How to make a genogram in psychotherapy

In clinical practice, obtaining information about the patient, the problem for which he comes to the consultation and the circumstances that surround said problem or can influence it is a fundamental part of the psychotherapeutic process. The psychologist needs this information to be able to work and contribute to deal with the issues the patient raises, serving as a guide through the process.

Within these information, understand the family structure and the type of relationships that the subject maintains with his closest environment can greatly help to understand the current situation of the subject. Obtaining this information is carried out through various methods, being able to register in a simple and easily understandable way if a genogram is prepared.

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What is a genogram?

We call a genogram a graphic representation in which the general information about the constitution of a family is captured. and the relationships among its members. It is a schematic way of visualizing family patterns and the type of relationships that are established between its members. A genogram reflects all the people that make up the family structure, both those who are still alive and those who have died or have separated from the family nucleus. Abortions are also included. Although it generally goes back up to a total of three generations, this can vary depending on the type of problem that motivates the consultation with the psychologist.

The genogram not only reflects the family structure, but also serves to visualize the presence of very important and vital events for the subject, such as the birth of a brother, the death of a relative, a wedding, a divorce or an abortion. This type of event can greatly mark the human psyche and change the type of relationships that each individual in the family system has, including the client or patient, being able to originate or contribute to the presence of disorders or problems related to the reason for consultation of the patient. That is why it is a tool widely used in clinical practice to analyze family relationships.

So, although the final result seems simple and straightforward, This type of representation offers a large amount of information the professional when it comes to understanding where the patient comes from and how his origins can help explain his present, allowing him to outline different strategies and courses of action.

• This article may interest you: "The 8 types of families and their characteristics"

building a genogram

At first glance, it may seem that creating a genogram is really fast and without any kind of complication. However, to develop a meaningful genogram it is not enough to make a series of interlocking symbols: family composition and structure need to be explored and taken into account while considering the effect such relationships may have on the patient. In addition, although it is a graphic representation that could be built in many different ways ways, to make it understandable and have practical sense, a series of symbols and Steps.

To start building a genogram, first the objective with which the representation is carried out must be taken into account. Since a family can be made up of a large number of people, it is necessary to delimit the type of relationships that have to be reflected, limiting the representation to those closest to or linked to the problem. Let us see below the steps to take in the elaboration of the genogram.

1. Construction of the basic structure

In the first moment proceeds to outline the basic structure of the family. Thus, at this point each of the family members is represented through a figure and the link that unites them from lines that unite the components of the system. Basically, a family tree is made focused on the client or patient and her closest relatives, generally limiting herself to assessing a total of three generations including that of the aforementioned.

In addition, a genogram not only indicates who is part of a family but also which members of said family live in the same location with the client or patient, for which all members of the family who cohabit with him are surrounded by a dashed line. This helps to understand with whom the patient has the greatest level of contact and how this contact affects her life.

2. Basic subject data collection

Once the structure of the genogram has been traced and the main people and relationships represented, it is necessary to understand the functioning of the family collect various general data.

For example, the age, educational and socio-professional level and the profession of close beings can affect the development of the subject, with which having these data allows to improve the understanding of the system. It is also useful to know the presence of a history of mental or medical disorders.

3. Marking what type of relationship they maintain

In addition to knowing who is who and the most basic vital data, it is necessary to observe the type of relationships and the emotional involvement they have, given its importance when the client interprets interpersonal relationships and even reality.

With this we can observe, among other things, if there are conflictive or very close relationships that serve as a support or risk factor to promote an improvement or worsening of the situation of the patient.

Symbology and its meaning

Apart from the process that is followed during the construction of the genogram, it is important for its understanding to know which symbols are used in each situation.

It must be taken into account that what is symbolized is not only each of the family members, but also the type of bond that unites them with the rest of the components.

symbolizing people

When analyzing or creating a genogram, we must take into account what or who is being represented by each of the symbols. Each individual in the family is represented by a unique symbol. Specifically, we will use the outline of a square when we refer to a man and that of a circle when we are representing a woman. Within the symbol will appear the current age of the subject if he is alive, above it the year of birth and just below the symbol the name of the individual. When representing the client or patient, the figure that represents it is double (ie, a square or circle center of another). If the person being represented is someone who has already passed away, we will find that the symbol appears crossed out, with an X above it.

Other symbols to have are those referring to the presence of abortions. In this aspect we find two symbols depending on whether the interruption of the pregnancy has been voluntary or accidental: in the first case it is going to use a small X without crossing out any symbol, while in case of spontaneous abortion a small circle is used completely painted.

In the event that it is necessary to assess the sexual orientation of one of the family members to understand the reason for patient consultation (for example, if a subject with problems accepting the sexual orientation of a family member comes to the consultation), can indicate if the subject belongs to the LGBT community with an inverted triangle inside the symbol indicating their sex.

The fact that the symbols are only an outline or are more or less filled has certain implications as well. Subjects who consume and abuse substances such as alcohol and drugs will have half of their symbol painted, horizontally. If the individual suffers from mental problems, the symbol will have half painted, but in this case vertically. If both psychiatric problems and substance abuse are added, it will be three quarters of the symbol that will be painted.

Representing family relationships

Apart from the subjects, the genogram also reflects the type of relationship that each component has with the rest. In this sense, we also find different representations in the connections between subjects.

The marital union between two people is symbolized with a straight and continuous line, the two individuals being at the same height. If two people have a relationship but are not married, that relationship will be represented by a dashed line, also being at the same height. If the couple separates, a diagonal bar will cut the line that unites them, marking the year of the breakup. In the case of a divorce we will find two diagonal bars. In the event that a divorced or separated couple were to join again later, the bars that mark their separation will be crossed out.

The presence of children is symbolized by lines that arise from the union of two people., being the continuous line in the case of biological children and discontinuous if we are dealing with an adopted child. If it is more than one sapling, they will be arranged from left to right based on age.

The presence of siblings presents some characteristics to take into account. If we are dealing with twins, the lines that represent the union with the parents will emerge from the same point. Otherwise, the lines will be born at different points from the one indicating the relationship between both parents.

Indicating the type of relationship

The type of structural bond maintained by family members has been indicated so far, but it is also possible indicate how this bonding is on an emotional level.

Positive and normative relationships will be marked by both being held at exactly the same height. A distant relationship can be marked by both being attached to different heights, not both being linked to the same point. Conflicting relationships will be indicated by zigzagging lines, and in the case of the presence of physical or mental abuse, said situation will be represented with a zigzag line that will end in an arrow that will mark the direction in which the abuse is going.

An intimate relationship can be indicated from two lines instead of one. while merged relations will be marked with three lines. Combinations can be made from these constructions.

• Related article: "Toxic Families: 4 Ways They Cause Mental Disorders"

Bibliographic references:

• Company, V.; Feixas, G.; Munoz, d. and Montesano, A. (2012)- The genogram in systemic family therapy. University of Barcelona. Department of Personality, Assessment and Psychological Treatment. Faculty of Psychology.

• McGoldrick, M. and Gerson, R. (1985) Genograms in family assessment. Barcelona: Gedisa (3rd ed. 2000).