A genogram and a role questionnaire for tracing hunger through a family's eating habits

Ask a client who overeats about her grandmother, and the conversation can reach the siege of Leningrad before it reaches her diet. Ksenia Novgorodova, a Moscow clinical psychologist and systemic family therapist specialising in eating disorders, has written this route down in a theoretical article with two working tools attached. Citing other authors, she gives 5 to 6 million victims of the Volga famine of 1921–1922 and 600 thousand to 1.5 million deaths from hunger in besieged Leningrad, and adds the 1990s shortages. Her argument is that rules formed under hunger – finish everything, never throw bread away, keep a stock for a rainy day – outlived the hunger and now feed overeating in grandchildren who never went without.

The first tool is a focused genogram of 29 questions: who in the family lived through hunger, what was said about an unfinished plate, who had the right to be full, whose body was discussed. The second is a questionnaire of 16 food roles built on Chernikov's Family Roles questionnaire from 2001. Neither has been tested on a sample; quotes from clients aged 23 to 55 serve as illustration.

A client who cannot throw food away

The plate rule strikes me as the shortest path from a client's eating to the family's past. A woman of 48 quoted in the article cannot throw food away and hears her grandmother: "So many people starved!" She never went hungry herself. A standard intake records this as eating past fullness. Question six of the genogram turns it into a family question. I would ask it early, together with who in the family went hungry: the answer moves the work from willpower to loyalty.