A genogram of a Nigerian extended family looks fundamentally different from that of a Swedish nuclear family – and anyone who believes this is simply a matter of size has the more interesting part of the story still ahead of them.

For a long time, family therapy had a blind spot of remarkable proportions: it assumed a Western, mostly white middle-class family model – two parents, two to three children, perhaps grandparents at the margins. A model about as universal as the assumption that all people eat with knife and fork. But what about families where five generations live under one roof? Where "uncle" is not a blood relative but the father's best friend, yet wields more influence than many a biological relation? Where the grandmother holds more authority than both parents combined, and everyone considers this perfectly normal?

In 1995, Kenneth Hardy and Tracey Laszloffy published an article in the Journal of Marital and Family Therapy (Volume 21, Issue 3) that named this blind spot plainly: the "Cultural Genogram". Their thesis was as simple as it was uncomfortable – one cannot understand a family without understanding the culture in which it lives, and one cannot understand the culture by making one's own the standard.

Monica McGoldrick, who had never shied away from uncomfortable questions, took up this thought and made it a core element of her later work. In the revised editions of her standard reference she increasingly emphasised what should perhaps have been self-evident: genograms must be capable of depicting cultural factors – experiences of migration, religious imprinting, experiences of discrimination, language barriers, and all the invisible rules that a culture passes on to its families without ever saying a word about it.

The New Questions

The expanded genogram has since asked not only: Who belongs to the family? But also – and this is the genuinely interesting question: Which cultural rules determine how this family functions – and which of these rules must on no account be spoken aloud?

• In many Asian families, the hierarchy by age is so formative that a genogram without this information would be about as revealing as a map without contour lines.
• In African-American families, chosen families often play an equally important role as blood relatives – and leaving them out of the genogram means leaving out half the picture.
• In families with a migration background, the cultural conflict between the generations produces its own patterns that become visible in the genogram: the grandparents holding on to the old world, the grandchildren living in the new one, and the parental generation standing in between, trying to be both at once.

This expansion made the genogram a truly universal tool – applicable not only in Western consulting rooms, but wherever people live in families, which, as far as is known, is everywhere.