Chapter 2a: Hermann Rorschach



CHAPTER 1

INTRODUCTION:

A PSYCHOLOGICAL X-RAY: THE POWER OF THE RORSCHACH

“The Rorschach, as a test, provides a broad array of data concerning many characteristics of the individual that, if read correctly, provide an in-depth portrait of the individual as an individual” John Exner, 1997

For more than half a century psychologists have prized the Rorschach as one of their most precious instruments. The patient is shown 10 inkblots and asked to tell what each resembles.[i] When scored and interpreted by an expert, the patient's responses to the blots are said to reveal a full and in-depth portrait of his or her personality.

Called a “psychological x-ray”[ii] and "perhaps the most powerful psychometric instrument ever envisioned,”[iii] the Rorschach is administered to more than a million people throughout the world each year. In the United States, where the test is routinely used in schools, mental health clinics, and legal cases, it is probably administered hundreds of thousands of times annually.[iv] Only one other personality test, the Minnesota Multiphasic Personality Inventory, is more popular.[v] Psychologists who advise courts in custody cases often use the Rorschach to help determine which parent a child will live with. The test is used in schools to identify children’s emotional and learning problems, and in prisons to evaluate prisoners for parole. Convicted murderers facing the death penalty, suspected victims of sexual abuse, young men seeking to enter the priesthood, airline pilots suspended from their jobs for alcohol abuse -- all may be given the Rorschach by a psychologist who will use the test scores to make critical decisions about their lives.

As a method of introducing the reader to how the Rorschach works, let’s begin by discussing a test spread on the desk in front of me, recently administered to a deeply disturbed 50-year-old man. I will begin by interpreting the findings, then examine how they reflect this man’s inner and outer realities. In this way we can gain a deeper understanding of the Rorschach and its power.

A Blind Analysis of Rorschach Scores

from a Deeply Disturbed 50-year-old Man

Rorschach experts sometimes engage in “blind analysis,” interpreting the test results without any information about the patient except age and gender. A blind analysis is the acid test of the expert’s skill because all the interpretations are based on the inkblot results alone. My blind analysis of this man's test results are based strictly on his Rorschach scores. The interpretations are taken from recent books by John Exner and Irving Weiner, the two most influential contemporary authorities on the Rorschach.

Most psychologists who use the Rorschach tend to interpret it “by the book,” adhering closely to the guidelines supplied by these two experts. Especially important are Exner’s manuals, which give detailed, step-by-step rules for the interpretation of each important Rorschach score. Weiner’s interpretive guide is used for more “in depth” understanding. In keeping with current practice, I have adhered closely to Exner’s and Weiner’s rules and recommendations. In a sense, I am simply a clerk transcribing what they have to say. Here, then, is a blind analysis of this man’s Rorschach, based on the interpretive guidelines of the test’s leading exponents.

Impaired thinking.

A patient’s statements while taking the Rorschach are written down verbatim in a transcript called a “protocol.” At the beginning of the interpretive process, the psychologist determines whether the images recorded in the protocol actually fit the shape of the blots. For example, one Rorschach blot is obviously shaped like a cat. If a patient looks at it and says that it looks like a cat, the response is considered to have “good form quality.” On the other hand, if the patient says that it looks like a giraffe, the response is considered “poor form quality,” because a giraffe really doesn’t fit the blot’s shape.

The Rorschach protocol on my desk shows that the man gave several responses with poor form quality. For example, in one blot he reported seeing an owl, even though the blot really doesn’t look much like an owl at all. In another blot he reported seeing “two blue crabs doing a tango,” a strange image bearing only the remotest resemblance to the blot itself.

When normal individuals take the Rorschach they are expected to give no more than 1 or 2 responses with poor form quality.[vi] By contrast, the man whose protocol I am examining gave 8. Exner and Weiner’s books indicate that the poor form quality of the man’s responses is highly unusual and that he probably suffers from moderately impaired thinking and a significantly distorted view of reality. [vii] It is likely that in several significant areas of his life he misinterprets events and the actions of people.

The man also gave several responses that involved people in movement, including “two women preparing dinner” and “two dancing dervishes.” Furthermore, the protocol shows that he took a complex approach to the blots, weaving their diverse parts into unified images. According to the books, these features of the Rorschach protocol indicate that the man is unusually cautious and thoughtful, preferring to gather information and reflect on it before he acts.[viii] He habitually approaches problem solving in an analytic way.

Severe depression

The Rorschach clearly reveals the presence of severe depression. In the blots the man reported seeing “a Georgia O’Keefe painting of a cow skull” and “a blue rug with coarse fiber that’s being pulled apart.” Such images, which involve death or damage, are called “Morbid responses” and suggest that the man takes a depressive, pessimistic view of himself.[ix] Furthermore, a disproportionate number of his responses focused on the black or gray features of the blots. In one blot he saw “a bat” and remarked on its black color. In another, he saw “the Eiffel Tower” and commented that it was gray. According to Exner’s manual, the large number of “achromatic responses” in this man’s protocol indicate that he is holding back his emotions.[x]

Exner’s manual describes how a patient’s Morbid responses, achromatic responses, and other Rorschach scores can be combined into a single “Depression Index.”

This man’s score on the Rorschach Depression Index. is very high.[xi] He has probably been suffering from extreme sadness and feelings of hopelessness for several weeks. The physical signs of depression are also likely, such as disrupted sleep, loss of appetite, and fatigue.

Interpersonal problems.

The Rorschach results indicate not only that this man is depressed, but also that he has persistent problems relating with other people. One very distinctive feature of the protocol is his tendency to see “pairs” of people in the blots, including “two Greek women dancing,” “two medieval guys with hats on,” and “two dwarves,” in addition to the “two women preparing dinner” and “two dancing dervishes” that I’ve already mentioned. According to Exner’s manual and Weiner’s interpretive guide, the profusion of “Pair responses” signals that the man is preoccupied with himself, focusing egocentrically on himself and his problems.[xii]

Another unusual feature is his tendency to see things in the spaces between the blots. For example, one blot contains a large white space in the middle without any ink. He identified this white space (not the blot itself) as “a jet.” He gave 7 such “Space” responses to various blots, whereas most normal adults give only 1 or 2. According to the manual, the many Space responses in this man’s Rorschach protocol indicate that he feels a great deal of anger, which probably hinders him from sustaining deep or meaningful relationships with other people.[xiii]

Also telling are the many fictional and fantasy figures that he saw in the blots. For example, he described one inkblot as “Tiger Lily from Peter Pan,” and another as “Two laughing gargoyles.” These responses, according to Exner’s manual, reveal a tendency toward fantasy and suggest that the man’s relationships with other people are based largely on his own imagination rather than reality.[xiv] He also saw several images involving clothing, such as a man wearing a pointed medieval hat and women in high heels. As Weiner’s interpretive guide warns, such “Clothing responses” can indicate guardedness and a desire to conceal something.[xv]

Mixed in with this man’s self-preoccupation, anger, predilection for fantasy, and guardedness, there's a paradoxical tendency to be dependent and “clingy” in his close relationships. This excessive dependency is revealed in his description of one blot as “a bullet popsicle.” Exner’s manual tells us that even a single “Food response” of this type identifies a person as unusually dependent in his personal relationships.[xvi]

On the other hand, more positive tendencies can also be discerned. In several blots the man saw human figures engaged in enjoyable or cooperative activities, such as the “two Greek women dancing” or the “two women preparing dinner”. Such positive human images -- according to the manual -- indicate that he's highly concerned about other people, relates to them effectively, and is probably regarded as likeable and outgoing.[xvii]

The Accuracy of This Rorschach Test

This blind analysis was based on definitive books by the current leading authorities. I also double-checked the results by running the scores through a popular computer interpretation program for the Rorschach. But is this interpretation really accurate? Does it truly provide deep insight about the 50-year-old man?

I can say with considerable confidence that it does not, since I was the subject of the test. The results are based on a Rorschach recently administered to me by a well-qualified clinical psychologist who is trained and experienced in the standard methods for administering and scoring the test. Here are my own reflections on my test results:

Impaired Thinking

If the Rorschach is correct, then I deserve a great deal of credit for having overcome my mental disabilities. My undergraduate degree was from Harvard. I received a master’s degree from the Yale Divinity School and a Ph.D. in Clinical Psychology from the University of Arizona. I have published over 30 articles and book chapters, including several during the past year It’s true that I’ll never win the Nobel Prize, but aside from my Rorschach results there’s little to suggest that my thinking is unusually impaired or that my view of reality is more distorted than average.

Severe Depression

Next is my “depression,” which shows up as a high score on the Rorschach Depression Index, some “Morbid” images, and several responses based on the black and gray (“achromatic”) aspects of the inkblots.

A depressed person is persistently sad, has little interest in normal activities, feels fatigued and is low on energy. He feels hopeless and may have thoughts of death or suicide. He has difficulty concentrating on things even so simple as reading a book or watching a television program. Sleep and appetite are usually disrupted.

I have none of these problems. My mood is normal, even a little cheerful. I am interested in many activities, such as writing this book, taking care of small home improvement projects, and spending time with my family. My energy level is about average. My concentration is fine and so is my appetite. I sleep soundly, though my wife complains about my snoring. If I am depressed, I haven’t noticed it.

How can it be that the Depression Index (usually called the DEPI) shows that I’m depressed even though I’m not? In fact, the large majority of studies over the past decade have found that the DEPI bears little or no relationship to depression. Despite these studies, the books of Exner, Weiner, and other Rorschach experts continue to claim that a high score on the DEPI indicates depression. Many clinical psychologists read the books and ignore the research.

What about the Morbid images that I saw in some blots, such as the cow skull from a Georgia O’Keefe painting? As it happens, there may be a slight relationship between Morbid responses and depression, although the research evidence tends to be conflicting.[xviii] However, the tendency of depressed individuals to give more Morbid responses (if it exists at all) is probably too weak to be clinically useful, and many non-depressed individuals give Morbid responses for a variety of reasons. For example, I lived many years in Arizona and New Mexico and own a book of Georgia O’Keefe’s paintings. When I see one of her cow skulls in an inkblot, it probably has more to do with my Southwestern heritage and interest in art than with depression.

Similarly, the fact that I saw several gray and black (“achromatic”) objects in the blots probably has nothing to do with depression. In the 1930s, a small group of psychiatrists and psychologists advanced the theory that people who comment on the black or gray tones of the Rorschach inkblots are “holding back” negative feelings, such as anxiety and depression. As I will explain later in this book, there was no good scientific evidence to substantiate the theory in the 1930s, nor has any compelling evidence turned up in the intervening 70 years. Nevertheless, Rorschach experts routinely interpret such responses as evidence of repressed or suppressed negative emotion.

Interpersonal Problems

Finally, according to the Rorschach results I am an interpersonal disaster -- self-centered, dependent, guarded and angry. When I took the test I fully expected this finding because practically everyone looks “sick” on the Rorschach. For instance, in one study conducted in the early 1980s, psychologists were asked to evaluate the Rorschach scores from a group of mental patients. Unbeknownst to the psychologists, the Rorschach results of some normal individuals were also included with the patients’ scores. The findings of the study were stunning: The psychologists classified nearly 80% of the normal individuals as having serious character flaws or being depressed..[xix]

Because 4 out of 5 normal people look disturbed on the Rorschach, I consider myself to be in good company. Besides, most Rorschach interpretations regarding character problems lack good scientific support and are probably no more valid than the predictions of a palm-reader. For example, consider the notion that “Clothing responses” (the pointed hats and high heels that I saw in the blots) constitute evidence of guardedness and a desire to conceal something. Weiner proffers this interpretation without citing any supportive research.[xx] Exner books give nothing more than a brief, ambiguous summary of an unpublished study, in which paranoid patients apparently gave more Clothing responses (he doesn’t say how many) than other individuals.[xxi] This single study, described vaguely and without numbers, apparently constitutes the entire basis for interpreting Clothing responses as a sign of guardedness.

Something similar is true regarding the “bullet popsicle” that I saw. According to the Rorschach books, even a single “Food response” indicates a high degree of dependency.[xxii] However, this interpretation is nothing more than opinion, unsupported by good evidence.[xxiii] Interestingly, there’s some research that suggests an alternative interpretation (which I prefer), that when someone gives a Food response to the Rorschach, it may be because he or she hasn’t eaten lately.[xxiv]

Inconsistencies and Direct Hits

Although my own test results provide an instructive example of how the Rorschach works, they’re unsatisfactory from a scientific viewpoint. Perhaps you wondered if my prior knowledge of the test may have unconsciously influenced my responses to the blots. If so, let me encourage your healthy doubts. As this book will show, the Rorschach has thrived for eight decades precisely because many people have squelched their doubts and politely accepted the pronouncements of Learned Experts, without asking questions or requiring solid proof. I hope that as you form your own opinions, you’ll rely not on my personal say-so, but on the extensive body of research and historical information that is documented in the footnotes and references of this book.

In fact, there’s really no way to know with certainty if I was unconsciously influenced when I took the Rorschach. After all, how could I be conscious of my own unconscious influences? I can only report that I took the test “straight,” without trying to shape my responses or make them turn out a certain way. Despite my experience giving the Rorschach as a graduate student and psychologist, this was the first time that I ever took it myself. The experience turned out to be enjoyable and relaxing, as I started seeing images in the blots that I’d never realized were there. The Georgia O’Keefe cow-skull was my most unexpected discovery. It seems so obvious now. How is it that I never noticed it before?

Before setting aside my Rorschach, I’d like to mention a few other points that are especially interesting. First, as you may have noticed, several of my Rorschach results are inconsistent or even contradictory. For instance even though my thinking is supposedly distorted, my Rorschach scores also indicate that I’m reflective and analytic in my approach to problem solving. Apparently my thinking is distorted and analytic all at the same time. As another example, even though the Rorschach indicates that I’m self-centered, guarded and angry in my interpersonal relationships, it also says that I relate well to other people and am well-liked.

Psychologists who use the Rorschach are well aware that it often generates self-contradictory statements about patients. There are several strategies for dealing with these anomalies when they crop up. Usually the inconsistencies can be smoothed over or simply ignored when the final test report is written up. Some psychologists actually argue that the contradictions are a proof of the Rorschach’s value: Human personality is complex and self-contradictory, they say, and the Rorschach results accurately reflect this fact.

One psychologist who uses the test in legal cases told me how an attorney had once subpoenaed a computerized Rorschach interpretation from her and then pointed out its inconsistencies in court. To avoid further embarrassments of this kind, the psychologist stopped using computerized interpretations in her court cases. In this way, the contradictions could be kept safely out of sight from overly inquisitive lawyers.

Nevertheless, a few of my Rorschach results are “direct hits” that describe me quite well. For instance consider the Rorschach finding that I am unusually thoughtful and reflective, and that I prefer to gather information and analyze situations before acting. I can vouch that the Rorschach is right: As might be expected with a professor, I tend to be more reflective and analytic than most people.

When I viewed the inkblots, I repeatedly saw people engaged in movement (“two dancing dervishes,” “two women preparing dinner”). According to the Rorschach books, “Human Movement” responses often indicate a thoughtful, reflective personality. In this case, the books are correct and the research supports them. A large number of studies have shown that Human Movement responses tend to be related to reflectiveness and self-restraint.

The Rorschach could be easily dismissed if it were all wrong. But the situation is more complicated. Although the large majority of Rorschach scores are useless, a few can provide genuine information about a patient who has taken the test. If clinical psychologists had tossed away the “chaff” of the test 50 years ago while keeping its few kernels of “wheat,” the Rorschach might now be a modestly successful psychological tool with a legitimate if narrow use.

Unfortunately, the history of the Rorschach has gone in a different direction. In its current form, the few worthwhile scores of the Rorschach are lost among the many scores and interpretations that are pure moonshine. The situation would be humorous if it did not regularly result in harm to innocent people. Psychologists using this test can and do cause serious damage in people’s lives. Let me tell you the story that first made me “deeply disturbed” about the Rorschach.

The Rorschach and Child Sexual Abuse Allegations:

The Story of Rose Martelli and her Children

Rose Martelli was blonde and softly pretty, with a deep if unconventional religious faith. Although she belonged to the Catholic Church, she also attended services at fundamentalist Christian churches and mailed in money to television evangelists.

Rose sang in the choir at St Leo’s, her Catholic parish, but never completely fit in. With her habit of reading the Bible each night for guidance and her enthusiastic references to “The Lord” as if he were a personal friend, she seemed more like a born-again Christian than a Catholic. Furthermore, as a welfare mother Rose was out of place in St. Leo’s middle class congregation. Living in subsidized housing with her teenaged daughter and young son, Rose attended a junior college and only worked part-time at a low-paying job.

Allegations of Abuse

Despite her heavy involvement in religion, Rose had been divorced three times. Her last marriage had been to an evangelical minister, which perhaps explained her religious mannerisms. She had been pregnant when she left him after only six months of marriage. When the baby was born, a boy named Noah, a fierce court battle had ensued over custody and visitation. Rose alleged that Donald River, her ex-husband, had been violent during their marriage and tried to kill her. Then a week before the case was scheduled for trial, Rose’s 8-year-old daughter by a previous marriage suddenly “remembered” that Donald had sexually abused her when she was five.

The domestic court judge, clearly skeptical about the timing of the daughter’s allegations, ruled that Donald should enjoy full rights as a father and regular unsupervised contact with his son. For a year or two Donald’s visitations with Noah proceeded without incident. Then Rose began to revive the accusations she had made during the custody dispute. She claimed that when Noah returned from visits with his father he sometimes bore unexplained bruises on his body and face. Shortly after Noah’s fourth birthday Rose began to call Child Protective Services, voicing suspicion that Donald was physically and sexually abusing him. When the CPS investigators asked for details, however, Rose was unable to provide much more than a few ambiguous remarks that Noah had let fall. CPS interviewed the little boy himself, but he did not tell the investigators anything that seemed to suggest abuse.

Still Rose’s phone calls to CPS continued. It was the kind of case that investigators regard with weary skepticism: A bitter wife making vague and unprovable allegations of abuse against her ex-husband. Unable simply to disregard Rose’s charges but seeking some kind of resolution, the CPS worker in charge of the case requested that she and her ex-husband submit to evaluation by a psychologist. Both parents agreed.

The Psychological Evaluations of Donald and Rose

Donald River’s psychological report came back looking normal. Because he had moved to another state, Donald had been unable to meet with the psychologist appointed by CPS. However, he arranged an evaluation by a psychologist in the city where he was living. It indicated that Donald was suffering emotional pain and was overconcerned with his own needs, but that he did not exhibit the personality characteristics of a child molestor. [Alan: You asked if he was given the Rorschach. I verified that he was given the test, but I do not have the original report, only a brief summary written by another psychologist. Can we leave this as written or did you want something more?]

In contrast, Rose’s psychological evaluation revealed a person with extensive emotional and mental impairments. The psychologist appointed by CPS had administered several psychological tests that did not indicate the presence of serious problems. However, the psychologist mainly disregarded these normal findings and based her opinions mainly on the Rorschach.

She reported that Rose was seriously disturbed and probably lacked any genuine concern for her two children. In addition, the test revealed that Rose’s thinking was impaired so that she distorted reality and the actions of other people. The psychologist speculated that Noah had probably made some ambiguous remarks about his father, which Rose had distorted in her mind until they seemed to constitute proof of abuse. Rose was willing to make such allegations, the psychologist added, because she was extremely self-centered, and probably unconcerned about the harm that might be done to either her ex-husband or her son. Rose’s stories about Donald should be treated with extreme caution, as the product of an unbalanced mind.

As might be expected, the attitude of CPS changed substantially after receiving the psychologist’s report. In a phone call the caseworker told Rose about the results and urged her to seek help from a therapist. Rose blew up and accused CPS of abandoning her and her children.

Aftermath of the Psychological Evaluations

In the months following the psychological evaluations Rose continued to batter CPS with phone calls. Her stories grew increasingly bizarre. She said that Donald had locked Noah in a dog cage as punishment, and had sexually abused him in the restroom of a shopping mall. Once she called from a hospital emergency room. She claimed that Noah had told a doctor “My Dad peed in my mouth,” and that bruising had been found in the boy’s throat. CPS duly recorded these strange reports but declined to investigate them further.

Then, eight months after the psychological evaluations had been filed, an event took place that altered the situation in an unexpected direction. Returning from a Sunday afternoon visit with his father, five-year-old Noah told Rose that during their time together his father had slapped and yelled at him, then taken off his clothes and “poked him in the butt.” Noah asked to see a doctor. Rose immediately drove him to a hospital, where Noah once again described what his father had done to him. Bruises on his body were noted by medical personnel and a swab was taken of his rectum using a rape kit. The laboratory test revealed the presence of sperm.

The Martelli Case: A Fuller Picture

Because I have professional expertise in the field of sexual abuse, Rose Martelli’s lawyer asked me to conduct a detailed review of this case. I read the legal documents and psychologists’ reports, reviewed the medical records and CPS files, and most importantly, interviewed several people who had known Donald River and Rose Martelli for years. Here is what could be learned by reading the record and making some phone calls.

Donald River

I quickly discovered that although Rose’s ex-husband was described as a “minister,” Donald River had never been ordained, did not have a congregation, and had never completed even a single year of college. He'd been married four times, including his marriage to Rose. The positive evaluation sent to CPS from a distant city was grossly misleading, written by a psychologist who had conducted a brief interview and then written his report, without bothering to obtain independent information about Donald or the allegations against him.

Donald’s real name was Albert Guadagnoli. Albert had shown no interest in religion until his 30s, when he had suddenly changed his name to “Donald River” and founded an organization named “Your Life in Jesus.” Before long he'd enticed several elderly people into supporting him and his organization.

Although Rose had said that Donald was physically abusive during their brief marriage, the CPS psychologist had treated this allegation as a manipulative distortion. However, I discovered from documents that Donald had broken Rose’s nose within a few months of their wedding. He'd also physically abused one of his prior wives.

Interestingly, Rose had given the CPS psychologist much of the information that I’ve described here. However, based on the Rorschach, the psychologist decided that Rose’s bizarre reports were unreliable and could be discounted.

The Abuse Allegations of Amity Martelli.

The allegations of sexual abuse against Donald by Rose’s 8-year-old daughter Amity had been disregarded by the family court judge several years previously. The CPS psychologist, without interviewing Amity, suggested that the girl might have been manipulated into making false statements. However, mental health records indicated that the psychologist should have looked into the matter more closely.

Amity had entered psychotherapy within a few months after Rose fled from her marriage with Donald. Treatment focused on the trauma that Amity had experienced from repeatedly seeing Donald batter her mother. It was only after several months of therapy that Amity began to tell her therapist about the sexual abuse by Donald. The incidents she recounted were detailed and highly compelling.

Rose Martelli.

Finally there was Rose, whom the CPS psychologist had characterized as emotionally disturbed, disordered in her thinking, and incapable of empathy. When I reviewed the hard facts of Rose Martelli’s biography, interviewed people who knew her, and examined her psychological test findings (aside from the Rorschach), they revealed a picture that was in striking disagreement with the psychologist’s conclusions.

First, Rose didn’t at all fit the label of “welfare mother” that was sometimes used to describe her. She’d held steady employment throughout her 20s and 30s and was enrolled in training as a computer graphics specialist. (She subsequently obtained her degree and, at the time of this writing, has completed many years of successful employment in her field).

Second, the psychologist’s conclusion that Rose lacked concern for her two children was manifestly wrong, as I learned from various people who knew the family. They agreed that Rose was a devoted and intelligent mother. Her success at combining the roles of mother, student, and employee, were inconsistent with claims that she was suffering from distorted thinking, mental impairments, and severe emotional disturbance.

Third and finally, Rose Martelli's religiosity was long-standing and well-known. She had a reputation for honesty and frankness. In the course of my evaluation I had the opportunity to check out many of her “bizarre” stories. In every instance that I looked into, she'd been meticulously accurate. For instance, Noah’s bruises following visitations with his father had been seen by several reliable witnesses, including a Catholic priest.

Any opinion that Rose Martelli was habitually inclined to falsehood or distortion was contrary to everything I could find about her. Yet CPS had blindly accepted and acted on just such an opinion, from a psychologist using the Rorschach.

Rose Martelli’s Rorschach.

After reviewing the documentary materials and conducting interviews of several key individuals, I was deeply puzzled by the psychological evaluation of Rose Martelli. This negative report, which had persuaded CPS to disregard her urgent calls for help and resulted in her son being left in a situation where he was continuously and gravely abused, simply made no sense in light of everything else that I’d learned.

At first I suspected that the psychologist who wrote it must have been incompetent. Only gradually did I realize that in fact this psychologist had done an adequate job according to the training she'd received. In fact, virtually all her errors could be traced to a single source: her reliance on the Rorschach Inkblot Test. Every damaging conclusion about Rose -- that she was emotionally disturbed, lacking in empathy, and distorted in her thinking -- came from this single test.

Why had the Rorschach mischaracterized Rose in such a negative way? As a graduate student in clinical psychology, I’d been trained to use the Rorschach and was acquainted with its history. I knew that in the 1950s and 1960s the test had come under intense criticism for its lack of scientific support. It might well have been abandoned except for the Herculean efforts of one resolute psychologist, John Exner.

Beginning in 1974 when the test was at its lowest ebb, Exner began to publish a series of books describing his own approach to the Rorschach, which he called the “Comprehensive System.” These thick volumes, which still appear every four or five years in costly new editions, have become the “Bible” of the Rorschach over the past 25 years. They not only provide meticulously detailed instructions for administering, scoring, and interpreting the test, but also describe the extensive scientific research that supports it. Most clinical psychology programs today train their students in the Comprehensive System for the Rorschach, and hundreds of psychologists pay to attend Exner’s “Rorschach Workshops” each year. His books have removed the stigma of the Rorschach and re-established it as a reputable psychological test.

Searching for the Truth

In pursuing the Martelli case, however, I began to probe the scientific literature on my own instead of depending on Exner’s books. Collecting journal articles and dissertations, I was surprised to discover that, contrary to Exner’s claims, most Rorschach scores lacked any good scientific support. Far from being full and balanced presentations of the scientific literature, Exner’s writings were often one-sided, presenting research findings that supported the test, while ignoring those that did not. The scientific basis for the Comprehensive System was weak at best and often non-existent.

The psychological report on Rose Martelli, I eventually realized, was little more than a fantasy, a fictitious personality description based on Rorschach scores that had little if any validity. As I went over the results one by one, they disintegrated under scrutiny.

As you may have guessed, several of Rose’s Rorschach scores were similar to my own. Like me, she had a high score on the Depression Index, a scale invented by Exner. Studies by many independent researchers have found that scores on the Depression Index bear little if any relation to depression,[xxv] an uncomfortable fact that Exner never mentions in his books.

Rose’s Rorschach, like my own, revealed the presence of “distorted thinking.” In fact research indicates that about 50% of normal people will be labeled in this way by the test,[xxvi] although again Exner makes no mention of this problem. Rose’s Rorschach also showed that she was a reflective person, giving a high number of Human Movement responses. This apparently contradictory Rorschach finding had been deftly smoothed over in the CPS psychologist’s report.

Rose’s Rorschach also contained a small element of humor. Viewing one of the blots, she had reported “A Thanksgiving turkey already eaten.” Following the recommendations in Exner’s books, the psychologist had interpreted this “Food response” as an indicator of extreme dependency: Rose was described as a clingy sort of person who needed someone to lean on. However, the psychologist had missed two relevant details. First, Rose had come to the testing session during her lunch hour without eating anything since breakfast. Food responses are probably more common when a person is hungry. Second, the date was December 5. About a week earlier, the top shelf in Rose’s refrigerator had been dominated by the carcass of her family’s Thanksgiving turkey. Already eaten.

Particularly damaging to Rose was the psychologist’s characterization of her as extremely self-centered and without empathy for her own children. This conclusion was based on a “Reflection response” that Rose had supposedly given to one of the blots. A Rorschach response is scored as a Reflection if it refers to a mirror image or reflection, such as “An elf looking at himself in a mirror” or “A pine tree reflected in a lake.” According to Exner’s books, such responses are very rare and always indicate that a person is “narcissistic” and self-centered, with little regard for the needs or wants of others.

The idea that a single Reflection response signals the presence of narcissism has never been substantiated by any good research. In fact, researchers other than Exner have found that Reflections are quite common, occurring in the Rorschachs of nearly 30% of normal individuals. Because the blots are symmetrical, people often turn them on edge and comment that the image resembles some sort of scene reflected in a lake. It’s a normal and predictable response.

However, any discussion of these issues was irrelevant to Rose Martelli’s Rorschach, for the simple reason that she had never given a Reflection response at all. The CPS psychologist had simply made a scoring error. According to Rose’s Rorschach protocol, she had said that one of the blots resembled “a paper snowflake, like you make by folding a piece of paper and cutting it out.” The psychologist had mistakenly scored this as a Reflection response, even though it didn’t involve a mirror or reflection. Scoring errors and disagreements are fairly common among psychologists who use the Rorschach, although the promoters of the test generally ignore the problem. This particular scoring error had caused Rose to be labeled as narcissistic and deficient in empathy for her children, thereby condemning her son to continued contact with a father who sexually molested him.

Unfortunately, these insights about Rose's Rorschach came after the legal system had already taken action. A domestic court judge, overwhelmed by what he thought was contradictory and confusing evidence, had awarded custody of Noah to his father. Donald moved to another state with the boy. Rose hasn’t seen her son in years.

The Mystique of the Rorschach

It would be comforting to believe that the story of Rose Martelli and her children is merely an isolated incident, not at all typical of the way that psychologists usually do their job. But just the opposite is true. Thanks largely to the enormous commercial success of the Comprehensive System over the past quarter century, the Rorschach is highly popular. Consider the following estimates from surveys in the past 10 years:

In surveys, the Rorschach typically ranks as the 2nd most widely used personality test among clinical psychologists (Number 1 is the Minnesota Multiphasic Personality Inventory, usually called the MMPI, a yes-no questionnaire that is used to identify psychiatric symptoms and psychological disorders) [xxvii]

80% of Ph.D. clinical psychology programs emphasize the Rorschach in required testing courses.[xxviii]

68% of specialist programs in School Psychology also include the Rorschach in standard training[xxix]

33% of clinical psychologists in practice consider the Rorschach to be one of the most important tests they use[xxx]

31% of psychologists who evaluate parents in custody evaluations use the Rorschach[xxxi]

35% of psychologists who evaluate children for abuse or neglect use the Rorschach[xxxii]

32% of psychologists who evaluate criminals for the courts use the Rorschach.[xxxiii]

Particularly striking are the numbers toward the bottom of the list. Between 30% and 35% of psychologists routinely use the Rorschach whenever they conduct assessments in legal cases, such as custody evaluations, child abuse assessments, and criminal evaluations. As such statistics show, there was nothing unusual in the fact that the psychologist in the Martelli case used the Rorschach. Approximately 1 out of 3 psychologists in legal settings do the same.

Nor was it unusual that she based her most important conclusions on the Rorschach, even though it was contradicted by other weighty evidence. Because the test is considered unique in its power to reveal the truth about a person, contradictory information is often either ignored or reinterpreted to be consistent with the Rorschach scores.

For example, the psychological report on Rose Martelli simply didn’t mention that the “distorted” stories she'd told about her ex-husband had been corroborated by other people. And the report deftly minimized her exemplary performance as a mother: “Although Ms. Martelli strives to give the impression that she is a dutiful mother to her children, it is unlikely that she cares deeply about their needs when they conflict with her own. ” Thus Rose’s positive qualities as a mother were explained away as mere illusion, and the negative Rorschach results accepted as “the real story.”

In the 1940s and 1950s the Rorschach was unblushingly promoted as a “psychological x-ray” that could penetrate surface qualities and reveal the deep secrets of an individual’s personality.[xxxiv] Although they might claim otherwise, many clinical psychologists today still view the test as an x-ray or, to update the image, as a psychological PET scan. Rorschach experts tend to subtly disparage ordinary questionnaires like the MMPI because such tests reveal only what a patient is willing to report about himself. By contrast, the Rorschach is said to uncover a deeper, “implicit” truth, even when the patient tries to conceal it.[xxxv]

Despite its failure to live up to such promises, the Rorschach still possesses a palpable and powerful “mystique.” When introduced into the United States in the 1930s, it attracted a tiny group of enthusiasts who published their own newsletter and held meetings to discuss the test’s subtleties. Because they made overstated claims that went far beyond the available scientific evidence, these early “Rorschachers” were often shunned by psychologists in universities and widely regarded as “cultish.”[xxxvi]

Although the Rorschach eventually outgrew this stage and achieved broader acceptance, the somewhat clannish atmosphere surrounding its beginnings has never entirely dissipated. When serious devotees talk about the extraordinary richness and subtlety of the Rorschach, their voices are still likely to take on a distinctive, reverent tone that is never heard in discussions of other psychological tests. Mention of the Rorschach’s well-known shortcomings is avoided as if in bad taste, and serious criticisms are often met with anger and derision.

Perhaps nothing is more telling than the awe and deference that are shown toward the leading Rorschach experts, who are often treated with the reverence usually reserved for religious figures. My favorite real-life example involved a psychologist testifying in a criminal case. While preparing her evaluation, she had taken the unusual step of phoning John Exner and asking his opinion about the interpretation of a particular Rorschach score.

“Oh, that’s right,” the judge interrupted. “Exner is the Godfather of the Rorschach, isn’t he, Doctor?”

“Oh no, your Honor,” the psychologist smilingly replied, “He’s the God of the Rorschach.”[xxxvii]

Organization and Purpose of This Book

The Rorschach is not merely a psychological test. It’s also a social and scientific phenomenon. In this book, my co-authors and I tell the extraordinary story of how this creaky, flawed assessment technique, invented over 80 years ago, has become one of clinical psychology’s most widely used tools, paradoxically still popular in an era when space stations are orbiting the earth and geneticists are unlocking the human genome.

The history of the Rorschach is unexpectedly fascinating because it provides insights into the way that mental health practices in both psychiatry and psychology have groped their way forward during the past century, influenced by science, charlatanism, professional interests, and a genuine desire to promote human welfare and relieve suffering.

As the story shows, there are powerful historical and professional reasons why psychologists adopted the Rorschach 70 years ago and have clung to it ever since. And there are equally powerful scientific and ethical reasons why the test has been intensely criticized for the past half century, though usually without much effect.

A Preview of the Chapters

Most of the book follows a historical sequence. Chapters 2 and 3 tell how the inkblot test was invented by Swiss psychiatrist Hermann Rorschach shortly after World War I, and how it spread to the United States during the Great Depression and achieved general acceptance during World War II. Chapter 4 describes the heyday of the test in the 1950s and 1960s, when the Rorschach inkblots were often seen as a clinical psychologist’s “trademark”, like a plumber’s wrench or a doctor’s stethoscope. Chapter 5 relates how during the same era research undermined confidence in the test, uncovering its flaws and failings.

Chapter 6 tells the dramatic story of how John Exner “saved” the test in the 1970s with his Comprehensive System for the Rorschach, and Chapter 7 recounts the disconcerting revelations and new wave of scientific criticism that have recently cast doubt on that work. Chapter 8 addresses the fascinating question of why psychologists still cling to the Rorschach, despite the overwhelming negative research evidence and the bad publicity for their profession. Chapter 9 discusses the probable fate of the Rorschach in years to come. Finally, Chapter 10 explains why and how the Rorschach can be kept out of courtrooms and other legal settings. This last chapter on mis-use of the Rorschach in forensic settings is dedicated to Rose Martelli and her children, as well as all the other individuals who have been harmed by psychologists wielding inkblots.

What You Won’t Find: Pictures of the Real Blots

Sadly, there is something that I‘d like to include in this book but can’t -- copies of the actual Rorschach inkblots. Readers who have never seen the blots will naturally want to know what they look like, and because the copyright has apparently expired, there's probably no legal obstacle to printing them here. However, after giving the matter some thought, my co-authors and I have decided not to do so.

Psychologists have never quite made up their minds whether the Rorschach inkblots can be safely revealed to the public. On the one hand, members of the profession are justifiably reluctant to reveal the materials of some psychological tests because their usefulness might be compromised. For example, if readers were to see the Rorschach inkblots in this book and later be given the test, they might give different responses than they would have otherwise, thus invalidating the test results. For this reason, some psychologists become quite irate when copies of the Rorschach inkblots appear on the World Wide Web, as they do from time to time, or are otherwise revealed to the public.

On the other hand, there's educational value in showing the blots to interested lay-people, and perhaps little danger of affecting their scores should they later take the test. For example, it's been reported that the Rorschach scores of psychiatric patients stayed pretty much the same when they were given the test a second time, and even when they deliberately tried to change their responses.[xxxviii] Research like this suggests that seeing the blots beforehand might not invalidate the test results.

Furthermore, the fact is that the cat -- or the Rorschach -- is already out of the bag. In the 1970s two psychologists published colored copies of the Rorschach blots in a book for the general public called The Nuremberg Mind (which I’ll discuss at greater length in Chapter 4).[xxxix] Furthermore, books containing the blots are available in most college libraries and from many used book stores. I even recently bought a set of used Rorschach cards for only $20 on the Web, and without being asked whether I was a psychologist. I also own an inexpensive paperback with the naughty title Big Secrets: The Uncensored Truth About All Sorts of Stuff You Are Never Supposed to Know.[xl] It contains black and white outlines of the blots, as well the formula for Coca-Cola and the recipe for Colonel Sanders’ Kentucky Fried Chicken.

Because the Rorschach inkblots are already an open secret, there may not be much point in trying to protect their privacy here. However, out of respect for the sensibilities of psychologists who feel otherwise, and because the profession’s ethics generally discourage the release of test materials to non-psychologists, my co-authors and I have decided not to reproduce the blots here, but instead to provide readers with some “imitation” blots that resemble the originals. These blots (unfortunately only in black-and-white) appear in the illustrations at the center of this book. Readers can look at these blots or show them to their friends and ask “What might this be?,” just as Hermann Rorschach did over 80 years ago when he first developed his test.

It is his story that I tell in the next chapter.

-----------------------

[i] The exact wording is usually “What might that be?”

[ii] Piotrowski (1980), “CPR: The psychological x-ray in mental disorders,” see also Klopfer (1940) “Personality aspects revealed by the Rorschach method.”

[iii] Board of Professional Affairs (1998 p. 392) of the American Psychological Association.

[iv] In the early 1990s, it was estimated that the Rorschach is given over a million times each year worldwide. The figure given here for the U.S. is intended to be a conservative estimate of the Rorschach’s usage.

[v] Give citation for “millions of times each year”.

[vi] See Exner (2001, p. 173).

[vii] “Cognitive impairment” and “distorted view of reality” are based on X-% of .23. For interpretation of this finding, see Exner’s (2000) A Primer for Rorschach Interpretation, p. 176, and Weiner’s (1998) Principles of Rorschach Interpretation, pages 113-114, also

[viii] “Thoughtful” is based on Pervasive Introversion and a high Zd score. For interpretaion of these findings, see Exner’s (2000) Interpretive Primer, pages 86 and 143.

[ix] The interpretation of two MOR responses may be found in Exner’s (2000) Interpretive Primer, page 263.

[x] Specifically, the sum of achromatic responses (SumC’) is higher than the weighted sum of chromatic responses (WSumC). The interpretation of this finding can be found in Exner’s (2000) Interpretive Primer, p. 94.

[xi] The interpretation of an elevated DEPI score may be found in

[xii] “Overly preocupied with himself” is based on the large number of Pair responses (no Reflections), which elevated his score on the Egocentricity Index. For the interpretation of this Index see Exner’s (2000) Interpretive Primer, p. 257 and Weiner’s (1998) Principles of Rorschach Interpretation, pages 154-155.

[xiii] “Angry” is based on a high number of Space responses. For the interpretation of this finding, see Exner (2000), pages 105-107.

[xiv] For interpretation of a high number of fictitious or part-human responses, see Exner’s (2000) Interpretive Primer, pages 267-268.

[xv] For the interpretation of Clothing responses, seeWeiner (1998), Principles of Rorschach Interpretation, pages 200-201.

[xvi] For the interpretation of Food response, see Exner (1991, p. 184).

[xvii] “Highly concerned about other people”” are based on the high scores for Pure Human responses and Sum Human responses. For interpretation of these findings, see Exner’s (2000) Interpretive Primer, page 320 . “Relates effectively” is based on GHR > PHR. For interpretation of this finding, see Exner’s (2000) Interpretive Primer, pages 322-324. “Regarded as likeable and outgoing” is based on COP = 5 and AG = 0. For interpretation of this finding see Exner’s (2000) Interpretive Primer, pages 329-330.

[xviii] Although a full literature review regarding Morbid responses and depression cannot be given here, some important findings can be noted. In one study with positive results (Caine, Frueh, & Kinder, 1995), Morbid responses were significantly related to diagnoses of depression among adult females. However, in two studies with negative results ( Archer & Gordon, 1988; and Archer & Krishnamurthy, 1997), Morbid responses were not significantly related to diagnoses of depression among adolescents. In one study the results seemed ambiguous (Lipovsky, Finch, & Belter,1989): There was a striking trend toward a higher number of Morbid responses among depressed adolescents, but the effect was not statistically significant..

[xix] This study was conducted by Beatrice Mittman, working with John Exner, and is described by Exner (1991, pages 432-433). For a critical discussion of these findings, see the recent article by Wood, Nezworski, Garb, and Lilienfeld (2001b).

[xx] Weiner (1998), Principles of Rorschach Interpretation, pages 200-201.

[xxi] Exner, 1991, pp. 29-30

[xxii]

[xxiii] Even though Exner (1991, p. 184) says flatly that a single Food response indicates a high level of dependency, he elsewhere concedes (Exner, 1997 ,“Future”, pp. 44-45) that “the findings concerning food answers are, at best, limited.”

[xxiv] See summary by Masling (1960/1992, pp. 625).

[xxv] Giver reference for DEPI to Jorgensen et al, also our summaries on DEPI literature.

[xxvi] Shaffer, Erdberg, & Haroian (1999?) and Wood, Nezworski, Garb, & Lilienfeld (2001) (correct ref for norms article?)

[xxvii] Archer & Newsom, 2000; Watkins, Campbell, Nieberding, & Hallmark, 1995.

[xxviii] Belter & Piotrowski, 2001, p. 720

[xxix] Culross & Nelson, 1997, p. 122

[xxx] Piotrowski, Belter, & Keller, 1998, p. 444

[xxxi] Hagen & Castagna, 2001, p. 271

[xxxii] Pinkerman, Haynes, & Keiser, 1993, p. 9

[xxxiii] Borum & Grisso, 1995.

[xxxiv] Give psychological x-ray citations again to Klopfer and Piotrowski.

[xxxv] Insert citation of Bornstein’s in press JPA article on the measurement of “implicit” characteristics by the Rorschach.

[xxxvi] Give citations for early Rorschachers being “cultish”.

[xxxvii] Personal communication, Dr. William J. Stejskal, December 20, 1994.

[xxxviii] Haller and Exner (1985)

[xxxix] The Nuremberg Mind by Florence Miale and Michael Selzer. Only the copies in the hardback version are in color. The copies in the paperback version are black and white facsimiles.

[xl] Give citation for book on “Big Secrets”.

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