1. GENOGRAM
Azman Anuar

2. Goals Disclaimer Participants in this CEP will gain:
Knowledge on the construction of genogram and the common symbols used
Disclaimer

3. Session’s outline Introduction 3 stages in drawing genogram
Stating the demographic data
Simple genogram
Complex genogram
Reflecting the state of functioning of family members
Drawing the relationships and roles
Genogram and Ecomap
Genogram as an interviewing tool
Genograms as an intervention tool

4. Source of information
Monica McGoldrick, Randy Gerson and Sylvia Shellenberger (1999), 2nd Edn, Genograms: Assessment and Interventions, W W Norton, USA.
Multicultural Family Institute (MFI), New Jersey website.

5. Confidentiality

6. Introduction
Genogram is widely among those in the field of psychology, medicine, social work and other health care, human service and even legal fields.
Genogram is known to be widely used by family therapists. It is a (family) therapist's version of a family tree. The organization of the genogram and its use of handy symbols permit the therapist and the patient to quickly identify and understand patterns in family history.

7. Introduction
 Family therapist Monica McGoldrick and her colleagues at the Multicultural Family Institute of New Jersey have pioneered the use of genograms as a diagnostic tool, and as a method of helping families see patterns within their past and present. To know more on the assumptions on the use of genograms in the family systems perspectives, read pg. 6, Monica McGoldrick, Randy Gerson and Sylvia Shellenberger (1999), 2nd Edn, Genograms: Assessment and Interventions, W W Norton, USA.
It is still a tool in progress. Symbols are evolving.
Standardization is developed by the North American Primary Care Research Group in collaboration with leading family therapists.
Source: MFI

8. Business Genogram
Genograms: A tool for understanding the family side of family business™
About the Program
Any good consultation begins with a thoughtful and thorough assessment of the three family business circles: the family, the owners, and the business. This program is designed to develop family business advisors’ skills in assessing the family circle, using the genogram as a tool for mapping, exploring and understanding both the structural and process elements of a family system.  
The program includes detailed information about constructing genograms, as well as how to conduct both a structural and process analysis of the information. Case examples illustrate such key concepts as enmeshment, triangles, alliances, conflict groups, branch dynamics, birth order, and family developmental stages. In addition, workshop participants have an opportunity to create and reflect on their own family genogram. This personal exploration can be an opportunity to improve self-awareness about how our own family and life experience affects our professional work with families.
Goals
 Participants in this seminar will gain:
  * Knowledge of how to use the genogram as a tool for assessing the structural and process elements of a family system.
* Skills in assessing family dynamics and understanding their impact on the family business.
* Understanding of how consultants’ perspectives can be influenced by their own family system dynamics.
 Source: Family Firm Institute,

9. Family systems therapy Genogram
One of the best ways to begin therapy and to gain understanding of how the emotional system operates in a family system is to put together the family genogram. Studying the patterns of behavior, and how they relate to those multigenerational family, reveals new and more effective options for solving problems and for changing individual’s response to the automatic role one is expected to play.

10. Commonly drawn genogram (e.g. 1)
2 generations

11. Commonly drawn genogram (e.g. 2)
3 generations

12. Commonly drawn genogram (e.g. 4)
3 generations

13. Commonly drawn genogram (e.g. 3)
4 generations

14. Commonly drawn genogram (e.g. 5)
4 generations

15. Stages in drawing genogram Stages in genogram drawing
There are about three stages in drawing genogram.
1. Stating the demographic data
Reflecting the state of functioning of family members
Drawing the relationships and roles

16. Stages in drawing genogram
Stating the demographic data
Age
Date of birth and death (cause of death)
Marital/Relationship status
Whereabouts (living arrangement)
Income
Occupation
Education
Ethnic
Religious practices
Trouble with the law

17. Standard Basic Symbols43 43
Transgender People
Gay
Lesbian
Bisexual
Pet
Pink Triangle
As most everyone knows, the pink triangle is a symbol taken directly from the Nazi concentration camps. Usually when concentration camps and Nazis are mentioned, most people tend to think of Jews and the Jewish Holocaust (for good reason). But the fact that a large number of homosexual prisoners were in those same camps is an often ignored or overlooked fact of history.
The real story behind the pink triangle begins prior to World War II. Paragraph 175, a clause in German law, prohibited homosexual relations (much like many states in the U.S. today have laws against "crimes of nature"). In 1935, during Hitler's rise to power, he extended this law to include homosexual kissing, embracing, and even having homosexual fantasies. An estimated 25,000 people were convicted under this law between 1937 and 1939 alone. They were sent to prisons and later concentration camps. Their sentence also included sterilization, most commonly in the form of castration. In 1942, Hitler extended the punishment for homosexuality to death.
Prisoners in Nazi concentration camps were labeled according to their crimes by inverted colored triangles. "Regular" criminals were denoted by a green triangle, political prisoners by red triangles and Jews by two overlapping yellow triangles (to form the Star of David, the most common Jewish symbol). Homosexual prisoners were labels with pink triangles. Gay Jews- the lowest form of prisoner- had overlapping yellow and pink triangles. This system also created a social hierarchy among the prisoners, and it has been reported that the pink triangle prisoners often received the worst workloads and were continually harassed and beaten by both guards and other prisoners.
The Pink (and Black) Triangle
Pink Triangle: Gay liberation groups in the 1970's started using the pink triangle as a symbol for the gay rights movement.
Black Triangle: The black triangle represents lesbians and feminists as a symbol of pride and solidarity.
Gay men were forced to wear pink triangles placed point down on both the left shirt sleeve and right pant leg. These men were sent to the camps under German law, Paragraph 175, which made illegal not only same-sex sexual acts, but also embraces, and even male homosexual fantasies. The law did not cover homosexuality in women. Authorities responded to this oversight by sending supposed lesbians to the concentration camps wearing black triangles, under the charge of being asocials
Source:
Man to
woman
Woman
to man
Note: Pink/Black Tri

18. Pink Triangle
As most everyone knows, the pink triangle is a symbol taken directly from the Nazi concentration camps. Usually when concentration camps and Nazis are mentioned, most people tend to think of Jews and the Jewish Holocaust (for good reason). But the fact that a large number of homosexual prisoners were in those same camps is an often ignored or overlooked fact of history.
The real story behind the pink triangle begins prior to World War II. Paragraph 175, a clause in German law, prohibited homosexual relations (much like many states in the U.S. today have laws against "crimes of nature"). In 1935, during Hitler's rise to power, he extended this law to include homosexual kissing, embracing, and even having homosexual fantasies. An estimated 25,000 people were convicted under this law between 1937 and 1939 alone. They were sent to prisons and later concentration camps. Their sentence also included sterilization, most commonly in the form of castration. In 1942, Hitler extended the punishment for homosexuality to death.
Prisoners in Nazi concentration camps were labeled according to their crimes by inverted colored triangles. "Regular" criminals were denoted by a green triangle, political prisoners by red triangles and Jews by two overlapping yellow triangles (to form the Star of David, the most common Jewish symbol). Homosexual prisoners were labels with pink triangles. Gay Jews- the lowest form of prisoner- had overlapping yellow and pink triangles. This system also created a social hierarchy among the prisoners, and it has been reported that the pink triangle prisoners often received the worst workloads and were continually harassed and beaten by both guards and other prisoners.

19. Types of Relationships: Married
Legal
Separation in fact
EMA

20. Types of Relationships: Not Married
EMA

21. Basic Symbols for Order and Type of Birth
Children: List in birth order beginning with the oldest on left

22. Sample of simple genogram – 2G18 15

23. Multiple marriages and Divorces
complex genogram
Multiple marriages and Divorces
How do you reflect a family where parents (either one or both) are divorced and remarried?
Is it like these? >>>

24. Sample 1 of genogram showing multiple marriages
Is it like this? >>>
Or this? >>>

25. Sample 2 of genogram showing multiple marriages
Or this? >>>

26. Multiple marriages and Divorces
complex genogram
Multiple marriages and Divorces
How do you reflect a family where parents are divorced and remarried?
Husband who has two previous failed marriages
Wife with two previous marriages and has one child from each marriage, including current marriage

27. Multiple marriages and Divorces: Husband with current and ex-wives
1st
m ’81 d ‘86
2nd
m ’90 d ‘00
3rd
m ’02
Husband , his current wife and his ex-wives (who are shown lower and smaller). Husband’s wives may go on left to be closest to him. Indicators “1st “, “2nd” and “3rd” etc make clear the order of his marriages.

28. Multiple marriages and Divorces: Wife with current and ex-husbands
1st
m ’81 d ‘86
2nd
m ’90 d ‘00
3rd
m ’02 6 16 22
Wife, her current husband and her ex-husbands (who are shown lower and smaller). Wives’ previous relationship are shown on left to keep children in birth order, since they remained in her custody.

29. Multiple marriages and Divorces
complex genogram
Multiple marriages and Divorces
How do you reflect a family where parents are divorced and remarried?
Both spouses have history of remarriages
Wife has previous two failed marriages , has one child in each marriage, age 14 (M ) and 9 (M) while husband has one failed marriage with a son age 8. They have a son, age 3, from current marriage. They were married in 2002.
Wife has three failed marriages and only one son from the 3rd marriage. Husband has 4 failed marriages , one child each from 2nd (26/M), 3rd (16/M) and 4th (11/M) marriage. From their current marriage, they have a 2 yr old son. Married in 2002.

30. Multiple marriages and Divorces: with current and ex-spouses
1st
m ’94 d ‘99
m ’90 d’92 3 8 14
97-
02-
2nd
m ’94 d ‘98 9
96-
91-
m ’02
Yr 2005
Where do you reflect non-marital relationship?
It is reflected at the end of the married relationship – see eg on page 16, fig 2.4
Couple with three year old son, showing their previous spouses (smaller symbols) and those spouses’ new partners (even smaller symbols) 32

31. Multiple marriages and Divorces: with current and ex-spouses, children and living arrangement
1st
m ’77 d ‘80
m ’85 d ‘89
m ’94 d’99 10 2 11
03-
95-
m ’02
Yr 2005
2nd
m ’81 d ‘86
3rd
m ’87 d ‘90
4th
m ’92 d ‘97
94-
55-
65 - 40 50 16
89- 23
82-
m ’90 d ‘93
Couple living with their joint child and wife’s child from previous marriage. The other spouses of the partners are shown smaller and lower on either side of the present household. How do we show custody over children?
Couple living with their joint child and wife’s child from previous marriage. The other spouses of the partners are shown smaller and lower on either side of the present household. 33

32. Adding more information: Income, education, occupation and place of living
Income is written above the birth and death date. (my preference: to state it below the occupation) Include the education and occupation near the name. The person’s place of living should be written at the top of the line connecting the symbols.
$20K/m
40-’99
$15K/m
57- 59 50
T Bo Lee
Surgeon
W SL
Doctor
m. ‘76 NY UK
$8K/m
77-
$?K/m
81-
83- 30 26 24
T Ah Lee
PhD/Psych
Lecturer
T Oh Lee
Degree/
Journalist
T Er Lee
Undergraduate

33. Stages in drawing genogram Stages in genogram drawing
Reflecting the state of functioning of family members
This means including data such as
Medical
Emotional
Behavioural (working history, drinking pattern, etc)
Look out for patterns of functions within and across generations such as
Substance abuse
Incest
Violence
Suicide, etc
Noting these may help to understand the client’s current adaptation to the situation and may provide ideas on how to address it.

34. Lightly shaded or striped
Symbols denoting addiction/substance abuse and medical or physical illness
Lightly shaded or striped
Substance Abuse
Mental or physical problems
In recovery from substance abuse and mental or physical problems S
Smoker O
Obesity L
Language problem
Other problems

35. Types of Medical Conditions: just for information only

36. Other information: Significant Institutional relationship18
depression
on medication
Counsellor
SAF Psychiatrist 15
Drug Rehab Ctr
Therapist
Depression
Date/yr
1st offence
Her, K,
Name
Edn
Occupation

37. Sample of genogram with substance, medical and physical problems

38. $1200
35- $0
35-
3-room flat, HDB
High blood P
Diabetic
Semi-ambulant 65 65 L
Name
Edn?
Artisan
Name
Edn?
Housewife UK $?
60- UK $0
63-
depression
on medication 48 45 ?
Norman /English
Edn?
Job?
Norma /Malay
Edn?
Unemployed ?
m.85 s. ’00 d. ‘02 UK
90-
87-
87-
90-
90-
87-
87-
depression
on medication 16 19 18 4 2 8 18
Name
Name
Name
Schooling
Name
Schooling
Name
Edn?
NSF
IDR
GCE ‘O’
Student
MGF
GCE ‘A’
Student
SAF Psychiatrist
Counsellor
2005

39. Stages in drawing genogram Stages in genogram drawing
Drawing the relationships and roles

40. Types of Family Relationship

41. Interactional Relationship Patterns Between People
Slight variation

42. Type of Emotional Relationship

43. $1200
35- $0
35-
3-room flat, HDB
High blood P
Diabetic
Semi-ambulant 65 65 L
Name
Edn?
Artisan
Name
Edn?
Housewife UK $?
60- UK $0
63-
depression
on medication 48 45
Norman /English
Edn?
Job? ?
Norma /Malay
Edn?
Unemployed ?
m.85 s. ’00 d. ‘02 UK
90-
87-
87-
90-
90-
87-
87-
depression
on medication 15 19 18 4 2 8 18
Name
Name
Name
Schooling
Name
Schooling
Name
Edn?
NSF
IDR
GCE ‘O’
Student
MGF
GCE ‘A’
Student
SAF Psychiatrist
Counsellor
2005

44. Sample of genogram

45. Sample of genogram

46. Genogram + Ecomap
It is common to supplement the use of genogram with ecomap. This will provide more richer information, involving the greater social circles

47. Genogram + Ecomap

48. Points to note Making genogram may not be a one-time exercise
Gradual improvements will have to be made over time as more information are gathered
A template should be made. New genograms depicting different themes should be made to reflect and see any significance (resource, medical history, etc).

49. Genogram as an interviewing tool
Interview using genogram.
The three stages has covered a substantial part of the genogram interview. For a detailed outline, see part 2 of the handout.

50. Genogram as an interviewing tool
Interpreting the genogram.
It depends on the ‘factual’ information shared by clients and counsellor’s knowledge in identifying composition, themes, patterns, counsellor’s perspective, etc and work with the client to generate discussion and understanding on the issue(s) raised.

51. A little exercise
A remake of a genogram (individual) A new construction of a new genogram (in group of four) Duration: 25 minutes

52. Exercise material – for individual

53. Exercise material – for individual: redrawing the genogram
Commonly drawn genogram (e.g. 5)
4 generations

54. Softwares available
GenoPro is a unique software perfectly suited for creating quick computer-generated genograms.
By entering key information, such as names of family members, key life events, emotional relationships, and social relationships, the user can easily create a multi-generational genogram of their family system or of their patient's family system.
The genogram thus created becomes a graphical picture of the family, helping the user to identify patterns of behavior and dysfunctions that need to be addressed.

55. Constructing own genogram
Our perspectives can be influenced by our own family system dynamics.

56. Hers Malaysian Chinese 1 4 Graduate Ex-bank mgr Doctor (2 clinics)PA
37- S
34- R
Sec Sch
940718
L L A
56-
57- Ro
60- SS RS
901110
S R
930508
KDGT 04
52- M
59-
A Q
900809
R A
921004
H S
951126
980529 1 4 A
65-
62- NR
96- NH
98- AH
00- RW
63-
M Z
F D
921031
941004
960307
A N
001219
64- Z
69-
M H
970527
70- H
020626
Graduate
Ex-bank mgr
Doctor (2 clinics)
Diploma
Snr Sup
A level
Homemaker
Ex-counsellor
CAAS/Mgr
Snr Reg. Manager
Teacher/Pri
A lelve
Technician
Ex-teacher
Chinese
66-
R S
Malaysian
Counsellor
Pri
Retired
Fireman
Muslim – adopted by Muslim family
Born in Malaysia

57. His Indian Chinese? 29 41 40 32 30 42 1 4 Graduate Homemaker
67-
68- SH
69- 40 SZ
76- 32 FA
M I
64- 30 Z H
79-
A A
40-
Z E
42- 42 AH
66-
Z H
R S AS
92-
NAD
94-
MAR
96-
97-
AHA
02-
MSJ
NSH
03- NS
91-
93-
95- HZ HR MI
010309 NM
031211
Chinese?
Indian
No record 1 4 A
65- R
62- NR NH
98-
00-
Graduate
Homemaker
Ex-counsellor
Counsellor
O lvl
Despatch
Foodstall x 2
Pri
Retired
Ex-plumber
Born in Malaysia
05-
Diploma
KDGT
Teacher
N lvl
Clerk
Snr Sup
Snr Nurse
ITE
Nurse
SCDF

58. 29 41 S
67-
68- SH
69- 40 SZ
76- 32 FA
M I
64- 30 Z H
79-
A A
40-
Z E
42- 42 AH
66-
Z H
R S AS
92-
NAD
94-
MAR
96-
97-
AHA
02-
MSJ
NSH
03- NS
91-
93-
95- HZ HR MI
010309 NM
031211
Chinese?
Indian
No record
O lvl
Despatch
Foodstall x 2
Pri
Retired
Ex-plumber
Homemaker
Born in Malaysia
05-
Diploma
KDGT
Teacher
N lvl
Clerk
Snr Sup
Graduate
Snr Nurse
ITE
Nurse
SCDF PA
37-
34- R
Sec Sch
940718
L L A
56-
57- Ro
60- SS RS
901110
S R
930508 04
52- M
59-
A Q
900809
R A
921004
H S
951126
980529 1 4 A
65-
62- NR NH
98-
00- RW
63-
M Z
F D
921031
941004
960307
A N
001219
M H
970527
70-
020626
Ex-bank mgr
Doctor (2 clinics)
A level
Ex-counsellor
CAAS/Mgr
Snr Reg. Manager
Teacher/Pri
A lelve
Technician
Ex-teacher
Chinese
Malaysian
Counsellor
Fireman
Muslim – adopted by Muslim family
Interesting data: * Number of siblings * Kampung of parents * Children * Ethnic background of mother/mil * Fathers/fil and mothers/mil * Upbringing background/SES

59. Genogram – sample answer