assessment can vary greatly. While the basic information can usu- allv be collected in 15 minutes, a comprehensive familv assessment interview involving several family mernbers may take one to two hours. Clinicians often prefer to spread the interviewing over a number of sessions or to develop the genogram as they go along in their work with families.

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Mapping the Family Structure T h e backbone of a genogram is a graphic depiction of how different family members are biologically and legally related to one another from o n e genera- tion to the next. This map is a construction of squares and circles representing people and lines delineating their relationships.

Each family member is represented by a box (male) or circle (female), depending o n his or her gender (Genogram 2.1). For t h e index person or iden- tified patient (1P) around whom the genogram is constructed, the lines are dou- bled, as for Woody Allen and Mia Farrow o n this genogram. For a person who is dead, a n X is placed inside t h e symbol, as indicated for Mia's brother Michael and her Darents J o h n and Maureen. Birth and death dates are indicated to the left and right above the symbol. T h e person's current age or age a t death is usu- ally indicated within the symbol, as indicated for Mia's oldest brother Michael, who died in 1958 a t t h e age of 19. T h e figures representing family members are connected by lines t h a t indicate their biological and legal relationships. Two people who are married are connected by lines t h a t go down and across, with the husband o n t h e left a n d t h e wife o n t h e right, as indicated o n Genogram 2.1 for Martin and Nettie. "m." followed by a date indicates when t h e couple was married. Sometimes o n l y t h e last two digits of t h e year are shown (e.g., met

Genogram 2.1 Woody Allen and Mia Farrow

room. WA NU" the",

umio Kooigsbug m a l P m 3 1

Allan Stewart Ko-iphrl Mia F a m w (Woody *Il.s,)

Rank si0.w Andm R r r i n

logcUla 80 1 9 1 .................................................... / .....................................................

Developing a Genogram to Trairk Famrly Pattern 15

29 m. 3 1 ) when there is little chance of confusion regarding the appropriate century. The marriage line is also the place where separations or divorces are indicated. The slashes signify a disruption in the marriag-ne slash for sepa- ration (as in Mia Farrow's separation line from Woody Allen, which occurred in 1992 (indicated by s. 92) and two for a divorce (as in the divorces of Mia from Frank Sinatra and Andre Previn and of Woody from his previous wives. In extended genograms that go back more than three generations, symbols for individuals in the distant past are not usually crossed out, since they are pre- sumably dead. Only relevant deaths are indicated on such genograps. Other

Genogram 2.2 Fnsrer and adopted children, twins, miscarriages, sctllbirrhs, aborr~ons, pregnancies

I fraternal ide~tical adopted foster miscarriage stillbirth abortion pregnancy twins owios child child

symbols are used to indicate twins, foster and adopted children, pregnancies, miscarriages, abortions, and stillbirths (Genogram 2.2). Converging lines con- nect twins to the parental line. If the twins are identical, a bar connects them to each other (Genogram 2.2). A dotted line is used to connect a foster child to the parents' line, while a dotted and a solid line connect an adopted child to the parents' line (Genogram 2.2).

Genogram 2.3 Husband w ~ t h many wives: Henry VIII

16 GENOGRAMS: ASSESSMENT AND ~NTERVENT~ON

Genogram 2.4 Husband (Ted Turner), wife (Jane Fonda), and several partners of each

Ted Turner Jane Fondn 1. I . Ebaugh Judy Roger Tom

Vadim Hayden

m. 1965.70 m 1973-s. 19% d. 1991 '../ .... ,, , N // ,/

Multiple marriages add a degree of complexity t h a t is challenging to depict. Genogram 2.3 shows one way of indicating several wives of o n e husband ( t h e wives of King Henry VIII). T h e rule of thumb is that, when feasible, the dif- ferent marriages foIlow in order from left t o right, with the most recent mar- riage coming last. T h e marriage and divorce dates should also help to make t h e order clear. However, when each spouse has had multiple partners (and possi- bly children from previous marriages), mapping t h e complex web of relation- ships can be very difficult indeed. O n e solution is t o place t h e relationship you are focusing o n in t h e center and the partner's other spouses off t o t h e side, as in Genogram 2.4 (Jane Fonda a n d Ted Turner). Of course, such situations c a n get very compIicated, as they d o for Jackie Kennedy's sister Lee Bouvier (Genogram 2 . 5 ) , because Lee's first husband, Michael Canfield, went o n t o many a woman, Laura Dudley, whose first husband, Eric Dudley, went o n to marry Stas Radziwell's previous wife, Grace Kolin.

Genogram 2.5 T h e Bouvier family

81mct lack B0v"icr

A u h r o r N o u . I.. Nio.

Onuris b w a G-e -75 j Dudlry r*IdlcY Kolm sw ~ . d u = ~

-63 lack Michael

flair 62-3

. . . . . . . . . . . . . . . . . . . . . . . . . . n. 53 r 51 m. sa

Developing a Genogram to Track Family Partems 17

Genogram 2.6 Fonda rnarrlages

If previous spouses have had other partners, it may be necessary to draw a second line, slightly above the first marriage line, to indicate these reIationships. For example, in Genogram 2.6 (Henry Fonda), each spouse has been married several times. Henry's first wife, Margaret Sullavan, had been married once before she married him, and she remarried afterwards. Fonda's second wife, Frances Seymour, had earlier been married to George Brokaw, who himself had previously been married to Clare Booth, who in tun1 later married Henry Luce.

Whenever possible it is preferable to show children from different marriages in their correct birth order (oldest on the left, youngest on the right). But some- times, when there are-many partners, this becomes impossible, as with Genogram 2.6, where Jane and Peter Fonda are shown after Amy, their adopt- ed half-sister, who was 13 years younger than Peter, but who grew up with them for the first two years. Their older half-sister, Pan, who was five years older than Jane and lived with them from age five until she went to college, is also not shown in birth order, since, in fact, she was the oldest of all. A n alternative genogram showing all the Fonda siblings in birth order (Genogram 2.7) could be relevant for understanding the siblings in relation to each other. Notice that in this case Brokaw's next wife, Clare Booth Luce, has been omitted to keep the graphic clear. With complex families like this, choices always have to be made between clarity, accuracy, and level of detail.

Genogram 2.7 Fonda children in birth order

Genogram 2.8 Heterosexual and homosexual couple relationships: Jodie Foster's family

I f a couple are involved in a love affair or living together but not legally married, their relationship is depicted as with married couples, but a dotted line is used (as shown for Mia Farrow and Woody Allen in Genogram 2.1). When spouses have had partners of both sexes, it may be necessary to draw separate connecting lines to clarify who had a relationship with whom. Genogram 2.8 shows the family of lodie Foster. Her father Lucius fathered children by five partners: three wives and two other partners. The dates for lodie's mother, Brandy Almond's marriage to Lucius are indicated by "m. 54 s. 59 d. 62." Recording the specific dates to track couple relationships can be significant in tracking family patterns. Jodie, for example, was conceived and born three years after the parents separated, indeed shortly before the divorce came through. It turns out she was the product of the father's financial, emotional, and physical abuse of the mother, conceived under pressure from the father for sex in return for owed child support.

lodie's mother was in a committed couple relationship with 10 Dominguez from 1959. The couple began living together in 1962 ("LT 62"). lo's promi- nence in the family is indicated by depicting the couple line for Brandy and Jo just above that of the biological father. "Aunt lo" became a haven of stability to the children, providing financial, physical, and emotional support to them for many years. They separated in 1969. lo's husband is shown smaller and high- er, along with the woman he spent the rest of his life with. He never divorced lo and was thus not free to many again, so his other relationship is indicated with a dotted line.

If a couple has children, each child's symbol hangs down from the line that connects the couple. Children are drawn left to right, going from the oldest to the youngest, as in Genogram 2.1, with the index person shown lower than the others, to distinguish him or her. If there are many children in a family, an alter- nate method (depicted for Margaret Sullavan and Leland Hayward's three chil- dren, Brooke, Bill, Bridget, on Genogram 2.6) may be used to save space. Parents of the index person are also depicted larger and lower than their sib- lings to clarify their importance (see Woody and Mia on Genogram 2.1).

Developing a Genogram to T~ack Famrly Patterns 19

Grnogram 2.9 h h a Farrow's children: Blologlcal and adopted

Single parent adoption can be indicated as in Genogram 2.9. This genogram shows the fanlily of Mia Farrow, who had biological children (including twin sons, Matthew and Sasha) and interracially adopted children (Soon-Yi, Lark, and Dalsy) wlth her second husband, Andre Previn. She then adopted another interracial child (Moses) and one who was American born (Dylan/Eliza) during her relationship with Woody Allen, after which they had a biological child together (Satchel, now called Seamus), and finally she adopted five more chil- dren on her own, Tam, Kaell Shea, Isaiah, Thakdeus, and Frankie-Minh Farrow. If at all possible, we indicate the cultural background, since it is an important part of anyone's history.

Where living situations are complicated, a line can be drawn to encircle the household(s). This is especially important in multi-nuclear families, where children spend time in various households, as in Genogram 2.10 for Jackie Bouv~er Kennedy and her sister Lee after their parents' separation when Jackie was seven. During the school year they lived with their mother, maternal grandparents, and maternal greategrandmother. During the summers they spent tlme w ~ t h then father, paternal grandparents, and all their paternal cousins on Long Island.

When the "functional" family is different from the biological or legal fami- ly, as when children are raised by a grandparent or in an informal adoptive fam- ily, it is useful to create a separate genogram to show the functional structure

20 GENOGRAMS: ASSESSMENT AND I N T E R V E N ~ O N

Genogram 2.10 The family of Jackie Bouvier (Kennedy)

(see Watts Jones, 1998). Where children have lived as part of several f a m i l i e s biological, foster, and adoptive-separate genograms may help to depict the child's multiple families over time (Genogram 2.11; see also Colon's genograms in Chapter 3). McMillen and Groze (1994), who have suggested another way to show children who have grown up in multiple placements, suggest accom- panying the graphic with a chronology, as shown in Genogram 2.12.

We can also indicate on a genogram (Genogram 2.13) a lesbian couple with a child born to one of them and adopted by the other. The very small square indi- cated as the biological parent of Meg is a sperm donor. Fran and Martha, the par- ents of Meg, had previous couple relationships that are also indicated on Genogram 2.13. Burke and Faber (1997) have suggested using a "gendergrid," an adaptation of the genogram, to help to depict the liaisons, long-term bonds, communities, and social networks of lesbian couples. The gendergrid provides for three levels of relationship: historical influences, primary emotional and social influences, and primary intimate relationships for an individual or a couple.

Constructing the Genogram Using the basic symbols and procedures for mapping the family structure o n a genogram, we can illustrate the construction of a genogram for Sigmund Freud. Neither Freud nor his biographers ever did extensive research into his family, and the details of his family life are sketchy. Nevertheless, we do know the basic structure of the Freud family.

Developing a Genogram to Track Family Patterns 2 1

Genogram 2.1 1 hlultiple livlng s~tuations of child raised in foster care and adoption w

Age 0-2 B W F d y

Fiml Fmorur F d y

John

rrrdennal rchm

Age 8-10 Rssrdroud Tru-l

If we map a basic three-generational genogram for Freud (Genogram 2.14) we can see Sigmund and his siblings, and then we can look back a generation and include Sigmund's parents with their siblings and parents (Sigmund's grandpar- ents). To highlight his central importance, the figure for Sigmund is lowered out of h e sibling line. T h e same has been done for the parents, Jacob and Amalia. In general, s~blings are shown in a horizontal line, except for any who have died early; they, like Sigmund's brother Julius, are depicted higher and smaller.

In taking a genogram we usually go back to the grandparents of the index person, including a t least three generations on the genogram (four or even five generations if the index person has children and grandchildren). T h e spouses of siblings are also usually placed slightly lower than the siblings themselves, to keep the sibling patterns clear.

T h e year that a genogram depicts is usually written in the upper lefthand comer. Usually the genogram depicts the current year, but a clinician might also use the genogram to freeze-frame a moment in the past, such as the time

Genogram 2.12 Placement genogram based on M c M i l l e n & Grors (1994)

.,.&%I q Q QI Q Family

h p a r u o l 1n1orm.um

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A d j u r d well in horn Gmd rclstimrhlpr wtlh lorur lull. I r f f g e c m = r and l a t e r 1-ly mkd A m b d vlmr pmblcm m u n d s h

Robl.rn, in r b m l hvon u t c r flmily or

Running .ray Roblcm m whml Dllrcrpcdul wilh s d f Rlt"S2 m ~ O C ~ O N

of symptom onset or critical change in a family. When we choose one date in a person's life, other information, deaths, ages, and important events are calcu- lated in relation to that date. It is then useful to put each person's age inside his or her figure. If the person is dead, the age a t death is used instead (Chapter 6 shows a number of Freud genograms for different dates in the family's life cycle, indicating the ages of family members at each point).

Genogram 2.13 Lesbian family

Biological child v r F m Adopled n blnh by Msnhs

Devehping a Genogram to Track Family Patterns

Genogram 2.14 Sigmund Freud family

When only partial information can be unearthed, that is included. For instance, Sigmund's father was married three times. We know that he had four children with his first wife, two of whom died early, but nothing is known about these two children or about his second w~fe, Rebecca. T h e third wife, of course, was Sigmund's mother, Amalia Nathansohn.

Tracking Family Patterns on the Genogram

Once the basic family structure or skeleton of the genogram is drawn, we can start adding information about the family, particularly about demographics, functioning, relationships, and critical family events. A t times it may be useful to make several different genograms to show the different kinds of information.

Demographic Information: Getting the "Facts" In fleshing out the history of the nuclear and extended families, our initial con- cern is with getting the "facts" on each family member. These are the vital sta- tistics of the family, the type of objective data that can usually be verified by public record. Demographic information includes ethnic background, ages, dates of birth and death, whereabouts, income, occupation, and educational level. There is a specific place to put some of this information: current age or age at death (inside the symbol); birthdate (above left); deathdate (above right); income (above birth and death dates). T h e other demographic informa-

Genogram 2.15 Fonda family: Demographics

Dhuh (1Wi.n) Aosb h s l o

Wm BRrs Fan&

A l d r n S h i r k 1 P r m s k " *d.",.

Forhcr did "0, ."

vmuu Tmy ncnru 8.589 8.A W

tion goes near the person's symbol wherever there is room (see Genogram 2.15 for Fonda family demographic information). The following information would be relevant for each family member:

dates of birth, marriage, separation, divorce, illness, and death (includ- ing cause) sibling position ethnic, class, and religious background any changes in class through education, income, or marriage current religious practices occupation and education current whereabouts

As the clinician collects more and more "facts" about family events, certain gaps will appear in the history. The clinician can use the genogram to map the family's evolution through time and to broaden the histurical perspective on the family. A t times family members themselves become so interested in their story that they begin historical research to expand their perspective. Family members may learn more information by speaking to relatives, consulting farn- ily bibles, reading local or regional histories, or obtaining medical and genealogical records.

Developing a Genogram ro Track Family Pattern 25

Genograrn 2.16 Fonda family: Functioning

P m n b r n w

4.3 .d&k

vm- 'h, U d** 83.89 ,j,,,i,,", .a PPL1L"ho, *lflim&

father on h~ncynoa

Information about functioning includes more or less objective data on the medical, emotional, and behavioral functioning of family members. Objective signs, such as absenteeism from work and drinking p a t t e r n , may be more useful indications of a person's functioning than vague reports by family members that someone is "weird." Signs of highly successful functioning should also be includ- ed. T h e information collected on each person is placed next to his or her sym- bol o n the genogram. Addictions are shown by filling in the bottom half of the square or circle. Those in recovery from addiction have only the lower left half filled in, while the lower right half has only slash marks (as shown for Ella o n Genogram 2.21). If they have attended therapy, AA, or another recovery pro- gram, or indeed if they have any strong institutional affiliation, such as with a church, fraternal organization, or other group, this can be indicated by a line out to a triangle. On Genogram 2.16 triangles linked to Ted Turner and Peter Fonda indicate these relationships with their therapists. T h e dates of treatment can also be shown. Suspected alcohol or drug abuse can be indicated by slanted lines o n the bottom half of the symbol, as indicated for Peter Fonda o n Genogram 2.16. In Peter's case, he has acknowledged using drugs over many years, but sees himself as lucky that it never became an addiction (Fonda, 1998).

Serious mental or physical illness can be indicated by filling in the left half of the symbol. In general, the nature of the illness should also be indicated near the symbol. Where a person has both an addiction and a mental illness, three- quarters of the symbol is filled in, and where he or she is mentally ill but in

recovery from addiction, the left half is filled in, and the lower right has light dots. Genogram 2.16 shows the functioning information for the Fonda family.

P a t t e r n of Functioning T h e functioning of family members may repeat itself across several generations. I n such cases, a particular style of functioning (whether adaptive or maladap- tive) or of dealing with problems is ~ a s s e d down from one generation t o the next. This transmission does n o t necessarily occur in linear fashion. A n alco- holic father may have children who become teetotalers, and their children may again become drinkers.

Often the presenting problem of the family will have occurred in previous generations. Numerous symptomatic patterns, such as alcoholism, incest, physi- cal symptoms, violence, and suicide, tend to be repeated in families from genera- tion to generation. By noting the pattem repetition, the clinician may be helped to understand the family's present adaptation to the situation and to short-circuit the process. For example, let's look again at the Fonda genogram (Genogram 2.16). Margaret Sullavan's daughter Brigit Hayward committed suicide less than a year after her mother did the same. Given the evidence that one suicide seems to make suicide an option for others in the family, specific efforts at suicide pre- vention may well be indicated in such families. T h e same can be said for preven- tive intervention in families with a history ofsuch symptoms as alcohol abuse and incest. For example, Ted Tumer (Genogram 2.17) reached a crisis at age 53, the same age at which his father had shot himself in the head with the gun with which he had taught Ted to shoot years before. Ted, like his father, had led a dri- ven life of work and hard drinking. But in this case Ted managed n o t to repeat his father's pattem, and, in fact, that age became for him a time of critical trans- formation of his life. I t was the year h e married J a n e Fonda. Both of them gave up drinking, and Ted committed himself to expanding his life rather than letting his obsession with work drive him over the edge, as it had with his father.

Clinicians can crack multigenerational patterns of resilience, strength, and success as well as failure (Walsh, 1995, 1998). All families should be assessed for their resilience as well as their problems. Among the most amazing in this book are the Hepbums (Genogram 3.6), who illustrate the repeated trauma of suicide and depression along with the resilience and power of strong women on their own; the Fondanumer families, which show a n amazing ability to survive and transform themselves beyond the trauma of loss, suicide, silence, and men- tal illness, turning hardship into productivity and self-regeneration; the Belt family (Genogram 5.4), in which deafness is complemented by inventiveness and resourcefulness with sound; and the genogram of Frida Kahlo and Diego Rivera (Genogram 5.5), which illustrates a n amazing ability t o transform cul-

Deueloping a Genogram to T~ack Family P a t m

Genogram 2.17 Ted Turner family: Functioning c,.nnum

tural difference and disruption, loss, trauma, and physical disability into tran- scendent strength and creative energy. The Blackwell family genogram (Genogram 2.18) shows a pattern of strong and successful women. Included in this remarkable family were the first woman physician and the first woman minister in the U S . , as well as numerous other successful woman physicians, ministers, artists, and suffragettes. Yet patterns of success and failure may coex- ist in the same family and in each succeeding generation. Looking again at the Blackwell family, we see that among all these successful women, one daughter in each generation appears to have been an invalid.

Another common functioning pattern is success in one generation followed by remarkable failure in the next. This may be particularly true of the families of famous people, where children may rebel against pressure to live up to the repu- tations of their parents. The Adams family (Genogram 3.13) is a powerful exam- ple of that phenomenon, with all but one of the children of John A d a m having serious problems. T h e same was true for the one successful son in that second gen- eration, John Quincy Adams, whose first two sons had serious problems. Only in the next generation did the one successful son, Charles Adams, manage to pm- duce a group of children who were, all but one, relatively functional.

Specific patterns of functioning may also be repeated across the generations. A good example would be the family of Carl Gustav Jung (Genogram 2.19). A

GENOGR~MS: ASSESSMENT AND ~NTERVENTION

Genogram 2.18 Blackwell family

quick glance at his genogram shows the preponderance of ministers: Jung's father, two paternal uncles, all six matemal uncles, the matemal grandfather, and two maternal granduncles. Next one sees that both his paternal grandfather, for whom he was named, and his paternal great-grandfather were physicians; finally, one can note several family members who believed in the supernatural: his mother, matemal grandfather, and matemal cousin, Helena Preiswerk, who claimed to be a medium and whose seances Jung attended in his youth. Thus, his becoming a physician with a profound interest in religion and in the super- natural very much fit with the predominant patterns in his family.

Family Relationships and Roks The third level of genogram construction is the most inferential. This involves delineating the relationships between family members. Such characterizations are based on the report of family members and direct observations. Different lines are used to symbolize various types of relationship between two family members (Genogram 2.20). Although such commonly used relationship descriptors as "fused" or "conflictual" are difficult to define operationally and have different connotations for clinicians with various perspectives, these sym- bols are useful in clinical practice. Relationships in a family do, of course, change over time, so this aspect of genograms is one of the most subjective and most

Detrloping a Genogram to TTnck Family Pattern 29

Genogram 2.19 Jung family

subject to change. Furthermore, one might argue that any conflictual relation- ship implies underlying connection, so that any highly conflictual relationship by definition reflects fusion as well as conflict. However, the fused/conflictual lines are usually used to illustrate a relationship that shows a high degree of con- nection as well as conflict at an overt level. Cut-offs can also involve great con- flict or silent distanc~ng. Dominance or relationships in which one person focus- es an enormous amount of energy on another may be illustrated by a heavy straight line with an arrow in the direction of the one who is focused upon, as in Genogram 2.20. Other important relationships, such as h~stilelde~endent and ambivalent ones, are harder to depict on a genogram. Relationships involv- Ing physical or sexual abuse are deplcted by a zlgzag line ending in a filled-in arrow, indicating who was abused by whom (Genogram 2.20).

Since relationship patterns can be quite complex, it is often useful to repre- sent them on a separate genogram. Questions on relationships include:

Are there any family members who do not speak to each other or who have ever had a period of not speaking? Are there any who werelare in serious conflict? Are there any family members who are extremely close?

GENOCRAMS: ASSESSMENT AND ~ N ~ R V E N T I O N

Genogram 2.20 Relationship lines on a genograrn

W h o helps out when help is needed? In whom d o family members con- fide? All couples have some sort of marital difficulties. W h a t sorts of problems and conflicts have you encountered? W h a t about your parents' and sib- lings' marriages? How d o you each get along with each child? Have any family members had particular problems dealing with their children?

T h e clinician should get as many perspectives o n family relationships as pos- sible. For example, the husband may be asked, "How close do you think your mother and your older brother were?" T h e wife might then be asked for her impression of that relationship. T h e goal is to uncover differences, as well as agreements, about family relationships and to use the different perceptions of the family to enrich the genogram picture for both the clinician and the family.

From the relationships between family members, the clinician also begins to get a sense of the complementarity of roles in the family. Questions that eluci- date the role structure include:

Has any family member been focused o n as the caretaker? T h e problem-

atic o n e ? T h e "sick" o n e ? T h e "bad" one? T h e "mad" one? Who in the family is seen as the strong o n e ? T h e weak o n e ? T h e domi-

nant one? T h e submissive o n e ? W h o in the family is seen as the successful o n e ? T h e failure? W h o is seen as warm! As cold? As caring? As distant!

Labels or nicknames used by family members are particularly instructive. Often, each family member has a family-wide label that describes and even circumscribes

Developing a Genogram to Track Family Pattems 3 1

liis or her position in the family, e.g., the tyrant, the supermother, the star, the rebel, or the baby. Labels are good clues to the emotional patterns in the system.

sometimes it is useful to ask how members of the present family would be characterized by other famlly members, e.g., "How do you think your older brother would describe your relationship with your wife!" or "How would your father have described you when you were 13, the age of your son now?" Again, gathering as many perspectives as poss~ble e n r ~ c h e s the family's view of itself and introduces channels for new information.

Relationsh~p patttlms of closeness, distance, conflict, etc., may also repeat themselves over the generations. Genograms often reveal complex relational pat- terns that would be missed if not mapped across a few generations. Recognizing such patterns can, it is hoped, help families avoid continuing the repetition in future generations. O n e example of such a repetition would be a family in which mother and son in each generation have a special alliance while father and son have a negative conflictual relationship. Realizing t h e predictability of such a pattem and the m ~ l t i ~ e n e r a t i o n a l programlning involved, a son might choose consciously to change his relationship with his parent5 to vary this pattern.

T h e O'Neill family (Genogram 2.21) shows a multigenerational pattem of estrangement between father and children. James O'Neill's father deserted his

Genogram 2.21 O'Ne~ll family: Repetitwe patterns

family, returned to Ireland and probably committed suicide. Both Eugene and his older brother Jamie felt estranged from their father, although they were both totally dependent on him emotionally and financially, and all of them blamed each other for the mother's drug addiction. In the next generation, the p l a y wright refused to see or even mention the name of his daughter Oona after her marriage to Charlie Chaplin or his son Shane after Shane's son died of neglect. O'Neill never even saw his oldest son, Eugene, Jr., until he was 12, and he was estranged from him at the time of this son's suicide.

In the family of Eleanor Roosevelt, the pattern was one of mother-daughter resentment and close feelings between father and daughter (Genogram 2.22). Although both her parents had died by the time she was 11, Eleanor remem- bered having a special relationship with her father while feeling her mother was harsh and insensitive to his predicament. Her father was in fact a n alcoholic and irresponsible, and her mother had to have him committed to a n asylum and later she separated from him. In the next generation, the daughter, Anna, an oldest like Eleanor, preferred her father and saw her own mother as overly harsh. Throughout her adolescence she had a stormy relationship with Eleanor, which did not change until her father contracted polio. Eleanor felt the ulti- mate betrayal in her daughter Anna's entertaining FDR and his girlfriend behind Eleanor's back at the m i t e House and C a m p David. But in later life Eleanor and A n n a reversed this pattern of mother-daughter cut-off a n d became very closely connected (see McGoldrick, 1995).

- Genogram 2.22 Eleanor Roosevelt's family: Repeated patterns

Developing a Genogram to Track Family Pattew 33

Critical Life Events Predictable life cycle transitions and unpredictable nodal life events are tracked on a genogram; they include important family transitions, job changes, entrances and exits of family members, relationship shifts, moves or migrations, losses and successes. These give a sense of the historical continuity of the fam- ily and of t h e effect of the family history on each individual. Some of these events will have been noted as demographic data, e.g., family births and deaths. Others include new romances, marriages, separations, divorces, moves, and job changes. Critical life events are recorded e ~ t h e r in the margin of the genogram or, if necessary, on a separate attached page.

l l e r e are certain critical life events that may be important t o explore in detail.

How did other family members react when a particular family member was born? W h o attended the christening ceremony or bris? W h o was named after whom and who "should have been"? How did the family react when a particular family member died? W h o took it the hardest? T h e easiest? W h o attended the funeral? W h a t was the effect when the will was read? W h o wasn't there? W h o "should have been"? W h e n and why did the family migrate t o this country? How did they cope with the multiple losses of migration? How many generations of the family have lived in the U.S.? W h a t was the context into which they came and how did they fit into it! How did the initial generations man- aee t h e adaotation to these new circumstances? How did thev survive? - Which members of the immigrant generation learned the language? W h a t gender constraints have the women and men in the family expe- rienced? W h a t cultural prejudices have family members experienced?

Family Chronologies I t is useful t o keep a family chronology (or listing of important family events) with the genogram (Weber & Levine, 1995). A timeline of important family dates is a n excellent way to track family patterns. I (MM) remember being stunned the first time I did my own chronology to see that the only two major health threats of my life before midlife were breast tumors that occurred a t ages 17 and 20, within six months after the only two major deaths I had ever expe- rienced. Recognition of this time sequence led me to track my own family's patterns of handling loss and later t o make a concerted effort to deal as fully as possible when deaths occurred. At times it is beneficial t o make a special

chronology for a critical time period, to track a family member's illness in rela- tion to other concurrent significant events or to events at the same point in the life cycle of other family members (Barth, 1993; Huygen, 1982).

A n individual chronology may also be useful for tracking a parricular family member's functioning, transitions, and symptoms within the context of the fam- ily. Generally each occurrence is listed with the date of its occurrence. When family members are unsure about dates, approximate dates should be given, pre- ceded by a question mark, e.g., ?84 or -84 (see Freud's maternal grandparents in Genogram 2.14). A chronology of family events may be written o n the side of the genogram or, if necessary, on a separate sheet of paper. T h e following chronology illustrates key dates indicated on the genogram for Ted Turner (Genogram 2.17). All the items on the chronology are shown o n the genogram, but the patternof family events gains clarity from the chronology. O n the other hand, the family structure would be hard to envision without the genogram.

Short Chronology for Ted Turner: Critical Events

1953 Ted's sister, Mary Jean, age 12, diagnosed with lupus erythematosus followed by encephalitis, which left her with brain damage.

1957 Parents separate. There are conflicts over sister's care. Mother does not want her institutionalized. Sister is suffering horribly-racked with pain.

1960 (Dcc. 15) Sister dies age 19. Neither Ted nor his father's new wife knew she was still alive at the time.

1961 (July) Ted's daughter Laura Lee is born. 1961 (July) Father, Ed Turner, goes to Silver Hill, a psychiatric hospital,

to withdraw from alcohol. 1962 (September) Father, Ed Turner, makes multimillion dollar deal of a

lifetime, turning his advertising business from middling company to largest outdoor advertising business in the south.

1962 (December) Ed Turner goes back to Silver Hill. 1963 (January) Ed Turner leaves Silver Hill. 1963 (March 5) Ed Turner, age 53, shoots himself in the head with gun

with which he taught Ted to shoot, following one of the many fights father and son had had over the years. Son Ted is 25.

1991 Ted Turner, age 53, suffering from depression, and having felt that as his father died tragically at that age he would do the same, instead changes the pattern. He is stabilized by therapy and med- ication. He marries Jane Fonda, whose mother committed suicide when she was 17.

Develol~in~ a Genogram to Track Family P a r t e m 35

Clearly, a family chronology \\,ill vary in length and detail, depending o n the hreadth and d e p t h of t h e information o n demographics, functioning, rela- tionships, and critical e v e n t s available or needed for a particular assessment.

Assessing genograms also requires a n understanding how life events and changes in family functioning are interconnected. Since t h e genogram records many critical dates in t h e family's h~story, it is useful t o the clinician for look- Ing a t coincidences of various life events and changes in family functioning. Often seemingly unconnected events that occur around the same time i n a family's history are systematically related and have a profound impact o n fami- ly functioning.

I t is particularly helpful t o track changes in a family's long-term Functioning as they relate to critlcal family life events. We examine t h e genogram carefully for a p ~ l e u p of stresses, t h e impact of traumatic events, anniversary reactions, and t h e relationship of family experiences to social, economic, and political events. Thus, we c a n assess t h e impact of change o n t h e family and its vulner- ablllty t o future changes.

Coincidences of Life Events Whenever several critical family experiences occur around t h e same time, it is wise t o request details. It is particularly Important t o notice t h e c o i n c ~ d i n g dates o n t h e genogram, which may indicate hidden connections and reveal emotional and systemic patterns. Such "coincidences" may indicate a stressful time in the family's history. If nothing else, they pinpoint t h e critical periods i n a family history, which are likely to have left an emotional legacy. W e are n o t talkinn here about o n e event "causina" another, but about t h e association of - - events that may be influential i n t h e development of family patterns. Q u e e n Elizabeth referred t o t h e year 1992 as t h e "annus horribilis" due t o t h e multiple traumas t h a t had plagued t h e royal family t h a t year: t h e separation of o n e son, Andrew, from his wife, Sarah Ferguson; the divorce of Princess A n n e from Captain Mark P h i l i p ; t h e ongoing rumors of marital problems between Charles and Diana; and a horrendous fire a t Windsor Castle that had d o n e $60 million dollars i n damage (Genogram 2.29). In situations where there is such a pileup of stressful life events, o n e must be o n t h e lookout for emotional reactivity among all family members as well as other hidden stressors influencing t h e fam- ily. T h e stress of such a pileup may show itself in physical symptoms as well, and indeed, w h e n the Q u e e n gave her speech o n the topic she had a severe cold and had almost lost her voice, perhaps a coincidence or perhaps a physical indica- tor of t h e stress she was describing, and it was reported t h a t she had difficulty sleeping for many months that year. As t h e Queen noted, h e r family's stress was compounded by stress i n the country a t t h e time. T h e r e had been months of

36 GENOGRAMS: ASSESSMENT A N D INTERVENTION

worldwide turmoil and uncertainty, and Britain had had three years of severe recession, with millions unemployed and a record number of personal bank- ruptcies and homes repossessed.

In other situations the coincidences take place over time, perhaps o n anniversaries or at the same life cycle trans~tion. For example, Gregory Bateson's genogram (Genogram 2.23) depicts a number of interesting coinci- dences. First, Gregory's parents were married shortly after the death of his mother's father. Second, the middle son, Martin, committed suicide o n the birthday of the oldest brother, John, who had died four years earlier. A n d final- ly, Gregory met Margaret Mead shortly after h e cut off from his mother.

Viewed systemically, these events may be more than coincidence. Gregory's parents' engagement was called off by Beatrice's mother when W. B. Bateson got drunk. This was a reaction t o Beatrice's father's alcoholism. However, three months after the alcoholic father died, Beatrice put a notice in the newspaper, hoping t o reconnect with W.B., who then recontacted her. They were married shortly afterward. In the next generation, Gregory happened t o meet and fall in love with Margaret just after becoming estranged from his mother. She and her second husband were doing anthropological work in a remote area of the world

~ -

Genogram 2.23 Bateson family

1829-1918

William 8-n Arthur D u b

M y E d r d pm1*c hi,,onan m b n i d j d ~ r

William B~cwrn

Dec'eloplng a Genogram to Track Family Pattern 37

a t that time. We might speculate that the children in this family could only con- nect to their spouses after disconnecting, through death or cut-off, from a parent.

Gregory Bateson, t h e youngest of three sons of a famous British geneticist, was considered t h e least promising of the three, sickly in childhood and not a n outstanding student. T h e oldest son, J o h n , was supposed to be t h e leader. H e and the middle brother, Martin, two years apart in age, were extremely close. Gregory, four years younger, grew up somewhat separately. W h e n J o h n was 2 0 h e was killed in World W a r I. A few days later his mother wrote to Martln t h a t "You and Gregory are left to me still and you must help m e back to some of t h e braveness that J o h n h a s taken away" (Lipset, 1980, p. 71).

Following John's d e a t h a rift developed between Martin and his father, whose own mother had died two months before J o h n (another coincidence). T h e father now began t o pressure this second son, Martin, who was a poet, t o become a zoologist. Relations between father and son deteriorated. W h e n , i n a d d i t ~ o n , Martln felt rebuffed by a young woman h e admired, h e took a gun a n d shot h ~ m s e l f in Trafalgar Square o n his brother John's birthday, April 22, 1922, in what was d e s c r ~ b e d as "probably t h e most dramatic and dellberate suicide ever witnessed i n London" (Lipset, 1980, p. 93). Martin's choosing to kill him- self o n his brother's birthday is also a n example of a n anniversary reaction, which will be discussed below.