Family Genogram Article

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Discovering Family Creatively:The Self-Created Genogram

Colleen M. Connolly, PhD

ABSTRACT.Creativity is a powerful force within the family therapyfield, central notonly to the therapeuticprocess butalso to counselor educa-

tion. Time-honoredtools, such as the genogramalong with its manyadapta-tions, remain useful in learning about family. However, as our rapidlychanging culture continually redefines and stretches the concept of fam-

ily, we must learn new methods to discover who family is from theexpert living within that family, i.e., the client or counselor-trainee.

This article introduces and describes a creative, self-initiated model,theself-created genogram, developed to amplify discovery of each per-sons own unique perspective and experience of family. Case examples

will be provided to illustrate the models use in both training and clinicalsettings. [Article copies available fora fee from The Haworth Document Deliv-ery Service: 1-800-HAWORTH. E-mail address: Website: 2005 by The HaworthPress, Inc. All rights reserved.]

KEYWORDS. Family, genogram, creativity

Colleen M. Connolly, PhD, is Associate Professor, Professional Counseling Pro-gram (Marriage and Family emphasis), Texas State University-San Marcos.

Address correspondence to: Colleen M. Connolly, Department of EAPS, TexasState University-San Marcos, 601 University Drive, San Marcos, TX 78666 (E-mail:[email protected]).

This article is dedicated to Janet Lynne Maples (January 1, 1947-January21, 2005),the core of a loving network of created family.

Journal of Creativity in Mental Health, Vol. 1(1) 2005Available online at http://www.haworthpress.com/web/JCMH 2005 by The Haworth Press, Inc. All rights reserved.

doi:10.1300/J456v01n01_07 81
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Our rapidly changing culture redefines and stretches societys con-cept of family. While the definition of family can differ from personto person (Gelles, 1995; Milewski-Hertlein, 2001; Trost, 1990) as wellas from culture to culture, a single definition of family has been ren-dered obsolete by current realities.

Familyscholars recognize that there is no unified definitionof familywithin the field (Milewski-Hertlein, 2001; Trost, 1990). Clinicians andeducators are attentive to the need for continued awareness, understand-ing, and sensitivity to how differently we might view family from theclients with whom we communicate (Trost, 1990). As a result, they of-ten continue to struggle alongside clients. Never-ending questionsabound, such as, What ismydefinition of family? and Howdowe

approach the discussion of family and honor the diversity inherent inour society?

At the same time, the creative arts continue to expand within thecounseling profession. Creativity in counseling has ancient historicalroots (Gladding, 1998), and its importance to the mental health field hascontinued to grow (Frey, 1975; Carson & Becker, 2003). Moreover,creativity as art and as science (Deacon & Volker, 2000; Gladding,1994) is central to both therapy and the training of future counselors(Carson & Becker, 2004). As Gladding (1994) underscores, The prac-tice of most family counselors demonstrates that the art and science ofhelping are complementary, not competing, forces (p. 3). Gladdingcalls for art and science to be maximized and dovetailed in theory andin practice (p. 10) to better ensure their viability.

Carson and Becker (2003) point out how often both novice and vet-eran therapists either overlook or underestimate the important role ofcreativity in the therapeutic process, especially whenworking with cou-ples and families. Although it is but one of several factors employed insuccessful clinical work, it garners increased importance because of thepressure towardbriefer, short-term therapies. In general, therapists havelost the luxury of taking their time, being cautious, or remaining non-in-novative. Instead, clinicians should be able to more fervently and ef-fectively facilitate creative thought and action in their clients, usingthemselves and their skills as creative agents of change (Carson &Becker, 2003, p. 5).

Family therapy and theories on creativity have many concepts incommon. By using the two concurrently, counselors have access to awhole new area of study and intervention (Deacon & Volker, 2000,p. 14). Many times, when technical skills are lacking, turning to inven-tiveness and creativity unleashes an array of possibilities (Frey, 1975).

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However, as Frey posits, frequently we are taught to apply ideas of theexperts rather than claiming the right to create ideas ourselves.

In this article I present a model, theself-created genogram, which Ideveloped in an introductory marriage and family course of a profes-sional counseling program and later expanded for clinical use. I devel-oped this model in response to the widening definition of family and theidentification of creativity as an important means of bridging cultures(Henderson & Gladding, 1998). This modified genogram provides anopportunity to discover family, invite creative expression, and mutuallyexplore areas of importance to others, whether used in family therapytraining, continuing education programs, or in clinical work.

This models development emerged because of several factors. I rec-

ognized my own struggle attending to the voices of the disenfranchised,and I sought to find a more inclusive way to initially assess family. Myscholarly and clinical interest in lesbian and gay couples and familiesreinforced the need for a model of this type that amplifies hearingfrom the insiders perspective as to who family might be rather thanlearning by posing directives and directions. It also evolved because ofmy belief in the power of creativity in counseling and its importantmulticultural application (Henderson & Gladding, 1998).

In developing and using the self-created genogram, several objec-tives were identified. First, it supplies a vehicle to discover the conceptof family, with the initiator marking the beginning and ending pointsof family in context and guiding its direction. It is driven by discoverythat is intentionally expansive and emerging from the expert living

within that contextual family.The second objective focuses on an atmosphere consistent with the

trend towarda strength-based, resource-oriented, collaborative-focusedtherapeutic process (Walsh, 1993, 2003). Dunn and Levitt (2000) notesome benefits for purposefully moving from diagnostics to mutualcollaboration in the construction of the genogram. The authors con-tend that a mutually collaborative genogram process can permanentlyanchor the therapeutic alliance and enhance the power of the genogramfor the client. This collaboration respects the person initiating thegenogram as having both expertise in her or his own life and capabilityof determining what information should be included in the genogram.Dunn and Levitt recommend modifications in training to ensure thatthe therapeutic power of collaborative genogram work in the field offamily therapy is reclaimed and remains firmly established (p. 241).

Third, this model invites creativity and can establish or stimulate anongoing atmosphere of discovery and creativeness. A fourth objective

Colleen M. Connolly 83


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involves offering a process inclusive ofallpeople within ones worldthat are significant rather than implicitly framing familyas blood-boundor legal-bound relationships. This model intentionally sets aside pre-conceptions of what familyshould be and temporarily suspends tradi-tional methods of learning about family. By stepping away from posingthe questions, and by inviting the expression of family in a creative, ex-periential fashion, counselors can open the door to exciting discoveriesand areas for future exploration.

In this article I briefly outline the historical roots of the genogram andprovide an assortment of adaptations and implications for training andtherapeutic use. Although many tools for exploring families exist, Ilimit the focus to the genogram and provide some examples of its previ-

ous adaptations that are most pertinent to the self-created genogram. Ithen highlight why creativity is important to our profession to set theframework for how the self-created genogram fits into the energyaround creativity. Next, I describe my approach for discovering familyin context and provide themes that emerged from student-trainees sur-rounding definitions of family, graphic depictions of the family, post-reflection comments from students on the process, and synthesis of thevisual product. Finally, I present a clinical intervention using a case ex-ample, an expansion of the creative representations that emerged, and atheoretical and contextual conceptualization, along with a discussion ofthe overall process.

THE TRADITIONAL GENOGRAM

The genogram has long been considered an integral component of acomprehensive, clinical assessment for many familycounselors and ed-ucators (McGoldrick, Gerson, & Shellenberger, 1999). The genealogi-cal charts that social scientists and families used to trace kinship andcompile family history provided the inspiration for its use in familytherapy (Hartman & Laird, 1983).

For decades, family-oriented therapists have considered the geno-gram to be the classic tool for gathering and utilizing family data(Hartman & Laird, 1983). It provides a roadmap of the family system(Guerin & Pendagast, 1976). Gerson (1995) refers to the genogram asthe supreme integrative tool for understanding families, the royalroad to both the family system and the inner world of the individuals inthat family (p. viii). While the field most often associates the genogramwith Murray Bowens work, clinicians of varying theoretical orienta-



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tions use it as well (DeMaria, Weeks, & Hof, 1999; McGoldrick &Gerson, 1985).

The more fundamental format of the genogram assesses families inthree steps (Friedman, Rohrbaugh, & Krakauer, 1988; McGoldrick &Gerson, 1985). First, the genogram charts the basic family structures,such as the biological and legal relationships across the generations.Second, it records information about individual familymembers includ-ing demographic data, personality characteristics, emotional or behav-ioral issues, and medical problems. A third focus of the genogramincludes delineating family relationships, viewing such processes asconflict and closeness between and among family members and theintergenerational patterns in the family.

Clinicians find the genogram appealing. Genograms are tangible,graphic, and function in mapping the family structure (McGoldrick etal., 1999; McGoldrick & Gerson, 1985). They also act as a therapeuticintervention, which can serve to free the therapeutic process from im-passes (Papadopoulos & Bor, 1997).

In the earlier years, the genogram graphically depicted the biologicaland legal relationship of different family members from one generationto the next, spanning at least three generations (McGoldrick & Gerson,1985). Only later, as the understanding of familyexpanded, did the fam-ily therapy field begin to include extended family and non-blood kin-ship (McGoldrick et al., 1999). In focusing the genogram on biologicalrelatives, the counselor assumes the risk of mapping an inaccuratefamily system (Milewski-Hertlein, 2001, p. 27).

Concentrating on content, a natural inclination for most mentalhealth practitioners often deemphasizes and obscures process (Beck,1987). Clinicians often succumb and become prisoners of content(Beck, 1987, p. 343; also in Milewski-Hertlein, 2001, p. 28) when con-structing a genogram. However, by attending to the process of thegenogram construction, the overall therapeutic experience is enhancedas clients actively participate in the formulating phase of the clinicalwork (Beck, 1987).

ADAPTATIONS TO THE GENOGRAM

The genogram format has experienced many facelifts since being in-tegrated into the family therapy field (Milewski-Hertlein, 2001), and avariety of adaptations have been developed that are particularly pertinentto the self-created genogram. The format shows flexibility in design and



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implementation, and through the years therapists have been encouragedto discover and create new methods for its use (McGoldrick & Gerson,1985; Milewski-Hertlein, 2001).

Some examples of expansion of genogram context include adding tothe original format a timeline dimension (Friedman et al., 1988) andcolor-coding to designate characteristics, traits, or issues (Lewis, 1989).Adaptations to the focus of the genogram also are plentiful. For in-stance, themulticultural genogramfocuses on cultural factors such asethnicity, race, immigration, social class, gender, and spirituality/reli-gion (Thomas, 1998). Thegendergrammakes gender role assumptionsovert, taking it from content to a consideration of gender as the well-spring of all behavior (White & Tyson-Rawson, 1995, p. 253). Track-

ing spirituality through the use of thespiritual genogramhas gainedmuch interest clinically (Frame, 2000; Hodge, 2001) and in counselortraining and supervision (Frame, 2001). Additional expansions of thegenogram include thesexual genogram(Hof & Berman, 1986) and theintimacy genogram(Sherman, 2000).

Kaslow (1995) expanded the use of the genogram when teaching afamily therapy course. She asked students to draw their family, usingthe typical genogram symbols. Kaslow then engaged students in a free-association about the results in a four-part process: (a) With whom didthe student begin and why? (b) Whom did they omit or exclude? (c)Whom would they like to eliminate? and (d) Whom would they like toadd to create a future fantasy family? (p. 26).

The genogram also has been recommended for specific groups, such

as engaged couples (Gilmour, 1995) and long-term and/or later-lifecouples for marital life review (Goldin & Mohr, 2000; Hartman, 1995).Furthermore, the genogram has been engaged for health issues, such asthose that are cardiovascular-specific (Wimbush & Peters, 2000) or forpeople with family histories of terminal illness (Hockley, 2000), in an at-tempt to identify those at risk, sources of support, and risk reduction(Niederhauser & Arnold, 2004). Clinicians typically construct genogramsface-to-face. Genograms also are self-administered outside of session,either prior to the initial visit or between sessions (Coupland &Serovich, 1999).

TRAINING CONSIDERATIONS

Teaching students the structure of the genogram and the conceptsthat emerge are critical.Students find the genogram helpful for visualiz-



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ingand understanding their familysystem (Bahr, 2001). Family therapyeducators consider the genogram useful for increasing awareness offamily therapy concepts and fostering a connection between systemicconcepts and the students own family system (Halevy, 1998). Achiev-ing the paradigm shift from an individual to a family-systems perspec-tive (Dunn & Levitt, 2000; Thomas & Striegel, 1994) can take time,care, and concentrated efforts (Pistole, 1998).

Dunn and Levitt (2000) point to several goals when employing thegenogram for family-of-origin work with trainees. It tends to developan internalized understanding of both structure and process from a sys-temic perspective. Integrating the genogram and family-of-origin workalso helps develop an awareness of personal values and emotional reac-

tivity, which can protect counselors-in-training from projecting theirown unresolved issues onto clients and families. Employing a geno-gram with a trainee also raises her or his capacity to remain an individ-ual, which can heighten clinical intentionality despite the highlyemotional conditions that frequently occur in session.

It is often difficult for students to step outside of their ownworldviewoffamily. As Gelles (1995) points out, most families function behindclosed doors, and many counselor-trainees enter their graduate studieswith a lack of knowledge about the diversity of family forms. An ideal-ized image of family can create blind spots for recognizing and appreci-ating varying family configurations, which can impede the view of whatfamily is and can be for others. Moreover, by holding a vision of theideal family without critical analysis and expansion, a trainee can

negatively impact the therapeutic process. This negative effect occurswhen the trainee marginalizes those peopleof importance to theclient.

If therapist-traineesare to become proficient in constructing process-oriented genograms, they must be offered ample opportunities to expe-rience and practice them while in training (Dunn & Levitt, 2000). Dunnand Levitt recommend implementing the genogram early in the trainingprocess and suggest that the manner in which it is introduced to studentsis equally as important as when and how we present it to our clients.

Challenges can occur in implementing a process-oriented genogramin family counseling training (Pistole, 1998). Although educators typi-cally recognize the importance of self-awareness for counselor-train-ees, they are often bound by the scholarly, knowledge-based studyrequired by many graduate schools. Expanding student awareness in di-dactic courses often proves difficult. An additional challenge occurswhen theories and methods of family therapy is the sole didactic courseoffered within a professional counseling program. That course then be-



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comes the major conduit for students to become alert and knowledge-able about how context and interpersonal relationships impact clientslives from a systemic framework.

CREATIVITY IN COUNSELING

Carson and Becker (2004) suggest that academia and creativity alsoare often at odds with one another (p. 3). The constraints and rigorsassociated with higher education can be counterproductive to coun-selor-trainees exploring and finding their creative voices (p. 4). Theauthors emphasize that learning about creativity starts as trainees begin

the program rather than something to be acquired post-graduation. Inother words, creativity should be considered foundational for effectivecounseling and counselor education, rather than being viewed as theicing on the cake (p. 4).

Timm and Blow (1999) recommend including experiential trainingactivities so that therapists and trainees can be touched at both the intel-lectual and emotional level. As Carson and Becker (2004) point out,creativity is a skill, something that one can learn, develop, and fosterover time. People learn most and remember best by experiencing, espe-cially as it relates to significant others. Experiences help people getcloser to feelings more quickly and genuinely than conversing.

An important distinction exists when using the genogram as a train-ing tool rather than as a clinical intervention. When used as a trainingtool, the main objective is to help students visualize and understandtheir family system, and their own place within it, rather than to changeit (Bahr, 2001, p. 243; Hardy & Laszloffy, 1995, p. 228).

When engaging in self-of-the-therapist work, supervisors and educa-tors still veer toward a pathology approach, according to Timm andBlow (1999). There remains a tendency to focus on deficits rather thanwhat resources emerge from the students lived experience. The focusthen becomes seeing potential problems, red flags (p. 332), and unre-solved family issues that might interfere with the therapeutic process.While using this lens is important, a resource lens helps balance the pro-cess by focusing on strengths that the trainee brings to the case as a re-sult of similar family-of-origin experiences. The resource focuses onprocesses that might make the student particularly well-suited to a case,thus maximizing how the student can use her or his family history tointervene effectively.



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Using the genogram in a training setting provides a learning oppor-tunity as well as an integration of the match between thoughts andfeelings, content and process, and incorporation of personal and profes-sional identities that can impact therapeutic style and clinical effective-ness (Hardy & Laszloffy, 1995). Furthermore, creativity invitesintimacy when one has the courage and willingness to become inti-mately involved in the lives of others (Carson & Becker, 2004).

Creativity involves applying traditional approaches in fresh and newways (Carson & Becker, 2004; Carson, Becker, Vance, & Forth, 2003;Murray & Rotter, 2002). Carson et al. (2003) conducted a national on-line study to discover therapists perceptions of the role of creativity incounseling. Participants reported that creativity involves the willing-

ness to improvise, take risks, and act with immediacy. Furthermore, be-ing creative in therapy requires the ability to access the creative andintuitiveparts of both self andclient. Impediments to creativity includedtime restraints and personal limitations of the therapist, such as inhibi-tions, self-doubts, and the lack of confidence as a creative being.

As Gladding (1995) points out, creativity in counseling offers op-portunities to view life events from different and more positive per-spectives, reduces stress, and enhances coping skills. Creativity incounseling can leave a trail of experience that a client can look backon, remember, and use in present or future difficult situations (p. 5).There is no one way to be creative in counseling (p. 8); the self-cre-ated genogram provides one way to creatively discover family.

DISCOVERING FAMILY IN CONTEXT

I originally developed the self-created genogram while teaching amarriage and family introductory course. I later expanded it when pro-viding continuing education to clinicians and counselor educators atprofessional conferences. I also have employed it in my clinical and su-pervision work. Following the process over several years in classroomsettings allowed me the greatest opportunity to understand, adapt, andsolidify this modified genogram into a useful tool for the self-creationand self-initiation of the family in context.

This access to extended exploration with students in family therapycourses also allowed opportunities to gather data and identify consistentthemes. I first will provide a four-part process that can be used whentraining counselors and family therapists and then describe how the



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self-created genogram can be used in a clinical setting by providing acase example and therapeutic engagement of the process.

The four-part process involves: (a) asking the student to write a per-sonal definition of family, (b) inviting the student to represent yourfamily in whatever way you would like, (c) classroom discussion,and (d) subsequent written reflection of the process. Students are ad-vised to participate and share only if they feel safe in doing so, and todecline response to any question with which they do not feel comfort-able. I reiterate these points several times throughout the process, asneeded.

Emerging Themes of the Self-Created Genogram

I discovered a consistency in themes among the students definitionsof family, graphic depictions in the self-created genogram, and re-flection papers. I will highlight representative samples of each area be-fore providing a clinical example.

Definitions of Family

I initially request that students write their definition of family. This

helps orient me to the students cognitive understanding of family and

the breadth of their concept of family. It also creates a grounding point

for classroom discussion.Some students supplied traditional definitions, such as: Family is a

multi-layered system, held together by blood and a sense of perma-

nency and trust and support. All members know of their membership

and, either passively or actively, maintain it. Other students automati-

cally included blood and non-blood relationships.Some students shared a more expanded definition of family. For ex-

ample, one students first thought when approaching the definition

was, My family includes the people I feel attached to because of

blood and/or a feeling of permanency. However, upon further reflec-

tion, her definition of family expanded.

Family tome means support and a willingness to remainas part ofa group with a shared history and a future purpose. A group whosemembers lives are intertwined in some way, bonded together, forbetter or worse, in a variety of degrees, but permanently.



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Five definitional themes of family emerged: family as (a) formative,(b) mutually responsive, (c) continuous, (d) dedicated, and (e) safe. Astudent example of the first theme of familyasformative is as follows:

The origin from which we learn nearly everything in life, how togo about life and form who we are. It is the place where we learnhow to trust, love, and carry out relationships. Family makes uswho we are (generally and/or through experiences).

Beingmutually responsivewas a second theme. Mutuality is definednot only as a reciprocal exchange of intimacy (Moss & Schwebel,1993), but as an openness to influence, emotional availability, and a

constantly changing pattern of responding to and affecting the othersstate (Jordan, 1991, p. 82). For example, one student captured manyothers sentiments: Family is two or more people who are connectedthrough love, respect, patience, and kindness. They depend on eachother and offer support during times of laughter and tears [acceptingeach other regardless of] similarities and differences.

Third, notonly was mutual care and respect for one another impor-tant to many. Family beingcontinuousappeared important. Family in-cludes the people or significant other in your life that you come hometo every day, share your life with. Family does notdesert you, butwillbe there in good times and in bad, and you/they willalwaysbe there,no matter what.

A fourth theme, family as people who arededicatedto each other,

surfaced. When someone is family, they make the well-being of theothers in the group their highest priority in times of need or crisis and re-ceive the same type of nurturance from the group in their time of need.Finally, the theme of feelingsafewas important to some: A supportnetwork of people you can rely on, trust and love through any circum-stance or crisis. Family is your safe place. You should always be toldthe truthbut loved.

Graphic Depictions

The self-created genogram offered a beginning point for understand-ing family in context as each unique student punctuated those persons,places, or things that came to the forefront dynamically at that particularjuncture. Several themes were reflected in the students depictions offamilies. Family was represented as (a) growth-oriented/foundational,(b) circular, (c) interrelational, (d) symbolic, (e) dynamic, and (f) repre-



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sented by place. Most students represented family entirely throughdrawing with names or descriptorsadded. Some students drew family inpicture-form without any words.

A growth-orientedorfoundational representation was depicted, suchas with the visual image of a tree. For one student, the center trunk of thetree was self and partner. Below self and partner were brother and sister;above were mother and father. Branches represented family units, suchas sibling with respective family or parents, or relationships, such asneighbors and pets.

Another theme involved a circularrepresentation of family. One stu-dent drew five concentric circles with names listed within each. Belowthis drawing was a narrative.

My family consists of a set of circles you might say that impact/createa village for me. . . The closer a person is to the center circle,the more impact they have on my immediate family. All the peopleplay an important role and all helponeanother whenever needed.

This process helped this student identify layers of the familys emo-tional closeness/distance, and recognize how geographical distance af-fected the relationships.

Some students depicted and described highlyinterrelationalpro-cesses of family. For example, the genogram adaptation helped onestudent expand her understanding of the uniqueness of relation-ships and the complex interconnectedness among the members. She

began her drawing in the middle, with herself in a circle; she thendrew additional circles around the initial circle. These circles repre-sented people and animals, really close friends, and deceasedgrandparents. Next she drew a line from herself to each of the othercircles. Then the student reflected and recognized the different re-lationships among the people represented by circles. She subse-quently drew lines linking each of those relationships. Finally, sheconnected each of the outer circles to each other. She wrote at thebottom: They all have a relationship with me, but they each have adifferent relationship with one another. Each relationship is uniqueto the individuals.

Others represented family in asymbolicfashion. Many students usedan icon to represent either a whole faction, such as all siblings, or oneperson. For example, a student drew her family and her husbands fam-ily facing each other. She represented two deceased persons through theillustration of an ear and a pair of glasses. She drew a horse, which rep-



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resented a grandparent. Her drawing also contained iconsnext to peopleto represent either issues that surrounded these people (such as moneysigns) or what she remembered most (such as an icon of a book symbol-izing a persons quest for knowledge).

Another theme that emerged was family as dynamic. One studentdrew well-spaced puzzle pieces with adjectives within the pieces: nur-turing, loving, respectful, and supportive. Other descriptorswere interspersed in between the puzzle pieces: dependable/loyal,critical (constructively), and circular. At the top, on the right-handside of the page, the student drew an easy chair with the word comfortwritten above. The student wrote at the bottom of the drawing: My de-piction of a family is best described as a puzzle. All of the pieces fit to-

gether to show the elements ina family. But its important to see each asan individual piece not only as a whole.

Familyalso was represented by place. One African-American femalestudent drew a large table that spanned the entire piece of paper. This ta-ble represented a room within her home that contained a large tablewhere family gathers. Those people coming to the table are consid-ered family, whether related by blood or not. This table represents theplace where intimate connection occurs.

Reflections

Students wrote reflection papers in the ensuing week. They generally

conveyed that they enjoyed the experiential activity and found it avery enriching experience. It increased knowledge. As described byone student, the exercise helped further define my constructs of familyand the world. Not onlywas I able to move more deeplywithinmyself, Ialso found more freedom, which then helped broaden the concept offamily into a more holistic framework. I felt personal development inprogress.

It also heightened awareness. For example, one student representedfamily by drawing hearts. Sibling and parents were each in separatehearts to show how the family has grown. She wrote:

Then I put a home in the middle of the three hearts, which symbol-izes my parents home, because I feel that I have truly comehomewhenever I go there. I am sure this will change eventually in mylife, but for right now, I still feel that home is where my parentslive, which is why I still associate familywith my parents. It is neat



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to think that when I become married and one day when I say fam-ily I will be referring to [my fianc] and our children.

Students also reflected onprocessesthat supported family. One stu-dent drew a house, within which were stick figures with the relationshipidentifiers of husband, son, daughter, wife, cats. She wrote:

Within the picture I showed smoke coming from the chimney [ofthe house], which indicates to me that the house is being lived inand is alive and important. . . There are also musical notes [drawn]inside and outside of the house, because music is a huge part of ourfamily life.

Another student, who used a music symbol to represent its importancein how his family functioned, also used a river to represent distancefrom important family members and a subway to represent travel to thatfamily. For him these processes remained important to connection withfamily.

Synthesis

When viewing the total created product, it is important to attend tonegative spaces, relationships and proportions, lights and shadows,edges, and the gestalt or total product, as with any visual arts medium(Gladding, 1998). One student drew a more traditional genogram,placing self and spouse in the middle. As the student continued toadd more and more members on the spouses side, the drawing be-came more and more crowded. This was in contrast to the sparse im-age on her side of the family (parents and one sibling). Her drawingunveiled a key process occurring within the relationship, that of feel-ing crowded out by her partners family, which was confirmedduring the discussion.

Another students drawing contained a great deal of negativespace. The top one-third of the paper had the name of the student andher boyfriend, underneath it, and circled were two dogs and a catwith their names. All words were encased. At the bottom-right quar-ter of the page was a box with the name of her brother, with an inter-

spersed/dotted line drawn to him. At the very bottom-left corner wasan unconnected box with Mom and sister written together withinthat box. One might recognize a connection with brother and discon-



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nection and/or issues with Mom and sister. However, the largeamount of negative space could suggest a lack of support. The visualimage actually punctuated a loving relationship, which mirrored thestudents life cycle stage of early adulthood. This period is oftenmarked by a focus on intense relationships and building a career(McGoldrick & Carter, 2005).

Clinical Intervention

The previous descriptions reveal how high-functioning graduate stu-dents uniquely self-identified their families, framing them in contextualand dynamic manners. The students provided many examples of the

self-createdgenograms use in a training setting. The followingvignetteillustrates how the self-expressed genogram can be used as an interven-tion tool in a clinical setting.

Vignette

Amy arrived for her first appointment with Cynthia, looking pre-occupied. Susan, her partner of eightyears, just had informed Amythat she would not be going home with her for a holiday weekend.During the intake call, the counselor learned that Amy and Susanhad been together for eight years, liked many of the same things,and rarely fought. However, Amy said that she felt a sense ofstuckness with the relationship: the love was there, the mutual

interests, the friendship, and even the sexual intimacy was presentalthough erratic over the last few months.

Amy had been to therapy twice before, but each time itstemmed from a crisis. John, her first therapist, helped her recog-nize and understand her discontent in a traditional marriage. Al-though John seemed okay as she began a same-sex relationship,Amy later realized that he was unsure of what to do when itcame to her process of coming out.

That first relationship did not last. Neither did the second orthird. Amysnext therapist, Marcia, supported her through thosebe-ginnings and endings and was helpful in Amys process of lesbianidentity formation and integration. Marcia understood to thepointthat at times Amy felt some difficult processes seemed to be setaside by the therapist. At times, Marcia, who had always known shewas lesbian, took solutions and processes for granted while Amystruggled with identity management in her contextual world.



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Upon entering this therapeutic relationship with Cynthia,Amy felt a mixture of anticipation and trepidation. Susan was herlife partner and the only female relationshipof which her familyhad known. Amy was afraid of losing what she had with Susan.She asked herself if Cynthia, a heterosexual woman but clearly astrong ally, could help her process. Cynthia was well-known in thelesbian community and many of Amys friends spoke highly ofCynthia as a therapist.

The first appointment had the typical getting-to-know-youfeel. However, Cynthia asked Amy to do something different:Amy, I think it would be very helpful to our process if I couldbetter see your family. Would you be willing to take this piece

of paper and represent family in whatever way you would like?It seemed a bit odd at first. Amy was used to responding to

therapeutic questions.Although a littlehesitant at first, shequicklybecame engaged in the process. She began at the center writingpartner/self. Around that Amy drew a triangle and at the left toppoint she wrote her family. On the right top point she wrote myfamily and at the bottom point, she wrote our family. Amypaused for a few seconds and then sketched various things in theupper-left-hand side. These included hills, music notes, fireworks,and a Christmas tree. Two stick figures were placed underneath.She broke her concentration for a moment. Im no artist, you cansee. Yet after a nervous giggle, Amy returned to the drawing.

At the lower-left was a rectangle with the word bible in-side. Four stick figures underneath were drawn. These looked likeone man, one woman, and two children. A few seconds went byand Amy drew a box with three question marks placed inside. Shesighed and she gently shook her head.

Amy then went to the upper-right corner and drew a musicnote that looked like a roughly-drawn basketball scene, and twostick figures joined together with a line. At this point she wrotebasketball, and dancing, and then drew a little smiley face.Over the top of these figures was what looked like a rainbow.

She glanced at her watch. At the lower-right side of the pa-per she wrote Mom/Dad, eight names, and two roughly drawnfour-legged creatures. This time she paused longer, scanned thedrawing, and then drew a line in the bottom center, wrote twonames, and two sad faces. Amy then turned the paper for the thera-pist to see.



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Creative Representation

This self-initiated genogram formed a foundation for Amys contex-tual world that stemmed from the emotional as well as the intellectual. Itprovided a base that was referred to and reflected upon often during thecourse of therapy. Amy and her partner were drawn first and were con-tained within the triangle, a standard symbol for the lesbian and gaycommunity. (This symbol, once used as a Nazi marker for homosex-ual, was claimed and celebrated within the community as a symbol ofpower.) Amy described the balancing act of her family (Susans)and my family (Amys), and the realization that our familyprovided the pivot point.

The hills, fireworks, music, and Christmas tree represented Amysidealized family of the past. Relocation and deaths of key family figuresshifted the ideal to the real. Two figures represented an aunt and acousin, the only blood family members with whom Amy remainedclose.

A substantial amount of work revolved around the loss and grief shesymbolized in the lower left corner. The bible represented religion toAmy and the loss of family members whose religious ties were such thatthey were unable to respect the love and dedication that Amy and Susanshared. Thefour stick figures were symbolic of the Dad-Mom- and two-children families and how she and Susan struggled with finding a placewithin that framework. Amy related that some family members were so

caught up in their world of traditional family that she and Susan felt likean appendage rather than an integral part of the whole. The box withquestion marks stood for the unknown, relationships with family mem-bers that felt strained. Amy was unsure of whether the strain was a resultof naturally growing apart, family distancing because of her relation-ship with Susan, or mutual awkwardness over a culturally-laden issue.

The upper-right corner had symbols of the lesbian community: fam-ily that grew as a result of events such as womens basketball games,womens music events, and dancing. This community carried forwardAmys memories of family that shed had as a youth. What began as ashared event developed into relationships, connections, and intercon-nections that have lasted for many years. The rainbow over the figureshad a double meaning. Rainbow is a prevalent symbol in the lesbianandgay communityrepresenting freedom and power. This rainbowalsosymbolized an event that produced a vivid experience. Amy and Susanhad attended a womens concert that ended with both feeling joy for the



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couple in sharing the event, safety in being among the lesbiancommunity, and an actual rainbow on the horizon.

The lower-right corner contained Amy and Susans two pets, Amysparents, a sister and her daughters, and another sister and her husband.She also included Amysand Susans previous partners who are consid-ered family. Another named person was a lesbian woman who hadbecome Susans surrogate Mother. This person provided a sense ofhistory of the lesbian community, an example of longevity in relation-ship, and expanded the circle of extended family for Susan and Amy.

The center line with two names and two sad faces were pet compan-ions who were now deceased. Their pets had been significant for thischildless same-sex couples relationship during their formative years.

Amy referred to them as our babies and reflected on the profound lossin losing them. They were considered shared family members and weresymbolic in the couples formation, history, and longevity.

Conceptualization in Context

The clinical vignette and creative representation illustrate how thismodified genogram, initiated by the client, can be employed as a clini-cal intervention. Amys self-created genogram provides factors andprocesses that give voice to what is often ignored or obscured in clinicalwork when employing the traditional genogram.

If the genogram had been used in a conventional manner, four key ar-eas might have been overlooked. First, Amy described ongoing stress-

ors. A stressor involves an event significant enough to perturb the statusquo. Boss (1988) refers to no volitional stressors, or those originatingfrom the outside, and ambiguous stressors. Amys family withdrawal,and at times devaluation of her same-sex affiliation provide an exampleof a no volitional stressor. Ambiguous stressors were seen in the strainshe experienced with some family members since bringing Susanhome. The experience is akin to living with a sleeping giant (p. 42);one is never sure whenthe heterosexismand discrimination prevalent inAmys life may come.

A second area that emerged from this self-created genogram isheterosexism and discrimination. As we see in Amys first two thera-peutic relatings, these issues are not always explored. Still, these pro-cesses play a large role in her contextual world, affecting Amy at theindividual, relational, familial, and sociocultural levels. Regardless ofthe appearance of insulation or resources, all same-sex couples functionin the context of these two interlocking forms of oppression and the re-



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sulting internalizationof both (Brown, 1999). Amydescribed thepreva-lent, sometimes subtle marginalization experienced by lesbian women;this experience can be one that is often ignored (Brown, 1995).

In a similar way, religious exclusion and/or ambiguity surroundinginclusion can create unrest at deep levels. Clinicians who wish to be ef-fective in working with lesbian and gay issues in counseling must un-derstand how debilitating and pervasive the stressors and isolationcan be for all those concerned and respond according to the contextualdilemmas (Dahlheimer & Feigal, 1994, p. 71) that clients bring tocounseling.

Third, creating family can be a critical process for those living orhaving been raised outside the traditional nuclear family. Older notions

of family surrounded the family of procreation, partner and chil-dren, and family of orientation, the person and parent (Gelles,1995). The term family of choice has become popularized, especiallywithin the lesbian and gay literature (Green & Mitchell, 2002; Slater,1995), and this clinical vignette adds insight as to why this might be so.The term created family recognizes a viable and often preferable op-tion for individuals and couples who have either lost family support orhave found amplified kinship with those who are chosen rather thanmaintained through involuntary membership.

Furthermore, Amys clinical example makes reference to the twoprevious partners of the couple. Continuing relationships with previouspartners remain vital for many lesbian women, and integrating newpartners into the base they have established becomes an important task

(Weinstock, 2000). This continued inter-reliance of partners might bean interlocking piece of the lesbian culture.

A fourth process spotlighted by Amys self-created genogram is thebroader context of community as an essential focus for many withinthis population (Dahlheimer & Feigal, 1994). Dahlheimer and Feigal(1994) point out how the lesbian and gay community provides the al-ternative (replacement) and supplemental (adjunct) roles in fulfillingthe core functions of family for gay and lesbian clients (p. 71). Com-munity can provide protection and socialization; it can also increaseself-esteem and a sense of identity and contribute to learning basic sur-vival skills to maneuver in contemporary society. Rather than continu-ally starting from scratch, group wisdom can be gained throughcommunity relationships (Slater, 1995).

Future interventions with Amy involved a content-based genogramwhere the self-created genogram could be placed contextually withinthe larger family system. New details emerged, as well as processes sur-



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rounding gender, power, intimacy, and oppression. The therapists un-derstanding of the cultureallowedan opportunity to communicate moreeffectively and make the best use of the metaphors generated in theprocess.

The self-created genogram highlighted key points in Amys presentworld, noted past historical context, and provided insight into potentialfuture issues and strengths. In sum, Amys drawing in context sug-gested her own self and her relationship as pivotal in Amys world. Itquickly and accurately identified that extended biological family werenot presently impacting Amy due to time and geographical distance. In-dividual, relational, and familial issues existed as a result of living in asometimes hostile and/or dismissive culture, and religious and spiritual

conflict resulted. Special events expand from typical socialization toreconnection with a social and intimate support system and familywithin the larger community. The model also captured strengths forAmy and her family: community, lesbian-mother figure, strong inter-reliance with previous partners, and the importance of pets, both aspractical companions and as symbols of shared relationship. Key bloodand legal-based relationships were identified, which provided a startingpoint for the therapeutic work and a marker for people who were lateridentified but missing within the self-created genogram.

This modified approach to the genogram facilitated a strong joiningbetween the therapist and Amy, lead to discovery of central processes inAmys life, and served as a guide for their therapeutic work. Themethod was time efficient; it spotlighted those issues pivotal to Amy

and set the stage for creativity in counseling. Moreover, those peopleand processes that emerged in this self-createdgenogram remained cen-tral throughout the entire therapeutic process.

CONCLUSION

The self-created genogram assesses family-like relationships andcontexts that might otherwise go unnoticed by traditional methods. Vi-tally important information might be lost or obscured without the thera-pist first finding out what is most contextually pertinent to the client. Ichose to use a clinical example of a lesbian woman, which employswhat Akamatsu, Basham, and Olson (1996) refer to asdecentering, orpivoting the center (p. 24). Decentering is to begin from the perspec-tive of the marginalized, foregoing loyalty to the socially sanctionedworld view and, especially, to the dominant canon (p. 24).



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Although the genogram remains an important tool by which we canlearn about family, the standard genogram does not address those areasof unresolved hurt that involve people with whom we are not geneti-cally tied (Milewski-Hertlein, 2001, p. 28). In addition, it does not al-ways address the multiple systems levels. The sociocultural, political,economic, and the community-associated levels of neighborhood,work, friends, religions, and organizations (Carter & McGoldrick,2005) are all sources of potential hurt. Just as the family therapy field ischanging in one direction, the expansion of the concept of family andthe concurrent trend toward and linking of marriage and familypresents a multi-systemic conundrum.

I am not implying the self-created genogram should be used instead

of the traditional genogram. On the contrary, in my experience employ-ing both the self-created genogram and a traditional genogram is ideal.This self-initiated adaptation is particularly useful when it is initiatedprior to gathering details for the more traditional genogram approach.

Although many adaptations of the genogram exist, I found no self-initiated, self-propelled, expressive modifications of the tool, such asthe self-created genogram. This model has a multicultural appeal thatcan transcend culture and create relational touch points. Expanding cre-ativity within the therapeutic arena becomes even more important as ourculture becomes increasingly diverse (Murray & Rotter, 2002).

The self-created genogram helps to formulate a conceptualization offamily and applies theoretical and clinical constructs in counselor train-ing. It creates a vehicle for counselor-trainees to better understand

themselves, the profession, and clients world. This adaptation of thegenogram increases insight for the students own experience of familyand how it might impact the therapeutic process. Group discussion ex-pands the language around family and normalizes diversity in form, in-viting students who lack a multicultural perspective of family to beginthe process of opening their viewpoints. Additionally, it provides a win-dow to how students process information, view family, and approachothers. The self-created genogram elicits an internal perspective thatcan be clinically broadened.

This type of genogram adaptation is important not only in counselortraining, but also in clinical settings. This creative genogram helps bringinto being a sense of discovery and openness, facilitates an expandedconcept of family, and supports an interdynamic exploration of fam-ily as process versus content. Through the ensuing discussion, experi-ences are shared and more is learned about the varied process ofexperience and expression.



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Formal academic and clinical training play an integral role in obtain-ing knowledge, attitudes, and skills for future professionals (Chung &Brack, 2005). Many biases and institutionalized isms exist (Adams,2005). It is during this important developmental phase that traineeslearn to become sensitive, affirming, and competent of sexual orienta-tion issues as well as all multicultural concerns (Chung & Brack, 2005).

Family therapy, creativity, and multiculturalism all play parts in thelarger professional picture. The self-created genogram is but one at-tempt to implement a creative means to discover family and infuse abroader, multicultural approach in counseling. Yet, each step taken to-ward creating an affirmative, diversity-based training and clinical envi-ronment can produce a ripple effect. The cumulative effect of a

multitudeof tiny waves engenders a subtle but systemic change that canhave far-reaching impact in the profession.

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