Appearance
History of Genograms
The genogram began as an unnamed sketching habit in psychiatrist Murray Bowen's clinical work in the 1950s and became a standardized tool in 1985, when Monica McGoldrick and Randy Gerson published the symbol system still in use today.
The Problem Bowen Was Solving
Bowen was working at the National Institute of Mental Health in the 1950s, studying families of patients diagnosed with schizophrenia.
Rather than treating the patient in isolation, he hospitalized entire families together, observing how emotional patterns moved between parents, children, and siblings rather than sitting inside one diagnosed individual.
That observation became the foundation of family systems theory; the idea that a family functions as a single emotional unit across generations, not a collection of separate people who happen to be related.
Tracking that kind of multigenerational pattern in writing was unwieldy.
A case note could describe one relationship at a time, but it couldn't show a reader how a pattern repeated across three generations at a glance.
Bowen began sketching simple family diagrams in his clinical work to solve exactly that problem, plotting out who was related to whom and where emotional patterns seemed to repeat.
He moved this work to Georgetown University in 1959, where he trained clinicians in family systems theory and in the use of these diagrams for assessment.
He never standardized a symbol system for them. That part came later, from someone else.
From Family Diagram to Genogram
Monica McGoldrick, working with Randy Gerson, took Bowen's informal family diagrams and turned them into something any clinician could read without additional explanation.
Their 1985 book, Genograms in Family Assessment, established the standardized symbols now used across the field: squares and circles for gender, specific line types for marriage, divorce, conflict, and cutoff, and a consistent format for recording medical and family history across generations.
The book also introduced the term "genogram" itself, combining "geno-" (family, in the Greek sense) with "-gram" (something written or drawn), a name chosen specifically to separate this clinical tool from an ordinary genealogical family tree.
Interestingly, the genogram wasn't the only major family-assessment diagram to emerge from this period.
Ann Hartman published her ecomap in the same decade, in a 1978 paper that introduced both the ecomap and an early version of the genogram to clinical social work practice.
The two tools ended up complementing each other for the reason they still do today; the genogram maps a family's internal structure and history, while the ecomap maps its current external environment. For the ecomap's own origin story, see the Ecomap History page.
Why the Notation Has Lasted
The McGoldrick-Gerson symbol system has gone through several editions since 1985 without being replaced.
A second edition in 1999, with Suzanne Shellenberger joining as co-author, expanded the case examples and applications.
A third edition followed in 2008, with Sueli Petry stepping in as co-author after Randy Gerson's death in 2007, adding more coverage of cultural genograms and diverse family structures.
The fourth edition, published in 2020, remains the current clinical reference, expanding coverage of LGBTQ+ families and trauma-informed practice while keeping the same core symbol set intact.
That continuity is part of why the notation has held.
A small, learnable symbol set means a clinician can read a colleague's genogram without a reference sheet in hand.
Each edition has added to the system rather than replacing it, so a genogram drawn under the 1985 standard is still legible under the 2020 one.
Where It Stands Today
The genogram is now standard practice well beyond the family therapy rooms where it started; medicine, nursing, genetic counseling, social work, and school counseling all use some version of the same core notation.
Bowen's original eight concepts; differentiation of self, triangles, the nuclear family emotional process, family projection process, multigenerational transmission, emotional cutoff, sibling position, and societal emotional process, remain the theoretical foundation underneath the diagram, even in clinical contexts that have little to do with Bowen's original psychiatric research.
FAQ
Where did genograms originate?
They originated with Murray Bowen's clinical work at the National Institute of Mental Health in the 1950s, where he began sketching family diagrams to track emotional patterns across generations while studying families of patients diagnosed with schizophrenia.
What theory are genograms based on?
Genograms are built on Bowen's family systems theory, which treats the family as a single emotional unit across generations rather than a collection of separate individuals. The standard symbols exist specifically to make patterns predicted by that theory, like triangles and cutoff, visible on paper.
Are genograms still used today?
Yes, widely. The same core notation established by McGoldrick and Gerson in 1985 is still standard practice across family therapy, medicine, nursing, genetic counseling, and social work, with the most recent edition of their reference text published in 2020.
Who is credited as the proponent of the genogram?
Murray Bowen originated the underlying concept and used informal family diagrams in his own clinical work, but Monica McGoldrick and Randy Gerson are credited with formalizing and standardizing the genogram as it's used today, publishing the first edition of their reference text in 1985.
Why is it called a "genogram" and not just a family tree?
The name was chosen specifically to distinguish it from a genealogical family tree. A family tree records lineage. A genogram adds relationship quality, health history, and emotional patterns to that same structure, which is why McGoldrick and Gerson gave it a distinct name.
Sources
- Family Therapy in Clinical Practice
- Genograms in Family Assessment