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Covers history, admin. & scoring, working tables & descriptive stats., interpretation, applications, etc.
The 10 figures that constitute the stimuli of the Rorschach test were first unveiled to the professional public in September 1921, with the release of Hermann Rorschach's famed monograph, Psychodiagnostik (1941/1942). Since that time, the test has generated much interest, extensive use, and considerable research. For at least two decades, the 1940s and 1950s, its name was almost synonymous with clinical psychology. During those years, the primary role of the clinician focused on assessment or psychodiagnosis. Although the role of the clinician broadened and diversified during the 1960s and 1970s, the Rorschach remained among the most commonly used tests in the clinical setting, and that status continues today. This is because considerable information about the psychological characteristics of an individual can be derived if the test is properly administered, scored, and interpreted.
Most any intelligent person can learn to administer and score (code) the Rorschach. The procedures are reasonably straightforward. On the other hand, Rorschach interpretation is neither simple nor mechanistic. It is a complex process that can be demanding. It is complex because it requires the interpreter to maintain a framework of logical conceptualization, without which it is impossible to develop meaningful conclusions. The process is demanding because it requires the interpreter to frequently challenge the integrity of the data. On the other hand, the routines of interpretation, that is, systematically questioning data and conceptually organizing findings, are not difficult to learn if the student of the testhas each of three basic prerequisites.
A first prerequisite is a reasonably good understanding of people and the notion of personality. This does not mean that the Rorschach data are, or should be, interpreted directly in the context of any particular theory of personality. That probably is a mistake. Rorschach-based conclusions ultimately can be translated into any of a variety of theoretical models concerning personality but, before doing so, the data should be interpreted in a manner that is consistent with findings on which their validity has been based.
Rorschach interpretation always proceeds with the objective of developing an understanding of the person as a unique individual. Stated differently, an awareness that no two people are exactly alike should prompt any interpreter to strive for an integration of findings about characteristics such as thinking, emotion, self-image, controls, and so on in a manner that highlights individuality as much as possible.
A second prerequisite for Rorschach interpretation is a good working knowledge of psychopathology and maladjustment. This does not mean a simple awareness of diagnostic labels, or a naive assumption that concepts such as normal and abnormal establish discrete criteria from which assets and liabilities can be identified. Rather, a good understanding of psychopathology and/or maladjustment evolves from an appreciation of how characteristics become liabilities, and how various mixtures of liabilities breed forms of internal and/or external maladjustment.
The third prerequisite is that the interpreter must have an understanding of the test itself. It consists of 10 inkblot figures which, when administered in a standardized manner, prompt the individual to make a sequence of decisions that lead to a series of responses. Once the responses are coded or scored, compiled sequentially, and used as a basis for numerous calculations, three interrelated data sets will exist:
The verbiage used by the subject when giving answers or responding to questions raised by the examiner,
The sequence in which the responses have occurred as reflected in both the substance of answers and the coding or scoring of them, and
The structural plot of frequencies for nearly 100 variables from which data for more than 60 variables, ratios, percentages, and indices are derived.
Collectively, these three data sets form the interpretive substance of the test and, typically, will yield enough information to construct a valid and useful description of the psychology of the individual.
Why bother using the Rorschach? There are many assessment methods that can produce valid and useful descriptions of people and, although a Rorschach-based description of a person usually is quite comprehensive, it stems from a rather modest sample of indirect behaviors (responses to inkblot figures). Thus, findings and conclusions are mainly inferential. What value do these inferentially based Rorschach descriptions of people have when contrasted with descriptions formulated after a well-developed interview, findings from other psychological tests, or a description based on the observations of significant others?
The answer to this question is not as straightforward as some Rorschach advocates might hope. In reality, Rorschach findings may have little or no value in some assessment situations. For instance, if an assessor or referring party is convinced that a "hardwired" relationship exists between the presenting symptoms of the person and the most appropriate treatment for those symptoms, Rorschach findings will contribute little or nothing to a treatment decision. There are other cases in which the purpose of the assessment is to select a diagnostic label. Rorschach findings can contribute to this decision, but it is a time-consuming test and other assessment methods might achieve the "labeling" objective more efficiently.
The greatest utility of the Rorschach is when an understanding of a person, as an individual, becomes important for the purpose of selecting treatment strategies or targets, or when that sort of information is important to other decisions concerning the individual. Few, if any, assessment procedures can capture the uniqueness of the person as does the Rorschach when used appropriately. This is because Rorschach responses are produced by a relatively broad range of psychological operations and experiences.
The same functions and experiences that generate Rorschach responses also produce other behaviors, such as those observed by friends or relatives, or noted by those conducting formal interviews. Behavioral descriptions of a person that are derived from observations of significant others or produced from lengthy interviews often are reasonably accurate but, typically, those descriptions do not include information about the psychological functions that produce the observed behaviors. The Rorschach results contain this sort of information.
The nature of the Rorschach task prompts a routine of decision making under the rather unusual conditions of looking at inkblot figures. A host of psychological characteristics come into play when this decision making is required and, because of this, the responses tend to reflect the features of the person as he or she goes about the routine decision making of everyday living. Many of these characteristics are not readily apparent to the observer of everyday behaviors. Observations focus on the products of psychological processes, that is, the behaviors. The Rorschach findings mainly reflect the processes that generate behaviors.
It is in this context that the Rorschach interpretations focus on the psychological organization and functioning of the person. The Rorschach test gives greater emphasis to the psychological structure or personality of the individual rather than to the behaviors of the person. It is the sort of information that goes beyond the identification of symptoms and searches out etiological issues that distinguish one person from another, even though both may present the same symptomatology. Why bother with the Rorschach? If a picture of the individual, as a unique psychological entity, will contribute significantly to the well-being of that individual by assisting in the selection of a treatment plan or contributing to other important decisions, the few hours involved in administering, scoring, and interpreting the test should be well worth the effort.
As noted earlier, anyone intending to develop skill in the use of the Rorschach should understand the nature of the test and how it works. Some of that understanding is gleaned from history, that is, how the test originated and how it evolved.
Although the Rorschach has become an important clinical tool, its development has not always proceeded in a very systematic manner. Notions about what the test is, and is not, and how best it can be used, have varied considerably over time, and its history has often been marked by controversy. It has often proved baffling to researchers, and very irritating to those advocating the stringent application of psychometric principles to any psychological test. In retrospect, it seems obvious that many of the problems that have marked the development of the test occurred because most of those directly involved with it were not always clear about Rorschach's conceptions or intentions, or not always ready to study it in the sort of empirical framework that Rorschach established in his own research.
Rorschach died at the age of 37, only seven months after Psychodiagnostik, was published. The 183 pages (English translation) that comprise the monograph are rich with concepts, findings, and case examples, but many issues about which Rorschach wrote are not fully explained, and some are addressed briefly, or in a manner that leaves important questions unanswered. This is not surprising because Rorschach did not regard his work as having yielded a test per se and, by no means, considered his work to be complete. Instead, he viewed his monograph as a report of findings from an investigation into perception. The original title that Rorschach selected for his monograph was, Method and Results of a Perceptual-Diagnostic Experiment: Interpretation of Arbitrary Forms. The issue of the title was raised in early August of 1920, when the manuscript was being reviewed before the type setting began. Walter Morgenthaler, a close friend and colleague, who was serving as the professional editor for the project, wrote to Rorschach:
I take this opportunity to include a word about the title of your work. I believe you are being very modest about it. Your subject concerns more than just Perception Diagnostics, much more than that, and all together more than a "mere" experiment. I would, therefore, like to suggest as the main title (in caps) PSYCHODIAGNOSTIK (or something similar). . . . As a subtitle I could see: "Through the Interpretation of Chance Forms," or "Experimental Investigations With the Interpretation of Accidental Forms." (Morgenthaler, 1920/1999)
Rorschach was not receptive to this suggestion and two days later wrote to Morgenthaler:
Now about this title. It is not just modesty, I have a sense of responsibility for the title. I have brooded a long time about this . . . but nothing has come forth that has suited me. Expressions such as Psychodiagnostik, Diagnostics of Diseases and Personality, and the like seem to me to go much too far. . . . Perhaps later, when there is a norm created through controlled investigations, such an expression can be used. For now it strikes me as being too pompous. . . . So I should like to ask you to let the title stand as it is. (Rorschach, 1920/1999)
But this did not end the matter and, for the next several days, Morgenthaler continued to argue forcefully for a title change, emphasizing that the original title could create difficulties in marketing the book. Before the end of the month, Rorschach acquiesced, "Not very happily I yield, but your arguments are weighty and so I can do nothing else."
The reasons for Rorschach's decision to investigate the use of inkblots as a way to detect characteristics of people are not fully clear. It was not an original idea, but his approach was distinctive. There had been several attempts to use inkblots as some form of test well before Rorschach began his investigation. Binet and Henri (1895–1896) had tried to incorporate them into their early efforts to devise an intelligence test. They, like many of their day, believed that the inkblot stimulus might be useful to study visual imagination. They abandoned the use of inkblots because of group administration problems. Several other investigators in the United States and Europe published articles about the use of inkblots to study imagination and creativeness (Dearborn, 1897, 1898; Kirkpatrick, 1900; Parsons, 1917; Pyle, 1913, 1915; Rybakov, 1911; Whipple, 1914). It is doubtful that any of this work stimulated Rorschach's original study, but it is likely that he became familiar with much of it before he wrote his monograph.
It is certain that Rorschach often played the popular Klecksographie (Blotto) game as a youth. In fact, he even had the nickname "Klex" during his last two years in the Kantonsschule, which might have reflected his enthusiasm for the game. Ellenberger (1954) has suggested that the nickname may simply have evolved from the fact that Rorschach's father was an artist, but that notion seems less plausible than the fact that Rorschach himself developed considerable artistic skill during his youth. Even before reaching adolescence, he was in the habit of making pencil sketches in small notebooks, and during adolescence created many very detailed ink drawings. In late adolescence and through the remainder of his life, he painted extensively with water colors. Most of his sketches and paintings are relatively small, and are quite remarkable for their realism and exquisite detailing. In fact, this skill probably contributed substantially to the creation of the 10 figures that were published with the monograph and comprise what has become known as the Rorschach Test.
It is very probable that his close friendship with a classmate from the Kantonsschule, Konrad Gehring, played an initial role in stimulating his exploration of the use of inkblots with patients. The Klecksographie game had flourished in Europe for several decades by the time Rorschach began his psychiatric residency in 1910 at the Münsterlingen Asylum on Lake Constance. The game was a favorite of both adults and children, and had several variations. Inkblots (Klecks) could be purchased in some stores or, as was more commonplace, players of the game could create their own. Sometimes, it was played by creating poem-like associations to the blots (Kerner, 1857). In another variation, a blot would be the centerpiece for charades. When children played the game in school, they or the teacher usually would create the blots and then compete in developing elaborate descriptions.
Konrad Gehring became a teacher at an intermediate school close to the Münsterlingen Asylum, and he and his pupils often visited the hospital to sing for patients. Gehring had discovered that if he contracted with his students to work diligently for a period of time and then permitted them to play Klecksographie, it not only provided an incentive, but his classroom management problems also were reduced considerably. This routine caused Rorschach to question whether Gehring's gifted pupils demonstrated more fantasy in their inkblot responses than did the less gifted pupils. In 1911, a brief "experiment" ensued, lasting only a few weeks, but the procedure and results caused Rorschach to become intrigued with the management potential that the game seemed to offer, and also provoked an interest in making comparisons between the Klecksographie responses of Gehring's male adolescent students and his own adult patients. Thus, in a very casual and unsystematic manner, they worked together for a brief period, making and testing out different inkblots.
It is possible that little would have come from the Rorschach-Gehring "experiment" had not another event occurred during the same year. This was the publication of Eugen Bleuler's famed work on Dementia Praecox in which the term schizophrenia was coined. Bleuler was one of Rorschach's professors and he directed Rorschach's Doctor's Thesis, which concerned hallucinations. The Bleuler concepts intrigued the psychiatric community, but they also posed the very important issue of how to differentiate the schizophrenic from those individuals with other forms of psychosis, especially those with organically induced dementia. As almost a passing matter, Rorschach noted that patients who had been identified as schizophrenic seemed to respond quite differently to the Klecksographie game than did others. He made a brief report of this to a regional psychiatric society, but little interest was expressed in his apparent finding. Thus, Rorschach did not pursue the matter with any thoroughness for several years.
In 1910, Rorschach married a Russian, Olga Stempelin, who was studying medicine in Switzerland. They agreed to ultimately practice in Russia. Rorschach completed his psychiatric residency in 1913 and moved to Russia with the expressed intention of remaining there for quite some time. He obtained a position at the Krukova Sanitorium where he worked for about five months, but then returned to Switzerland and accepted a position as a resident psychiatrist at the Waldau Mental Hospital near Bern, where he was to work for the next 14 months. It was during that time that he renewed his close friendship with Walter Morgenthaler, a senior psychiatrist at the hospital. It is very evident that Morgenthaler stimulated Rorschach's thinking about the potential usefulness of inkblots, and he played a key role in the publication of Rorschach's monograph.
In 1915, Rorschach obtained a position as a Senior Psychiatrist at the Krombach Mental Hospital in Herisau, and later became the Associate Director of that facility. It was at Herisau, in late 1917 or early 1918, that Rorschach decided to investigate the Klecksographie game more systematically. It is likely that the stimulus to that decision was the publication of the "Doctor's Thesis" of Szymon Hens, a Polish medical student who studied under Bleuler at the Medical Policlinic in Zurich. Hens developed his own series of eight inkblots which he group administered to 1,000 children, 100 nonpatient adults, and 100 psychotic patients. His thesis focused on how the contents of responses were both similar and different across these three groups, and he suggested that a classification system for the contents of responses might be diagnostically useful (Hens, 1917).
There is no doubt that Rorschach questioned the conclusions offered by Hens. Hens' approach to classification was very different from the one Rorschach and Gehring had conceptualized in their casual 1911 exploration. Unlike the Hens emphasis on classifying content, Rorschach was interested in classifying other salient characteristics of the responses. He was familiar with much of the literature on perception and seemed intrigued with, and influenced by, the concepts of Ach, Mach, Loetze, and Helmholtz, and especially the notion of an apperceptive mass. That concept is subtly pervasive in much of his writing.
Rorschach began his systematic investigation with the premise that groups of individuals, when presented with a series of inkblots, would be differentiated by the characteristics of their responses to the question, What might this be? It is evident that one of his basic postulates was that this variation of the Klecksographie procedure might ultimately lend itself as a way of differentiating schizophrenia.
Rorschach made dozens of inkblots in preparing for his experiment. It is certain that he made at least 40, and tried out different combinations of 15 to 20 at the onset. Shortly after beginning this pilot work, he decided against using simple inkblots. He did not write much about that decision. His failure to do so, plus the manner in which he described the "Apparatus" in his monograph, caused many to assume that the figures of the test are largely ambiguous inkblots. But that is not true.
Each of the figures in the test contain numerous distinctive contours that are reasonably commensurate with objects with which most people have familiarity. Nonetheless, for several decades after the test was published, most who used and researched it were unaware of the substantial frequency of potentially reasonable answers that seem to be readily available to most people. There are probably several reasons for this, beginning with Rorschach's report of his experiment. In the monograph, Rorschach wrote, "The production of arbitrary forms is very simple: a few large ink blots are thrown on a piece of paper, the paper is folded, and the ink spread between the two halves of the sheet " (p. 15). This description carries the implication that the stimulus figures are ambiguous inkblots. Beyond this point in the monograph, he discontinued the use of the term inkblot (klecks) and referred to the materials as pictures (bilder), plates (tafeln), or figures (figurs).
He also wrote, "Not all figures so obtained can be used, for those used must fulfill certain conditions . . . the forms must be relatively simple . . . [they] must fulfill certain requirements of composition or they will not be suggestive, with the result that many subjects will reject them as "simply an inkblot . . ." (p. 15). Most who are familiar with the monograph have tended to assume that the figures he selected for use in the test were selected from a larger group of inkblots that he created, but that assumption probably is not entirely correct.
Rorschach typically made his inkblots on tissue paper. A large number of them were donated to the Rorschach Archives and Museum in 1998–1999 by his son and daughter, Wadim and Elisabeth Rorschach. They had been safekeeping a large quantity of their father's papers, protocols, tables, correspondence, figures, and artwork until a satisfactory site could be established for their storage and display. Between 15 and 20 of the tissue paper blots have some similarity to the published figures, but none contain the exquisite detailing that is evident in the figures used in the test. Seven or eight of the tissue paper blots might easily be confused as being the published figures at first glance, but even a casual comparison reveals the published figures are much more precisely detailed.
It is possible that Rorschach discovered some method for creating much more detailing when creating inkblots, but it seems more likely that he used his considerable artistic talent to detail and embellish the figures that he produced, and add some of the colorings. In doing so, he added many more contours and colors to those that appeared in the original blot. He did this to ensure that each figure contained numerous distinctive features that could easily be identified as similar to objects stored in the memory traces of the individual. This was important in constructing the figures because the premise underlying his experiment was based on the perception of arbitrary "forms."
Rorschach did not elaborate further on the manner in which the figures were created, but he did briefly mention the importance of "two or three parallel series" that he was creating, or intending to create, with the objective that each parallel figure should be designed so that, " the number of answers should compare favorably. Plate I of the new series should give approximately the same number of F's and M's as Plate I of the original, and so on. Plate V of the parallel series should present an object equally easy to recognize . . ." (p. 52).
After a few months, he had created a series of 15 or 16 figures that seemed most useful for his purpose. He used at least 15 figures through much of 1918, and possibly into early 1919. Then, apparently after reviewing his findings, reduced the series to 12 figures, and continued to administer the 12 figures until circumstances caused him to eliminate two more.
During the period from 1917 to 1919, he maintained frequent contact with Morgenthaler and also presented three brief papers concerning his experiment at professional meetings. It was in this time frame that Morgenthaler encouraged him to publish information about his experiment and, by mid-1919, Rorschach became convinced that his work had progressed sufficiently to warrant publication. He was especially interested in having the figures that he was using printed in a standard format so that they could be used by the numerous colleagues who had expressed interest in his work.
The data that Rorschach had analyzed by mid-1919 were sufficient for him to demonstrate that the method he had devised offered considerable diagnostic usefulness, especially in identifying schizophrenia. In the course of the investigation, he also discovered that clusterings of high frequencies of certain kinds of responses, mainly movement or color responses, appeared related to distinctive kinds of psychological and/or behavioral characteristics. Thus, the method seemed to have both a diagnostic potential and the possibility of detecting some qualities of the person which, in the terminology of contemporary psychology, would probably be called personality traits, habits, or styles.
In addition to Morgenthaler, other colleagues, including Bleuler, were impressed with Rorschach's experiment and the diagnostic potential that it seemed to hold. Several pleaded with him for a loan of the figures he was using so that they could try them out and numerous colleagues encouraged Rorschach to publish his findings in a form from which others could learn to use the method. Gradually, Rorschach became enthusiastic about this prospect, but encountered a significant obstacle when he proposed the work to several publishers. They were uniformly negative about the printing of the inkblot figures, citing the complexities and expense involved. One publisher expressed interest, provided that the printing of only one figure would be required. Another agreed to publish a manuscript but with the proviso that the number of figures be reduced to six. Rorschach rejected these possibilities but continued with his work, adding more subjects to his samples.
It was at this point that Morgenthaler interceded on Rorschach's behalf. Morgenthaler was, at that time, a consulting editor for the firm of Ernst Bircher, a publishing house specializing in medical books. Morgenthaler had agreed to organize a series of works, to be published by Bircher, concerning various issues in psychiatry. He was also well along toward the completion of two books to be included in the series. One of these, planned as the first in the series, was a book about one of Morgenthaler's patients named Wölfli, which attracted much interest after it was published (Morgenthaler, 1921/1992). It contained considerable artwork that was difficult to reproduce accurately. The manner in which Bircher addressed the problem of the Wölfli artwork convinced Morgenthaler that he could also deal successfully with the problems involved in reproducing the blots that Rorschach had created, and he appealed to Bircher to undertake the publication of Rorschach's monograph.
Bircher agreed, somewhat reluctantly, but some compromises were necessary. Bircher refused to reproduce more than 10 inkblot figures and also decided that those used by Rorschach were too large. Although probably dissatisfied, Rorschach agreed to rework the various data tables that he had created so that they would reflect the accumulated findings for only 10 figures. He also agreed to a one-sixth reduction in the size of the figures, but even well into 1920, before the final manuscript was submitted, appealed for at least one more figure to be added to the series.
After the final manuscript was submitted in July 1920, Rorschach had to reduce it by more than 60 pages because of cost factors, but more significant problems occurred as the proofs of the figures were created. When they were reproduced, some of the colors were altered substantially, especially on Cards VIII and IX, and a much greater differentiation in the shades of grey and black were produced in the achromatic figures. Whereas three of Rorschach's original figures (IV, V, and VI) had been created with almost no shading, the printing process created very notable contrasts in the tones. Ultimately, Rorschach accepted these "glitches" as offering new possibilities (Ellenberger, 1954), but it is clear that he was not enthusiastic about them at the onset. Proof versions for all of the original figures were made at least twice, and as many as four proofs were created for some of the plates. Finally, in October 1920, Bircher wrote to Rorschach, ". . . the glitches can no longer be changed . . . I cannot do it because each print costs too much."
The manuscript was finally published in September 1921. Much of it is based on the findings that had accumulated for 405 subjects, of which 117 were nonpatients that he subdivided into "educated" and "noneducated." The sample also included 188 schizophrenics who comprised his basic target population. True to his casual 1911 observations, the schizophrenic group did respond to the figures quite differently than did the other groups. His major thrust avoided and/or minimized content and, instead, focused on the development of a format for classifying responses by different characteristics. He developed a set of codes, following largely from the work of the Gestaltists (mainly Wertheimer), that would permit the differentiation of response features. One set of codes, or scores as they have come to be called, was used to represent the area of the blot to which the response was given, such as W for the whole blot, D for large detail areas, and so on. A second set of codes concerned the features of the blot that were mainly responsible for the identification of the image reported by the subject, such as F for form or shape, C for chromatic color, and M for the impression of human movement. A third set of codes was used to classify contents, such as H for human, A for animal, An for anatomy, and so on.
Rorschach sternly cautioned that his findings were preliminary and stressed the importance of much more experimentation. It is apparent that he looked forward to much more research with the method and invested himself vigorously in it during the next several months. But then tragedy struck. On April 1, 1922, he was admitted to the emergency room at the Herisau hospital after having suffered abdominal pains for nearly a week. He died the next morning from acute peritonitis. He had devoted less than four years to his investigation of the "Blotto Game." Had he lived to extend his work, the nature of the test and the direction of its development might have been much different than proved to be the case.
It is evident that Rorschach was disappointed about the seeming indifference to his work after Psychodiagnostik was published. The only Swiss psychiatric journal did not review it and other European psychiatric journals did little more than publish brief summaries of the work. The monograph was a financial disaster for the publisher. Only a few copies were sold before Rorschach died and before the House of Bircher entered bankruptcy. Fortunately, the subsequent auction of Bircher goods left the monograph and the 10 plates in the hands of a highly respected publishing house in Bern, Verlag Hans Huber. Huber's reputation for quality publications, plus a few favorable reviews of the monograph, stimulated interest in pursuing Rorschach's work further. However, Rorschach's death, and the fact that the figures created in the printing were somewhat different than those used by Rorschach in his experiment, posed a significant problem for those who would try to continue his work. But, as discussed in the next chapter, those were only the basic seeds of problems for those who became interested in developing and using Rorschach's method.
The Nature of the Rorschach.
ADMINISTRATION AND SCORING.
Decisions and Procedures.
Scoring: The Rorschach Language.
Location and Development Quality: Symbols and Criteria.
Determinants: Symbols and Criteria.
Blends, Organizational Activity, and Form Quality.
Content Categories and Populars.
The Structural Summary.
WORKING TABLES AND DESCRIPTIVE STATISTICS.
Normative Data and Reference Samples.
Some General Guidelines.
The Tactics of Interpretation.
Key Variables 1--SCZI, DEPI, CDI.
Key Variables 2--The D Scores: Control and Stress Tolerance.
Key Variables 3--Dominant Personality Styles.
Cluster Interpretation 1--The Cognitive Triad.
Cluster Interpretation 2--Affect, Self-Perception, Interpersonal Perception.
Integrating Findings to Address Issues.