Foster Placement
Draw a dotted line from biological parents. Give date of foster placement (F.P.).
The Strauss Family Genogram
Sarah is the index person. She is the second child and firstborn daughter in her sibling group. She has an older, adopted brother, Joe, whose entrance into the family followed a miscarriage. Sarah has a younger brother, Bill.
Sarah’s father, Gregory, is the youngest of three sons. Gregory’s older brother, Ralph, the first-born son, died in a car accident at the age of nineteen.
Sarah’s mother, Edith, is a middle sibling. Her two older siblings, Roger and Eve, are twins. Eve had a child, Karen, with a man whom she chose not to marry. Edith’s younger brother, Paul, has been married and divorced three times and has no children from his prior marriages. He is an alcoholic.
The genogram helps us to see that Sarah’s father, Gregory, is at an important anniversary time. His youngest child, Bill, has turned 13, the age that Gregory was when Ralph was killed. Joe (who is in Ralph’s sibling position) will soon be 19, the age when Ralph died. In addition, Sarah’s three living grandparents are in very poor health. From this information alone one can speculate that this might be a stressful time in the life cycle of Sarah’s family.
The genogram also suggests that Sarah’s brother Bill was born into a particularly anxious emotional field. Just before Bill’s birth his parents separated and reconciled and his paternal grandmother died of cancer. During the first year of Bill’s life, his uncle Edward divorced and his maternal grandmother had a stroke. These events surrounding Bill’s entrance into the family may have predisposed his early relationship with one or both parents to be emotionally intense. As a youngest child, Bill shares a common sibling position with his underfunctioning uncle Paul. How might this influence the relationship between Bill and his mother?
This genogram is only partially completed for purposes of illustration. Keep in mind that the usual amount of information included on a genogram are age, birthdate (and adoption date), highest level of education, occupation, significant health problems (including date of diagnosis), and date and cause of death for every circle and square on your family diagram and for as far back as you can search.
You may want to put other significant information on your genogram such as immigrations, retirements, and drug and alcohol problems, constructing your own shorthand or symbols to save space (for example, ALC or for alcoholic). To keep your genogram from becoming too cluttered, use a large piece of oaktag or oversized paper and keep track of important information elsewhere (job changes, re-locations, ethnic and religious backgrounds, psychiatric hospitalizations, etc).
Bibliographical Information on Genograms*
Genograms in Family Assessment by Monica McGoldrick and Randy Gerson (New York: Norton, 1985). This informative book provides a detailed description of constructing a genogram along with an introduction to its underlying interpretation and application. The authors use genograms of famous people such as Sigmund Freud, Margaret Mead, Virginia Woolf, and Jane Fonda to illustrate their points.
Constructing the Multigenerational Family Genogram: Exploring a Problem in Context. Available for rental or sale through Menninger Video Productions, Box 829, Topeka, KS 66601, 1–800–345–6036. This video illustrates the construction and use of the multigenerational family genogram. A detailed case vignette highlights the important areas of information a genogram can provide.
Notes
Chapter 1 The Pursuit of Intimacy: Is It Women’s Work?
On the impact of marriage on women’s mental health see E. Carmen, N. F. Russo, and J. B. Miller, “Inequality and Women’s Mental Health,” in the American Journal of Psychiatry 138/10 (1981): 1319–1330, which also appears in P. Reiker and E. Carmen, eds., The Gender Gap in Psychotherapy (New York: Coward McCann, 1983). Also see Jessie Bernard, The Future of Marriage, 2nd edition, (New Haven: Yale University Press, 1982) and M. Walters, B. Carter, P. Papp, and O. Silverstein, The Invisible Web: Gender Patterns in Family Relationships (New York: Guilford Press, 1988).
See Jean Baker Miller, Toward a New Psychology of Women (Boston: Beacon Press, 1986), for an appreciation of the complex links between women’s relationship orientation and women’s subordinate group status. Miller’s pioneering work has inspired new psychoanalytic perspectives on women’s investment in connectedness and relatedness. See The Stone Center Working Papers on women (The Stone Center, Wellesley College, Wellesley, MA 02181). Also see Carol Gilligan, In a Different Voice (Cambridge: Harvard University Press, 1982).
Chapter 2 The Challenge of Change
The story of the New England farmer (and related insights about the quest for personal growth) is from Robert J. McAllister, Living the Vows (San Francisco: Harper & Row, 1986), pp. 127–143.
On the subject of change (and resistance to change in families) see Peggy Papp, The Process of Change (New York: Guilford Press, 1983).
Chapter 3 Selfhood: At What Cost?
“Letter to the Editor,” Ms. magazine, September 1980.
More about women’s compromised and de-selfed position in marriage and with men can be found in H. G. Lerner, The Dance of Anger (New York: Harper & Row, 1985), chapter 2. Also see H. G. Lerner, Women in Therapy, (Northvale, NJ: Jason Aronson, 1988; paperback edition from Harper & Row, 1989), chapters 11 and 13.
See also Paula Kaplan, The Myth of Women’s Masochism, (New York: E. P. Dutton, 1984).
Traditional psychoanalytic concepts of self and theories regarding dependency and autonomy in women continue to be re-examined and revised by feminist theorists such as Jean Baker Miller and the work of the Stone Center, op. cit. See also Lerner, op. cit, 1988, Gilligan, op. cit., 1982, Luise Eichenbaum and Susie Orbach, What Do Women Want (New York: Coward McCann, 1983), and Nancy Chodorow, The Reproduction of Mothering (Berkeley: University of California Press, 1978).
The concept of self and the complex interplay between separateness and connectedness have been most fully elaborated in psychoanalytic theory and Bowen family systems theory. For a comprehensive review of Bowen theory see Michael Kerr, “Family Systems Theory and Therapy,” in Alan Gurman and David Knistern, eds., Handbook of Family Therapy (New York: Brunner/Mazel, 1981), pp. 226–64 and Michael Kerr, “Chronic Anxiety and Defining a Self,” The Atlantic Monthly 262/3 (September 1988): 35–58. Also see Michael Kerr and Murray Bowen, Family Evaluation (New York: Norton, 1988).
Bowen family systems theory differs from other systemic approaches in its attempts to root theory in evolutionary biology rather than general systems theory. Because the writings of Bowen and his colleagues are singularly male-centered in language and worldview, it may be difficult to appreciate the value of Bowen’s ideas for the psychotherapy of women. For a feminist critique of Bowen theory see Deborah A. Luepnitz, The Family Interpreted: Feminist Theory in Clinical Practice (New York: Basic Books, Inc., 1988), chapter 3, pp. 36–47. For the clinical application of Bowen’s ideas by a feminist therapist see Lerner, op. cit., 1988, chapters 12 and 13 and H. G. Lerner, “The Challenge of Change” in Carol Tavris, ed., Everywoman ‘s Emotional Well-being (New York: Doubleday & Company, 1986), chapter 18.
Overfunctioning-underfunctioning reciprocity, fighting, distancing, and child-focus have been described at length in the family systems literature as ways of managing anxiety and navigating relationships under stress. See Murray Bowen, Family Therapy in Clinical Practice (New York: Jason Aronson, 1978), Kerr, op. cit., 1981, and Kerr and Bowen, op. cit., 1988.
Chapter 4 Anxiety Revisited: Naming the Problem
The pattern of pursuit and distance has been widely described in the family therapy literature. See Phillip Guerin and Katherine Buckley Guenn, “Theoretical Aspects and Clinical Relevance of the Multigenerational Model of Family Therapy,” in Philip Guenn, ed., Family Therapy (New York: Gardner Press, 1976), pp. 91–110.
On breaking the pursuit cycle see the example of Sandra and Larry, chapter 3, in Lerner, op. cit., 1985.
Most therapeutic approaches strive for the reduction of anxiety and the awareness of its sources. On the impact of anxiety moving down and across generations see Betty Carter and Monica McGoldrick, “Overview: The Changing Family Life Cycle,” in Betty Carter and Monica McGoldrick, eds., The Changing Family Life Cycle: A Framework for Family Therapy, 2nd edition, (New York: Gardner Press, 1988), pp. 8–9. Also see Betty Carter, “The Transgenerational Scripts and Nuclear Family Stress: Theory and Clinical Implications,” in R. R. Sager, ed., Georgetown Family Symposium 3 (Washington, D.C.: Georgetown University, 1975–76).
Chapter 5 Distance and More Distance
I am grateful to the well-developed theoretical insights of Murray Bowen regarding distance and cutoff from nuclear and extended family.
Chapter 6 Dealing with Differences
My interest in ethnicity in the therapeutic process was sparked by a workshop conducted by family therapist Monica McGoldrick, whose teachings are reflected in this clinical example. Also see Monica McGoldrick, J. K. Pearce, and J. Giordano, Ethnicity and Family Therapy (New York: Guilford Press, 1982) and Monica McGoldrick and N. Garcia Preto, “Ethnic Intermarriage: Implications for Therapy,” Family Process 23/3 (1984): 347–364.
Reactivity should not be confused with effectively voiced anger that serves to challenge the status quo and preserve the dignity and integrity of the self. On the importance of female anger and protest see Teresa Bernardez-Bonesatti, “Women and Anger: Conflicts with Aggression in Contemporary Women,” in the Journal of the American Medical Women’s Association 33 (1978): 215–19. For a comprehensive overview on anger see Carol Tavris, Anger: The Misunderstood Emotion (New York: Simon & Schuster, 1982).
Marla Beth Isaacs, Braulio Montalvo, and David Abelsohn have written a useful book for therapists (and others involved in the divorce process) to help divorcing parents move out of intense, child-focused triangles toward more functional parenting. See The Difficult Divorce (New York: Basic Books, Inc., 1986).
Chapter 8 Understanding Overfunctioning
I am grateful to Katherine Glenn Kent for helping me to appreciate the fine points of the overfunctioning-underfunctioning reciprocity in my clinical work. More on this subject can be found in Bowen, op. cit., 1978, Kerr, op. cit., 1981, and Kerr and Bowen, op. cit., 1988.
On modifying an overfunctioning-underfunctioning pattern see the example of Lois and her brother in Lerner, op. cit., 1985, chapter 4.
Family therapist Marianne Ault-Riché has co-produced an educational videotape describing her attempts to modify her overfunctioning position in her family of origin. See Love and Work: One Woman’s Study of Her Family of Origin, (Menninger Video Productions, The Menninger Foundation, Box 829, Topeka, KS 66601).
Part of this case example was previously published by H. G. Lerner, “Get Yourself Unstuck from Mom,” in Working Mother, December 1986, pp. 64–72.
Chapter 9 Very Hot Issues: A Process View of Change
Lyrics by Jo-Ann Krestan from the musical Elizabeth Rex or The Well-Bred Mother Goes to Camp. Produced by the Broadway-Times Theatre Co. New York City, December 1983. Used by permission.
On a daughter’s disclosure of lesbianism to her mother see Jo-Ann Krestan, “Lesbian Daughters and Lesbian Mothers: The Crisis of Disclosure from a Family Systems Perspective,” in Lois Braverman, ed., Women, Feminism, and Family Therapy (New York: The Haworth Press, 1988).
On the costs of secrecy for the lesbian couple see Jo-Ann Krestan and Claudia Bepko, “The Problem of Fusion in the Lesbian Relationship,” Family Process 19 (1980): 277–289.
I am indebted to Sallyann Roth and Bianca Cody Murphy for these and other questions and for their lucid work on systemic questioning with lesbian clients. See Sallyann Roth and Bianca Cody, “Therapeutic Work with Lesbian Clients: A Systemic Therapy View,” in M. Ault-Riché, ed., Women and Family Therapy (Rockville, MD: Aspen Systems Corporation, 1986), pp. 78–89.
Chapter 10 Tackling Triangles
Triangles are a key concept in most family systems approaches. I am grateful to the teachings of Katherine Glenn Kent on triangles in family and work systems.
For a comprehensive review of triangles within marriage and the family see Philip Guerin, L. Fay, S. Burden, and J. Gilbert Kautto, The Evaluation and Treatment of Marital Conflict (New York: Basic Books, 1987). Also see Kerr, op. cit., 1981 and Kerr and Bowen, op. cit., 1988.
Chapter 11 Bold New Moves: The Story of Linda
For a detailed description of moving out of a child-focused triangle, see Lerner, op. cit., 1985, chapter 8. Also see Maggie Scarf, Intimate Partners (New York: Random House, 1987).
Chapter 12 Our Mother/Her Mother/Our Self
Part of this case example appeared in Lerner, “Get Unstuck from Mom,” op. cit., 1986.
For more on the subject of navigating separateness and connectedness in the mother-daughter relationship see Lerner, op. cit., 1985, chapter 4. Also see Lerner, op. cit., 1988.
Mother-blaming and a narrow mother-focused view of family problems still characterize both psychoanalytic and family systems theory and therapy. See Nancy Chodorow and S. Contratto’s “The Fantasy of the Perfect Mother,” in B. Thorne and M. Yalom, eds., Rethinking the Family: Some Feminist Questions (New York: Longman, 1982), pp. 54–75. Also see Lerner, op. cit., 1988, pp. 255–285 and Evan Imber Black, “Women, Families, and Larger Systems,” in Ault-Riché, ed., op. cit., 1986, pp 25–33.
See also Adrienne Rich, Of Woman Born (New York: W. W. Norton, 1976), Lois Braverman, “Beyond the Myth of Motherhood,” in Monica McGoldrick, C. M. Anderson, and F. Walsh, eds., Women in Families (New York: W. W. Norton, 1989), chapter 12, Luepnitz, op. cit., 1988, and Walters, Carter, Papp, and Silverstein, op. cit., 1988.
Thanks to Rachel Hare-Mustin, a pioneer in feminist family therapy, for her quote on women’s guilt.
Psychoanalytic theory has tended to “pathologize” the mother-daughter dyad, focusing narrowly on the darker side of separation struggles in this relationship. For new psychoanalytic contributions that challenge traditional views see J. V. Jordon and J. L. Surrey, “The Self-in-Relation: Empathy and the Mother-Daughter Relationship,” in T. Bernay and D. W. Cantor, eds., The Psychology of Today’s Woman (Hillsdale, NJ: The Analytic Press, 1986), pp. 81–104. Also see J. L. Herman and H. B. Lewis, “Anger in the Mother-Daughter Relationship,” in Bernay and Cantor, eds., op. cit., 1986, pp. 139–168.
Chapter 13 Reviewing Self-Focus: The Foundations of Intimacy
Communicating from a self-focused position requires the ability to take an “I” position on important issues. Thomas Gordon, founder of Parent Effectiveness Training has done pioneering work on “I” messages. His book Parent Effectiveness Training (New York: New American Library, 1975) is a useful model of self-focused communication for all relationships. See also Lerner, op. cit., 1985, chapter 5.
Bowen theory and therapy are especially useful in gaining a broader, more objective perspective on the emotional process (including cutoffs and triangles) in one’s own family and working to gradually modify one’s own part in the patterns that block growth. The adoption experience is an example of a particularly intense cutoff where the adoptee’s inquiry and search for birth parents may consciously or unconsciously be experienced as a disloyalty, threat, or betrayal. See Betty Jean Lifton, Lost and Found: The Adoption Experience (New York: Harper & Row, 1988) and Twice Born: Memoirs of an Adopted Daughter (New York: Penguin Books, 1977). As a rule, any significant cutoff from a key family member binds intense underground anxiety and emotionality that may hit one like a ton of bricks during (and not until) the process of re-connecting.
While the importance of a life plan for women may seem more than obvious, I am grateful to Betty Carter and Katherine Glenn Kent for their insightful thoughts on the subject.
A life plan is crucial for women, not only because of our special vulnerability to poverty, but also because economic dependence on a man impedes or precludes the process of defining the self and taking a bottom-line posit
ion in that relationship. See Lerner, op. cit., 1988, pp. 243–246 and Walters, Carter, Papp, and Silverstein, op. cit., 1988.
Epilogue
Any attempt to understand, diagnose, or treat human problems apart from the socio-political context (including the profound impact of gender-determined family and work roles) is necessarily problematic. For a provocative commentary on current psychiatric diagnosis see Matthew P. Dumont, “A Diagnostic Parable (First Edition–Unrevised),” in Readings: A Journal of Reviews and Commentary in Mental Health 2/4 (December 1987): 9–12.
Feminist psychoanalytic thinkers have long challenged and revised traditional phallocentric views on female psychology, and they continue to do so. Only recently are family systems thinkers re-examining theory and practice from a feminist perspective. See McGoldrick, Anderson, and Walsh, eds., op. cit., 1989, chapter 1, for a brief history of feminist contributions to the family therapy field. Also see Judith Myers Avis, “Deepening Awareness: A Private Study Guide to Feminism and Family Therapy,” in Braverman, op. cit., 1987, pp. 15–46 and Walters, Carter, Papp, and Silverstein, op. cit., 1988.
To raise one’s consciousness and to keep current on ideas and issues central to women’s lives I recommend subscribing to New Directions for Women (published since 1972), 108 West Palisade Avenue, Englewood, NJ 07631.
About the Author
Harriet Lerner is one of today’s most respected voices on family relationships. She is an internationally renowned lecturer and consultant who has published widely here and abroad, in professional journals as well as popular magazines. For more than two decades, Lerner was a clinical psychologist and psychotherapist at the Menninger Clinic in Topeka, Kansas and a faculty member of the Karl Menninger School of Psychiatry. She currently has a private practice in Topeka, Kansas. Her books include the New York Times bestseller, The Dance of Anger, and The Mother Dance: How Children Change Your Life.
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