"Where does this come from?" – this question arises when symptoms stubbornly refuse to respond to the usual treatments, when relationship patterns repeat even though one has seen through them, and when the feeling persists that the answer lies somewhere in the family history, though one does not know where. Dr. med. Birgit Hickey has made of this a method that combines genogram analysis with systemic constellations – and thereby reaches the places that words alone cannot.

Aufstellungsraum mit Bodenankern und Stellvertretern um das Genogramm
Bodenanker bilden das Genogramm liegend ab — Stellvertreter treten in Resonanz.

Who Is Birgit Hickey?

Dr. med. Birgit Hickey is a physician and diploma biologist, in private practice since 1992, a recognised systemic constellation facilitator, training therapist and systemic mediator. Her training encompasses systemic family therapy, family-biographical genogram work, systemic structural constellations, solution-focused brief therapy and hypnotherapy – a combination that suggests she did not stop searching until she had found the approach that works.

What makes her approach distinctive: it combines the analytical clarity of genogram work according to McGoldrick and Gerson with the experience-based force of systemic constellation work. The genogram shows the pattern; the constellation makes it felt – and only both together make it possible not merely to understand the pattern but to change it.

Vergleich von sitzender Genogramm-Arbeit und räumlicher Aufstellung
Sitzend versus aufgestellt — zwei Wege ins gleiche System.

The Family-Biographical Transgenerational Approach

Hickey's core thesis is as unsettling as it is plausible: many problems that persistently elude purely individual therapy have their roots in unresolved themes of the family system. Transgenerational bonds of fate – unconscious loyalties to earlier generations – can manifest as physical symptoms, relationship problems or professional blocks, and the insidious thing about them is that they disguise themselves as "one's own" problems.

The family-biographical genogram analysis systematically captures:

  • Fateful blows: Early deaths, losses, displacement, war trauma, and their transmission across generations.
  • Entanglements: Unconscious identifications with family members who have suffered a heavy fate.
  • Interrupted reaching-towards movements: Relationship cutoffs, adoptions or family secrets that burden the system.
  • Repetition patterns: Striking parallels in illnesses, separations, career choice patterns or life crises across several generations.

The Methodology: From Genogram to Constellation

In Hickey's family-biographical transgenerational approach, genogram analysis and constellation work complement each other in four phases:

  1. Phase 1 – Creating the genogram: Systematic recording of the family history across at least three generations. Not only facts are gathered but also emotional qualities, family secrets and significant life events documented.
  2. Phase 2 – Analysing patterns: Together with the client, transgenerational patterns are identified. Where do themes repeat? What parallels exist between the current problem and events in earlier generations?
  3. Phase 3 – Conducting the constellation: The hypotheses identified in the genogram are made experiential in a systemic constellation. Representatives or symbols represent family members and their relationships to one another.
  4. Phase 4 – Integration: The insights from genogram analysis and constellation are brought together. Resolution images emerge that can free the client from transgenerational entanglements.
Core thought: The genogram shows WHAT repeats across generations. The constellation makes it experiential WHY it repeats. And only those who bring both together find the path from insight to change.

Areas of Application

Hickey's approach is used in various therapeutic and advisory contexts:

  • Treatment-resistant symptoms: Physical or psychological complaints that elude conventional treatment may be caused by transgenerational entanglements.
  • Relationship patterns: Recurring conflicts, separations or difficulties in partnerships that do not resolve despite couples therapy.
  • Parenting questions: Parents who relapse in child-rearing into patterns they actually wished to avoid.
  • Professional blocks: Inexplicable difficulties at work or in self-realisation that may be connected to family loyalties.
Book recommendation: "Wie die Familie unser Leben bestimmt"

Dr. med. Birgit Hickey: "Wie die Familie unser Leben bestimmt – Genogramm und systemische Aufstellungen". Carl-Auer Verlag, 2nd edition 2024, 359 pages, 78 illustrations. ISBN 978-3-8497-0443-8. Price: EUR 49.00.

The practical guide describes, through numerous case examples, how family-biographical genogram analysis and systemic constellations are combined in therapeutic practice. It is directed at therapists, counsellors and all those who wish to understand how family history influences our present lives.

Experiencing Genogram Work Live: Seminar in Berlin

Those who wish to experience Dr. Birgit Hickey's approach in practice have the opportunity to do so at Systemisch.Weiter.Denken. In introductory seminars and practical workshops, Hickey works live with genograms and systemic constellations – a unique opportunity to experience the methodology through one's own family system.

Seminar: Genograms and Systemic Constellations with Dr. Birgit Hickey

Organiser: Systemisch.Weiter.Denken. | Venue: SIBUZ Kreuzberg, Berlin | Introduction (Fri 4–8 pm) and practical workshop (Sat/Sun all day).

Dates and registration at systemischweiterdenken.de →

Digital Genograms for Practice

Whether in preparation for a seminar, in individual therapeutic work or in supervision – a digital genogram considerably eases the family-biographical analysis. Patterns can be highlighted with colour, changes are possible at any time, and the finished genogram can be exported as PDF, which becomes important at the latest when one wishes to present it in supervision.

GenoEasy was developed for precisely this need: standards-compliant symbols, encrypted storage of sensitive data and an operation that gets by without a manual. Because the tool should remain in the background, so that the therapeutic work can occupy the foreground.

Try GenoEasy for free

Try GenoEasy free for 14 days and discover how easy it can be to create professional genograms.

Download now
Vier-Phasen-Workflow nach Hickey mit Sicherheitsregeln
Vier Phasen Hickey: Sammlung, Anker, Aufstellung, Reflexion.