We are social creatures. Perhaps more than anything, our relationships with our family members and friends define us. Healthy relationships bolster us and help us act confidently in our communities; estranged or conflicted relationships undermine our sense of wellbeing and send ripples through our engagement with others.
The consequences of a damaged relationship can be far-reaching, even more so than we might understand in our day-to-day and personal interactions. Families replicate patterns of individuals long gone. And feelings of anger, anxiety, or depression may find in their origins a conflict long forgotten or ignored.
One of the significant challenges of therapy — for both clinicians and patients — is understanding and tracking those key relationships. In The Genogram Casebook: A Clinical Companion to Genograms: Assessment and Intervention, Monica McGoldrick outlines her method for doing just that by using genograms to diagram the wide range of human relationships.
The Genogram Casebook, as evident from the title, is a practical guide to the use of genograms. Within it, McGoldrick shares examples and strategies for using genograms in therapy. Ahe also addresses particular points of concern, such as dealing with adult siblings or blended families.
It easy easy to identify therapists, clinicians, and students as its primary audience, and they should find it a useful companion text to McGoldrick’s other work on the subject of genograms. However, layreaders with a background in the field may also find much of interest here and McGoldrick’s style is both accessible and informative. For any audience, The Genogram Casebook stands well on its own as a foundational text in the clinical field.
All readers will likely find this to be a sensibly arranged guide, beginning with the basics of using genograms in clinical practice: Getting started and introducing genograms to clients; properly assessing and engaging clients in therapy and addressing client resistance to using genograms.
McGoldrick then goes in to discuss the specific relationship configurations and how to approach them, including fusion and cutoff; triangles; dealing with loss and mourning in families; couples and the associated concerns of marriage, divorce, and remarriage; families with children and adult siblings.
The Genogram Casebook ends with a chapter on diagramming the therapist’s own family, emphasizing the point that understanding our own relationships is a necessary aspect to successfully diagramming others’.
Each chapter contains both discussions of key concepts and several examples to illustrate the applicable points. McGoldrick shares her dialogues with clients, as well as their genograms and her assessments. She grapples with the challenges of discussing gender roles, racial sensitivity, and religion, as well as mitigating conflicts between clients.
As McGoldrick’s practice largely focuses on couples and families — and as genograms are designed with families in mind — family sessions make up the bulk of the examples used. However, she makes the point that friends, long-time coworkers and pets also have a tremendous impact on our lives and certainly encourages their inclusion. Indeed, the more information regarding one’s relationships, often the better, especially at the outset.
As noted above, established and aspiring clinicians will find plenty to consider in The Genogram Casebook. The book helpfully includes a guide to genogram symbols in the front cover for those new to the practice. Moreover, McGoldrick models the ideas and behaviors she would have us engage in, and is generous in her inclusion of her strategies and approaches for different situations.
The genogram approach is striking in its emphasis on communication and healing relationships; the avoidance of estrangement is a central goal, even for the most fraught interactions. While McGoldrick emphasizes that the abused should never be made to leave themselves open to more harm from their abusers — a point which is especially crucial for children — she also notes that all relationships can be better understood. She asserts that the possibility for reconciliation is always present, however faint it may seem.
Consequently, The Genogram Casebook reads like far more than a simple clinical guide, although it is nonetheless effective in that aim. McGoldrick espouses the idea that our connectivity is one of our greatest assets, that by better understanding the relationships in our families, we create a meaningful sense of continuity with the past and future.
Moreover, we learn about ourselves as we learn about each other and come to better comprehend our own patterns and behaviors. While we might imagine scenarios in which genograms might seem ineffective or at least mistimed as a clinical tool, the central tenant behind them is one of unity and better understanding of the people in our lives, which is always relevant and timely. We do not all have to be aspiring clinicians to appreciate or seek that.
The Genogram Casebook
W.W. Norton & Company, August 2016
Softcover, 304 pages