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Journal of Projective Psychology and Mental Health: Volume 14, Number 2, July 2007 Editorial

1. Editorial : SIS : A Journey of Projective Technique from Assessment to Treatment: Amool R. Singh pages 85-86.

Projective technique began its journey systematically in the year of 1921 by the publication of the Rorschach Psycho-diagnotic test and occupied major positions. The work of Herman Rorschach in the field of inkblot paved the way to many researchers to think seriously about the concept of formless stimuli that can stimulate an individual’s imagination and help to understand about the personality.

Projective tests of personality assessment adapt a very different approach. Ambiguous stimuli that can generate a force into an individual to represent his/her own inner-often unconscious feelings and needs. These stimuli are interpreted in different ways spontaneously as per psychic structure of the organisms. Since the stimuli themselves are ambiguous, it is assumed that the response given by the individuals will automatically reflect various aspects of their personality. Meaning there by, different individuals will perceive different things in these stimuli because individuals differ from one another in important ways.

In 1959 germination of SIS took place in Dr. Wilfred A. Cassell’s mind while working with Seymour Fisher, who was an authority on body perception. While initiating the idea of a newer test, the concept of body image got significant place as Cassell thought that projection carried through using an inkblot technique might yield good results in the clinical practice of psychiatry. And then, the first series of Somatic Inkblots based on the concept of body image was developed in 1960. The Somatic Inkblot Series (SIS) provides images in three forms : on cards, in a booklet and on videotape. The Somatic Inkblot Series consists of inkblot images printed in black, red and gray colours on white cards. SIS images provide enough obvious anatomical structure to evoke spontaneous verbalization, but not enough to limit the responses solely to the naming of body parts or colours. In this way, an obvious anatomical structure provides a feeling of security, which makes deeper and symbolic repressed material more accessible to the person for evaluation and assessment (Cassell & Dubey, 1990).

Cassell & Dubey (1990) concluded that “SIS is especially helpful in evaluating patients with limited language and verbal skills, the learning disabled or mentally subnormal as well as the normal population such as children, foreign born or new immigrants, native peoples. Those with limited language and verbal skills usually rely more on visualisation and adopt better to SIS than verbal interviews or testing that requires reading or language skills. SIS images generally use the language of dreams, visual imagery, and symbolic thought along with the most basic forms of thinking and expression. It is also the language of expression and brings whatever is buried in the mind”.

The SIS provides a new diagnostic aid and can be used to assess in depth the significance of somatic symptoms, conversion reactions, somatic delusions and sexual dysfunctions. Psychodynamics of mutilated or distorted anatomy responses pave the ways to assess the possibility or level of castration anxiety (Cassell, 1980). Responses depicting themes of body assault may further clarify the extent of aggressive impulses (Cassell, 1977). Undetected affective disorders can be evaluated through somatic inkblot series (SIS). The responses to SIS inkblots might uncover body perceptual disturbances such as in catatonia, or the cognitive deficits of early schizophrenia. Death anxiety in those going through major surgical operations or those suffering from terminal illness may give indication by excessive anatomical responses (Cassell, 1979).

To make the procedure more interesting and dream-like, the video version of SIS was developed by Cassell in 1984. The SIS video begins with pictures of flowers and soft background music, followed by stimulus images, one at a time. Many of the images are coloured, and for some, impression of movement is also created. Many of the images are sharper on screen than they are in the booklet. The floral presentation, with soft background music, induces the subject to relax. Through the power of projection, it can reveal material from the inner self (Panek, 2001). Relatively unstructured and semi-structured images afford the trained examiner a wide range of opportunities for the comprehensive examination of the subject’s cognitive and emotional processes.

The SIS has both diagnostic and therapeutic properties. Besides diagnostics it provides a useful aid to therapy which has been proved by a number of innovative clinicians and researchers. As more clinicians avail themselves of the SIS technology, they will be more effective at developing in depth and sophisticated treatment plans. One can envision and apply optimal blending of information from the medical and psychological aspects of human existence for the purpose of psychotherapy strategy.

References:

Cassell, W. A. Aggressive Imagery and Clinical Symptoms in Schizophrenia. British J. of Projective Techniques,1977. 16: 21-31. Cassell, W. A. Anatomical Rorschach Responses and Death Symbolism. British J. of Projective Technique and Personality Study, 1979. 24: 7-16. Cassell, W. A. Body Awareness and Somatic Delusions Involving Sexual Organs. American Journal of Psychoanalysis, 1980. 40: 125-135. Cassell, W. A. & Dubey, B. L. Interpreting Inner World Through Somatic Imagery : Manual of the Somatic Inkblot Series. Somatic Inkblot Center, 1990. Panek, P. E., Editorial: Projective Psychology in the New Millennium: Issues and Challenges. SIS J. Proj, Psy. & Mental Health, 2001. 8:73-74. Rorschach, H. Psychodiagnostic. Ernst Bircher, Bern, 1921.

Amool R. Singh, Ph.D. Editor-in-chief, and Prof. & Head, Clinical Psychology, RINPAS, Ranchi-834006, e-mail : sisamool@yahoo.com

2. SIS and Sand Tray Psychotherapy of Suicidal adolescents : Wilfred A. Cassell and Bankey L. Dubey, pages 87-97.

Many highly skilled psychotherapists are so immersed in practice that they rarely find time to publish their clinical findings. Yet they will gladly give of their time in case history training seminars. This article is based upon a transcript of an educational television interview with a practicing child psychiatrist and Jungian trained analyst experienced in Sand Tray technique. This is a widely used diagnostic/treatment approach which at this time of publication has 9,170 references in a Yahoo search engine.

3. NEO and Hand Test Differences Between Chronic Pain Patients and Non-pain Controls: Paul E. Panek , John J. Skowronski, J. Michael George and Edwin E. Wagner, pages 98-109.

The NEO-FFI and the Hand Test (HT) were administered to 100 individuals seeking treatment in a pain clinic and a control group of 100 individuals who did not report any past or present chronic pain complaints. Contradicting previous research, these results suggest that there are general psychological concomitants of the experience of chronic pain. Using NEO and HT scores, a discriminant analysis correctly classified 92 % of the pain group participants and 89 % of the non-pain participants. Important contributors to the best fitting discriminant function were the HT quantitative variables of Activity, Communication, and Acquisition and the latency variables of High-Low and Average Initial Response Time. Further, while there were five major discriminative variables, differences were noted on a variety of other variables, suggesting that, psychologically, persons seeking treatment at a pain clinic do differ from normal control participants in a number of ways.

4. Gender Differences in Factor Structure of SIS-II Responses Umed Singh: pages 110-116.

The present study was designed to investigate the pattern of responses on SIS-II in normal high school male and female students. The sample consisted of 100 male and 100 female high school students. SIS-II was administered individually. The mean, SD, and t-ratio were computed to compare the two groups. Principal Component Factor Analysis was carried out to understand the factor structure of SIS responses in two groups. T-test and factor structures have revealed significant gender differences in some SIS-response patterns. Females have been found scoring significantly high on SIS-II scales of Animal responses, Pathological Anatomy and Depression, and low on Anatomy and Sex than their counterpart males. Five principal components each have been located in the two data, which also differentiate the SIS response patterns of male and female subjects.

5. Projective Indices of Creativity: A Pilot Study Dharmendra K. Singh, Gobinda Majhi and Amool R. Singh: pages 117-120.

The Rorschach Inkblot test has been widely used for psycho diagnostic purposes; however, it is also used as a tool to measure intellectual functioning. Some indices of the Rorschach test were considered as the index of intelligence (W, N, C,F+%, A% & P). The present study was carried out to examine the validity of projective tests as a measure of creativity. The sample consisted of 100 normal subjects, who were chosen by purposive sampling. Individual scoring above cut off point on General Health Questionnaire (Shamsunder et al.,1986), in the age range of 18-20 years, of either sex, educated up to 12th were consisted the sample. As a tool, General Health Questionnaire (Shamsunder et al., 1986), Verbal test of creative thinking and Rorschach Test (Beck System), were used. Findings of this study show that both the groups (High Vs low creativity) differ significantly on the total number of Response (R), Whole response (W) and Popular response (P).

6. Rorschach Profiles of Mentally Challenged and Severely Hearing Impaired Children: K. C. Vashistha and Shweta Bhardwaj: pages 121-128.

Personality profiles of Mentally Challenged and Severely Hearing Impaired children will be helpful in developing the essential educational infrastructure, proper methodology of teaching and an effective teaching – learning environment for such children. Considering this in mind the personality profiles of special schools going mentally challenged children and severely hearing impaired children, have been studied through Rorschach Inkblot Test in the present study. It was also assumed that they do have somewhat similar patterns due to their sensory-motor impairments directly influencing their cognition and learning abilities. The findings reveal that mentally challenged children have extraversion personality , while severely hearing impaired children have an introversive personality structure. Further the study uncovers some specific personality configuration of both groups.

7. A Study of Potential Correlates of Reasons for Living in College Students Atanu Kumar Dogra, Sujoy Kar and Saugata Basu: pages 129-134.

The present study aims to find out the relationship between reasons for living and a) presumptive stress, b) Various dimensions of ego functions among college students. The Presumptive Stressful Life Event Scale or PSLES (Singh et al., 1984), The Ego Function Assessment Scale-Modified or EFA-M (Bellak et al., 1989), Reasons for Living Inventory for Young Adults or RFL-YA (Gutierrrez, et al., 1992) were administered to 140 college students comprising of 70 males and 70- females, of 4 colleges of Kolkata. For statistical analysis, product moment correlation coefficients were done to fulfil the objectives. The results of present study revealed that there was no significant relationship between reasons for living and presumptive stress in the last 1 year in college students, but a significant negative relationship exists between reasons for living and presumptive stress during the past life. As far as the magnitude and direction of relationships of different ego functions with reasons for living are concerned, It was found that 1) Drive Control (DC), 2) Synthetic integrative Functioning (SF) and 3) Mastery Competence (MC) 4) Adaptive Regression (AR) as components of ego functions have significant positive correlation coefficients with reasons for living.

8. A Personality Perspective on Female Infertility: An Analysis through Wartegg Test: S. Daini, L. Bernardini and C. Panetta: pages 135-144.

Psychological aspects of Infertility have been analysed more through psychometric methods rather than through projective tests. We examined three samples of infertile women through Wartegg Test: primary organic sterility (20 patients), primary unexplained sterility (20 patients) and consecutive miscarriages patients (21 patients) being in diagnostic phase before starting therapy. They were compared to a sample of thirty healthy women. The quantitative analysis on Wartegg Test scores, by ANOVA and MANOVA, shows significant differences between infertile women and controls regarding Evocative Character and Formal Quality. These differences confirm the emotional impact of infertility on imaginative life and rational ability to plan. The three patient subgroups appear significantly different. Unexplained sterility subgroup seems more similar to healthy women. The organic aetiology subgroup seems to have less adaptability and integration and the consecutive miscarriages subgroups seem to be affected by strong identity problems. Women affected by organic sterility and consecutive miscarriages showed lower affective stability than others. Regarding Affective Quality, we didn’t find significant differences. Therefore, going on trying to be pregnant seems to happen on an unconscious level and also to be an element to reach psychological affective integration and to overcome depression.

9. SIS in Paranoid Ideation: A Case Study: Radhe Shyam.: pages 145-149.

Mr. Rohit is a 26 year old medical practitioner. His presenting symptoms at initial psychological evaluation were insomnia, loss of appetite, excessive sweating, restlessness, difficulty in concentration, sadness of mood, lack of confidence, lack of interest in self and work. He believed that he had a psychological problem not requiring medication. As part of the psychological assessment, he was administered Raven's Progressive Matrices test and was found to have average intelligence. In addition the Somatic Inkblot (SIS) Series-II (booklet version) was also administered. The responses on SIS projected his aggression and inner cry. SIS further helped in expressing himself, and in recovering from the financial and emotional trauma. The treatment plan involved eight sessions of Rational Emotive Therapy supplemented by introducing SIS symbolism in the therapeutic process. This combination appeared to have marked therapeutic effects. He reported considerable improvement in mood, cognition and a significant reduction in depressive symptoms.

10. Rorschach Responses of Indian Children and Adolescents with Psychiatric Disorders: Suprakash Chaudhury, D. Saldanha, K. Srivastava, S.G.Jyothi, G.S.Sundari, and M. Augustine: pages 150-161.

The Rorschach test by Klopfer’s method was administered to 313 children and adolescent patients with psychiatric disorders viz. schizophrenia (n=66) mania (n=10) depression (n=33), anxiety state (n=24) hysteria (n=45) nocturnal enuresis (n=48) head injury (n=16) epilepsy (n=32) and mental retardation (n=39). The Rorschach profiles of the various groups of patients showed significant differences among the groups from normal Indian subjects and the Western norms. Interpretation of the Rorschach protocols of Indian children and adolescents with psychiatric disorders using the Western norms would be fallacious and misleading. The use of the Rorschach test as an aid to clinical diagnosis was strongly supported.

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