Friday, 7/9/10 - Rorschach

"Shouldn't I be lying down?"

"Are you tired?"

"No."

"Then, no, as long as you are comfortable, sitting would be fine." The doctor scribbled a few words in his notebook before continuing. "Like you, most people assume that all psychiatrists will be like the ones they see on TV. As you can see," he said fanning his hand slowly across the room, "this is more like a living room than a doctor's office."

Adam agreed that it was not what he had expected. It was almost comfortable.

"And, just so you know, I am not going hypnotize you or make you do anything against your will. I am here to help you. Tell me as much or as little as you like."

Adam considered what the doctor was saying and relaxed a little.

"Since this is your first visit, we will make it a short one. When you go to a medical doctor, he will often perform tests to determine how your body is functioning. A visit to a psychiatrist is no different in that we will need to run some tests to see how your mind is functioning. The simplest test is called the Rorschach test, it works like this: I hold up a picture and you tell me the first thing that comes into your mind. As an example, if I hold my hand out like this," the doctor held up two fingers, "what is the first thing you think of?"

"Two."

"Very good. Some people might have said 'peace' because to them it resembles a peace sign. One woman said 'evil' because it was the sign her grandmother used to ward off evil spirits. The point is that there are no right or wrong answers. Just tell me the first thing that comes into your mind. Ok?"

"OK."

The doctor pulled a short stack of paper from inside the notebook resting on his lap. He turned over the top sheet and held it up. "What do you see in this image?"



"That's easy, a tape measure."

The doctor scribbled something in his notebook. "Interesting."

Adam didn't know what he wanted to be but 'interesting' was not one of them. "Is that wrong?"

"Oh, no. There are no wrong answers."

"But you said, 'Interesting' and you wrote something down."

"I'm sorry, I guess I didn't explain very well. I will write down your answers so that I can review them later. It's similar to a medical doctor having the ability to review the results of a blood test. I hope you don't find my writing distracting."

"No, no, I guess not."

"Shall we continue?"

"OK."

The doctor revealed the next sheet. "And this one looks like?"



"A screwdriver."

The doctor scratched in his notebook and raised the next sheet.



"A wrench."

More scratching and the next one was lifted.



Adam hesitated before answering, "A hammer."

"And how does this hammer make you feel?"

"Angry."

"Angry? Why would the hammer make you feel angry."

"Because it's chipped."

"As though it had been over used?"

"No, as if it had been used improperly. As if someone didn't know how to use it or didn't care enough to use it correctly."

The doctor wrote in his notebook, a little more than he had written for any of the other sheets. "I think that will be enough for today." He tapped the pages into a nice, even pile and placed them face down in the center of the coffee table between himself and Adam.

"So doc, what do you think? Am I crazy?"

"I know you are just joking but I also know that you are concerned so rather than answering your question, I will ask you one. Do you feel over-worked?"

"Doesn't everyone these days? I know a lot of people without a job. I am lucky to have one and I thank God every day for that. The problem is that the boss knows that there are no jobs so he works us as hard as he wants and no one complains." Adam noticed his blood pressure rising so he stopped and took a deep breath. "My answers told you that I felt overworked?"

"Considering the images that you were shown, your responses were interesting."

"What do you mean, 'interesting'?"

"Well, your first response was 'tape measure'. In all of my years as a psychiatrist I have never heard that response. It was interesting."

"But it really did look like a tape measure." Adam reached down and picked up the sheets. He turned over the pile, "See..." but even he didn't see.



The image was just a blot of ink that looked more like a butterfly than a tape measure. He turned it upside down then right side up looking for the tape measure.

It was not there. He flipped to the next page.



"For that one you said, 'screwdriver'."

There was no screwdriver on that page, no wrench on the next.

"These images are intentionally vague. It's not uncommon for people to see different things each time they look at them."

But there was no ambiguity in the images Adam had first viewed. There was no doubt, the tape measure was a tape measure and it could have been nothing else. He flipped back to the beginning and started through the stack again. This time he noticed that some of the images were in color. He hadn't seen those before.



"We normally have no concerns unless..."

Adam looked up at the doctor, "Unless?"

"... unless someone starts seeing the images in color. All of these images are printed in black and white. Some more advanced illnesses result in patients seeing the images in color. We take that as a warning sign. But you have nothing to worry about."

As if there was a bug crawling on them, Adam quickly pushed the pages onto the table and backed into his chair as far as he could. He wanted to run from the room but he waited quietly and tried to appear normal.

The doctor scribbled something else in the notebook then snapped it shut. "If you have no questions then I think that we are done for today. Shall I schedule your next appointment for, oh..." he opened a calendar and flipped through the pages, "How about next month?"

Adam had seen the colors. A month was too long. "Ummm..."

"Sooner? Let's see," the doctor flipped back a few pages, "Will Tuesday at 9am work for you?"

Adam nodded, "Yes, yes, Tuesday will be fine."

"Very well, I will see you on Tuesday at 9am. If you need me before then, please call my answering service. They know how to get in touch with me at any time."

The two men stood and shook hands. The doctor escorted Adam to the door then returned to his seat and relaxed for a moment before checking his watch. His next appointment, Elsa Gordon - a new patient, is scheduled for 10am. Five minutes, just enough time to assemble the sheets he would be using for her test.

He quickly read what information he had on her - two kids, bad relationship, possible divorce - and decided to use a series of broken heart images in the first stack. The second stack, the one he would place on the table - the one she would sort through looking for the broken hearts, was the same one he used for everyone. It contained actual Rorschach prints, some of which are in color.

He had gotten very good at two critical elements: switching the stacks of images and timing his comments about color. Switching the pages was simple sleight-of-hand: tap the stack into a neat pile, lay them down on top of the notebook and pull the new stack from underneath. No one ever watched what he was doing but if they did, it would appear as if he were working with only the one stack.

Timing his comments was an art. Everyone was different and to get the most impact he had to listen closely to their unspoken languages - posture, breathing, eye movement, anything that indicated discomfort. Listen, then at the right moment mention 'problems' associated with seeing colors. If he did it correctly, the reaction was always the same: they couldn't get away from the images fast enough.

He arranged the two stacks of images in his notebook and checked his watch again.

He thought about Adam and felt a warm glow inside knowing that he will be able to help. All it took was getting Adam to recognize that he needs help. That's the problem with most people: they are sick and they don't even know it.

"Yes," he thinks, "Most people are crazy. I just help them see how crazy."