What a genogram reveals: patterns that repeat in a family across generations

Perhaps you have drawn a family tree at some point. Names, birth years, maybe a marriage or two. A lovely document for the family archive — but most trees stay on the surface: they tell you who was who, not what went on between those people. A genogram is different. On paper it looks similar, but it reads like a map with layers: beneath the names and dates lie dates that match suspiciously well, occupations that repeat, alliances and resentments that are inherited, and people who have simply vanished from the tree.

I have written about what a genogram actually is and what it looks like in my introductory piece on the genogram. This time we go deeper: what interests us is everything a practised eye actually reads in it — and why it so often produces that moment when someone falls quiet and says: “I’ve never seen it like that before.”

One important thing in advance: a genogram does not prove and does not condemn. It opens hypotheses — questions worth exploring. And that is precisely where its power lies.

A map that is read in layers

A genogram usually takes in at least three generations: you, your parents and your grandparents, often aunts, uncles and siblings too. But the key difference from a family tree is not its scope, it is what gets written into it. Monica McGoldrick, one of the founders of the modern use of the genogram, emphasises that alongside the “hard” data, a genogram records the nature of relationships: who was closely bonded with whom, who was in conflict, who was cut off; when losses, moves and illnesses occurred; who carried which role.

That is why in therapy we read it in layers, rather like peeling an onion:

• The first layer is facts — names, dates, marriages, children. The first gaps already show here: years nobody knows anything about, people with no story.
• The second layer is events and dates — losses, illnesses, moves, wars. And above all: when they happened and how old people were at the time.
• The third layer is threads — themes running through the generations: occupations, illnesses, ways of getting through hard times.
• The fourth layer is relationships — alliances, triangles, coalitions, severed contact.
• The fifth layer is patterns and messages — what only emerges from all of it together: the unwritten rules the family lives by.

Each layer says something of its own. Together they tell a story that no single piece of data can.

Dates that match: anniversaries the body remembers

One of the first things I check when reading a genogram is dates and ages. For decades the clinical literature has described a phenomenon known as the anniversary reaction: around the anniversary of a significant loss or trauma, sadness, anxiety, physical symptoms or restlessness can appear — often with no conscious connection made. The American Psychological Association defines it the same way: an emotional response that returns at a time associated with a past emotionally significant event, even if the person does not consciously remember it.

In practice this looks like this: someone says that every autumn something grips them “for no reason” — and the genogram shows that their father died in October twenty years ago. Or: a woman at thirty-nine develops an unusually strong fear of illness — her mother fell ill with cancer at thirty-nine. The French psychologist Anne Ancelin Schützenberger, who devoted much of her career to this phenomenon, also described repetitions across generations: significant events clustering in a family around the same ages or the same dates. An honest note is due here: these are clinical observations, not solid experimental science — but as a source of questions they are valuable. When I see that three men in a family were injured or fell ill around the age of forty-five, I do not declare this to be fate. But I do ask: what happened in this family at forty-five — and what does that mean for you, who are approaching that age?

You can examine this layer yourself, before you even start on a full genogram. Take a sheet of paper and in one column write down your “unexplained” difficult points: the months when your mood regularly drops; the ages at which you made big or drastic decisions; the periods when your body spoke up with illness. In the second column write your family’s key events with dates and the ages of those involved. Then compare the columns. You will not necessarily find matches — but if you do, you will be holding for the first time the end of a thread that can be unwound further.

Threads through occupations and health

The second layer of reading is threads — themes running vertically through the generations. Occupational threads are often the most obvious: families of doctors, teachers, tradespeople; families where all the men worked “out in the field” and were rarely home; families where work always mattered more than rest. Sometimes the thread runs the other way — someone chooses an occupation that is the exact opposite of the family’s, and that too is information: what had to be pushed against so firmly?

Then there are health threads. Some have a genetic basis and belong first and foremost with a doctor. But a genogram often reveals something else as well: how the family handles illness. Is illness something that gets talked about, or a secret? Are the ill cared for, or kept at a distance? Was illness the only legitimate way in this family to be allowed to rest or to ask for attention? In my work with people I notice that this last one is surprisingly common: in families where there was no room for tiredness and distress, the body finds its own language. The same holds for threads of coping — in one family a crisis is met with silence, in another with explosion, in a third by reaching for alcohol. These strategies are not inherited through genes but through example, which I write about in more detail in my piece on intergenerational transmission.

And one more thing that is easily forgotten: threads are not only burdens. A genogram shows resources just as reliably — the stubbornness that carried the family through a war; the humour that turns up in every generation; the grandmother who knew how to look after herself when nobody else did. When reading, I always look for both. Because the strength you carry is often inherited too — you have simply never taken any credit for it, because it seems self-evident to you.

Marriages, divorces, losses: the calendar of relationships

The third layer is the key relational events and their rhythm. At what age did people in your family marry? Were the marriages made for love, because of a pregnancy, to escape home? When did the divorces come — and did they follow a pattern (for example: several couples separating once the children had left home)?

I pay particular attention to losses. The early death of a parent is one of the most powerful events in a family system: it changes roles, burdens the surviving children, and often leaves unfinished grief that travels onward. If your grandmother lost her mother at eight and then spent her whole life “holding together” a large family, she probably developed a stance that others are not to be relied on — and may have passed that stance unwittingly to your mother, and she to you. On a genogram such a chain is visible at a glance: loss, new role, repetition.

Here too I am not looking for proof but for questions. If three generations of women married before the age of twenty-two, and at thirty you feel an unexplained pressure or an unexplained resistance to commitment — it is worth looking at whose calendar is actually ticking inside you.

Triangles and coalitions: who is with whom, who against whom

Now we come to the layer that is hardest to see from the inside — and the one that Murray Bowen, the father of family systems theory, placed at the very centre of his understanding of families. Bowen noticed that a relationship between two people is unstable under stress: as tension rises, the pair almost automatically draws in a third. A triangle forms — the smallest stable unit of an emotional system.

Triangles are not pathology in themselves; they are how systems distribute tension. The problem arises when they set like concrete. A classic example: tension between the parents, which is never spoken about, is redirected into the child — one parent forms a coalition with them against the other, and the child becomes a confidant, an arbiter, or the problem around which the parents still meet at all. On a genogram such structures are drawn with particular lines: a close bond here, conflict there, severed contact on the third side. And when you look at three generations at once, it often turns out that the same triangle repeats — only the cast changes.

This is also where the outcasts belong: the uncle who is in none of the photographs; the sister who has not been “spoken to” for thirty years and nobody really remembers why any more. Bowen understood cut-off not as a solution but as frozen tension — an unresolved attachment that passes onward beneath the surface. Who was cast out in your family, and what they represented, is one of the most eloquent questions in the whole genogram; it often leads straight to family secrets. And how an individual extricates themselves from these structures without severing ties is the subject of the piece on differentiation.

“Coincidences” that are not coincidences

Once the layers are on the table, things that previously looked like coincidence start to connect. That you “happened” to change jobs at the same age at which your father lost his. That for the third generation running, the eldest child sacrifices themselves for the younger ones. That all your significant relationships have stalled at exactly the same point — where vulnerability would have to be shown.

The family therapist Ivan Boszormenyi-Nagy coined the term invisible loyalties for the forces that drive such repetitions: deeply rooted commitments to the family that we fulfil without knowing about them. A child who watched their mother suffer may unconsciously forbid themselves to be happier than she was. The grandson of a man who went bankrupt may handle money as though repaying a debt that is not his. These are not mystical forces — they are entirely human mechanisms of learning, attachment and belonging, working below the threshold of awareness. But until you see them, you follow them.

A worked reading: three generations (an illustration)

So that we do not stay with theory, here is an invented but typical example — and I stress that it is an illustration, assembled from common patterns, not the story of any actual family.

Ana, 34, comes because of exhaustion and a feeling that in her relationship “everything always lands on her”. The genogram: Ana’s grandmother lost her father in the war at the age of seven; as the eldest she looked after four younger brothers. She married a silent, absent man. Her daughter — Ana’s mother — left home at eighteen, married quickly and became the one who “held it all together” while her husband worked abroad. Ana is the eldest of three children. Her bond with her brother, the “eternal child”, is tense; she and her sister form a coalition around their mother; with her father there is barely any contact at all.

What do I see? Three generations of eldest daughters who became adults too soon. Three generations of women beside absent men. A thread that begins with a wartime loss and unfinished grief, and continues as a family rule: “A woman endures. A woman takes care of things. Asking for help is not done.” All at once Ana’s exhaustion is no longer a personal failing of hers — it is the third act of a story that began in 1943. And because she can now see it, she can for the first time genuinely decide whether the fourth act will be written the same way.

What a genogram does not tell you

Before we close, a caution that I regard as part of professional honesty. A genogram is not a diagnostic test and not an oracle. A pattern on paper is a hypothesis — an invitation to a conversation, not a verdict. Two families with identical genograms can be living completely different stories, because paper does not show everything: it does not show the warmth in a voice, nor the thousands of good ordinary moments, nor the inner world of people who may have kept silent out of love rather than coldness.

It is also worth resisting the temptation to explain everything with a genogram. “I’m like this because of my grandmother” can be a liberating realisation — or a new hiding place, an excuse that shifts responsibility for change onto the dead. A healthy reading of a genogram runs both ways: it understands where I come from and at the same time holds that I am responsible for what comes next. The past explains; it does not excuse and it does not determine.

What you do with what you see

A genogram is not a condemnation of your ancestors. The people on it were mostly doing the best they could, with the wounds they carried. And it is not a forecast of your future — the pattern you see is a pattern you can change. That is exactly why we draw it in therapy: a pattern brought into awareness loses most of its power, whereas one left out of awareness rules from the background.

If this piece has touched a nerve — if you suspect that something is repeating in your life that is not entirely yours — you can begin on your own: ask your parents and relatives, write down the dates, look at where the story goes quiet. Or we can do it together: as part of the service A Look into the Past, in a 90-minute session we draw your genogram and read it together through all the layers I have described. You will find more about the session on the Services page, and I am available for questions via the contact page.

Three generations on a single sheet of paper. Sometimes that is all it takes for coincidences to stop being coincidences — and for the story that has been writing you to become a story you write.