One's family of origin—the family one grew up in, as opposed to the people one currently lives with—is the place where people typically learn to become who they are. From the family of origin, a person learns how to communicate, process emotions, and get needs met. People also learn many of their values and beliefs from their families. In every family there are events that affect the fate of the next generations and thus form the attitude to life, to the world and others, to success and failure. The transgenerational approach in psychology and psychotherapy is based on Freud's ideas that individual human experience bears the imprint of the experience added by previous generations. Those who experience emotional concerns related to their family of origin may find it helpful to meet with a mental health professional in order to begin working through these issues.
Family of origin experiences shape not only our immediate relationships but can have lasting effects across generations. Research from a 2023 meta-analysis found associations between adverse childhood experiences (ACEs) and modest increases in risks of mental health problems after quasi-experimental adjustment for unmeasured confounders. Prospectively ascertained data on clinically confirmed adult psychiatric disorders showed that associations between ACEs and psychiatric conditions in adulthood remained after adjustment for underlying shared confounders.
Table of Contents
- How Family of Origin Issues Relate to Development
- The Impact of Childhood Experiences on Adult Mental Health
- Marriage, Relationships, and Family of Origin Issues
- Intergenerational Transmission of Trauma and Attachment
- Mapping Family Patterns with Genograms
- Evidence-Based Therapy Approaches
- Frequently Asked Questions
- How Therapy Can Help
- References
How Family of Origin Issues Relate to Development
Individuals typically develop a sense of self in the context of their family of origin. Children who are shown love and kept safe may develop a strong sense of self, but if love and safety are frequently unavailable, a child's sense of self may be weak or damaged. Attachment theory, first developed by John Bowlby (1969, 1982), posits that early emotional bonds formed between infants and primary caregivers serve as the foundation for psychological development and social functioning across the lifespan. Bowlby argued that human infants possess an innate behavioral system that motivates proximity-seeking behaviors toward attachment figures, especially under conditions of stress or threat. These early interactions shape internal working models—cognitive-affective schemas that influence expectations about self, others, and relationships—which, in turn, guide emotional regulation, interpersonal functioning, and future attachment experiences.
Most families will have some negative aspects as well as positive ones, and any family traits may have an effect on a person's adult life. If one's family of origin was dysfunctional—faced issues such as abuse, substance abuse, poor health, or poverty; did not provide children with real-world skills; or did not adequately demonstrate love—that person may experience difficulties in these areas later in life. Secure attachments foster a child's confidence in exploring the environment, regulating emotions, and developing healthy relationships. Children with securely attached parents tend to exhibit higher levels of empathy, resilience, and social competence. Children raised in environments marked by inconsistency, emotional unavailability, or parental trauma are at increased risk for internalizing (e.g., anxiety, depression) and externalizing (e.g., defiance, aggression) problems.
The Impact of Childhood Experiences on Adult Mental Health
Recent research has extensively documented the relationship between childhood experiences within the family of origin and adult mental health outcomes. Exposure to adverse childhood experiences can lead to intense and prolonged activation of the stress response, which can impact brain development, as well as cognitive, social, and emotional functioning in childhood. Adoption of risky behaviors, such as substance misuse, can then occur, which can exacerbate later-life health problems (e.g., cardiovascular, lung, liver, and respiratory diseases; cancer, hypertension, diabetes), leading to premature death.
A comprehensive meta-analysis examining over half a million adults found significant prevalence of adverse childhood experiences across diverse populations. Recent review evidence suggests that ACEs are, unfortunately, widespread. A meta-analysis of 206 studies, including over half a million adult participants, found that approximately 60% reported exposure to at least one ACE and 16% reported exposure to four or more ACEs.
The effects of adverse childhood experiences are not limited to immediate psychological distress but extend into adulthood through various pathways. A systematic review revealed a significant association between childhood exposures including bullying, emotional abuse, neglect, physical abuse, parental loss, and general maltreatment and adult mental disorder, with odds ratios ranging from 1.24 to 2.09. There was strong evidence of an association between childhood adversity and later mental illness. The evidence suggests that childhood and adolescence is an important time for risk for later mental illness, and an important period in which to focus intervention strategies for those known to have been exposed to adversity, particularly multiple adversities.
Marriage, Relationships, and Family of Origin Issues
Whether they intend to or not, most people carry their family of origin with them throughout life. Early attachment experiences are crucial to parental functioning, as determined by the adult manifestation of these early experiences. In adult attachment theory, four major styles are assumed: fearful-avoidant, avoidant (dismissing), anxious (preoccupied), and secure. All styles indicate varying comfort levels with intimacy, dependency, and emotion regulation. Securely attached adults tend to have higher emotional intelligence and greater satisfaction in their relationships, which enables them to parent more sensitively and consistently. Conversely, anxious parents tend to be hypervigilant, fear rejection, and are likely to be overinvolved emotionally in their children, hence poor caregiving. Avoidant persons block the relational communication and close the door to intimacy, and thus, they might have difficulties with satisfying the emotional needs of their children, resulting from emotional neglect or detachment.
Issues in one's adult life with friendships and relationships may reflect family of origin patterns. An individual who sought attention from parents by attempting to be perfect may continue to work toward perfection in order to achieve approval from a romantic partner. Some people may also, consciously or unconsciously, place certain expectations on a partner who may be unaware, unable, or unwilling to live up to them.
Bringing unaddressed family of origin issues into a romantic relationship can create problems that are often confusing and overwhelming to both partners. A person whose parents divorced may resolve to avoid divorce and work hard in a relationship to prevent it, but unresolved effects of family of origin issues—such as communication problems or difficulty with trust—may still cause the relationship to fail. Understanding these patterns is essential for breaking negative cycles and building healthier relationships.
Intergenerational Transmission of Trauma and Attachment
One of the most significant discoveries in recent mental health research is the understanding of how trauma and attachment patterns can be transmitted across generations. Intergenerational trauma, also known as transgenerational trauma or inherited trauma, refers to the transmission of trauma from one generation to another. There are several basic mechanisms for the transmission of trauma across generations.
Intergenerational patterns of insecure attachment have also been widely substantiated, particularly when examining the impact of parents' unresolved trauma on their children. The presence of unresolved trauma or loss can impair the mother's ability to respond sensitively and effectively to the infant's needs and increase the risk of developing an insecure attachment. Unresolved trauma or loss can alter a mother's expectations and perceptions of her child, as well as her ability to respond sensitively, thereby compromising the infant's development of secure attachment.
Research has shown that the effects of family trauma can persist across multiple generations. Generational trauma, also known as intergenerational trauma, refers to the transmission of traumatic experiences and their psychological effects across generations. This phenomenon has significant implications for the newer generation of parents, impacting their mental health, parenting styles, and relationships with their children.
Mapping Family Patterns with Genograms
A genogram, or family diagram, can be considered an elaboration of the family tree. It is used to map out family relationships and patterns by giving information on family structures and showing the relationships between family members. Currently, genograms have become a basic and fundamental tool used to graphically represent a detailed record of family information. Their construction should include not only basic details and family structure, but also information that can outline different approaches for both research and clinical intervention.
Genograms are particularly valuable in therapeutic settings because they provide a visual representation that can reveal patterns not immediately apparent through conversation alone. The complexity of a family's emotional and relational structures can often make it difficult to examine patterns that create and perpetuate symptomatic behavior. Genograms serve the simple but important function of displaying these patterns and relationships visually, often in ways that have not been considered before.
The genogram allows therapists and clients to visually track the complex dynamics within a family, providing insights into how ancestral patterns, family roles, and historical events continue to impact current family functioning and individual mental health. A genogram goes beyond the simplicity of a traditional family tree, incorporating multiple layers of information such as mental health diagnoses, substance abuse, divorce and remarriage patterns, intergenerational trauma, attachment styles, and conflict dynamics. By charting these factors, therapists can identify recurring patterns, unresolved conflicts, or systemic issues that contribute to mental health challenges and relational difficulties in the present.
Recent literature has begun to examine the therapeutic effectiveness of genograms more systematically. There are minimal studies on the effectiveness of genograms as a therapeutic tool in family therapy. This review will inform clinicians working in family therapy and other relevant disciplines on the usefulness of genograms as a therapeutic tool, examples of adaptations to the traditional genogram for specific populations and purposes, and, to a lesser extent, the therapeutic effectiveness of genograms in family therapy.
Evidence-Based Therapy Approaches
Attachment-Based Family Therapy
Recent research has demonstrated the effectiveness of attachment-based approaches for addressing family of origin issues. Attachment-based family therapy (ABFT) is an empirically supported treatment designed to capitalize on the innate, biologically based, caregiving instinct and adolescent need for attachment security. This therapy is grounded in attachment and emotional processing theory and provides an interpersonal, process-oriented, trauma-informed approach to treating adolescents struggling with suicide and associated problems such as depression and trauma. ABFT offers a clear structure and road map to help therapists quickly address the attachment ruptures that lie at the core of family conflict, which can fuel adolescent distress. Several clinical trials and process studies have demonstrated empirical support for the model and its proposed mechanisms of change.
The therapeutic process in ABFT involves helping family members understand how their own attachment histories influence current relationships. The therapist helps caregivers consider how their own life stressors and intergenerational legacies of attachment affect their ability to connect better with their child. This self-reflection helps caregivers develop greater empathy for themselves and then their adolescents. With this insight, caregivers become more motivated to learn new emotion-coaching parenting skills and be more present, open, and supportive of their child's struggles.
Family Systems Therapy
Family systems approaches view the family as an interconnected unit where each member influences and is influenced by the others. Family systems theory views the family as a unit, where each family member experiences an emotional interdependence with the others, and the system ultimately seeks homeostasis or a sense of balance. As such, belonging to a family system opens an individual to reciprocal influences and involves them in the behaviors of other members of the system. A core concept of family systems theory states that a family system will organize itself to meet and overcome the challenges that occur throughout life and will adjust according to changes experienced by the members. These adjustments can often be expressed as changes in behavior.
Trauma-Informed Approaches
Given the high prevalence of trauma in family of origin issues, trauma-informed therapeutic approaches have become increasingly important. A comprehensive narrative review explores trauma from a trauma-informed perspective, emphasizing its complex, layered nature across individual, relational, and systemic levels. The review integrates interdisciplinary findings to highlight how trauma-informed care can mitigate the long-term effects of adverse experiences, particularly in vulnerable populations. Their synthesis advocates for cultural sensitivity and systemic responsiveness in trauma interventions, aligning well with current models addressing childhood parentification and its psychosocial impacts.
Frequently Asked Questions
What exactly is meant by "family of origin"?
Your family of origin refers to the family you grew up in—typically your parents and siblings—as opposed to the family you may create as an adult. This includes biological, adoptive, or foster families, as well as other primary caregivers who raised you.
Can family of origin issues affect me even if I had a "normal" childhood?
Yes. Even families without obvious dysfunction can transmit patterns, beliefs, and coping strategies that may not serve you well in adulthood. Additionally, what seems "normal" in childhood may be recognized as problematic only with adult perspective and understanding.
How do I know if my current problems are related to my family of origin?
Common signs include: repeating relationship patterns from your childhood, strong emotional reactions to situations that remind you of family dynamics, difficulty with boundaries, persistent feelings of not being "good enough," or finding yourself in roles (like caretaker or peacemaker) that you played in your childhood family.
Is it necessary to involve my family members in therapy to address these issues?
No, it's not necessary. Many people successfully work through family of origin issues in individual therapy. While family therapy can be beneficial when family members are willing and able to participate constructively, individual therapy can be equally effective in helping you understand patterns and develop healthier ways of relating.
Can working on family of origin issues damage my relationship with my family?
Therapy aims to help you understand and improve relationships, not damage them. While exploring these issues might temporarily bring up difficult emotions or lead to changes in family dynamics, the goal is to help you establish healthier boundaries and more authentic relationships. Many people find their family relationships actually improve after working through these issues.
How long does it typically take to work through family of origin issues in therapy?
The timeline varies greatly depending on the complexity of the issues, your goals, and the therapeutic approach used. Some people see significant improvements in a few months, while others may benefit from longer-term therapy. What's most important is finding a pace that feels right for you and allows for sustainable change.
How Therapy Can Help
While one's family experiences do not explain all issues that may present in treatment, research consistently shows that examining family of origin experiences can be beneficial. Evidence-based approaches like Coordinated Specialty Care for first-episode psychosis and support from Certified Community Behavioral Health Clinics explicitly emphasize the importance of families' involvement in care recipient assessment and treatment planning and provision of family supports. Recommendations from the Interdepartmental Serious Mental Illness Coordinating Committee (ISMICC) echo the importance of family involvement in mental health treatment.
In therapy, a person can map family patterns with a genogram and then begin to explore the reasons that certain issues may have developed and possibly come to understand the reasons behind certain choices, beliefs, and emotions. Working through family issues can help one overcome fears, pursue goals, and achieve a sense of peace. For all these reasons, it's essential that the processes of psychological and psychiatric attention begin with the construction of the patient's genogram. This will form the basis for the development of biomedical research and the treatment of complex social and psychological phenomena in a more efficient way, reducing intervention times and improving therapeutic results.
Severe abuse or neglect in the family of origin can often lead to serious difficulties throughout life. Research has found that associations between adverse childhood experiences and adult mental health outcomes remained after controlling for shared genetic and environmental factors, which was particularly evident after multiple ACEs or sexual abuse. Therapy can help a person who has experienced abuse or neglect in their family of origin to work through and overcome the distressing emotions that are often associated with these experiences.
Find a Therapist
If you're struggling with family of origin issues, finding the right therapist is an important first step. Look for mental health professionals who have experience with:
- Family systems therapy
- Attachment-based approaches
- Trauma-informed care
- Intergenerational trauma
The GoodTherapy directory can help you find qualified therapists in your area who specialize in these approaches. Remember that addressing family of origin issues is a courageous step toward breaking negative patterns and creating healthier relationships in your life.
References:
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
- Bravo, H. I. (2024). Generational trauma and its effects on newer generation parents. Undergraduate Theses and Capstone Projects. 40. Digital Collections @ Suffolk.
- Centers for Disease Control and Prevention (CDC). (2024). Mental Health Data Channel. Retrieved from https://www.cdc.gov/mental-health/about-data/index.html
- Cuartas Arias, J. M. (2017). Genogram: Tool for exploring and improving biomedical and psychological research. International Journal of Psychological Research, 10(2), 6-7. https://doi.org/10.21500/20112084
- Daníelsdóttir, H. B., Aspelund, T., Shen, Q., Halldorsdottir, T., Jakobsdóttir, J., Song, H., Lu, D., Kuja-Halkola, R., Larsson, H., Fall, K., Magnusson, P. K. E., Fang, F., Bergstedt, J., & Valdimarsdóttir, U. A. (2024). Adverse childhood experiences and adult mental health outcomes. JAMA Psychiatry, 81(6), 586-594. https://doi.org/10.1001/jamapsychiatry.2024.0039
- Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation (ASPE). (2024). Supporting Families and Caregivers of Adults with Behavioral Health Disorders. Retrieved from https://aspe.hhs.gov/sites/default/files/documents/c1d761ef927aaed9054e7c1abda590c0/supporting-families-caregivers-adults-bh-disorders.pdf
- Diamond, G. S., Kobak, R., Krauthamer Ewing, E. S., Levy, S., Herres, J. L., Russon, J. M., & Gallop, R. J. (2021). Attachment-based family therapy: Theory, clinical model, outcomes, and process research. Journal of Affective Disorders, 294, 286-295. https://doi.org/10.1016/j.jad.2021.07.005
- 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
- Kostova, Z., & Matanova, V. L. (2024). Transgenerational trauma and attachment. Frontiers in Psychology, 15, 1362561. https://doi.org/10.3389/fpsyg.2024.1362561
- Landa-Blanco, M., Vásquez, G., Portillo, G., Sproviero, F., & Echenique, Y. (2024). The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood. Frontiers in Psychiatry, 15, 1352824. https://doi.org/10.3389/fpsyt.2024.1352824
- Madigan, S., Deneault, A. A., Racine, N., Park, J., Thiemann, R., Zhu, J., Dimitropoulos, G., Williamson, T., Fearon, P., Cénat, J. M., McDonald, S., Devereux, C., & Neville, R. D. (2023). Adverse childhood experiences: A meta‐analysis of prevalence and moderators among half a million adults in 206 studies. World Psychiatry, 22(3), 463-471. https://doi.org/10.1002/wps.21122
- McElwain, A. D., Buchanan, A., & Shapiro, H. (2023). Parentification vulnerability, reactivity, resilience, and thriving: A mixed methods systematic literature review. Trauma, Violence, & Abuse, 24(5), 3458-3476. https://doi.org/10.1177/15248380231165707
- McKay, M. T., Cannon, M., Chambers, D., Conroy, R. M., Coughlan, H., Dodd, P., Healy, C., O'Donnell, L., & Clarke, M. C. (2022). A revised and extended systematic review and meta-analysis of the relationship between childhood adversity and adult psychiatric disorder. Journal of Psychiatric Research, 156, 268-283. https://doi.org/10.1016/j.jpsychires.2022.10.015
- National Alliance on Mental Illness (NAMI). (2025). Mental health by the numbers. Retrieved from https://www.nami.org/about-mental-illness/mental-health-by-the-numbers/
- National Institute of Mental Health (NIMH). (2023). Strategic Framework for Addressing Youth Mental Health Disparities. Retrieved from https://www.nimh.nih.gov/research/research-funded-by-nimh/inside-nimh/2023-winter-inside-nimh
- National Institute of Mental Health (NIMH). (2024). 2024 Autumn Inside NIMH. Retrieved from https://www.nimh.nih.gov/research/research-funded-by-nimh/inside-nimh/2024-autumn-inside-nimh
- Substance Abuse and Mental Health Services Administration (SAMHSA). (2024). Interdepartmental Serious Mental Illness Coordinating Committee Report to Congress. Retrieved from https://www.samhsa.gov/sites/default/files/ismicc-rtc-2024.pdf
- Teixeira, M. (2024). The use of genograms in family therapy: Mapping ancestral and family patterns. Abnormal Behavior Psychology, 10(5), 288. https://doi.org/10.37421/2472-0496.2023.10.288
- Thurston, C., Murray, A. L., Franchino-Olsen, H., Silima, M., Hemady, C. L., & Meinck, F. (2023). Prospective longitudinal associations between adverse childhood experiences and adult mental health outcomes: A protocol for a systematic review and meta-analysis. Systematic Reviews, 12, 181. https://doi.org/10.1186/s13643-023-02330-1
- Torrey, E. F., Simmons, W. W., & Dailey, L. (2023). The NIMH research portfolio: An update. The Primary Care Companion for CNS Disorders, 25(4), 23m03486. https://doi.org/10.4088/PCC.23m03486
