Psychosomatic Medicine 7:85-89 (1945)
© 1945 American Psychosomatic Society

Rorschach Method and Psychosomatic Diagnosis

Personality Traits of Patients with Rheumatic Disease, Hypertensive Cardiovascular Disease, Coronary Occlusion, and Fracture

Rorschach study of hospital patients with rheumatic disease, hypertensive cardiovascular disease, coronary occlusion, and fracture show that certain distinctive personalities are associated with each illness syndrome. Patients with rheumatic disease are characteristically passive, masochistic, instinctively weak and infantile, with an underlying hysteria. Hypertensive patients are more ambitious for power; they have more conscious hostility and experience a more constant, acute conflict between aggression and their dominant passive, dependence needs. They are more introversive, less labile and hysterical. Obsessive-compulsive defenses are conspicuous in hypertensive patients, and particularly obsessive doubts.

Patients with coronary occlusion show a distinctive pattern of aggressiveness and compulsive striving for power and prestige. Introversive experience of creative thought is undeveloped, making them more dependent upon external achievement for satisfaction and security. They are reactive and express considerable hostility.

Fracture patients are divided into 3 groups: the introversive, constricted, and extratensive; the first two groups showing the highest incidence of accidents. Among all groups is an effort to compromise between passivity and aggression, with a marked emphasis on adaptation, self-determination, independence of authority, and day-to-day pleasures.

Personality constriction increases with organic damage. Neurotic conflict is evident in nearly all hospital cases, but the more limited the psychological defense mechanisms, the greater the likelihood of serious physical illness.

The Rorschach method yields no simple pathognomonic signs; a certain illness or propensity for it may be deduced only from the Rorschach picture of the personality as a complex whole. The method has proved its value not only for research, but also for differential diagnosis and for outlining a therapeutic program.

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