Sexual Genogram: Making Sense of Your History

Sexual Genogram: Making Sense of Your History.  The types of questions sex therapists at Sex Therapy in Philadelphia ask while taking a sexual history.

At Sex Therapy in Philadelphia / Center for Growth, we believe your past impacts your current sexual functioning more than you think it does.  We believe that the experiences we have had in our lives inevitably shapes us into the person that we become.  We all go through experiences that help to develop our personality, temperament, and other important characteristics that make us unique.  Additionally, our experiences can create our patterns of behavior–both good and bad. the purpose of taking a thorough sexual genogram is to help the client locate and understand the origins of the clients current sexual behavior, sexual thoughts, sexual feelings, sexual attitudes and sexual beliefs.

Sexual Genogram, also known as a Sexual History

  • What is your first memory of sex?  Did your parents leave books around?  Did an older sibling explain sex to you?  Did they explain orgasm to you? Was school where you went to learn the basic information?  Did your parents talk to you about sex?  Was one parent more open about sex than the other?  In what ways did your parent’s communication style differ?  Whom would you go to and why?  What was your parent’s relationship like? What did intimacy look like? What did affection between your parents look like?  Did they hold hands, French kiss or hug in front of you?  Did you ever walk in on your parents having sex?  If so, how did they handle the situation?  Who would have been more embarrassed and why?  Who go you your first bra? Your first tampon? Did you know what a period was when you first got one? Did you know what a wet dream was before you had one? Whom did you tell?
  • My first feeling about sex / sexuality was . . . .
  • My hope about sex/sexuality was . .
  • My fear about sex/sexuality was . .
  • My secret fear about me having sex was . . .
  • If you had a sexual question now, and you had to go to a family member now, who would it be and why?  Whose sexuality then and now would you want to emulate the most and why?  What sexual problems have other family members had/have?
  • I felt safest talking about sex / sexuality when . .
  • To make sex safer to talk about I would . .
  • What I do today to make sex safer to talk about . .
  • What were your family’s expectations about sex and sexuality?  Were they spoken or unspoken?  How do you know?  How were values communicated about sex and sexuality? Did everyone live up to these standards? Would it have been OK to come home pregnant?  Was abortion an option for your family?  At what age were you allowed to date?  At what age would your family have considered you odd not to be dating?  At what age would your parents have been OK with your kissing someone?  Engaging in digital stimulation or hand-job?  At what age, and in what types of situations would your parents have been OK with your having had sexual intercourse?  What would have happened if you didn’t live up to the family’s standards?
  • My families sexual expectations of me were to . .
  • My sexual expectations of myself were / are . .
  • To ensure that I met my families sexual expectations I . . .
  • To ensure that I met my own sexual expectations I . . .
  • What role did religion play in shaping your sexual values? What role did your culture play in shaping your sexual values?
  • Were there any “secrets” in your family about sex?  What were they?  Were these secrets quiet or open to family discussion?  Who knew the “secrets?”  Were there a lot of secrets?  Do you still have secrets as an adult? Does anyone in your family have a history of sex abuse, sex addiction and/or more general compulsivity?  Does mental illness run in your family?  Have any family members ever been jailed?  Were there any stillbirths, abortions, deaths, mental retardation, etc.?
  • When it comes to sex / sexuality, I used to feel most vulnerable when . . .
  • As an adult I feel most vulnerable in the bedroom when . .
  • When was the first time you masturbated?  Who knew?  How old were you?  What did you do?  Are you able to orgasm when you masturbate?  How did it make you feel?  What were your parents’ views about masturbation?  When was the first time you ever told someone that you masturbated?  When was the first time you masturbated in front of someone else?  How often do you masturbate now?  What do you do to masturbate?  Have you video taped yourself masturbating to watch later?  Now, re-read this section and put replace masturbation with oral sex, or intercourse, or anal sex, or S&M etc.
  • When was your first sexual experience?  How old were you?  What did you do?  How did it make you feel then?  How does it make you feel now?
  • The way I wish I was in the bedroom is . . .
  • What prevents me from being my ideal self in the bedroom is . . . .
  • The piece of myself that I am comfortable showing in the bedroom is . . .
  • How many sexual partners have you had?  How do you define “sex?”  How has your definition of “sex” changed throughout your lifetime?
  • What are your sexual rituals?   When did these rituals being?  How are they helpful and how are they hurtful?  How much time do you spend preparing for sex?  What happens if you don’t prepare?  Has anyone in your family had a similar experience?
  • When did your sexual behavior(s) begin to feel problematic?  What have you done to try to fix them?  Who knows?  What made you decide to tell the people that you did (or not tell)?  What are hoping to accomplish now?
  • When I look back at my answers to questions around my sexual history, what I am most struck by is . . .

Understanding a sexual genogram / sexual history:

On a simplistic level, as a child you learn adaptations in order to make your life run effectively.  We have developed methods that work for us and allow us to continue succeeding in life.  Of course these adaptations and normal and can be very healthy; however, they can also be harmful if we get “stuck.”  For example, imagine that as a child you learned that masturbation was “wrong and dirty.”  Overall masturbation was not talked about within your household, but as you entered puberty you began masturbating regularly and exploring your body; however, one day your mother walked in on you masturbating.  She reacted by yelling at you.  She told you that what you were doing was not healthy and that you should never do it again.  Embarrassed and scared, you decided to never masturbate again.  You knew you couldn’t talk to your mother about it because it had just been such a scaring experience, so you stayed away from the topic all together.  For a while, especially through your teen years this modification served you well.  You didn’t have to run the risk of your mother finding you again and as a result you were not worried about anything.

However there has recently become a point in your life where this sexual adaptation has not been very helpful. There are several possible outcomes, but here are two possibilities: (1) you could have a new partner that asks you what you like sexually and you don’t know because you haven’t had the opportunity to try it for yourself or (2) your partner could ask you to masturbate in front of them but you don’t know how or you are crippled by embarrassment and fear.  For these reasons, as the example highlights, it is critical that we understand where the adaptation came from and how it is no longer helping you.  That is why it is important for us to be able to critically look at our past to understand the positive and negative experiences that have impacted us and to examine just how they influence us–particularly our behavior.  By examining and understanding your past you can make sense of your current sex “hang-ups.”  Here are some questions you can ask yourself to start recognizing how your sexual past is influencing your current sex life.  Feel free to answer these questions however you are most comfortable; in written form (hand written or typed), out loud (to practice verbalizing your feelings), or in your head (think through your answers before you share them).

It is important to understand your sexual history.  Now by doing a sexual genogram you understand more about your sexuality share your answers to the questions with a member of your support system.  Your support system can be anyone that you trust with this information (i.e. lover, friend, therapist, or sibling).  After going through these questions and sharing your answers, you might be able to connect a few aspects of your past with certain elements of your current sexual issue. If sharing your answers feels too taboo, call Sex Therapy in Philadelphia and schedule an appointment.  Help is available.