The Psychology of Projective Techniques in General and the TA.T. in Particular
THEORETICAL FOUNDATIONS FOR PROJECTIVE TESTING 27
To speak of chaff is reminiscent of the days when psychoanalysts still saw resistance as a nasty way in which patients behaved and something they had to overcome. With the analysis of the ego, the analyst has learned a great deal from the analysis of the resistance. The analyst learns, in fact, how the ego and the defenses are structured, which was not possible to learn with- out also understanding the resistances. Similarly, analysis of the chaff, of what is considered barren, will give much information about the defenses of the ego, as in the earlier examples. From the standpoint of determinism as an essential axiom of psychological science, every psychological performance--and thus every utterance - must be meaningfully related to the total structure of personality. It is true that, practically and clinically speaking, it will usually not be worthwhile or possible to investigate each detail. In patients whom we have treated for as long as three years, and whose T.A.T.s and other projective data we also have, we have had occasion to compare production in treatment and on the tests. For all practical purposes, the generalization can be made that the defenses used in the clinical situation and on the projective techniques were identical: Those who use avoidance, denial, and isolation, and who gave barren records, also tended to spend hours on the couch reporting apparently meaningless data that had to be interpreted and could become meaningful only by inferring the basic issue about which they were.
Considerable experimental studies have supported the fact, long known in clinical practice, that avoidance of aggressive responses to aggressive stimuli is indicative of a great deal of aggression (Bellak, 1950a; Kaplan, 1967;
Kornadt, 1982; Megargee, 1967; Megargee & Hokanson, 1970; Tachibana et al., 1984).
Inconsistent Result In certain cases, failure to obtain test data that one could expect to find may be understandable in terms of ego psychology. For instance, in lobotomized or topectomized patients, various projective techniques and other tests may fail to show any deficit behavior. Lobotomies, in particular, and topectomies, to some ex- tent, are still blind procedures neurologically and, particularly, psychologically speaking. The results and effects differ widely from case to case, sometimes strengthening and sometimes weakening the ego. When the surgical procedure somehow interferes with the "drive push" of the patient, the ego may be secondarily strengthened and none of its integrating functions impaired in such a way that a disturbance in the ego function would manifest itself in psychological test behavior. In other words, the failure of tests to reveal expected pathology incident to the surgical trauma is due to the fact that none of the ego functions involved in test behavior were involved in the trauma.
Signs Organic signs are symptoms of ego defect in situations in which the organic lesion involves ego functions. The reliability and validity of organic signs will be greatly improved if they will be expected only in such lesions that are likely to involve the ego functions tested in a particular procedure. Other inconsistencies in test results may consist not only of not finding what "ought" to be there but also, not infrequently, of finding data that "ought not" to be there, in the sense of indicating much more pathology than can be accounted for.
28 CHAPTER 2
For example, if more than 50 percent of the students of a city high school show schizophrenic signs on the Rorschach, there is obviously something wrong with the signs. Signs are a result of the pressure for nomothetic data in the search for the "average" person and the hunted deviant. Many of them are arrived at simply by the use of faulty
generalizations by the factor-analysis hunters. Schizophrenia being the most fashionable diagnosis, faulty diagnosis of this syndrome probably constitutes the majority of all misdiagnosis. It is safe to say that the less experienced the psychiatrist or psychologist, the more often she or he will make the diagnosis of schizophrenia, notwithstanding the fact that she or he will sometimes miss it when it does exist. The main problem seems to be that the so-called signs of schizophrenia are almost all signals of disturbances of the ego, such as poor control, poor reality testing, and so on.
Although ego weakness is a primary factor in schizophrenia and other disorders (Bellak, 1952b), it must be
remembered that it is not the sole criterion (cathexis also playing a role) and that other conditions of ego weakness may obtain the same ego indicators. Adolescents notably have weak egos, and many phenomena in adolescence would have to be interpreted as schizophrenia in other age groups (which makes the diagnosis of the real adolescent schizophrenic one of the most difficult). By the same token, an artist who has learned to exclude his or her ego functions in creative situations may "let go" in the testing situation to the point of giving signs of ego weakness that may be inappropriately interpreted as schizophrenic. Eron (1948) has shown that what was reported as schizophrenic in T.A.T.s by Rapaport (1946) could frequently be found in nonschizophrenics of all kinds, including people who are considered "normal."
Another group that is frequently inappropriately diagnosed as schizophrenic on the basis of signs is the mentally deficient. These subjects also have a defect of the ego, which often manifests itself in poor control, poor perception of reality, and even paranoid interpretation of an environment that they have every reason to fear and suspect of "putting something over" on them. It is not useful to mistake their intellectual deficit state for a psychosis.
Color Shock Color shock is one of the most interesting and most embattled signs of the Rorschach. Siipola (1950) has done important work on this phenomenon. She has contended that when color and form suggest divergent concepts, there may be three different ways of dealing with the situation. The normal individual may be able to achieve an integration nevertheless (an object first suggesting a bear by shape but being green in color may be quickly seen as a chameleon) ; the neurotic may be stymied and "shocked" into silence by the conceptual conflict; and the psychotic may have judgment impaired to the point where he or she cheerfully gives the response, "green grass bear." It is Siipola's contention that color shock occurs only where form and color clash, and that it constitutes a response to a more difficult task. We would go further and say that this is best stated in terms of ego psychologymnamely, that the normal ego is strong enough to achieve a difficult integration, the neurotic's ego is too weak to accomplish this, and the judgment
“ought not" to be accounted a school show with the signs.
THEORETICAL FOUNDATIONS FOR PROJECTIVE TESTING 29
ch for the "av- simply by the ;nia being the ly constitutes ,.nced the psyinosis of schiz- aiss it when it schizophrenia t, poor reality ophrenia and ot the sole cri- weakness may and many phe- .ia in other age .nic one of the [ude his or her 0n to the point :eted as schizorenic in T.A.T.s ics of all kinds,
S schizophrenic have a defect of n of reality, and y reason to fear to mistake their
Jed signs of the inenon. She has , there may be ividual may be ;sting a bear by n); the neurotic ict; and the psy- cheerfully gives or shock occurs .' to a more diffi-erms of ego psy- e a difficult inte- d the judgment
functions of the psychotic ego are so impaired that he or she easily combines form and color inappropriately. In line with what was said about caution in the interpretation of signs, it must be pointed out that a nonrepresentational artist, accustomed to decreasing ego functions without being psychotic, might well not hesitate to say "green grass bear," and that a psychoanalyzed subject may equate the testing situation with the analytic situation and induce a similar ego-excluding "set" that might permit the same "green grass bear" response.
Conscious Control and Faking Superseding questionnaires and rating scales, projective psychologists like to think of themselves as real scientists and of their instruments as practically fool- proof. All the more disturbing to them, therefore, are reports of successful conscious control and faking on the Rorschach, the T.A.T., and other tests (Holmes, 1974; Lindzey, 1952; Orpen, 1978). Such faking can be understood and restricted to its limitations by understanding the productions from an ego point of view. To the extent to which conscious attitudes and conscious ego control can be intro- duced, the subject may alter the record to a relatively small degree in one direction or another, concerning such variables as overall "wholesomeness." Particularly with regard to Weisskopf and Dieppa's (1951) work with the T.A.T., it must be remembered that only a few pictures were used, and the most difficult task for the subject would be to fake consistently over the whole series of pictures. Furthermore, an analysis of the defenses would probably reveal the basic structure of the character, no matter how much faking the subject endeavored to engage in. Naturally, such
characteristics, which, though under the control of the ego, are not under its conscious control and not on the semantic level, are unlikely to be affected at all.
Possible Means of Increasing Productivity of T.A.T. Material by an Ego Psychological Approach
If relative "barrenness" of records is the chief complaint of psychologists, we may be able to suggest a number of ways to increase productivity:
1. An analysis of the defenses as they appear in the T.A.T. record has already been discussed at some length as a means of increasing the yield, which has been reviewed in detail in books on the thematic apperception tests and defenses by Brody and Siegel (1992), Cramer (1991a), and Dias (1976). If barrenness is the result of overly increased ego control, for example, a number of measures capable of decreasing ego control must then increase the productivity. This could be accomplished by: 2. Providing stronger stimuli. If the stimuli have more affective pull, the ego will find it more difficult to control the affect. In the T.A.T., this coincides with the need for better pictures - primarily a wider range of stimuli to facilitate study of apperceptive distortions of situations not currently provided for in the existing set. A recent example is the Senior Apperception Test (S.A.T.), which now has new, improved drawings that are able to elicit richer fantasy responses (Bellak & Bellak, 1996).
30 CHAPTER 2
3. Any other form of increase of pressure might also increase productivity. Stein's (1949) use of tachistoscope exposure is one way in which this might be done, the shorter exposure time causing more tensions and increasing the ambiguity (see item 4). Both this approach and the one of stronger stimuli might prove a double-edged sword: Although this might decrease the ego control in some subjects, others might freeze up even more. It is helpful to utilize the standard approach first, and only if this has failed and if there are no other contraindications (such as excessive anxiety) will it be economical to increase the pressure. 4. Increasing ambiguity has been attempted by Weisskopf (1950a) and Weisskopf and Lynn (1953) with the T.A.T. and the Children's Apperception Test (C.A.T.). Presenting tracings of the usual pictures and interrupting the out- lines to make less good Gestalten may - up to a point - increase productivity to some extent. Murray's (1951c) modification in presenting the pictures for only 30 seconds and then removing them also increases ambiguity and pre- vents excessive descriptive clinging to the stimulus. Other studies indicate that cards that are medium ambiguous are best for projection (Epstein, 1966, Kaplan, 1969, 1970). Murstein (1965d) suggested that pictures most useful for thematic production are those that are clearly structured as to who is in the picture but relatively ambiguous as to what is going on. Such cards are medium ambiguous. Many studies have indicated that highly ambiguous cards are least useful for personality assessment (Kaplan, 1967; Kenny, 1961). Lazarus (1953) and Kaplan (1970) have noted that, because of high ambiguity of stimuli in projective tests, the lack of expression of certain needs (i.e., aggression) could be due either to lack of arousal value of the stimulus or to ego defenses against the related impulses. 5. Physiological means of weakening the ego, such as barbiturates or alcohol, have worked well at times. 6.
A stress inquiry in the form of a request for controlled associations to any of the stories, and particularly to any specific concrete references in them (after all the stories have been told), may be a useful means of increasing the data of otherwise barren records. 7. Finally, if a certain test fails to give the necessary data, use another test. Some
psychologists utilize a variable series of different tests, rather than a standard battery of a core of the same tests for all individuals of the same age group. This is reminiscent of the shotgun prescriptions of prescientific medicine. The doctor puts dozens of ingredients into every prescription in the hope that, if one would not help, another might. Clearly, a psychological test should be fitted to the needs. If one needs content of the psychodynamics, one should use the apperceptive tests; if one wants an assay of ego strength and generally quantitative indicators, one should use the formal expressive tests. But if, for example, aggression is not meaningfully expressed in the T.A.T., it may be very useful to study figure drawings. The verbal expression of aggression may be successfully controlled when its muscular expression is clearly seen in heavy line pressure of the human figure or other drawings. Often enough, the problem can be stated in a generalization--namely, that when one fails to obtain data on the semantic level, tests probing the subsemantic area may produce information.
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n s( o e" s c a ti C
THEORETICAL FOUNDATIONS FOR PROJECTIVE TESTING 31
There is good reason, on the other hand, not to leave out the semantic tests routinely, since they can elicit much more detailed, more subtle information than can safely be inferred from the organizational subsemantic methods of personality appraisal.