Harrower’s test seemed to work, to some extent. The results for 329 “unselected normals,” 225 male prison inmates, 30 students consulting a college psychiatrist (“some of them with rather serious diagnoses, others considered much improved following psychotherapy”), and 143 institutionalized mental patients clearly categorized the groups differently. The latter groups were more likely to fail, while fully 55 percent of the “superior adults” tested had no poor answers at all, and the only one with more than four turned out to have been hospitalized twice for manic depression. Harrower soon made some basic adjustments, for instance factoring in that doctors and nurses give more Anatomical answers, which were otherwise scored as bad. She also found that a trained Rorschacher looking at people’s results could make better judgments, especially with the borderline cases who gave three or four poor answers. But even “sticking religiously to purely quantitative terms” gave real results. She argued that her quick and dirty test had “undeniable advantages, not over and against the Rorschach but as a procedure in its own right.”
The Multiple-Choice Test met with a positive reception in education and business, but several studies found it too unreliable for military screenings, and it was never adopted for mass use by the military. Still, having been reframed in 1939 as the ultimate projective method for revealing the subtleties of personality, the Rorschach was now being reinvented again as a test yielding a quick number, a yes/no. While the Rorschach proper “remained a method requiring its own specialists,” Harrower wrote, she had turned the inkblots into “a psychological test in the usual sense of the word” (emphasis added). That was what the army needed, and what Americans wanted.
Sixty million standardized tests, educational and vocational as well as psychological, were given to twenty million Americans in 1944 alone. In 1940, The Mental Measurements Yearbook reviewed 325 different tests and listed 200 more. Most were used by only a handful of psychologists, and only one would come to be known as “the queen of tests,” for reasons having less to do with the inkblots than with the transformation of American psychology.
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World War II was the turning point in the history of mental health in America. Before the war, psychiatrists had worked in mental hospitals, psychologists—still “hard” scientists, not “soft” therapists—largely stayed confined to university labs, and the few clinical psychologists there were tended to focus on children and education. Freudian ideas had been appropriated by psychiatrists in the United States, to the point where psychoanalysis was seen almost exclusively as a way to treat mental illness—not as, say, a vehicle for scientific inquiry or personal exploration.
Most Americans had never undergone mental health treatment and didn’t know what it was. Even if a psychoanalytic approach drew some psychiatrists out of the hospitals and into private practice or Child Guidance clinics in a few major cities, psychotherapy remained marginal in society as a whole. Psychiatrists treated patients, psychologists studied subjects, and most people were left for their communities to help as best they could.
With the war, and the nation’s first general draft, every able-bodied man in the country was given a psychological screening along with intelligence tests and medical exams. The number of potential soldiers screened out with “intolerable psychological risk profiles” was astonishingly high: some 1,875,000 men in the army alone, or 12 percent of those tested in the years 1942–45. Even with this exclusion rate, six times the rate during World War I, war neurosis in the US Armed Forces was reported at more than twice the rate as in World War I. There were more than a million neuropsychiatric admissions to army medical services, with another 150,000 from the navy, and so on—and these were from the soldiers who had passed the screening. Some 380,000 were discharged for psychiatric reasons (more than a third of all medical discharges), another 137,000 for “personality disorders”; 120,000 psychiatric patients had to be evacuated from the field of operations, 28,000 by air.
Whether these numbers show how badly screening was needed or that it didn’t work—General George C. Marshall ordered it discontinued in 1944—there was clearly a crisis. Some people were faking, but the vast majority of cases were real, which meant two things: that mental illness affected a far greater portion of the population than anyone had dreamed of and that “healthy” people needed psychological treatment too. Only a minority of nervous breakdowns in the military took place on the front lines or even overseas. Most were caused by a variety of factors that affected people back home as well, such as “stress,” a concept rapidly spreading from military psychiatry circles to the public at large.
It was a national concern. As one history of psychotherapy in America puts it, the “pitiful” physical health of America’s young men was dire enough—“missing teeth, untreated abscesses and sores, uncorrected vision problems, uncorrected skeletal deformities, untreated chronic infections”—prompting efforts to increase the number of medical doctors and access to them across the country. Still, “the 12 percent rejection rate for mental illness stood alone for its shock value.”
When the war started, the US Army had thirty-five psychiatrists, total. The “very great shortage of trained personnel, not only of psychiatrists and neurologists but of psychologists and psychiatric social workers,” was a “revelation,” according to the man in charge, Brigadier General William C. Menninger. By the end of the war, the thirty-five had become a thousand in the army and another seven hundred in the rest of the military, including “practically every member” of the American Psychiatric Association “not barred by age, disability or ear-marked as essential for civilian psychiatry,” as well as plenty of new recruits.
They were needed at hundreds of induction centers, basic training camps, disciplinary barracks, rehab centers, and hospitals at home and abroad. Aside from psychiatrists, military psychologists were at work on tasks such as designing complex instrument panels adapted to the mental capacities and perceptual limitations of the people using them. “Not until the war was almost over,” Menninger later summed up, “did we have anywhere near enough personnel to do the job.”
In fact, there weren’t enough personnel anywhere in the country. Barely a third of the medical officers assigned in neuropsychiatry had had any psychiatric experience before the war. At war’s end, with sixteen million returning troops to look after, the need was even greater; more than half of the postwar Veterans Administration hospitalizations would be for mental health disorders. Civilians, too, were starting to learn about the benefits of mental health treatment. In General Menninger’s postwar words, “Conservatively there are at least two million people who have had direct contact or relationship with psychiatry as a result of mental sickness or personality disorders that occurred in soldiers in this war. For a large percentage of this group it is their first. They are becoming educated.” Having learned his own lesson, Menninger started working aggressively to promote mental health training, preventive care, and treatment around the country. The nation had to ramp up its mental health services as much as the military just had.
Congress passed the National Mental Health Act in 1946, creating the National Institute of Mental Health with a broad public service mission. It created new standards for the field, whereby clinical psychologists were “scientist-practitioners” meant to work with the public, not just in labs. The VA set up joint programs between its hospitals and nearby medical schools to turn out the psychotherapists it needed, and before long was employing three times more clinical psychologists than had existed in the whole country in 1940. Clinical psychology was booming, heavily supported by government funding.
The Rorschach was poised to benefit on all fronts, as both a diagnostic tool with tangible benefits for practicing psychiatrists and a test compatible with the drive for quantifiable scoring in academic psychology. Psychology, meanwhile, was becoming more psychoanalytical and less quantitative anyway, with the rise of clinical psychologists and their new “scientist-practitioner” training. By an accident of
timing, there were no competing assessment textbooks until the late forties, so all the new clinical psychology programs springing up had no choice but to use books on the Rorschach. In 1946, the Rorschach was the second most popular personality test, behind the simpler Goodenough Draw-a-Man Test, and the fourth most popular test overall, behind two different IQ tests. It was the most popular clinical psychology dissertation topic for years.
Within the military, the Rorschach had remained in limited use. It was still slower than other tests, and there were not enough doctors with the specialized training required to give it to all those millions of soldiers. Or even enough inkblots: one first lieutenant assigned to a psychiatric unit in Paris during the war couldn’t find a set of cards anywhere and had to arrange for his wife to meet Bruno Klopfer in Manhattan to pick up a set and mail them to him. (A few weeks later, he stumbled across a hundred sets of Rorschach and TAT cards in the basement of the Eisenhower headquarters: the army had ordered and then forgotten them.) Still, despite the failure of the Multiple-Choice Test for mass screening, the Rorschach proper found many other military applications, both in psychiatry—diagnosing and treating patients—and in psychology, for instance, to study operational fatigue in air force combat pilots.
In a broader context, the new value placed on testing, and the jockeying for position between psychiatrists and psychologists, helped the Rorschach’s fortunes. Case review conferences, an increasingly common practice that had started in Child Guidance clinics, brought together a psychiatrist in charge of treatment, a psychologist who gave tests, and a psychiatric social worker who participated in therapy. In the past, the psychologist would report the patient’s IQ and maybe another numerical result or two; then his work was done. But if he was expert in the intricate and mysterious Rorschach, he might hold the floor with a discussion of color shock, Experience Type, or a rigid problem-solving approach, and his colleagues around the table would nod their heads, recognizing truths about their patient.
Thousands of psychiatrists and psychologists had seen what they felt were shockingly fast and exact blind diagnoses, or findings with the Rorschach that no other approach could offer. Psychoanalytic psychiatrists in particular, suspicious of “self-reporting” tests like questionnaires that in their view underestimated the power of the unconscious, felt the Rorschach was speaking their language. It was those psychiatrists, as much as the psychologists, who called the Rorschach “the queen of tests.”
In other ways, both psychologists and psychiatrists were struggling to define their professional roles against a common threat. The medical officers hastily trained for military service, without degrees in psychology or psychiatry, had done a pretty good job. And what about social workers? If they could help people just as well, after less rigorous training and for less money—calling it “counseling” instead of “psychotherapy”—then what was the point of psychiatrists and clinical psychologists at all? The point, they argued, was their training and expertise, and the Rorschach was a respected and intimidating sign of that expertise. The ten inkblot cards became an important and vivid status symbol, good for the clinician’s job security and self-image.
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Klopfer’s textbook The Rorschach Technique: A Manual for a Projective Method of Personality Diagnosis came out in 1942, at just the right moment for it to be taken up as the bible of psychological testers and the standard textbook in graduate programs, shaping the next generation. Klopfer noted in his foreword that the book was being published “at a time of emergency when we are all called upon to make the most effective possible use of our resources, whether these be men or materials. The Rorschach method is proving its worth in helping us to avoid waste of human resources” in both the army and civilian defense, and he was grateful for the chance to do his part. Since he was an escaped German Jew, his patriotism was certainly heartfelt; it was also excellent marketing. In the words of a leading educational psychologist named Lee J. Cronbach, in the late fifties, no book “had more influence on American Rorschach technique—and therefore on clinical diagnostic practice—than the Klopfer-Kelley book of 1942.”
Two women working as MA-level psychologists at New York’s Bellevue, Ruth Bochner and Florence Halpern, would never become famous, but they published that same year what may have been, in real terms, the most influential Rorschach book of all. Written under the pressures of wartime, The Clinical Application of the Rorschach Test was pooh-poohed by Rorschach experts at the time (“a carelessly written work, replete with loose statements, contradictions, and misleading conclusions”), but it was popular—reviewed in Time magazine, going into a second edition in 1945. It told all those new army psychologists under orders to turn themselves into Rorschachers on the double, many of them to be plucked from analyzing rats in mazes at university labs or with no previous training in what the test was and how to use it.
Oversimplified or not, the book was straightforward. With a foldout table of fractions in the back, you could calculate all the percentage scores without wasting time with long division or breaking out the slide rule (13/29 = 44.7 percent). Chapters were called things like “What the Symbols in Column I Mean,” a level of practical clarity that the leading Rorschachers rarely descended to. Klopfer covered the same material in “Scoring Categories for Location of Responses,” nearly a hundred pages into his book, while Beck’s 1944 textbook would discuss it in six separate chapters, including “Scoring Problems” and “Approach and Sequence: Ap, Seq.” Which do you think could teach you how to give a Rorschach?
Bochner and Halpern were well aware of the Klopfer and Beck debates, the nuances and caveats in Rorschach’s own work, and the complexities of how different parts of the test could interact—but they cut to the chase. Someone giving one kind of answer “is obviously a person of ability, and social rapport will be more difficult for him”; someone giving another kind “is an egocentric person, full of demands, and inclined to irritability. Since he cannot make the necessary adjustment he expects the rest of the world to adjust to him.” People who found one particular card “sinister” were “easily disturbed by concentrated darkness, and tend to be anxious and easily depressed.” One woman’s resistance to a certain card “is obviously of a sexual nature, and from an analysis of the contents of her responses seems linked with the question of pregnancy,” which she tried to avoid by “misinterpreting or denying the symbols of male genitalia” in the inkblot. Lo and behold, her case history revealed that she and her boyfriend “went beyond the usual petting” six weeks ago, and now her period was late. A detailed report for therapy or analysis could equally well be replaced with a sentence or two, to be used for classification. The Rorschach might be harder to master than most tests, but that didn’t mean it couldn’t be standardized.
These sweeping assertions and others like them laid out what would become the received wisdom about the nature and meaning of the Rorschach. Bochner and Halpern firmly cast it as a projective method, not a perceptual experiment, and they downplayed the objective qualities of the actual images: “Since the blots are primarily without content, the subject must of necessity project himself into them.” They declared that a test taker “must be made to think that any response he gives is a good response” and that anything else “is incompatible with the ideology of the experiment,” even though responses actually were scored good or bad, and Rorschach himself had written that misleading people was unethical if the test results would have practical consequences.
Their version of the Rorschach was what entered popular culture. No right or wrong answers, you were free to say whatever you wanted, and then before you knew it you’d been categorized, your secrets revealed. Bochner and Halpern never directly reached a mass audience, like popularizations of Freud or Ruth Benedict’s Patterns of Culture for anthropology, but what the American public thought it knew about the Rorschach was all right there.
A third book came out in 1942: Hermann Rorschach’s Psychodiagnostics, in English at last. Here, it seemed, was
the authoritative statement that could remind readers what the test was truly about, bring it back to its bearings. But too much had happened in twenty years. Badly translated, confusingly partial, and self-contradictory with its inclusion of the posthumous 1922 essay, Psychodiagnostics had nothing to say about projective methods, X-rays of the soul, character and personality, group testing, anthropology (beyond Bernese and Appenzeller Swiss!), or Beck’s and Klopfer’s dueling systems. If Rorschach had lived, he would have been only fifty-seven years old, able to weigh in on all these topics himself. On its own, the book was too little, too late, to rein in the sorcerer’s apprentice.
By the midforties, practically every American had a son, brother, or other loved one who had been given psychological testing in the draft; an increasing number had taken such tests themselves. Not surprisingly, it was just then that Freudian jargon—inferiority complex, repression, and so forth—exploded into popular culture, along with psychotherapy in general, and the inkblots.
In October 1946, millions would have seen “Personality Tests: Ink Blots Are Used to Learn How People’s Minds Work” in Life magazine, which in the late 1940s reached some 22.5 million readers, more than 20 percent of the entire adult and teenage US population. This article showed four “successful young New Yorkers” looking at inkblots—the Lawyer, the Executive, the Producer, and the Composer (future novelist Paul Bowles, as it happens)—along with Thomas M. Harris, “who gives a course at Harvard in adapting the Rorschach to job selection.” It accurately covered details like norms and scores: “Responses are judged not so much by their actual content as by how they compare with the responses in thousands of tests previously given….It belongs to a class of tests which is called projective.” Readers were gently invited to give it a try themselves.
The Inkblots Page 24
