One day around the turn of the twenty-first century, a man came into Finn’s office wondering why he always tended to avoid conflict and criticism. When prompted to turn that abstract why-question into a focused goal, the client spelled out: “How can I become more comfortable with other people’s displeasure?”
His Rorschach scores indicated a tendency to avoid or flee emotional situations (Afr. = 0.16, C = 0), but Finn didn’t talk scores. Instead, he read back to the man one of his responses to Card VIII, the colored card with the pink bearlike shapes on the sides: “These two creatures are scurrying away from a bad situation….It looks like an explosion could happen at any minute and they’re running like hell to save their lives.”
Finn: “Do you identify with those creatures at all?”
The man smiled. “I sure do! That’s what I’m doing all day long at work. I guess I think I’ll get killed if I stick around. The explosion these two are running from is a bad one.”
“And is that true for you?”
“Not that bad, really. But I never really realized before that it feels like I’ll die.”
“Yes, that seems like an important insight into why you avoid confrontation,” Finn said.
“I’ll say. No wonder I’ve had such a hard time with this.”
Treatment was concluded after just a few sessions. In their last meeting, Finn returned to the original assessment question: “So from what we’ve discussed so far, do you see any way to get more comfortable confronting other people?”
The man replied, “I guess I just need to learn that I won’t die if other people are mad at me….Perhaps I could start with some people who aren’t that important to me. That would make it less scary.”
All the decades of debate about the Rorschach’s validity were irrelevant here—those terrified creatures on Card VIII gave Finn a way to see what the client was feeling and present it in a way that helped him learn about himself. This was Brokaw’s do-it-yourself Rorschach shirt brought back into the doctor’s office, with a therapist experienced in standard Rorschach scoring able to home in on which answers were most telling—in this case, shapes usually seen as sluggish animals running like hell for their lives.
Finn has argued that a good therapist has to both adopt the patient’s perspective and then step back to take a more distanced, objective view of the patient’s problems. Failure in either direction can be damaging, whether the therapist overidentifies with patients, to the point where their destructive or pathological behavior seems normal, or is so intent on diagnosing abnormal behavior that she cannot recognize its significance in the patient’s life or culture and intervene effectively. Psychological tests, Finn argued, can help a therapist with both of these movements: “Tests may serve both as empathy magnifiers—allowing us to step into our clients’ shoes—and as external handholds—allowing us to pull ourselves back out of those shoes to an outside perspective.”
In practice, then, Finn’s approach means presenting test results as theories to be accepted, rejected, or modified by the client. People are “experts on themselves” and need to be involved in interpreting their own responses to any test. The therapist shares the results in nontechnical language, in personal letters instead of reports, or as fables for children. And instead of trying to answer a referral question—“Is X suffering from depression?”—therapists agree with clients on assessment goals and real-life questions to address, such as “Why do women call me emotionally unavailable? I think I’m just self-sufficient and self-controlled, but are they right about me?” Or from children: “Why do I get so mad at my mom?” “Am I good at anything?”
The idea is that when test results are connected to personally felt questions or goals, a client will be more likely to accept and benefit from them. A client’s “coming for a psychological assessment is very different than their coming for a blood test or x-ray,” Finn writes: it is an “interpersonal event,” depending on the relationship that develops between client and therapist to make sense of what comes out.
Needless to say, this kind of “client-centered” model is not typically used in the courts, or in other contexts where an outside view on the person is called for. But as an increasing number of controlled studies demonstrate that C/TA is effective—that such brief assessments actually can accelerate treatment, or even give people life-changing insight into themselves, sometimes more incisively than traditional longer-term therapy—insurance companies are starting to pay for it. A 2010 meta-analysis of seventeen specific studies showed that Finn’s approach has “positive, clinically meaningful effects on treatment” and “important implications for assessment practice, training, and policy making.” (A skeptical response to the article was also published—written by three of the coauthors of What’s Wrong with the Rorschach?)
Sometimes just the process of taking a test could be therapeutic. One woman in her forties who came in for assessment was an overachiever who had worked hard her whole life but had burned out at a demanding job several years before and had not recovered. On the Rorschach, she strove to give Whole responses to all the cards; the assessment team discussed this with her, and she agreed that she always avoided “taking the easy way out.” They assured her that responses about parts were “just fine” and asked her to look back over several cards, just to see what it was like to answer that way. After tentatively offering some Detail responses, with continual reassurance from the assessors that the answers were okay, she finally sighed, looked relieved, and said, “This is so much easier.” They had a long discussion about how she might have exaggerated ideas of what was expected of her and how this approach to life came out of her childhood.
Such nonstandard use of the test clearly makes those Detail responses scientifically invalid—but it helped the woman see things in a new way. Does that mean the test “worked” or not? Her initial test, with its high number of W’s and lack of D’s, was conducted scientifically, and in fact gave Finn valid information about her and prompted a therapeutic intervention that proved effective—but what about the follow-ups?
Tests are supposed to detect something; treatments are supposed to do something: this is the perspective Exner, Wood, and the R-PAS creators shared. A score on a test works if it gives valid and reliable information about a person. Results are true or false. But Hermann Rorschach had called his invention an inkblot experiment—an exploration, not a test. Taking a test is doing something. In Finn’s words: “We would not necessarily consider our work in vain if the results of an assessment were not used by outside professionals to make decisions or to shape their interactions with clients. If a client felt deeply touched and changed by an assessment and was able to maintain that change over time, we would consider the assessment to have been well worth our time and effort.”
Finn has trained thousands of psychologists in his methods over the years, and at personality assessment conferences C/TA is considered the most important development to have come along in a generation. Of course its roots go back further—Constance Fischer pioneered “collaborative psychological assessment” in the seventies; in 1956 Molly Harrower described “projective counseling,” where people discuss their own Rorschach answers with examiners to “come to grips with some of their problems.” Rorschach himself used his inkblots in much this way, with Greti and Pastor Burri and many others. C/TA is both the latest thing and the original.
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Therapeutic assessment, as an open-ended method to get to insights that feel right, may seem to occupy a kind of parallel universe from the R-PAS creators’ efforts to improve and validate a scientific test. In fact, though, the R-PAS and Finn’s C/TA reframe the nature of the Rorschach in similar ways.
Gone is reference to projection, much less X-rays. Instead, just as Finn focuses on the “interpersonal event” of the test, R-PAS—the Rorschach Performance Assessment System—treats the test as a task to be performed for an examiner. As the R-PAS manual lays out: “At its core, the Rorschach is a behavioral task tha
t allows wide latitude” for responses and behaviors expressing “one’s personality features and processing style”: “Rorschach scores identify personality characteristics that are based on what people do, which is a complement to the characteristics they consciously recognize and willingly endorse on a self-report instrument. As such, the Rorschach is able to assess implicit characteristics that may not be recognized by the respondent him or herself.” Taking a Rorschach means showing your stuff: problem solving under stress, nothing Freudian about it. People’s actions are framed not as “projections” of their psyche but simply as behavior in our shared objective world. Unlike an audition or a time trial, though, it isn’t obvious to the test taker how this task relates to life outside the testing situation. The fact that we’re not quite sure what’s being asked of us is what makes the test work.
Although Meyer and Finn rarely cite him, their emphasis on interpersonal performance returns to the insights of Ernest Schachtel, the philosopher of the early Rorschach. Both R-PAS and collaborative assessment, in their different ways, reiterate Schachtel’s point that “the Rorschach performance and the experiences of the testee in the Rorschach situation are an interpersonal performance and interpersonal experiences.” As he elsewhere says more evocatively, “the encounter with the inkblot world” is a part of life. The act of responding to blots for an examiner can be artificially seen in isolation from this human context, but it doesn’t truly exist there.
This is especially clear when C/TA is used to help people that other therapies often cannot reach—people other than educated, white, upper- or upper-middle-class clients already familiar with the language and worldview of traditional psychotherapy. The WestCoast Children’s Clinic in Oakland, California, provides services to thousands of vulnerable and often abused children, many of them living with foster parents, most from families without the financial or transportation resources to make use of other services. The clinic was founded with the conviction that these children have to be seen in the context of their often extreme situations, not simply classified with standardized measures of, say, “behavioral problems.” From the start, the clinic tried to take a flexible and respectful approach; in 2008, it started to apply Finn’s C/TA in particular.
Lanice, an eleven-year-old African American girl, no longer lived with her mother, who had mild to moderate intellectual disabilities. She lived instead with her aunt, Paula, and Paula’s adult daughter. Lanice was acting out in school and at home; one time, she poured nail polish into her cousin’s drink and sat quietly waiting to see what would happen when she drank it. Paula tended to minimize Lanice’s problems at home and to focus on her increasing problems at school. When Lanice was in third grade, her teachers had urged Paula to request an evaluation, but when the school finally tested Lanice—a year and a half after Paula’s request—they determined that she did not qualify for services, despite the fact that she was reading at a kindergarten level. Paula brought her to the WestCoast Children’s Clinic for help.
The assessment questions, arrived at in collaboration with Paula and Lanice’s mother, included “Does Lanice really not have a learning disability?” and “Why is she so angry?” The crucial breakthrough came about because of the C/TA practice of encouraging caregivers to observe a child’s testing sessions, to help them better understand how the child operates. After a rapport-building first session, in which Lanice was mostly allowed to act out, she was given a Rorschach and other tests the next day. This time, when she squirmed in her seat, sprawled across the table, or spun the Rorschach cards on her finger like a basketball, the examiner set firmer limits than before. Paula watched it all on a live video feed.
Having spent the day in testing, Lanice went straight to afterschool, where her behavior seemed worse than ever: angrily pulling away from the teacher, refusing to follow instructions. When Paula picked her up, she was told that Lanice had acted out and was in danger of being expelled. Paula felt blindsided—everything had been fine earlier that afternoon.
The third day, when Paula and Lanice’s mother returned to check in before the last session, it was Paula who blew up. She blamed the therapists for Lanice’s behavior, insisting that by letting Lanice act out they had ruined her sense of how to behave in public. The therapists were then able to talk through not only Lanice’s problems but Paula’s expectations and anger. The therapists said they would try to support Paula and would talk to the afterschool teacher to explain the situation; they “acknowledged that the previous day’s session was rather intense and that we would do more to plan for Lanice’s transition from the testing session to school.”
By the end of the session that day, Paula was able to see the extent to which Lanice’s behavior was due to feeling overwhelmed and how Paula’s own expectations were contributing to Lanice’s problems. The acting out was a form of communication; Lanice hadn’t known how to verbally communicate her feelings, including shame about her mother and anger at feeling abandoned by her, but those feelings had showed up in the assessments, as Paula watched on live video and started to understand.
In a joint storytelling task afterward, where Lanice and her aunt and mother had to come up with a story together, the family “began to listen, tolerate, and identify Lanice’s anger and frustration.” The treatment had worked by expanding the assessment process to include Lanice’s family and the community—to help Lanice, the therapists had needed to understand her mother, support her aunt, reconsider their own approach, and talk to the people making decisions at her school. Insight into her psychology meant insight into her wider life context.
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In the R-PAS framework, the Rorschach works as a performance challenge because it’s mysterious. The inkblots and the task of interpreting them are unfamiliar and disorienting, forcing people to react without their usual self-presentation strategies or “impression management.” As collaborative therapy, the Rorschach works because what you see in the inkblot is not mysterious: that explosion or screeching bat is concrete, vivid, ready to be shared and meaningfully discussed with a therapist.
From both of these perspectives, the Rorschach moves beyond the dichotomy between objective and subjective. The test is not just a set of images, not just a wolf that we either find in the cards or put there, but a process of grappling with a complex situation, acting in a confusing environment fraught with expectations and demands.
If Finn and Meyer’s findings are any indication, this vision of the test as a task we perform, or as a possible way for a client and therapist to connect, may capture its complexity better than either alleged objectivity or purely subjective projection. That is why Meyer has proposed to scrap the old labels for “objective” and “projective” tests and instead call them “self-report tests” and “performance-based tests.” Both kinds yield real information, and both are subjective, too, but in the first kind of test you say who you are; in the second kind of test you show it.
Framing the difference this way is a subtle move to highlight what the Rorschach has to offer. After all, in the skeptics’ view, “to rely heavily on the Rorschach, even when it conflicts with biographical information and MMPI results,” simply “puts the weakest source of information first (the Rorschach)” and is “forty years behind the times and out of step with scientific evidence.” For Meyer and Finn, who have each extensively studied the relationship between Rorschach and MMPI results, both kinds of test are valid, but they work differently. A conflict between the results is meaningful information, not reason to reject either approach.
The MMPI is highly structured, noninteractive, and taken in schoolroom fashion by filling in bubble sheets or pressing buttons. Its True/False answers reflect a person’s conscious self-image and conscious or unconscious coping mechanisms. In Finn’s view, if someone is functioning reasonably well—perhaps showing up for counseling or with relationship problems but not in acute crisis—he is likely to do well on such structured tasks. The Rorschach can then reveal his underlying problems, emotiona
l struggles, or propensities to act “crazy” that otherwise turn up only in private, or in intimate relationships that are as unstructured, interpersonal, and emotionally charged as the inkblot experiment. These may be difficulties he is unaware of, so can’t express on an MMPI questionnaire—and yet the reason why he turned up seeking mental health services in the first place might be that he is having problems in his life that don’t fit with his self-image. A Rorschach that finds things other tests don’t may be “overpathologizing,” or it may be getting at real issues that we can usually keep under control.
Finn found the reverse scenario, of someone producing a normal Rorschach protocol and a disturbed MMPI test, to be much less common. It usually meant one of two things: Either a test taker was faking, perhaps to claim disability benefits or as a “cry for help,” and could consciously exaggerate on the MMPI but didn’t know how to exaggerate on a Rorschach. Or else the more emotionally challenging and potentially overwhelming task of a Rorschach made him or her “shut down” and produce a dull but unremarkable protocol with few and simple responses. In the first case, the Rorschach was “right”; in the second, the MMPI was more accurate.
From this perspective, the MMPI’s basis in self-reporting is both its strength and its weakness. Such tests show how you try to present yourself. The strength and weakness of the Rorschach is that it sidesteps these conscious intentions. You can manage what you want to say, but you can’t manage what you want to see.
Rorschach Test, Card VIII
Draft versions
Final Card III
The Inkblots Page 33