Genogram Symbol Reference

Comprehensive visual guide to all standardized genogram symbols following McGoldrick & Gerson conventions.

For playful practice sessions, we remix icons in EmojiMix before converting successful motifs into formal clinical symbols.

Basic Shapes & Life Events

□

Male

Represents a male family member

Usage Guideline:
Use a square to represent all male-identified family members. Place at appropriate generational level. Can be combined with other symbols (deceased, medical conditions, etc.).
Clinical Context:
The square is the foundational symbol in genograms. When analyzing patterns, note how males are positioned in the family structure and their relationship quality indicators.
Keywords: male, man, boy, square
○

Female

Represents a female family member

Usage Guideline:
Use a circle to represent all female-identified family members. Place at appropriate generational level alongside siblings and partners. Can be combined with medical/mental health indicators.
Clinical Context:
Circles represent female family members. When analyzing genograms, pay attention to maternal lineage patterns, female relationship dynamics, and intergenerational transmission of roles.
Keywords: female, woman, girl, circle
◇

Other/Unknown Gender

Represents a person with non-binary, unknown, or unspecified gender

Keywords: other, unknown, non-binary, diamond
⚧

Transgender

Transgender family member

Keywords: transgender, trans, gender identity
☒

Deceased Male

Male family member who is deceased (X through square)

Usage Guideline:
Mark deceased males with an X through the square. Always include death date and age at death when known. Consider including cause of death in notes if clinically relevant.
Clinical Context:
Death in family systems often creates lasting impact. Note patterns of early death, causes (suicide, addiction, violence), and how the family processed grief. Unresolved grief can affect multiple generations.
Keywords: deceased, dead, male, death
⊗

Deceased Female

Female family member who is deceased (X through circle)

Keywords: deceased, dead, female, death
◉

Index Patient/Client

The identified patient or primary client (double outline)

Usage Guideline:
Mark the primary client with double outline or arrow. This is the person who brought the family to therapy or is the focus of assessment.
Clinical Context:
The index patient is often the "symptom bearer" in the family system. Consider how family dynamics contribute to their presentation and whether symptoms serve a function in the system.
Keywords: index, patient, client, identified patient, ip
🐾

Pet

Represents a family pet

Keywords: pet, animal, dog, cat
△

Pregnancy

Current pregnancy

Usage Guideline:
Use triangle for current pregnancies. Include due date if known. Connect to mother with parent-child line. Update to appropriate symbol after birth.
Clinical Context:
Pregnancies can be times of both joy and stress in family systems. Consider family reactions, support systems, timing in family lifecycle, and whether pregnancy was planned.
Keywords: pregnancy, pregnant, expecting, triangle
▽

Miscarriage

Pregnancy loss before 20 weeks

Keywords: miscarriage, pregnancy loss, loss
✕

Induced Abortion

Terminated pregnancy

Keywords: abortion, terminated pregnancy
⊠

Stillbirth

Pregnancy loss after 20 weeks

Keywords: stillbirth, stillborn, late pregnancy loss
⋯

Adoption

Adopted child (dashed line indicates adoption)

Keywords: adoption, adopted, foster
🏠

Foster Child

Child in foster care

Keywords: foster, foster care, placement
👥

Twins

Twin birth (identical or fraternal)

Keywords: twins, twin, multiple birth
🔬

Infertility Issues

History of infertility or fertility treatment

Keywords: infertility, ivf, fertility, conception difficulty
✈️

Immigration

Immigration or migration event

Keywords: immigration, migration, emigration, moved
🪖

Military Service

Military service history

Keywords: military, veteran, service, armed forces
💔

Death by Suicide

Death by suicide

Usage Guideline:
Mark with X through symbol plus suicide indicator. Include date and note family's response. Consider impact on survivors.
Clinical Context:
Suicide profoundly affects family systems. Assess for survivor guilt, unresolved grief, increased risk in family members, and whether suicide is spoken about or remains a family secret.
Keywords: suicide, death by suicide, completed suicide
🕯️

Death by Homicide

Death by homicide

Keywords: homicide, murder, killed, death by violence
⚠️

Death by Accident

Accidental death

Keywords: accident, accidental death, car accident, fatal accident
🎓

Higher Education

College, university, or advanced degree

Keywords: education, college, university, degree, phd, masters
📉

Unemployment

Significant period of unemployment

Keywords: unemployment, jobless, unemployed, job loss
💸

Financial Crisis

Bankruptcy, foreclosure, or major financial loss

Keywords: bankruptcy, foreclosure, financial crisis, debt

Relationship Lines

━━━

Marriage/Partnership

Married or committed partnership (double line)

Usage Guideline:
Connect partners horizontally with double line. Include marriage date (m. YYYY) above line. For multiple marriages, show in chronological order left to right.
Clinical Context:
Marriage relationships are central to family structure. Note patterns of partner selection, age at marriage, number of marriages, and how partnerships function across generations. Consider cultural contexts.
Keywords: marriage, married, partnership, spouse
━━━

Divorce

Divorced relationship (double line with slashes)

Keywords: divorce, divorced, separated legally
━━━

Separation

Separated relationship (dotted line)

Keywords: separation, separated, living apart
━━━

Parent-Child

Biological parent-child relationship (vertical line)

Keywords: parent, child, biological, birth
━━━

Sibling

Sibling relationship (horizontal line)

Keywords: sibling, brother, sister
━━━

Close Relationship

Emotionally close relationship (thick solid line)

Keywords: close, bonded, intimate, strong bond
━━━

Distant Relationship

Emotionally distant relationship (dashed line)

Keywords: distant, remote, disconnected, weak bond
━━━

Conflictual Relationship

Conflictual relationship (jagged line)

Usage Guideline:
Draw jagged line between people in conflict. Can overlay on marriage, parent-child, or sibling lines. Note nature and duration of conflict in annotations.
Clinical Context:
Conflict patterns often repeat across generations. Assess whether conflict is acute or chronic, what triggers it, and how it affects other family members. Consider family rules about expressing anger.
Keywords: conflict, fighting, hostile, tension
━━━

Enmeshed Relationship

Enmeshed or overly close (triple line)

Keywords: enmeshed, codependent, fused, boundary issues
━━━

Estranged

Estranged relationship (line with single slash)

Keywords: estranged, alienated, detached
━━━

Cut-Off

Complete cut-off (line with double slash)

Keywords: cutoff, cut off, no contact, severed

Medical Condition Indicators

🎗️

Cancer

Cancer diagnosis or history

Keywords: cancer, tumor, oncology, malignancy
❤️

Heart Disease

Cardiovascular disease

Keywords: heart, cardiovascular, cardiac, heart disease
💉

Diabetes

Diabetes mellitus diagnosis

Keywords: diabetes, blood sugar, insulin
🏥

Chronic Illness

Long-term medical condition

Keywords: chronic, illness, disease, medical
♿

Disability

Physical or cognitive disability

Keywords: disability, disabled, handicap, impairment
🧠

Stroke

History of stroke or cerebrovascular accident

Keywords: stroke, cva, cerebrovascular, brain attack
🧩

Alzheimer's/Dementia

Alzheimer's disease or other dementia

Keywords: alzheimers, dementia, memory loss, cognitive decline
🩺

Hypertension

High blood pressure

Keywords: hypertension, high blood pressure, hbp
🫁

Asthma

Chronic respiratory condition

Keywords: asthma, respiratory, breathing, wheezing
⚡

Epilepsy/Seizure Disorder

Seizure disorder

Keywords: epilepsy, seizure, convulsion
🩹

Chronic Pain

Chronic pain condition

Keywords: chronic pain, pain, fibromyalgia, arthritis
🫘

Kidney Disease

Chronic kidney disease or renal failure

Keywords: kidney, renal, dialysis, kidney disease
🫀

Liver Disease

Chronic liver disease or cirrhosis

Keywords: liver, hepatic, cirrhosis, hepatitis
🩸

HIV/AIDS

HIV infection or AIDS diagnosis

Keywords: hiv, aids, immunodeficiency
🧬

Genetic Disorder

Inherited genetic condition

Keywords: genetic, hereditary, inherited, dna
⚖️

Obesity

Obesity or significant weight issues

Keywords: obesity, overweight, weight, bmi
🦠

Autoimmune Disorder

Autoimmune disease (lupus, MS, rheumatoid arthritis, etc.)

Keywords: autoimmune, lupus, ms, multiple sclerosis, rheumatoid arthritis
🦋

Thyroid Disorder

Thyroid disease (hyper/hypothyroid)

Keywords: thyroid, hyperthyroid, hypothyroid, thyroid disease
👁️

Vision Impairment

Blindness or significant vision impairment

Keywords: blind, vision, visually impaired, sight
👂

Hearing Impairment

Deafness or significant hearing loss

Keywords: deaf, hearing, hearing impaired, hard of hearing

Mental Health Indicators

😔

Depression

Major depressive disorder

Usage Guideline:
Place indicator near or inside the person's symbol. Include diagnosis date and treatment status in notes. Track across generations to identify patterns.
Clinical Context:
Depression often runs in families through genetic and environmental factors. Look for patterns across generations, triggers (loss, trauma), and how family dynamics may maintain or alleviate symptoms.
Keywords: depression, depressed, sad, mood disorder
😰

Anxiety Disorder

Anxiety disorder diagnosis

Keywords: anxiety, anxious, worry, panic
🔄

Bipolar Disorder

Bipolar affective disorder

Keywords: bipolar, manic, depression, mood swings
🧠

Schizophrenia

Schizophrenia spectrum disorder

Keywords: schizophrenia, psychosis, psychotic
⚡

PTSD

Post-traumatic stress disorder

Keywords: ptsd, trauma, post-traumatic, stress
🍽️

Eating Disorder

Eating disorder (anorexia, bulimia, etc.)

Keywords: eating disorder, anorexia, bulimia, binge
🔁

OCD

Obsessive-compulsive disorder

Keywords: ocd, obsessive, compulsive, obsessive-compulsive
😱

Panic Disorder

Panic disorder with or without agoraphobia

Keywords: panic, panic disorder, panic attack, agoraphobia
🎭

Personality Disorder

Personality disorder diagnosis

Keywords: personality disorder, bpd, borderline, narcissistic, antisocial
🆘

Suicidal Ideation/Attempt

History of suicidal thoughts or attempts

Keywords: suicide, suicidal, self-harm, suicide attempt
🩹

Self-Harm

Non-suicidal self-injury

Keywords: self-harm, self-injury, cutting, nssi

Substance Use Indicators

🍷

Alcohol Abuse

Alcohol use disorder

Keywords: alcohol, alcoholic, drinking, substance abuse
💊

Drug Abuse

Substance use disorder (drugs)

Keywords: drugs, substance abuse, addiction, narcotics
🚬

Tobacco Dependence

Nicotine/tobacco dependence

Keywords: tobacco, smoking, nicotine, cigarettes
🌟

In Recovery

Currently in recovery from substance abuse

Keywords: recovery, sober, sobriety, clean
💉

Opioid Dependence

Opioid/narcotic dependence or addiction

Keywords: opioid, opiates, heroin, fentanyl, painkillers
🌿

Marijuana Use

Cannabis/marijuana use disorder

Keywords: marijuana, cannabis, weed, thc
⚡

Stimulant Abuse

Cocaine, methamphetamine, or other stimulant abuse

Keywords: cocaine, meth, methamphetamine, stimulants, amphetamines
💊

Prescription Drug Abuse

Misuse of prescription medications

Keywords: prescription, rx abuse, medication misuse, pills
🎰

Gambling Addiction

Compulsive gambling disorder

Keywords: gambling, betting, compulsive gambling, gambling addiction
🚨

Overdose History

History of drug overdose

Keywords: overdose, od, drug overdose

Standards Reference

These symbols follow the standardized notation system established by McGoldrick, M., & Gerson, R. in "Genograms: Assessment and Intervention" (3rd ed.). This is the most widely accepted notation system in family therapy, social work, and clinical psychology.