SCZI or PTI – Schizophrenia or Psychosis?

Abstract

Abstract. This paper attempts to illustrate the usefulness of therapy follow-up studies with the Rorschach, based on a particularly striking and difficult protocol (including Structural Summary 1 and 2), in which the two indexes pointed to either schizophrenia (Schizophrenia Index, SCZI) or a psychotic episode (Perceptual-Thinking Index, PTI) in an adolescent whose later development was distinctly positive. Implications of the interpretive process are discussed, of the use of both indexes in favor of the PTI, as well as of the danger of depending on single indexes or of using the Rorschach for psychiatric diagnosis.

Psychodynamic Assessment of Psychosis in Adolescence

“…However, a more accurate qualitative analysis would show that these seemingly conflicting tendencies implicate the same positive evolution and reflect the structural differences of each test. In fact, John's formalization in the Rorschach indicates his efforts in fighting narcissistic regression and his lability in the TAT underlines his efforts of integrating object relations, enabling him on both tests to "think more and feel less" (Campo, 2018). While they both gave rise to more responses in bad form and the emergence of primary processes, they offered openness to therapeutic alliance as witnessed by John's attempts to better understand family dynamics as well as his efforts to symbolize his experience and ideal wishes through storytelling during the final meeting where transference and play seemed more tolerable.…”