Psychosomatic Medicine 17:428-454 (1955)
© 1955 American Psychosomatic Society

Observations on the House-Tree-Person Drawing Test Before and After Surgery

¹ Department of Psychiatry, Mount Sinai Hospital, New York, N. Y.

The House-Tree-Person test was administered to a group of 22 surgical patients before and after surgery. Brief psychiatric investigations were conducted at approximately the same time. The observations noted in this study have led to the following conclusions:

Subtle or gross paranoid attitudes were readily elicited by the not infrequent refusals to participate in the tests.

Striking dissimilarities between the pre-and postoperative drawings of the same patient presented a sharp contrast to the usual finding of constancy in the H-T-P drawings performed by an individual over a period of time.

The preoperative drawings were usually characterized by multiple indications of psychologic regression, far exceeding any clinical impression.

Somatic illness, site of pathology, and surgery were rarely directly alluded to in the person drawings. On the contrary, references to these factors tended to be expressed either symbolically or through a graphic equivalent of familiar psychologic defenses. In many instances such representations attained their clearest expression in the house drawings.

Postoperative drawings often revealed an abandonment of the regressive aspects noted preoperatively, leading to the surmise that the latter arises as a response to anxiety and a sense of imminent catastrophe. Where the operations resulted in obvious mutilation the postoperative drawings appeared to reflect psychic reactions to it. Here again direct representation of body change was unusual. Allusion to the physical alteration tended to be expressed either symbolically or through multiple psychic defenses and through changes in mood. In cases with a more fortunate outcome, the postoperative pictures revealed appropriate changes in mood as well as in the abandonment of the several defensive measures employed in the preoperative pictures.

Pre- and postoperative drawings also revealed certain characterological features of these patients, apart from their reactions to the acute surgical emergency.

Theoretical considerations have been discussed and the suggestion is offered that although the drawings are produced upon order they may serve a psychotherapeutic function in aiding the subject to cope with a threatening and traumatic reality.

This article has been cited by other articles:

				S. W. Nathan Coping with Disability and the Surgical Experience: Body Image of Scoliotic Female Adolescents Clinical Pediatrics, May 1, 1978; 17(5): 434 - 440. [Abstract] [PDF]