Applying Rorschach: an art with rules and guidelines

When in working on a psychological evaluation, you must be precise and very careful in order to not interfere in the process and to avoid influencing the test results. The very same idea and notion applies to projective tests, probably even more so.

In the case of Rorschach, there are many points where you should be careful and attentive, so the test result can be as reliable as possible.

When you start the test application (phase 1) you must be very precise in the instructions you give to your patient, or you’ll risk having an undesirable impact on the results. You shouldn’t give an instruction that’s too long, yet it should be informative enough for the patient to fully grasp the concept. It should be able to provide the patient with a little relaxation and be able to remain calm knowing that there are no good and bad answers.

The most common instruction given is “I will show you 10 cards and you’ll tell me everything they make you think of, or what you can imagine from these cards.”

When you hand over the card to the patient, you should be certain that you give it over in the right position, so you can observe how the patient manipulates it. If he or she changes its position, it’s an important fact for you should take note of, as well as the position he or she puts the card in.

The content is very important, of course, but the way it is given to you is just as important. Does your patient tell you immediately what he thinks the ink spot shows? Does he hesitate? Are there very long silences in his or her speech?

After you go through all the cards, you should start the inquiry phase. Here, you’ll try to go deeper on the answers you were given.

Then you go directly to the third phase, when you’ll push your patient to the limit in his or her answers (inquiry to the limits) and try to lead him towards everything he’s been avoiding. Why? Usually the avoided subjects are the most important ones for any patient.

There are answers that must be present in some way (like Human figure and same banal answers) otherwise the therapist needs to insist with the patient in order to get at them. This is particularly important regarding the human figure, because it can show you the relationship of the subject with a reality, humanely socialized.

Finally, there is the test of choices. This is a test where you’ll ask the patient to choose the 2 cards he likes the most and two he doesn’t like so much or at all. This phase is an appeal to the affections within them. In this phase you’ll realize which cards received the most positive and negative investment by the subject and it also allows a bigger development by you regarding these cards.

Rorschach – The most famous of projective tests

Whether it be in movies or jokes involving psychiatrists, most people already seen or heard about Rorschach, but just a few know what it really is.

A bunch of ink spots in a piece of paper would be a description you’d get upon asking, but, as a projective test, Rorschach is much more than that. Ancient, some may say, useless, others would argue, it introduces some mistrust into the relationship with the patient and therefore undesirable, some will claim, yet the Rorschach remains a renowned test in the field.

Despite all of its weaknesses, this apparently simple test, together with the clinical interview can indeed prove very useful. Because of its fame, some people think it’s fun to do it, completely bypassing the argument about the mistrust that it might cause, and, of course, its main goal will be achieved: allow us a glimpse into and a better understanding of our subject.

Why do we use it and how does it works?

The Rorschach is used to grant us access to the internal reality of a suffering subject. It will help us understand him, and luckily, show us the way to easing his pain.

This will be made by the articulation of the perception and projection, present in it.

The ink spot is perceived by the subject (manifest content), yet it’s just a spot, nothing concrete, so it will allow the subject to elaborate on what’s perceived according to his experiences and psychic functioning (projecting).

During the test, the subject will (or at least should) be relaxed, have his guard down and then the intrapsychic and interpersonal conflicts will emerge in the shape of desires and frustrations.

Application

As a professional, you must keep in mind that your own perception will naturally interfere in the test results, so, you must apply it in accordance with a rigorous methodological procedure, in order to grant scientific reliability to this instrument.

Projective Tests and their applications

Psychological evaluation is a current procedure, used in many contexts with children and adults alike. Testing is a part of that evaluation and that’s where and when we’ll find the projective tests. However, it’s important to remember that they are an auxiliary method and can never give us a diagnosis by themselves.

Projective tests are inserted in a complete psychological evaluation and can’t be used as a definitive portrait of an individual. By itself, a projective test can’t tell us who a person is or what they are thinking.

 

How do I decide among them?

It’s important to know exactly how they work and the answers they might, or might not, provide you with, so you can choose properly what the best option for you and your patient, actually is, taking into consideration the evaluation’s goals. The truth is that some tests actually complement each other (such as Rorschach and TAT for adults) and you should choose carefully what and which ones you’ll use and apply both when the situation requires it.

 

Are they truly accurate?

You’ll probably find many different opinions about projective tests, but, the better answer for this question is that it “depends on what you’re looking for”.

Projective tests show us a life’s reality, but it must be analyzed within that person’s context to make any sense. The same answer might have different meanings to different people with different lives and experiences, so you can’t make a projective test and expect to know a person solely based on the outcome. Actually, you should know your patient, have some sort of clinical relationship with them and maybe then, the projective test may have some validity.

The answers you’ll get during the test, as well as the behavior the subject will exhibit during its application (for example, trying to create a distance or, otherwise, giving the test an excessive meaning and living the situation with too much intensity – everything counts) are an interesting manifestation of the way that particular person interacts with and interprets the world around them.

The information given by projective tests together with other information from different sources will allow us a better apprehension of the psychic functioning of our subjects.

 

Sounds good, but… what about my patient? How would he or she experience it?

This is one of the first questions you should ask yourself. You know your patients well enough to realize the impact this kind of test will have on them (if you don’t, then probably now is not the time), and, thanks to that, you can evaluate if it’s a good option or if it will do more harm than good. Of course, this is different when you’re facing a mandatory evaluation…

So, I’ll present you with three delicate situations you might find yourself in and that can prevent you from reaching your goals.

You can have in front of you, a person that will live the test like if they were still in school taking some crucial final exam. This is not good for the evaluation as the person will not be relaxed and will probably lie or omit something in their answers whilst lost searching for the best answer in order to get “good grades”.

The most common difficulty however, is what I’d call the suspicious patient. It’s normal to find some mistrust in a patient under evaluation (this also tends to say something about the person), but you should try to change this feeling. Trust is important for accurate results.

And, the last one: the subject that uses the test as a way of expand, sometimes totally and uncontrollably opening themselves up. This kind of patient will use the test to say everything that comes to his mind, no matter what it might be. The test will function as an excuse for them to free themselves and say whatever they want, without filter. Again, it says something about the person and this kind of behavior cannot be ignored.

Projective Techniques and Clinical Psychology

There was a time, where the projective techniques were the most used in any field of psychology, however, with the continuous development of science and the deviations of psychology regarding philosophy, they are now, mostly used by clinical therapists.

Psychology no longer just stands for an individual telling things to a therapist in a closed room. There are many areas of psychology (such as social, educational, forensic…), all of them with a huge development, scientifically speaking, which was a big determinant for clinical field too.

Methods and tools are now widely validated theoretically and methodologically and that provided great advances in the field. However, clinical psychology focuses on the individual as a specific person, a psychological being, according to a specific theoretical and strategical reference.

For us to reach through to the individual, we must have more than what he is saying at this very moment, we have to contextualize that, according to the person’s life story, the context, where all of what they’re saying is inserted, and based on it, the therapist will make the interpretation of such information and make more sense of it.

This is the context where projective techniques and tests are born.

Projection Concept

For a more accurate understanding of all this, it’s necessary to know what the concept of projection means in the field. Psychologically speaking, projection is the way a subject understands his environment and how he answers to it taking into account his experiences.

Consequently, the projective techniques intend to deconstruct a reality, allowing the therapist access to recognize the psychological filters and schemes that may, or are indeed interfering in his relationship with the patient.

Therefore, they are quite important and even effective in clinical psychology, despite the fact that they are considered a little outdated within other fields.