(Re)introducing the Rorschach

Following the exciting news that Hogrefe will be offering training in the famous Rorschach test, we spoke to the course trainer, Dr Kari Carstairs, to find more about the Rorschach's rich history, its modern day applications, and why the test continues to fascinate.

Dr Carstairs has used the Rorschach in a variety of settings and is the President of the British Rorschach Society. She is currently overseeing a UK normative study in the Rorschach Comprehensive System and has been training others in the use of the test since 1995. Read the interview in full below:

Hi Kari, thanks for speaking with us today to discuss the Rorschach and the upcoming training course. Please could you tell us about your experience with Rorschach?

I was first introduced to the Rorschach in my clinical training in the US in the 1980s. I actually first learnt the Piotrowski System, taught by a professor called Clifford DeCato. Then I learned the Comprehensive System from Virginia Brabender - who is past president at the Society for Personality Assessment, so she's very well-versed in the Rorschach. Because I trained in the US and because I did a Psy. D. rather than a PhD, it was a very practice-based doctorate. So throughout the five year training, alongside the formal teaching in the classroom, we did placements where I was doing testing under supervision and I used the Rorschach regularly, with both children and adults.

Then I graduated and I came to this country in 1991 to take up a post in the NHS in adult mental health. This included a position at the inpatient psychiatric hospital, where psychiatrists had various diagnostic questions. I was doing assessments and the Rorschach was part of that work.

I gradually moved to private practice. I left the NHS completely in 1998, but it was a gradual process. One of the things that I do in private practice is to provide assessments for the courts. I've used the Rorschach throughout my decades of private practice. It's formed an important part of my professional life. I've also taught it here in London, and also with my colleague, Justine McCarthy Woods, in Hong Kong. And I try to keep myself up to date. I'm a fellow at the Society for Personality Assessment now, and I go to their annual conference when I can.

Why did you want to run the upcoming training course in the use of the Rorschach?

Due to historical accident really, the Rorschach has fallen out of the regular psychology training programs in this country. That's not true around the world. Internationally, the Rorschach is well-respected and used clinically in many different countries, but not here. That has to do with a critique by Hans Eysenck. The time of his critique was prior to the development of the Comprehensive System, and so you had lots of different systems for interpreting it. So I think that some of what Eysenck was saying was due to that lack of standardisation.

Exner then pulled the different systems altogether into what he called the Comprehensive System. But by then, the Rorschach had fallen out of favour here. And now, you're in the situation whereby people don't know about it. Or what they do know about it is a prejudiced, biased view, coming only from the side of the critique, and they're completely ignorant of decades of research that supports the use of the test. Even the most severest critic of the test, Wood, who wrote his book 'What's Wrong with the Rorschach?' and has made it his career to critique the test, even he will say that when it comes to assessing thought disorder, it is very robust. But psychologists in this country are not aware of it, so they've lost the tradition. The problem now is 'how do you reintroduce it'?

The Rorschach is a complex tool. What kind of information can it provide?

The Rorschach gets at personality structure and functioning. So it covers coping resources, cognition, perceptual accuracy, information processing, emotional processing, view of self, and to some extent, view of others. It gives you a picture of the person's predominant modes of interacting with the world, as things stand now in the person's life. You could say it's atheoretical - it doesn't make assumptions about the aetiology of anything, but it describes certain things very well. It's not about what patients tell you about themselves; it's more how they process information. Some of it is not necessarily something that the patient would immediately be able to report about themselves. It's different from a self-report instrument and that's one of the reasons why it is so useful in court, because it compliments other things - like the Millon, the MMPI-2, or the SCL-90 self-report instruments. Those are helpful, but they cover the issue in a different way. And the Rorschach gives you something that is more structural.

The Rorschach has faced controversy over the years. What would you say to those who are sceptical of its modern day applications?

I would just say "look at the research". If you look at the research, you will see that it is just as valid as the MMPI-2 or the IQ test. But one of the things about the Rorschach is that it tends to generate strong feelings. I think that's because it's not self-report and because it's not self-evident, there's inevitably a threatening aspect to it. The idea that you could find out something about somebody without them telling you directly is threatening to some people, and they don't like that. But anybody who seriously goes into the psychological literature will see that there is a vast amount of evidence for it, so long as it is used correctly.

Finally, why do you think people remain fascinated with the Rorschach, all these many decades later?

It's absolutely the most interesting psychological test, without a doubt. And I can say that with decades of practice of using other instruments too. It is absolutely fascinating because it allows the person to give their own responses, so you've got the possibility of an ideographic interpretation - looking at the uniqueness of that individual. But because you've got the scoring, you've also got psychometric information. It's psychometrically robust. So you've got those two dimensions. In my training I learned the TAT and I think the TAT is very interesting, but it doesn't have that psychometric rigour that the Rorschach has. It has the ideographic bit, but it doesn't have the psychometric rigour. If you look at the MMPI-2, it has excellent psychometric rigour, but zero ideographic information. The person is just answering "true / false, true / false" and they're never given the opportunity to express themselves in their own unique way, whatever that may be. So the Rorschach is very interesting - you've got these two bits in it. And I think that's very appealing to clinicians.

Thank you, Kari!

You can find the details of the Rorschach training course here. If you have any questions about the course, feel free to email us.

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