The Genogram

I started working with primarily Native American program participants in 1984, after completing my coursework in community counseling with a concentration in chemical dependency counseling. At first, I interned and then worked at detox.

Soon after, I worked at a men's halfway house for a few years before moving on to an inpatient treatment program. There, I worked with both adult males and females, with an occasional 16-18 year old.

When working at the treatment program I met Virginia Satir and her work with Native Americans was a great fit. I could see how her methods would be helpful. She had her institute and teachings at a program in South Dakota. It was called a Tiospaye.

While there I was told some of her philosophy. She believed that symptoms of individuals in families express family pain. It took me a few more years until I went to graduate school to learn family and couples therapy.

I started using the family tree and other pictures or maps after graduating with a community counseling degree. So when working with family reconstruction I was familiar with the genogram. I just didn't think many would get the symbols without help.

I was wrong, but always gave people the option of drawing their family or making a family tree. Many Native American people are visual learners and benefit from pictures explaining the family and what is going on.

I had been asking people to draw their family to talk about what may be learned from that or I would draw it as we talked to have a reference to what would be important to work on to show them.

We would use family reconstruction with the treatment group and staff during family week. The person's family that we would reconstruct would be someone in the middle of their treatment experience. They would volunteer.

Our lead counselor, who had the most experience and training with Virginia Satir would handle the reconstruction. A couple of times we were asked to go to another program during a family program to do a reconstruction.

While there, at the first one, we had the group working on genograms, when one of the participants called me over. He said, look at this! No wonder I am here! I couldn't be anywhere else! Looking at his genogram I could see what he was referring to.

He had identified everyone in his family, except the very youngest as alcoholic or drug addicted. Then he said, "How could I be anything else!" That young man was sober until he died. He probably had 30+ years in recovery by then.

A few of the things that were important to me when working with people:

Were there any suicides in the family tree? If so, that permits someone else in the family to do that. Was there boarding school, foster care, or adoption involved in the family? That makes it difficult to keep children, even when they don't understand why they want to place them.

It helps the program participants to get the connection. I would recommend respite from relatives or friends as there were too many voluntarily placing children in foster care or group homes. It seemed to take place at the age they were placed.

If the parent had something happen, like cancer, diabetes, or addiction, how likely would that be to happen to their child or grandchildren? Are prevention activities reasonable then?

When you know what is going on with the person and their family, it is possible then to help to put some things in place to help work through that. Grief work is always necessary and the genogram helps to identify some of the areas where the work is needed.