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Journal of Projective Psychology and Mental Health: Volume 20, Number 2, July 2013 Editorial

1. Editorial: A Somatic Inkblot Series “bucket list” Exercise, pages 75-77.

In less than a year, (if “God” wishes) my body will become eighty years old. Thankfully I do not feel its age! Yet, my energy for both personal and professional activities gives out much earlier at his senior stage in the life cycle. I now have to prioritize my personal life and SOMATIC INKBLOT SERIES (SIS) activities. It often reflect about what is essential in the time I have remaining until I die, or what is commonly called “kick the bucket”. Based upon a popular American movie involving two aging men planning fun activities to complete before their dying, I now am envisioning a “Bucket List”. This can be enriched by soon to be outlined SIS-II aided projective exercise which was originally created to dissolve death denial defenses.

When the somatic structure in which I temporarily reside was younger, I confess that sometimes I participated in dangerous death defying outdoor activities. During such adventures, my brain’s “Mental Mechanisms” employed the psychological defense of Denial. This is consistent with the theory outlined by Ernest Becker, my now long deceased anthological professor, in his 1973 Pulitzer Prize winning book entitled “Denial of Death”.

Years later Becker’s views originally shaped my planning the design of the suggestive structure intentionally embedded into the last card of the first Somatic Inkblot Series- Card 20 (SIS-I).It may be recalled that in the SIS-I manual “BODY SYMBOLISM”, Chapter 9 was devoted to the phenomenon of “Death Anxiety”. Earlier normative data for Card XX of SIS-I was published for a healthy group of adolescents. This configuration was purposely designed to stimulate “Inner World” imagery with potential threat to the body. The expected life span of these responders far removed them in time from their body’s death by natural disease conditions of late life aging. Without the peering power of projective assessment (or dream analysis), it might seem that they would only be experiencing low Death Anxiety in their “Inner World”.

Their symbolic responses to Card XX along with their associations in the detailed enquiry in brackets follow: “A face. There’s a mask over the eyes (It‘s the Devil). Another person with blood running down. An ancient mask. The face of a baboon (someone gave it a sinister or threatening appearance). A face again. Another face. It looks mean. Another monster face (Its scary. Doesn’t look nice. It’s going to attack). Monster’s face. Face. Face of a vampire bat. Mouth of a dog with two eyes. (It’s a type of wild dog or wolf. Its mouth is open and ready to attack). A head skeleton. An animal opening its mouth. Death.” These responses are consistent with the notion that structure in Card XX partially accomplished its preconceived goal. It stimulated the release from memory storage of imagery symbolically linked to “DEATH ANXIETY”.

Clinical experience suggested that this original Card can frequently provide a projective method for clinical assessment in various Mental Disorders. Moreover, its use enables an examiner to challenge psychological denial defenses of so-called normal death-denying individuals. (e.g. Male adolescents) who impulsively place their bodies at risk by participating in “thrilling” life threatening activities. In Alaska where male Native adolescents have one of the highest rates of body directed violence frequently producing death, the projective use of this visual stimulus can assist in preventing death by suicide.

Years later when SIS-II was contemplated, because of the importance in addressing issues related to violence certain additional “inkblots” were designed. Several were created to evoke imagery calculated to throw more specific projective light for illuminating otherwise unreported aggressive impulses.

In my article in this month’s journal, an illustrative example of SIS-II (Booklet version) projective findings are reviewed portraying the “Inner World” of both marital partners after the husband developed a severe paranoid psychosis. His wife felt terrorized after in bouts of psychotic rage, he erroneously accused her of marital infidelity. Although diagnostically useful as an interview aide in illuminating otherwise denied dangerous impulses in such potentially violent situations, SIS-I has definite limitations.

None of the stimulus arrays replicate the temporal final existential state of “a body dying” with its resident’s spiritual departing. Assisting one in mentally processing subjective experiences stemming from anticipating one’s death historically was the task of a primitive group’s “Medicine Man” . In more advanced cultures it gave rise to the impetus for the Death Anxiety dissolving dogma of the world’s organized religions. In the modern world when dogma bound religious fanatics clash in ideology, it can provide rationalization fuel for irrational terrorists.

Throughout my work I have hoped that SIS scientific studies could throw more rational light on what constitutes optimal cognitive/affect processing of existential issues. Consequently, when SIS-II was contemplated, a decision was made to create more symbolic specific electronic color-form-movement stimulus releasing patterns. I envisioned designing a system of artificial intelligence that might act as a robotic consultant to enable the examiner to more specifically focus on a viewer’s inner world of projective consciousness during the final stages of dying. Thus B22 was created depicting a human body with electronic movement patterns suggestive of the “living spirit” departing from a dying body.

As might be expected, the viewer’s religious training and cultural background strongly color the symbolism projected in relation to this ambiguous array. For example, an atheist or agnostic responder might simply see “A person dying with the breath departing “or simply “A death scene”. Even for such cognitively focused responders, if the viewer suffers from a Mental Disorder with unresolved grief, such projected material may be utilized to release the “inner cry” in psychotherapy.

For those who benefit from a positive inner spiritual world a more symbolically enriched approach may be planned in treatment. In such cases the therapist may verbally expand upon the visual scene. A suggestion may be given that the scene symbolizes a dying person’s spirit moving to a higher spiritual plane of existence. Dogma consistent with the responder’s religious belief system may be utilized and then an appropriate referral made to the professional religious authorities. A typical vision of a devout responder portrays the soul as leaving the body… to bond again with those of departed loved ones … ultimately radiating positive feelings of a viewer’s higher power…or loving “God”.

Now as a senior citizen, it is more difficult to deny the ultimate somatic reality of one’s mortality. Elderly people for additional reality testing, frequently experience the loss of friends who have made “one way out of the body trips”. As one matures, I now advocate subjective spiritual image training for one’s ultimate spiritual travel. This is quite analogous to an athlete preparing for a competitive event by conjuring up in body-mind-spirit consciousness patterns of the anticipated competition.

Similar subjective visualization exercises may be utilized in other than clinical situations. For example, such futuristic inner world travel may be conjured up in projective awareness as a modality for rethinking professional goals for all viewers, including members of our SIS society. For this type of existential application, before ending the trance like state, each professional member when introspecting while viewing B22 might ask the following question: “What legacy do I hope to leave for the SIS Society at the moment of my body’s death?”

The conceptual projective basis for dissolving death denial defenses facilitates bridging symbolic SIS work related to a death anxiety with what some clinicians collectively call “Mindful exercise” such as Yoga, Qi Gong and Tai Chi. At this time in the 21st century scientific literature there is substantial statistical evidence supporting the physiological and health benefits of such exercises.

SIS workers are challenged to conceptually and clinically build future bridges with these growing disciplines. Moreover, it is suggested that future SIS research should be directed to developing symbolic specific sensory input applications for 21st century communication technologies. Examples are “touch screen” tablets, smart phone and all related potential SIS theory empowering applications.

2. SIS Illumination of Unreported Violent Impulses, Wilfred A. Cassell, pages 78-80.

This clinical case report examines the marital stressors activated when a husband develops paranoid delusions with dangerous suicidal/ homicidal impulses. He falsely portrayed that his wife is sexually unfaithful to him. The SIS-II booklet form of the test was administered to him and his wife. The SIS responses were able to bring out physical and sexual abuse during his childhood. The SIS responses also projected his wife’s fear of being murdered. The SIS responses further helped in therapeutic intervention.

3. Somatic Inkblot Series-II (SIS-II): The Therapeutic Window of Emotionally-Withdrawn Children, Nilanjana Sanyal, pages 81-90.

Projections of varied kinds are part and parcel of daily emotional exchanges with the environment. They give vent to the unconscious realm of the mind that tends to threaten the ego-system. Resistance and consequently repression are resultant effects. Projective techniques come at the aid at this juncture to penetrate deeper into the unconscious folds in a non-threatening way, thereby offering space for clients to open up their inner veils on a face-to face basis. The Somatic Inkblot Series–II (SIS-II) is one such projective assessment tool that is apt enough to provide therapeutic elements to unravel the unknown contents of one’s personality. The present theoretical discourse plunges into the attempt to verify the therapeutic bearing of SIS-II as a “lens” or “window” in offering light to the unconscious in a non-threatening way with the help of some selected case studies in the form of child cases, whose responses to the same test provided dynamic meaning, in terms of their emotionality. The responses to the SIS-II seemed to verify the assumption that it serves as a “therapeutic template” on the basis of which the next line of treatment in terms of psychotherapy may be designed in future.

4. Therapeutic Effectiveness of SIS- II in a Case of Psychogenic Cough, LSS Manickam, Mahbobeh Ghanbary and M. Kruthi, pages 91-97.

Psychogenic cough in adults is not commonly reported and the treatment of the medically unexplainable symptom is a challenge to the health professionals. A case of a 26 year old married male from Afghanistan, who was coughing for one year, diagnosed as a psychogenic headache was administered by the Somatic Inkblot Series (SIS-II). He avoided perceiving sexual responses on images generally depicting sexual imagery, which may indicate deep rooted sexual conflict. The SIS responses further helped in planning and providing integrative psychotherapy to him. Follow up of the client after one year showed that he is free of symptoms, has legally migrated to one of the European countries and is effectively engaged in work. There were two responses, which may be typical for Afghans, which need further exploration. There is a need for revamping the therapeutic supervision of the trainees while dealing with clients who have sexual misconceptions and those who hail from multicultural settings.

5. Personality Characteristic of Juvenile Delinquents as Compared to Non-Delinquents on Rorschach Test, Shweta Sharma, Deapti Mishra and Ranjeet Kumar, pages 98-105.

The incidence of Juvenile delinquency is increasing internationally. Various psychological, social and environmental factors are playing a vital role in its development. The present study aims to find out the personality characteristics of juvenile delinquents as compared to non-delinquents on the Rorschach Inkblot test. The sample consisted of 30 male delinquents from “Bal-Sampreshan Grah” and 30 non-delinquents from general Higher Secondary Schools, Raipur (Chhattisgarh).The findings revealed that both the groups differed significantly on W, Dd, FQ-, DQ+, DQV, M, Passive Movement p, Human Movement Passive, H, Hd, Ad, Hh, Experience Stimulation (es), Adjusted es, X-%, X+%, Zf, Interpersonal interest- Human content, and Total number of blends on Rorschach test.

6. Does Psychotherapy Benefit Pre and Post-operative Anxiety in Eye Diseases? Daniel Saldanha,Vivek Goel, Anuja Kelkar, Arpita Karmakar,Preethi Menon, Kavita Bhatnagar, S.L. Jadav and Labanya Bhattacharya, pages 106-109.

Patients about to undergo surgery are often anxious. The fear of impending surgery on an important organ such as the eye involves considerable anxiety as complications often result in infection and blindness. Long term psychological problems may follow surgical interventions. Does early psychotherapy and psychoactive drugs benefit these cases? The study attempts to answer some of these questions.

7. The Efficacy of Dance/ Movement Therapy as Revealed through the Qualitative Lens of Somatic Inkblot Series (SIS-II), Manisha Dasgupta, pages 110-121.

Synergies of meaningful movements form the basic elements of individuals’ unique way of relating with others in the environment. Mind-body-connectivity serves as one of the chief pillars of dance/ movement therapy, which relies on the search for one’s “authentic movements”, to bring about gradual somatic transformations and consequent psychic modifications. The study involved the use of dance/ movement as a therapeutic tool in a clinical case having emotional problems to verify its efficacy. The Somatic Inkblot Series-II (SIS-II) was used as a measure to determine any significant change(s) through the projective mode following a pretest and posttest design paradigm, where eight sessions of dance movement therapy (DMT) were carried about with distinct focus on different body movements following the Limon technique. Both quantitative as well as qualitative analyses were done to unfurl the efficacy of the therapeutic intervention, if any, on the client’s personality profile and profile of mood states. DMT was found to have a substantial qualitative effect in molding the personality profile along with mood state as revealed through qualitative improvement in the nature of responses on the SIS-II. The case manifested a specific trend of “inner growth” in personality make-up in the post-test sessions. This effect was also found to persist even after the therapeutic sessions had been withdrawn (for at least a period of two weeks). Implications of dance/ movement therapy in the clinical arena have also been discussed.

8. Therapeutic Intervention through SIS Imagery: Two Case Studies, Antonio Cervigni, pages 122-127.

The Somatic Inkblot Series Card form was administered to two cases for diagnostic formulation and therapeutic intervention. The test was used first time by the clinician though he has heard about it in Italy. The test was found valid in assessing personality and diagnostic evaluation. It helped in therapeutic planning and trapping unprocessed unconscious material. The test must be included in every clinic as a therapeutic procedure.

9. Mental Health Problems in Alexithymia: Role of Positive and Negative Emotional Experiences Akanksha Dubey and Rakesh Pandey, pages 128-136.

Previous empirical evidence shows that although alexithymia is associated with a variety of somatic and mental health problems, the exact mechanism that makes alexithymic individuals prone to mental or somatic illness has not yet been uncovered. Based on earlier observations that alexithymic individuals are characterized by anhedonia and a proneness to negative emotional experiences, the present study examines the mediational role of positive negative emotional experiences in alexithymia – health relationship. Hundred fifty adults were assessed on the measures of alexithymia, mental health, and positive/negative affectivity. The correlation analysis revealed alexithymia and its that various dimensions correlated significantly positively with mental health problems and negative affect and negatively with positive affect which suggest that alexithymic individuals are prone to mental health problems and negative emotional experiences and lack hedonic capacity. Further, it was also noted that negative emotional experiences and reduced capacity for positive emotions were related with a greater number of mental health problems. This pattern of relationship among the measures of alexithymia, mental health and positive-negative affect suggests the possibility that anhedonia and proneness to negative emotions may explain the link between alexithymia and mental illness. To test this possibility a structural relationship model linking alexithymia and mental health directly as well as indirectly through positive and negative effects was tested using AMOS 20. The findings revealed a significant direct effect of alexithymia on mental health as well as an indirect effect through positive/negative emotions. The findings suggest that alexithymia is associated with mental health problems and these problems may be partly due to the alexithymics' anhedonic tendency and their propensity to experience negative emotions. The findings have been discussed in the light of the existing literature and a future direction for research has also been proposed.

10. Behavioral Assessment of Mentally Challenged Children, L. N. Bunker, Subhash Meena and Laxmi Prajapat, pages 137-140.

The present study assessed 10 mentally challenged children on the Madras Development Programming System (MDPS) Behavioural Scale before and after a training programme. The comparison of the behavioural assessment data on six domains of using ‘t’ revealed a significant difference between pre and post activities. The findings indicated that training brought a significant improvement in gross motor activities, fine motor activities, meal time activities, dressing behaviour, toileting activities, and receptive language among the mentally challenged children as indicated by higher post test scores as compared to the pretest score. The findings have been discussed in the light of available empirical evidence.

11. Neonatal Outcomes in Women with Depression during Pregnancy, Shilpa Kumari and Shobhna Joshi, 141-145.

The present study examined the relationship of maternal depression with gestational age, infant birth weight and apgar score of 1 and 5 minutes. It was hypothesized that maternal depression would be related with lower gestational age, lower birth weight of infants and lower apgar scores. The study was conducted on a sample of two hundred pregnant women (aged 20-30years) in the IInd and IIIrd trimester of their pregnancy. Using a personal datasheet, sociodemographic information was collected and information regarding the delivery and health status of the baby was collected from the hospital record. The assessment of gestational age was based on the last menstrual period and the assessment of depression was done by using Radloff's Epidemiological Studies Scale (CES-D; 1972). The findings of correlation analysis indicated that depression as well as demographic characteristics (e.g., age, education etc.) both has significant influence on the neonatal outcomes. However, the results of the regression analysis revealed that depression significantly predicted the gestational age and birth weight of infants even after controlling the effect of demographic variables. The findings imply that women experiencing high level of depression are more likely to deliver an infant with less gestational age, low birth weight and lower apgar scores of 1and 5 minutes.

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