My name is Sam Vaknin, and I am the author of Malignant Self-Love, Narcissism Revisited.

Today we will discuss the Rorschach Ink Blots Test.

Swiss psychiatrist Hermann Rorschach developed a set of blots of ink, ink blots, to test subjects in his clinical research.

In a 1921 monograph published in English in 1942 and 1951 respectively, Rorschach postulated that the blots of ink evoked consistent and similar responses in groups of patients.

Only ten of the original ink blots are currently in diagnostic use.

It was John Exner who systematized the administration and scoring of the test, combining the best of several systems in use at the time, systems developed by Beck, Kloper, Rapaport and Singer.

The Rorschach Ink Blots are ambiguous forms, printed on 18 x 24 cm cards, in both black and white, and sometimes in color.

The very ambiguity of the ink blots provokes free associations in the test subject.

The diagnostician stimulates the formation of flights of fantasy and fancy by asking questions such as, what do you think this is? What might this be?

The diagnostician then proceeds to record verbatim the patient’s responses as well as the ink blots’ spatial position and orientation.

An example of such record would read, card V upside down, child sitting on a porch and crying, waiting for his mother to return.

Heading down through the entire deck, the examiner then proceeds to read aloud the responses while asking the patient to explain, in each and every case, why she or he chose to interpret the card the way they did. He asks, what in card V prompted you to think of an abandoned child?

In this case, the patient is allowed to add details and expand upon his or her original answer.

Again, everything is noted and the subject is asked to explain, what is the card, or in his previous response, gave birth to the added details.

So it’s an iterative process, a process where the answer expands as the conversation continues and the card is merely a trigger.

Scoring the Rorschach test is a demanding task. Inevitably, due to its literary nature, there is no uniform automated scoring system.

Methodologically, the scorer notes four items for each card.

One, location, which parts of the inkblot were singled out or emphasized in the subject responses? Did the patient refer to the whole blot, to a detail in the inkblot? And if so, was it a common or an unusual detail? Did the patient refer at all to the white spaces between the blots?

The second item is determinant.

Does the blot resemble what the patient saw in it? Which parts of the blot correspond to the subject’s visual and fantasy and narrative? Is it the blot’s form, movement, color, texture, dimensionality, shading, or symmetrical pairing that might have provoked in the subject the responses that he gave, elicited them?

The third thing noted by the diagnostician is the content.

Which of Exner’s 27 content categories was selected by the patient? A human figure, an animal detail, blood, fire, sex, x-ray, and so on?

Popularity.

The patient’s responses are compared to the overall distribution of answers among people tested, hither to. Statistically, certain cards are linked to specific images and plots.

For example, card 1 often provokes associations of bats or butterflies. The sixth most popular response to card 4 is animal skin or human figure dressed in fur, and so on.

Then there is the issue of organizational activity.

How coherent and organized is the patient’s narrative, and how well does he or she link the various images together?

There is form quality. How well does the patient’s percept fit with a plot and with a blot?

There are four grades from superior through ordinary, and weak to minus.

Exner defined minus as the distorted, arbitrary, unrealistic use of form as related to the content offered, where an answer is imposed on the blot area with total or near total disregard for the structure of the area.

The interpretation of the test results of both the scores obtained and what we know about mental health disorders is somewhat questionable.

The test teaches the skill diagnostician how the subject processes information and what is the structure and content of his internal one. These provide meaningful insights into the patient’s defenses, psychological defenses, reality tests, intelligence, fantasy life and psychosexual makeup. Or, so it is thought.

The Rorschach test is highly subjective and depends inordinately on the skills and training of the diagnostician and his interpretative abilities. It therefore cannot be used to reliably diagnose patients. It merely draws attention to the patient’s defenses and personal style.

In the case of narcissists, that’s not enough.