The Arts in Psychotherapy 35 (2008) 171–180

“It’s hard to be the child of a fish and a butterfly”Creative genograms: Bridging objective and

subjective experiences

Ephrat Huss, Ph.D. a,∗, Julie Cwikel, Ph.D. b

a Lesley University, Netanya and Ben-Gurion University of the Negev, Beer Sheva, Israelb The Center for Women’s Health Studies and Promotion, Ben Gurion University of the Negev, Beer Sheva, Israel

Abstract

This paper describes the use of a creative genogram that combines the client’s objective and subjective phenomenologicalexperience of his family constellation. The creative genogram includes personal symbols, colors, and shapes, as well as varyingthe overall page designs and formats of the basic family genogram. Taken together, the objective and subjective attributes of thegenograms create a group narrative of the impact of culturally embedded identities on shared familial experiences. The creativegenogram technique integrates a contextualized or “objective” experience of reality with a hermeneutic or “subjective” understandingof that experience. Thus, this interdisciplinary approach helps to counteract the flooding of difficult external realities within socialwork and family therapy, as well as the exclusive focus on subjective reactions within dynamic and art therapy that ignores the socialcontext. The paper describes how creative genograms were applied through personal examples derived from a group of social workstudents.© 2007 Elsevier Inc. All rights reserved.

Keywords: Genorgams; Creativity; Art therapy

Introduction

This paper presents a technique that uses a visually creative process to explore the phenomenological experienceof the family constellation in the clinical setting. The process combines a subjective level with the “objective” datarecorded in the genogram. The creative genogram has an added diagnostic value since the client expresses concerns andissues about his family in expressive fashion, rather than focusing on a pre-determined issue derived from the therapist’sunderstanding of family dynamics. In addition, the artwork simultaneously highlights the emotive timbre of the family,as well as the coping strategies used in dealing with family challenges. The client’s creativity or problem-solvingabilities are stimulated, intensifying his interpretive voice within the client–therapist interaction. The combination ofobjective and subjective levels can challenge the overly technical or contextual level of social work on the one hand,and the overly subjective level of dynamic art therapy on the other hand. The client is understood to be not only theproduct of his or her past, but also, an active and creative interpreter of the past allowing for new options on how toshift the dynamics of the family in the future.

∗ Corresponding author. Tel.: +972 86900695.E-mail addresses: ehuss@bgu.ac.il (E. Huss), jcwikel@bgu.ac.il (J. Cwikel).

0197-4556/$ – see front matter © 2007 Elsevier Inc. All rights reserved.doi:10.1016/j.aip.2007.10.002

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Literature survey

The genogram can capture family history by noting relationships between births, losses, connections, patterns, roles,occupations, and communications within a family unit over generations. Genograms are used in medicine, social work,psychological treatment, family therapy, and research contexts (McGoldrick, M. & Gerson, S., 1985; Magnuson andShaw, 2003; Coupland, Serovich, & Glenn, 1995; Kuehl, 1995).

McGoldrick, M. and Gerson, R. (1985), in the first edition of “Genograms: Assessment and Intervention,” constructeda universal diagramed presentation with fixed graphic forms of a family’s history in the genogram. This paradigmreflected a standardization developed by the North American Primary Care Research Group in collaboration withleading family therapists. This has been revised to reflect additional diverse family forms and patterns (McGoldrick,Gerson, & Shellenberger, 1999).

Social work and genograms

Both social work and family therapy use genograms in order to record the client’s view of their family within itssocial context. The information can be used either diagnostically or as a method to highlight patterns within the familystructure in order to promote insight as part of the therapeutic process. These patterns are often national, cultural, class,and gender specific, but also belong to the personal “culture” and specific family history.

While the genogram is a standardized way of mapping information, it can be a continually evolving tool, aimed atpromoting insight into treatment issues. For example, it has been extended to include or highlight different types ofinformation such as community affiliations, relationship characteristics, employment, or health histories. Examples ofsuch innovations are its use to map out specific experiences, such as traumatic events (Jordan, 2006); to enable thecontextualized examination of a specific element such as ethical decision-making within the family (Peluso, 2003); orto map out cultural differences within the family (Hardy & Laszloffy, 1995).

Art therapy and genograms

Art therapy is most commonly associated with a psychodynamic perspective, which views art as an expression ofthe subconscious, or the client’s subjective reality, without addressing the macro social realities of the client’s situation.Creative genograms expand the art therapy approach by working, through a creative iterative process, from the startingpoint of the contextualized historical reality of the family. The use of the phenomenological level of experience throughart creates a reflective dialogue, first between the artist and artwork, and second, between the therapist and the artistregarding the artwork’s possible interpretations (Betinsky, 1995).

Riley and Malchiody (1994) proposed using art within family therapy whereby creating art becomes the vehiclefor family collaboration and re-interaction, through the joint creation of an artwork. In addition, art may be utilizedto indirectly express hidden family experiences. Similarly, art is also used within socially contextualized communityprojects to create a group voice and express the experience of a particular group of socially silenced people throughcollective murals, graffiti, or quilts (Hogan, 1997).

Groups and genograms

Genograms within social work and art therapy tend to be presented as individual and intimate knowledge, perhapsdue to the personal nature of disclosed information that may implicate other family members, rather than withingroup work. However, a group exhibition of genograms graphically demonstrates the connection between personal andpolitical or social reality. This group experience contextualizes the presented problems within common social fabricrather than only personal issues and furthers genograms as a tool in critical consciousness (Friere, 1987). Thus, thegenogram can point to social oppressions that influence personal experience.

As Fals-Borda and Rahman (1991) state:

“Storytelling, plays, drawing and painting encourage a social validation of ‘objective’ data that cannot be obtainedthrough the orthodox processes of survey and fieldwork, it is important for processed groups, which may be partof a culture of silence- to find ways to tell and thus reclaim their own story” (Fals-Borda & Rahman, 1991, p. 44).

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Research method

The aim of the paper is to describe a method of using creative genograms rather than to present a formal, empiricalevaluation. This paper will demonstrate how creative genograms were used in a group context, through examplesgenerated by a group of 14 social work students who learned creative interventions for social workers within auniversity social work department at the MSW level. The data sources are the written documentation of the lessons inwhich the creative genograms were utilized, including copies of the genogram-art products themselves.

First, in order to describe what is meant by creative interventions to the reader who may not be familiar with theuses of arts within therapy, the students were asked to prepare class exercises based on the following instructions:

(a) Use personally selected symbols, colors, sizes, or shapes to depict different people within the family (e.g., cuttingout people from magazines, drawing people as different animals, or different symbols).

(b) Use different colors, sizes, and shapes or textures to express the relationships between the people in the family (e.g.,using different textures and types of lines, or different types of threads to depict different types of relationship).

(c) Use the space of the page to express the use of space within the family and of the family in relation to the outerworld (e.g., showing who takes up more space by bigger symbols, or showing how the family feels in the worldby placing the genogram in a corner of the page, or by filling the whole page).

(d) Frame the genogram map within a page that constitutes an overall symbol, color, or shape that expresses theexperience of the family as a whole (i.e., the family within a ship, house, or animal, drawn on different textures ofpages, such as newspapers, hardboard, etc.).

(e) Record specific events in the family history by using additional symbols within the genogram, showing how it“colored” different people in the family.

The suggestions above do not demand complex materials or art skills, but can be undertaken on the same page asthe genogram with the help of felt tip pens, panda crayons, different paper sizes, and/or magazines used for collage.

The ethical considerations of presenting genograms in a paper are complicated as the information is very personaland identifiable. Therefore, the authors disguised specific facts, and re-sketched the genograms without the names anddetails of the family as rendered in the original genogram, so as to protect the privacy of the participants and of thefamilies (Mulched & Riley, 1996). In addition, all students gave informed consent as to whether they agreed to havetheir genograms included in an academic paper prepared for publication. Their decision had no bearing on the groupactivity, discussion or course evaluation.

The examples below were done using simple felt tip pens and oil crayons on white paper. The data will be presentedalong four levels: first, the original genogram that forms the base; second, the creative rendering of the genogram;and third, the relationship between this creative genogram and the participants’ interactions in the “here and now” ofthe group. Finally, suggestions on how to transform or change the above by continuing to work creatively with thegenogram will be presented.

The different examples are categorized according to the three themes:

(1) Relationships of tension or disengagement.(2) Binary gendered roles.(3) Ethnic and historical influences on family interaction.

It is important to state that all of the students were female, and thus the term “she” is used throughout.

Results

Relationships of tension or disengagement

The participant demonstrated the pattern in her family of having a single child within each relationship followed bydivorce. The quality of the relationships between the men and women reflected discontentment and disengagement.However, on a professional level, all the members of the family were considered successful. All the women in thefamily, including the participant who is a social worker, work in various capacities in the helping professions, as if the

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Fig. 1. Disengagement or lack of intimacy: “it always breaks up, eventually.”

women are attempting to “put right” their personal difficulties. The participant emphasized the high value placed onprivacy in her family, simultaneously internalizing family norms while at the same time expressing concern about shewould succeed in achieving lasting intimacy within the context of her approaching marriage.

Visually, the participant noticed that she had drawn the family genogram as a whole encased within a very smallhouse, perhaps in an attempt to keep family members close together, an expression of resistance to their tendency todisengage or divorce. (This genogram is not presented at the participants’ request.) Within the group, the participantrelated her fear of intimacy to her ambivalence about whether to stay at a “safe distance” from group intimacy or torisk greater sharing. The group suggested that the participant draw in more detail different shades of the “unhappy”relationships between men and women in her family of origin, using images and symbols for each relationship, so asto address them more specifically, rather than as general “relationship failures.” Another suggestion was to draw inmore detail, the spheres of closeness and of distance within her current relationship in order to find a good balance thatwould enable both privacy and intimacy.

We see how the creative genogram presented “hard data” that illustrated a conflictual pattern of divorce and tension.This helped to identify a central problem for this young woman just prior to her own marriage, which is a criticaltransition in adult life. The data presented in the genogram generated emotional and verbal interpretations from thestudent and possible ideas and solutions from the other group participants.

Similarly, another participant, (Fig. 1) who had recently married, also stated her concern about repeating a history ofconflicted and “complicated” relationships between the women and men in her family. “Everything is so complicated,how do I make relationships less complicated?” Her sister’s recent divorce intensified her feelings.

The student highlighted all the relationships she perceived as negative in red, so that red lines dominated thegenogram. Observing her genogram, she realized that her fears about these “red relationships” was preventing herfrom experiencing the positive aspects of her family.

While the two stories delineated above may be similar in content, we see marked differences in coping styles andthe interpretations made by the participants of their own genogram. The former participant expressed her wish for anideal family, while the latter articulated being overwhelmed by her family’s troubles. In accordance with this differencein coping strategy, different art activities were suggested in order to integrate the positive elements in the family, or tounfold and address the negative elements, both through the medium of the art which allowed both of them to retain asense of control.

The above quote is attributed to an older participant describing her extended family’s pattern of disconnecting overfamily rows and not speaking to one another for years. Throughout her life, she intensely disliked this pattern andavoided disconnecting from anyone in the family. Nonetheless, at present she finds herself “cut off” by a relative, adevelopment that causes her much grief (Fig. 2).

The participant described this dynamic through a symbol of a spiral of the generations, with bits of the spiral cut off,thus, creating the appearance of barbed wire. The image of the barbed wire, reminiscent of a “war zone,” expressed thelife-threatening (as in war) feelings these disconnection experiences evoked for the participant. She was then able tosee how this need to achieve solidarity and conflict resolution was a central motivation for much of her behavior in thegroup context. This was expressed in the group through behaviors such as prohibiting others from expressing conflict,

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Fig. 2. Cutting off family members—“this is the most unbearable thing.”

an action which angered many group members. The group suggested that she try to create an integrated symbol thatincludes disconnections or points of conflict, but not as barbed wire, but rather an expression of a continuing wholeness.

The above three creative genograms demonstrate the different ways that the participants experienced and reactedto conflict and disengagement within the family (denial, flooding of anxiety, or ambivalence). These reactions wereapparent both in their art and through their group behavior. Suggestions relating to the creative continuation of thegenograms opened the possibility of re-framing, not the reality, but of the cognitive processing of the reality, throughthe breaking down and focusing on smaller and more specific elements of the conflicts or disengagement patterns. Theuse of a creative art process helped to maintain feelings of control while allowing the participants to experiment withalternative modes of interpretation.

This responsibility for relationships and for “fixing” things, or, in other words, the concern with relationships, wasdiscussed with regard to the common profession chosen by the group members—social work. The responsibility ofwomen to “mend” relationships, both privately and professionally, was discussed and analyzed, creating a group voiceand a critical stance towards this gendered expectation, as will be shown in the following section.

Binary gendered roles in the family

Similar to the women described earlier, this participant noticed that while relationships within her family wereharmonious, all the women worked in the helping professions, while all the men worked in scientific and engineeringrelated professions. This pattern included herself and her new husband. She had majored in science but, in compliancewith the described pattern, later chose to retrain as a social worker. The participant pointed out that the two divorcedwomen in her family had careers in science, and therefore, she thought that perhaps “it really was a mistake for womento try to enter a ‘men’s’ profession.” While the above explanation accepts the familial and gendered message, theparticipant had covered her genogram with a “prison” grid. She realized how her creative visual rendering expressedher internal rebellion towards the gendered roles that she had apparently accepted. The group stated that even hercloser friends had not known that she had majored in the sciences, as it was an area she had deleted from her presentedidentity. Within the group space, she had fully complied with the role of a “helping” professional (Fig. 3).

The gap between the participant’s art and her verbal explanation (as in the first example of the disengaged familyin the small house) expressed her central conflict and directed toward more creative solutions that were proposed inthe group setting. Suggestions included counteracting this denial of the “prison” experience through amplifying thevisual metaphor of the prison into words, and composing poetry against gendered roles. In addition, enrolling in anon-credited course in the sciences was suggested, as well as discussing with the divorced women (as well as with herown husband) the impact of career choice on their decision to divorce. The above example demonstrates how drawingscan express hidden rebellion against repressive cultural standards.

This participant described how men in her family chose professional military careers, creating many military widows.These widows are strong and independent and very close to one another, but the participant wondered if she was only

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Fig. 3. The helping professions are for women.

allowed intimacy with other women, rather than with her new husband. The participant’s picture contained two swanswith entwined necks and young cygnets placed on a different level (Fig. 4).

This portrayal stressed a partnership between a man and a woman, depicted as “mirror image” swans (compared toengagement with other women, which was the result of losing a spouse through military actions). She explained herdrawing as correcting the messages within the family and as a wish for an alternate future with her husband rather thanearly widowhood. Group members described the participant as a strong-willed woman, similar to the other womendescribed in her family. This description reframed a positive quality that could be maintained together with intimacywith her husband. One suggestion to envisage this new pattern was to fill in the contents of the heart-shaped spacebetween the male and female swan, so as to imagine what elements can connect between the genders. Another groupmember suggested hanging the swan picture above her bed in order to create an image that may be gradually internalized

“Women are strong,” then she burst out cryingThis participant also described how the women in her family are strong, although her mother experienced an

extremely difficult period when divorcing her father six years ago. The genogram was situated within a picture ofan ideal house, similar to houses drawn by small children, equipped with a red roof and surrounded by flowers. Theparticipant recognized this depiction as a denial of the divorce, or a yearning to return to an idealized safe place, lostin childhood. Subsequent to verbalizing this realization, the participant cried, thereby recognizing that one doesn’talways need to save face by acting in a “strong” manner, reflecting her mother’s distressing experience of divorce.Group members were very surprised, as they had not heard about the participant’s parents’ divorce in previous group

Fig. 4. War widows stick together.

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Fig. 5. “It’s hard to be the child of a fish and a butterfly.”

discussions. One group member recalled how the participant frequently spoke about her conflicting feelings aboutwanting to return home at the same as she wanted to remain with her boyfriend, as if she felt the need to protecther mother, defined here as “strong” but experienced as “weak.” The group suggested that she explore and integratethe concepts of strong versus weak in connection to female behavior, constructing a new construction of femininitythat encompasses being both strong and weak. It was also suggested that she discuss with her mother how to create abalance between being responsive to her mother’s needs while attending to her own need for freedom to develop herown life.

A very quiet participant stated that in her family, over three generations, she observed that the men are introvertedwhile the women are extroverted. The exception to this rule is the participant herself, who described herself as intro-verted, similar to her father, as compared to her extroverted sister, who she sees as similar to her mother. The participantrepresented the quiet men and herself as fish, and the loud women as butterflies. She noticed how hard it was to bethe child of a fish and a butterfly, as they are totally different animals (the experience of sub-groups within the family)and how one had to choose which animal to be (Fig. 5). Members of the group pointed out that throughout the groupdiscussions, the participant expressed a wish to become a “butterfly” within the group space, and to learn to talk.However, after her explanation, they realized that she had somehow made a decision to be a “fish,” and had mostly beensilent in the group. The group reframed her expressed desire as an act of reforming a new identity, and encouragedher not to concede and to further explore the meanings of her creative act. The solution was to draw a new animalthat combined both butterfly and fish characteristics. Another suggestions were to create a dialogue between the twoanimals through drama or to help the fish learn to “talk” and explain its silence in greater depth.

It’s my turn to stick with momA similar example to the above was a participant from a traditional family who stated that while her older siblings

were present she was allowed to be with her father, but when her older sisters left home, she was expected to becomeher mother’s companion. She was not happy with this new expectation, identifying with her father’s creative abilitiesand ambitions. She noted that although they were not wealthy, her father had a creative quality which she shares to“make something out of nothing.” As though to illustrate this, the participant placed a transparent cellophane cover overher genogram, showing how it was before, and how it is now. (The participant did not wish to present her genogramvisually.) The cellophane was invisible, like the passing of time, and indicative of her thoughts that, similar to hersiblings, she should be moving on and leaving home. The group pointed out that the legacy of her father’s creativitywas apparent in her construction of the genogram. Thus, she need not choose one parent over the other, as she wasalready similar to her father, even if, at present, she spent a greater amount of time with her mother. The group suggestedthat the participant create a new genogram that presented herself in the center, with elements of both parents integratedinto her identity.

The stereotypical and rigid cultural definitions of gendered roles described above can be understood as possibleexplanations for the first category of disengagement or conflict between the sexes: while the first group of examples

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related to processes of disengagement within the family, this second group of examples demonstrates the limitationsof binary approaches to female and male roles, such as being quiet or loud, strong or weak, nurturing or scientificallyoriented, and the ensuing fields of study or vocation. Regarding the identity of the young women participants, wesaw concern not only with integrating common characteristics with men, but also with creating a broader definition offemale roles within Israeli society. This process can be viewed as the development of a type of critical consciousness,thereby, challenging typical “coping” roles of Israeli women, who, due to the ongoing wars, have to be strong andemotionally responsible for the “home front,” while the men have to embrace a soldier identity that forces them to bestrong and pugilist.

The above binary definitions are further developed through history and ethnicity in the last two examples.

Ethnic and historical influences on family interaction

The personal price of Jewish historyAn older participant described a dramatic pogrom that her grandparents had endured and the “secret” nature of

this event, as perceived by the family. The participant believed that her father’s childhood “secret” was the core ofhis emotional absence from the family and his general passiveness. The participant noted that she drew the genogramsprawled across a huge page, as if to express the wondering and disconnectedness of her father’s Holocaust experience,thus re-amplifying his voice. The size of the paper also signified a rebellion against having to keep secrets that sheexperienced as a central factor in her personality. The group members demonstrated how the participant’s explanationclarified her constant concern regarding the appropriate level of disclosure. In addition, the group members stated theirunderstanding of the participant’s occasionally loud verbal style that may have resulted from a fear of being “wipedout” if silent. The group suggested that the participant express the story creatively so that she may experience it asbeing “heard” in a way that was not overwhelming, but also was not a secret.

The Ashkenazi woman always dominates the Sephardic manThis participant explained differences in power and style according to ethnic sources: her mother was of Ashkenazi

(European Jewish) origin and her father was of Sephardic (Middle Eastern-Jewish) origin. The participant described hermother as dominant within her family, a trait that she associated with her mother’s Ashkenazi culture. She experiencedher Sephardic father as warm, spontaneous, and fun-loving, but with little power within the family enclave. Theparticipant emphasized that she did not want to continue this pattern in her own relationships. The participant useda page that was half black, and half white to illustrate the ethnic impact on her family. Observing the genogram, shestated that perhaps her representation was an oversimplification in that the perceived differences may also be affectedby her parents’ individual temperaments, rather than exclusively cultural differences, as depicted in the genogram.Also she noted that since her parents claimed to be satisfied with their relationship, the problem might be with herperception.

Here, as in the “prison” example of gendered professions, the genogram is a forceful statement that resists thedifferences in power between cultures that is then softened by the verbal explanation, pointing to the difficulty inmaintaining a radical stance. These last two examples showed the direct impact on Israeli families of historical and socialrealities such as the Holocaust, and the power struggles between Ashkenazi and Sephardic Jews. Interestingly enough,these familial quandaries that were related to historical events or societal oppression were particularly challengingemotionally for the participants, in contrast with the earlier interpersonal but personal themes. This difficulty may beexplained by the fact that historical or social realities are not readily resolvable through the use of therapeutic tools.

Summary

In terms of a practice model, we saw above four steps within the use of creative genograms:

(1) Explanation of the genograms’ contents.(2) Explanation of the genograms’ creative and artistic form.(3) Explanation of the connection between the genogram and between the participant’s behavior in the here and now

and within the group context.

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(4) Suggestions that derived from the group discussion on how to continue working with the genogram and theemotional issues that were revealed in a creative fashion.

We saw that these steps led to the following outcomes:

(a) The art enabled the reconstruction of the emotional flooding and anxiety that the family history engendered, thusgaining of control of the emotions expressed through the art.

(b) The art helped to make overt formerly hidden, non-acceptable stances on roles and standards through expressingthem “silently” in a non-verbal fashion.

(c) The art “solutions” helped to create more integrated and multifaceted expression of roles and inter-relationships,moving beyond rigid or binary categories.

The creative genogram, used as a tool in teaching or therapy simultaneously generated diagnostic information,created a space for reflective processes, either by reframing problems or direct problem solving, thus also making theprocess time-effective. The overall effect of the addition of the creative art process to the genograms created an intenseand rapid presentation of problems and solutions. This created client focused and solution focused approach to usinggenograms to describe a seemingly “given” reality within a genogram. The limitations of this model as presented hereinclude the small sample size and the homogenous makeup of the group (MA students in social work). In addition,participating students had a vested interest in being cooperative, and had undergone different therapeutic processeswithin their studies. However, these optimal conditions also help to highlight, in this preliminary study, the potentialdirections and contributions of using genograms both phenomenologically and creatively.

The participants, many of whom were both at the stage of becoming social work professionals and mothers andwives, found themselves repeating negative family patterns that do not support closeness and intimacy. They alsosaw the connection between their personal difficulties and rigid definitions of gender, created according to the needsof Israeli society. Women were often presented as strong and responsible for emotional interactions in the family,while men were presented as emotionally distant, withdrawn, shy, or weak. Professionally, men were associated withrational scientific or engineering or military careers while women were concentrated in the helping professions. Thewomen experienced themselves as responsible for the emotional “work” in relationships, and thus also entered socialwork, a helping profession where this work is also emphasized, making it difficult to connect to other aspects of theirpersonalities.

The overall message is the connection between subjective experience and the group interaction which allowedfor the examination of objective roles and tensions within society. For instance, the need to define gender in a moreflexible way within a given family would enable subjective changes in roles within the family, and the ensuing potentialfor intimacy between men and women. Art is used here subversively and critically, in that the creative depictions ofthe genogram challenge the above cultural expectations, through showing the experiences of pain, weakness, fear,and loneliness generated through having to choose rigid definitions of gendered identity. The personal interpretation,expressed creatively, taken together with the “reality” or “hard data” about of the family and its history, expressedthrough the genogram, encouraged the participants to choose novel interpretations, or to “reframe” the experience inanother way, enabling both expressions of weakness, pain, rebellion, and integration. This situates the arts within acritical discourse, rather than a dynamic one in which it is seen as useful for the diagnosis or ventilation of emotion,rather than placing the emotion within a social and problem solving context.

Jones (1997), a feminist art therapist, also supports these finding, stressing the nonverbal elements of expression asenabling women to express stands not accepted within the dominant male discourses:

“For women, in contrast to the linguistic tradition, art offers a means of expression which is less readily male inits vocabulary, and is therefore more readily open to and able to reference the true experience of the women . . .

The image may speak for itself, reducing the possibility of the artist client being spoken over” (p. 75).

Thus, art can be subversive, because it helps to see things from a fresh perspective and to use a language of expressionthat is not dominated by either male or society’s typical mind-sets.

On this level, the use of creative genograms may be particularly useful to social workers. On the one hand, interms of practice, the phenomenological level of accessing pain, ambivalence, and denial may help generate empathywith the clients’ processes, thus, modifying the omnipotent “fixing” level of social worker. On the other hand, the

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enhancement of the client’s problem solving level may help to resist the sense of hopelessness and burn-out thatthe client’s oppressive contexts create within the social workers themselves. Creative genograms are also especiallyuseful to art therapists, where the inclusion of the client’s macro context rather than only the client’s subjective microexperience is an area not often dealt with by art therapy. While the descriptive and ventilating qualities of art are citedwithin the art therapy literature, the specific ways that art can be used in problem-solving demand further expositionand research. On a theoretical level, as stated above, the creative genogram successfully integrates between dynamicand systemic or contextualized approaches of therapy within one tool. The creative genogram illustrates the complexinteraction between the micro world of the client and the macro cultural and societal trends that affect all of us.

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Dr Ephrat Huss is an art therapist, social worker, and family therapist, holding a lectureship at Ben Gurion University and teaching creativeinterventions to social workers in Israel. Her doctorate was on art therapy with Bedouin women in Israel.

Prof Julie Cwikel is the head of the Center for Women’s Health Studies, and had researched women’s issues extensively from a mind, body, andsocial perspective.