Ego Psychoanalytic Rorschach Interpretation

Abstract

Abstract. This article concerns the utility of ego psychoanalytic perspectives in Rorschach interpretation. Psychoanalytic ego psychology focuses on how people cope with events in their lives and how effectively they can meet challenges to their sense of well-being. The way people deal with experienced distress constitutes their defensive style and determines to a large extent what kind of person they are. Adequate defenses against anxiety promote comfortable and productive adjustment, whereas ineffective defenses typically cause adjustment difficulties and susceptibility to psychological disorders. In Rorschach assessment, the nature and effectiveness of a person’s defensive style can often be identified with a sequence analysis that integrates the structural, thematic, and behavioral features in the protocol. In particular, the sequential quality of responses, especially preceding and following instances of cognitive slippage, can help identify causes of upsetting concerns, defensive efforts to alleviating these concerns, and the adequacy of these defensive efforts in restoring equanimity. This interpretive process is illustrated with attention to implications for differential diagnosis and treatment planning in the Rorschach protocol of a 20-year-old suicidal woman.

Discussion of Special Issue Articles “A Rorschach Case Study: Multiple Psychoanalytic Models of Interpretation”

“…Weiner (2017) anchors us to the history of ego psychology. Ego psychology is equated with defense analysis.…”

“…要約 本論文は精神分析的な観点からロールシャッハのデータを分析した一連の論文を吟味したものである。患 者はうつ状態にある若い女性であり、自殺の考えと行動化、そして治療者との複雑な関係と苦闘していた (Kleiger, 2017)。様々な精神分析の考えがそれぞれの分析において明らかにされた。これらの分析は 構造変数や主題イメージをどのように使用するかについて異なっており、Ms.B の問題の詳細な分析を提供 している。それらは、自我心理学の観点から見た彼女の防衛操作の理解 (Weiner, 2017) 、対象関係 の葛藤 (Smith, 2017) 、広範な安心できなさと関連した中核的な不安と対人関係の葛藤 (Evans, 2017) 、 自己心理学的な情報に基づく彼女の壊れそうな自己評価の明確な説述 (Silverstein, 2017)、関連す る欠損に対する広範囲に及ぶ愛着のニーズ (Berant, 2017)。また、思考の組織化、感情の調整、中 核的な葛藤の領域が同定された。Ms.B の包括的理解にはそれぞれの精神分析の観点からの洞察が 必要であり、それはケースの定式化を全体的に高めることに役立つことは明らかであった。…”

“…The papers comprising this special section (Berant, 2017; Evans, 2017; Kleiger, 2017; Silverstein, 2017; Smith, 2017; Weiner, 2017) speak directly and expertly to the value of diversity of psychoanalytic thought. In so doing, each author anchors to a specific theory, while also respecting Freud’s grand plan of a broad psychoanalytic scholarship, inferred from his chess-game metaphor (Freud, 1913/1981), in which multiple strategies (at times, overlapping each other) inform the analytic process.…”

“…Thus, as it relates to different psychoanalytic theories and how they each approach the Rorschach, we might surmise the following points. From the ego psychological perspective (e.g., Schafer, 1954) that Weiner (2017) represents, we see sadomasochistic behavior in which Ms. B. hurts herself and her therapist; this is followed rigidly by defensive denial and a seemingly manic flight into health. From the object relational/Winnicottian perspective that Smith (1990, 2017) represents, we see the spoiling of a good-enough maternal hold in which help is equated with toxic impingement and the periodic collapsing of transitional space between self and object.…”

“…The patient was a depressed, young adult female struggling with suicidal ideation, acting-out behavior, and a complex relationship with her therapist (Kleiger, 2017). Diversity of psychoanalytic thought was evidenced in each analysis, which varied in utilization of structural variables and thematic imagery, while offering a detailed analysis of Ms. B.’s problems: an understanding of her defensive operations from an ego psychological viewpoint (Weiner, 2017), object relational conflicts (Smith, 2017), core anxiety and interpersonal conflicts associated with pervasive insecurity (Evans, 2017), a self psychologically informed formulation of her fragile self-esteem (Silverstein, 2017), and extensive attachment needs with associated deficits (Berant, 2017). Thought organization, affect regulation, and core conflict areas were also identified.…”