Chapter 22: Beyond True or False
densely quantitative papers: One such article collated data from more than 125 meta-analyses on test validity and eight hundred samples examining multimethod assessment, concluding that: “(a) Psychological test validity is strong and compelling, (b) psychological test validity is comparable to medical test validity, (c) distinct assessment methods provide unique sources of information, and (d) clinicians who rely exclusively on interviews are prone to incomplete understandings” (Meyer et al., “Psychological Testing and Psychological Assessment: A Review of Evidence and Issues,” American Psychologist 56.2 [2001]: 128–65).
“inaccurate” to call it a “schism”: Interview, September 2013. The statement in print is in Erard, Meyer, and Viglione, “Setting the Record Straight: Comment on Gurley, Piechowski, Sheehan, and Gray (2014) on the Admissibility of the Rorschach Performance Assessment System (R-PAS) in Court,” Psychological Injury and Law 7 (2014): 165–77, esp. the history on 166–68: “RPAS is not really competing with the CS; it is evolving beyond it and is designed to replace it.”
Rorschach Performance Assessment System, or R-PAS: Meyer et al., Rorschach Performance Assessment System Manual (see note to my Author’s Note, p. 329), hereafter Manual.
“not advisable”: Lecture to teachers in St. Gallen, May 18, 1921 (HRA 3:2:1:7), 1.
no right or wrong answer: Manual, 11.
“How can you get anything”: Manual, 10.
SPARC, a support group: They seemed to take the position that the Rorschach was unfair to men, while Rorschach opponents concerned about unfairness to women were just as vocal on the other side, e.g., Elizabeth J. Kates (“Re-evaluating the Evaluators” and “The Rorschach Psychological Test”: n.d., accessed July 11, 2016, www.thelizlibrary.org/liz/child-custody-evaluations.html and www.thelizlibrary.org/therapeutic-jurisprudence/custody-evaluator-testing/rorschach.html). See the website for SPARC, especially the pages “The Rorschach Test” and “The Rorschach Test: Additional Information and Commentary” (www.deltabravo.net/cms/plugins/content/content.php?content.35 and…content.36). Interview with Waylon (SPARC’s founder), November 2011.
trademarked since 1991: Silvia Schultius, Hogrefe Verlag, personal communication, 2016.
“Has Wikipedia Created Rorschach Cheat Sheet?”: By Noam Cohen, New York Times, July 28, 2009.
“Because the inkblot images”: Manual, 11.
preliminary 2013 study: D. S. Schultz and V. M. Brabender, “More Challenges Since Wikipedia: The Effects of Exposure to Internet Information About the Rorschach on Selected Comprehensive System Variables,” JPA 95.2 (2013): 149–58: “Recent research aimed at investigating the Rorschach’s ability to remain unaffected by conscious attempts at response distortion [has] yielded inconsistent results.” See also Ronald J. Ganellen, “Rorschach Assessment of Malingering and Defensive Response Sets,” in Gacono and Evans, Handbook, 89–120.
test with multiple metrics: Wood, Nezworski, and Stejska, “Comprehensive System,” 5.
In 2013, Mihura’s findings: J. L. Mihura et al., “The Validity of Individual Rorschach Variables,” Psychological Bulletin 139.3 (2013): 548–605.
seems to have come to an end: Some of the usual critics pointed out ways the R-PAS didn’t go far enough, calling it a half measure rushed into existence before a truly empirical, scientific groundwork could be laid (see next note, and interview with James M. Wood, January 2014). Meanwhile, others criticized the R-PAS as going too far. They rallied to Exner’s posthumous defense and founded an “International Rorschach Organization for the Comprehensive System,” with the heartfelt cry that the developers of R-PAS had “confused and bewildered many in the psychological community” with their corrections. “Our goal should be to continue Dr. Exner’s deliberate and methodical evolutionary process for a still better Comprehensive System,” even though it is not clear how any of the actual materials can legally be updated, evolutionarily or not. Carl-Erik Mattlar, “The Issue of an Evolutionary Development of the Rorschach Comprehensive System (RCS) Versus a Revolutionary Change (R-PAS),” Rorschach Training Programs, 2011, www.rorschachtraining.com/wp-content/uploads/2011/10/The-Issue-of-an-Evolutionary-Development-of-the-Rorschach-Comprehensive-System.pdf. Squabbles aside, the scientific debates seem settled.
The critics called: James M. Wood et al., “A Second Look at the Validity of Widely Used Rorschach Indices: Comment,” Psychological Bulletin 141.1 (2015): 236–49. They still had various complaints, but for a convincing rebuttal see Mihura et al., “Standards, Accuracy, and Questions of Bias in Rorschach Meta-analyses: Reply,” Psychological Bulletin 141.1 (2015): 250–60.
legal case for the new system: Erard, Meyer, and Viglione, “Setting the Record Straight.” I was not able to consult Mihura and Meyer, ed., Applications of the Rorschach Performance Assessment System (R-PAS) (New York: Guilford Press, forthcoming 2017), which has several articles on the topic.
more than 80 percent: 35 out of 43 programs, versus 23 out of 43 (Joni L. Mihura, Manali Roy, and Robert A. Graceffo, “Psychological Assessment Training in Clinical Psychology Doctoral Programs,” JPA [2016, published online], 6).
Collaborative/Therapeutic Assessment: Stephen E. Finn and Mary E. Tonsager, “Information-Gathering and Therapeutic Models of Assessment: Complementary Paradigms,” Psychological Assessment 9.4 (1997): 374–85, and “How Therapeutic Assessment Became Humanistic,” Humanistic Psychologist 30.1–2 (2002): 10–22; Stephen E. Finn, In Our Clients’ Shoes: Theory and Techniques of Therapeutic Assessment (Mahwah, NJ: Lawrence Erlbaum, 2007) and “Journeys Through the Valley of Death: Multimethod Psychological Assessment and Personality Transformation in Long-Term Psychotherapy,” JPA 93.2 (2011): 123–41; Stephen E. Finn, Constance T. Fischer, and Leonard Handler, Collaborative/Therapeutic Assessment: A Casebook and Guide (Hoboken, NJ: John Wiley, 2012); Stephen E. Finn, “2012 Therapeutic Assessment Advanced Training,” TA Connection newsletter 1.1 (2013): 21–23.
a man came into Finn’s office: Finn and Tonsager, “How Therapeutic Assessment Became Humanistic.”
“empathy magnifiers”: Finn and Tonsager, “Information-Gathering.”
“coming for a psychological assessment”: Finn, Fischer, and Handler, Collaborative/Therapeutic Assessment, 11.
But an increasing number of controlled studies: Ibid., 13 ff.
2010 meta-analysis: John M. Poston and William E. Hanson, “Meta-analysis of Psychological Assessment as a Therapeutic Intervention,” Psychological Assessment 22.2 (2010): 203–12. S. O. Lilienfeld, H. N. Garb, and J. M. Wood, “Unresolved Questions Concerning the Effectiveness of Psychological Assessment as a Therapeutic Intervention: Comment,” and discussion, Psychological Assessment 23.4 (2011): 1047–55.
One woman in her forties: Finn, “2012 Therapeutic Assessment Advanced Training.”
“We would not necessarily consider”: Finn and Tonsager, “Information-Gathering,” 380.
its roots go back further: Molly Harrower, “Projective Counseling, a Psychotherapeutic Technique,” American Journal of Psychotherapy 10.1 (1956): 86, emended. For a history, see Finn, Fischer, and Handler, Collaborative/Therapeutic Assessment, chap. 1.
“At its core, the Rorschach”: Manual, 1.
“the Rorschach performance and the experiences”: Schachtel, Experiential Foundations, 269.
“the encounter with the inkblot world”: Ibid., 51.
people that other therapies often cannot reach: B. L. Mercer, “Psychological Assessment of Children in a Community Mental Health Clinic”; B. Guerrero, J. Lipkind, and A. Rosenberg, “Why Did She Put Nail Polish in My Drink? Applying the Therapeutic Assessment Model with an African American Foster Child in a Community Mental Health Setting”; M. E. Haydel, B. L. Mercer, and E. Rosenblatt, “Training Assessors in Therapeutic Assessment”; and Stephen E. Finn, “Therapeutic Assessment ‘On the Front Lines,’ ” all in JPA 93 (2011): 1–6, 7–15, 16–22, 23–25. Cf. Barb
ara L. Mercer, Tricia Fong, and Erin Rosenblatt, Assessing Children in the Urban Community (New York: Routledge, 2016).
Lanice, an eleven-year-old: Guerrero, Lipkind, and Rosenberg, “Why Did She Put Nail Polish?” Lanice and other names are pseudonyms.
scrap the old labels: Meyer and Kurtz, “Advancing Personality Assessment Terminology.” Exner started the process of downplaying the unconscious and talking more about cognitive processes: “Searching for Projection in the Rorschach,” JPA 53.3 (1989): 520–36. The most recent edition of the Exner system textbook puts it this way: “The nature of the Rorschach task provokes a complicated process, that includes processing, classification, conceptualization, decision making, and lays open the door for projection to occur” (ExCS [2003], 185). And even when a test taker is projecting something onto the image, that isn’t entirely subjective or arbitrary. Different things call up different projections; different things ask, as it were, to be projected onto in different ways. As the psychoanalyst and essayist Adam Phillips writes, “Projection is often a relationship of considerable subtlety” because “people, and groups of people, call up different things in each other” (Equals [New York: Basic Books, 2002], 183).
the skeptics’ view: Wood, 144; he assumes that the Rorschach as “an interpersonal situation” simply can’t be reliable (151–53).
For Meyer and Finn: Gregory Meyer, “The Rorschach and MMPI,” JPA 67.3 (1996): 558–78, and “On the Integration of Personality Assessment Methods,” JPA 68.2 (1997): 297–330; Stephen E. Finn, “Assessment Feedback Integrating MMPI-2 and Rorschach Findings,” JPA 67.3 (1996): 543–57, and “Journeys Through the Valley.”
Chapter 23: Looking Ahead
Chris Piotrowski: Personal communication, July 2015. In his view: “This all depends on the type of practitioner you survey—clinical psychologists versus counselors versus psychiatrists and so on. If you look at all mental health practitioners, then the Rorschach would probably more accurately rank 12th (as of late 2015, 2016).” Another survey, published in 2016 but conducted in 2009 and aiming to cover the field of psychology as a whole, found the Rorschach ranked below the MMPI, MCMI, and an unstated number of “symptom-specific measures” such as the Beck Depression Inventory (along with intelligence tests and measures of cognitive functioning), and slightly ahead of other performance-based or projective assessments (C. V. Wright et al., “Assessment Practices of Professional Psychologists: Results of a National Survey,” Professional Psychology: Research and Practice [online, 2016]: 1–6; my thanks to Joni Mihura for the reference).
The Rorschach had become: Bruce L. Smith, interview, November 2011; Chris Hopwood, interview, January 2014.
also critics of Freud: See the review of Wood by Frederick Crews: “Out, Damned Blot!” (New York Review of Books, July 15, 2004), which concludes, predictably: “This test is a ludicrous but still dangerous relic.”
In the popular media: The lone exception I have seen is “The Rorschach Test: A Few Blots in the Copybook,” Economist, November 12, 2011.
a 2011 survey: Rebecca E. Ready and Heather Barnett Veague, “Training in Psychological Assessment: Current Practices of Clinical Psychology Programs,” Professional Psychology: Research and Practice 45 (2014): 278–82.
Piotrowski called the decline: Chris Piotrowski, “On the Decline of Projective Techniques in Professional Psychology Training,” North American Journal of Psychology 17.2 (2015): 259–66, esp. 259, 263.
course coverage of the Rorschach: Mihura et al., “Psychological Assessment Training,” 7–8. As the authors note, it is hard to compare data across different studies, which might ask whether a topic is “taught,” is “emphasized in required courses,” is something “students should be familiar with,” or other variations.
almost all “practitioner-focused”: Ibid.
The APA requires: Ibid., 1.
might get two three-hour class sessions: Chris Hopwood, interview, March 2015.
“Even for sympathizers”: Chris Hopwood, interview, January 2014.
If a woman: June Wolf, interview, August 2015.
a Finnish scientist: Emiliano Muzio, “Rorschach Performance of Patients at the Mild and Moderate Stages of Dementia of the Alzheimer’s Type,” Society for Psychology Assessment conference, New York, March 7, 2015; the research goes back to his 2006 dissertation, and the tests were administered between 1997 and 2003.
“ten ambiguous figures”: Tomoki Asari et al., “Right Temporopolar Activation Associated with Unique Perception,” NeuroImage 41.1 (2008): 145–52.
“This suggests that emotional activation”: Stephen E. Finn, “Implications of Recent Research in Neurobiology for Psychological Assessment,” JPA 94.5 (2012): 442–43, referencing Tomoki Asari et al., “Amygdalar Enlargement Associated with Unique Perception,” Cortex 46.1 (2008): 94–99.
our eye movements as we scan: Dauphin and Greene, “Here’s Looking at You: Eye Movement Exploration of Rorschach Images,” Rorschachiana 33.1 (2012): 3–22.
“how a person perceives”: Rorschach, St. Gallen lecture, May 18, 1921 (HRA 3:2:1:7).
Look closely at this picture: G. Ganis, W. L. Thompson, and S. M. Kosslyn, “Brain Areas Underlying Visual Mental Imagery and Visual Perception: An fMRI Study,” Cognitive Brain Research 20 (2004): 226–41, building on S. M. Kosslyn, W. L. Thompson, and N. M. Alpert, “Neural Systems Shared by Visual Imagery and Visual Perception: A Positron Emission Tomography Study,” NeuroImage 6 (1997): 320–34.
Stephen Kosslyn: “Mental Images and the Brain,” Cognitive Neuropsychology 22.3/4 (2005): 333–47. See also “Cognitive Scientist Stephen Kosslyn: Why Different People Interpret the Same Thing Differently” (vimeo.com/55140758) and “Stanford Cognitive Scientist Stephen Kosslyn: Mental Imagery and Perception” (vimeo.com/55140759, both uploaded December 7, 2012).
Kenya Hara: White (Zurich: Lars Müller, 2007), 3.
“In perception, there are three processes”: PD, 17. Rorschach did not accept Bleuler’s overall framework uncritically (see note “a journal” on this page).
impulsively, dreamily, hesitantly: The adverbs are from Schachtel, who emphasized that how a person sees on the Rorschach “may be hesitant, tentative, groping, bewildered, anxious, unseeing, vague, impulsive, forceful, patient, impatient, searching, laborious, intuitive, playful, indolent, actively curious, explorative, absorbed, bored, annoyed, stymied, dutiful, spontaneous, dreamy, critical, and so forth” (Experiential Foundations, 16–17).
“When we look”: HRA 3:2:1:7.
Ernest Schachtel pointed out: Experiential Foundations, 15 f., 24 f.
Being asked “What do you see?”: Ibid., 73.
psychedelic drugs: Research into the therapeutic properties of LSD and other psychedelics, enormously promising in the fifties and sixties and shut down in the early seventies, has started up again with what look to be extraordinary results (Michael Pollan, “The Trip Treatment,” New Yorker, February 9, 2015).
One 2007 meta-analysis: M. J. Diener, M. J. Hilsenroth, and J. Weinberger, “Therapist Affect Focus and Patient Outcomes in Psychodynamic Psychotherapy: A Meta-Analysis,” cited in Finn, “Implications of Recent Research,” 441.
“Basically, I propose”: Ibid., 442, condensed.
a troubled eight-year-old girl: Amy M. Hamilton et al., “ ‘Why Won’t My Parents Help Me?’ Therapeutic Assessment of a Child and Her Family,” JPA 91.2 (2009): 118.
seeing doesn’t precede thinking: Arnheim, Visual Thinking, 13, 72–79; cf. “A Plea for Visual Thinking,” in Arnheim, New Essays, 135–52.
Interest in visual thinking: Visual storytelling in books has also risen to full respectability, with milestones including Art Spiegelman’s Maus (1992), Chris Ware’s Jimmy Corrigan, the Smartest Kid on Earth (2000), and Alison Bechdel’s Fun Home (2006); in nonfiction, Peter Mendelsund’s much-praised What We See When We Read (2014) and Nick Sousanis’s Unflattening (2015), a comic book on the principles of visual thinking, which quotes Arnheim among many others.
Brazilian men and women: Gregory Meyer and Philip Erdberg, conference presentation, Boston, October 25, 2013; Meyer also discusses this research in “X-Rays of the Soul Panel Discussion,” vimeo.com/46502939.
“A key point”: Diary, November 3, 1919.
a “social” connection: Arnheim, Visual Thinking, 63.
Jean Starobinski: “L’imagination projective (Le Test de Rorschach),” in La relation critique (Paris: Gallimard, 1970), 238.
continue to be recognized: “Rorschach’s most creative contribution to the study of personality” (Samuel J. Beck, The Rorschach Test: Exemplified in Classics of Drama and Fiction [New York: Stratton Intercontinental Medical Book, 1976], 79). “Since…Rorschach’s monograph, human movement (M) responses to the test have been almost unanimously considered as one of the best sources of information about personality dynamics” (Piero Porcelli et al., “Mirroring Activity in the Brain and Movement Determinant in the Rorschach Test,” JPA 95.5 [2013]: 444, quoting several examples from past decades). Akavia is the first book to set Rorschach’s ideas about movement in their rich cultural context, linking them not only to Bleuler, Freud, Jung, and earlier psychiatrists of catatonia but to Futurism, Expressionism, and Émile Jaques-Dalcroze’s “Eurhythmics,” a Swiss system of teaching music through movement.
In the early 1990s: An enthusiastic overview of mirror neurons is Marco Iacoboni, Mirroring People: The New Science of How We Connect to Others (New York: Farrar, Straus and Giroux, 2009). Skeptical accounts include Christian Jarrett, “Mirror Neurons: The Most Hyped Concept in Neuroscience?,” Psychology Today, December 10, 2012, and Alison Gopnik, “Cells That Read Minds? What the Myth of Mirror Neurons Gets Wrong About the Human Brain,” Slate, April 26, 2007, who writes: “Mirror neurons have become the ‘left brain/right brain’ of the 21st century….The intuition that we are deeply and specially connected to other people is certainly right. And there is absolutely no doubt that this is due to our brains, because everything about our experience is due to our brains. (It certainly isn’t due to our big toes or our earlobes.) But it’s little more than a lovely metaphor to say that our mirror neurons bring us together.” The 2012 views of leading figures on different sides of the debates are usefully summarized in Ben Thomas, “What’s So Special About Mirror Neurons?,” Scientific American Blog, November 6, 2012.
The Inkblots Page 47
