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Module 9 — Drawing the Family
See the patterns you both grew up with, so you stop repeating the ones you never chose.
Watch first: the Module 9 video
A narrated video of about three and a half minutes in a paper-craft style that opens on the title “Part Three: Where It Started” and closes on the Neurodiverse Couples Counseling Center logo. It shows childhood homes and a family gathered in a living room, then the family drawing itself: hands arranging a family tree, a chart titled “The Tree and the Timeline,” and “Looking for Patterns” across Mom’s side and Dad’s side, with notes such as “critical” and “suspected autistic.” Last comes “The Next Step.”
Watch the Module 9 video: Drawing the Family (MP4, about 3 minutes). The written lesson below covers the same ground in full.
Part Three is about the families the two of you grew up in, and it begins with a picture. While one of you talks, your therapist draws that family on paper: a family tree, and beside it a timeline of what happened when. At the end of the session the drawing is held up to the camera, and for many people it is the first time they have seen their whole family at once.
The family drawing
Summary: what usually happens in the session
1 Worksheets go out to both of you. Family of Origin sheets, one set each. No date they are due back.
2 We agree whose family we are doing first. One family per session, and you know in advance whose.
3 Your therapist draws while you talk. On paper, not on the shared screen. You see the picture at the end.
4 Your therapist asks about your family members. What they were like, what they were good at and struggled with, and their relationship with you.
5 Symbols and words are placed beside names. We capture the key information that makes up the story of your childhood.
6 We accept the unknown. Nobody gets diagnosed, and uncertainty is part of the journey.
7 We sit with the big picture. You have a chance to reflect on your childhood, and to see its patterns.
One way this session can go, not a script. Your therapist will shape it to the two of you and to their own way of working.
Step 1. Worksheets go out to both of you
After your first session, a set of Family of Origin worksheets goes to each of you. They cover the home you grew up in: who was in it, who came before them, what each person was like, what happened and when.
There is no deadline. If yours is not done, we take the other family first, or we wait. This material is heavy for a lot of people, and taking a month over it is not falling behind.
Why we do this together, not alone. Many therapists explore childhood one to one. However, we prefer to do it with your partner in the room. Your partner gets to understand the wounds you carried into the relationship, and to see, often for the first time, how those wounds shape what happens between the two of you. Then the two of you have a chance to find a healing path together, rather than one of you doing it alone.
That only works if it is emotionally safe for your partner to hear it. Making sure that safety is in place is your therapist’s job, not yours. If it does not feel safe yet, say so, and we will work on that first.
Step 2. We agree whose family we are doing first
Both of you fill the sheets in, but a session only ever explores one family. Two in an hour turns into a comparison. Your therapist says who goes first before the session, so nobody arrives braced for the wrong thing.
The other partner is there the whole time, and their job is to listen. Many people learn more about their partner in this hour than in years of living together.
Step 3. Your therapist draws while you talk
Your therapist draws your family on paper as you answer, and you do not see it until the end. People who watch themselves being drawn start managing the drawing, so we would rather you just talked.
Opening. I am going to draw your family on paper while we talk, and I will hold it up to the camera at the end so you can both see it. Let us start with you and your brothers and sisters.
Beside the tree, your therapist draws a timeline of what happened when. It keeps going past childhood, into your adult life.
The ages and events here are only an example; yours will be your own.
Why a drawing at all. Most people have never looked at their whole family at once. Seeing it on one page gives you perspective: you can see things you had never seen before, because you were always standing inside it. The drawing itself has little outcome research behind it,1 so what we claim for it is that perspective, and the conversation it starts.
Step 4. Your therapist asks about your family members
Then your therapist goes round the page person by person, asking the same things about each. Nobody is skipped for seeming unimportant.
Asked about every name on the sheet. What were they like? What were they good at, what did they struggle with, and was there anything neurodivergent about them, looking back?
Any mental health difficulty, named or not? Any addiction? Were you close to them or distant? How did they treat you, and was there criticism or abuse?
The neurodiversity question comes early rather than last, because it is the one people have been quietly holding. Somebody’s mother could not have music on in the house, went rigid when the plan changed, and was called difficult all her life.
Asking about a grandparent. Tell me about your grandmother. What could she not stand? What did she do the same way every day? What did the family call her? … Do you think that might fit an autistic profile? We cannot know for sure, and that is all right.
You can pass on any question, or take a minute before you answer. Naming what hurt you is not disloyal.
Some of this is hard to say in front of your partner. Talking about a parent’s drinking, their criticism, or abuse is hard to do in front of your partner, and we recognize that. You can always say: “I would prefer to talk about that person in an individual session.” Your couples therapist will then meet with you alone to go over it. Often, though, saying it with your partner there helps a great deal: many partners have never understood what happened, or how it still affects you. If you do not feel safe with your partner now, tell your therapist alone; that comes first.
Step 5. Symbols and words are placed beside names
The tree uses the usual family-tree symbols: a circle for each woman, a square for each man, and lines for marriages and children.
Where the answers point at a neurotype, your therapist writes it next to the name, with a note saying how sure we are: assessed, self-identified or suspected. Autistic, assessed, 2019. ADHD, self-identified. Where nobody ever had a word, the word the family used goes down in quotation marks.
The neurotype is one layer of four. The depression, the drinking, the strengths and the distance go down in the same plain words.
Not everyone gets a note. Here Grandpa Joe, Mom and Ben have only their names.
Step 6. We accept the unknown
Nobody on the page gets diagnosed in this session. A note that says suspected stays suspected, and the pattern is still useful without a diagnosis.
Writing the note. I am putting suspected next to her name. We may never know for sure, and that is all right.
Among older adults, about ten times as many meet the criteria for ADHD as carry a diagnosis.2 So many relatives are marked suspected because of a hole in the record, not a hole in your memory.
The way this goes wrong. One partner diagnoses the other’s family: “her mother is obviously autistic, look at her father”. The page belongs to the person whose family it is. Your therapist redirects to what you watched your mother-in-law do, and that goes down as something you noticed, not a diagnosis.
Step 7. We sit with the big picture
Your therapist holds both sheets up to the camera, and the two of you see them together for the first time. Then the three of you look at the whole family.
You point out the patterns. Your therapist asks what you see. We try not to point patterns out ourselves: one you notice in your own family means far more than one somebody hands you.
Often the neurodivergence and the rest of the family story turn out to be connected. A child who was different got bullied at school, or spent a lot of time alone. A parent who did not understand an ADHD child criticized them for it, and the criticism outlived the childhood. Other patterns have nothing to do with neurodivergence at all: a parent who drank and a child who became the caretaker, or a family rule that nobody talked about feelings, or money.
How it all fits together. The question is how the whole family worked, and what you learned in it about being loved, being heard and being safe. Seeing it can change the story you tell about someone, yourself included, and it can bring grief as well as relief. Some women diagnosed autistic in middle age describe moving from self-critical to self-compassionate.3 The woman on your tree who was called difficult may have been autistic, and nobody knew.
Neurodivergence rarely stands alone: here it sits beside drinking, criticism passed down a generation, and a child who was teased and had few friends.
Before you finish, your therapist asks each of you what it was like: to tell it, and to hear it. Your therapist keeps the drawing. Your partner’s family is drawn next, and both drawings come back out for the wound session in the next module.
After the session
More will come to you later. The relative you had nothing to say about on Tuesday may be the one you have a lot to say about by Thursday. When that happens, add it to your worksheets and bring it to your next session. If a painful memory comes back and is hard to carry, contact your therapist before then.
If your partner’s family was drawn first, yours is coming. If you would rather it were not yet, say so; that is information, not a failure.
If this is hard to do. If the worksheets are hard to face this week, do not push through them. Spend some time with your partner talking about what makes it hard, and share the feelings that come up when you talk about your family. That conversation is part of the work.
Will the therapist diagnose my relatives as autistic or ADHD?
Nobody on the page gets diagnosed. Where your answers point at a neurotype, your therapist writes it next to the name with a note saying how sure anyone is: assessed, self-identified or suspected. A relative marked suspected stays suspected, and the pattern is still useful without a diagnosis. Where nobody ever had a word, the word the family used goes down in quotation marks.
What if I don't want to talk about a parent's drinking or abuse in front of my partner?
You can say you would prefer to talk about that person in an individual session, and your couples therapist will meet with you alone to go over it. You can also pass on any question, or take a minute before you answer. If you do not feel safe with your partner now, tell your therapist alone; that comes first.
What does my partner do while my family is being drawn?
Your partner is there the whole session, and their job is to listen. The page belongs to the person whose family it is, so if one partner starts diagnosing the other's family, the therapist redirects to what they actually watched, noted as something they noticed. Many people learn more about their partner in this hour than in years of living together.
Is there a deadline for the family of origin worksheets?
There is no deadline. Each of you fills in your own set of Family of Origin worksheets, and if yours is not done, the other family can go first, or you can wait. This material is heavy for a lot of people, and taking a month over it is not falling behind.
Your workbook
Your answers save to this device only - we cannot see a word of what you write. This one is your tree in words, for the week between the drawing and the next session.
The tree and the timeline
Siblings first, then outward. Names and rough ages only, not everyone.
You and your brothers and sisters, oldest to youngest, with rough ages, and the role each of you had, if there were roles
Which parent are you most like? — My mother, My father, Another caregiver, Neither, and I know who I am like instead, I have never been able to answer this
Up to five big events, in order, with your age at each: a divorce, a death, a move, an injury, anything you count as major
The notes beside the names
One relative per line. The note says how sure we are: assessed, self-identified or suspected.
Assessed: who, what, by whom, roughly when
Self-identified: who, and what they call it
Suspected: who, and three things you watched them do
Patterns you noticed when you saw the whole page: neurodivergence, criticism, drinking, things nobody talked about
A few days later
Fill this in a few days after the session, not the same evening.
What arrived later: a relative you forgot, an event missing from the timeline, a pattern you never had a place for
If your partner's family was drawn first: — I want mine drawn next, I am not sure I want mine drawn, I would rather not, and I will say so, Mine was drawn first
Where this comes from
Every source below was checked against the published record. They are grouped by the kind of evidence they are, so the numbers may not run straight down the page — a number points back to where the source is used in the lesson.
Research discussion
The family drawing, or genogram, is standard practice in family therapy. It has been written about a great deal but tested very little. The review the lesson cites searched five research databases and found that most papers describe where and how genograms are used, with very few studies of whether they help.1 It does not say how many studies it included, so the lesson says little research, not none.
Nobody has tested whether drawing a family this way helps a couple, and we do not claim it does. Our claim is narrower: the value is in the conversation, and the drawing is how the conversation gets started.
The notes beside each name (assessed, self-identified, suspected) and the questions about each relative are the practice’s own way of working. Nothing official exists. Their value is that they are consistent: the same notes on every family, so that months later everyone can still tell what was known from what was guessed. Like the rest of this program, the session rests on what thousands of neurodiverse couples have told us, not on a trial.
The ADHD figure explains why so many relatives are marked suspected; it does not test the drawing. It comes from a review that combined twenty studies of adults aged fifty and over, about twenty-one million people. The studies differed a lot from one another, so ten times is a rough guide, not an exact number.2
The late-diagnosis study interviewed eleven women diagnosed after forty. It shows what a late diagnosis can be like, not how common any of it is.3 The observation that undiagnosed relatives survive in family language as character rather than condition has no study behind it, and the lesson presents it as a pattern we notice.
Who this research was done with. The studies behind this module drew heavily on white, comparatively well-off, English-speaking participants. If your household carries pressures those samples did not — money, immigration, racism, disability, unsafe housing — the practice still applies, but the room you are practicing in is harder. That is the room, not you.
Clinically reviewed by Harry Motro, PsyD, LMFT · California LMFT #53452 · Founder and Clinical Director, Neurodiverse Couples Counseling Center · Clinical supervisor · Updated September 27, 2026
Peer-reviewed research
1. Joseph B, Dickenson S, McCall A, Roga E (2023) Exploring the therapeutic effectiveness of genograms in family therapy: A literature review. The Family Journal, 31(1), 21-30. https://doi.org/10.1177/10664807221104133 Literature review searching MEDLINE, EMBASE, CINAHL, SCOPUS and PsycINFO, including all studies irrespective of methodology. The literature was found to be predominantly about the use of genograms in various settings and adaptations, with minimal studies on the effectiveness of genograms as a therapeutic tool in family therapy. Limitation: the abstract gives no count of included studies and no limitations statement; it says minimal, not none.
2. Dobrosavljevic M, Solares C, Cortese S, Andershed H, Larsson H (2020) Prevalence of attention-deficit/hyperactivity disorder in older adults: A systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 118, 282-289. https://doi.org/10.1016/j.neubiorev.2020.07.042 Systematic review and meta-analysis of 20 studies (32 datasets, 20,999,871 individuals). Pooled prevalence of ADHD in older adults differed by method: 2.18 percent (95 percent CI 1.51-3.16) by research diagnosis on validated scales, 0.23 percent (0.12-0.43) by clinical diagnosis, and 0.09 percent (0.06-0.15) by treatment. Older adults are defined as 50 and over in the methods. Limitation: heterogeneity across studies was significant for every method, and the age threshold is stated in the full text rather than the abstract.
3. Leedham A, Thompson AR, Smith R, Freeth M (2020) 'I was exhausted trying to figure it out': The experiences of females receiving an autism diagnosis in middle to late adulthood. Autism, 24(1), 135-146. https://doi.org/10.1177/1362361319853442 Eleven autistic women diagnosed over the age of 40, semi-structured interviews analyzed by Interpretative Phenomenological Analysis. Four superordinate themes: a hidden condition (pretending to be normal and fitting in; mental health and mislabeling), the process of acceptance, the impact of others post-diagnosis, and a new identity on the autism spectrum. Several participants experienced diagnosis as a transition from self-critical to self-compassionate, with an increased sense of agency, though the adjustment was painful at such a late stage. Limitation: eleven people, so it describes what late diagnosis can be like and cannot say how common any of it is.
A family you can look at together, instead of defend
The Neurodiverse Couples Counseling Center works with couples where one or both partners are autistic, ADHD or AuDHD. Your family-of-origin session opens with a drawing: your family tree and a timeline, drawn while you talk, then looked at together for the patterns you grew up inside. Therapy for clients in California, coaching worldwide, all by telehealth. A first conversation costs nothing.
Up next
Module 10 — Your Childhood Wound