How a Genogram Can Help You Understand Family Patterns, Trauma, and Relationships

J. Elise Reichle, SWTC & Graduate Intern

When most people think about therapy, they imagine talking about their personal lives in the present. They expect to only talk about stress, anxiety, relationship difficulties, or traumatic experiences they are currently, or have recently, experienced. For our clinicians who specialize in trauma-informed therapy in Madison, the present is just the tip of the iceberg.

While the importance of these conversations cannot be overlooked, one of the most powerful tools I use as a therapist-in-training involves analyzing a client’s family history long before my clients were born. I find that exploring the family system that helped shape who you are today often helps my clients and I gain a significant amount of insight into their current challenges. 

The way I most often conceptualize a client’s intergenerational family history (whether they are aware of it or not) is by creating a genogram.

 

Many clients have never heard of a genogram before their first therapy session, and may not even hear of one by the time they are discharged from therapy. However, odds are likely that your therapist created some kind of map or chart (even if that was very surface-level) to conceptualize the relationships that you have to those close to you. After all, how else would we remember the name of your sister’s boyfriend’s dog that you’ve told us so much about?

While therapists have many tools, including genograms, to understand the relationships in clients’ lives, it is also common practice for therapists and clients to work together to create a genogram.

Once we begin working with a client to create a genogram, clients are often shocked by how much insight it provides. A genogram can help us identify patterns that have existed across generations, understand how trauma impacts families over time, and recognize strengths that have been passed down alongside those challenges.

What Is a Genogram?

A genogram is a visual map of a person’s family system that goes above and beyond your typical family tree. While a family tree shows the biological relationships between family members, a genogram includes far more information.

You can think about a family tree as the brainstorm and the genogram as the final draft. The information you and your therapist choose to include in a genogram is up to you, but examples of information you can include are:

• Family relationships (non-biological) and emotional connections (both positive and negative)
• Birthdays and ages
• Significant life events
• Mental health concerns
• Medical conditions
• Substance use patterns
• Losses and grief experiences
• Cultural influences
• Caregiving roles
• Educational and occupational patterns
• Trauma and resilience across generations

A genogram is a map that tells the longer, detailed version of your family’s story.

Instead of just writing who is someone’s sister, or documenting whose grandmother is on what side, a genogram helps us understand how family members influence one another. They allow us to see how certain patterns in families may, and often do, repeat over time.

Why Therapists Use Genograms

As therapists, we are often trying to answer several important questions, one of which is:

“How did someone become who they are today?”

This answer to this question is complex and unquantifiable. The answer to this questions does not boil down to a single event. The answer has to do with complex interactions between the systems inside and outside of a person, including their family relationships, life experiences, cultural influences, and intergenerational patterns.

Genograms help us see the connections between these systems more clearly.

For example, while creating a genogram, a client may notice that anxiety has appeared across multiple generations of their family. Another client might recognize that several family members have experienced depression, addiction, chronic illness, or significant losses.

Others discover patterns in relationships. They may notice recurring themes of conflict, emotional distance, caregiving responsibilities, divorce, estrangement, or difficulty setting boundaries.

These observations are not about determining who to blame, but helping us develop a deeper and more nuanced understanding of the systems that shaped us, and the role we play in those systems.

Genograms and Trauma-Informed Therapy

At HEART Counseling, we approach therapy through a trauma-informed lens. This means we recognize that a client’s current challenges and struggles make more sense when viewed within the context of their past experiences.

Trauma does not impact isolated individuals. It ripples through families, and the effects flow across generations.

Sometimes clients come to therapy wondering why they struggle with anxiety, perfectionism, emotional reactivity, people-pleasing, or difficulty trusting others. Through the process of creating a genogram, we may begin to see how these responses developed as adaptations to family circumstances but may no longer serve us.

For example, we might identify:

• Generations of caregivers who learned to prioritize others’ needs over their own
• Patterns of substance use that affected family relationships
• Repeated experiences of loss, illness, or instability
• Family systems organized around chronic stress or trauma
• Unspoken family rules about emotions, conflict, or vulnerability

A trauma-informed genogram helps us understand these patterns without pathologizing them. Instead of asking, “What’s wrong with me?” clients can ask, “What happened, and how did I, or my family, adapt?” That shift can be very healing, as it leads clients to practice self-compassion. 

The Surprising Insights Clients Gain

One of my favorite aspects of using genograms is observing clients make connections they had never considered before.

When creating my own genogram, I recognized that several family relationships had been influenced by events that happened well before I was born.

Some individuals might notice how caregiving roles have been passed from generation to generation. In many families, one person fills the role of caregiving. They adopt the role of, and are consistently relied upon for, managing crises, caring for ill relatives, and mediating or keeping the peace. Caregivers are often individuals that love others very deeply, and every family needs caregivers out of necessity, but roles like these can also contribute to burnout, resentment, and unclear boundaries.

Clients may also recognize strengths that have been inherited across generations.

Resilience, determination, creativity, strong family bonds, and perseverance are all patterns that can emerge when we zoom out on a genogram. Therapy isn’t just about identifying challenges. It’s also about recognizing the strengths that have helped families survive difficult circumstances.

Genograms Are Collaborative

Creating a genogram is a team process where you, the client, are the expert.

One misconception about therapy is that the therapist is the expert who analyzes everything while the client simply answers questions. In reality, we couldn’t take a more different approach here at HEART Counseling.

As therapists, we may ask questions about relationships, significant life events, family history, and cultural influences, but clients are the experts on their own experiences.

Together, we explore patterns, ask questions, and consider different perspectives.

Many clients find that discussing their genogram feels surprisingly meaningful and vulnerable. Family history often contains stories of love, sacrifice, grief, resilience, and growth. Exploring those stories can create a deeper understanding of ourselves and those who came before us.

You Don’t Need to Know Everything About Your Family

Some clients worry they won’t be able to complete a genogram because they have limited information about their family history, but that’s completely okay!

Genograms are not about creating a perfect record. They’re about gathering the information that is available and exploring what it might mean. Unsure about your biological family? Tell us about your support system and the people you love.

Whether you know details going back several generations or only have information about your immediate family, a genogram can still be just as valuable. Often times, the missing pieces are just as meaningful too.

How to Talk to Your Therapist About a Genogram

If you’re interested in exploring your family history, relationships, or intergenerational patterns, consider bringing up genograms in therapy.

You might say:

• “Could we create a genogram together?”
• “I think family history may be impacting my current relationships. Have you ever made a genogram with a client before?”
• “I’m curious about intergenerational trauma in my family. How can I make a genogram?”

Most therapists who work from family systems, trauma-informed, attachment-based, EMDR, trauma-informed and relational approaches to therapy are familiar with genograms and can help guide the process. Nine times out of ten, they’ve made their own at some point.

Curious About What Your Family Story Might Reveal?

Many of the challenges people bring to therapy do not begin or end with them.

A genogram can help uncover your relational family patterns, identify sources of resilience, and provide a deeper understanding of how and why your family experiences influence current relationships, emotions, and coping strategies.

At HEART Counseling, we believe healing happens when people can make sense of their experiences with compassion rather than judgment. Exploring your family story through a genogram is one way to begin that process.

If you’re interested in learning more about trauma-informed therapy, EMDR, family systems work, or understanding intergenerational patterns, we’d be honored to support you and walk with you through that journey.

Contact HEART Counseling to schedule a consultation and learn whether our approach is a good fit for your goals!

Interested in trauma-informed therapy in Madison WI, and working specifically with clinicians who have collaborated with clients to create extensive genograms before?

Check out our clinicians Sunshine Stephens, Elise Reichle, and Savannah Buttermore, and reach out using our contact form below to schedule a free 15-minute consultation call!

 

 

About the Author: J. Elise Reichle is a Graduate Social Work Intern at HEART Counseling who works with children, teens, and adults using trauma-informed approaches such as Internal Family Systems (IFS), CBT, and family systems concepts to support healing and growth.