Journal of Family Therapy (1979) 1: 51-64

Transgenerational analysis : the geneogram as a

technique in family therapy

Stuart Lieberman"

This paperintroduces the concept of transgenerational analysis and

describes the use of the family geneogram as an important instrument in
the elucidation of family structure and dynamics.Familytherapy is a
rapidly growing field of psychological treatment which Glick and Kessler
(1974) have defined as'anytype of psychotherapeuticapproach that
attempts to understand or to intervene in an organically-viewed family
system'. T h e growth of thisapproach to psychosocial problemshas
required the development of concepts andinterventions based onthe
familywhichcan beintegratedwithpreviousintrapsychicandinter-
personal models. Crowe (1976) describes three broad theoretical schools
in familytherapy,behaviourism,systemstheoryand psychoanalysis,
which are rangedalong a dimensionfromdirective to non-directive
respectively. He describes another dimension from the radical view that
all problemsare essentially familyones tothe conservative view that
familypressureswhichworsenindividualpathologymay usefully be
treated.
There is a third dimension which ranges from the position that the
current verbal and non-verbal interactions are the sole material on which
to base treatment to the historical approach in which exploration of the
past provides the sole basis for insight into thepresent circumstances. It is
to this dimension which transgenerational analysis addresses itself, in an
attempt to understand and catalyse the present through the use of the
past.
Transgenerational analysis is an analysis of the transmission of family
culture in itsbroadest sense from one generation to the next, encompassing
thosepatterns,styles,customs,ceremonies,secrets,mythsanddys-
functions which determine the uniqueness of a family. It has been defined
(Paul and Paul, 1975) as the decoding of influences in areas such as sexual

* Department of Psychiatry, St George's Hospital Medical School, London

SW 17.
0163-4445/79/010051+ 14$02.00/0 01979 The Association for Family Therapy
51
52 S. Lieberman
behaviour, patterns of communication, death and grief which then enable
the family to gain the self-knowledge needed for a maturing andsatisfying
relationship. It thereforeseeksto link thepresentdisturbed nuclear
family to the past, if necessary four or five generations back, as well as to
the
present extended family. Transgenerational analysis allows the
therapist to obtainessential data about importantaspects of family history
and life, providing a blueprint for the changes required to alter present
dysfunctional interactions. For the family, the analysis can build up the
familys feeling of identity and provide a collective experience which may
temporarily reduce current tension, produce feelings of empathy between
hitherto hostile family members, and allow a dialogue to develop across
generational boundaries (Walrond-Skinner, 1976).
The analysis of family themes and the communication of maladaptive
behaviourwithin families wasdescribedbyMendelandFisher (1956,
1958). They analysed communication responses toprojective psychological
testswhichwereadministeredseparatelyto up to 27 different family
members of the same family. Common recurrent themes such as a concern
for unworthinessorstrictandrigidcontrolwereevident.Mendeland
Fisher later went on to use this method clinically to determine the best
means of practical intervention intheir families undertreatment,but
theirmethodrequiredlengthyindividual sessions with psychologists
(skilled in administering projective tests). Recently, a detailed account of
marital therapy using transgenerational analysis was published (Paul and
Paul,1975)describing the way in whicha sensitive clinician usedhis
skill to remove the influence of the previous generations from position
a of
dominance within and between a couple.
T h e clinical background of thispaper is the writers experience in
individual, conjoint maritaland conjoint family therapywith over 100
families seen in a number of settings oversix years. Most of the designated
patients were late adolescents or adults. The clinical setting hasvaried
from inpatient and outpatient units in an American Teaching Hospital,
outpatient units in an American State Hospital and both inpatient and
outpatientunits of EnglishMentalHospitalsandTeaching Hospitals.
The majority of families were treated without a co-therapist. The length
of treatment varied from one to 18 sessions over a period of 18 months.
The frequency of meetingsvaried from weekly to bi-monthly.Most
sessions lastedoneanda half hours. The diagnoses of the designated
patients and some other family members included neurotic, personality
and psychotic disorders. I n all treated families transgenerational analysis
was employed.
 Tramgenerationalanalysis 53

Construction of the geneogram

A geneogram is a visual diagram of family structure, which may be used
to elicit family patterns. It incorporates family relatedness, age, sex, life
events such as births,marriages,divorces and deaths, and may include
profession,familyrole and emotionalbonds. Its descriptionhasbeen
publishedonlyoncepreviously(Guerin, 1976) although the methodis
widely used by family and marital therapists. The geneogram is used in a
family sessionto build the family structure in frontof the family, involving
all of them in the process. By particular attention to emotionally charged
events, specific areas of family disturbance are covered systematically and
thoroughly in a neutral context which helps the family to deal with the

RTLR
m
Figure 1
54 S. Lieberman
emotionallychargedmaterial. The systematic nature of the process
allows family secrets and family myths (Byng-Hall, 1973) to be revealed.
Attempts at concealment can be inferred from conflicting statements or
any associated reluctance to speak freely.
The technique is used as follows: The family are invited to respond to
questions and the data is written either on a blackboard or on paper for
all to see. Information which is repressed or unknown is noticed by its
absence, and the family are asked to discover the missing facts and bring
them to the next session. The figurative representations are easily learned
and can be taught to family members so that they can make their own
drawings. T h e following transcript illustrates its use. It is an important
inclusion because of the difficulty inherent in describing a process which
depends on interpersonal interaction. It is descriptive of the mechanics
of constructing a geneogram, aswell as the use of the process in obtaining
data, involving the marital couple, and providing a blueprint for change.
Figure 1 indicates the different stages reached in the transcript and shows
the step-by-step process of construction.

Therapist : You had to learn to be theway you are from someone. Maybe
this is a good time to draw your family back up on theboard.
(Moves to blackboard.)
Husband: I used to ask about the past an awful lot but its very hard to
get anything out of my family.
Therapist: They wouldnt answer.
Husband: Right, or they didnt know.
Therapist: Thats you. [Figure l(a).] We want to go up to grandparents.
Youre an only child?
Husband: Yes.
Therapist:Andwhen I ask you that, were there any miscarriages or
stillbirths?
Husband: Not that I know of. [Figure l(b).]
Therapist: Do you know why youre an only child?
Husband: I think my mother had a very hard time with my birth and
wasnt able, or didnt want any more children afterwards.
Therapist: Have you asked her?
Husband: Its not something I can talk about with my parents.
Therapist: Now, your grandmother.
Husband: My mothers mother. Shes still alive. She had two children.
I think my uncle is older. Her name is Nelly. Mothers name
is Lilly.
Therapist : And your grandfather?
 Transgenerationalanalysis 55
Husband: Grandfather? He was quite a character. He left her quite early.
Hes dead. [Figure l(c).]
Therapist : He left her !
Husband: After the two children were born he left pretty soon after-
wards-apparently went off with another woman and had lots
more children, so I have some other family somewhere.
Therapist : And they were divorced?
Husband: Im not sure. That is a subject Ive tried my hardest to find
somethingabout. It just upsetsmygrandmother so much
trying to talk about it.
Therapist : Did she love him?
Husband: I think so, very much so.
Therapist: Did she ever lose her love for him even though he left? Is she
bitter about it?
Husband: She cries when she talks about it now.
Therapist: She still does.
Husband: Yeah.
Therapist: But is it bitterness? A feeling of missing him? . . . loss?
Husband: Maybe a little bitterness and a little loss. Shes always going
on that my mother isalways giving my father a hard time and
doesnt realize what a good man he is being my father. She
says she doesnt know how lucky she is to have him. Shes a
lonely old lady, my grandmother and she had nothing but a
hard time all her life. Its a shame !
Therapist: How old is your mother?
Husband: Lets say 54.
Therapist: And your uncle?
Husband: My uncle would be two years older, I think hes 56.
Therapist : Whats his name?
Husband: Bill. [Figurel(d).]
Therapist: Bill, O.K. and where do they live?
Husband: They live all within about 200 yards of each other in a block
of flats in Brighton, which is my home.
Therapist: So, its not for want of not having the opportunity to go visit
them that you dont see them!
Husband: Well, I used to go and see my grandmother nearly every day,
or at least two or three times week.
a Id try and cheer her up.
Therapist: She sounds as if she is really one of the crucial people in your
life.
Husband: I think she was especially when I was young. I always used to
turn to her andshed protect me.
56 S. Lieberman
Therapist : And also that he (grandfather)was one of the crucial people in
her life. When did he die?
Husband: 1 dont know. Its a mystery, a total mystery. I can only guess
about him.
Therapist: Have you asked your uncle?
Husband: I tried to, but no one would answer. They cut him off from
the family.
Therapist: It sounds as if you just dont know how to ask them.
Husband: Well, maybe I dont. You know, whatdo I say?Grandma,
can you tell me about grandpa?
Therapist: Well, maybe its something to do with them wanting to know
why you want to know.
Husband: Why I want to know. (Pause.) I dont see that. I think that
theyd volunteer the information if they had it.
Therapist : They obviously have a lotof information theyre not volunteer-
ing.
Husband: Yeah. He had some trouble with the police I think at one time.
Wife: Well, maybe they feel itis a veryshamefulthing.
Husband: Yeah. Thats a lot of it I think. You know, those days divorce
was aterrible,terriblethingand especially whentheres
children and hed go off with another woman. Hed be a real
black sheep and thedisgrace of it all; theyd probably have to
suffer at the time . . . oldladiestalkingbehindtheir lace
handkerchiefs about them and thattheyd cover it all up.
Therapist: But is it still a disgrace after all these years?
Husband: Oh, I think it doesnt disappear. Those timesareincredibly
different to what they are now.
Therapist: So why do you want to knowaboutitall?Why have you
actually gone back and asked qucstions?
Husband: I always wantedagrandad. I hadanidea of anoldwhite-
haired man and youd sit on his lap and hed tell me stories.
I never had that. My grandmothers mother was alive until a
few years ago and when I was young my fathers mother was
alive but his fatherwas dead so it was a nearlyall female family.
Therapist: Except for your uncle.
Husband: Except for my uncle Bill and my father.
Therapist : Does your father have brothers and sisters?
Husband: Yeah, he has about eight . . .
Therapist : You didnt know anything about them?
Husband: Ive met them periodically but not that often. He was one of
eight lets say some boys, some girls.
 Tramgenerationalanalysis 57
Therapist: And he died? (Pointing tofathers father.)
Husband:Whenmyfather was eightyearsold andmygrandmother
died when I was about that age, I think.
Therapist : Eight?
Husband: Letssayeight.
Therapist: How old are you now?
Husband : 26.
Therapist : When were you born?
Husband: 1949.
.
Therapist: Born 1949. Lets see that would be 1957 . . [Figure l(e).]
Husband: Yeah,nearenough. I dont really know. At the funeral we
went along and played with my cousins in the garden while
they went off and buried her.
Therapist: How did that affect your father?
Husband: Its hard to say. Obviously he was very upset. I think death
and illness really worry my father.
T h e following analysis is based on the husbands geneogram as well as
that of his wifes.

Analysis
T h e husband, M r R. feltresponsibleforcheering his wife from the
depressionwhichbeganshortlyaftertheirmarriage,which was the
cause of her presenting symptoms. This tendency to cheer up others
was present in all previous relationships of his with other females and
was rooted in his childhood when he cheered his grandmother from her
depression. He also gained the expectation that after marriage, husbands
either die or leave home but that they do not last long enough to be
grandfathers. Mrs R. whose depressionhad itsantecedentsinher
fathers death when she was eight years old, presented with depression
soon after marriage. Marriage for her re-awakened her childhood feelings
of loss. T h e more her husband attempted to cheer her up, the greater
was her feeling of loss stimulated by his presence and imagined proxi-
mate death, or departure.
This analysis provideda provisional blueprintforchangebywhich
the husband could be induced to form a new relationship with his grand-
mother based on understanding and empathy, rather than a responsibility
to cheer her up and replace her husband. Through that change he could
alter his relationship with his wife. If he no longer need cheer his grand-
mother,and couldtalkwith herabout distressingpersonal details, he
58 S. Lieberman
would thenbe able to relatetohis wife in a similar way. Whenhe
accomplished this change through task setting, his changed reactions to
his wife were enoughto considerably ease herdepressivesymptoms.
Further work was necessary to deal with the transgenerational input from
her family.

Transgenerational analysis in practice

T h e following additional case material is included to illustrate the uses
and limitations of this method. T h e examples were chosen to underline
the important ways in which it can be helpful in psychological treatment.

Figure 2

T h e first example(see Figure 2) shows its useas a meansof obtaining the

information that a therapist requires to integrate the past emotive history
and the present existing circumstances into a cogent whole, in order to
set goals in therapy.
Mr and Mrs H. were referred for marital treatment by her G.P. She
had been treated for five years for chronic anxiety and depression, but
had become exteremely anxious and depressed since the ending of a
lesbian affair with a much younger woman at work. Her husband was a
genial inoffensive man whose outward acceptance was viewed by his
wife as indifference. He was genuinely puzzled by his wifes disturbance.
She expressed strong guilt and disgust that were not dispelled by
medicationsorsupportivepsychotherapy, and maritalrelationshad
become tense.
 Transgenerational analysis S9
A marital session in which a geneogram was constructed revealedthat
Mrs H. was the oldest and only daughter of a mother who was sexually
promiscuous. She was married three times, thefirst of which was ended
after she gave birth to a child whose father was her husbands brother.
Her mothers brothers and sisters had all had sexual problems. These
were related to Mrs H.s grandmother who died of carcinoma of the
utcrus. Her grandfather re-married soon afterwards, but the children
were fostered for several years in their early teens. No discussion was
ever allowed about the death of their mother on their return to the
parental home.
Mrs H. related the facts about her mothers sexual abuses with the
same disgust and guilt she had reserved for her catalogue of her lesbian
relationship.Sheangrilydenouncedhermotherandherhusband
confirmed that his wifes guiding principle was to avoid being in any
way similar toherownmother. Mr H. came fromastable family
background in which he was the youngest of six sons. He admitted his
naivete on sexual matters and his lack of experience with women. Mr
and Mrs H. had two children, both girls.

Analysis
T h e lesbian affair had three meanings, first, a loss of sexual control;
second, a similarity with mother, a hated object; and third, a hidden
love for mother. The resultant internal conflict led to the symptoms of
guilt,disgust,anxietyanddepression. The familial theme of sexual
difficulties were directly traced to grandmothers disease, death and its
aftermath. Fear for the effects of her own indiscretion on her children
was an unconsciousacknawledgement of the familial pattern.Her
husbandsfamilybackgroundprovidedhimwithlittleexperiencein
dealing with women and their problems.
From this analysis, a plan was devised to (1) change Mrs H.s view of
andrelationshipwithhermother; (2) educate Mr and Mrs H. about
sexual matters and (3) bring Mrs H. more closely into her ownfamily life,
reducingher fear of her influence onthechildren. T h e effect of the
accomplishment of these tasks was to remove all symptoms,endthe
necessity for psychotropic medication and strengthen the marital bond.
The second example (see Figure 3) is illustrative of the way in which
transgenerational analysis serves as a therapy on itsown. A representative
case has been chosen of a patient seen individually. The use of trans-
generational analysis can be particularly effective with individual patients
60 S . Liebermun
who are thenmotivated to investigatein vivo, through task setting, the data
and analysis generated during the session. This method of treatment in
which the family are involved in therapy outsideof the individual sessions
was pioneered by Bowen (1975). It can also be used in conjoint family
sessions.
M = MARRIED

VIOLENT MAN
D - DIVORCED

4th 5th 6th 3rd 2nd 1st MARRIAGE

MRS B. SUICIDE AnEMPT

Figure 3

Mrs B. a 32-year-old banker, was referred suffering from unremitting

bouts of crying following hersecondmarriagetoa colleague. Her
symptoms included waves of tearfulness, poor sleep and appetite and
feelings of worthlessness. Ive lost my independence since marriage
was her plea. She complained of lack of trust in her second husband,
a poor sexual relationship and constant rejection which was mutually
felt. Her husband had agreed to marital treatment but she was seen on
her own. Her geneogram revealed that for three generations her aunts,
sisters, mother and grandmother had all been unable to maintain stable
marital relationships.
Mrs B.s mother had been divorced six times and was seen by her as
an incompetent women needing men to structure herlife. Grandmother
 Tramgenerational analysis 61
had left her husband, hadnever re-married andwas seen as independent
and resourceful. The patienthadbeenpartlyraisedbyhermother,
partly by her grandmother. Mrs B. had made a poor marital choice in
her first marriage and was now wondering if she had done the same a
second time.

Analysis
The patient was theproduct of atransgenerationalhistory of poor
marital relations. Her conflict was, in family terms, whether to emulate
grandmother, independent and resourceful with no need of men, or
to be like mother,inadequateanddependenttiedtounsatisfactory
relationships with men. Her need to fulfil a womans role of sexual and
family life conflicted with the need to be an independentperson.
The analysis above was explained to Mrs B. who then recounted that
her symptoms had begun when her husband, after two months marriage,
haddecided not tohavechildrencontrary to theirpre-maritalunder-
standing. The explanation of the transgenerational history and its effects
oncurrentinternal conflictsled Mrs B. to becomemore independent
fromhersecondhusband. A consciousdecision was madebyherto
integrate the best from both mother and grandmother. Her relationship
improved steadily and by her next appointment she was asymptomatic.
The third example(see Figure 4)illustrates the use of transgenerational
analysis to build up a familys feeling of identity and involvement, and
reduce tension in a session.
Miss S. a 17-year-old anorexic girl was discharged from a specialized
anorexic unit after failing to co-operate on her diet. Her family were
referred during the ensuing crisis. The interview began with all four
family members tense and angry. Discussion about the patient and her
dietandeatinghabitsheightenedthehostilitywith Mr and Mrs S.
joining together angrily against their daughter while their 20-year-old
sonwithdrewinto silence. A blackboard and chalkgeneogram was
introducedintothe session at thispoint. The details revealed the
marriage between Mrs S. and Mr S. to be a stormyIrish-English union
with Mr S. identifyinghisdaughterwithhismuch-lovedandover-
protective mother. Mrs S. revealed that she had left her husband and
gone backto Ireland while hewas having an affair with another woman.
When she had been in Ireland for a week her father died from a stroke.
Her husband ended his affair and rushed to Ireland. Mrs S. lost all
feeling for her husband at that time.
62 S. Lieberman
T h e marital home became a battleground relieved by the infrequent
closeness of sexual relations between Mr and Mrs S. When her meno-
pause occurred the sexual relationship ended and the identified patient
began to lose weight. The effect of the uncovering of this material in
the session was to draw brother andsister closer together, while Mr and
Mrs S. acknowledged for the firsttime theirdeep marital division.
The tension and anger was significantly reduced between all parties.

W R YJOHN
EMlLY HORATIO

ANOREXIA NERVOSA
IARTHURI MARTIN JOANEMllY
k k
3 MOMHS 3 MOMHS

0
Figure 4

Analysis
Marital tension between the parents was traced to the loss of affection
Mrs S. felt at her fathers death. She blamed her husband for his death
and allowed sexual relations only when tension at homewas unbearable.
After menopause sexual relationsceased and thetension at homebecame
too great. M r S. lavished his affection on his daughter, the image of his
mother and she began to worry and lose weight, as her struggles for
independencefromherparents nowseemed impossible. Uncovering
the marital tension relieved the family tension in the session.
Mr and Mrs S. agreed to joint marital sessions and Miss S. was dis-
charged fromtreatment.Shereturnedfor several conjoint sessions.
Althoughremainingbelow her targetweight,she was no longer losing
weight. She showed a visibly lowered sensitivity to her parents arguments
and hassincemoved away fromhome in pursuit of her professional
career.
 Transgenerational analysis 63

Discussion
T h e geneogramserves both historical andtherapeuticfunctions. The
geneogram is a formal and neutral way to take a history. Some systems
theorists mayfeel the gestalt of the family and theirinteractions are enough
to proceed onintherapybutfew familytherapiststotallyignore the
historical approach.
Traditionally, medicine hasrelied heavily on history-taking as providing
60 to 80% of the necessary information for the diagnosis of dysfunctions.
There is no reason to suppose that this contribution is any less in family
pathology. The observations of a gestalt of the family interactions is more
akin to the physical examinationwhich is an integral part of the total
process bkt cannot displacethe whole. T h e systematic nature of geneogram
construction can ensurea measure of uniformity in taking family histories
for family pathology. T h e history can then be used along with other data
to proceed tothe transgenerational analysis which will provide the
formulation of a case and suggest the required treatment for thefamily.
History-taking, ordinarily, is no substitute for treatment. T h e confusion
arises when insight gained from the history-taking process leads patients
to change their behaviour towards their family. Providing meaning is an
element of most psychotherapeutic procedures. T h e meaning inherent in
family patterns, myths and dysfunctions is readily understandable at face
value. It requires little in theoretical underpinning to explain that in each
of three or four generationsmaritaldiscordhasbeen the rule, or that
fathershavedivorced,disappearedordied in earlymarriage. If these
insights lead to spontaneous behaviour change which cause relief from
family dysfunctions, then it is a therapy in itself. As in the R. family, the
geneogram forced recognition that an existing extended family member
was a vital influenceand pointed the way to a method bywhich the therapy
could extend outside the session. Changes in relationships occurredthrough
the changedcommunicationpattern, allowing arelativewhomay have
been unwilling to enter the formal family sessionto enter therapy without
actually meeting the therapist.
T h e limitations of the geneogram and transgenerational analysis arise
with those families who realize the meaning of their dysfunctions, under-
stand the transgenerationalpatterns that pervadetheirinteractions, yet
cannotchangetheirinteractions. The repetition of patternsfromone
generationto the nextleadsomepatients to fatalistically accept the
immutable nature of their problems, entrenching them further in their
pathology. The temporary reduction of tension achieved in the S. family
hadnopermanent effect onthe maritaldiscordwhile the patients
64 S. Lieberman
anorexia,thoughcontrolled, didnot rcmit. I n these families the use
of historymustbetochangethepresent,not seek for causes inthe
past.
Searching for past causes with no prospect of future changes is history-
taking for its own sake. An analysis which helps conceptualize need not
make the solution to a family dysfunction or an individual problem any
less painful or difficult. For example, to know that one mustconfront ones
grandmother as Mrs R. did makes the confrontation no less difficult,
nor does it provide the inner resolve for that confrontation.
For transgenerational analysis to be effective it must predict problem
areas and those predictions shouldbe used towork out successful strategies
of treatment. T h e examples provide evidence that use of geneograms and
their subsequent analyses were clinically useful. The dimension of time,
in determining aspects of family life, is brought into treatment so that the
emotionally important historical events of the family are integrated with
the existing circumstances. I n this way there is an ordering of the view of
the family and the therapist which can, at times, provide the sole or main
therapeutic intervention.

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GLICK,I. D. and KESSLER,D. R. (1974) Murital and Family Therapy. London.
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GUERIN,P. J., JR (1976) Family Therapy-Theory and Practice. Gardner Press, Inc.
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