Podcast season 4: Episode 12 – Making genograms more creative and meaningful

Please note that this transcript is auto-generated and therefore will contain some errors and natural pauses in conversation.

TRAILER: [00:00:00] Hello, this is a reminder that as well as listening to this show on a browser via the Creative Life Story Work website, you can also listen to it on your favorite audio app too. You’ll find us on Apple Podcasts, Spotify, audible, Amazon Music, YouTube, music, and many others. Search Creative Life Story Work podcast.

DAWN: Welcome to the Creative Life Story Work podcast, where we explore how to make life story work better for all care experienced children and young people. Creative Life story work is an approach which can improve children and young people’s lives and their relationships with others, both at home and at school. It’s based on the Rose model of therapeutic life story work.

[00:01:00] Every month we’ll explore a different aspect of creative life story work. And we’ll give insights into how you can use this approach to help care experience children and young people make sense of their past and build a brighter future.

Today we’re going to be diving into a powerful tool called the Genogram. We will explore what genograms are, how they can help us understand identity and belonging, and why they matter so much in trauma-informed care. I’m absolutely delighted to welcome to our podcast studio, Dr. Karen Treisman, MBE. Karen is an award-winning highly specialist clinical psychologist, organizational consultant, trainer, author, and trauma specialist who’s worked in the national health system and children’s social services for several years. Karen has also worked cross-culturally in both Africa and Asia with groups ranging from former child soldiers, asylum seeking young people to those living with HIV and aids and to survivors of the Rwandan genocide.

[00:02:00] She’s also the bestselling author of several books, including the Therapeutic Treasure Box for creating trauma informed organizations, six children’s workbooks, and five sets of therapeutic card decks. A very warm welcome to you this morning, Karen.

KAREN: Oh, thanks so much Dawn. Thanks for having me. And it’s lovely, lovely way to spend, spend the morning chatting to you, so thanks for having.

DAWN: You are very, very welcome. I wondered like the very first question, and for those who may be new to the concept, what would you say what a genogram is?

KAREN: Yeah, so a genogram, in essence, it is a, um, systemic family therapy tool. And in essence it’s a visual representation of like a family tree. It’s usually spans three – can be less, can be more – generations.

[00:03:00] And traditionally it used to be used with different symbols to represent different people. So circles to represent certain people or squares or different types of relationships. Um, so in essence it’s a visual representation of a family tree that’s often used in information gathering, sometimes referred to as assessments and interventions. Um, so yeah, that’s in a nutshell, the most simple way to describe it.

DAWN: Thank you. And what was it that inspired you to start using or developing genograms in your trauma-informed work?

KAREN: So I guess genograms in a lot of the work that I did were almost a mandatory part of the process. So for example, within social services, generally when you are going to court, you need to have a genogram. When I was working within family therapy, it’s a core part of the assessment or as a clinical psychologist, it’s a massive part of our information gathering formulation.

[00:04:00] It’s almost something that is very often done, but I suppose what I noticed was that it was often done in a very checklist, tick box way, you know, quickly scribbling something out with circles or squares. And actually I wanted to make it a really enriching, layered tool or technique, and I wanted to bring in some of my creative tools of using puppets and masks and miniatures and to make it a living tool and not just something that is an entry point and something that you have to do, but actually something that can be really relational, really meaningful, and really part of the work.

So that’s where I became quite interested because I was having to do them almost on a daily basis, and I was like, this actually isn’t feeling very relational or meaningful or creative.

[00:05:00] What can I do to embed it and expand and enrich it even further?

DAWN: You started talking there about, um, using some creative methods into genograms. What resources or materials do you find most useful, what are your go-to ones when creating genograms, especially with young people?

KAREN: So what I absolutely love about genograms is they’re so versatile, you can literally use anything. So in the workshop, I’m gonna talk lots about different ones, but you can use household items from, you know, lipstick and books that you find, through to things in nature, stone shells, sticks, leaves, there’s so many possibilities – stickers, things from newspapers or magazines.

[00:06:00] My personal favorite is miniatures ’cause I absolutely love using little figurines and little miniatures to represent different people in our lives, but it’s really amazing in that if you understand the concept, you can actually use anything that you have: puppets, cut toys to really find ways to make it more fun and playful and engaging.

DAWN: You talked before about using some symbols, so are there key ones that you use or prompts that you might recommend when making a genogram?

KAREN: So that’s a really interesting question, which I will go into a little bit more when we do the workshop. So there are traditional symbols that were almost a shared language that were created when genograms were introduced.

And there’s books you can buy and you can Google particular symbol, symbols for a man, symbols for a woman, symbols for people who are divorced, symbols for someone who have died. So there is almost a key that you can use.

[00:07:00] However, part of the creative relational thing that I find is actually asking people to choose or select what symbol they wanna use.

And it’s really beautiful ’cause you might have a child who picks a particular shape or a particular color or a particular pattern. And actually then it becomes even more tailored to them. So yes, there are particular symbols, but you can absolutely be creative as long as you have a key. Yeah, so that other people look at it and know what you’ve selected in essence.

DAWN: Yeah. Oh, wow. So actually, if it was a map, it would have their own legend down the side with their own symbols and keys on it.

KAREN: Yeah, absolutely. And the, the most beautiful thing about a genogram is, although it’s something that’s visual, it’s the questions that you can ask that really allow you to open doors and to gather lots of the layers and the textures.

But it gives you something that you can look at, that you can come back to, that you can share, that you can photograph.

[00:08:00] So it’s a sort of work in progress and it’s a living tool. As we have new people enter our life, as we have new themes that we discover, like in life story work, it’s a real sense that it can work beautifully alongside those sorts of things. So yeah.

DAWN: And I’m just thinking about some of the children who’ve been in our Blue Cabin sessions might not know much about their own family background. So how can you adapt this process for those children?

KAREN: So lots of different ways. So firstly, I suppose sometimes you do it directly with the child and sometimes you might be doing it indirectly. So for your own thinking or with a foster carer, or with an adopter or with the social worker. And sometimes you might do it indirectly. Sometimes you might use it to explore with a child about other families, like they might do their favorite Disney family or their favorite superheroes.

[00:09:00] But I suppose what’s amazing about it is actually if you are doing work within your role, you might use it to explore the questions that they wish they could ask, or to be able to bear witness to the uncertainties or not knowing, or to be able to open up avenues to process some of the bits that they do know or they don’t know.

And sometimes it’s not factual. Sometimes it’s much more around, you know, if they choose a shark to represent their dad, you know, if the shark could talk, what would it say or who, if anyone, would you go to if the sadness visited or if you wanted to share something exciting, or what are things that might be similar to some of these people, or what are things that you might want to be different. Or if you could ask one question to this person, what would you  ask?

[00:10:00] Or you know, so often it’s actually about a journey of discovery and gives you a tool to almost step into that inner world and landscape, but also acknowledge the questions we don’t know the bits that we are interested in, and to be able to sort of explore some of those aspects.

DAWN: I’m just really interested in all the different creative hooks in there. So I’m just wondering, would you ever build a genogram, almost like through movement or collage or story, are all those different ways into a genogram?

KAREN: Absolutely. And the other thing just to add is you might do more than one genogram. So a child might do their foster family who they’re living with or multiple different foster families, and then might do their family of origin. So there might be different ones or they might wanna integrate wider people.

[00:11:00] So it might lead you into an eco map of who else is important in your life, the librarian, the school nurse. But yes, it really is a springboard into further avenues. So as the initial thing, it often is used trying to understand intergenerational themes, intergenerational patterns, but it can lead you into absolutely choosing songs to represent different people or different relationships or how someone makes you feel.

It could be in movement, it might lead you to do a family sculpture, or perhaps a collage. I often say it’s an amazing entry point to all those other beautiful, creative things, and you can go back to it. So you might do some other activities and then go back to, oh, is there anything we’ve not looked at? The same as you might do a genogram with a child or someone else. I often do them with parents, carers, or myself is around what’s your family like on a scary day  or a day when something horrible has happened and what’s it like when we’re getting on well and we feel more connected?

[00:12:00] So it might be on different days, and I suppose that’s a big thing about a genogram.

When I was training to be a psychologist, it was probably one of my favorite days of my entire doctorate was when we literally spent our entire day doing our own, because I think for ourselves as practitioners to be able to think about our themes and patterns and intergenerational wisdom and intergenerational trauma and different things that make us, US also is incredibly helpful.

So it might sometimes be for yourself as a practitioner or for the foster carer, or for the doctor or for the social worker to also think about. Your own biases, lens patterns, angels and ghosts of the past.

DAWN: Let’s take a short break to hear more about our membership offer.

[00:13:00] TRAILER: We want people to gain more of an understanding about what it’s like to be care experienced and to have a better understanding of what it actually means. Could creative life story work make a difference to the care experienced children and young people you work with? Maybe you are a social worker: I think we forget at our peril that actually telling a child the story of their early life is one of the most profound uses of social work power that we could ever operate. Perhaps you are a foster carer: You know, when they say it’s all about the child, it’s not because our experiences, it’s about the carer and the child, and it just gives a new angle to our relationship because we’re learning about each other together.

A creative life story work membership will give you or your whole team access to resources, including activities you can use in direct work with children and young people, training with life story work experts and lots more.

[00:14:00] TRAILER: And I think a lot of our children looking for meaning, looking for, you know, well, why is it I feel this way? You know, my friends don’t. Why is it I get angry internally and my friends don’t? The greatest thing we see is when we are able to say to young people, this is your story. This is about who you are. And then children towards the end say, it’s not my fault that these things happened, but it is something that I can do something about. And once we have that. Then we know we can move forward,

Find out about our membership for individuals and for organizations on our website, creative life story work.com.

DAWN: I just have to ask you, Karen, what is a family sculpture? That’s what you said before – what is that?

KAREN: That is another therapeutic tool. In essence, it’s where people will almost position different people in the room or use different miniatures or models about, for example, where, how would you describe your family or who are you closest to or where do you feel there’s distance between?

[00:15:00] So you might have someone put someone on one side of the room and the other side of the room, or you might have someone right by you or holding your hand, and it kind of gives a representation of the family, closeness, distance, relationships, positioning, but in quite a sort of physical way.

DAWN: Sorry, that’s me going off down Tangent Boulevard. It’s such a theater practice as well of sculpting and things. So I was only doing last week in Peterborough with a group of artists. So they were sculpting their best facilitative experience and you look over somebody’s shoulder and get them to describe what they’re seeing on the faces of everybody else.

So I was just going, was she in that room last week? I’m really into psychodrama and lots of of those elements. Yeah. But it is, it’s another sort of another tool but that could work alongside one of your genogram exercises.

KAREN: Oh, that’s the thing with genograms, you can literally put pretty much any other tool alongside it to pick and mix and match. But a genogram does take quite a lot of time. That’s, it’s not like a quick, it’s not a quick thing.

DAWN: Just in your description there of. Exploring a genogram. I’m just wondering because we have at Blue Cabin, some of your books that are a bit like our Bibles. I’m just wondering what are some of the trauma informed principles that you need to keep in mind when you are exploring a genogram, either with the child or with the foster carer?

KAREN: Love that question. So I suppose all of them, in essence, are incredibly important. And I think that’s the thing with trauma informed values and principles. You know, they should not be sprinkled over the top of something.

[00:17:00] They should be absolutely baked in and infused and present. So all of them, so for example, safety, you know how we ask questions, how we support someone that they can pass or opt out, how we think about that. They might need brain breaks, or we might need to do regulating activities first. The language that we choose, that we ask, you know, is there a word that is a no-no or a goes in the banish bin? You know, if we are using the word mum and they don’t wanna use the word mum, or you know, if they wanna move around, that we’re also strengths that we are not just asking about the thorny, painful, difficult bits, but we’re also asking about themes of wisdom and pride and joy and relief. Another is the value of collaboration, that it’s a huge amount of, it’s a relational tool, it’s a collaboration – it’s working alongside that. We are absolutely not doing things to push too far or, or to activate – we are treading gently.

[00:18:00] So in terms of the values or actually how someone might respond when they’re doing the genogram or how we respond not with judgment and being curious and, you know, treating the person with dignity and supporting the person to be able to, for us to have humility and, and to wonder. So all of the values are incredibly important and all of your basic therapeutic skills are really important to do a genogram because it can be a very powerful tool, and so you don’t go in lightly. You go in with all of those, setting the scene first, and is this the right time and is this the right moment?

And what do we need to do first? And you know, all of those skills that are super important. .

DAWN: And for somebody who’s maybe listening to this podcast, or who’s in your live classroom, who wants to try this tool out?

[00:19:00] What is a simple first step that they could take towards using a genogram? And you said before, do one on yourself. Do you do your own one first? Is that, is that the first step to take?

KAREN: Yeah, absolutely. I’d say the first step is obviously coming to the workshop and getting a flavor and a sense. But absolutely, I think doing it on yourself, if you feel able to do it on yourself, and if not able to do it for yourself, doing it about a celebrity family or a Disney character family to practice or a vignette before you absolutely go and do it. Doing it sometimes with someone you are working with, whether it’s in supervision or a team meeting about a family, but not necessarily directly with them. So, yeah, absolutely.

But I think, as with all tools, we don’t wanna do anything that we haven’t tried ourselves or practiced or built our confidence on using it.

[00:20:00] And I suppose in the workshop a lot of people who are gonna be coming will already use genograms ’cause they’re are very widely used. As I said, most people have to do them as part of some of the standard therapy services or within social services.

So it’s more for those people to think about if I’m already doing it, how can I do it in a more relational, enriched, expanding way, rather than just doing it as a quick, right, okay, this is one of the things we have to do. Go, go, go. That is such a galaxy of missed opportunities. Then there’s so many possibilities. And I find often I do a lot of assessments within social services. Sometimes I can do 80% of my assessment just from the genogram because it will be such a launch pad, and I’ll be able to ask so many different questions that are on the form that I have to do, but by infusing them and so it really can be a tool that can open up lots of possibilities and actually make assessments feel less like going through questions on a form or, you know, holding your flip chart.

[00:21:00] DAWN: And my final question to you today, so what would be one thing that you hope every therapist or social worker who might be listening today takes away from our conversation about genograms?

KAREN: I’d hope that people could take away the versatility and the many textures and nuances and layers, that it isn’t just something to get over and done with because court’s asking for it, or because the NHS is asking for it, that actually it can be an incredibly textured, layered, enriching relational tool.

It can be done in a really fun, creative way, and it can be as useful directly with the child, but also with the team around them, and for yourself.

[00:22:00] It’s not us and them, it’s a 360.

DAWN: Thank you very much Karen this morning for shining a light on genograms and how they can be used to support children and the adults in their lives.

KAREN: Pleasure – thank you.

DAWN: Whether you are a foster carer, someone who has experience with the care system. Or you work with children and young people. We hope this episode has given you an insight into how we can make life story work better for young people and how you can use it in your own practice. You can find out more about Creative Life Story, work on our website, creative life story work.com, and you can find us on LinkedIn and Blue Sky at CreativeLSW.

Please do get in touch there with any comments or questions as we’d really love to hear from you.

[00:23:00] And if your podcast app allows you, please do leave us a review as it really helps others to find our show. So until next month, bye for now.