Countertransference in the Rorschach Situation as a Clue to the Patient’s Affective Functioning

Abstract

The Rorschach inkblot method (RIM) is a procedure that challenges an individual’s capacities for regulating affective experience. An individual who cannot self-regulate and needs an external agent to do so will find the Rorschach task particularly difficult. Distress is a manifestation of self-regulating difficulties which can lead to interpersonal regulation. Projective identification is a mechanism for regulating intense affects which has been linked with countertransference, and has been defined as the reactions and manifestations in the person of the analyst to the contents projected into him by the patient. Therefore, the clinician’s reactions to his patient are now considered important sources of information about the patient’s mental functioning. In the present study, we empirically evaluated the examiner’s experience and CS variables related to affect regulation, in order to see if it can be used as a source of information about the mental functioning of patients. A sample of 30 participants were administered the Rorschach, and both participants and examiners self-reported their affective experience of the Rorschach situation with the PANAS-m. We found that the emotional experiences of the examinee that have the strongest impact on the examiner (hostile, overwhelmed-invaded, emptied) seem to possess a specific quality. They appear to consist of important aspects of the experience of distress (overwhelmed-invaded and emptied), with hostile features. When looking at CS variables, affect regulation linked variables were found to be generally unrelated to the examiner’s affective experience during the administration of the RIM, except for the affective ratio (Afr), which appeared to be somewhat protective of an interpersonal communication of sadness and emptiness. However, indicators of self and interpersonal perceptions from the CS were found to be quite strongly related to the examiner’s experience during the administration: Morbid content (MOR) and aggressive movement (AG). Thus, a reduced interest in emotional events, a pessimistic view of the self and the anticipation of aggressive exchanges with others appear to be associated with a tendency to regulate painful affects or distress interpersonally.

Assessing the Alternate-Form Reliability of Interview-Based and Web-Based Rorschach Responses Measuring Body Boundary Imagery and Regressive Imagery

“…In this sense, the Rorschach inkblot test does not represent an assessment tool only but equally represents a therapeutic intervention. Because of the mechanical and nonhuman interface of the Internet, individuals conducting a web-based Rorschach test could not be reassured that they were following the test instructions correctly, for which individuals with difficulties in functionally regulating their affective responses might experience increased anxieties and frustration (Deschenaux et al, 2012). Similarly, web-based administration of the Rorschach inkblot test would not facilitate offering the patient immediate emotional support and empathic responses to hurtful associations and traumatic memories, as would a clinician in a traditional Rorschach interview setting.…”

“…In these therapeutic situations, the clinician is able to provide reassurance to the individual performing the task in addition to responding empathically to the patient’s free associations and memories that might have been triggered by the exposure to the Rorschach inkblot cards. These reassuring and empathic responses are assumed to help individuals to regulate their affective functioning (Deschenaux, Lecours, Doyon, & Briand-Malenfant, 2012) and to facilitate transformative processes, thus representing healing elements in the patient–clinician interaction (Finn, 2009; Lerner, 2005). In this sense, the Rorschach inkblot test does not represent an assessment tool only but equally represents a therapeutic intervention.…”