Contemporary Rorschach Interpretation

J. Reid Meloy, Marvin W. Acklin, Carl B. Gacono, James F. Murray, J. Reid Meloy, Marvin W. Acklin, Carl B. Gacono, James F. Murray

• Publisher: Routledge
• Year: 2013
• Print ISBN: 9781138971714
• eBook ISBN: 9781317843672
• Topic: Psychology
• Subtopic: Clinical Psychology
• Index: Psychology

Appreciation of the beauty and complexity of the human mind when perceiving an ambiguous stimulus led Dr. Hermann Rorschach to develop his scientific method eighty years ago. Full of gratitude for his brief life and work, the editors hope this volume will stand as an idiographic testament to his brilliance for the Rorschach students of the future. The contributors are clearly the most notable Rorschach clinicians in practice, and their work integrates the Comprehensive System and psychoanalytic methods.

This book is organized into four sections. Within each of the first three sections -- devoted to psychotic, borderline, and neurotic disorders respectively -- the editors and invited authors have contributed Rorschach case studies which vertically cut a character pathology, personality disorder, or clinical diagnosis through a particular level of personality organization. The last section charts the enormously varied course that Rorschach work can navigate -- from the understanding of a Nobel laureate, the pain of trauma and transexuality, and the Nazi perversion of youth, to the consensus Rorschach in couple's therapy and cutting edge work in neuropsychology.

1

Introduction

J. Reid Meloy

James F. Murray

Hamlet. Do you see yonder cloud that’s almost in shape of a camel?

Polonius. By the mass, and ‘tis like a camel, indeed.

Hamlet. Methinks it is like a weasel.

Polonius. It is back’d like a weasel.

Hamlet. Or like a whale?

Polonius. Very like a whale.

—Shakespeare, Hamlet, Act 3, Scene 2

The dilemma of Polonius was that with each of his empathic comments, Hamlet produced another different response. Such is the beauty and complexity of the human mind when perceiving an ambiguous stimulus, an insight that led Hermann Rorschach to develop his scientific method 80 years ago.

We are full of gratitude for his brief life and work, and we hope this book will stand as an idiographic testament to his brilliance for those Rorschach students who come after us. But what of the origins of this particular project? Although the paternity status of this book is multiple, the maternity lies within the fecundity of the Society for Personality Assessment (SPA). The Society has nurtured, cajoled, and inspired the professional growth and development of each of the editors, most notably through the annual pilgrimage to our Mecca—the various cities selected for the SPA Midwinter Meeting each year.

As young psychologists, Meloy, Acklin, Gacono, Murray, and Peterson would attend various presentations at the meetings, retreat to their often shared hotel rooms, commiserate over the seminar content and familial dynamics of SPA, and gratify their senses in the evening with the ambience of a blues bar, selected by Peterson, and the elixir of the moment. Henry V was often bonded with us in spirit: “We few, we happy few, we band of brothers.”

But something intellectual also happened. We noticed a shared view emerging that defined how we worked with the Rorschach. We were empiricists, but we also thought from within a psychoanalytic frame. Our data confirmed or disconfirmed theory, but theory gave flesh to the bone.

In those days, only a mindful decade ago, Rorschach work was fundamentally divided into two often fractious and occasionally warring camps: those adamant proponents of Exner’s Comprehensive System, and their opponents, the psychoanalytic disciples of Rorschach interpretation. Each side would offer what to us were often valid critiques of the other side, but to our astonishment, remained painfully blind to the opposing camp’s assets. Background checks of these individuals revealed a certain pedigree. Often, the Comprehensive System purists had worked closely and trained with John Exner, Jr., and the psychoanalytic Rorschach clinicians had been bred at the Menninger Clinic, Austen Riggs Center, or Yale University. If one paid close attention, the pungent aroma of East Coast Ivy League intellectual elitism wafted through the air, blanketing the crusty exterior of Midwest dustbowl empiricism. Balkanization of the Rorschach, we were afraid, was at hand.

From our clinical and research perspective, the combination of Comprehensive System empirical data and psychoanalytic theory concerning the Rorschach had a synergistic strength, each ameliorated by the other. We were also cognizant of the paper trail that these two avenues of Rorschach work were leaving behind—the Comprehensive System was rooted in the published volumes of Exner (1969, 1974, 1986, 1991), and the psychoanalytic research methods were defined in a series of books by different authors of the same ilk (Kissen, 1986; Kwawer, Lerner, Lerner, & Sugarman, 1980; Lerner, 1991; Lerner & Lerner, 1988). We could not help but notice historical parallels with the Anna Freud and Melanie Klein controversies a half-century earlier, and perhaps the need for a Rorschach analogue to the so-called “British School” of independent psychoanalysts that bore such luminaries as Fairbairn, Winnicott, and Guntrip. Or maybe we were just swept up in the psychohistorical pull of a Hegelian synthesis.

We observed another curious phenomenon, most eloquently captured by Peterson (1994) in his comments on the absence of “idiographic cartographers” among the authors of published Rorschach research. In other words, nomothetic (group) Rorschach studies were ubiquitous in the journals; but where were the Rorschach clinicians willing to score, analyze, and interpret a single Rorschach case for publication? And if no one was willing to do this (with a few notable exceptions; e.g., Viglione, 1990), how could we even pretend to mentor the next generation of Rorschach clinicians beyond our own doctoral students whom we personally trained?

These concerns are what motivated us to plan a 3-year series of presentations (1991–1993) at the SPA meetings titled, “Through the Looking Glass.” With the trepidation and excitement that accompanies any intellectual risk, particularly one that will be contemporaneously scrutinized by our colleagues, we decided to present three cases illustrating a level of personality organization each year, beginning with psychotic personality organization, each framed by a theoretical and empirical introduction by Marvin Acklin. Needless to say, the symposiums were enjoyable, well-attended, and cordially received as scholarly attempts to conduct idiographic research with the Rorschach. The papers were published as a series in the Journal of Personality Assessment each subsequent year, expertly tooled by the editor, Irving Weiner, and are reprinted in full in this book.

Our understanding of the power of integrating the Comprehensive System with psychoanalytic approaches still leaves us with the question of how to best present this perspective to others. Any formal codification seems almost impossible given the daunting complexity of the issues at hand; to say nothing of the hard-headed, or at least highly individualistic, nature of each of us when dealing with the small details (Dd) of our own approaches to Rorschach data. Thus, largely without knowing it, we have stumbled on two truths about learning the Rorschach. First, the Rorschach can only be learned in a clinical setting. To use the Rorschach with any degree of sophistication, one must be able to weave the Rorschach within the warp and weft of developmental theory and research, theories of psychopathology, personality theory (particularly psychoanalysis), and knowledge of psychotherapy and psychopharmacology. The individual under study comes alive only in the fabric of this tapestry.

The demands imposed by such a sophisticated weave bring us to the second truth. Rorschach interpretation is the only activity in psychology that can even approach psychoanalysis in providing a deep psychological understanding of the individual. Consequently, it is best learned from a mentor through the process by which one can see how someone who knows more than you goes about analyzing and interpreting a Rorschach protocol, and integrates the findings with theory, research, and real-world behavior. It is only after several “good enough mentorings” that one has a chance to become competent with the Rorschach. Inevitably, the mentoring stage is accompanied by idealization and imitation. But after a period of time maturation occurs, and the student acquires his or her own unique style.

This book is in large part an effort to provide this mentoring to fellow students of the Rorschach, and to thank those who sheparded us. Although assimilation of one’s mentor’s knowledge with the student’s own insights, in a true Piagetian sense, takes one beyond mere imitation, there is an indelible mark left by the experience of one’s teachers. Each of us would like to thank our own teachers through a recounting of our own Rorschach genealogies, and offer this book as a token of gratitude for their patience and wisdom.

Reid Meloy was originally taught the Rorschach by Sidney Smith during his graduate studies, utilizing the methodology of Rapaport, Gill, and Schafer and the form-level scoring of Martin Mayman. He got a “B” on his first interpreted protocol, and regrets that he was never administered the Rorschach before he learned what it meant; therefore an accurate count of his reflection responses is impossible. Sidney Smith has since died, but for years made his home, and left his mark, at the Menninger Clinic. Meloy was subsequently trained in the Comprehensive System through Rorschach Workshops, his principal teachers being Phil Erdberg, John Exner, and Irving Weiner. To all these men he is grateful, but when an original mentor becomes, through the years, a close personal friend, as Phil Erdberg has become, a true gift has been received. Meloy’s body of Rorschach work, moreover, is deeply influenced by psychoanalytic theory, and no one person has been more central to his grounding of analytic thought in personal experience than his psychoanalyst, James Morris, a true archaeologist of the mind.

A number of mentors have played a role in Marvin Acklin’s interest and skills in the Rorschach, most notably Ray Craddick, who first taught him the Rorschach in 1980, and John Exner, whose Comprehensive System has been the matrix of his development as a clinical psychologist. Craddick taught projectives with a spirit that inspired and excited his students. He introduced Acklin to John Exner at one of the 5-day basic tutorials that Exner used to do a long time ago. Others too, less directly, but not less influentially, include Sidney Blatt, though he may never have known it; his students, Barry Ritzler and Howard Lerner; and Irving Weiner, former editor of the Journal of Personality Assessment. Acklin’s colleagues in the SPA have been a continuing influence in recent years, including Paul Lerner, Jim Murray, Reid Meloy, Carl Gacono, Jim Kleiger, Martin Leichtman, Don Viglione, and others. Finally, he could not encompass his genealogy without mentioning his good friend and colleague, Charles Peterson. A consummate scholar and blues man, he exemplifies the analytic attitude and virtues of loyal friendship to the highest degree.

Carl Gacono’s graduate studies included training with James Madero, utilizing the Comprehensive System; Jay Kwawer’s primitive modes of relating; and Paul and Howard Lerner’s defense scales. Subsequently, he trained and consulted with Phil Erdberg, Paul Lerner, Irving Weiner, and John Exner. Strongly influenced by the work of David Rapaport, Roy Schafer, Martin Mayman, and others, Gacono’s early training set the stage for an integrative approach to Rorschach interpretation.

James Murray initially trained in the Rorschach at Case Western Reserve University with Sandra Russ and Irving Weiner. Their work has served as a source of inspiration throughout the years. He also had the privilege of serving as a teaching assistant to Marguerite Hertz for her 2-week Rorschach seminar. In this role his responsibilities included keeping Dr. Hertz in her cigarillos and coffee, and being available to be pointed at when she referred to “those Exner people” (a position she softened on over the years). While a postdoctoral fellow at Yale Psychiatric Institute, he had the delightful opportunity to study with Sidney Blatt.

Charles Peterson was first taught the Comprehensive System by Karen Maitland Schilling, a student of Molly Harrower, who studied with Bruno Klopfer, who studied with Oberholzer, who studied with Rorschach. His understanding of the Rorschach deepened and was inspired by the writings of David Rapaport, Ernest Schachtel, and Roy Schafer, and by the supervision of Gus Crivolio, Steve Gryll, Murray Tieger, and Robert Tureen.

We have organized this book into four sections; the first three—psychotic, borderline, and neurotic levels of personality organization—are literary analogues for the horizontally demarcated levels of personality organization most recently advanced by Kernberg (1975, 1976, 1980, 1984). Within each section the editors and invited authors have contributed a Rorschach case study that vertically cuts a character pathology, personality disorder, or clinical diagnosis through that particular level of personality organization. The last section we have labeled “special” because it charts the enormously varied course that Rorschach work can navigate—from the understanding of a Nobel laureate, the pain of trauma and transvestism, and the Nazi perversion of youth, to the consensus Rorschach in couples’ therapy and cutting-edge work in neuropsychology.

We are especially indebted to our contributors, and want them to know, for the first time, why they were invited. We perused the Rorschach research for individuals who had shown an interest and skill in idiographic research, and who did not shrink from the task. We also wanted individuals who were pragmatic enough—as both Comprehensive System empiricists and theorists—to not let fealty get in the way of science. We were delighted with the response to our invitations, and as you will see, they did not fail us. Our contributors are clearly the most notable Rorschach clinicians in practice, and their work should both delight and stimulate the reader. Parenthetically, the number of contributors to this book who invited a student to coauthor their chapter is emblematic of their generosity.

The integration of the Rorschach and psychoanalysis is not solely a one-way street in which the Rorschach approach is enhanced by the richness and depth of psychoanalytic insight. The Rorschach gives back to psychoanalysis almost as much as it receives. There exists a long and worthy tradition involving the use of the Rorschach to operationally define, test out, and refine psychoanalytic concepts and formulations; it stretches from Holt (1960) through the contributions of Paul and Howard Lerner and their associates (Kwawer et al., 1980; Lerner & Lerner, 1988) to Gacono and Meloy’s (1994) use of the Rorschach to reformulate the psychodynamics and psychopathology of aggression and violence.

As contemporary psychoanalytic theory threatens to break through the intellectual stratosphere under the expansive influence of hermeneutics, gender politics, and deconstructionism, the Rorschach allows us to grab psychoanalysis by the toe and drag one foot back to the terra firma proffered by the natural science tradition. The Rorschach, with its unique window into the depth and complexity of the individual, is unrivaled in its capacity to offer a level of insight that does justice to psychoanalytic conceptualizations, while still being amenable to the more quotidian world of statistics and science. It is this close-to-magical intersection of nomothetic and idiographic that is the heart and soul of contemporary Rorschach understanding, and hopefully the heart and soul of this book.

Finally, as senior editor, Reid Meloy cannot resist a forensic comment. Several of the chapters have arisen from forensic cases, and illustrate the depth and range of Rorschach data in contributing to the resolution of legal questions. However, skepticism is still heard concerning the use of the Rorschach in court. There are a number of published articles that empirically document the wide clinical and research use of the test (Piotrowski, 1996; Piotrowski & Keller, 1989, 1992; Piotrowski, Sherry, & Keller, 1985); but most germane to the legal arena, the Rorschach continues to leave an indelible stamp (Meloy, 1991). In a research study in progress we searched the federal, state, and military case laws in the United States between 1945 and 1995 for references to the Rorschach. Almost 200 legal citations were found in which the Rorschach was discussed by the courts in substantive, if not foundational, terms (T. Hansen, personal communication, Augu...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Foreword
• Contributors
• 1 Introduction
• I. Psychotic Personality Organization
• II. Borderline Personality Organization
• III. Neurotic Personality Organization
• IV. Special Applications
• Author Index
• Subject Index