Genogram

Marriage Secret Affair

Sexual Relationship Living Together

o LT950 1 1

Therapy or Family I Household shown by circling members living together

Male Female Pet Institutional Secret (couple living with their dog after launching children)

0 0 0 Connection$ D ~Heterosexual ~ © ©

Has lived in Immigration 2+ Cultures

Gay Lesbian Bisexual

~ ~ Transgender People

0 0 I c: 62 primarygenogrammembersman to woman woman to man written lowerthan siblings '; I" GenaDeath location &

Birth Date

~

1941-2001 Annual Income

4~ 82- [iO] "",ro~ Sam [ill I~ oDog / I,' Thir60 $100,000

23 X and age 72- above inside at death in

identified patient (lP)

symbol symbol symbol, death above birth date symbol has double line y o spouses writtendate above* and is written lower smaller & lower

*When multiple deceased generators than siblings are included, use an X only for untimely death.

Ym19709 Ci_._9 Affair 95

Marital Reconciliation After Separation

Q s95-96 9 X

Marital Separation

Q m70Y5 9 Divorce

Q m70,s 95,d 97-# Divorce and Remarriage

m959 m80, s85-86 ><Q

d 90, remar93, rediv94 if( ?fL

Committed Relationship

y LT959

~ ~o\~~. lr

Adopted Child/Foster Child

[J0]iL ..J use an arrow); ~- : A99 to show family ~ 10 into which child moved adopted at 5

Reconciliation After Divorce9 Q d98,)!arOO 9 ~I ---------------1

Donor Insemination

2 m 97 9

LW98-99 94-;

[ill Biological Foster Adopted child child child

Twins

lesbian couple's daughter conceived with egg of one partner and

Identical Pregnancy I sperm donor twins

Interactional Patterns Between People

a--.o D=O 0=::0 Focused on Close Fused

0Vv\0 O=D cr.+D Hostile Close-hostile Focused

on negatively

0---0 D-1f--U D--*-O Distant Cutoff* Cutoff repaired

0--7>0 o-«: G-O Caretaker Spiritual connection Positive relationship

or affinity

~ OV\C>O ~ Physical abuse Emotional abuse Sexual Abuse

*Arrow (optional) shows directions

gay couple's daughter conceived with sperm of one partner and egg donor, carried by surrogate mother

Addiction, Physical or Mental Illness or Other Problem

IT] Physical or.psychological illness B ~

EE

Physical or psychological illness in remission

Substance abuse In recovery from substance abuse

Suspected Substance abuse

Serious mental or physical problems and substance abuse

o Smoker s

0 0 Obesity c