In Defense of Inkblots

Rorschach, Blot 10

[This post is partially written to be contrarian. Please do not abandon your nice therapist in favor of getting inkblotted.]

I was recently linked to this part of the Less Wrong Sequences, Schools Proliferating Without Evidence. It contains a bit of the attitude towards psychology I run up against in this community, and I want to talk about it.

“Remember Rorschach ink-blot tests? It’s such an appealing argument: the patient looks at the ink-blot and says what he sees, the psychotherapist interprets their psychological state based on this. There’ve been hundreds of experiments looking for some evidence that it actually works. Since you’re reading this, you can guess the answer is simply “No.” Yet the Rorschach is still in use. It’s just such a good story that psychotherapists just can’t bring themselves to believe the vast mounds of experimental evidence saying it doesn’t work—

—which tells you what sort of field we’re dealing with here.”

But but but…

If I could speak in defense of inkblots (words I never thought I’d say), well, they’re not helpful as predictive tests. We can all fairly well conclude that this is not how to determine risk for depression or somesuch. It’s probably a non-terrible way to determine if someone has a thought disorder like schizophrenia. Give them a thing to construct a story around, and see how they connect thoughts and ideas.

A card from the TAT
A card from the TAT

But projective tests like Rorschach inkblots and the Thematic Apperception Test (“here’s an ambiguous picture, what are the people in it thinking?”) CAN be helpful for getting clients who are uncomfortable in therapy to open up. Client John Doe isn’t sure about this whole “talking about his feelings” stuff, but get him started telling a story about an inkblot and he might relax into conversation more easily than if you ask him to talk about his latest self-harm experience or troubled childhood.

Handing a stranger your feelings, or telling them about trauma or mental experiences that you know are abnormal is hard. People can go months and years in therapy before mentioning that one time they were assaulted, or how yeah, they’re fine now but they were abused as a child. It takes a lot of work to force yourself to share something in a vulnerable place…and it’s all too easy to feel like you’ve let it go too long without sharing…so why not just wait until the next session? Or the session after that? How do you squeeze that information in between explaining how your previous week was and this week’s focus?

Inkblots are a performative way to introduce those discussions. You say how Inkblot #5 looks a bit like a cow chasing a butterfly and the therapist says oh, they remember you saying you grew up on a farm, how was that. And lo, five minutes later you’re talking about your childhood.

Look, inkblots are not going to magically inform the therapist about your chances of being sociopathic, or convey a ton about your personality. It’s a bit ridiculous that some therapists use them for this. On this, the Sequences and I agree. But, this usage is rare. The cards are expensive, at $125 for the ten plates, and all of the blots are now available online for anyone to read about, removing much of the mystery. But for as long as clients keep requesting them, and they keep being an avenue into comfortable discussion, I think inkblots will be hanging around.

 

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