Contemporary Rorschach Interpretation

By J. Reid Meloy; Marvin W. Acklin et al. | Go to book overview

level of relatedness, according to Urist ( 1977) schema for assessing object relations, in that the figures are interacting in a way that acknowledges some individuality and mutuality. They are talking; they are friends. This paradox may suggest that Mr. Q's delusional identity (a fusion fantasy) as "a woman trapped inside a man's body" is compelling enough to function as a significant, transitional organizer, containing the bulk of the psychosis in psychotic restitution.

Space does not permit a microscopic analysis of each response in the record, which closes with themes of fecundity, the feminine aggressively triumphing over the masculine, frenzied denial of the phallus, and an intolerance of depressive affect. As per Holt ( 1977), libidinal content is primarily oral, with some fairly direct oral aggressive, some indirect oral receptive imagery, and some indirect sexual imagery. The aggressive content is the socially tolerated variety. Perhaps the implication here is that Mr. Q is balanced on the cusp of individuation and has insufficient aggression to help propel him from the symbiosis. In closing, the patient's last words on the inquiry to his response to Card X may be considered an unconscious summation of the transsexual self and a testimonial to the power of the Rorschach to sample the representational world: Mr. Q stated, "you can't see the details til you get up close." In this case, getting up close revealed an individual with a predominance of id over ego, a psychotic level of ego boundaries, thought processes dominated by the primary process, drives penetrating the repression barrier, marginal neutralization of libidinal and neutralization of aggressive drives, a delusional adaptation, an incompletely individuated self having difficulty maintaining a separation between independent events, self and the poorly articulated object world centered on separation, and the fantasy of the male being devoured and absorbed within the female. The Rorschach was able to detect Mr. Q's psychosis, best illuminated in the atheoretical nomothetic contributions of the structural summary. Using the complementary perspective of a theory saturated, idiographic, content analytic approach derived from clinical psychoanalysis, the Rorschach was able to describe the object world and interpersonal modes of this psychotic personality.

Paraphrasing Blatt and Ritzler ( 1974) trenchant insight, diagnoses made using the nomothetic structural summary can be enriched by idiographic content analytic approaches devoted to the concepts of self and other. Although Mr. Q will remain barren, a marriage between the psychometric and the clinical psychoanalytic traditions will ensure that the Rorschach remains fecund.


ACKNOWLEDGMENTS

This chapter was initially part of a symposium entitled "Psychotic Personality Organization: Through the Looking Glass" presented at the midwinter meet-

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