Understanding Family Relationships And Medical History Using Genograms

The Use of Genograms in Analyzing Family Dynamics and Medical Histories

Question:

Discuss about the Family Genogram for Psychological Factors and Hereditary.

A genogram or family diagram is a pictorial display of the index person’s family relationships and past medical history. This pictorial presentation is different from a traditional family tree that allows an individual to visualize the psychological factors and hereditary patterns that revolve around family relationships. Murray Bowen is the inventor of genogram that later popularized in scientific study and varieties of disciplines like psychiatry, medicine, education, social work and education (Haefner, 2014). In the given hypothetical case scenario of Derick Miller (index person) and Abena Miller up to three generations illustrated that the family shows divorces, unsuccessful marriages, strained relationships, abortions and miscarriages. Therefore, the following discussion involves the analysis of Miller’ genogram that is beneficial for discovering family history, sibling rivalry and abusive relationships between the family members.

Figure: Family genogram of Derick Miller (Index person)

Profession, illnesses and personalities can be studied through genogram of Derick Miller. The family owns their clothing business that is being looked after by Derick who is now running the business. In context to personalities, it is evident from the genogram that the family is intertwined in complex relationships and separations. Derick’s grandfather (William Miller) was divorced from his wife (Emily Steele) and later married a widow (Anna White). He was an alcoholic and took divorce from this wife and eventually, it affected their children growth and development. William has three children, Christina is the eldest daughter followed by John and Alfred (index person’s father). Due to heavy drinking, the grandfather was negligent towards his children. The grandfather was distant from his three children where Christina and Alfred were neglected; however, John and Alfred maintained close relationships with each other. Referring to the illness witnessed in the family, William was addicted to alcohol and died of liver cirrhosis. He neglected his son Alfred (index person’s family) and as a result, he suffered from depression that had a directly effect on the growth and development of Derick Miller due to neglect. Therefore, from the above genogram, it is evident that complex and abusive family members greatly influence the physical and mental health status of the children and spouses (Norman et al., 2012).

This comprises of biological and maturation factors, nutrition, and physical growth genetic influences that greatly affect the growth and maturation of the index person. Derick Miller’s father suffered from depression and that has a direct effect on his growth and maturation. Due to disruptive parenting, a child suffers from mental health issues and social isolation (Crittenden, 2013). Depressive father is more hostile and have disengaged parenting patterns and as a result, there is lack of warmth and affection that is required for proper child’s growth and development (Blair & Raver, 2012). Derick’s grandfather (William) neglected his children (including Alfred) and divorced his spouse as he was alcoholic and demonstrated negative parenting. This is associated with poor health and wellbeing of Alfred as a child and learned that neglect, annoyance and negative attitude is a part of normal behaviour. This made Alfred prone to stress and withdrawn attitude that ultimately resulted in depression. Later on, this bad parenting during childhood affected his married life and eventually divorce.

The Case of Derick Miller: Disrupted Family Relationships and Divorce

During this phase, Alfred’s behaviour became more hostile and that affected the childhood development of Derick. There might have been early signs of vulnerabilities like insecure attachment, temperament, negative functioning and dysregulated aggression that affected his maturation, growth and development (Santrock, 2009).

The main social factor that affected Derick’s proper social development and physical growth is his divorce. The divorce is an unexpected factor where children are unable to recover from it and fear loss, conflict and change (Strohschein, 2012). There might have been behavioural and adjustment problems in Derick due to divorced parents. For a child like Derick, divorce shattered his basic safety, as he believed that parents could take good care of them. They have the ability to make decisions for him truly considering his well-being. However, the scenario is different and as a result, he got divorced with two miscarriages. Derick might have believed that the right family relationship could be in between his parents. However, his parents’ configuration presented betrayal or conflict that tends to affect the health and wellbeing of Derick. These emotional scars made him suffer from lost security and relationship with visible repercussions.

The factors like family disruptions and divorce greatly affected during the three generations. Firstly, William Miller was an alcoholic and abuser that influenced his married life and three children. The father neglected his eldest daughter, Christina and as a result, she left home and started residing in a living relationship with her boyfriend, Godwin Smith. They are happy and have twins who are closely connected to each other. On a contrary, the second neglected child, John physically abuses his wife Maria with an aborted child. However, Alfred, Derick’s father is closely connected to John who physically abuses his wife. He saw that physical abuse is certain in married life and as a result, he too divorced from Johney Sly, his wife. This divorce resulted in feeling of uncertainty in every child in second and third generation due to level of conflict and poor parenting after separation. The divorce in Derick’s family generations disrupted the individual families’ structures. The family disruptions had negative outcomes for the children in every generation at a high level of delinquency and emotional impact (Ambert, 2014). Therefore, it can be concluded that all these factors have a negative effect on Derick’s developmental path like life and personality.

According to Freud's Psychosexual Developmental Theory, unconscious and childhood experiences greatly influence behavior in children. Conflicts that occur in every stage of childhood development have a lifelong influence on their behavior and personality development. Considering this theory, Derick’s childhood is also driven by conflicts, family disruption that eventually resulted in separation. This divorce greatly shaped his behavior and thinking as it is depicted in his own marriage that ended in family disruptions and miscarriages (Kline, 2014).

Relationships Between Family Members Through Different Developmental Theories

Bowlby's Attachment Theory is another significant theory that suggests children are born with an innate quality of forming attachments. These attachments are important for their physical, emotional and mental wellbeing of the children. The children want to stay close to their parents or caregivers as they feel safe and secure.  However, there is no secured relationship of Derick with his parents except for his brother, John. This greatly affected his emotional development, as he had no secured relationships with his father who is suffering from depression (Bowlby & Ainsworth, 2013).

Bandura's Social Learning Theory is another theory that states children learn behavior through observation and modeling. Observation plays a vital role in child development as they learn through verbal instructions to listening. In the given case scenario, Derick observed his parents and elder brother, John being separated and physically abusing their respective spouses and that he considered normal behavior and as a result, tried to perform. He observed his parents, brother and considered them role model for performing the abusive and neglected behavior (Cherry, 2012).

In addition, religion also influences childhood development as spirituality and socialization offers potential that reinforces protective affects and thereby, promoting resilience.

From the above discussion, it can be concluded that genograms are used to explain the family dynamics to an individual by family therapists. The genealogists study the complex family generations graphically through this genogram like emotional, physical and social relationships. In the given case scenario of Derick Miller, there are disrupted family relationships with divorces and legal separation. This greatly influenced his behaviour and unsuccessful disrupted marriage relationships with miscarriages. The genogram of the index person (Derick) is quite helpful in understanding the underlying causes of family disruptions, divorce, illness and relationships and intimacy between the family members. This pictorial representation also helps in detecting patterns in the family history, hereditary diseases and psychological health through symbols. Therefore, genograms are beneficial in foreseeing the risk of future perturbations and illnesses that are likely to affect a family used by genealogists.

References

Ambert, A. M. (2014). The effect of children on parents. Routledge.

Blair, C., & Raver, C. C. (2012). Child development in the context of adversity: experiential canalization of brain and behavior. American Psychologist, 67(4), 309.

Bowlby, J., & Ainsworth, M. (2013). The origins of attachment theory. Attachment Theory: Social, Developmental, and Clinical Perspectives, 45.

Cherry, K. (2012). Social learning theory. Retrieved July, 2, 2012.

Crittenden, P. M. (2013). Raising parents: Attachment, parenting and child safety. Routledge.

Haefner, J. (2014). An application of Bowen family systems theory. Issues in Mental Health Nursing, 35(11), 835-841.

Kline, P. (2014). Psychology and Freudian theory: An introduction. Routledge.

Norman, R. E., Byambaa, M., De, R., Butchart, A., Scott, J., & Vos, T. (2012). The long-term health consequences of child physical abuse, emotional abuse, and neglect: a systematic review and meta-analysis. PLoS medicine, 9(11), e1001349.

Santrock, J. W. (2009). Life-span development (No. Sirsi) i9780073370217). Boston, MA: McGraw-Hill.

Strohschein, L. (2012). Parental divorce and child mental health: Accounting for predisruption differences. Journal of Divorce & Remarriage, 53(6), 489-502.