The Rorschach test

Despite spending 6 months of a 3 year neurology residency on the psychiatry service (as was typical in those days) the Rorschach test never came up. Of course, it was well known in the wider world, primarily by a joke.

For those who don’t know, the Rorschach test is a series of 10 inkblots and subjects were asked to tell the examiner what they brought to mind.  To learn more about the test see — https://en.wikipedia.org/wiki/Rorschach_test

The joke:  The response to all 10 by one frisky subject was that they reminded him of sex. The examiner asked him why he was so obsessed with sex. The subject asked the examiner why he was showing him dirty pictures.

There is a very interesting review of a book about Dr. Rorschach in the current issue of Science (vol. 355 p.588 ’17). The reviewer is at the Department of Translational Science and Molecular Medicine, Michigan State University, Grand Rapids, MI 49503, USA. Email: erin.mckay@hc.msu.edu

Here is the first part — unfortunately I can’t reproduce it all, as you must be a subscriber to Science —
“We’re all familiar with the inkblots that make up the Rorschach test: black and white, bilaterally symmetrical figures that hover close to familiarity. Or, at least, we think we are. In modern times,the term “Rorschach test” often serves as a metaphor for our divisiveness, as shorthand for an encoded message, or as a warning that appearances

Inkblots were used in psychology to gauge a person’s imagination for nearly two decades before Rorschach developed his version. Rorschach’s contribution was born of his desire to detect the differences in perceptual processes that explained seemingly nonsensical delusions and neuroses. When designing his inkblots, he can be deceiving. But we may not know as much as we think we do about this classic psychological tool or the man behind it, argues Damion Searls in The Inkblots: Hermann Rorschach, His Iconic Test, and The Power of Seeing.

In tracing the story of the inkblots, Searls sets out to restore two vital stipulations of the Rorschach test: that there are good answers and bad answers and that the test is a measure of perception, not of imagination or projection. The book addresses many questions fundamental to understanding the genesis and effectiveness of Rorschach’s eponymous test as well as the life of the man himself.

Hoping to create images that were suggestive of shape and movement, Rorschach hand-painted each of his 10 eponymous inkblots.”

It always seemed incredibly subjective to me (typical of much of psychoanalysis IMHO).

Not so.

I asked two friends long in the field, whose experience and intelligence and hardheadedness isn’t open to question.

The psychiatrist’s response

As a psychiatrist I was never trained in the Rorschach as psychologists are but have generally found them very helpful. In fact, I took one myself back in residency and had the psychologist interpret the results, which at the time left me feeling naked, ie, all my defenses stripped away.

My office mate doesn’t favor it largely for the reasons in the article: the lack of a scientific basis. Since he is a forensic psychiatrist, this drawback is even worse, since one might potentially have to present the results to a jury, which is almost universally likely to view it as hocus pocus even if there was more scientific basis.
There is a technology to interpret the results, but I think an experienced clinician is also key to its results being helpful. It gives a much deeper dimension to the findings s/w similar to other projective tests and relative to more scientifically based tests such as the MMPI.

Interesting article; thanks for sending.

The Psychiatric Nurse’s response

I actually did use the Rorschach test when leading groups on the in patient psychiatric unit at — a prominent Boston Hospiutal (1975-1980). It was always a challenge to get depressed, withdrawn, and psychotic people to express themselves. Trying to be creative and engaging, I would hold up the ink blots and get anywhere from 1-100 word responses……dependent upon their diagnosis! OF COURSE the bipolar manics, with pressured speech, had to be interrupted for the sake of time!

Then, the artist in me would come out. I had people make their own Rorschach’s with paint. It helped engage the withdrawn members in a different format. The response was that those with paucity of speech were able to express themselves in a non-verbal way. There was always more discussion stimulated by their own creations.

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