Randy Gerson had a dream in the eighties that struck his contemporaries as mildly eccentric: drawing genograms on a computer. Forty years later this dream has become reality, and it goes far beyond what Gerson could have imagined – which, admittedly, is true of most dreams that are ahead of their time.

When Gerson founded his company GenoWare and developed one of the first digital genogram programmes, it was pioneering work on ungainly desktop computers with greenish-flickering screens. Most therapists continued to draw by hand – on flip-chart paper, with coloured pens, directly in the session – and saw no reason to stop.

And the hand-drawn genogram retains its charm, one must fairly say. It takes shape in conversation, grows with every telling, is crossed out and amended, and some therapists swear it is precisely the imperfect, handmade quality that promotes the therapeutic process – much as some music lovers swear that vinyl sounds better than any digital format.

The Limits of Paper

Paper does, however, have limits that cannot simply be blacked out:

• A complex genogram spanning four generations, with step-families, foster children, and chosen family members, quickly becomes as illegible as a map over which someone has spilled coffee.
• Paper genograms are difficult to update without the result looking more like modern expressionism than a family diagram.
• They are hard to share – even the attempt to photograph a hand-drawn genogram and send it to a co-therapist is an adventure with an uncertain outcome.
• And documentation in the case file often requires a separate, "tidy" genogram – double work that nobody enjoys and that is accordingly left undone.

Digital tools solve these problems with an elegance that Gerson would have appreciated. They make it possible to create genograms to the standards of McGoldrick and Gerson, edit them flexibly, export them professionally, and store them securely – and they do so without disturbing the therapeutic process, which is the real trick.

A Circle That Closes

In doing so, a circle closes that spans more than four hundred years, and it is one of those rare circles that actually feels round: from Michaël Eytzinger's ancestral chart of 1590, through Murray Bowen's family analyses and Monica McGoldrick's standardization, to modern digital tools. The technology has changed fundamentally in that time. The need has not: understand families, recognise patterns, make connections visible.

The methods have become different. The questions have remained the same.

Because in the end, every genogram – whether drawn on parchment, sketched on flip-chart paper, or created on a screen – is about the most fundamental of all questions: Where do I come from, and what part of that do I carry forward? And perhaps also about the quieter question behind it: What of that would I like to put down – and is it even possible?