An overview on the Rorschach Test in psychological assessment
Sílvia Pereira, 2011/2012 - Cientific article presented at the XX International Congress of Rorschach and projective methods, Tokyo - Publshed in the "Japanese Rorschach journal"
Abstract
Currently, and despite the many proven over the time and its scientific developments, the Rorschach Test is still controversial. As such, it seems relevant to us the appropriate expression of contributions in order to consolidate the importance of this instrument of psychological assessment. While many agree with the idea of usefulness and validity of this test, others don’t. So, this paper explores the controversy and the usefulness of the Rorschach in psychological assessment of personality nowadays, as well as the validity and usefulness of its use in the future. The paper also suggests the need for a comprehensive approach of the test more concerned with the individual as a whole, more than what we can measure from him. The human being is much more than what we can measure!
An overview on the Rorschach Test in psychological assessment.
As everybody knows, nowadays the Rorschach test continues to generate controversy; however, it also continues to be one of the most widely used personality tests worldwide.
In clinical experience, in teaching and training courses it appears that also in Portugal, the Rorschach test is now increasingly used in psychological and neuropsychological evaluations as a useful and powerful tool in the evaluation of personality structure and emotional functioning, for new psychologists.
Means that the Rorschach, if properly understood, provides extensive and detailed explanations in psychological assessment in the various fields of psychology. So, it contributes to a reliable assessment of the individual's mental functioning, allowing to identify commitments, throughout the analysis that allows the development relatively to the balance, or not, of the internal psychological operations, supported, as claimed V'gotskíi (2007), in a relational and social context within the environment that surrounds it. Thus, the Rorschach allows us to realize that individuals are identical to each other in many aspects, but also that they are unique and different from all the others.
The productions that the Rorschach test raises reveal a work of thought (Chabert, 2000), and the study of the protocol covers the several articulations and inter-relationships inherent in this work. Chabert (2000) defends that this psychic work, as Rorschach calls it, raises the judgement function, however, I would rather say that, it raises the need for decision-making inherent to the mediation activities which are at the basis of higher psychological processes V'gotskíi (2007). But these decisions emerge impregnated with the individuals’ representations arising from their perceptions. Thus, individual representations, along with the affections, are, in Rorschach test, placed in the form of the individual's identity. As stated by Marques (1999), the relation between these two factors reveals what is the deepest that constitute the essence of the subject in the possibilities it presents, or not, of connection to itself and to the real and relational world - that allow us to access to the qualities and the nature of mental functioning.
Through the application of the Rorschach test the exploitation of human psychic functioning is made possible, through the specifics of this projective method.
The richness of the Rorschach components allows us to understand many features of human emotional and intellectual functioning, unveiling in an explicit and remarkable way present mental disorders and disorganizations. But it also allows us to obtain characteristics, sometimes barely perceptible, of the type of intellectual functioning, as well as valuable contributions to the interpretation and understanding of psychic functioning of the individual in a very precise moment of its existence.
Frank (1939) stated that the Rorschach method provides a technique whereby the individual is induced to reveal its private inner world, expressing what he sees in several blades where he can project his feelings, just because the blades don’t constitute socially standardized objects... The Rorschach method is essentially a system to reveal the personality of an individual as an individual, in contrast to systems that seek to classify it or determine its value according to its degree of compliance and adjustment to social standards of action and language. The Rorschach… is revealing, given that the examinee is unaware of what he is being expressing and has no cultural norms behind which to hide.
We believe that the Rorschach test appeals to the order of relation, of reality, of perception, of imagination, of interpretation and, of course, of projection, implying structural and sensory dimensions (Marques, 1999). As such, its use goes far beyond mere exploration of fantasy and imagination unlike what some colleagues suggest.
Through the application of the Rorschach test psychological functioning is, thus, activated and reactivated by the projective situation itself and the answer given clearly reflects the mode of psychological functioning (action and reaction) of the patient. The way their superior psychological functions operate dynamic, holistic and systemically (Luria, 1981) in terms of mental functioning, are understood taking into account the originality and individual uniqueness. Hence the importance of the results obtained in the Rorschach test: they express the psychological essence of the identity of the patient.
As Exner refers (2000), the greatest utility of Rorschach interpretation is when an understanding of a person as an individual becomes important for the purposes of treatment selection or when other important decisions concerning the individual are required. 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. If we can think of Luria findings in his neuropsychological approach, this is quite well understandable: he divided the human brain in three basic functional units – first, the alert and attention unit (located in the reticular formation and cerebellum); second, the reception, integration, coding and sensory processing unit (located in the occipital, temporal and parietal lobes) – units most involved in the processing and mediation processes; and third the motor execution, planning and self-regulation unit (located in the frontal lobes) – unit most involved in the control and ideation processes. Consequently, all of these are very much involved in every Rorschach responses.
Therefore, the Rorschach is a mental X-ray of the individual, where all his baggage of life emerges, where the individual specificities and the proper sense differ according to the forms of individual human psychic functioning, unique and particular.
Some controversial aspects in relation to Rorschach test refer to the issue of complexity: some colleagues argue that the Rorschach test is too complex, namely, that the Exner Comprehensive System is too complex to allow someone to be able to learn the basic aspects of the Rorschach method, especially for students of introductory courses. In this regard, we believe that the step by step formation courses, from the first contacts with the use of the test, going through permanent training with exploration of real-world cases, continuous training and training updates are essential for students of introductory courses immediately feel comfortable using the test and have a proper perception of all the assumptions involved in using the Rorschach test, but also it can help more experienced colleagues not making coding and interpretation mistakes as well as being aware of their difficulties. That’s the only way to improve skills in our work.
Another controversial aspect is the question of objectivity. On this issue it is worth thinking about objectivity not only as the measurement, quantification and verification of the similarity of the results, but also as the efficiency and richness of obtained data. Taking as an example the evaluation of intellectual capacities, the Rorschach test gives us much more complete, specific and objective information, than other psychometric tests where we can have a final conclusion based on the sum of several contributions obtained in the different determined aspects. From the statistical point of view it may be more objective, however, with the Rorschach test it is possible to verify a better inter-correlation of the different components of intelligence of the individual. That is, the way how these components are expressed by the individual, the current intellectual resources and those that are available, but also those who might be in use but, because of the presence of emotional disturbance, aren’t being used (Adrados, 2000).
On the issue of subjectivity of the examiner, Binder (1953) also states that "the practical results of the Rorschach method repeatedly show that the subjectivity of those who qualify it do not influence significantly, whenever the protocols are evaluated by true connoisseurs of the test, who have handled a sufficiently extensive material that they can use as a point of comparison in order to accurately and safely ponder on the results". We believe in this statement. This is because, even when submitting a protocol to analyze to a number of experienced experts in the Rorschach test, it appears that the results are very similar or even equal.
Yet in order to refute the issue of subjectivity, the application of the Rorschach test to a patient repeatedly between short intervals of time, gives us the opportunity to realize that, if there are no significant changes in their life experience, the results remain consistent, with no sensitive modifications, in their personality structure.
Thus, we believe that the issue of objectivity versus subjectivity of the Rorschach test is a false issue. The codings are clear and are only assigned to an answer when they are present. Hence, in our view, the Rorschach test seems to us, in fact, very objective. After all, we have to answer very clear and objective questions when faced with the issues related to coding: does the response have colour? What kind of color? Does it have movement? What kind of movement? Does it have texture, does it have relief, does it have depth, does it have dimension, etc? Of what kind? The answer to these questions seems quite objective to us and without any place for subjectivity or own interpretation of the examiner or the examinee. The minuteness of the variables and the attention given to every detail of the response removes, in our opinion, any doubt as to the issue of subjectivity. There is a valuation of all the factors involved in the response.
From the many environments of training and supervision in Rorschach we attend and from the many conversations with colleagues, who use the Rorschach test in their professional practice regularly, come a common idea: of course there is no scientific breakthrough without criticism – a constructive one I guess.
However, it is important to underline that, in general, the criticism is often made by colleagues, on one hand, that does not always hold a deep knowledge of the Rorschach test or are unfamiliar with it, and on the other hand, may be too focused on the data interpretation process propelled by the deviation principle (that is, a datum is seemingly very different than expected when normative findings are used as the basis for the expectation) (Exner, 2000), or even they may have as single purpose of evaluation, to select the diagnostic label only - Rorschach goes far beyond that. As such, little attention is paid to the rich and various elements made available by the test. Other criticisms often heard are still expressed by colleagues who do not use the test at all. So, the criticism emerges, in many cases, by unawareness, rather than by the real contestation to the real knowledge provided by the Rorschach test. It is, therefore, not acceptable that the lack of familiarity with the test is the basis for the criticism. The examiner is required to dominate the psychological assessment tools he uses, since the more he knows about the test, more probabilities he will have to know more about his patient.
Of course we have to question, to research, to investigate! Only then we can move forward in the analysis of human mental functioning, but regarding the Rorschach test, it does not seem to us that we can do it if we do not respect the basic assumptions of the test. Nowadays, the enormous and increasing scientific work you can find are seeking to determine the stability of scores and to discover the relationship between Rorschach responses and other criteria. A lot of work can be found in this issue, increasing every year as we can see in the many international Psychology congresses and meetings worldwide.
So, more modern and refined studies are very important, of course, but it must be done carefully, not to deviate too much from the main guidelines and standards that Hermann Rorschach clearly defined.
As it could not be different, to do so, it becomes essential that psychologists working in the field of psychological assessment with the Rorschach test invest in their ongoing training and frequent supervision, so as to minimize the difficulties they may feel and experience in the application, coding and interpretation of the Rorschach test.
Thus, they will be contributing, on the one hand, to a significant improvement of their performance as professionals, but on the other hand, to dissipate doubts and defend sustained criticism that can be used for a real deepening of knowledge and scientific development within the psychological assessment of personality and emotional functioning through the use of the Rorschach test, in order that the projective value of this instrument can be maximized. It seems clear that, as claimed by Exner (2001), “practice is the key to proficiency”.
Final considerations
For all this, and in conclusion, we understand the Rorschach Test as a remarkable instrument that continues to be very valuable and powerful in the psychological evaluation, but also as a tool that allows us to develop and move forward within the understanding of human psychic functioning through research. In sum, we consider essential for the development and evolution of psychological assessment of personality that in the future, the Rorschach remains one of the working tools of choice.
References
Adrados, I. (2000). Teoria e prática do teste de Rorschach. Rio de Janeiro: Editora Vozes.
Binder, H. (1953). Lehrbuch der Rorschach Psychodiagnostik. Na tradução espanhola, Madrid: Ediciones Morata.
Chabert, C. (1999). O Rorschach na clínica do adulto. Lisboa: Climepsi.
Chabert, C. (2000). A psicopatologia à prova de Rorschach. Lisboa: Climepsi.
Exner Jr., J. E. (2007). A Rorschach Workbook for the Comprehensive System, 5th Edition. Rorschach Workshops, Asheville, North Carolina.
Exner Jr., J. E. (2003). Basic Foundations and Principles of interpretation, 4th Edition. The Rorschach – A Comprehensive System. Vol. I. John Wiley & Sons, Inc. Hoboken, New Jersey.
Exner Jr., J. E. (2006). A primer for Rorschach interpretation. Rorschach Workshops, Asheville, North Carolina.
Frank, L. K. (1939). Comments on the proposed standardization of the Rorschach Method. Vol.3. Rorschach Res. Exchange.
Luria, A.R. (1981). The working brain – An introduction to neuropsychology. Na tradução portuguesa, Rio de Janeiro: Livros técnicos e científicos Editora & São Paulo: Editora da Universidade de São Paulo.
Marques, M. E. (1999). A psicologia clínica e o Rorschach. Lisboa: Climepsi.
V’gotskíi, L. S. (2007). A formação social da mente. São Paulo: Martins Fontes.