Rorschach Test

The various methods of personality assessment that have become known as projective tests developed slowly over an extended period of time (Rabin, 1968). A projective technique “evokes from the subject what is in various ways expressive of his private world and personality process” (Frank, 1948, p. 47). Perhaps the most widely used projective test is the Rorschach, developed by Swiss psychiatrist Hermann Rorschach in 1921 and brought to the United States by David Levy around 1924 (Klopfer and Kelly, 1942). Although the efficacy of the test has been questioned mostly by nonclinical researchers, its sustained popularity for over 80 years has been well documented (Bornstein, 2001; Piotrowski and Keller, 1992). The Rorschach is regularly utilized in both clinical and forensic settings. And contrary to the popular myth, the Rorschach is welcomed in the courtroom and its scientific validity has only been attacked very infrequently (Meloy, Hansen, and Weiner, 1997; Weiner, Exner, and Sciara, 1996). In fact, the Society for Personality Assessment (2005) published a statement on the status of the Rorschach in clinical and forensic practice. Having reviewed the scientific evidence, they concluded: “the Rorschach possesses reliability and validity similar to that of other generally accepted personality assessment instruments” (p.219).

The Rorschach is invaluable in understanding the psychopathology of criminal offenders, in general, and sexual murderers, in particular (Revitch and Schlesinger, 1981 Gacono and Meloy, 2013; Gacono, Evans, and Viglione, 2002). In a series of empirically based studies (Gacono, 1992a,b; Gacono Meloy, and Bridges, 2000; Meloy Gacono, and Kenney, 1994), researchers compared the Rorschachs of sexual murderers to those of nonsexually offending (but violent) male psychopaths and (nonviolent) pedophiles. They found a number of personality characteristics that shed light on the psychological makeup of the sexual murderer. For example, traits such as attachment abnormality, characterological anger, pathological narcissism, formal thought disorder, borderline reality testing, and obsessional thoughts differentiated the sexual murderers from the two control groups. On the basis of these findings, Gacono, Meloy, and Bridges (2000) developed a model of sexual homicide.

In attempting to gain a full understanding of the psychological makeup of an offender, one must look beneath overt traits and behaviors to the basic personality structure or framework on which these traits are fixed. The psychologist must ascertain how strong or weak the framework is and where the vulnerable areas are. Just as a structural engineer inspects a building by examining the strength and composition of the beams and underpinnings (rather than the color or type of siding), the psychologist must accurately and inclusively describe the structure of the subject’s personality.

By focusing simply on overt traits and behaviors, we overlook an important aspect of the assessment. Understanding what is beneath traits and behavior leads to a much different understanding of the offender. For example, two individuals may present with impulsivity as a problem, but one of these individuals may have a weakened bor- derline-like structure, whereas the other may be structurally more intact. The extent of structural weakness has major implications for treatment as well as prognosis, particularly in differentiating individuals who may act out from those who do not. That is, an individual who harbors disturbed, sexually aggressive fantasies but does not act on them may have more structural integrity than someone who has similar fantasies but cannot control the urge to act.

An individual’s level of structural integration, as well as his level of inner cohesiveness, is assessed by an analysis of the formal characteristics of the subject’s Rorschach responses, and also by a practical commonsense view of the content of what is perceived. For example, one (serial) sexual murderer gave many primitive Rorschach perceptions suggesting severe inner disorganization and structural weakness which might account, in part, for some of his behavior: “A bug somebody stepped on, squashed, blood, it’s blood.” “An explosion like a war movie.” “A slide under a microscope smeared under glass, all spread out, trapped under glass.” “An X-ray of twins being born. Pink little babies crapped up.” “Someone could have hemorrhoids and this is a piece of toilet paper. It’s what the person was eating to make him shit like that. I don’t know what he ate. The green is spinach, the yellow is corn not digested.” “Somebody vomited. The colors. The way it’s all splattered out.” In contrast, another individual, who had elaborate fantasies of keeping women captive and torturing them but was able to control any inner urge to act, gave relatively clear responses, the most disturbing being “the stump of a tree gnawed off” (given to card IV). Certainly, the mere presence of bizarre, aggressive, and primitive content does not—by itself—suggest the potential for violence (or sexual homicide) if an individual is not otherwise predisposed to commit such acts.

Revitch and Schlesinger (1981) reported the case of a 19-year-old boy who murdered his mother by stabbing her repeatedly while she slept. This boy, who had a history of sadistic acts toward animals, gave the following extremely aggressive and primitive Rorschach content: “A cockroach crushed. The guts are pouring out. The stomach, the blood, the insides, it was killed violently and smeared around.” “This is a lady with her head chopped off. The blood is flying all over the place.” “A butterfly with his head bashed in and his feet are bleeding.” “Two rabbits bleeding. They were shot in the body and out the mouth.” “Two native ladies fighting over something. The loser is gonna die and bash her head against this.” “A gigantic cockroach shot in the back. Here is all the blood.” “A deformed bug with his guts on the side.” “A dead horse drowning in its own blood.” “Insects fighting over the blood of losers.” This young man was not overtly psychotic but, instead, appeared withdrawn; he was diagnosed as schizoid and evidenced paranoid ideation periodically. He had fantasized for years about committing a sexual homicide but finally committed a matricide. His Rorschach illustrates the enormous amount of anger, primitive aggression, and inner disorganization that contributed to his loss of control.

Psychodynamic inferences come from an analysis of Rorschach content, with special attention given to the specific stimulus pull of the various inkblots. Although content analysis has always occupied an important place in Rorschach interpretation (Aronow, 1994; Lane, 1984; Lindner, 1946, 1950), it has fallen out of favor in recent years in preference to structural analysis that is more empirically based (using the

Exner [1974] system). Nevertheless, we have found dynamic interpretation, although perhaps not empirically anchored, to be very useful. For example, the dynamic significance of the following Rorschach responses of several sexual murderers is too important to ignore: Card IV (male card): “Ovaries of a woman.” “A monster, he looks like he is defecating. It’s diarrhea coming out of him.” Card VI (sexual card): “It looks like a gun. Here’s the barrel, here’s the trigger. It’s a gun with a bullet coming out.” “Vagina exploding, all in pieces.” Card VII (female card): “Scum from a pond, spread out.” “A woman with her legs spread open. Her legs are all mutilated. Something up her vagina and it’s broken off, a piece right here.”

An individual’s ability to empathize, which is fundamental in a psychological evaluation, is illuminated by the Rorschach. Schaefer (1959) defines empathy as “the inner experience of sharing in and comprehending the momentary, psychological state of another person” (p. 345). In other words, empathy is the ability to put oneself in the position of another, so that he can experience how the other person feels. Empathic capacity is obviously important in understanding sexual murderers (many of whom torture their victims); moreover, the ability to empathize may also help to distinguish those who act out their fantasies from those who do not. Gacono, Meloy, and Bridges (2000) refer to entitlement and grandiosity, as well as abnormal bonding, as characteristics important in the psychodynamic understanding of sexual homicide; these traits are clearly related to empathy. A careful assessment of Rorschach human movement perceptions is enormously helpful in assessing the level of empathic capacity. Miller and Looney (1974) studied Rorschachs of murderers who dehumanized their victims and found that such offenders did not regard these victims as people: “There is a paucity of images that would suggest a stance that other people are full, warm, and alive” (p. 191). Lack of empathy, revealed by an absence of human perceptions on the Rorschach, was also noted by De Bousingin (1971) in a study of six cases of murder. Thus, empathic capacity assessed clinically and bolstered by Rorschach findings is an important aspect to be considered in any assessment of the sexual murderer’s personality.