Contents:
Who was Hermann Rorschach?
The Rorschach traditions
The European way
American schools
Differences and controversies
Using the Rorschach method in patients with brain damage
Theoretical issues: Perceptual and cognitive processes in the
Rorschach
Contents:
Abstract
Introduction
Early history
The crisis of the 1960s
The goals of research
Methodologies
The future is here - how well did we predict it?
Further suggestions
References
Abstract
In 1988, the author completed a comprehensive review of the preRorschach and Rorschach literature dealing with its use in
evaluating organic brain dysfunctions. Monographs, journals
articles, presented papers and oral history reports from 1890 to
1988 yielded over 6000 records; 4500 were within the scope of the
investigation. Review and preliminary analysis of these 4500
studies narrowed the final review set to 600 Rorschach studies of
varied neuropsychological populations worldwide. Much of this
work came from the 1930s to 1950s, and much of it was criticized
in the 1960s to 1980s, with the development of neuropsychology as
a subspeciality while the Rorschach was devalued by its opponents.
As part of the same 1988 study, leading neuropsychologists and
leading Rorschach proponents were asked to predict the role of the
Rorschach for neuropsychological needs of the twenty-first
century. The last ten years of Rorschach literature shows that very
little additional research on organic populations has taken place,
although interest in such studies has frequently been expressed.
The present paper includes a concise overview of past uses of the
Rorschach with neuropsychological populations, including this
decade, and summarizes the populations and the amassed
Rorschach data on them. The paper identifies methodological
strengths and weaknesses of the past studies, with relevance to
future research. Suggestions for needed future investigations are
offered, including those areas identified by the experts' 1988
predictions of the role of the Rorschach as a neuropsychological
instrument for the coming century.
Introduction
The idea of using the Rorschach as a means of assessing behavioral and
cognitive changes that accompany various neurological diseases dates back
to Rorschach himself, who in early years thought his method might be used
to detect epilepsy at early stages. Proof that we continue to wonder about
the role of the Rorschach with neurological populations is evident in this
symposium today.
The first neuropsychological Rorschach record to be published was part of
the Psychodiagnostik (1921), as Rorschach included an illustrative record
from a patient suffering from Korsakoff's Syndrome. However, the largest
potential neuropsychological population in the early years of the method
was epileptic; Rorschach and his colleagues had a great interest in this
population. Unfortunately for them, but of great good fortune for the
patients, the invention of the electroencephalograph in 1929 made a huge
contribution to the diagnosis of epilepsy and the Rorschach method was not
needed as a primary diagnostic tool. However, when Oberholzer (1931)
published the first paper on the Rorschach record of epileptics, he used the
data to identify organic signs similar to those Piotrowski later elaborated so
succinctly.
Population Type
1920s
1930s
1940s
1950s
1960s
1970s
1980s
1990s
Total
Unspecified
"Neuropsychiatric"
Moderate-Severe
Traumatic Brain
Injury
10
37
Mild Traumatic
Brain
Injury,Concussion
19
Infectious Brain
Disease
10
Anoxia
Brain Tumor
16
Cerebral Infarct
Vascular Dementia
Alzheimer-Type
Dementia, Pick's,
BSE
15
Parkinsons, Chorea
15
Multiple Sclerosis,
Dystrophies, CP,
Torticollis
16
Seizure Disorders,
ECT, Tourette's
22
20
75
Chemical
Abuse/Dependency
10
13
53
Learning Disability,
Minimal Brain
Dysfunction
17
Mental Retardation,
Developmental
Delay, Autism
12
36
Sleep Disorder
Lobe-Specific
Injuries,
Experimental
Lesions
11
17
40
Experimental
Perceptual
Conditions
Mis-Identified as
Brain Damage
Totals by Decade
25
83
79
46
60
45
30
373
This paper will present a brief overview of the historical trend of nearly 400
Rorschach studies over eight decades, identifying neuropsychological
populations that have been of interest to Rorschachers to date, the research
questions they have asked and the strengths and weaknesses of their studies.
After reviewing the past and looking at the present, it will be time to look to
the future. In 1989 I conducted a predictive study asking experts in the
Rorschach, in neuropsychology, and in psychohistory how
neuropsychologists would be likely to use the Rorschach in the twenty-first
century. Their answers were not only interesting, some of them were
correct. I will also share a brief glimpse of some of those ideas with you
today and suggest some of the research questions I think we need to
consider in the next decade.
Early history
At the beginning of this century, psychiatric hospitals included many people
who had neurological disorders. In addition to those who suffered from
seizure disorders and mental retardation, there were also tumor patients, and
survivors of traumatic brain injury. As a practicing psychiatrist, Rorschach
and his contemporaries had many opportunities to include these populations
in their studies.
In the 1920s there was a unitary concept of organicity with a dichotomy of
patients: quite simply, those who were considered organic and those who
Continent Where
Published
1920s
1930s
1940s
1950s
1960s
1970s
1980s
1990s
Total
Europe
12
19*
19*
15
26
15
15
126
North America
11
62*
58*
27
25
20
12
215
Asia
18
South America
12
Africa
Totals by Decade
25
83
79
46
60
45
30
373
1920s
1930s
1940s
1950s
1960s
1970s
1980s
1990s
Total
Differential
Diagnosis of Brain
Damage
10
32
22
26
27
25
147
Cognitive Studies of
Organic Populations
17
19
16
10
82
Personality Studies
of Organic
Populations
12
16
16
11
12
78
Identification of
Organic Signs in
Rorschach Records
25
19
68
Lesion localization
Tool
13
Exploration of
Perceptual Skills
10
13
Statistical Analysis
Assist in Treatment
Planning
Compare the
Rorschach with
Other
Neuropsychological
Instruments
Exploration of
Evolving Organicity
Totals by Decade
28
90
85
51
72
45
42
419
Research Goal
Traumatic brain injury has been, and remains, one of the most fascinating of
research populations. Even from the early years, an interest in identifying
signs to detect and thus diagnose brain damage took clear precedence over
the use of the Rorschach as a means to facilitate treatment planning. In
1929 the EEG machine was the most advanced medical technology since
Marie Curie showed the world how to use radioactivity to help wounded
World War I soldiers. The search for Rorschach signs of organicity that
Oberholzer had started was elaborated by Piotrowski (1957); this successful
task was necessary due to the absence of imaging technology that exists
today.
Some studies were crude, with gross generalizations made from single cases
or from very small and poorly controlled samples. Tests of statistical
significance were rare. In brain injury studies, confounding variables, such
as location, source, and force of injury were frequently ignored and
The single greatest weakness of Rorschach studies over the past eighty years
has been the focus on single populations without matched control groups.
References
Caputo J., Rorschach Studies of Neuropsychological Groups of the Past,
Present and Future. Dissertation, Central Michigan University 1989.
Oberholzer E., Zur Differentialdiagnose psychischer Folgezustande nach
Schdeltrauma mittels des Rorschach'schen Formdeutversuches. Zeitschrift
fr die gesamte Neurologie und Psychiatrie 136 (1931), 596-629.
Piotrowski Z., Perceptanalysis. Macmillan, New York 1957.
Diller L., Riklan M., Rorschach correlates in Parkinson's Disease: M, motor
inhibition, perceived cause of illness, and self-attitudes. Psychosomatic
Medicine 19 (1957), 120-126.
Rorschach H., Psychodiagnostik. Bircher, Bern 1921.
Ross W.D., Block, S.L., "The use of projective techniques in the evaluation
of neurosurgical approaches to psychiatric treatment." J. of Projective
Techniques 14 (1950), 5-14.
Top of page
Back to Rorschach Texts page
as: which part of the blot is being interpreted? is it a small or a big part? is
the percept diffuse or structured? is it based on contours, or on the colours
and shadings? is it a good form or a bad form?, and so on. This insight
is nowadays represented in a four-fold way of classifying responses: manner
of approach, determinant, content and originality. Rorschach does not
himself use these terms, but it is convenient to reconstruct his ideas with the
help of them.
The most original, and probably the most debated, of Hermann Rorschachs
ideas is that of movement as a determinant. In his book,2 Rorschach
defines the movement responses as
...those interpretations which are determined by the perception of form plus kinaesthetic
contributions.
that what is known it is not primarily a visual position. The body schema is
nothing but this fundamental system of practical knowledge. According to
Merleau-Ponty the body schema as a system of practical apprehensions
is essentially involved when one imitates another person. He also makes
the point that imitation does not presuppose that the subject can see his own
movements.14 It is therefore, in a certain sense, immediate.
_______________________
11
Meltzoff & Moore (1995).
12
The methods and results of Meltzoff and Moore have been subject to criticism. See
for example Heimann (in press). My main conclusion is however not threatened by
this criticism. Cf. also Wyrwicka (1996).
13
Merleau-Ponty (1962). For my choice of the term body schema rather than body
image cf Gallagher (1995).
14
Merleau-Ponty (1962) pp. 352.
act depends on the practical knowledge how the other person acts. Only
because the fighter knows practically what the other guy intends to do, can
he avoid its consequences. If this description is correct, manifest imitation is
just the special case where the two seen patterns are the same. The basic
mechanism is much more general and has high ecological validity apart
from imitation.
_______________________
15
Cf Redstrm (1998).
16
J. Gibson (1979), p. 42; see also Bruce, Green & Georgeson (1996), ch. 16.
Physiognomic perception
Before we go deeper into the philosophical aspects of our theme, I want to
point to another psychological and psychopathological field of relevance for
it. I am referring to the existence of so-called physiognomic perception, of
which at least a part may be described as misplaced practical apprehension
of motor intentions. Hermann Rorschach points out that several test subjects
seem to see and feel human-like movements or motor attitudes in
objects such as trees, household artefacts, etc. For example, a tree can be
seen as standing proudly erect, or as stretching their branches towards
another tree. Now, this way of seeing things is certainly not restricted to the
test situation. People vary a lot with respect to how strong their tendency to
this kind of perceptual animism is.17 The same holds for the tendency to
perceive faces and facial expressions in objects. 18 The pioneer in
developmental psychology, Heinz Werner, tells us that physiognomic
perception is more common in young people,19 and the psychopathologist
Klaus Conrad describes how the initial phases of confusional states are often
characterised by a loosening of ordinary object perception and the intrusion
of more and more physiognomic material.20
A natural explanation of these phenomena is the biological one. It is very
important for the survival of organisms that they have a low threshold for
the perception of other living creatures, so that they will be able to flee from
aggressors in time. In this perspective, the sensitivity to movements of the
peripheral part of the retina can be classified among the relevant facts. Also,
a low threshold for physiognomic perception helps intraspecific cooperation to work smoothly. The price to be paid is a lot of misplaced
perceptions.
However, I suspect that this explanation may be too simple, and that the ease
with which physiognomic perception of inanimate objects can be initiated
reflects that it may have a even more fundamental perceptual function than
warning us about the possible presence of other creatures. I will next
speculate a little about the nature of our perception of space.
_______________________
17
Some (including the present author) can very easily put themselves in an attitude
where almost everything is seen under such an aspect. For a marvellous description of
how the world can seem to a person who is sensitive to physiognomic traits, cf Lingis
(1996).
18
An interesting report on another case of high sensistivity in this respect can be found
in the work of Franz From, who was a close collaborator of the famous Gestalt
psychologist Edgar Rubin. Cf From (1971), pp. 66f.
19
Werner (1961).
20
Conrad (1960), pp. 385ff.
Acknowledgements
I want to thank Gsta Frbrj, Susanna Lundqvist, Filip Radovic and Johan Redstrm for valuable
comments and Linnea Malmgren for the blots!
References
Berkeley, G., An Essay towards a New Theory of Vision (1709, in: A. Campbell Fraser ed., The works
of George Berkeley, Vol. I, Oxford 1901).
Bohm, E., Lehrbuch der Rorschach-Psychodiagnostik. 4 Aufl., Huber 1972.
Bruce, V., Green, P.R., Georgeson, M.A., Visual Perception. Psychology Press 1996.
Conrad, K., Die symptomatischen Psychosen. In: Gruhle et al, Psychiatrie der Gegenwart, Bd. II.
Springer 1960, 369-436.
Ellenberger, H., The life and work of Hermann Rorschach (1884-1922). Bulletin of the Menninger
Clinic, 18 (1954), 172-219. Reprinted many times, e.g. in Beyond the Unconscious. Essays by Henri F.
Ellenberger. Ed. M. Micale, Princeton U.P. 1993.
Exner, J., The Rorschach: A Comprehensive System. Part I. Wiley 1993.
From, F., Perception of Other People. Columbia U.P. 1971.
Gallagher, S., Body schema and intentionality. In: Bermdez, J.L. (ed), The Body and the Self. MIT
Press 1995, 225-44.
Gibson, E.J., Ontogenesis of the perceived self. In: U. Neisser (ed.), The Perceived Self. Cambridge
U.P. 1993, 25-43.
Gibson, J.J., The Ecological Approach to Visual Perception. Erlbaum 1979, 1986.
Heimann, M., Imitation in neonates, in older infants, and in children with autism: feedback to theory.
In: Brten, S. (ed.), Intersubjective Communication and Emotion in Early Ontogeny. Cambridge U.P.
(in press).
Kramer, R., The Rorschach M response: a return to its roots. J. of Personality Assessment, 57 (1991),
30-6.
Lindqvist, G., Malmgren, H., Classification and Diagnosis in Organic Psychiatry (= Acta Psychiatrica
Scandinavica 88, Suppl. 373, 1993).
Lingis, A., The body postured and dissolute. In: Fti, V.M. (ed.), Merleau-Ponty: Difference,
Materiality, Painting. Humanities Press 1996, 60-71.
Malmgren, H., Immediate knowledge of other minds. Theoria 42, 1976, 189-205.
Malmgren, H., Immediate Knowledge: A study in G.E. Moores epistemology. Doxa, Lund 1983.
Meltzoff, A.N., Moore, M.K., Infants understanding of people and things: from body imitation to folk
psychology. In: Bermdez, J.L. (ed), The Body and the Self. MIT Press 1995, 43-70.
Merleau-Ponty, M., Phnomenologie de la Perception (Paris 1945). English translation
Phenomenology of Perception (Routledge 1962).
Mourly Vold, J., Ueber Hallucinationen, vorzglich Gesichtshallucinationen, auf der Grundlage
von cutan-motorischen Zustnden und auf derjenigen von vergangenen Gesichts-Eindrcken.
Allgemeine Zeitschr. fr Psychiatrie, 57 (1900).
Mourly Vold, J., ber den Traum. Ed. O. Klemm. Barth, Leipzig 1910-12.
Redstrm, J., Affordances, information pickup, och direkt perception. Gteborg University, 1998
(mimeographed).
Rorschach, H., Psychodiagnostik. Eine Wahrnehmungsdiagnostische Experiment. Bircher, Bern 1921;
later eds. Huber, Bern. All quotes from 9th ed (1972).
Rorschach, H., ber Reflexhallucinationen und verwandte Erscheinungen. Zeitschr. fr die gesamte
Neurologie und Psychiatrie, 30 (1912), 357-400.
Werner, H., Comparative Psychology of Mental Development. New York 1961.
Wittgenstein, L., Philosophische Untersuchungen/Philosophical Investigations. Blackwell 1953.
Wyrwicka, W., Imitation in Human and Animal Behavior. Transaction Publ., 1996.
Addendum
It would be of obvious interest to compare Hermann Rorschachs ideas with a number of contemporary
theories and empirical findings which I have not discussed in the poster. Pertinent examples are
Kosslyns theory of mental imagery and the recent neuropsychological findings by Jeannerod and
others about visuo-motor couplings in the brain. I intend to make these comparisons in a later, longer
version of the paper.
_______________________
29
Kosslyn, S., Image and Brain. MIT Press 1994.
30
Jeannerod, M., The Cognitive Neuroscience of Action. Blackwell 1997.
Card 1
Card 2
Is this two persons whose postures express discontent with the dance on the
previous picture?
Card 3
Card 4
THERORSCHACHASA
NEUROPSYCHOLOGICALINSTRUMENT
HelgeMalmgren1,MarianneBilting2,GstaFrbrjandGranLindqvist2
1
2
Contents:
Abstract
Introduction
Method
Analysis
Results and discussion
Conclusions
References
Abstract
Sixpatientswithorganicmentaldisorders,inallcasesincludingKorsakoffsamnestic
disorder(KAD)andinfourcasesduetoacomplicationafterananeurysmoperation,
werefollowedforuptotwoyears.Eachpatientwasassessedatleastthreetimes;the
totalnumberofassessmentpointswas26.Thepatientsneuropsychiatricstatuswas
assessedclinicallyaccordingtothediagnosticsystemofLindqvist&Malmgren.The
severityoftheindividualdisordersandtheglobalseverityoftheneuropsychiatric
disturbancewereestimatedoneachoccasion.Thepatientswereassessedusing
memory,concentrationandgeneralintelligencetests,andindependentlywith
RorschachaccordingtoBohmsmethod.
Thescoreson38selectedRorschachvariableswerecomparedwiththeclinical
assessmentsandwiththeothertestdata.Inaccordwithearlierstudieswefoundthat
KADhasaRorschachprofilewhichdifferssignificantlyfromthefindingsinpatients
whereotherorganicmentaldisordersdominatetheclinicalpicture.Wealsosawa
previouslynotreportedsignofKAD,namely,frequentcontaminatedwhole
responses.
Acomparisonwiththejudgmentsofglobalseverityalsogavesomesupporttothe
thesisthattheRorschachisavalidindicatoroforganicmentaldisorderingeneral.
Altogetherthestudyshowsthatthelongitudinaldesignoffersgreatpossibilitiesfor
theanalysisofRorschachsignsoforganicmentaldisorders.
KeyWords:
Rorschach, Intracerebral aneurysm, Korsakoffs amnestic disorder, Organic mental
disorders.
Introduction
ThestudyoftheRorschachtestinorganicmentaldisordershasalong
history,beginningwithRorschachsowninvestigations(1921pp171ff)of
patientswithdementia,Korsakoffspsychosis,generalparesisandlethargic
encephalitis.OtherpioneerSwissresearchersinthisfieldinclude
Oberholzer(1931).Piotrowskisten"organicsigns"(Piotrowski1937)also
heldearlypromise.AlotofresearchwasdoneintheU.S.A.duringthe
followingdecadestotestandtoimprovePiotrowskissignsbutwithno
greatsuccessexceptforestablishingbeyondreasonabledoubtthat
Piotrowskissignsdohavesomevalidityindiscriminatingnormalsubjects
frombraindamagedones.ForreviewsseeGoldfriedetal(1971),Velez
Diaz(1973);muchoftherelevantworkuptoabout1970intheclassical
EuropeanandtheAmericanRorschachtraditionshasalsobeensummarised
byBohm(1972pp320ff,1975pp145ff).Duringthe70sand80s
comparativelylittleresearchwasdonewiththeRorschachregardingorganic
disorders(foranexcellentreviewseeCaputo1989),andupuntilthepast
fewyearsonlysporadicattemptsweremadetouseExnersRorschachin
connectionwithneuropsychiatricconditions(butcfEllis&Zahn1985).
AshasbeennotedbyVelezDiaz(1973),Caputo(1989)andothersthereare
severalmajormethodologicalproblemsinvolvedinanystudyofthe
Rorschachinorganicmentaldisorders.Twowellknownsuchproblemsare:
TheRorschachtestissensitivetosomanydimensionsofhuman
personalitythatthevariabilityduetotheorganiccomponentmayeasily
vanishin"noise"duetoothersources.
Theorganicmentaldisordersareaveryheterogeneousfamilyof
disturbanceswhichcannotbeexpectedtoproduceaunitaryRorschach
picture.
Tothese,twoothersmustbeadded,theimportanceofwhichhaveinour
opinionnotbeensufficientlyappreciated:
Muchoftheclinicalpsychiatricheterogeneityremainsevenifgroupsof
patientswithunitaryaetiologyarestudied.Compareforexamplethe
diversityoforganicmentalsyndromesobservedinagroupof100patients
havingundergonetranssphenoidalhypophysectomi(Lindqvist1966).
Manydiagnosticdifficultiesinorganicpsychiatry,especiallyincaseswith
multiplesimultaneousreactionforms,canberesolvedonlyinalongitudinal
perspective.ComparetheproblemwithintheframeworkofDSMIIIR,
1987ofdiagnosingDementiaorAmnesticSyndromeinapatient
fulfillingthecriteriaforDelirium(seealsoMalmgren&Lindqvist1993).
Theseconsiderationsimplythefollowingmethodologicalcriteria:
(i)thatthediagnosticframeworkwhichisusedmustdefinetheorganic
mentaldisordersintermsofpsychopathology(independentlyofaetiology);
(ii)thatthesubjectsstudiedshouldbecarefullydescribedwithrespecttothe
kinds,severityandtimecourseoftheorganicmentaldisordersthatthey
exhibit;
(iii)thatalongitudinal(ormixedgroup/longitudinal)studydesigncould
offergreatadvantages,bothbyimprovingdiagnosticprecisionandby
reducingvariabilityduetoirrelevantfactors.
Thestudyreportedonherefulfilsthesecriteria.Itisapilotinvestigation,
basedonsixcasesofKorsakoffsamnesticdisorder(KAD,seebelow),and
itsaimswere:
topresentdetailedcaseanalysesofthetimecourseofKAD;
toexploretheperceptualprocessesinRorschachonthecaselevelby
comparingdifferentprotocolsfromthesamepatientsintheamnesticstate;
tosuggestnewRorschachindicatorsofKAD;and
toexploreonapilotscalethepossibilitiesofusingthelongitudinal
approachfortheformaltestingofRorschachcriteriafororganicmental
disorders.
SomeearlyresultsofthestudywerepublishedinSwedish(Malmgren1973,
1977),mainlyfocusingoncaseorientedcomparisonsoftestsofthesame
patientondifferentoccasions.AfterthepublicationofLindqvist
Malmgrenssystemoforganicpsychiatry(theLMsystem,Lindqvist&
Malmgren1990,1993),theclinicalpatientdatawerereclassifiedaccording
tothatsysteminordertoenableamorestringentanalysis.
ThesixmaindisordersrecognisedintheLMsystemarethefollowing(for
furtherexplanationsseealsoLindqvist&Malmgren1993):
1Somnolencesoporcomadisorder(SSCD),alsoknownas"pathological
impairmentofwakefulness".
2Asthenoemotionaldisorder(AED).ThemildformsofAED,mainly
manifestingthemselvesasconcentrationdifficulties,mentalfatiguability,
secondarymemorydisturbancesandirritability,havetraditionallybeen
called"neurasthenia".Themoresevereformsoftenjustifyadiagnosisof
dementia.
3Confusionaldisorder(CD)ordelirium.
4Hallucinationcenestopathydepersonalisationdisorder(HCDD),a
disorderwhichinitsfullblownformcomprisesallthreeofthesymptoms
mentionedinitsname.
5Korsakoffsamnesticdisorder(KAD),whichischaracterisedbyprimary
retrogradeandanterogradeamnesia,oftentogetherwithconfabulations.The
DSMIIIRtermforthisdisorderis"AmnesticSyndrome".Asarule,KAD
iscombinedwiththefollowingdisorder:
6Emotionalmotivationalbluntingdisorder(EMD),alsoknownas"the
frontallobesyndrome"althoughtheunderlyingbraindisturbanceneednot
belocalisedtothefrontallobes.
Thesedisordersoftenoccurtogetherindifferentcombinations,sometimes
givingrisetocomplicatedclinicalpictureswhichcanberesolvedintotheir
componentsonlybymeansofacarefullongitudinalanalysis.
Thepresentpaperaimsattheevaluationofthefollowingthreehypotheses
concerningthesixpatientsstudied(notethatthereisapotentialconflict
betweenthethirdhypothesisandthetwofirstones):
Thetestsfromalloccasionswhenthesubjectshaveasignificantorganic
mentaldisordersshouldfulfilsuggestedRorschachcriteriafororganic
diseaseingeneral;
Thereshouldbeacorrelationbetweenanindependentestimateofglobal
severityandRorschachvariablessuggestedasgeneralsignsoforganic
mentaldisorders;
ThereshouldbeacorrelationbetweenthedegreeofKAD(Korsakoffs
amnesticdisorder)andRorschachvariablesdescribedascharacteristicof
KAD(orrelatedcategoriessuchasKorsakoffssyndrome).
Method
Subjects
Beforethemicroneurosurgicalera,operationsforrupturedaneurysmsonthe
anteriorcommunicatingarteryoftenproducedseverecomplicationsinthe
formofatransientorchronicmixedorganicmentaldisorderdominatedby
memorydisturbancesofKorsakoffstype.Thiscomplicationwasfirst
describedbyLindqvist&Norln(1966).In197274,thefirstauthor(HM)
hadtheuniqueopportunitytorepeatedlyadministertheRorschachtoa
numberofpatientswithsuchrupturedaneurysms("aneurysmpatients")and
toasmallnumberofpatientswithKorsakoffsamnesticdisorderdueto
othercauses.Altogether,11patientsweretested;sixofthesewereselected
fordataanalysisbasedonthefollowinginclusioncriteria:averifiedKAD,
longenoughobservationtime,reasonablycertainclinicaldiagnosesatthe
timeofthetestings,andacertifiedchangeinrelevantneuropsychiatric
variablesbetweentestings.Theremainingmaterialcomprises4aneurysm
patients(onewomanandthreemen,referredtobelowasPats.A,B,Cand
G)andtwootherpatients(bothmen:Pat.E,traumaticbraininjury,andPat.
F,heartarrest).Theageofthe6patientsatthefirsttestrangedfrom44to
63years,mean54.Foradetailedclinicaldescriptionofthetimecourseof
thepatientsorganicmentaldisorders,see"Resultsanddiscussion".
Data
Thefirstauthor(HM)testedall6patientsrepeatedlywiththeRorschach
accordingtoBohmsmethod(Bohm1972).Threeoftheaneurysmpatients
(A,BandC)weretestedalsobeforetheoperation.Altogether26testswere
performed,allexceptoneinclosetemporalconnectionwithregularly
scheduledneuropsychiatricexaminations.Thefollowuptimevariedfrom2
to22months.Atmostretests,therewasacompleteornearcomplete
amnesiaforprevioustestings.AtthetimeofeachRorschachtesttheclinical
mentalstatusofthepatientswasindependentlyjudgedbyGL,and
complementarypsychometrictestingwasperformedbyMB.TheRorschach
protocolswerescoredbyHMandGFincollaboration.
WhenthedatawerereclassifiedaccordingtotheLMsystem,theseverity
ofeachdisorderoneachoccasionwasfirstratedonafourstepscale(using
1,2and3formild,moderateandseveredisturbancesrespectively,but0.5
forverymildforms)basedontheclinicaldocumentationandthe
psychometricdataexceptRorschach.Withthepossibleexceptionofthe
ratingsforAED,theseestimatesarenotsufficientlystandardisedtobeused
inpreciseinterpatientcomparisons.Onsomeoccasions,theclinical
judgementhadtobebasedonanextrapolationfromestablishedknowledge
aboutthenaturalcourseofthedifferentorganicmentaldisorders.Because
ofdiagnosticdifficultiesnoseparationwasmadebetweenSSCDand
unspecificfatiguereactions(UF).Anestimateoftheglobalseverityofthe
patientsdisturbancewasalsomadeforeachoccasion.Theprimaryratings
wereadjustedaccordingtotheclinicaljudgementsofimprovementor
deterioration,resultinginamorefinegrainedpictureofeachpatients
developmentovertime.
Theclinicalpsychopathologicalprofilesandtheirtimecourseswere
comparedwiththefindingson37Rorschachvariables(Table1),mostof
whichhaveearlierbeensuggestedas"organic"indicators.Theyincludethe
individualPiotrowskisignsandthePiotrowskiindex,mostitemsinBohms
(1975,p147)"generalorganicRorschachsyndrome",mostitemsinBohms
list(1975,p157)offindingsinalcoholicKorsakoff(Table2),andfinallya
fewvariablestheanalysisofwhichwerepromptedbythedata.
Table1:Rorschachvariablesselectedforanalysis
Var.
Description
Exp.
Source
Totalno.ofresponses
/+
Piot1,BohmK
T/R
Timeperresponse
Piot2
W%
Percentageofwholeresp.(notDW,
WS)
+/(?)
BohmG,K
*W%
Percentageofwholeresp.(inclDW,
WS)
+/(?)
BohmG,K
DW
NumberofweakDWresponses
BohmG
*M+
Numberofsharpmovementresponses /(?)
(includingMC+andMCh+)
Piot3,BohmK
M/M Numberofweakmovementresponses
BohmK
Ms
Numberofsmallmovementresponses
BohmK
F+%
Formlevel(Rorschachsmethod)
Piot5,BohmK
Conf1
Numberofclearconfabulations
BohmG
*Conf
Weightedindexofconfabulations
BohmG
CoC1
Numberofclearconfabulatorycombs.
BohmK
*CoC
Weightedindexofconfabulatory
combs.
BohmK
*Cr
Numberofcolourresponses(allkinds)
BohmG
CType Colourtype(Bash,numericalversion)
BohmG
CNam
Colournaming
Piot4
A%
Percentageofanimalresponses
+/(?)
BohmG,K
Libi1
Numberofclearlyuninhibited
responses
Study
*Libi
Weightedindexofuninhibited
responses
Study
Numberofvulgar(popular)responses
BohmG
V%
Percentageofvulgar(popular)
responses
Piot6
Orig+
Numberofgoodoriginalresponses
/(?)
BohmG,K
Orig
Numberofweakoriginalresponses
BohmG
Orig% Percentageoforiginalresponses
BohmG,K
Rej
BohmG
Rejections
CoNe1 Numberofclearcontams./neologisms
Study
*CoNe Indexofcontaminations/neologisms
Study
PersG
Perseveration,grossorganictype
BohmG
*Pers
Perseveration,anykind
Piot7
Rep
Repetitions
BohmK
Stp
Stereotypephrases
Piot10
Imp
Impotence
Piot8
Plx
Perplexity
Piot9
Locd
LocalizationdifficultiesinInquiry
BohmG
Edg
Edging
BohmG
LAw
Loweredawarenessofinterpretation
BohmG
Piot
Piotrowskisindex
Piot
Var.,variablename.Exp.,expectedsignaccordingtoPiotrowskiandBohm
ofcorrelationbetweenRorschachvariableandorganicmentaldisorders:/
+,negativeexpectedcorrelationwithglobalseverity,positivewithKAD./
(?),negativeexpectedcorrelationwithglobalseverity,undeterminedwith
KAD.+/(?),positiveexpectedcorrelationwithglobalseverity,
undeterminedwithKAD.Abbreviationsofsources:Piot1,Piotrowskis
firstsign,etc.BohmG,BohmsgeneralorganicRorschachsyndrome.
BohmK,BohmssignsforalcoholicKorsakoff.Study,variablederivedfrom
obvioustrendsinpresentdata.
Thereisalargeamountofredundancyinthefullsetofvariables,sofor
someofthetasksinthestudyasubsampleconsistingof16variableswas
usedinstead.
Table2:SomesuggestedcharacteristicsofalcoholicKorsakoffssyndrome
*Numberofresponsessometimesveryhigh
*NotsofewB
Introversiveexperiencebalance
*OftenWassuccessivecombinationsorconfabulatory
combinations
*TendencytosmallMresponses
*SporadicMresponses
*ConsiderablyloweredF+%
*MediumA%
*SometimesveryhighOrig%()
MannerofapproachWD(Dd)
Loosesuccession
*Repetitions
Subjectenjoysinterpreting
*)meansthatthevariableisinvestigatedinthepresentstudy.
AfterBohm(1972),p.331.ComparealsoBohm(1975),p.157.
Analysis
Threedifferentmethodsofstatisticalanalysiswereemployed:
Statisticalmethod1
Descriptivestatisticswerecollectedon16Rorschachvariablesforalltests
donewhenthesubjecthadsomesignificantorganicmentaldisorders.This
turnedouttobeall26occasions.Inthisway:
thenumberoffalsenegativesonPiotrowskisindexcouldbecalculated,
and
caveatsconcerninganumberofsuggested"organic"signscouldbe
formulated.
Statisticalmethod2
Fromthesetof26protocols,twosubsetswerepickedout.Thefirstgroup
(KAD+)consistsof14protocolstakenwhenKADwasjudgedtobethe
dominatingorganicmentaldisorder.Thiswasalwaysatorclosetothe
heightofthesubjectsglobalpsychopathology.Thesecondgroup(AED+)
contains7protocolstakenpreoperativelyorlateinconvalescence,whena
mildAEDwasjudgedtobethedominatingorganicmentaldisorder(orone
ofthetwoequallydominatingdisorders).Fornaturalreasonsthesetwo
groupswere"high"and"low",respectively,ontheestimateofglobal
severity.Descriptivestatisticsonthetwogroupswerecalculatedforthe16
Rorschachvariables,andtheresultswerecomparedonanintuitivebasis.
Thegroupscontainunequalnumbersofprotocolsfromthedifferent
patients,whichmakesformalsignificancetestingofdifferenceswith
standardmethodsimpossible.Thecomparisonwasthereforemainlyused
heuristically:
tosuggestcorrelationsbetweenclinicalandRorschachvariables;
tohelpfindtentativeRorschachpatternscharacteristicforpatientswith
KADandwithamildAED,respectively(thelatterfindingsarenotreported
here).
Statisticalmethod3
Foreachpatient,thecorrelationovertimeforaselectedpairofmeasures
wascalculated,andthemeanofall6intrapatientcorrelationswastakenas
anestimateofoverallcorrelationofthetwomeasures.Thenumberofintra
patientcorrelationcoefficientshavingthesamesignwerecounted,andthe
SignTestwasusedtoassesswhetherthetruemeanofthecoefficients
differedfromzero.Thesameanalysiswasrepeatedforalargenumberof
pairsofmeasures,anditwasthustested
towhatextenttheclinicalsyndromescorrelatedwitheachotherandwith
globalseverity,and
towhatextentglobalseverityandseverityofKADcorrelatedwiththe37
Rorschachvariablesinthewayexpectedfromourhypotheses.
Itshouldbenotedthatwithasamplesizeofsixpatients,signtest
significanceatthe5%levelrequiresthatall6correlationshavethesame
sign.
Resultsanddiscussion
Clinicalcourses
FourofthesixmaindisordersoftheLMsystemwererepresentedonatleast
onetestoccasion,namely,SSCD(possiblymixedwithUF),AED,KADand
EMD.InFigure1,theseverityofthesedisordersandtheestimatedglobal
severityareshownforeachtestoccasion.Itcaneasilybeseenthatalthough
boththetimecourseandthestateattheendoffollowupvaryconsiderably
betweenpatients,therewasaconsistenttrendtowardsfinalimprovementin
allclinicalvariablesexceptAED.SSCD/UFwasrareandgenerallymild
andtransient,AEDwasomnipresent,mildandstationary,whiletheamounts
ofKADandtoalesserdegreeEMDvariedconsiderablyfrompatientto
patientandbetweendifferenttestoccasions.Therewasnotestoccasion
withoutthepresenceofanysignificantorganicmentaldisorder.
Time courses of the different organic mental disorders in patients A-C. Abbreviations:
A1 = patient A, first test occasion (etc)
Global = estimate of global severity
SSCD/UF = somnolence-sopor-coma disorder, and/or unspecific fatigue
KAD = Korsakoffs amnestic disorder
AED = astheno-emotional disorder
EMD = emotional-motivational blunting disorder
Arrow: operation or (for patients E and F) other main causative event
Figures below each occasion: days before (-) or after main event
Time courses of the different organic mental disorders in patients E-G. Abbreviations:
A1 = patient A, first test occasion (etc)
Global = estimate of global severity
SSCD/UF = somnolence-sopor-coma disorder, and/or unspecific fatigue
KAD = Korsakoffs amnestic disorder
AED = astheno-emotional disorder
EMD = emotional-motivational blunting disorder
Arrow: operation or (for patients E and F) other main causative event
Figures below each occasion: days before (-) or after main event
Thecorrelationsbetweentheestimateofglobalseverity(Global)andthe
severityofthespecificorganicmentaldisorders,andbetweenthese
disordersthemselves,wereanalysedaccordingtothethirdmethod
mentionedabove(intraindividualcorrelationcoefficientsandsigntest).All
coefficientmeanswerepositiveexceptthatbetweenKADandSSCD/UF
whichwasweaklynegative.ThecorrelationsbetweenGlobalandKAD,
betweenEMDandKAD,andbetweenGlobalandEMD,wereallstrongly
positive,andthetwofirstonesapproachsignificanceonthesigntest(p=.
0625).
Theresultsimplythatintraindividualvariabilityintheglobalseverityscore
wasprobablymostlyduetotheamountofKAD(andtoalesserdegree,
EMD)present.Theyalsoindicatethatitisvirtuallyimpossibleto
disentangletheeffectsofKADfromthoseofEMDinthepresentstudy.
However,sinceEMDismostprobablyaninvariableaccompanimentof
KAD,thisimpossibilityneednotdetractmuchfromtheclinicalvalueofour
results.Forthesamereason,wehavechosentosimplifythefollowing
discussionbyleavingoutmostfurtherreferencestoEMD.
Rorschachdata
Statisticalmethod1
InTable3,thebasicdescriptivestatisticsfor16selectedRorschach
variablesinthewholegroupof26protocolsisshown.Ifseenonlyinthe
lightofcertainsuggestedRorschachsignsoforganicmentaldisordersin
general,someofourdatamayatfirstsightseemsurprising,namely:
ThemedianofthenumberofpositivePiotrowskisignswas4which,even
takingintoaccountthefactthatwescore"Impotence"conservatively,
meansthatthefalsenegatives(using5asthecutoffpoint)makeupatleast
50%ofthegroup.
ThemediansofR,F+%andM+were19,81.5%and2,whichshouldbe
comparedwiththePiotrowskicuttingpointsof15,70%and1,respectively.
Table3:Basicdescriptivestatistics,forthewholesampleof26protocols,
onthe37RorschachvariablesdescribedinTable1.Forexplanationsof
variablenames,seeTable1
Mean Std.dev. Count Minimum Maximum Median
19,2
7,4
26
8,0
40,0
19,0
T/R
89,2
34,4
26
48,0
155,0
78,5
W%
40,7
15,8
26
9,5
78,9
39,6
*W%
51,4
17,8
26
20,0
78,9
52,1
DW
0,3
0,6
26
2,0
*M+
1,9
1,4
26
5,0
2,0
M/M
0,2
0,3
26
1,0
Ms
0,04
0,2
26
1,0
F+%
75,8
17,7
26
38,0
100,0
80,5
Conf1
0,7
1,0
26
3,0
*Conf
1,1
1,1
26
3,5
1,0
CoC1
0,5
0,9
26
3,0
*CoC
1,9
2,0
26
7,0
1,0
*Cr
2,8
2,1
26
9,0
2,0
CType
0,9
0,1
23
0,8
1,2
0,9
CNam
26
55,7
15,5
26
31,0
85,0
53,0
Libi1
1,7
1,8
26
6,0
1,0
*Libi
3,6
3,6
26
12,0
2,0
5,5
2,4
26
2,0
10,0
5,0
30,1
11,1
26
8,0
50,0
31,5
Orig+
1,5
2,1
26
6,0
Orig
3,3
2,9
26
10,0
2,0
Orig%
26,8
16,4
26
57,9
26,3
Rej
0,5
1,0
26
4,0
CoNe1
1,0
1,3
26
6,0
1,0
*CoNe
2,9
3,2
26
13,0
2,5
PersG
0,4
0,4
26
1,0
0,5
*Pers
1,8
1,1
26
0,5
4,5
1,5
Rep
0,7
0,8
26
2,0
Stp
0,1
0,2
26
1,0
Imp
0,1
0,3
26
1,0
Plx
1,0
26
1,0
1,0
1,0
Locd
0,7
0,5
26
1,0
1,0
Edg
0,2
0,5
26
2,0
A%
V%
LAw
1,0
0,2
26
1,0
1,0
Piot
4,1
1,3
26
2,0
6,5
4,0
Wethinkthattheseaberrationsfrom"expected"valuescanallbeexplained
bythepeculiaritiesoftheKAD(and/orEMD,cfabove).Ithasalreadybeen
notedbyotherinvestigatorsthatRandM+donotbehaveinthesameway
inpatientswith(alcoholinduced)KADasinother"organics"(cfTable2).
OccurrencesofhighF+%wouldaccordwiththeclinicalobservationthat
KADpatientsareoftenwellpreservedintellectually.AverylowF+%has
beensuggestedastypicalforalcoholicKAD(Table2),butitshouldbe
emphasisedthatthealcoholiccasesmostprobablydifferfromthepost
operativeonesbyhavingmuchmoreotherorganicpsychopathology.
AnothernoteworthyfindinginTable3isthefollowing:
Contaminationsandneologisms(CoNe)arerareinthegeneralpopulation,
andtheyhavenotbeensuggestedassignsoforganicityingeneral.Inthe
presentsample,however,theywerefrequent.Weinterpretthisasevidence
thattheyareduetothepresenceofKAD(cfalsobelow).
Statisticalmethod2
InFigure3,themeans(2SE)forKAD,AED,Globaland16selected
RorschachvariablesinthetwogroupsofprotocolsKAD+andAED+(as
definedinMethod)areshown.Theresultsofthiscomparisonmaybe
summarisedasfollows.
MostoftheRorschachvariablesbehavedaswouldbeexpectedfrom
PiotrowskisandBohmscriteria(Table1),consideringtheintergroup
differenceinglobalseverity.
TheexceptionsareR,T/R,W%andCoNe.
Mean values ( 2 SE) of 16 selected Rorschach variables and 3 clinical variables for
two sets of protocols. Abbreviations:
AED+ = protocols from occasions when AED was judged to be the dominant organic
mental disorder (or one of the two dominant ones); the 7 occasions were A1, A4, A5,
C3, E3, E4 and G4.
KAD+ = protocols from occasions when KAD was judged to be the dominant organic
mental disorder; the 14 occasions were A2, A3, B3, B4, B5, C2, E1, E2, F1, F2, F3,
G1, G2 and G3.
Rorschach variables as in Table 1; note that the following variables have been scaled
by a factor of 10: *M+, *CoC, CType, *Libi, *CoNe, *Pers, Edg and Piot. Clinical
variables, scaled by a factor of 10: Glob = estimate of global severity. AED = asthenoemotional disorder. KAD = Korsakoffs amnestic disorder.
Allbutthesecondoftheseexceptionscanagainbeexplainedbythe
peculiaritiesofKAD(cfTable3andabove).Thesecondexceptionmayalso
havetodowiththenatureofamildAED.Intypicalcasesofthiscondition
thepatientscognitiveambitionsarehigh,buttoliveuptothemhemustuse
acontinuous,energyconsumingconsciouseffort(cfalsoLindqvist&
Malmgren1990,ChapterIII:2).Incontrast,thetypicalKADpatientismuch
lessselfcriticalandcanthereforeusefasterstrategies.
Statisticalmethod3
Foreachiteminthefullsetof37selectedRorschachvariables,anattempt
wasmadetodeterminean"expected"directionofitscorrelationwiththe
clinicalvariableGlobal,usingTables12andtheknowncorrelation(inthe
presentsample)betweenGlobalandKAD.Actualintrapatientcorrelations
betweentheRorschachvariablesandGlobalwerethencalculated,and
significancetestingwasperformedasdescribedin"Method".Figure3
illustratesoneessentialstepoftheanalysis.ItshowsthecoursesofGlobal
and16RorschachvariablesinPatientBandthecoefficientofcorrelation
(overtime)betweeneachvariableandGlobalforthispatient.
Theresultsforthewholesampleandall37variablesareshowninTable4.
ForeachRorschachvariable,Table4lists:theexpectedsign(ifany)ofthe
correlationcoefficient;theactualnumberofpositive,negativeandzero
intrapatientcorrelations;themeancorrelationcoefficient;thePvalue
(usingthesigntest)forthenullhypothesisthatthecorrelationmeanwas
zero;andfinallyabriefevaluationtowhatdegreeeachresultsupportsor
disconfirmsourhypotheses.Themainfindingsarethefollowing:
FourofthesignificantresultsconcernLibi1,Libi,CoNe1andCoNe,none
ofwhichhadany"expected"signofcorrelation.Althoughuninhibited
contentsdonotbelongtothePiotrowskiorBohmgeneralsignsoforganic
disorders(Table1),wedonotbelievethatthehighscoresonLibi1andLibi
werespecificallyduetothepresenceofKAD(orEMD).Uninhibited
contentsareprobablybestregardedasveryunspecificindicatorsofimpaired
egofunctioning;cfalsotheuseof"DerepressedContents"intheEgo
ImpairmentIndexofPerry&Viglione(1991).
Concerningcontaminationsandneologisms,seeabove.
Althoughtherewereonly3othersignificantresults,25ofthose31
variableswhichhadan"expected"directionofcorrelationdidtendtohavea
correlationinthatdirection,whiletherewereonly3(weakly)disconfirming
and3ambiguoustrends.This"variablecount"mustofcoursebeinterpreted
withgreatcaution,sincetherearemanyconceptualdependenciesamongthe
variables.
Table4:IntrapatientcorrelationsbetweenRorschachvariablesandglobal
severity
Var.
Exp. Noofcorr
+
Mean ST
Eval. Comment
/+
.158
>.3
T/R
.337
.219
W%
+/(?) 5
.252
.219
*W%
+/(?) 5
.283
.219
DW
.365
>.3
(E)
*M+
/(?)
.405
>.3
(E)
M/M
.385
>.3
(E)
Ms
.864
>.3
(U)
F+%
.682
.0312 E!
OnlyinB1
Conf1
.371
.219
*Conf
.410
.219
CoC1
.672
.250
*CoC
.237
>.3
(E)
*Cr
.023
>.3
(U)
CType
.340
>.3
(E)
CNam
A%
+/(?) 4
.126
>.3
Libi1
.532
.0312 !
*Libi
.588
.0312 !
Notseen
(unexpectedly
rare,Piot4)
(E)
.568
.0312 E!
V%
.353
.219
Orig+
/(?)
.092
>.3
Orig
.723
.0312 E!
Orig%
.399
>.3
(E)
Rej
+/
.070
>.3
CoNe1
.703
.0312 !
*CoNe
.733
.0312 !
PersG
.140
>.3
(E)
*Pers
.395
.219
Rep
.175
>.3
(E)
Stp
.417
>.3
(U)
Imp
.439
>.3
(E)
Unexpectedly
rare,
Piot8.
Plx
Allprotocols
(accordswith
Piot9).
Locd
.606
.219
Edg
.484
.250
LAw
.866
>.3
(E)
Piot
.493
.219
AllexceptC3
(accordsw.
BohmG).
Var.,variablename;forvariabledescriptionsseeTable1.Exp.,expected
signaccordingtoPiotrowskiandBohmofcorrelationbetweenRorschach
variableandorganicmentaldisorders:/+,negativeexpectedcorrelation
withglobalseverity,positivewithKAD./(?),negativeexpectedcorrelation
withglobalseverity,undeterminedwithKAD.+/(?),positiveexpected
correlationwithglobalseverity,undeterminedwithKAD.Noofcorr,
numberofpositive(+),zero(0)andnegative()intrapatientcorrelations.
ST,PvaluewiththeSignTest.Mean,meancorrelation.Eval.,evaluation
ofresultsfromlongitudinaldata:E!,significantresultintheexpected
direction.E,clearbutnonsignificanttrendintheexpecteddirection.(E),
weaktrendintheexpecteddirection.A,ambiguousdata(toofew
correlationsornotrendindata).(U),weaktrendoppositetotheexpected
direction.X,nodefinitepredictionfromBohmorPiotrowski.!,other
significantresult.Comment,verbalcomment,includingotherthan
longitudinalresults.B1,protocol1frompatientB.Piot4,Piotrowskis
fourthsign,etc.BohmG,BohmsgeneralorganicRorschachsyndrome.
AsimilaranalysiscorrelatingthedegreeofKADwiththesame37
Rorschachvariableswasperformed,buttheresultsarenottabulatedsince
therewereveryfewdifferencesfromtheoneanalysistotheother.Thisisof
courseexpectedinviewoftheheavypositiveintercorrelationbetweenKAD
andGlobal.
Conclusions
AlmosteverysingleRorschachsignispolyvalent,i.e.ithasacontext
dependentsignificance,andasimple"signapproach"liketheoneusedhere
cannotevencomeclosetomimickingtheholisticjudgementofthequalified
clinician.Ontheotherhand,thesizeofthepresentsamplehardlyjustifies
theuseofmultivariateorothermoreadvancedanalyticmethods.Inspiteof
this,thestudygivesstrongsupporttotheideathatthenatureanddegreeofa
patientsorganicmentaldisorderistoalargeextentreflectedinhis
Rorschach.Mostsuggestedsignsoforganicmentaldisorderingeneral,and
ofKADorrelatedcategories,behaveasexpected;however,forafewsuch
signsthedatatendtodisconfirmearliersuggestions.Concerning
Piotrowskisindex,ourresultsareinlinewiththemaintrendofearlier
research.
Severalofthesupported"organic"RorschachsignsdonotoccurinExners
"ComprehensiveSystem"(Exner1993),forexampleT/R,Orig,Orig%and
LAw.OthersmaybedifficulttoevaluateinExnerssystemdueto
peculiaritiesofhisrulesofadministration,notablyRandRejwhenthe
numberofspontaneousresponsesisverylowandthepatienthastobe
encouragedverymuchinordertofulfilthedesideratumforaminimum
numberofresponses.ThiscastssomedoubtsonthesufficiencyofExners
systemforanadequateanalysisof"organic"cases.
References
Bohm,E.(1972).LehrbuchderRorschachPsychodiagnostik.(4ed.).Bern:Huber.
Bohm,E.(1975).PsychodiagnostischesVademecum.(3ed.).Bern:Huber.
Caputo,J.(1989).Rorschachstudiesofneuropsychologicalgroupsofthepast,
presentandfuture.UnpublishedthesisforthedegreeofPsy.D.,CentralMichigan
University,MountPleasant,MI.
Ellis,D.,&Zahn,B.(1985).Psychologicalfunctioningaftersevereclosedhead
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Exner,J.(1993).TheRorschach:Acomprehensivesystem.(3ed.).(Vol.1).New
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Goldfried,M.,Stricker,G.,&Weiner,I.(Eds.).(1971).Rorschachhandbookof
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Related Articles:
Psychological Tests
Common
Most people have heard of the Rorschach test (pronounced "rawshock"), but few have ever seen a real Rorschach inkblot. The blots
are kept secret. When you see an inkblot in a popular article on the
test (as in the Encyclopaedia Britannica entry on the Rorschach
test), it's a fake: it's an an inkblot, but not one of the inkblots.
There are only ten Rorschach inkblots.
Psychologists want the blots to remain a secret from the general
public so that reactions to the blots will be spontaneous. Hermann
Rorschach hoped these spontaneous reactions would yield valuable
clues to the test subject's personality. Whether they do remains
controversial. Many psychologists think the Rorschach test is
hopelessly unreliable; others see it as one of the cardinal tools of
modern psychodiagnosis. Even among those who acknowledge the
value of the test, there is disagreement on interpretation of
responses.
Just as secret as the blots themselves are the ground rules for
administering the test. There are a few things that you, as a
subject, are supposed to know and a lot of things you aren't
supposed to know. If you ask about something you're not supposed
to know, the psychologist will give you a pat answer as prescribed in
Rorschach literature. For example, if you ask if it is okay to turn the
card upside down, the psychologist will respond that you may do as
you like; it's up to you. The psychologist won't say that many of the
cards are easier to interpret when turned; that most people do turn
the cards; that he or she will make a notation with a little
arrowhead every time you do turn a card; and that you lose points
in the initiative department if you don't turn the cards.
You'll be handed the cards one by one in the fixed order devised by
Rorschach (there are numbers on the backs of the cards for the
psychologist's benefit). The first card, for instance, looks like a fox's
head or a jack-o-lantern. The cards are thick, rectangular
cardboard, 6 5/8 inches by 9 1/5 inches. Half of the blots are black
ink on a white background. Two others are black and red ink on
white, and the last three blots are multicolored. The psychologist
will always put each card in your hands "right" side up.
You aren't supposed to know it, but the psychologist will write down
everything you say. This includes any seemingly irrelevant questions
you may have. To keep you from getting wise, the psychologist
always arranges to sit to your side and a little behind you, so that
you can't look at the card and the psychologist at the same time.
Most subjects realize the psychologist is taking notes, of course, but
they don't realize that the notes are a special shorthand record of
everything said. Some psychologists use hidden tape recorders.
The psychologist will also time how long it takes you to respond,
using a "tickless" watch. The psychologist will not ask you to hurry
up or slow down and will not make any reference to time, but
Plate I
Plate II
Plate III
Black and red ink. Two obvious .figures (black ink) facing each
other. Butterfly-shaped red blot between the figures; an elongated
red blot behind each figure's head. Naughty bits: penises and
breasts (at anatomically appropriate positions for each figure).
This is the blot that supposedly can determine sexual preference.
Most people see the two human figures. Both figures have
prominent "breasts" and an equally prominent "penis." If you don't
volunteer the gender of the figures, you'll be asked to specify it. By
the traditional interpretation, seeing the figures as male is a
heterosexual response (for test subjects of both sexes). Describing
the figures as female or acknowledging the androgynous nature of
the blot is supposed to be a homosexual response. Does it work?
Not really--many straights describe the figures as women, and not
all gays give a gay response. A 1971 study at Mount Sinai Hospital
in New York showed the traditionally heterosexual response (two
male figures) to be declining in popularity.
The splotches of red ink are usually perceived separately. Common
responses are "bow-tie" or "ribbon" (inner red area) and a stomach
and esophagus (outer red areas).
Plate IV
Black ink. A roughly triangular blot, point up, with the two lower
comer regions resembling boots or pet. Naughty bits: two penises
(on either side of blot, near top of triangle); vagina (on center line
near top of blot).
Plate IV is the "father card." At first glance it is a difficult blot to see
as a single image. The "boots" are fairly conspicuous; between them
is the apparent head of a dog or Chinese dragon. Many subjects see
the blot as an animal skin. After a few seconds, though, most can
see it as a standing figure seen from below.
The boots become the feet, enlarged because of the unusual
perspective. The arms and head, at the top, are smaller. Common
descriptions are bear, gorilla, or man in a heavy coat. Bad
descriptions are monster or attacking bear or gorilla-Rorschach
theorists equate your description of the figure with your perception
of your father or male authority figures.
Plate V
Black ink. A simple, batlike shape. Naughty bits: two penises (the
"ears" or "antennae").
Rorschach himself thought this was the easiest blot to interpret. It is
a bat or a butterfly, period. You don't want to mention anything
else. Seeing the projections on the ends of the bat wings as
crocodile heads signifies hostility. Seeing the paired butterfly
antennae or feet as scissors or pliers signifies a castration complex.
Schizophrenics sometimes see moving people in this blot. Many
psychologists take particular note of the number of responses given
to this plate. If you mention more images here than in either Plate
IV or VI, it is suggestive of schizophrenia.
Plate VI
Plate VII
Plate VIII
Plate IX
Plate X
Pink, blue, gray, green, yellow, and orange ink. A loose assortment
of brightly colored shapes, the most chaotic of the plates. Naughty
bits: penis and testes (top center, gray ink).
The unspoken purpose of this last blot is to test your organizational
ability. Plate X is full of colorful odds and ends easy to identify---
Additional Notes:
Many professionals feel that the Rorschach is outdated, inaccurate,
and meaningless. For example:
"Nobody agrees how to score Rorschach responses
objectively. There is nothing to show what any
particular response means to the person who gives it.
And, there is nothing to show what it means if a
number of people give the same response. The ink
blots are scientifically useless." (Bartol, 1983).
"The only thing the inkblots do reveal is the secret
world of the examiner who interprets them. These
doctors are probably saying more about themselves
than about the subjects." (Anastasi, 1982).
What these comments seem to indicate is that the Rorschach is
potentially unreliable, easily mis-interpreted, and essentially not a
valid means of determining what it claims to detect. For more
information on the use and potential unreliability of the Rorschach
test (including comments sent in to us by mental health
professionals) read the Additional Rorschach Information page and
"Misuse of Psychological Tests in Forensic Settings: Some Horrible
Examples" by Ralph Underwager and Hollida Wakefield.
Page Location:
http://www.deltabravo.net/custody/rorschach.htm
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Kit de fiches
protocolaire
s pour le
test de
Rorschach
Voici un ensemble de documents contenant les fiches qui permettent de prendre des notes structures
lors de la passation du test de Rorschach ainsi que d'autres qui facilitent la cotation des rponses et le
calcul des variables signifiantes.
Sont reprises les fiches telles qu'elles sont classiquement utilises dans le systme "
franais " ainsi que dans le Systme Intgr de J.E. EXNER.
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Hermann Rorschach ( 1884 - 1922) nat Zurich, d'une vieille famille suisse
du canton de Thurgovie. Il est le fils an d'un peintre, professeur de dessin. Il
perd son pre en 1903. Il finissait alors de bonnes tudes l'cole secondaire
de Schaffhouse, o ce dernier enseignait depuis 1886. Trs dou pour le
dessin, il hsite entre une carrire artistique et des tudes mdicales.
Le grand biologiste Haeckel le dcide pour les secondes. Il les mne, comme
c'est alors l'habitude, travers plusieurs Universits : Neuchtel, Berlin,
Berne et surtout Zurich (1904 - 1909).
Il frquente la colonie russe de Zurich, s'enthousiasme par la langue et littrature russes, passe ses
vacances en Russie en 1906 et 1910, pouse en 1910 une collgue russe, Olga Stempelin, et fait le
projet de s'installer en Russie. Il travaille dans ce pays de dcembre 1913 juin 1914, mais, pour des
raisons restes inconnues, revient dfinitivement en Suisse.
Entre-temps, il s'est spcialis en psychiatrie, gagn par l'enthousiasme qui rgne au Burghlzi, la
clinique psychiatrique de l'universit de Zurich, dirige par Eugne Bleuler, o brille Jung, l'inventeur
du test d'associations de mots et o, pour la premire fois, on appliquait aux psychoses les conceptions
psychanalytiques. Il exerait aux asiles de Mnsterlingen (1909 - 1913), et de Mnsingen (1913), de
Waldau, prs de Berne (1914 - 15) et celui de Herisau dont il est directeur adjoint (1915 - 1922).
Deux enfants lui naissent, un garon (1917) et une fille (1919).
Il soutient sa thse de mdecine en 1912, sur les hallucinations-rflexes et les phnomnes associs.
Bien que n'ayant point entrepris une psychanalyse personnelle pralable - la chose tant rare l'poque
-, il pratique des cures psychanalytique sur ses malades et acquiert la comprhension de la maladie
mentale dans la perspective psychanalytique. Il frquente le groupe psychanalytique de Zurich de 1909
1913 (Bleuler, Jung, Maeder, Binswanger et Pfister) et publie des articles, notes et comptes-rendus
assez nombreux dans Zentralblatt fr psychoanalyse. La scession de Jung hors du mouvement
psychanalytique freudien, puis la guerre, disperse le groupe. Quand une socit suisse de psychanalyse
est fonde en 1919 avec Oberholzer, Zulliger, et Pfister, etc., Rorschach en est vice-prsident ; il y
prsente plusieurs communications sur son test et fait des deux premiers nomms d'actifs adeptes. Ces
autres principaux disciples sont des confrres de Waldau (Morgenthaler, Fankhauser) et de Herisau (G.
Roemer et Behn-Eschenburg), ainsi que A. Friedemann, qui fut secrtaire gnral de la socit
internationale Rorschach, et le fils et de Bleuler, Manfred.
Elle aurait constitu une vaste synthse d'observations pathologiques et de recherches sociologiques
effectues sur certaines sectes suisses, dont l'un des fondateurs avait t intern Mnsingen (celui-ci
avait tabli le culte de son propre pnis, donnait son urine en communion et chassait les dmons par le
cot) et dont la trace remontait jusqu'au Moyen Age, toujours chez les mmes familles de tisserands des
mmes rgions. Les prophtes de ces sectes qui prnaient tous l'inceste, apparaissaient Rorschach
comme des nvross ou des psychotiques, dont la mythologie exprimait, de faon communicative, les
complexes personnels et les archtypes de l' inconscient. Son Psychodiagnostik parat en 1921. Peu
aprs, Rorschach est emport en vingt-quatre heures par une pritonite inoprable, Herisau (2 avril
1922).
Cette biographie est extraite de "Les methodes projectives" de D. ANZIEU (1976) pp. 38-40.
Complete URL to this document:
http://www.ulb.ac.be/psycho/fr/docs/contrib/rorschach/hermann.htm
Clinical Psychology
General Information
Psychology Department Home Page
UT Austin Home Page
8. If you would like more information regarding the Rorschach, you may want
to order following publication authored by Dr. Campbell.
"Cross-Examining Psychologists and Psychiatrists as Expert Witnesses." This
is a 79-page, single-spaced outline, containing 214 footnoted references. This
outline is bound. (Order article #15, cost $59.00).
Home Page | Available Publications | Curriculum Vitae | Professional History
1999 Dr. Terence W. Campbell, Ph.D.
This was published as an appendix to: Linus Pauling: A Life in Science and Politics, Basic Books,
1995, which is now out of print.
------------------------------------------------------------
Table One
Key Images in Linus Pauling's Rorschach Protocol
Card I.
1. pelvis
2. vulva
3. pair of butterflies ... wings vertical ... facing each
other
4. pair of sharp-nosed pliers
5. two rabbits ... in an attitude of supplication
Card III.
1. two men perhaps waiters ... formal dress ... facing each other ...
Joos dancers or some other pair of male dancers
2. Dali's watches ... the two arms ... hang over in that
limp manner
3. spigot that iron comes out of a cupola
4. testicles and penis
pile of skins (referring to 1)
5. gorilla ... standing there, illuminated by a bright light
close behind his back
2. insects
3. pelvic bones ... from in front instead of above
(referring to Card I)
4. water is dripping, perhaps blood dripping down
5. peaches or similar fruit, four of them arranged in a row
7. two caterpillars
8. nice yellow sea shells, not exactly conch shells ...some sea shells
are spiny
9. sea horses, but the tails are bent the wrong way
10. Irish appearance too, the nose, and there is
something hanging from both upper and lower lips,
mouth open, it's ectoplasmic
11. the California peninsula, geographical costal contour
To the layman who has never studied the Rorschach, Pauling's answers seem very
imaginative and creative. As one might expect, there is some scientific terminology.
There are more references to animals, plants and geography than to molecular
structures. Pauling's lifelong hobby of reading encyclopedias had apparently given
him a tremendous wealth of images to draw upon, and he enjoyed the creative process
that the test called for.
Rorschach experts, however, can find a great deal more meaning in these responses
than lay people. Ted Goertzel asked his colleague, psychologist Michael Wogan, to
review the Rorschach protocol. Wogan knew that it was Linus Pauling's protocol, and
took his knowledge of Pauling into account in his interpretations. His interpretation
highlighted a number of aspects of Pauling's own personality. Wogan thought that
Pauling:
- was extremely ambitious
- used a great deal of effort to protect himself against showing emotion
- tended to establish intellectual distance between himself and others, treating himself
and others as objects.
- felt considerable emptiness due to the psychic effort devoted to his defenses.
- had a pervasive fearfulness, visualizing the world as being crushed, cleaved apart,
split, or bloodied.
- felt a constant need to be in control, which could make problems in intimate
relationships. Wogan thought that Pauling's marriage was probably one-sided, and that
he was generally sexist with women although bright enough to avoid expressing this
too openly.
The most outstanding feature of Pauling's Rorschach, in Wogan's view, was the lack
of emotion. Wogan thought that Pauling was a person who felt little of life's pains and
pleasures, avoiding strong emotion through denial and defenses.
In order to check on the reliability of the Rorschach interpretation, we went to the
library and compiled a list of 22 specialists who had published articles on Rorschach
interpretation in the Journal of Personality Assessment. We wrote to them and asked if
they would be willing to do a "blind" interpretation, knowing nothing but the subject's
sex and age at the time of testing. Fortunately, seven of these distinguished Rorschach
experts generously agreed to participate in this research, purely on a voluntary basis.
When the experts' reports came in, we were pleased to find that they confirmed many
of Michael Wogan's impressions. The fact that they were also consistent with each
other in many ways increased our belief in the reliability and usefulness of the
Rorschach test. On the other hand, we were quite surprised that the experts found as
much pathology as they did in Pauling's responses, since Pauling had never required
treatment for any kind of psychiatric illness.
The first blind Rorschach interpretation we received was from Clifford DeCato of
Widener University. Dr. DeCato has practiced and taught Rorschach interpretation for
twenty-five years, and has published widely on the topic. He became intrigued with
what he called the "Mystery Case," spending as much as fifty hours of his time
scoring and analyzing the record. He used two different scoring systems, the
Perceptanalytic system developed by Z.A. Piotrowski and the Comprehensive System
developed by John Exner, Jr. He provided us with the computer printouts and scoring
records for the systems. Dr. DeCato warned us, however, that there were instances in
which he had to make "educated guesses" as to aspects of Pauling's responses, since
the psychologist who administered the test was not available for questioning. Several
of the other experts, also, had told us that it was not always clear from the record
which part of the ink blot Pauling was looking at when he made a particular remark.
The record of the session, which was done over forty years ago, was not made with
the complete rigor and precision expected of Rorschach records in the 1990s.
Dr. DeCato also warned us that "psychopathology may emerge more dramatically" in
the Rorschach than in other tests. This was a useful warning, since his interpretation
based on the Comprehensive System began with this rather ominous quote from the
computer printout (The Rorschach Interpretation Assistance Program): "Warning!! -He has many of the characteristics common to people who effect suicide. The
possibility of a suicidal preoccupation should be evaluated carefully, and those
responsible for his care should be alerted." DeCato went on to note that "the
composite of findings concerning thinking and perceptual inaccuracy suggests a
possibility of schizophrenia...he appears to be prone to frequent episodes of
depression or emotional turmoil...he processes information hastily and
haphazardly...his conception of himself is not well developed and is probably rather
distorted. His self image includes many more negative features than should be the
case."
In real life, Pauling was certainly not schizophrenic, he had never shown any signs of
being suicidal, nor had he needed anyone to be "responsible for his care."
Using the Perceptanalytic Method, Dr. DeCato's observations were much closer to the
mark, although still focusing on the negatives in Pauling's makeup. He found that the
"Mystery Case" was a person who "gives the impression of an adult man who is
intellectually very bright and has acquired through reading, education, or experience a
wide array of information. He attempts to make his adaptation to the world through
the use of his intelligence in a rapid-response fashion...he is often quick to respond
without taking the time to review the situation in depth. He often responds hastily and
avoids searching for a more thorough understanding of the whole. The upshot of this
cognitive style is that he may often use his intelligence in relatively superficial ways
and may make some errors of judgment by forming his opinions too hastily, or at the
very least, not engaging his intelligence to the fullest... At times his judgment can
become quite unrealistic and disorganized when he is assessing himself or others... He
tends to focus on himself and his own feelings more than most people do which along
with other features of his protocol suggests a painful sense of distortion in his self, a
sense of being insufficient or damaged in some way, along with tendencies to brood
on his own emotions."
Dr. DeCato further observed that "a strong trait of ingrained long standing anger
expressed as hostility and a trend toward being oppositional and/or stubborn is a
prominent feature of his personality...the need for his own space, to be his own
master, to do things his own way, not be controlled by authorities, or to have control
over his own life and be independent are some of the possibilities singly or in
combination. People with this trait can sometimes accomplish outstanding
The next psychologist to report in was James Kleiger of the Meninger Clinic in
Topeka, Kansas. Dr. Kleiger has had 15 years of clinical, teaching, and supervisory
experience with the Rorschach and has published several papers on its clinical uses.
Dr. Kleiger observed that the subject was erudite and took pride in his intellectual
judgments. He thought, however, that "unfortunately, his good natured attempts to
amuse himself and impress the examiner with his knowledge and wit are quite
strained and reveal a desperate effort to manage his confusing world by relying on an
ineffective intellectual style... His responses were infused with a language of scientific
precision; however, on occasion, he was unable to actually produce a scorable
response. Characterologically, one is left with an impression of an individual with
narcissistic, obsessional and histrionic traits... There is evidence that this man is
working hard to ward off a clinical depression, most likely associated with his
underlying sense of narcissistic vulnerability and deterioration. While not actively
psychotic, he reveals some signs of idiosyncratic thinking, especially under the impact
of his frantic efforts to fend off an unwanted sense of himself as weak and
inadequate."
Dr. Kleiger concluded that Pauling's defensive style was generally ineffective and did
not fend off feelings of vulnerability or his "nagging sense of cognitive and physical
decline." He thought that Pauling showed a tendency to get caught up in emotionally
evocative stimuli that would lead one to wonder about a possible hypomanic
condition.
The next psychologist to answer was Paul Lerner of Asheville, North Carolina, who
has been a leader in Rorschach analysis for many years and has published standard
reference works on the subject. Dr. Lerner thought that "the subject presented as a
highly pressured, manicky, very striving, idiosyncratic individual who is markedly
self centered. He is intellectually exhibitionistic and pretentious. He used the test
more to show off his vast storehouse of information than to merely comply with the
task... Prominent in the subject's character make-up are obsessive compulsive and
narcissistic features... he is self-centered, self-absorbed, egocentric and highly
sensitive as to how he is regarded and treated by others... With respect to his thinking,
he was an exceptionally bright individual who at this time is losing it."
Lerner thought that Pauling was depressed, and that this depression was related to
declining mental powers in middle age. He observed that "the most prominent affect
to appear on his test was depression... Particularly distressing is his sense of being a
shell of the person he once was...at the time of testing there were test signs to indicate
he was suicidal. While I cannot assess the acuteness of the danger, it would be related
to feelings of helplessness and powerlessness and a sense of inability to regain his lost
self-esteem."
In summary, Lerner concluded that "this once high striving, high-powered,
exceptionally bright, proud individual is faltering. Despite attempts to cover it over
and compensate for it, he is aware of it and feels it. His brain was exceptionally
important to him. It was active, big and powerful, and a source of self-esteem. His
pride and joy if you will. It was also his competitive weapon. It is now a source of
shame and embarrassment... He is experiencing considerable pain. There is much
depressive affect centered around a loss of self-esteem, inner feelings of emptiness,
and a sense of being a mere shadow of what and who he once was."
The next interpretation came from John E. Exner, Jr., Executive Director of the
Rorschach Workshops and creator of the Comprehensive System for analyzing the
Rorschach. He expressed some reservations about the protocol which was "not well
taken and apparently the examiner lost control of the situation." He also thought that
having some information about marital status and interpersonal relations might have
helped to clarify the "obvious issue of loneliness and/or emotional deprivation" which
he observed in the protocol.
Exner thought Pauling "conveys the impression of a very disorganized individual
whose thinking currently is fragmented, impulsive, and often quite chaotic. The
characteristics of his disorganized thinking are typical of individuals who are unable
to control and direct their thinking effectively." This disorganization, in Exner's view,
was a chronic feature of Pauling's personality.
This observation is remarkably inconsistent with the known facts about Linus Pauling.
If there was one thing Pauling could do, better than almost any other human being, it
was organize his thoughts effectively (even if his thoughts, like anyone's, were not
always accurate). If Pauling did not organize his responses to the ink blots in the way
that most people do, perhaps it was simply because he thought the test did not call for
organized, systematic thinking, but for a disorganized "brainstorming" process.
Pauling had read the literature on creative thinking, and this literature strongly
recommends against imposing structure on the initial phases of a creative process.
Pauling's skill in doing this may give some insight into how a highly creative person
differs from more typical people.
Exner also felt that Pauling was undergoing some kind of "situationally related stress"
which gave him "a marked sense of helplessness regarding his ability to respond
effectively to the current circumstances." He thought Pauling was "burdened with
some very intense negative feelings which included a marked sense of loneliness and
a general pessimistic outlook concerning himself and his world." He observed that "it
is obvious that he is a very intellectual person and, among other things, is prone to
deal with his feelings on a more intellectual level than is customary for most people."
This is certainly a valid observation about Pauling, and one which was noted by the
other Rorschachers as well.
Exner thought that Pauling "does not process new information very well even though
he makes a very concerted effort to do so. It seems obvious that he had a superior
capacity to organize new information, but he often becomes almost obsessively
trapped in details and his rather hectic thinking causes him to scan a stimulus field too
hastily... This issue of reality testing is complicated even further when issues
concerning his self image or self esteem are involved. Under those circumstances, he
tends to distort reality considerably... He is not the sort of person who controls his
emotional expressions very effectively.. He would like to be close to people but feels
a marked sense of loss or failure in his attempts to develop close relations with
others."
"In summary," says Exner, "it is very likely that this is an individual who will be
regarded by those around him as `crazy.' Certainly, the disorganization of his thinking
will convey this impression if one sits and listens to him for any lengthy period of
time." In real life, of course, Pauling was a brilliant lecturer who impressed tens of
thousands of people with his encyclopedic knowledge, rigorous logic, and brilliant
insights.
The next Rorschach interpretation was from Eric Zillmer of Drexel University, who
has just completed a book analyzing the Rorschachs of Nazi war criminals. Dr.
Zillmer also noted the deficiencies of the protocol, but thought that it appeared valid
in terms of being able to offer meaningful interpretations. He also observed that it was
"particularly rich, spontaneous, and included a variety of imagery that would pique
the curiosity of any experienced Rorschach analyst." He had it scored separately by
two experts, using the Exner Comprehensive System, and the inter-scorer agreement
among all the responses exceeded 80%. He then used two different computer
programs to generate interpretative hypotheses.
Zillmer thought that Pauling was "a very bright and capable person who responds
inconsistently to new problem solving situations or when making decisions... The
protocol further suggests that this individual was experiencing substantial emotional
uneasiness or distress at the time of the Rorschach administration. This may be related
to a general sense of anxiety and tension, unmet dependency needs, and the
internalization of emotional experiences."
Zillmer observed that Pauling "is somewhat uncomfortable in dealing with emotional
experiences or situations directly... Individuals with this style usually feel
uncomfortable about their ability to deal with negative feelings adequately and often
`bend reality' to avoid dealing with perceived or anticipated negatives in their
environment. This may lead to social isolation, a sense of loneliness, or emotional
deprivation. This presents a conflict for this subject since there are indications of
strong unmet needs for emotional sharing, accessibility, and interpersonal closeness."
Zillmer thought that Pauling had "unusually good internal resources to meet stress
demands," but that he "may not be as controlled in situations where there is an
increase in confusion about feelings, or when confronted with highly ambiguous
situations." He thought that "a core element in this subject's personality is a
`look' at the cards in some `neutral way,' trying to figure out what is there...he just
assumes he does see reality without questioning and that it all must relate to him and
his experience of the world. Possibly this is a characteristic of individuals who are
`famous' for their unique intelligence but who have more difficulty with the world as
it is `commonly' perceived by the average person."
He also observed that "I am getting the sense that this was once a man with a highly
`functional' intellectual style that is now starting to become less efficient and
organized due to aging."
Finally, Dr. Nunno warned that "it is always difficult to evaluate `creative' or
`exceptional' people with a test that is grounded in the concept or `normality' as these
individuals are not `normals' in the true sense of the word, and their `uniqueness'
should not be conceptualized as a pathological deviation from normal expectancies."
At the last minute, we received an interpretation from Dr. Richard Kramer, a clinical
psychologist in Israel whose busy schedule did not permit him to spend as much time
as he would have liked with the record. Dr. Kramer thought that Pauling was
"superficially very bright however his intelligence is more for show rather than what
he can actually utilize...he is pedantic and does not think things out in a deep
fashion...he is very reactive to his environment and exhibits signs of emotional
impulsiveness, defensively, he operates via denial and attempts to psychologically
distance himself from things in a narcissistic fashion. The individual is a very
aggressive man...he has a great deal of hostility and contempt toward women, in this
respect there is a great deal of classic masochism. It may even be that he is impotent
(however, this is admittedly really pushing it as there is no actual data - this is more
inferential)."
In real life, of course, Pauling had no problems with women or sexuality, enjoyed life
fully with no signs of masochism, and was extraordinarily effective in utilizing his
intelligence. When the interpretations diverge so sharply from the reality of Pauling's
personality, it is tempting to simply dismiss the Rorschach results as invalid. It would
be wrong to reach a conclusion about the validity of the Rorschach as a psychological
measure, however, from one case. It may be that there was something in Pauling's
personality which made him a particularly difficult subject for Rorschach
interpretation. Over the years, many people have observed that genius and madness
seem to have something in common. As long ago as 1680, the poet John Dryden
wrote:
Great wits are sure to madness near allied,
And thin partitions do their bounds divide.
The Line Between Creativity and Madness.
In his recent biography of Richard Feynman, James Gleick asks "when people speak
of the borderline between genius and madness, why is it so evident what they mean?"
Perhaps these Rorschach interpretations, so many of which confuse Pauling's
creativity with psychiatric disorder, can help us to answer Gleick's question. There is
evidence that highly creative people often score similarly to schizophrenics on the
Rorschach, even though they do not have any kind of psychiatric disorder. This is
believed to be true because creative people are able to draw on primitive
psychological processes which "normal" people do not often use. However, they are
not stuck on a primitive or chaotic level of thinking, as some mentally ill people are,
but are quite capable of integrating their thinking in a mature way when appropriate.
Bernice Eiduson observed this phenomenon in her study of scientists (in which
Pauling was included). She thought that scientists as a group had a heightened
sensitivity to experiences which:
is accompanied in thinking by over alertness to relatively unimportant or tangential
aspects of problems. It makes them look for and postulate significance in things
which customarily would not be singled out. It encourages highly individualized and
even autistic ways of thinking. Were this thinking not in the framework of scientific
work, it would be considered paranoid. In scientific work, creative thinking demands
seeing things not seen previously, or in ways not previously imagined; and this
necessitates jumping off from "normal" positions, and taking risks by departing from
reality. The difference between the thinking of the paranoid patient and the scientist
comes in the latter's ability and willingness to test out his fantasies or grandiose
conceptualizations through the systems of checks and balances science has
established... One might say that scientific thinking is in a way institutionalized
paranoid thinking; it sanctions it not only as proper, but also as the irrational that
ultimately promotes the rationality of science.
In many ways, Pauling's personality and life history fits the pattern which Eiduson found in many of
the scientists which she studied. She observed that scientists:
- were intellectually gifted children, whose greatest talent was their mind
- had limited intimacy with their families as children, particularly with their fathers
who were often absent
- found nurturance in intellectual life, turning to reading, puzzles, daydreams and
fantasies for entertainment and escape
- received tangible recognition for their intellectual accomplishments in the forms of
scholarships and prizes
- built a set of "intellectual fences" to defend themselves against problems or
disturbances at home
- learned to value novelty, innovation, and difference, while tolerating any ambiguity
and uncertainty which this might create
- developed into intellectual rebels, channeling their aggressions into their intellectual
life
- valued logic, rationality and emotional control
- were likely to enter into traditional marriages with competent women who took
responsibility for home and children
-were fulfilled by their work as an end in itself, not primarily for the extrinsic rewards
it provides
These findings fit Linus Pauling remarkably well. In many ways, Pauling's personality
profile was much like other distinguished scientists. Pauling differed from most of the
scientists Eiduson studied by his intense involvement in political and medical
controversies, and his tendency to take very strong positions on issues where the
objective evidence was ambivalent at best. To understand these traits, we need to look
at the specifics of Pauling's personality structure.
We sent a summary of our results to each of the Rorschach experts, letting them know
who the subject was and sending them a copy of the article on Pauling which we had
published in the Antioch Review in 1981. In response, Dr. DeCato rose to the defense
of the Rorschach, observing that "there are many startlingly consistent points between
your Antioch article and my Rorschach blind analysis." His "attempt to theorize about
what might have occurred with Dr. Pauling" is worth quoting at length:
"The description of Dr. Pauling given in the article by Goertzel, et al., in The Antioch
Review corresponds on many points with the blind analysis by the Perceptanalytic
method. This analysis suggested that he was very bright and intellectualized which
means in part that he loved his own ideas more than most things in life. The many
instances of unrealistic logic and other instances of "cognitive slippage" which are
often found in impaired populations such as schizophrenia were counterbalanced in
his personality by a high degree of social awareness and conventionality. In other
words, Dr. Pauling was a complex mixture of both conventional trends and highly
unconventional trends and at times impulsive and unrealistic thinking.
by responding to cues from their clients. In the blind analyses, the experts had no way of knowing
which of their interpretations were off the mark.
In his personal life, Pauling was stiff and formal, not the kind of person who enjoyed
casual, lighthearted activities. He was happy to leave the responsibility for personal
and social matters to his wife, to whom he was quite devoted. He did not spend much
time on close friendships which involved meaningful interpersonal commitments. His
wife was certain he would never have an affair, because he would not want to spend
the time needed to romance a woman. He might have felt isolated or lonely, if it were
not for the devoted companionship of his wife and the continual stream of attention
from admirers around the world.
He had the capacity for brilliant insight, but also for distorted thinking particularly
when confronted with situations which were emotionally laden. In these situations, his
intellectual defenses sometimes broke down. The sad confrontation with Arthur
Robinson was the worst example of this pattern. It can also be seen in his response to
Dr. Moertel and the New England Journal of Medicine.
The personality patterns which Pauling displayed throughout life developed in the
period after his father's death. His father had admired him greatly, and encouraged his
intellectuality. His mother, because of her illness and vulnerability as a widow, was
not able to provide the same degree of support. He found that he could use his
intellectual brilliance to maintain independence from her and obtain approval from
others. He married a woman who gave him the devotion he was unable to get from his
mother.
Despite his tremendous success as a young scientist, Linus Pauling was never
satisfied. Having won two Nobel Prizes, he felt he deserved a third. When his
brilliance as a scientific innovator declined with age, he fell more and more into his
second intellectual style. In his later years, his combativeness and defensiveness
increasingly triumphed over his brilliance and creativity.
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Hermann Rorschach
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Biography:
Hermann Rorschach was born in Zurich to an ancient Swiss family from the Canton Thurgau
Hermann Rorschach has been described as a studious and orderly pupil who completed his ba
studies with top marks in all disciplines. He took a great interest in drawing, being an artist of
some merit. Towards the end of his schooling in Schaffhausen he wrote to Ernst Haeckel (1834
1919) - the famous advocate of Darwin's evolutionary theory - asking him whether he should
into further studies of art or natural sciences. Haeckel advised the second, so in 1904 he
entered medical school in Zurich, spending some time at Neuchtel (German: Neuenburg),
Berlin and Berne, but spending the majority of his time in Zurich.
At this time Zurich was a world centre of psychiatry, and a major part of clinical education in
Switzerland was devoted to psychiatry. Already in his early days as a medical student Rorscha
planned to become a psychiatrist, and his interest in this speciality was undoubtedly boosted
during the courses of clinical and theoretical psychiatry which he attended at the Burghlzli
university clinic. Not very surprising, with teachers like Auguste-Henri Forel (1848-1931), the
almost equally famous successor, Eugen Bleuler 1857-1939), and as fame goes, no other than
Carl Gustav Jung (1875-1961), who had just worked out the association test to explore the
unconscious mind. At this stage the work of Sigmund Freud (1856-1939) was just beginning t
gain in popularity.
In his student days he developed an intense interest in Russia and Russians, and in Zurich he
was soon to meet members of the Russian colony in the town. This elite group counted among
its members men like Constantin von Monakow (1853-1930), the famous neurologist.
Rorschach began learning Russian, and in 1906, while studying in Berlin, he went for a holiday
in Russia.
Rorschach graduated in medicine at Zurich in 1909 and at the same time became engaged to
Olga Stempelin, a Russian girl in Switzerland, and then visited her family in Kazan. At this tim
he had decided to move to Russia permanently, but first wanted to complete his education in
Switzerland.
Since both he and his fiance were poor, in 1909 he chose to take a position in the psychiatric
hospital in Mnsterlingen because the salary was much better than he would have obtained in
university clinic. He married in 1910 and remained at the asylum until 1913, becoming very
popular with the patients by organising theatrical entertainment and keeping very close record
of the patients, including a photographic record which he himself took. At one time he bought
monkey and kept it to observe the patients' reactions to it, and also to entertain them.
With a school teacher friend of his, K. Gehring, Rorschach in 1911 was experimenting with
inkblots and Jung's word association test on school children and patients. He described these
experiments in 1911, though not very systematically. His growing interest in psychoanalysis w
probably the reason why he put aside this work. He had become interested in the interpretatio
of art works by psychotics and neurotics and their own abilities to paint.
Like many psychiatrists of his time he was impressed by symbolic associations, and in a paper
Clock and time, he proposed that some neurotics' love of watches was related to a subconscio
longing for the mother's breast with the ticking representing heart beats.
It was in Mnsterlingen he became interested in reflexive hallucinations and began his work o
the treatise ber Reflexhalluzonationen und verwandte Erscheinungen. His supervisor in this
work was Eugen Bleuler (1857-1939).
In 1912, having finished his doctoral dissertation, sur les hallucinations-rflexes et les
phnomnes associs he moved to Russia with his wife Olga in 1913. Although he obtained a
well paid position in a fashionable asylum, he remained in Russia for only seven months. This
was probably caused by his wish to pursue his more scientific interest, something he could no
do in this position.
Back in Switzerland in 1914 he had no choice but to accept a position at the Waldau psychiatr
clinic near Bern. Rorschachs wife was detained from leaving Russia by a declaration of war an
did not rejoin him in Switzerland until the spring of 1915. Mrs. Rorschachs explanation for her
husbands return to Switzerland was that "in spite of his interest in Russia and the Russians, h
remained a true Swiss, attached to his native land.... He was European and intended to remai
so at any price.
Hermann and Olga Rorschach had two children, a boy born 1917, and a girl born in 1919.
There was a saying amongst psychiatric residents of the day " if you want to eat well, go to
Friedmatt; if you want to sleep well, go to Waldau; if you want to learn well, go to Burghlzli".
The latter was the main university clinic in Zurich and was were Eugen Bleuler taught.
Towards the end of 1915 Rorschach was appointed associate director of the asylum at Herisau
in the eastern part of Switzerland, close to the Austrian border. He remained here until his
premature death in 1922.
In Herisau Rorschach faced a rather heavy workload. The hospital had room for some 300
patients, yet there were only two psychiatrist, the director and the associate director of the
clinic. There were no social workers or secretaries, and at the beginning, no subordinate
physicians. Here he introduced a course of lectures for the nursing staff, the first of its kind in
Switzerland.
Despite his business in the daily routine of the hospital, Rorschach found time for his interest
the psychoanalysis and psychopathology in religion. While investigating some of the strange
religious sects in Switzerland, he examined a gentleman called Binggeli who taught his disciple
that his penis was sacred and that they should adore it; his urine was called "heaven's drops"
"heaven's balm" and he gave it to them as a medication or instead of the wine for the holy
communion. One of his teachings was that the method of expelling demons from young wome
was to have sexual relations with him! Binggeli was imprisoned for incest with his daughter.
When Rorschach examined the situation more fully he found that the sect was similar to the
sect of Anton Unternhrer (1759-1824) the Antonianer - which had existed towards the end
the 18th century and which had also preached the holiness of incest. When he went back
through the centuries he found that besides "normal" religious sects, similar aberrant sects
which were identical or very similar to those of Binggeli's had been taking place in the same
geographic regions aback to the 12th century. When he examined the family three of Binggeli
he found that over four centuries, ten relations had played a leading role in these sects.
Then, abruptly his interest in the inkblot test was revoked, when Szyman Hens in 1917
published a doctoral thesis on an inkblot test he had devised with Eugen Bleuler. Hens'
technique was similar to the one applied by Rorschach in 1911, as Hens had studied the
phantasies of his subjects using inkblot cards.
This led Rorschach to resume his own experiments in 1918, now working frantically. He used
altogether 40 cards, but 15 of them much more often than the rest, and he collected the
answers to the test from 305 persons, 117 of them non-patients, 188 of them schizophrenous
He showed them the cards and asked the question: "What might this be?" Their subjective
responses enabled him to distinguish among his patients on the basis of their perceptive
abilities, intelligence, and emotional characteristics.
Several of Rorschach's colleagues, Bleuler not least so, seem to have been very positive to
Rorschach's work and encouraged him to publish his findings. His manuscript containing the
original version of the test, consisting of 15 cards, was sent to six publishers - who all refused
it. Eventually Rorschach in Bern found a publisher who was willing to print the book - on the
condition that the number of cards were reduced to ten. In June 1921 the book was finally
printed, but the printing quality of the inkblot cards was anything but satisfying. They had bee
reduced in size, the colours had been altered and the original patches of uniform colour densit
had been reproduced with a varying degree of saturation. In this way a very important variabl
was included in the text, the so-called shading qualities of the pattern. It is these ten cards th
are presently being used and are known as the Rorschach test.
The potential sources of inspiration for the use of inkblots as a means to study personality we
many. Alfred Binet (1857-1911) had reported on experimentation with inkblots as a test of
creativity in the early twentieth century. Even before that, in Germany, Justinus Kerner had
published Kleksographien, a book of inkblot-inspired poems in 1857. Kerner, a physician and a
painter of some repute, had produced inkblots "through chance" by folding a piece of paper on
which some ink had been dropped. He then wrote poems inspired by each of the inkblots. The
published book was well received in German-speaking countries and was probably known to
Rorschach.
His book Psychodiagnostik represents Rorschach's masterpiece, but the publication was a tota
disaster. The entire edition remained unsold, and those few who showed some interest, were
almost hostile in their critics. The publisher, Bircher, went bankrupt shortly afterwards.
Rorschach was somewhat depressed, but far from knocked out. In a lecture to the Swiss
psychoanalytic society in February 1922, one month after publication, he spoke of a further
development of his test. But fate decided otherwise. On April 1st, 1922, Hermann Rorschach
was hospitalised after a week of abdominal pains, probably caused by a ruptured appendix. An
explorative laparotomy was performed, but the condition proved to be inoperable, and
Rorschach died of peritonitis the following day, only 37 years of age.
In 1927, Hans Huber founded his own publishing house and he purchased Psychodiagnostics o
of the inventory of Ernst Bircher. Since 1927 Hans Huber has been the publisher of
Psychodiagnostik. Even today, each reprinting of the plates themselves requires great attentio
and is done on what can now only be regarded as ancient equipment, which is carefully
maintained exclusively for this purpose, so as to maintain a virtually identical reproduction of
the originals. Even the weather has to be taken into account, and if it is too humid, or too dry,
the printing process has to be rescheduled.
When the Swiss psychoanalytic society had been founded in 1919 with Emil Oberholzer, Zullige
and Pfister, Rorschach was elected vice president, and gave several lectures at the scientific
meetings of the organisation. His work won international respect and an institute was founded
in his name in New York in 1939.
Rorschach was described as having an attractive personality, a cultivated, brilliant and profoun
conversationalist. Although somewhat reserved, he was a man of great benevolence to those
closest to him
Bibliography:
Gesammelte Aufsatze.
Zusammengestellt u. hrsg. von K. W. Bash Bern : H. Huber, 1965.
References
E. Bohm, et al:
A Textbook in Rorschach Test Diagnosis.
Grune & Stratton, New York & London,1958.
Der Rorschach-Test.Bern, Huber.1974.
Lehrbuch der Rorschach-Psychodiagnostik.
4th ed. Huber, Bern 1972. Later editions are unchanged.
Blindauswertung eines Rorschach-Protokolls : wie steht es um die Validitt des
Rorschach'schen Formdeutversuchs? : Vergleich mit der Originaluntersuchung und
dem Psychogramm von Hermann Rorschach.
Bern : H. Huber, 1975. In the Rorschachiana series; 12. Beiheft zur Schweizerischen
Zeitschrift fr Psychologie und ihre Anwendungen ; Nr. 59.
P. Pichot:
Centenary of the birth of Hermann Rorschach.
(S. Rosenzweig & E. Schriber, Trans.).
Journal of Personality Assessment, 1984, 48, 591596.
M. W. Acklin:
Avoiding Rorschach dichotomies: Integrating Rorschach interpretation.
Journal of Personality Assessment, 1995, 64, 235238.
B. Ritzler:
Putting your eggs in the content analysis basket: A response to Aronow, Reznikoff an
Moreland.
Journal of Personality Assessment, 1995, 64, 229234.
J. H. Kleiger:
Rorschach shading responses: From a printers error to an integrated psychoanalytic
paradigm.
Journal of Personality Assessment, 1997, 69, 342364.
Most people have heard of the Rorschach test (pronounced "raw-shock"), but f
have ever seen a real Rorschach inkblot. The blots are kept secret. When you
inkblot in a popular article on the test (as in the Encyclopedia Britannica entry o
Rorschach test), it's a fake: it's an an inkblot, but not one of the inkblots. There
only ten Rorschach inkblots.
Psychologists want the blots to remain a secret from the general public so that
reactions to the blots will be spontaneous. Hermann Rorschach hoped these
spontaneous reactions would yield valuable clues to the test subject's persona
Whether they do remains controversial. Many psychologists think the Rorschac
is hopelessly unreliable; others see it as one of the cardinal tools of modern
psychodiagnosis. Even among those who acknowledge the value of the test, th
disagreement on interpretation of responses.
Just as secret as the blots themselves are the ground rules for administering th
There are a few things that you, as a subject, are supposed to know and a lot o
things you aren't supposed to know. If you ask about something you're not sup
to know, the psychologist will give you a pat answer as prescribed in Rorschac
literature. For example, if you ask if it is okay to turn the card upside down, the
psychologist will respond that you may do as you like; it's up to you. The psych
won't say that many of the cards are easier to interpret when turned; that most
people do turn the cards; that he or she will make a notation with a little arrowh
every time you do turn a card; and that you lose points in the initiative departm
you don't turn the cards.
You'll be handed the cards one by one in the fixed order devised by Rorschach
are numbers on the backs of the cards for the psychologist's benefit). The first
for instance, looks like a fox's head or a jack-o-lantern. The cards are thick,
rectangular cardboard, 6 5/8 inches by 9 1/5 inches. Half of the blots are black
a white background. Two others are black and red ink on white, and the last th
blots are multicolored. The psychologist will always put each card in your hand
"right" side up.
You aren't supposed to know it, but the psychologist will write down everything
say. This includes any seemingly irrelevant questions you may have. To keep y
from getting wise, the psychologist always arranges to sit to your side and a litt
behind you, so that you can't look at the card and the psychologist at the same
Most subjects realize the psychologist is taking notes, of course, but they don't
realize that the notes are a special shorthand record of everything said. Some
psychologists use hidden tape recorders.
The psychologist will also time how long it takes you to respond, using a "tickle
watch. The psychologist will not ask you to hurry up or slow down and will not m
any reference to time, but response times (in seconds) are one of the things he
she is writing in the notes.
Don't hold the card at an unusual angle. Watch how you phrase things. Say "T
looks like ..." or "This could be ..." never "This is..." After all, you're supposed to
realize that it is just a blot of ink on a card. By the same token, don't be too liter
say things as, "This is a blotch of black ink." Don't groan, get emotional, or mak
irrelevant comments. Don't put your hands on the cards to block out parts. The
psychologist will watch for all of the foregoing as signs of brain damage.
If there are no right answers for the test, there are some general guidelines as
what is a normal response. You can probably see images in the inkblots prope
in the white spaces they enclose. Stick to the former. Don't be afraid of being
obvious. There are several responses that almost everyone gives; mentioning
shows the psychologist you're a regular guy.
It is okay to be original if you can justify what you see in the shape, shading, or
of the blot. If you see an abalone and can point out why it looks like one, then s
Justifiable original responses are usually judged to be indicative of creativity or
intelligence.
You don't want non sequiturs, images that don't fit the blot in the judgment of th
psychologist. These may be signs of psychosis.
You're expected to see more than one thing on all or most of the cards. Not be
able to see anything on a card suggests neurosis. Usually the more things you
see, the better, as long as they fit the form and color of the blot. Of course, you
see things in the whole blot or in parts of it, and images may overlap.
Since time is a factor, it is important to come up with good answers fast. (It look
particularly bad if you take a long time and give a dumb, inappropriate answer.
most reliable way to come up with good answers is to memorize what the good
answers are. Copyright restrictions prevent us from showing you the blots
themselves, so we'll use outlines. We'll refer to the blots as psychologists do, a
Plates I through X. The psychologist won't mention the numbers to you, but the
will always be in order.
Plate I
Black ink. A roughly triangular shape, point down, suggesting a broad, fox like
with prominent ears. Naughty bits: a pair of breasts (rounded projections at top
blot); a vertical female figure, her torso partly visible through a gauzy dress (alo
center line).
The first blot is easy. How fast you answer is taken as an indication of how wel
cope with new situations. The best reaction is to give one of the most common
responses immediately. Good answers are bat, butterfly, moth, and (in center o
a female figure. Mask, jack-o'-lantern, and animal face are common responses
but in some interpretation schemes they suggest paranoia. A bad response is a
that says something untoward about the central female figure. "She" is often ju
to be a projection of your own self-image. Avoid the obvious comment that the
has two breasts but no head.
If you don't give more than one answer for Plate I, many psychologists will drop
hint--tell you to look closer.
Plate II
Black and red ink. Two dark-gray splotches suggesting dancing figures. Red
splotches at top of each figure and at bottom center. Naughty bits: penis (uppe
center, black ink); vagina (the red area at bottom center).
It is important to see this blot as two human figures usually females or clowns.
don't, it's seen as a sign that you have trouble relating to people. You may give
responses as well, such as cave entrance (the triangular white space between
two figures) and butterfly (the red "vagina," bottom center).
Should you mention the penis and vagina? Not necessarily. Every Rorsehach p
has at least one obvious representation of sexual anatomy. You're not expecte
mention them all. In some interpretation schemes, mentioning more than four s
images in the ten plates is diagnostic of schizophrenia. The trouble is, subjects
took Psychology 101 often assume they should detail every possible sex respo
so allowances must be made. Most Rorschach workers believe the sex images
should play a part in the interpretation of responses even when not mentioned.
may not say that the lower red area looks like a vagina, but psychologists assu
that what you do say will show how you feel about women. Nix on "crab"; stick
"butterfly."
Plate III
Black and red ink. Two obvious .figures (black ink) facing each other. Butterflyshaped red blot between the figures; an elongated red blot behind each figure'
head. Naughty bits: penises and breasts (at anatomically appropriate positions
each figure).
This is the blot that supposedly can determine sexual preference. Most people
the two human figures. Both figures have prominent "breasts" and an equally
prominent "penis." If you don't volunteer the gender of the figures, you'll be ask
specify it. By the traditional interpretation, seeing the figures as male is a
heterosexual response (for test subjects of both sexes). Describing the figures
female or acknowledging the androgynous nature of the blot is supposed to be
homosexual response. Does it work? Not really--many straights describe the fi
as women, and not all gays give a gay response. A 1971 study at Mount Sinai
Hospital in New York showed the traditionally heterosexual response (two male
figures) to be declining in popularity.
The splotches of red ink are usually perceived separately. Common responses
"bow-tie" or "ribbon" (inner red area) and a stomach and esophagus (outer red
areas).
Plate IV
Black ink. A roughly triangular blot, point up, with the two lower comer regions
resembling boots or pet. Naughty bits: two penises (on either side of blot, near
triangle); vagina (on center line near top of blot).
Plate IV is the "father card." At first glance it is a difficult blot to see as a single
The "boots" are fairly conspicuous; between them is the apparent head of a do
Chinese dragon. Many subjects see the blot as an animal skin. After a few sec
though, most can see it as a standing figure seen from below.
The boots become the feet, enlarged because of the unusual perspective. The
and head, at the top, are smaller. Common descriptions are bear, gorilla, or ma
heavy coat. Bad descriptions are monster or attacking bear or gorilla-Rorschac
theorists equate your description of the figure with your perception of your fath
male authority figures.
Plate V
Black ink. A simple, bat like shape. Naughty bits: two penises (the "ears" or
"antennae").
Rorschach himself thought this was the easiest blot to interpret. It is a bat or a
butterfly, period. You don't want to mention anything else. Seeing the projection
the ends of the bat wings as crocodile heads signifies hostility. Seeing the paire
butterfly antennae or feet as scissors or pliers signifies a castration complex.
Schizophrenics sometimes see moving people in this blot. Many psychologists
particular note of the number of responses given to this plate. If you mention m
images here than in either Plate IV or VI, it is suggestive of schizophrenia.
Plate VI
Black ink. An irregular shape like that of an animal-skin rug. Naughty bits: peni
(center line at top); vagina (below penis).
Plate VI is the most difficult blot. The best-rendered penis of all the blots is at to
few subjects mention it. The rest of the blot doesn't look like much of anything.
hold that the value of this blot is to have the subject grope for images and poss
reveal subconscious attitudes about sexuality.
Basically, the secret of this plate is to turn it. A good response is to say it looks
animal hide (about the only reasonable response when held right side up), then
on its side and say it looks like a boat or surfaced submarine with reflection, an
turn it upside down and say it looks like a mushroom cloud, a pair of theater m
or caricatures of men with long noses and goatees.
Plate VII
Black ink. A U-shaped blot, each side of the U resembling a female figure in a
narrow-waisted dress. Naughty bits: a vagina (on center line at bottom of U).
There is an entirely different side to this blot, but you're not supposed to see it.
white space between the girls or women can be interpreted as an oil lamp or s
object. It is claimed that only schizophrenics usually see the lamp.
Plate VIII
Pink, blue, gray, and orange ink. An almost circular array of interconnected form
gray triangle (point up) at top, a pair of blue rectangles in the center, a pink and
orange splotch at bottom, and two pink "animal" shapes forming the right and l
sides of the circle. Naughty bits: a vagina (pink-orange area at bottom).
The first full-color card is easy. It is important that you see the four-legged anim
lions, pigs, bears, etc. -on the sides of the blot. They're one of the most commo
responses on the test, and you're assumed to be a mental defective if you don
them. Other good responses are tree (gray triangle at top), butterfly (pink and o
area at bottom), and rib cage or anatomy chart (skeletal pattern in center betw
blue rectangles and gray triangles). The entire configuration can be seen as a
heraldic design (good answer) or a Christmas tree with ornaments (reaching).
Children tend to like this blot and say a lot about it-the bright colors and animal
shapes make it more interesting than your basic penis/vagina number (II, IV, or
Plate IV
Green, orange, and pink ink. A very irregular upright rectangle. Orange at top,
protruding green areas at center, pink at bottom. Naughty bits: a vagina (cente
at bottom).
There aren't many good answers here. If you're going to throw up your hands
(figuratively; see warning about emotional outbursts above) and plead a menta
block, this is the place to do it. The colors clash, apparently by Rorschach's de
Good answers are a fire with smoke, an explosion (but paranoids are claimed
apt to note the pale green mushroom cloud on the center line at top), a map,
anatomy, or a flower. If you turn the card ninety degrees, you can make out a m
head in the pink areas at bottom. (The man is identified as Mark Twain, Santa
or Teddy Roosevelt.) A bad response is to describe the orange areas at top as
monsters or men fighting---a sign of poor social development. As with Plate V,
psychologist may be counting the number of responses you give to this blot for
comparison with the preceding and succeeding blots. You want to give fewer
responses to this blot.
Plate X
Pink, blue, gray, green, yellow, and orange ink. A loose assortment of brightly c
shapes, the most chaotic of the plates. Naughty bits: penis and testes (top cen
gray ink).
The unspoken purpose of this last blot is to test your organizational ability. Plat
full of colorful odds and ends easy to identify---blue spiders, gray crabs, paired
orange maple seeds, green caterpillars, a light-green rabbit's head, yellow and
orange fried eggs--and you're expected to list them. But the psychologist will a
looking for a comprehensive answer, something that shows you grok the whole
Gestalt. There are two good holistic answers: sea life and a view through a
microscope. Some subjects see two reddish faces at top center, separated by
orange maple key. If you describe them as blowing bubbles or smoking pipes,
be interpreted as evidence of an oral fixation. Seeing the gray "testes" and "pe
two animals eating a stick or tree indicates castration anxiety.
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Common Psychological
matter."
Marvin W. Acklin, Ph.D, ABPP
Some additional notes from "Misuse of Psychological Tests in
Forensic Settings: Some Horrible Examples" by Ralph Underwager
and Hollida Wakefield
"Few evaluators using the Rorschach acknowledge its limitations. If
the Rorschach is used, its limitations should be clearly noted unless
the Exner system is used. And then, it is necessary to say what is
being scored by the Exner system. But often, idiosyncratic
interpretation techniques are used to form conclusions and make
recommendations which affect the lives of people."
"There is no empirical support for the validity of the Rorschach,
except when the Exner system is used. Reviews in the Buros
Mental Measurement Yearbook for every year in which this test has
been reviewed state that there is no research demonstrating its
validity. For example, in the Eighth Mental Measurements Yearbook
Peterson concluded: "The general lack of predicted validity for the
Rorschach raises serious questions about its continued use in clinical
practice.""
In commenting upon the use of the Rorschach, Dawes writes:
"Now that I am no longer a member of the American
Psychological Association Ethics Committee, I can
express my personal opinion that the use of
Rorschach interpretations in establishing an
individual's legal status and child custody is the single
most unethical practice of my colleagues. It is done,
widely. Losing legal rights as a result of responding to
what is presented as a "test of imagination," often in
the context of "helping" violates what I believe to be a
basic ethical principle in this society that people are
judged on the basis of what they do, not on the basis
of what they feel, think, or might have a propensity to
do. And being judged on an invalid assessment of
such thoughts, feelings, and propensities amounts to
losing one's civil rights on an essentially random
basis."
Example 8
The psychologist in this example interpreted the Rorschach as
reflecting:
[a] ... highly defensive stance which is accompanied
with blocking, censoring, and inhibition of his
underlying affect ... an undercurrent of anxiety,
unrequited love, and cloaked sexuality ... difficulty
with relating appropriately to others ... latent
polymorphous perverse orientation to the
environment ... fantasies (that may include)
homosexual, bisexual, and exhibitionist feelings ...
http://www.deltabravo.net/custody/rorschach2.htm
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an example
the model
mmse test
Rorschach test is a set of 10 plate
maked in the first half of past
century.
The author used symetrical ink
splashes
with different colours and forms.
The test allows evaluation
of various aspects
of personality.
In clinical psychopathology
it has high diagnostic specificitie
and sensibilities.
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