Projective Psychodiagnostics: Inkblots, Stories, and Drawings as Clinical Measures
Projective Psychodiagnostics: Inkblots, Stories, and Drawings as Clinical Measures
- Marla EbyMarla EbyCambridge Health Alliance
Projective psychodiagnostics refers to the use of psychological instruments through which the subject is asked to respond to a set of ambiguous (though often suggestive) stimuli, thereby “projecting” aspects of their personality into these responses. The most prominent of these instruments includes the Rorschach Inkblot Technique, in which the subject is confronted with ten inkblots and is asked what these stimuli look like, and then what perceptual features make them look that way. Another common projective technique is the Thematic Apperception Test (TAT), a storytelling exercise in which the subject responds with a narrative to a series of ambiguous but sometimes highly charged black and white pictures depicting human interactions. Over time, new pictures have been developed for similar storytelling instruments targeted to children (the Children’s Apperception Test) or different ethnic populations. Both of these tests emerged under the influence of psychodynamic theories, and of the work of Carl Jung, whose Word Association Test served as a projective measure of psychological conflicts. Finally, there is a series of drawing tests which, while less commonly used, have had a projective history, including human figure drawings, the Bender–Gestalt Test, and the Wartegg Drawing Completion Test.
Projective instruments have been used in a variety of psychiatric settings and have been criticized for being insufficiently grounded in either quantitative measures or scientific validity. The Rorschach has emerged with increasingly statistically based scoring systems addressing perceptual features, language, and content in the assessment of risk and diagnosis. The TAT is essentially a structured interview (since most scoring systems are not used by clinicians), but it nonetheless appears to be useful in gleaning information about a subject’s relationships with other people. Drawing tasks and sentence completion tests (derived from word association tests) are less commonly used, though more prevalent with children whose verbal abilities may be more limited. In general, projective tests appear to have some limited ability to define diagnosis and risk (and can be especially helpful in defining thought disorder and prognosis), but they may be most useful in helping clinicians obtain a deeper picture of conflicts and resources within the person tested.
- History and Systems of Psychology
Projective psychodiagnostics (also referred to as projective tests or projective techniques) refers to a set of psychological instruments in which ambiguous stimuli are offered to subjects with the expectation that they will “project” aspects of their personalities into their responses. Lawrence Frank is credited with the first use of the term “projective techniques,” in an article published in 1939 (Exner, 1989). Frank (1939) suggested that a child is subject to the dual processes of socialization (demanding conformity to the outside world) and individuation (establishing a private world of idiosyncratic meanings). Frank argued that projective tests allowed entry into the subject’s private world of meaning-making. It may be noted that this concept came into play soon after Frederic Bartlett’s 1932 groundbreaking study Remembering, in which Bartlett states that the process of memory is inevitably affected by the meaning assigned to the material to be remembered (in some contrast to the earlier quantitative work with nonsense syllables by Hermann Ebbinghaus in 1885). In this light, one could argue, as does Paul Meehl (2000, pp. 367–368), that any test, even a so-called objective test, contains an element of projection of meaning into the questions posed.
Projective diagnostics, however, typically refers to a narrower group of tests especially chosen for their ambiguous—yet evocative—qualities. Chief among these would be the Rorschach Inkblot Technique, followed by a variety of storytelling techniques of which the leading representative is the Thematic Apperception Test (TAT). These were certainly the key examples characterizing projective techniques in a seminal 1942 paper by David Rapaport, who developed the principle of the “projective hypothesis” as follows: “All behavior manifestations of the human being, including the least and the most significant, are revealing and expressive of his personality, by which we mean that individual principle of which he is the carrier” (Rapaport, 1942, pp. 213–214). Rapaport noted that in both the Rorschach test and the TAT, the subject needed to give meaning to the stimuli by organizing them and making choices among possible responses.
Rapaport went on to say that projective techniques should have a system of scoring, a requirement not always met by these tests, as will be noted later. Rapaport further argued that the subject should be unaware of the significance of the test and his or her responses to it. Hence the stimuli for such tests should be carefully controlled and held secret by professional psychologists, as Joanne Brown (1992) argued in her discussion of psychology as a profession (though her premise was based on the users of intellectual tests). However, this requirement has also been challenged, with the full publication of the Rorschach inkblots along with common responses on Wikipedia in 2009.
The United States has been the dominant home for projective techniques, though they have also had a limited international presence (Piotrowski et al., 1993). Projective tests enjoyed great popularity in the United States especially in the 1940s and 1950s, though there was less interest elsewhere, most notably in the United Kingdom (Hubbard & Hegarty, 2016). Life magazine published an article in 1946 entitled “Personality Tests: Ink Blots are Used to Learn How People’s Minds Work,” which included various sample inkblots and TAT-like images, with sample responses from different subjects (Life Magazine, 1946). The blots in this issue, however, were not those designed by Rorschach, but instead were the work of Molly Harrower, a prominent psychologist who developed a method for group administration of the Rorschach. The same year saw the production of a film by Robert Siodmak (1946), The Dark Mirror, in which the identification of a psychotic murderer in a set of twins (both played by Olivia de Havilland) is discerned by a psychologist administering a battery of projective tests (including not only inkblots but a word association test). This film suggested that projective techniques held great promise, though later analysis, which we will consider for the individual tests, often argues otherwise. The film also highlights the danger of potential duplicity in the use of such instruments: not only is the murderous twin dishonest in her statements, but the psychologist administering the tests is too, since he tells his subjects he is just studying twins rather than conducting what is essentially a forensic examination.
Despite such risks, projective techniques played a significant role in evaluating Nazi leaders in the Nuremburg trials of 1945–1946, and both the Rorschach and the TAT were prominent in these assessments. The Rorschach results were equivocal, both at the time and in a later analysis by Molly Harrower (1976), who found that psychologists blind to the identity of the subjects could not reliably distinguish the Nazi records from those of control subjects. Nonetheless, Leopold Bellak (1950) argued that the Thematic Apperception stories of the Nazi subjects were strongly influenced by the situation of the testing—faced with the high likelihood of execution, these prisoners appeared to use the stories as a kind of displaced offering of explanation and even justification.
As we consider these various diagnostic tests in their turn, it is important to note key features of their construction. The demands of any test include an input component (here, a set of stimuli) as well as an output feature (the responses required of the subject), and the projective instruments discussed here differ in those elements. And a test, properly, must be measured against some sort of standard or norm. Some, perhaps most, of the instruments here lack such clear-cut standards and so might more properly be called techniques, rather than tests. Nonetheless, they offer structured tasks with the possibility of quantification, and so can be distinguished from other more free-form activities such as psychodrama or doll play.
Word Association Methods
Perhaps the first attempt to develop a standardized projective test was the Word Association Test created by Carl Jung with his colleague Franz Riklin in 1904, predating the better-known Rorschach by more than 15 years. In his early papers on this subject, Jung gave credit to several predecessors, the first of whom was Darwin’s cousin, the eugenicist Francis Galton, whose preoccupation with measurement extended to an investigation in 1879 of reactions (and reaction times) to a series of words. This method was then picked up by the experimental psychologist Wilhelm Wundt, who measured reaction times to such associations in both normal and pathological subjects. Emil Kraepelin and Eugen Bleuler extended this method to the study of psychiatric patients, but Jung observed that there were no normal standards for such associations, and so he developed a standardized set of a hundred words on which he tested normal subjects, measuring both atypical associations (particularly to affectively laden words such as “mother” and “bury”) and delays in reaction times. Jung postulated that there were essentially two types of associations: first, a typical response closely coupled with the objective meaning of the word offered, and second, an atypical egocentric response related to the underlying psyche of the individual, which Jung related to the complexes of the subject (Jung, 1969). In this distinction, he anticipates Frank’s notion of the dual processes of socialization and individuation noted earlier. Jung’s explorations of affect-laden words stand in some contrast to the efforts of the Americans Grace Kent and A. J. Rosanoff (1910), who also tested psychiatric patients and developed norms, but with a word list that was more deliberately neutral in content.
Despite Jung’s efforts at standardization, and his later efforts at relating these associations to psychopathology, and indeed to psychoanalysis itself, the Word Association Test essentially fell by the wayside as a clinical projective test, though later papers have updated his norms (Guibert & Martin-Tur, 2018) and even examined word association results for fMRI findings of brain activity in areas of the brain noted for mindfulness and empathy (Petchkovsky et al., 2013). Nonetheless, Jung’s work spawned a later projective association method, the sentence completion test, in which the stem of a sentence is completed by the subject. A well-known example of this method for adults is the Rotter Incomplete Sentences Test (Rotter & Willerman, 1947), which includes examples such as: “Back home …,” “A mother …,” and “What annoys me …” which proposes a scoring system where each response receives a score from 0 to 6, resulting in a general measure of maladjustment. Another instrument of this type, the Washington University Sentence Completion Test, was created in 1970 by Jane Loevinger (1998), first for adults and later for children, with a scoring system based on Loevinger’s Ego Development Scale. Other more curious spinoffs from the Word Association Test include the counterculture neuroscientist John C. Lilly’s (1972) tape loop of the word “cogitate” (causing the listener to imagine or associate new words to the repeated stimulus) and B. F. Skinner’s 1936 Verbal Summator test, in which vague auditory stimuli must be interpreted by the subject as words, described by Alexandra Rutherford (2003) as the Auditory Inkblot.
The Rorschach Inkblot Test (or experiment, as its author called it) was significantly different from the Word Association Test, in both the stimuli offered and the expectation of the subject. And yet it grew from the same environment—Hermann Rorschach was a Swiss psychiatrist who was powerfully influenced by Jung’s Word Association Test, which he administered to the patients in the asylum in which he worked, many of whom were schizophrenic. And like Jung, he had strong connections to Bleuler, who supervised Rorschach’s 1912 doctoral dissertation “On Reflex-Hallucinations and Kindred Manifestations,” a work related to his interest in kinesthesia and the relationship between perception and physical possibilities (Ellenberger, 1954).
But Rorschach was more than a research-oriented psychiatrist—he was also an artist (whose childhood nickname reportedly was Klex, German for blot), and so he experimented in the visual realm. While inkblots in the early 20th century were a common stimulus for imagination (for both poets as well as the general public), Rorschach sought to dive deeper into these images, claiming that the way a person perceived the world was a driving force behind responses. He was particularly interested in whether subjects focused on the color of his blots (as would extratensive outgoing personalities), or, as one might expect from his earlier research, the inherent movement – especially human movement – apparent in his stimuli (as would introversive creative sorts). While these traits are evocative of Jung’s concepts of extraversion and introversion, Rorschach took some pains to note that he was instead interested in perceptual style as a representation of one’s approach to the world. Unlike Alfred Binet, who used the blots as a measure of imagination and thus intelligence (Galison, 2004), Rorschach was less interested in content per se than he was in whether the percept provided was a good match to what others easily saw in the blots, or form quality. These qualities—color, movement, form quality—are called determinants, and they remain a centerpiece of the current scoring systems even now (Exner, 1969). As it is currently administered, 10 blots (five black and white, two black and red, and three multicolored) are set forth individually in front of the subject, who is asked, “what might this be?” After these responses are recorded, the cards are then administered a second time, so that the subject may locate his responses on the card, and identify “what makes it look that way?”
Unfortunately, Rorschach died within 9 months of the 1921 publication of Psychodiagnostik, the manual for his inkblot experiment, and so the clinical application of his technique was not further developed by him. Nonetheless, his work found its way into American psychology by way of two disciples: Bruno Klopfer (1942), who further defined Rorschach’s more minor determinants of the test such as achromatic color, various forms of shading, and different forms of movement, such as animal movement and inanimate movement; and Samuel Beck (1945), who, determined to set the task on a more scientific footing, created a normative table of frequent and unusual form quality responses. In a similar fashion, Marguerite Hertz (1936) collected Rorschach data on children and adolescents. Zygmund Piotrowski extended the scientific footing of the test through his development of profiles for subjects with neurological damage and schizophrenia, and he was keenly interested in the integration of percepts, outlined in his book Perceptanalysis (Piotrowski, 1957). And working at Austen Riggs, David Rapaport and Roy Schafer were interested in the Rorschach as a tool for psychoanalytic understanding (Schafer, 1954).
John Exner (1969) tried to integrate these approaches into his Comprehensive System of scoring, which included the creation of new normative tables (particularly including form quality, following Beck’s lead). With Exner’s death, this system was replaced by the statistically based Rorschach Performance Assessment System (R-PAS) (Mihura & Meyer, 2018). For the most part, these systems do not focus on the content of the responses, though both Exner and the R-PAS included scores for morbid and aggressive content, and the R-PAS has added a research-based Oral Dependency Scale.
Yet content was what many psychoanalytically oriented psychologists looked at, particularly including Roy Schafer (1954) and Robert Holt (1978), who were especially interested in libidinal and aggressive features. Partly as a consequence of that tendency—and of Exner’s rather guarded research methods—the Rorschach has been heavily criticized. Roderick Buchanan (1997) has contended that, in contrast to the Minnesota Multiphasic Personality Inventory (MMPI), the Rorschach is highly subjective and more a craft than a quantifiable scientific instrument. Wood, Nezworski, Lilienfeld, and Garb (2003) have further argued that the Rorschach is an invalid tool for assessing diagnosis and risk, that an overreliance by many psychologists on the content of responses allows for unscientific conjectures by those clinicians, and that the use of the Rorschach in clinical settings is troubling because of the tendency of many psychologists to dangerously overestimate pathology in a way that is poorly justified by the data. Nonetheless, three of these same authors (Wood, Nezworski, & Garb, 2003) later wrote an article in which they confirmed the validity of several research-based Rorschach measurements, notably Klopfer’s Rorschach Prognostic Rating Scale (which predicts better psychotherapy outcomes in patients who report imagery involving movement), the Oral Dependency Scale (which uses oral content to assess dependency needs), overall intelligence (determined by the complexity of responses), and the Thought Disorder Index (based on research by Mary Hollis Johnston and Philip Holzman (1979) characterizing different types of thought-disordered responses for schizophrenic vs. bipolar patients). In addition, Fowler et al. (2001) have confirmed that Exner’s suicide constellation has a strong correlation with near-lethal suicide attempts. Later work added artistic and neuroscientific analysis of the perceptual qualities of the blots, exploring symmetry, figure–ground relationships, and movement, this last being related through fMRI studies to areas of the brain associated with empathy (Schott, 2014). Despite such findings, however, the test has fallen out of favor in many clinical psychology graduate programs, replaced by instruments that are more empirically based and less time-consuming to administer and score (Piotrowski, 2015).
Less complex, and admittedly less scientific, was the TAT, a series of 20 black and white pictures (some of which differed according to age and gender) created by Henry Murray with illustrations by his colleague Christiana Morgan in 1935. Like Rorschach, they were heavily influenced by Carl Jung—Morgan in particular provided drawings of her dreams to Jung for his analysis. For the TAT, she used magazine pictures or paintings as a foundation for her drawings, which she often made both more evocative with deep shading, as well as more ambiguous. Subjects were instructed to tell a story about the picture, with a beginning, a middle, and an end, and to report what the characters were thinking and feeling. Murray stated that the idea for the test came from one of his graduate students, who reported that her young son was able to tell creative stories when prompted just with pictures from a book. Murray was adamant that the test should not be scored; his idea was that the pictures would reveal the characteristics of the individual situated in the environment—the perceived presses of their environment, and their needs and unique coping strategies—rather than the universal or group traits often found in a psychological experiment (Murray & McAdams, 2007). That said, psychologists have tried to develop scoring procedures for this test. In the early 1950s, David McClelland (1999) notably studied the needs for achievement, affiliation, and power, which fostered a series of studies on the TAT and similar pictures, which can still be found in the Henry A. Murray Research Archive at Harvard University. Drew Westen (1991) used TAT stories to evaluate the nature of relationships that the subject has with other people, with a particular focus on the complexity and tone of those relationships. None of these scoring systems are typically used by most clinical psychologists, and again, this test (though strictly speaking it is not a test) is no longer emphasized in many clinical psychology programs.
In contrast to Rorschach, who was interested in perceptual styles, Murray announced himself through the TAT as interested in the context of situations, and the subject’s unique interpretation of context. New storytelling tests were developed that were child-friendly: the 1949 Children’s Apperception Test (which has images of animals doing familiar tasks), and the 1947 Blacky Pictures Test, drawn by an artist from the Disney studio, featuring a black dog in a variety of heavily laden Freudian situations (Blum, 1950). The 1982 Roberts Apperception Test (with line drawings of children in various potentially conflictual situations) has developed several different versions for different racial groups. A more multicultural TAT spinoff is the 1984 Tell-Me-A-Story (TEMAS) Test, aimed toward the experiences of minority children.
In the adult testing world, it was observed early on that African American subjects looking at TAT cards (which have exclusively white protagonists) produced shorter and more guarded stories than their white counterparts (as later experimentally confirmed by Bailey & Green, 1977). Consequently, psychologist Charles E. Thompson tried an experiment—he asked an African American subject to imagine that the TAT characters were Black, and to tell the stories accordingly. Since the subject then produced more detailed and longer stories than average, Thompson decided to substitute Black figures for the White figures in the usual TAT. The result is the Thompson Modification of the TAT, otherwise known as the Black TAT, created in 1949. However, this is a relatively little-known test, and the drawings are not up to the standard set by Christiana Morgan in the standard TAT. Criticism of the Thompson TAT has also centered on simply putting Black faces in what were originally White situations. Consequently, subsequent storytelling tests have sought to alter the context as well as the race of the figures depicted. One such test was created in 1972 by the Black psychologist Robert L. Williams, known as a longstanding proponent of culture-specific testing. He explicitly designed his TAT-like test to reflect situations common to African American experience and created Themes Concerning Blacks, which again has not gained extensive clinical traction.
Since Murray (who was spurned by the experimental psychologists at Harvard) found himself in the newly formed department of Social Relations, he was co-located with social anthropologists, and in addition TAT-like clones with a variety of ethnic backgrounds were developed in the late 1940s and 1950s as a way to study different cultures, including the Pacific Island TAT, the Congo TAT, the Instrumental Activities Test for Native Americans, and the Values Test (also assessing Native Americans). Many of these tests have been criticized for being Eurocentric and even related to social control, as the historian of science Rebecca Lemov (2011) suggests in her review of these measures. While they were frequently given (along with the Rorschach) by anthropologists of the 1950s, this approach of cross-cultural studies through projective tests has long been abandoned. Yet all these efforts strongly confirm Kurt Danzinger’s (1990) point that the assessment of personality characteristics is highly dependent on social context.
While the stimuli for the Rorschach and the TAT are visual, the output from the subject is highly dependent on verbal ability, which is sometimes a problem in assessing the mentally disabled, subjects from different cultures, and children. Child psychologists in particular sought nonverbal techniques and arrived at a variety of drawing tasks, most of which involved the production of human figures. Examples here include the Draw-A-Person Test (created by Florence Goodenough in 1926), the House-Tree-Person Test (developed in 1948 by John Buck and Emanual Hammer), and the Kinetic Family Drawing Test (in which the subject is asked to draw family members doing something together, developed by Robert Burns and S. H. Kaufman in 1970). Early scoring methods for these tasks involved assessment using various signs (for instance, enlarged eyes were thought to be related to paranoia), particularly represented by the work of Karen Machover (1949). A later scoring method by Elizabeth Koppitz (1968) focused on a more global assessment that examined overall quality and expressions. A critical review by Scott Lilienfeld et al. (2017) concluded that while the validity of these tests is generally quite limited (particularly when individual signs are emphasized), global scoring methods yield some associations with anxiety, depression, and overall psychopathology. They also point out that artistic ability is a distracting factor, since the degree of skill is strongly related to overall scores in these instruments.
A similar criticism could be leveled at the Bender Visuo-Motor Gestalt Test, in which the subject is asked to reproduce nine geometric figures introduced individually on small cards. This instrument was developed by Lauretta Bender in 1938 primarily as a test for neurological conditions, but since patients with severe mental illness also distorted these designs, it was also adopted as a projective test in which various distortions were associated with various personality traits (Bender, 1938). This use was abandoned when these hypothetical connections were generally not substantiated, though it still has some use as a neurological screen, particularly when the test is administered with a distracting background on the paper on which the figures are to be drawn.
The German gestalt psychologist Ehrig Wartegg created yet another structured drawing test in 1939 (Crisi, 2014). Known originally as the Wartegg Zeichen Test, and in English as the Wartegg Drawing Completion Test, the subject is given a page with eight outlined squares each of which contains a stimulus sign, such as a dot, a line, a series of lines, or a squiggle. The subject is told to use this sign as a stem to create a new drawing. While this test has had a substantial though somewhat scattered international following, it has been slow to catch on in the United States. However, a meta-analysis by Jarna Soilevuo Grønnerød and Cato Grønnerød (2012) found few consistent findings, with isolated studies often hampered by inadequate methodology and grounding in the work of others. While this test is quite easy to administer, scoring reliability is uncertain (and linked to various competing schools of scoring methods), and though it appears to be less culturally bound, again it is likely to be affected by wide variations in drawing skill and experience.
How the Projective Tests Live On
Projective methods have been roundly criticized almost from their introduction, both within and outside the psychological profession. These criticisms have largely centered on the scientific value and psychometric properties of these instruments, particularly when they are used in high-stakes classifications of patients in hospitals and forensic settings. Historically, projective tests occupied a significant portion of the journal Character and Personality from its inception in 1932, but this influence waned as the journal was renamed in 1945 as the Journal of Personality and its focus grew increasingly more experimental (Craik, 1986). The strong standing of the Rorschach led to the founding in 1936 of the Rorschach Research Exchange by Klopfer, leading to the creation of a new periodical, the Journal of Projective Techniques, in 1950, but here too name changes (to the Journal of Projective Techniques and Personality Assessment in 1963, and then to the Journal of Personality Assessment in 1971) announced the increasing influence of the nonprojective MMPI (Weinter, 2018).
However, it is worth noting that Meyer et al. (2001) have gathered evidence demonstrating that the validity of psychological tests in a variety of areas is consistent with that of frequently used medical tests. And two projective measures—notably the Rorschach inkblots and the TAT—have persisted as clinical tools for close to a century. In considering why this is so, it makes sense to examine the instruments themselves more closely.
The historian of science Peter Galison (2015) has made the argument that the Rorschach, for instance, is a technology, and that this technology has a reciprocal relationship with the self—the instrument is fashioned in a certain way because of ideas of who we are, and it also works to change what we are. All these projective instruments were created during a period when ideas about the unconscious altered our sense of identity. Galison argues that a shift occurred in which we saw ourselves no longer as a collection of faculties (such as imagination) engineered by a sense of will; instead, there are large aspects of who we are that are hidden not only from others, but even from ourselves. In talking about the TAT, Henry Murray famously said that the test could reveal not only what the subject knew and chose not to say, but also things that the subject neither knew nor was able to say (Evans, 1964).
But what kind of technique—or technology—is able to effect such a result? And what factors enable the use of some tests to persist, while others are confined to the archives? In exploring the Rorschach, Naamah Akavia (2013) claims that Rorschach’s ability to elicit the movement response in his inkblots is at the center of the test, and indeed Rorschach was quite taken with experiments at the time in which restrained subjects then had dreams of motion. Parenthetically, it is worth noting that both photography and art were also considering how to portray movement in the early 20th century (Frizot, 1998). In other words, the inkblots were not simply accidental: they were constructed by this physician-artist with the addition of paint to his thoughtfully selected blots. Akavia’s carefully researched theory is supported not only by history but by the blots themselves; common responses as collected by Beck and then Exner often involve movement, and later attempts to create new projective inkblots, in 1953 by John Howard (1953) and in 1961 by Wayne Holtzman (2002), seem almost flat by comparison. In a similar way, the TAT, though it consists of still portraits of human figures, often suggests the potential for movement about to take place, thus prompting a causal narrative line. In both cases, the subject is drawn in by the fact that something is about to happen.
Second, both the Rorschach and the TAT artfully combine highly specific detail with deliberately ambiguous features and evocative shading. The Rorschach inkblots are highly suggestive, especially of animals and people, but also of textured surfaces such as fur, and anatomical details as well. Yet each blot has features that fight against an easy statement such as “Oh, that’s a bat”—there’s always a part of the blot that doesn’t quite fit in. In the TAT, Christiana Morgan (also an artist) started with images from magazines and pictures, but she added and subtracted: a silhouette against a window opening up to another room with wallpaper is not especially suggestive, but when Morgan took this image and removed the wallpaper and left white space, it could be a man greeting a sunny day, a thief in the night, or a man about to jump. In other items, she created ambiguity in key places—a figure on the floor huddled over a bench has an item nearby—but is it a gun or a set of keys? A girl is holding what appears to be a baby—but could it be a doll? The images of those small details are unclear. Like a short story by Chekhov, the overall picture is painted in great detail, but something is a little confusing, or left out, inviting the viewer in. With these points in mind, it is perhaps less surprising that tests involving simple word associations or drawings have gained less clinical ground—they do not offer the same carefully constructed stimuli as the Rorschach and the TAT.
One could therefore make the argument that some of these techniques are psychological and also that they are evocative of projections from the subject. But are they diagnostic? Classically, psychiatric diagnosis is associated with pathology—one classifies the patient subject into one diagnostic group or another. There is reason to believe that projective tests are of some usefulness in that regard: research supports that the Rorschach can diagnose different forms of thought disorder, as well as the presence of psychosis itself. Johnston and Holtzman (1979) have observed that a key feature of poor reality testing is the loss of distance between the blot and the subject, who experiences the inkblot as all too real, in concert with Peter Galison’s (2004) attention to the difference between seeing and seeing as. And as Schafer (1954) long ago pointed out, the coherence and formal qualities of TAT narratives can also reveal disturbed thinking. These tests can detect—as Frank argued and the presence of norms confirms—deviance from a standard “normality.” However, they identify not just a pathology or a diagnostic group membership; they also bend psychological inquiry—as suggested by Sigmund Koch and Suzanne Langer—beyond laboratory science toward the hermeneutical (Koch & Leary, 1985). Projective tests may categorize, but they may also ask: Who is this person? How do the subjects of these tests perceive the world, how do they imagine themselves in it, what do they want, and how do they cope? What undiscovered secrets may lurk beneath? And how do they use their minds to make meaning?
“I am like a Rorschach test,” said Barack Obama in a 2008 New York Times interview. “Even if people find me disappointing ultimately, they might gain something” (Powell, 2008). And with those remarks, Obama may have effectively summarized not only his own standing, but also that of the Rorschach and other projective tests. For the past hundred years, a significant number of psychologists have held on to these instruments in the face of much criticism, because despite their shortcomings, they tell us something, even though that something is often hard to define.
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