SIS Journal of Projective Psychology & Mental Health

JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH The Official Publication of the Somatic Inkblot Society Volume 6 Number 2 July, 1999 SIS ISSN 0971 - 6610 Vol. 6, No. 2, Pgs. 1-76 SIS JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH 1999

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH is published twice a year (January & July) by the SOMATIC INKBLOT SOCIETY and is devoted to the advancement of research in the areas of projective psychology, personality assessment, psychotherapy and mental health. The journal is broadly concerned with the development of inkblot tests and personality assessment in clinical, counselling, cross cultural, organizational and health psychology settings. It aims to reach clinical psychologists, psychotherapists, psychiatrists, social workers, medical professionals and professional managers interested in the understanding and modification of human behaviour. The journal includes (a) research articles (b) book reviews (c) brief reports (d) news about conferences etc. and letters to the editor. MANUSCRIPTS PREPARATION : Manuscripts should be typewritten (double spaced throughout) submitted in duplicate to B.L. Dubey, Ph.D. Chief Editor SIS Journal, P.O.Box 1107, Sector-15 Post Office, Chandigarh 160015 (India). Manuscript can also be submitted to Wilfred A. Cassell. M.D., Editor, 4501E, 104th Avenue, Anchorage, AK-99516 (USA). The Editors reserve the right to refuse manuscript submitted and to make minor additions/deletions. Authors should prepare their manuscripts according to the Journal of Personality Assessment. SUBSCRIPTION : The journal is free to members of the Society, Annual membership fees are US $50 for foreign members and Rs. 250, for Indian members, Institutional subscriptions are US $100 for Foreign institutions and Rs. 500 for Indian institutions. Life membership is US $300 for foreign members and Rs. 1500 for Indian members. Non-members may subscribe for $30 or Rs. 150/- per issue. Cheques should be made payable to 'SOMATIC INKBLOT SOCIETY’ Chandigarh and should reach Dr. B.L. Dubey, Chief Editor, (Address given above). Please add $5./Rs. 30 if you are sending subscription through cheque. CHANGE OF ADDRESS : Society / journal members should inform Mrs Padma Dwivedi, Secretary, SIS Center, Post Box 1107, Sector-15 Post Office, Chandigarh-160015 (India), Tel/Fax 91-172-710986, E-Mail: sisdubey@ch1.dot.net.in OR sisdubey@hotmail.com and Foreign Members should inform Mrs. Mary Cassell, Executive Director, Somatic Inkblot Center, 4501E, 104th Avenue, Anchorage, AK-99516 (USA). Fax : (907) 563-3746. E-Mail:drcassell@corecom.net of any change of mailing address. Copyright @ 1994. SOMATIC INKBLOT SOCIETY, Anchorage U.S.A./India

SIS Journal of Projective Psychology & Mental Health Volume 6, Number 2, July 1999 Contents Page Nos. 1. Editorial : New Horizons in Psychotherapy. 1-3 N.L. Dosajh 2. A Case of Family Therapy 4-6 N. L. Dosajh and Rajiv Dosajh 3. Stimilating Becon Images fo Meditation and Projective 7-30 Psychotherapy. Wilfred A. Cassell, Bankey L. Dubey, Elaine Molchanov and Lisa Routh 4. Stability of SIS - II Response Contents Across Time and 31-37 Predesignated Image Clusters Rakesh Pandey, Mridula Mishra, Rejendra Mishra & C. B. Dwivedi 5. Validation of Weiner's Signs in Schizophrenia 38-44 S. Chaudhury, T.R. John & S.G. Jyothi 6. Psychogenic Symptoms in Learning Disabled Children 45-50 Sheetala Prasad and A. N. Srivastava 7. Effect of Age and Sex on SIS-II References. 51-76 M.P. Singh, A. Singh and B.L. Dubey

SOMATIC INKBLOT SOCIETY is an International organization helping thru SOMATIC INKBLOT SERIES TEST (SIS). The SIS is a structured, projective, diagnostic test and an adjunct to psychotherapy. It helps in hearing the inner cry of suffering individuals. SOMATIC INKBLOT SOCIETY is publishing its Journal SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH a half yearly publication in January and July. It has 2 Awards of $250 employing the use of Inkblot Tests SIS & Rorschach. For details please contact : Wilfred A. Cassell, M.D., FAPA, APC, FSIS, Director, Somatic Inkblot Center, President, Somatic Inkblot Society and Editor, SIS Journal of Projective Psychology & Mental Health, 4501E, 104th Avenue, Anchorage, AK-99516 (USA). Fax : (907) 563-3746 E-Mail : drcassell@corecom.net Web Site at http: //www.owt.com/sis/ OR B.L. Dubey, Ph.D., DPM, FSIS, Chief Editor, SIS Jr. of Proj. Psy. & Mental Health, Director, Somatic Inkblot Center India, Post Box 1107, Sector 15 Post Office, Chandigarh-160015 (India) Tele/Fax : 91 - 172 - 710986, Tel. : 91 - 172-710985, E-Mail: sisdubey@ch1.dot.net.in OR sisdubey@hotmail.com

Editorial New Horizons in Psychotherapy Most of the troubles with which a psychotherapist has to deal with are of a psychosomatic nature, which can be approached from two sides-Mind or Body or both. If we approach from the mental side we have to take into consideration the whole of the psyche - its conscious as well as to its unconscious aspects. The conscious aspect is easy to tackle with, because the trouble is at the surface level and is apparent both to the patient as well as the clinician. But when the trouble is at the deeper level of the personal unconscious or still deeper at the collective unconscious level, the problem of diagnosis becomes very difficult because neither the patient knows the causes and the cure nor the clinician. Then comes the necessity of a very sensitive tool like~ a projective technique as Rorschach, Thematic Apperception Test, lloltzman Test, Dosajh (D) Test or Somatic Inkblot Series Test or some such other tests. During the author’s experience of about fiery years as a Clinical Psychologist, he has found Somatic Inkblot Series (SI S) to be an excellent and a very effective psycho diagnostic tool (July, 1998). It is because of its special merits that it has spread all over the world in the span of a few years. It has a number of forms like : SIS-I(20 cards set), SIS - 11(62 images test) and 515-Il Video. The Video test makes the procedure more interesting and dream - like. The subject’s interest is sustained by using light music, floral presentation to the background and zoom-in and zoom-out impressions (1997). By introducing the video technology, Cassell (1984) has widened the scope of the use of this test. This way the test can be administered to a group of persons at the same time. The Video Test is available on ‘INTERNET’ thus the test now can be administered world-wide simultaneously to all those who are connected with the ‘INTERNET’. Treatment As far as treatment is concerned, this test is a very good psychoanalytical tool particularly for those having psych~~somatic symptoms. However, the combination of psychoanalytic and psycho synthetic approach may add to the value of the procedure. Psychosynthesis The idea of psycho synthesis may have originated from Carl Jung when he talks of ‘Individuation’ in one of his famous books - ‘Integration of Personality’, in the 2 nosajh 1; West, and YOGA in the East, especially by Patently reship. Now many techniques for psycho synthesis or integration of personality have been evolved. Self- SIS J. Proj. & Mental Health, 1999, 1-3

actualization by Adler and Maslow, Functional Autonomy by AIlport are some attempts in this direction. Shri Aurobindo gives a complete description of integral personality through integral Yoga. Alf9nso Caycedo gives his technique of Sophrotherapy where he combines the traditional methods with the modern tech nique. Assagioli explains his technique of psycho synthesis (1959). Dosajh (Jan. ~83) talks of Sublimation (May, 1983). Transpersonal Psychotherapy widens the element of consciousness and this enables the subject to solve his problems. Vaughan (1986) states “Transpersonal therapies that are concerned with liberation and transcendence are more likely to aim at developing a context of self-consciousness within which the process unfolds. A transpersonal approach need not exclude the other types of work but holds a broader perspective. In addition to the usual therapeutic techniques, this approach also questions belief about the nature of the self and reality and thus establishes a favorable context for healing at any level.” For details of each of these psycho synthetic techniques the reader is referred to original sources given under references. Here the author is giving a general idea of psycho synthesis. Psycho synthesis gives a method of integrating the various sub-personalities of the individual. The initial stage is body-mind integration. This is followed by body-mind-spirit integration. This leads to complete synthesis. How does this psycho synthesis take place, especially from body-mind to body-mind-spirit can be understood in terms of consciousness. Consciousness is a sort of awareness of our environments outside us and understanding of our phenomena that are taking place within us. This ordinary consciousness is raised to higher levels of transcendental consciousness-cosmic, micro and unity (macro). This is effected through one of the methods of meditation or through the instructions of a Sopliro therapist. As the consciousness levels rise, the various conflicts, complexes and prejudices get resolved till complete enlightenment takes place. The individual gradually affairs the power of intuition, first only for occasional moments but then for all times unless he comes to the lower level of consciousness. The various levels of consciousness have their own characteristics, which are well explained by Aurobindo (1972), Dr. Anthony Campbell (1980), Majority Mahesh Yogi (1966) and Dr. Harold H. Bloomfield (1975).515 & Psychotherapy 3 This combination of the two approaches as explained earlier- psychoanalytical and psychosynthetic lead to the development of both spheres of the cerebrum of the man 2 Dosajh

and makes him a ‘Whole Man’ possessed of supernatural powers. Such people may bring peace into the war torn world and usher in a new era of peace and enlightenment. References Anthony Carnpbell (1980) States of~onsciousness, Victor Gollness Ltd, London, p.110. Assagioli Robent (1959) Psychosynthesis, Psychosynthesis Research Foundation, P.O. Box. 3695, Greenville, Delaware, USA. Aurobindo Shri (1972) The Synthesis ofYoga, Part II, Pondicheny, Vol. 20, p.511. Cassell WA. (1977) Desensitization Therapy for body image anxiety, Canadian Psychitric Association Journal, 22,239-242 Cassell W. A. & Dubey B. L. (1997) Somatic Inkblot Series II ‘video Manual, SIS Ccntrc. Anchorage, Alaska. Dosajh,N.L. (1983)Vitalism Bombay Psycho~o gist. 5:1, 3-7. I)os~hN. L. (1983)Psychotherapy, Kohli Publishers, Chandigarh. Dosajh N. L. (1998) Somatic Inkblot Series-an excellent diagnostic tool, 515 J. of Proj. Psy. & Ment. Health, 5 :24 ~6-l38. Harold H. Bloomtield (1975) TM: Discovering Inner Energy & Overcoming Stress, Delacoric Press. New York. Mahesh Yogi (1966) ‘The Science of Being and Art ofLiving’, International SRM Publi~,ttion. London, Rishikesh (India). Vaughan, F. (1986) The Inward Arc : Healing and wholeness-psychotherapy and Spirituality, Boston. Sharnbhala, New Science Library. N.L. Dosajh; Ph.D., Diplomat in Professional Counselling Professor of Psychology, 1121, Sector 15-B, Chandigarh - 60015 SIS PSISJ. Proj. Psy.&Ment. Health, 1999,1-3sychology

A Case of Family Therapy N. L. Dosajh and Rajiv Dosajh A 45 years male, working as an Assistant Manager in a bank with two children was referred to the first author for Psychotherapy. Somatic Inkblot Series II was administered to him. The responses revealed his poor interpersonal relationship with his wife and family tension. Responses found significant are discussed in the case. A Case was referred by the second author to the first with the following MRI Scan Report: Minimal early changes of lumber spondylosis with early degeneration of L5 S intervertebral disc and mild disc bulge. Mild bilateral root canal narrowing at the level. Normal study of remaining discs. No neural compromise noted at any level. Socialized L5 vertebra with rudimentary L5 S disc. The patient is a male, 45 years, working as an Assistant Manager in a bank. He is married, with two children - a daughter about 17 years studying in BAMS and a son about 15 years studying in junior college, wife is also serving in a subordinate position in an office. The Patient feels lot of pain in the lumbar region. There is tension in the family, so much so that the wife stays in a boarding house but visits her house daily to help in cooking etc. The patient is on medical leave and is thinking of premature retirement. He visits a guru who gives him instructions in meditation, bhajan and dancing. He is very much attached to his guru, who told him that his wife and children are parasites on him and that they wish to eat him up as much as they can by forcing him to go to the bank and earn for them inspire of his illness. The guru has implanted this idea in his mind. The patient repeats this again and again. All this according to the second author creates lot of tension in this patient and results in greater pain at the lumbar region and is very much responsible for his deteriorating condition. He has referred this case for ‘Family Therapy’, so as to remove the patient’s tension. This may help in lowering his pain at the lumber region, and may help him to resume his duties in the bank. Treatment The first author put him on ‘Shav Asan’ and other relaxation exercises along with Pharmacotherapy as suggested by the second author. He was also trained to perform pra.nayam. The patient was administered SI S-Il and a few significant responses are interpreted and discussed here: N. L. Dosajh, Ph.D., Former Professor of Psychology & Clinical Psychologist, 1121, Sector IS- B. Chandigarh. Raj iv Dosajh, Orthopaedic Surgeon, Panchkula (Haryana). Family Therapy 5 SIS J. Proj. & Mental Health, 1999, 4-6

Image A9 : He perceived ‘Playing two friends’. Generally people perceive two persons- Male & Female doing something. The patient has avoided seeing Female figure because the acceptance of female object seems to be very painful to him. Image ~l was viewed as ‘Dancing in loose clothes’. This is an OK response, however, avoiding two children/babies on either side might be indicative of his disturbed family life. Image A 22 : He could perceive “Yogasana”. The image stimulates spinal column or male sex organ, which has been denied by the patient. It is quite natural that in his present situation when the patient has no relationship with his wife may deny such sexual symbols. Image A25 : He has seen ‘Mirror’ instead of female sex organ-the frequent~ seen response on this image. Not perceiving female sex organ reveals his area conflict and probably dissatisfied sex relations The other explanation overseeing’~ mirror might be his effort at self-analysis. Image A31 He ‘saw ‘Two Friends’ on this image, though most ‘people perceive ‘Male & Female’. Once again the disturbed interpersonal relationship between husband and wife has been projected through this image. Image B18 : He viewed ‘Fish’, though ‘male sex organ’ is the frequent response on this image. Once again the theme of disturbed interpersonal relationship particularly in the sexual area is brought out on the surface. Image B22 : He responded ‘Falling Man’. He projects his depressive contents and deteriorating health conditions. He has passive attitude and feels deprived of his wife. Image B28 He saw ‘a man’ though ‘Mother holding her child’ is the most common response on this image. Unable to perceive a mother with child may project his own disturbed home environment where children are left with father and mother is staying away from the family. In fact the disturbed home situation has been projected through his response on this image. Image B31 Though he has perceived ‘Family’ on this image, is a normal response but Family Therapy 5

could not view it as Husband wife and two children. Wherever he has to view female/ female object, he does not feel comfortable and finds it difficult to have a global view of family, wife and children. The SIS images helped in understanding the psychopathology of the patient and provided indications of disturbed family life, deprived sexual relations, feelings of separation and depressive contents. The SIS further suggested the need for ‘Family Therapy’. A number of interviews were held with each member of the family by author number I so as to make their attitude towards the patient sympathetic rather than inimical and dominating. His senior officers in the bank were contacted and apprised of the illness of the patient. They were requested to give the patient light work in the beginning and as his health condition improved to gradually increase the load of his work till it reached the maximum he is expected to do. After the expiry of his medical leave the patient joined his duty and with the full cooperation of the family members and superior officers of the bank the patient is on the way to recovery. 6 Dosajh & Dosajh

STIMULATING BEACON IMAGES FOR MEDITATION AND PROJECTIVE PSYCHOTHERAPY Wilfred A. Cassell, Bankey L. Dubey, Elaine Molchanov and Lisa Routh Much previous work suggests that the Somatic Inkblot Series(SIS) and Living Images video(LIV) can prove effective treatment aides. Viewing the inkblots can activate imagery accessing the “inner cry" of suffering individuals (Cassell,1980). In those highly resistant to interviewing, the pulling power of the projective approach may be combined with hypnosis, to probe more deeply in releasing grief (Savage 1995). Television viewing prior to sleep, can be particularly effective in stimulating the emergence in full consciousness of long forgotten posttraumatic dreams (Cassell & Dubey, 1997). The latter may then become available for subsequent therapeutic analysis and resolution with the assistance of a trained therapist. The present application uses these inkblot techniques to stimulate clinically effective psyche beacons for therapeutically guiding meditation. Some of the theoretical background for this approach was previously outlined in this journal (Cassell, Dubey & Roth, 1997). These concepts will be further expanded upon in this presentation. Clinical case histories will be reviewed of two women whose background included past personal experience in Yoga. In both instances, the essential educational information was recorded in a commercial television studio. This article summarizes the two training video tapes. Much previous work suggests that inkblot stimulation can provide effective treatment in Projective Psychotherapy. For the card form of the Somatic Inkblot Series (SIS), this innovative therapy technique was first noted several years ago (Cassell, 1971). Viewing such inkblots can activate imagery for releasing suppressed suffering (Cassell, 1980). In those highly resistant to interviewing, the pulling power of the projective methodology may be combined with hypnosis to more effectively release grief (Savage 1995). For the video versions, television viewing prior to sleep can be particularly effective in stimulating the emergence in full consciousness of long forgotten posttraumatic dreams (Cassell & Dubey, 1997). The latter may then become available for subsequent therapeutic analysis with a trained SIS therapist. The SIS can also provide a useful aide in assessing personality problems of adolescents (Khromov, Cassell, Dubey, 1999). Wilfred A. Cassell, M.D., Director; Lisa Routh, M.D., Psychiatrist, SIS Center, 4105, Tudor Center Drive, B-6, Anchorage, Alaska-99508 (USA). Elaine Molchanof, Ph.D., Jungian Analist, 615 East, 82nd Ave, Suite 102, Anchorage, Alaska-99518 (USA). Bankey L. Dubey, Ph.D., SIS Center, P.O. Box 1107 Sector 15 Post Office, Chandigarh-160015 (India)

One of the sources of the techniques pulling power concerns the fact that the anatomical and human structure in the SIS provides a psychologically relevant source of visual input. When mentally transformed by the power of projective technique, the stimuli can activate images of parental figures, family members, and other loved ones. In a similar fashion, the human qualities of the inkblots can arouse imagery, emotions, and cognitive conflict arising from memories of hated, threatening figures. The present application uses video inkblot techniques to stimulate in the subject’s visual field psyche beacons for therapeutically guiding meditation. Two clinical cases will be presented to illustrate how television stimuli can excite in visual consciousness association chains of subsequent secondary images. It will be shown how these mental pictures can in turn provide inner therapeutic guideposts for the meditator. Some of the theoretical background for this approach was recently outlined (Cassell, Dubey & Roth, 1997; Cassell et.al., 1999). These concepts will be expanded upon and clinically illustrated. Case histories will be outlined of two women whose background included past personal experience in Yoga. In both instances, in order to establish a permanent record for teaching and study purposes, the essential educational information was recorded. Case I For this demonstration program, the patient was present on camera in the television recording. At the time she was in the recovery phase of her treatment for Major Depression, previously precipitated by a psychologically traumatic miscarriage. Part I of the video recording presented an introduction by Elaine Molchanov, a qualified trainer for Yoga meditation, and Jungian analyst. Part II of the program included the woman involved in the study, along with Wilfred A. Cassell & Lisa C. Routh. A partially edited transcript of the demonstration television program follows: SIS is a very exciting projective instrument, which I think this videotape will reveal. One of the reasons it is so interesting to me is because it promotes the connection between the mind and the body. We are going to be seeing how the instrument itself is part of the whole healing process. Mary’s history that Dr. Cassell worked with over a period of time will be now considered. At first Mary came to Dr.Cassell after miscarriage. She was referred to him by 8 Cassell et al

her own Dr. and boss, I believe who knew that she was having difficulty going through this loss, that there was disturbances of poor concentration, headaches, and just in general the inability to function was being impaired. Well, she decided to meet Dr. Cassell who at that time gave her the SIS-II test, containing 62 images.The SIS has images of shining light and these are derived from body organs… they stimulate this particular woman’s vision and I think people in general in terms of unconscious part of the mind. Now as part of the process of the SIS you will see some experiencing it yourself, but it begins with bringing I think a person into what we refer to in Yoga as a deeper state of relaxation. A shift of consciousness, the mind going more into deeper aspect of the unconscious and that’s done through this instrument by the use in the beginning of the blue balls of light. I was very interested in seeing that because it corresponded very much with what I have studied in terms of the east in Yoga and the aspect of the lights is a very common experience of people that are very deep in meditation and there is a whole Yoga that has to do with lights and sounds and the blue sphere represents in both in Yoga and Jungian psychology we know the body of the spirit. That part of the mind that is connected to the spirit. The SIS imagery is no doubt stimulates the deep images in the mind and psyche and as we will see in this patient, stimulates a dream which then begins to take effect into the patient’s meditation experience and I think that that correlation occurs from more of a subtle level of the mind in terms of the dream and into her more personal levels of the mind in terms of bringing the healing process to completion. Now, I will be joining Dr. Cassell and the patient Mary and his colleague Dr. Routh. Dr. Cassell: This presentation concerns how the somatic video procedure may be used in assisting the processing of stresses related to the female reproductive cycles and grieving miscarriage. The somatic video procedure gets its name from the fact that many images in fact have some somatic content. Certain of these relate to female reproductive structures and also birth issues like babies fetus and so on. I wanted to present a case today showing how the somatic video procedure helped in the understanding and the release of material in a woman who has had some trauma in that area. Mary, I appreciate your courage in coming here. I originally had the opportunity to meet Mary just over two years ago. She was referred by her family physician and also Mary is a medical technician who I believe worked for the doctor and so she has some more sophistication in medicine and has a higher level of awareness of anatomical structure. Mary, can you say a little bit about the reason that Dr. Jones wanted SIS & Projective Psychotherapy 9

you to see me back in 1993. Mary: Well, I had a miscarriage and lost a baby and that happened in November and I was just getting too many headaches and I think that I was just becoming too distracted and unable to concentrate and I am sure that those were symptoms of depression so he rather than put me on anti-depressants he referred me to you and then I started seeing you. Dr. Cassell: Yes. Mary: I was becoming unable to function. Dr. Cassell: The first time you took the somatic video procedure can you just tell me your overall impression of viewing the inkblots and so on. Mary: I was surprised that everything looked like body parts. To me it looked like a lot of them looked like X-rays or um, or just um, it just looked like internal organs and I was surprised at how much of it looked like that. Well, anyway, it looked like that to everybody or if it was just because I took X-rays and knew a little bit more about anatomy or you know whether I was too preoccupied with that or what, but that surprised me. Dr. Cassell: Well, it is a little bit of an occupational hazard for doctors and nurses. We have all those images floating around, so that is very understandable. When you rated the images, you found one particularly threatening, and that was 30A which you saw as a skull and it reminded you of agony as you indicated in filling out the answers sheet. That it made you feel very badly. Mary: Yes, I know what you are talking about. Dr. Cassell: Can you recall what you actually saw there and in what way it disturbed you. Mary: I think because it is kind of a scary image and then you can’t really see it on that picture but on the video there is like a moving color with it, I can’t remember what color, maybe green or purple and it looked like pain. And it was just a skull with empty eyes, so it was kind of disturbing. It is not like a real skull, it does not look exactly like a skull, it just kind of resembles a skull. Dr. Cassell: And what about death, did it remind you of death. Mary: Um hum, I think so. 10 Cassell et al

Dr. Cassell: And your loss? Mary: I think so. I don’t know, just death, I think. Emptiness, that there wasn’t really anything there, anything inside. Dr. Cassell: I notice in looking at the protocol that a number of your responses at that time you saw fetus imagery in a number of them, for example 12A you said: “It looks like a fetus, a woman pregnant, standing profile.” Mary: Yea, I did. Dr. Cassell: You remember? Any emotions that you had at that time looking at that. Mary: I don’t think with that one because it is kind of a pleasant picture. It is not unpleasant colors or you know, it was a pleasant picture. I didn’t see that last night when I looked at it. Dr. Cassell: We have the advantage that we have you back in 1993, and then you are viewing about three years later. Another image dealing with the pregnancy theme, 15A, your first association was a stomach and then an umbilical cord and a fetus. Mary: I remember that I did not like that one very much. Because it was dark and again, it does not look exactly like a picture of a fetus that you would expect and the kind of unreality of it. It kind of makes me feel uncomfortable. Dr. Cassell: And the darkness. Did that remind you of any of the sadness that you felt in losing your baby. Mary: Yea, I think so. Dr.Cassell: Could you share that please. Mary: At the time I just thought it was no big deal. It happens a lot to people and a lot of times even before woman knows that they are pregnant they lose a baby. I knew a doctor who wouldn’t do an early pregnancy test because it just caused . . . then you know if the baby was lost at two months then he felt that they didn’t even really know for sure and it caused less pain. But, it was a big deal and it kind of brought up all of the other elements in my life that I was not dealing with like low self-esteem and not prioritizing my life well, you know, trying to do everything for everybody else and finally I just kind of broke and I think it was the straw that broke the camel’s back. You know, I just . . . I SIS & Projective Psychotherapy 11

became unable to function. Dr. Cassell: We also, I am pleased we have Dr. Lisa Routh here who is a psychiatric colleague and who has some knowledge about difficulties in the reproductive cycle of women. Do you have any comments on that response (… unintelligible.) Dr. Routh: It is a very interesting case but it is unfortunately not very uncommon. Women suffer post partum depression after miscarriage or after a therapeutic abortion at the same rate that women who have a normal pregnancy outcome do. You remain at risk for up to two years following that pregnancy loss because your body responds as though there was a baby there and now it is out of there. And just as though you had carried that child to term and delivered it. So, it is interesting to me that again, unfortunately, it is not uncommon. I wish it was more uncommon than it is. But, you are a prime candidate for heading a post partum type depression. Were you a person who remembers being emotional while taking birth control pills. Mary: No bad. I did at the time that I came to see Dr. Cassell, I had my daughter. She was born in 1991. And I think that kind of started actually, there was post partum depression with her. And then when I lost the second, you know, had the miscarriage, I think it just compounded it. You know, exponentially, it was just . . . I couldn’t drive, I couldn’t think, you know, and I was just barely hanging on. I stayed home with my daughter so if I would have been working I think it would have been maybe quicker to show up. All I could do was just take care of her and I think that is why Dr. Smith referred me to Dr. Cassell because I just wasn’t coping. So I think that I had post partum depression times two and I was ignoring what happened, because to me it was just a medical thing, it wasn’t anything that should, you know, no big deal. It was very early in the pregnancy, it wasn’t . . .you know I already had one beautiful child and you know, I just ... but it was a big deal. It was very painful. Dr. Routh: Well, she’s got a couple different things going on, you know. We don’t do a very good job of educating women about depression through the female life cycle and there are plenty of times you are set up for depression. One is post-partum, as you already know. People who are upset or emotional on birth control pills or infertility workups, when you are taking drugs for that. During menopausal states, (unintelligible), PMS type of symptoms are all a set up for major depressive events. On top of that, you had a major loss. 12 Cassell et al

Mary: Yea. Dr. Cassell: So there is both the physical and psychological component. Dr. Routh: Exactly that. And it is easy to focus on the physical, rather than the the psychological. Because the physical is what you see. You had a loss. Mary: Well, for weeks when I would come in to see Dr. Cassell the first thing he would say to me was I am sorry about the baby. And the first time he said it, it really made me uncomfortable but it was like it made me recognize that there had been a loss and that it was very sad. Dr. Cassell: Another one that you said that bothered you was 2 B. At first you said that it looked like uterus and ovaries, but the position is wrong. Mary: Like this part, what that looks like. Dr. Cassell: Right. So what was your emotional response to that image. Mary: Oh, I can’t believe I’m . . . I think I was disturbed by the fact that that is what I was seeing in all these. When it doesn’t really look, you know, ovaries would be much further away, you know. But I do think it bothered me that I thought so much of that. Dr. Cassell: So here would be an example where there is not much structure suggestive of and so that indicates that it really was on your mind and you were suffering from that. Another response I wanted to have you look at is 19 B, a broken heart with lots of ties to other people. Do you remember . . . Mary: I do remember that picture. That was one of the ones that I remembered. The inside of it looked like a cracked heart and it looked like it was broken and I kind of at that time imagined, because I was having problems getting . . . everybody wanted me to do things that . . . I had to learn to say no. You know. But at that time I think that is why I felt that those little cillia or whatever they are were connecting to other people. Dr. Cassell: When in fact you had a broken heart from you loss. And then just a couple of other responses. 27 B two fetuses with the one on the right different. Mary: Yea. In this picture there, they looked like fetus to me but this one was much darker. The one on the right was much darker than the one on the left was colored or more light. SIS & Projective Psychotherapy 13

Dr. Cassell: And what emotional response did that invoke? Mary: I didn’t like it. It made me uncomfortable to look at it Dr. Cassell: In any case, we worked in therapy and you have been on antidepressant medication and how have you been doing? Mary: I have another child. A little boy and I’m still at home and then I experienced another loss of a baby. Dr. Cassell: How long ago was that? Mary: That was in February of this year. Dr. Cassell: Could you tell us about that loss, Mary. Mary: Well, I thought, you know, that I had gained a lot of strength after being in therapy and I thought I know how to handle this even though this is sad and I used my network of people and talked more about what my feelings were but it just started happening again. I just started to be unable to function because at that time I wasn’t, you know, I hadn’t been in therapy for about eight months. And I think that the combination of up here it, it is so hard the sunlight and second loss, it was Dr. Cassell: The absence of the sun, the seasonal affective disorder . . . Mary: Yea, I do I think, yea and um so I said well just go see Dr. Cassell, go see Dr. Cassell and I thought no, I can handle this but then I had to come here. It is interesting that the first time I came in 1993 it was in April and then also I came back in April in 1996. April is a tough month. Dr. Cassell: Okay. When we had her therapy session yesterday I was very impressed by some of the work you did with imagery, which really in fact was healing, and I wanted to compliment you again on that. I wonder if you could share some of that because I think that perhaps some of the folks seeing this tape could benefit from the insights from that. Mary: Well, from therapy I learned that during the dreams and images can be very healing and there were some dreams that we had discussed that you know, were very healing and very special. Dr. Cassell: Could you pull up one from memory of a healing dream that . . . 14 Cassell et al

Mary: Well, there was one that I had that you asked me to draw and it was um, since I work in the lab, I am not exactly a nurse, I had a dream where there was men standing around the table with a large light over them and they were, I was standing off away from them and I just wanted to get closer and it was like they weren’t doctors but they were scientists and they deserved great respect and I didn’t want to interrupt them or talk to them or anything but one of them had their back to me and was touching the table and these balls of light were coming up and off the table and they were such pretty colors and they blue and yellow and kind of a turquoise and green and I just remembered feeling very good about it and wanted to see what they were doing and wondering what they were experimenting with and wanted to get closer but it was kind of a dark room and it wasn’t at all scary and it was just a feeling of great respect and I wished I could get just right over there and look right over that guy’s shoulder; that is what I kept thinking, I wish I could peek in there and see what they were doing to make the colors come up and it was a nice dream and you had me draw it and I am not a good artist but I just sketched it out on my notepad from school, I was kind of doodling and kind of drawing it and every time I look at it, even though it is just in ink, I like looking at it, it makes me feel good to look at it. Dr. Cassell: And what did we make of that dream, Mary. Mary: Just that I think we decided I was getting closer to understanding and closer to that discovery of really being happy and being able to have those colors, I don’t know, maybe in your waking life, you know in your thoughts during the day. Dr. Cassell: To experience joy. Mary: But I was getting closer and closer to it. Dr. Cassell: The significance of the scientist. How did that relate to you and your answers in furthering your education? Mary: Just that I have always been you know, very interested, I have an associates degree and I wish that I had more and I really enjoy science and just that experimenting and that learning is very important and I center onto it, I still want to learn more and I am still drawn to it. Dr. Cassell: One of the reasons that I have people draw healing dreams is that coming to the back to the artwork can actually bring back some of the healing dream imagery that frequently we forget over time. Have you been SIS & Projective Psychotherapy 15

able to use that art at times? Mary: I think so because in class when I get bored or when its nothing relating to me, I turn the page and look at it. Even though the drawing isn’t very good, but I look at my drawing and I can see the colors and everything and it just it does, it makes me feel good. Dr. Cassell: And then what impressed me so much yesterday was your experience meditating and I wish we could take credit for that but you did that on your own. Mary: Well, I have been learning to meditate and it is a class that deals with other things and just learning to calm the mind and meditate in a positive way and I tend to be kind of a rebel so I do it the way that I was taught. I began my meditation when I was having childing, when I first had children. A tape was given to me about kind of a technique for relaxing yourself and looking inward and usually it works. But, the way I was taught was to go to a place. Fill your body with light and become relaxed and then when you meet here to go to a place that you like. Some people go to the ocean, to the beach or some people will go wherever they like and I at this one session usually try and meditate for 15 minutes. I decided to go, I was very close to my grandmother and it was kind of in two parts, but I was very close to my grandmother and loved her very much and I realized that I was not able to be with her when she died and I had always told her throughout my life that I loved her but I wasn’t there and I decided to go Dr. Cassell: How long ago? Mary: My family still discusses her a lot. Probably nine years ago. She was a very big part of our family. And I went to her garden, she had always had an incredible garden and I was an adult but I was sitting but I said that I wanted to go for a swing and so … and it was a good place to go because I could image it really well and the flowers were beautiful, beautiful beautiful flowers and so I was sitting on the swing that was actually in an apple tree and it was like it was when I was a child, it was new and it still had the board underneath for your feet and I was swinging and Grandma came into the garden and I could see her and although I knew I was sitting in a chair at the table, it was very deep and it was almost like a controlled dream but I wasn’t really controlling it at that point. You know, I went to the garden but I didn’t plan on going there. 16 Cassell et al

Dr. Cassell: Your higher power was actually giving you images. Mary: I didn’t plan on talking to the Grandma. I didn’t really consciously go and talk with Grandma. And I told her when she came and I mean I could see the freckles on her arm and the funky old tee shirt that she used to wear to garden in and everything. Dr. Cassell: And when you were telling me about that I was thinking of my own Aunt Florence, she is no longer with us. Mary: Yea, she used to wear different clothes. I told her that I wanted to tell her that we all loved her and that we missed her and I was crying. I was actually crying. And she reached out and touched me and I don’t know if she talked or if she . . .. I did, I really was crying and I still was meditating too. Dr. Cassell: There was a lot of emotional release. Mary: We all loved her and missed her and then that part of it kind of ended and since time wasn’t up, well I usually go when I meditate to the side of a mountain and I sit on a rock and I kind of wait to see if anyone will come down the mountain and talk to me. And, we had discussed whether or not I had forgiven myself for the loss of the baby. And it didn’t make any sense but I think that you feel like it is your fault. Dr.Cassell: When something happens to someone we love, close or this sort of thing, we always blame ourselves. Mary: And so I thought maybe I could do something along the same lines and just happened. And what happened was, you know this may sound a little strange. Two balls of energy came down the hill and I knew they were representative of the babies. Dr.Cassell: How were those images in your visual feel. What did they look like? Mary: Just white balls of light. And it was almost like they were holding hands, if they could hold hands they were holding hands. And they came down and told me that it wasn’t my fault and I had nothing to feel bad for and that they would go on and be energy of another sort in another way and that it was, you know, I believe that you can learn lessons from everything and they were there to teach me a lesson, not a bad lesson, a good lesson about life. A growing lesson, you know, not to punish me or anything. And they forgave me. And I SIS & Projective Psychotherapy 17

thought you know, Dr. Cassell will be so proud of me. And then it was time for meditation to be up. I read a lot of science fiction and I have a really good imagination and I think that is part of the reason that I was able to do that. But it was very healing. I do think that . . . I do feel like I was forgiven. Dr.Cassell: Lisa, do you have any thoughts about her images or meditation? Dr.Routh: I think it is a real indication that she has done a lot of work on healing. That you were able to transform a whole lot of negative energy that was just self-directed previously and depression is, we really beat ourself up when we are depressed. We feel a lot of negative things about ourselves to ourselves and to others and that you were able to turn that around to be positive energy. Its excellent. And, of course, if you were sitting on Kilamenjaro in your meditation, it was probably me coming down the mountain. Dr.Cassell: Lisa has climbed Kilamenjaro in Africa. Mary: Did you really? How interesting. Lisa: It was healing process for me. Mary: Yea that must have been. What an accomplishment. Lisa: How remote some of our problems are when you are really on top of the world. Dr. Cassell: In any case, Mary, when you viewed the SIS last night. My first question is since I am very interested in the SIS and dreams, did you have any dreams last night? Mary: I did see a couple of the inkblots. I woke up thinking I was dreaming about the inkblots. And I think because there was a couple that I really had to push to see anything.Dr. Cassell:Can you tell me which one. . .? Mary: Well, there was one that I just said, “I don’t know.” This one, 3B, I really like this picture, but it didn’t look like anything, it was very beautiful colors. It was very abstract, but I couldn’t see anything. Dr. Cassell: Was that in your dream then? Mary: I think this one was without so much color. And then this one right here, I just couldn’t think of anything that it really looked like. Dr. Cassell: And that was in your dream as well. 18 Cassell et al

Mary: And it was kind of . . .it wasn’t a very frustrating dream, but I just got the impression I had been looking at inkblots and not being to tell, I was supposed to able to find something in them and I couldn’t. Dr. Cassell: And it fact you actually dreamt that the images that you had difficulty with . . .. And did any of the images that you saw content in appear in your dreams? Mary: They were more the random, very abstract ones. Dr. Cassell: When you first saw image 30B, you saw it as two ears and a man’s face. Mary: I mean I do now that I see it on the paper, but I don’t . . . Dr.: So, it is interesting that it didn’t break through in consciousness, but the one thing that struck me in looking at your images here this morning, that there certainly is very few images with reproductive themes. Mary: Yea, and I didn’t realize just how much more there had been in the 1993 one but I can see that much of it. Dr. Cassell: And what do you suppose that means? Mary: I would say that I was preoccupied with it. I saw a lot more flowers And flowering and, of course, I have been gardening so maybe that’s Dr. Cassell: And you are in a better psychic space. That is really interesting that I noticed in looking at it, is this one. Dr. Cassell: Yes, the image 22B which you saw the first time is a dead person’s spirit drifting away I was say that’s when you had the theme of death on your mind. Mary: I think so. Dr. Cassell:And then 22B this time last night you saw as a person dreaming. Can you elaborate on that Mary? Mary: It just. I didn’t even really remember that I had seen it as a dead person before, but to me it is just like night and day, just a total difference. Dr. Cassell: And so what accounts for the difference? The focus in on dreaming SIS & Projective Psychotherapy 19

rather than death. Mary: Just I think that I have really dreamed that the healing that dreams can have. That if you look at them they will tell you, you know, what is going on with you. And then I am just not thinking of death as the only way to find inner peace anymore. I think that I was really thinking then that was the only way that anybody was ever going to be happy. Dr. Cassell: Did you have some transient suicidal thoughts back then? Mary: Yea, I did. Dr. Cassell: Well, it is so nice to get beyond that. Dr. Cassell: Well thank you Dr. Routh. Did you have any comments on how the meditation images have been healing plus looking at the SIS. Dr Routh: Well, I will start by your comment that you were having headaches, you know, and just physically felt unwell and again this goes back to some of our previous discussions on how this type of procedure helps people get beyond headaches or some other somatic symptom, which no doubt you had. It was real. But you get beyond that and look at some of the things precipitating that kind of stress that express itself physically for you. And you know when you did that, you had lot of very depressing content. Themes of death and dying and alienation, not much motion, not much color. There was not much life. Mary: Yea, I just don’t see that in the pictures, now. Dr. Routh: Right, and preoccupation with the events that had happened. And now subsequently, you are in a lot better place. I agree with you to cope with anything that is going on it looks like you have really had a lot of healing experiences. The test results are completely different. With this second procedure, you are like a person who has got a lot of hopefulness about the future, you see rather than death and alienation all around you, you see connections, you see colors, you see motion. You know, you see dreaming rather than black thoughts and that sort of thing. And I think it goes right a long with your dreams and your images during meditation, those are all again healing, positive energy. You know, moving forward, releasing. Dr. Cassell: Anything more you would like to say, Mary. Mary: No. 20 Cassell et al

Dr. Cassell: Well, we appreciate your growth and how about you Dr. Routh, one of the problems that we have, as you know, in the current, oh I would say, medical politics, is that while Rorschach was a psychiatrist and developed the Rorschah ink blot test and many psychiatrists have been involved in psychological test development, such as Dr. Hathaway, M.M.P.I. Psychiatrists have grown away from that and yet, my personal belief is that this is an area where I would like to see psychiatrists receive some training in projective techniques. Can you comment on that and your own experiences with SIS and um maybe you think some other psychiatrists could benefit? Case II In this television recorded interview, only professional participants appeared on camera for the recording in the following order: Part I Wilfred A. Cassell, Part II Bankey L. Dubey, Part III Lisa C. Routh & Elaine Molchanov, Part IV Wilfred A. Cassell & Bankey L. Dubey. The transcript follows: This is Lisa Routh. I am here to introduce a case that Dr. Cassell and Dr. Dubey mentioned. I will be speaking with my colleague, Elaine Molchanov who will help with the interpretation. Elaine, I wanted to talk a little bit about a 43 year old woman who is currently in a residential treatment facility for cocaine dependence. She is a divorced woman who lives with her adult daughter and granddaughter. She came to us with a significant problem involving substance abuse. She has been smoking crack cocaine as well as using inhalant cocaine for a number of years. During the course of my time in taking care of her for her addiction, it became apparent that she was also suffering from significant symptoms of depression, so she was started on Prozac. After about two to three weeks she seemed to improve in her depressive syndrome then relapsed with depressive symptoms. The chemical dependency treatment program had to focus largely on maintaining sobriety from drugs. However, it really didn’t deal with underlying psychological conflict very well. She, herself, was very highly defended, not only about her addiction problems, but otherwise as well. She did not have dreams. She was not very productive in psychotherapy. For example, she did not want to say much about her prior relationships. For these reasons, I decided to refer her for the SIS and Living Images videos. She was so guarded in our interviews, that I thought there was something driving her depression, in addition to the addiction. SIS & Projective Psychotherapy 21

As you know we encode memory differently. Non-traumatic, or normal memory, like one’s ability to remember this case report later is formed in a totally different way than traumatic memory. In the case of regular memory, it is formed and stored in the cortex. It does not have significant emotional tone attached. It stays for a much longer time in different parts of the brain and is not very easily accessed verbally. So many times people who have had a traumatic background or series of occurrences really cannot report to a therapist what their problems. They cannot access it verbally. So being suspicious that this woman had a traumatic background, that she was very unable to access, I anticipated that her viewing the videos might prove helpful. In reviewing her responses, the first thing that was very interesting concerns the comforting images that she liked most. These fitted in with her background of having studied meditative techniques. Consistent with this observation, she projected a lot of images depicting attractive “ocean things”. She also envisioned a lot of Native American and Oriental motifs. Many of these seem to fit her earlier religious background of having practiced meditation techniques prior to developing her addictions. Unfortunately she had withdrawn from her spirituality, in association with having developed addiction and clinical depression. The next thing that proved remarkable and which confirmed my suspicion about her possibly having a past history of abusive relationships with males, concerned her avoidance of certain female imagery. Any reference to female sexuality, genitalia that sort of thing was very highly defended against. In fact, there are themes where she moves from idealizing these, making them romantic images, hearts, valentines, flowers, that sort of thing to turning them into actual objects such as a tiny face or something like that. Finally, almost as though she has been disillusioned over time, she became very defensive about it by symbolically transforming the anatomical structure in the inkblot into a mask that is almost impenetrable. Associated with that, there were other very threatening images where she saw monsters carrying young girls away. Similarly, she lacked the ability to recognize video material suggestive of human content and movement. By contrast, she was able to see birds, that were intimate lovebirds, which could kiss each other however, when the human figures were displayed, they were visualized concretely as Japanese writing, or again an object. The other thing that stood out signifying her difficulaty in imaging interpersonal intimacy, concerned the fact, that any close-up visual image of human faces was perceived as parts of cars, the moon or such things. It almost 22 Cassell et al

approximated a paranoid stance, such as: “Don’t get too close to me.” She just can’t tolerate closeness - especially with a man. Dr.Routh: Elaine, I was hoping that you could help me understand her reaction to the videos. Elaine: Yes, initially I would like to refer specifically, to some of the inkblots that might substantiate a little bit more of what you were saying.On SIS 25A, “the warriors mask”, she saw “steel on top of a shield”. That clearly symbolically portrayed her mental picture of female genitalia. It certainly says that the defensive structure is like “steel “and again suggests sexual trauma. The SIS inkblot 15A was seen as “a woman hanging she on a swing”. This is again the poles of opposites, like she has the idealized view of romance, or she is stepping on the chest of a man. I think it is important to understand too, that she is forty-three and in midlife. Finally, now she is dealing with a strong addictive history. What you see in the first phase of recovery are the kinds of images like the inkblot where she saw “the tidal waves”. Her past emotions are now going to be experienced that way to her ego structure - like “a tidal wave”. On the positive side, with regard to ego assets, I thought that she had a great deal of spiritual strength. Moreover, the videos not only uncovered personal problems of sexual trauma, they also threw light on difficulties in imagery within the family structure, and the collective layer of the psyche. The responses suggest wounding at all deeper levels. When she projected, in viewing Living Images 37, (representing the uterus) the response “hole in the buffalo head”, she was revealing her distorted view of her inner reproductive structures. It also made me recall recent Native American Indian culture, whereby the birth of a white calf was such a symbol of hope. Contrast that with he depressive view she presented, not just at a personal way, but also a “hole” in the collective psyche, the disconnection and the yearning to return to roots and that I think is both on a personal level, and in terms of the feminine roots, as well as the earth itself. The only kind of cure for people who have such addictions is to connect to spirituality. The person that has this kind of suffering will be more sensitive to the neurosis of the time then other people, and also once healed, could be the next step in the cultural revolutions of our time. Also, there were a lot of material depicting ancestors and dead people. This is again signifying her psyche numbness and deadness. It is readily SIS & Projective Psychotherapy 23

understandable that she would turn to cocaine for stimulation and psyche pain relief. Dr Routh: This could be herself at this time. She is aware that she drifted from her individuality previously she was very involved in that. She was raised Roman Catholic then developed a lot of meditative techniques and got more into Eastern culture and then drifted from it in the course of her depression. She seems to be searching for a way to reconnect and this is still a part of her and it comes out very strongly so she looks for a way to reconnect to that and at this point I think she feels it would be very important to reconnect to that for her recovery to organize her life around something other than the addiction. Elaine : Again it is the opposite, the destructive images that are in some of her inkblots, the rage and the anger that she needs to be connected with and defend against her boundaries and be able to stand up for what she believes and living the kind of life that she would value. Dr Routh: In the Living Images video she made reference “a woman who was extremely frustrated and taking out her aggressions and frustrations by beating a bed”. Another time she made reference to “a woman bent over a table in exhaustion in the Living Images Video. She saw herself as very frustrated and weak and empty in points in her life. Several times in addition to not wanting to look at humans interacting with each other and human intimacy, she did see a lot of female images. She went from seeing positive maternal images to woman that are exhausted and frustrated or being carried off by monsters. Elaine : In the sense of that again the connection of masculine is either one of negative, being hurt. There is a lot of references to violence too and the ambivalence that she seems to have to the future and had said, "the man was talking but she was already gone”. Dr Routh: Following the video image stimulation experience and her hearing our analysis I interpreted to her certain of her responses. For example, themes of frustration, depression where she saw “the moon with the clouds over it”. I would think that there was some sort of traumatic or abusive background that she had not talked about and actually gave her illustrative interpretations. It was at that time that she talked about having grown up without a father figure. She had subsequently married a man for all intents and purposes on the surface looked like a very appropriate choice, an attorney. He was a provider for her, yet he himself had a horrible alcohol problem. He had been extremely abusive, 24 Cassell et al

withholding and usually in the context of his own substance use. She had in fact experienced horrific amounts of aggression in the relationship, emotional, verbal and physical aggression. She had been grossly disillusioned since she had idealized this man. He had been a father figure to her, as well as her partner in life, and a lover.All these themes really came out when she talked about that relationship. The interesting image of a man is talking about his feelings to woman, but she is already gone, she commented on. She indicate that at the end of their relationship after they had already split he had gotten treatment himself for his alcohol problem. He had then wanted to correct the relationship but it was too late. In her words: “Well he just gave me too little too late, I was already gone.” It was amazing that she said almost exactly that when viewing the television images, and then previously. It actually has been a very relieving thing for her. The other thing was that since having the video stimulation, she actually has been able to remember dreams. They are now having more pleasant themes. For example, she rather than a monster carry her daughter and her granddaughter off. Moreover, she now has recurrent dreams of leaving and going back home to reunite with her mother and her sisters. It is almost a return to a more positive female image. Elaine : In her female journey, going back to her mother, there is some longing for - a more positive connection there. Illustrative responses and further comment after the televised interview: For the SIS video, her three favorite images were as follows: 2A: Abalone sea shell. This gave me the desire to go south to the beaches which I usually do this time of year. It made me want to listen to the ocean and run barefoot through the sand. I am tired of winter in Alaska this time of year. 27B: Two unborn babies. I liked this because my granddaughter is one year’s old. I don’t get to see her as often as I would like but my daughter Amey tells me all about her escapades with her other little friends, and they sound cute. 25B: This one I liked a lot but made me feel wistful somewhat. I see a higher state of consciousness, but it is not all here at this time. For Living Images video, her three favorite images were as follows: together and swaying around each other in happiness SIS & Projective Psychotherapy 25

was being beconed to somewhere positive. It was like “Come this way!’ (In this response, she indicated that the video image was a BEACON, which stimulated her to begin meditation again, and a more positive mental outlook.) I was happy with Amey and then a baby before me that I lost, I was very happy. The three most threatening images with the SIS video were as follows: 13A: A hand reaching out of violence. 31A: A man talking to a woman about his feelings, but she is already gone. This gave me a feeling of lonliness and despair - a definite sadness, grief, aloneness etc. 14B: Nothing...oblivion. I didn’t like this because that’s all I saw in it at first. I could have flipped it into the positive, but i decided to stay with my first thoughts,for the proper response to this exercise. The three most disliked images with Living Images video were as follows: 20: A woman bent over a table in exhaustion - because I’ve felt like that so much in the past. Head on the table with disappointment, sadness, and grief. and mentally abused women out there still suffering. sometimes, but knowing my age and my life. It’s more biologic sadness (consistent with her projecing negative qualities of men and sexuality, even sperm are imagined to be abusive). (Even sperm - male product - are imagined to have abusive characteristcs). Discussion It is challenging to develop technical video aides, which can facilitate dreaming and therapeutic meditation. The outlined case history studies must be considered very rudimentary. Clinicians may guide the mediator in conjuring up optimally effective imagery by providing specific sensory input into the visual centers of the brain. Even though the projective stimulation procedures are always the same in their color-form-movement arrays, thereby making them constant variables that can be introduced under various experimental conditions, it is extremely difficult to design quantitative controlled scientific studies. 26 Cassell et al

Consequently, a phenomenological case history approach has merit as a starting point. One of the advantages of video recording the clinical information’s that it provides a permanent database for examination by independent behavioral scientists. With content analysis, the overt and symbolic meaning of responses can be open to a variety of theoretical interpretations. The clinicians age, sex, cultural background and language also represent contaminating influences. More of a subtle force than is generally recognized, is the distorting effect of the professional’s unresolved personal background issues, and occupationally related “compassion fatigue” skewed subjective perceptions. While these variables may pose problems to insight based therapies, in which cognitive meaning is emphasized, their contaminating influence is minimized when the videos are primarily used for image brain stimulation. One of the authors realized this in 1992, when the first SIS teaching video tape was recorded in 1992(Cassell, 1994). A police officer who had developed post traumatic stress disorder, spontaneously reported that he felt psychological benefits initially viewing the SIS video. At the time he experienced the stimulating video, he was on a psychiatric ward, with no one interpreting the psychological significance of his responses. For him, and many others subsequently, “insight” has not been required for subjectively detectable positive therapeutic effects. In fact, it is the now widely recognized that attempting to use only verbal techniques in analyzing those with past histories of severe stress and/or abuse can frequently overwhelm the individual, producing psychological decompensation. The similarity to inkblot image activation and that observed in EMDR therapy was noted in the last issues of this journal (Cassell,. That article also reviewed some of the recent theory concerning possible neurological mechanisms. What is needed are comprehensive multidimensional studies, in which specific external visual stimuli are used to activate imagery as concurrent measurements nervous system activity are computer quantified. Until then, guidelines for future research can be developed employing a case history method concerning the way individual process imagery in various conditions of consciousness. These include include fantasy episodes during which those with active imaginations subjectively conjure up images when daydreaming. The two case histories illustrated how the video technology can stimulate clinically relevant dream material and beacons for meditation. Other applications include the techniques ability to provide clues for deciphering the symbolic language of visual hallucinations, flashbacks of post SIS & Projective Psychotherapy 27

traumatic stress, disociative states and related disorders. In addition, the projective reactions to the somatic stucture in the inkblots can sometimes provide important body consciousness information. This can assist the Yoga trainer concerning the mediators idiosyncratic body awareness and regional relaxation needs. Individuals differ in regional channelling of psychophysiologic stress to various skeletal muscle groups. A trainer may benefit from SIS testing to obtain specific information concerning which regions to more actively direct the movement and relaxation excercises. This also has relevancy to practitioners of biofeedback. Once an altered state of consciousness has been created with relaxation exercises, as noted, the stage is then set for image processing under the trainer’s guidance. In the first case history illustration, after visualizing the “balls of light” arising from the simulated electrocardiogram at the beginning of the SIS video, the woman was able to therapeutically move forward in meditation. First she conjured up image of her loving and emotionally supportive grandmother. Then experiencing the emotional support of her spiritual presence, she was able to mentally process her “inner cry” concerning miscarriage. She did so by incorporating these light structures into visual input of the foetuses in Image 27B into her memory bank. Subsequently, the healing forces of dreaming and guided meditation positively transformed them. This facilitated resolution of her irrational guilt and eventual therapeutic release through grieving.It was remarkable how in the retest situation, three years later, that concurrent with her being more socially outgoing and less focused on body discomfort, the imagery was much more positive. It is important in training suffering individuals to meditate, to encourage their own inherent creative abilities in conjuring up imagery and to carefully respect the person’s spiritual boundaries. In all humility, it is not human designed visual stimuli, which provide the most powerful internal source of beacon meditation images. While beacon dreaming is a relatively rare subjective state, they do not originally arise from the trainer’s suggestions, nor from the dreamer’s conscious cognitive ability. What is seen and felt primarily represent gifts from an inner spiritual force for health. This is quite analogous to that experienced in beautiful outer world nature scenes, and worshiped in many world religions. The wonderful inner feelings of peace, love, and unity may be continued for hours into the waking state. The therapist needs to help the individual recognize these internally derived images as valid, and foster a feeling of reverence for their sacred source. 28 Cassell et al

In addition, the trainer needs to comment on the time-space-energy aspects of meditation, so that the newness of the experience is acceptable and comforting. The time period of imaging in meditation is analogous to what the Greeks referred In addition, the trainer needs to comment on the time-space-energy aspects of meditation, so that the newness of the experience is acceptable and comforting. The time period of imaging in meditation is analogous to what the Greeks referred to as “kairos” - free flowing sacred time, in contrast to “kronos” - chronological time with rigid constraints. The space dimension when meditating, is the body and the visual field that is imagined in front of the eyes and forehead. The energy concerns all the body sensations and emotions experienced in the trance like state. Sometimes recall assistance can be given by encouraging the person to draw and develop a permanet external pictorial reminder. Such art therapy can assist, so that the divine inspired memories can more readily be conjured up in future meditation. In doing so, the trainer should also have a repect for the right of the medidator to privacy. Some images and meditation experiences are too beautiful, and potentially fragile, to risk sharing be with anyone. It is essential to always have a reverence for the fact, that becon images provide the psychic substances for spiritual intimacy and healing. References Baberjee S., Mukhopadhyay A. & Singh, U. (1998) An Indepth Study of Somatization in Heroin Addicts through SIS-I & Rorschach Inkblot Test. SIS J. Proj. Psy & Ment. Health 5:1, 33-39 Benson, H. And Stuart, E.M. (1992) The Wellness book. Fireside Simon and Schuster, New York, N.Y., U.S.A. Cassell W.A. (1991) Art Therapy Using The SIS-II Video Japanese bulletin of Arts Therapy, 22:1, 131-137 Cassell, W.A., Dubey, B.L. & Roth,.J.(1997) SIS J. Proj. Psy. & Ment. Health 4:2, 89-112 Cassell, M.A., Cassell, W.A., Dubey, B.L., Dwivedi, P., Molchanov, E., O’Roark, A.M. & Routh L. (1999) A Video Projective Technique for PTSD in Women, SIS J Proj. Psy. & Ment. Health 6:3-28 Dosajh, N.L.(1999) How Repression of Spiritual Urge Leads to Psychological Troubles. SIS & Projective Psychotherapy 29

McBride J.L., Brooiks, A.G. & Pilkington L.(1998) The Relationship Between a Patient’s Spirituality and Health Experiences Family medicine 30(2):122-126 Mukhopadhyay, A., Banerjee,S. & Mitra, G.(1996) A Comprehensive Profile of the Personality Characteristics of Male Drug Addicts. SIS J. Proj.Psy. & Ment. Health 3:33-41 Savage, G.(1995) Bereavment and Hypnosis - a case study.SIS J. Proj. Psy. & Ment. Health, 1:19-29 Singh, A.R. & Dubey, B.L. (1997) SIS-II Profile of Drug And Alcohol Dependant Cases. Tewari M.K. & Dwivedi,P. (1999) SIS-Video in a Case of Depression. SIS J. Proj. Psy. & Ment. Health, 6:47-49 Verma S.K. & Nehra A. (1998) Projective Psychotherapy SIS J. Proj. Psy. & Ment. Health, 5:!, 59-62 30 Cassell et al

Stability of SIS - II Response Contents Across Time and Predesignated Image Clusters Rakesh Pandey, Mridula Mishra, Rejendra Mishra & C. B. Dwivedi The present study examines the stability of SIS-II response contents on a sample of 30 subjects over time in two ways, i.e., it analyses the consistency of responses evolved by individual images in a number of people, as well as it measures an individual’s consistency in responding to all the 62 images of SIS-II. Besides this, it also attempts to present an appraisal of the test-retest reliability of some commonly used SIS-II quantitative indices and response consistency of personality dimension related SIS-II image clusters as proposed by Dubey and associates (Dubey et al., 1995). Separate analyses of respone consistency for unstructured and semi-structured images have also been done in this study to substantiate the speculation regarding unstructured images yielding lower response consistency as compared to semi-structured images. An analysis of images of the Somatic Inkblot Series reveals that the projective images of this series differ in a number of ways from other conventional inkblot type tests. For example, the conventional inkblots are bilaterally symmetrical and look like inkblots in their appearance. Besides this, other inkblots had not been developed with any pre-assumed structure and that is why they maintain an unstructured look. On the other hand, most of the SIS images are neither bilaterally symmetrical nor in appearance they look like unstructured inkblots. In fact, the author of SIS (Cassell, 1980,1990) has admitted that certain preassumed anatomical structures have been deliberately introduced in some of the SIS images in such a way that other interpretations of the images (percepts other than the predecided ones) are also available. In other words, the SIS images are semi-structured. The SIS is also available on video (Cassell & Dubey 1997). Presently SIS is available in five forms using either of the three types of stimulus presentations, i.e., card, booklet, or video (see Cassell & Dubey, 1998 for a brief description of the various forms of SIS). Rakesh Pandey, Ph.D., Lecturer in Psychology. Deen Dayal Upadhyaya Gorakhpur University, Gorakhpur. Mridula Mishra, Ph.D., Lecturer in Psychology, Bihar Yog Bharti, Munger (Bihar). Rajendra Mishra, Ph.D., Professor & Head, Dept. of Psychology, BRA Bihar University, Muzaffarpur & C.B. Dwivedi, Ph.D., Professor of Psychology, Banaras Hindu University, Varanasi.

The booklet form of the SIS has been named as the SIS-II (Cassell, 1990) and is one of those projective tests which can be either self-administered or can be administered in group. The SIS-II has several advantages over other projective tests including some forms of the SIS. Pandey (1995) has presented certain psychometric advantages of SIS-II over other projective tests in terms of economy of administration and scoring, control of test anxiety, and efficacy of revealing unconscious materials. Besides these advantages, SIS-II uses such hazy semistructured stimuli which enhance the stability of responses by reducing the error variance attributable to stimulus factors. Over and above these advantages, the psychometric evaluation of SIS-II has yielded satisfactory reliability and validity. For example, Pershad and Dubey (1994) using the video version of SIS-II demonstrated satisfactory split-half reliability. They also reported the response consistency of various images and found that 38 out of the 62 images had satisfactory response consistency. Strangely very little has been reported about the stability of various quantitative SIS-II indices as well as of the theoretically clustered SIS-II images for assessing conflicts and pathology of various domains of personality such as interpersonal relationship, feeling of insecurity, self-image, etc. Dubey and associates (Dubey, Cassell, Pershad, & Dwivedi, 1995) have clustered the 62 images of the SIS-II in seven clusters related to interpersonal relationship, self-image, healthy body image, erotic image, hostility / aggression, insecurity, and thinking in group conformity. Though reliability of such clusters has not been reported in the literature, number of researchers have started using them (e.g. Pandey, Mishra, & Dwivedi, 1996). Moreover, mere examination of the response consistency of the items (i.e. for specific stimulus images) hardly reveals a convincing picture of reliability. The individual responses to items (images) do not depend only upon the stimulus parameters but they also depend on the individuals characteristics, a fact which has often been emphasized by a number of psychometricians (see Davis, 1987; Nunnally, 1978). Fluctuation in responses (instability) may be either due to sheer vagueness and unreliability of the item/stimulus or it could also be due to variation in some important and test relevant individual characteristic. The estimate of error variance attributable to the testee provides certain valuable informations in interpreting the reliability of a test (Kubiszyn & Borich, 1993). The present study examines the stability of SIS-II response contents over time in both ways, i.e., it analyses the consistency of responses evolved by individual images in a number of people, as well as it measures an individual’s consistency in responding to all the 62 images of SIS-II. Besides this, it also attempts to 32 Pandey et al

present an appraisal of the test-retest reliability of some commonly used SIS-II quantitative indices and the responses consistency of personality dimension related SIS-II image clusters as proposed by Dubey and associates (Dubey et al., 1995). Separate analyses of response consistency for unstructured and semi-structured images have also been done in this study to substantiate the speculation regarding unstructured images yielding lower response consistency as compared to semistructured images. METHOD Sample Twenty male and ten female adults, aged 24 to 60 years served as subjects. All subjects were literate and belonged to middle class socio-economic status. None of the subjects reported any history of mental illness or neurological disorder. Tool The Somatic Inkblot Series - II (SIS-II, Cassell, 1990), consisting of 62 semistructured images printed in hazy blue and white in two series A and B with 31 images in each, was used. Procedure The subjects completed the SIS-II booklet in two small groups, 15 in each. The standard Instruction printed on the SIS-II booklet was read loudly to the groups and the queries and questions were adequately attended to. Though the standard administration procedure for SIS-II allows the subjects to take the booklet to their own place or to complete it in different sessions (Cassell, 1990), it was not done in the present study. All the subjects were requested to complete the booklet in one session in the testing half itself. This was done in order to ensure similar influence of test taking environment on the subjects. The same subject groups were re-tested on SIS-II after an interval of 15 days in a condition identical to the pre-test. Results and Discussion The responses given by the subjects on each of the 62 images of SIS-II were analysed for the similarity of contents which (see Table 1) reveals that 19.35% images of set A and 16.13% images of set B of SIS-II evoked similar response contents among 90% to 100% of the subjects (mean = 88.87%). Approximately 29% images of both sets A and B produced a response consistency ranging between 60% to 79% with a mean response consistency of 69.74% and 72.22% respectively for sets A and B. A moderate response consistency (50% to 59%) Reliability of SIS-II 33

was obtained for approximately 25.8% images of set A and 12.9% images of set B. Combining the results for set A and B, approximately 66.13% images of SIS-II (41 images) showed a moderate to highly satisfactory response consistency (i.e. 50% to 100%). The remaining 34% images showed a response consistency less than 50%. Out of these 21 less stable images only 7 images (11.29% of the total images) showed a response consistency below 30%. Table 1 Percent Mean Response Consistencies and Ranges for sets A and B Mean response consistency No. of images (in parentheses) and their ranges (in per cent) Set A (88.87) 80-100% 13,15,21, 23,30,31 (69.74) 60-79% 2,6,7,9,12,16,20,22, 26 (52.78) 50-59% 3,8,11,14,17,19, 25,27 (44.44) 40-49% 6,10,29 (35.34) 30-39% 1,4,18,24,28 Less than 30% Set B (92.22) 80 -100% 4,5,9,28,29 (72.22) 60-79% 15,16,20,21,22,23,27,30,31 (52.78) 50—59% 6,19,24,26 (44.44) 40-49% 7,10,11 (37.50) 30-39% 1,3,8,12,13,17,18,25 (27.78) 20-29% (16.67) Less than 20% Further analysis of less reliable images revealed that most of them were either the unstructured projective images (e.g. images 1,2,3, & 29 of set A and images 1,2,3 & 14 of set B) or semi-structured images (set A: 4,8,11,19,24, 26, 28; set B: 6,7,10,12,13,15,24, & 25) which are designed to facilitate projection and thereby to produce some variation in response content (Cassell, 1990). The average response consistency for the aforesaid unstructured and semi-structured images were also determined. The average response consistency for unstructured set A and B images were found to be 50% and 38.8% respectively. Slightly higher response consistency for set A unstructured images was obtained due to 34 Pandey et al

extremely high response consistency of image (66.67%). When this image was dropped from the analysis the average response consistency also dropped from 50% to 44.44%. These findings extend the theory that the semi-structured images of both sets yield a lower response consistency than the unstructured images. Average response consistency of semi-structured images was found to be 44.44% for both sets. Thus, due to the presence of vague (unstructured and semi-structured images) and less reliable stimuli, the overall response consistency of the 62 SIS-II images was found to be low (55.09%; set A : 61.1% & Set B: 49.09%). We speculated that the reported lower response consistency of SIS-II could be due to the error variance. Therefore, we also determined the response consistency of each testee over all the 62 images as well as separately for the images of set A and set B. Results revealed that only 16.67% subjects showed a consistent response on more than 80% of SIS-II images. There were 33.33% subjects who produced similar responses 60% to 79% of the SIS - II images. Thus, 50% subjects showed a consistent response on 60% or more images while the remaining 50% subjects gave similar response contents on less than 60% images. This finding supports the speculation that lower observed reliability of the SIS-II is not only due to the less reliable images; it could also be due to a less reliable testee. In other words, it means greater individual variance. Comparison of the individual respone consistency between sets A and B revealed that 55.55% subjects showed a difference of 7% while the remaining 44.45% subjects showed a difference ranging from 9.68% to 25.82% This observation further attests the contribution of individual error variance in the overall response consistency of SIS-II images. The stability coefficients for some of the most commonly used SIS-II quantitative indices were also computed by obtaining a product-moment correlation between pre-test and post-test scores. Table 2 presents the means and SDs of the scored SIS-II indices on pre-test and post-test. It also displays the stability coefficients. Most of the SIS-II indices have shown moderate to satisfactory stability coefficients (see Table 2). Reliability of SIS-II 35

Table 2 Stability Coefficients, along with Means and SDs for the First and Second Test Across Nine SIS-II Indices SIS-II First Test Retest Stability Level of Indices coefficient significance Mean SD Mean SD R 59.92 2.72 61.15 2.34 0.50 0.01 H 17.07 6.06 19.46 4.80 0.64 0.01 A 7.07 3.43 8.38 3.37 0.49 0.01 At 13.84 7.69 11.54 4.65 0.60 0.01 M 2.54 2.06 1.92 1.04 0.25 NS FM 0.69 0.85 0.69 0.48 0.36 0.05 Rej 3.00 2.55 3.00 2.48 0.51 0.01 MT 12.08 4.72 13.31 2.53 0.45 0.05 T 20.38 7.21 22.69 4.68 0.62 0.01 The seven categories of SIS-II image clusters which have been identified for the purposes of obtaining specific information about various personality dimensions (Dubey et al., 1995) were also analysed for ascertaining the response consistency. Table 3 presents the average response consistency for each of these personality dimension - related images Table 3 Average Response Consistencies Across Seven Clusters of Images Identified by Dubey et al. (1995) Observed Average Image numbers No. of Imaages Personality response separately for Dimensions consistency sets A and B Thinking in group 81.37% A:7,9,13,20,23,27,30,31 conformity B: 4,5,9,22,27,28,29,30,31 Ego / Self-image 73.01% A: 5,6,7 B: 2,27,28,29 Interpersonal relationship 70.07% A: 9,21,24,28,31 B: 4,5,28,31 Hostility / Aggression 69.45% B: 15,21 Health body image 64.81% A:10,12,20,22,23 B: 9,11,16,17,20,30 Insecurity 62.50% A: 13,24,26 B: 19 Erotic image 47.62% A: 4, 8, 22,25,27 B : 18,25 36 Pandey et al

All the image categories demonstrate a satisfactory response consistency ranging from 47.62% to 81.37%. Excepting the category of erotic images all other image categories have a response consistency greater than 60%. References Cassell, W.A. (1980). Body symbolism and the Somatic Inkblot Series, Aurora Publishing Co. Anchorage, Alaska. Cassell, W.A. (1990). Somatic Inkblot Series Manual : Administration Scoring and Interpretation SIS Center, Anchorage, Alaska. Cassell, W.A. & Dubey, B.L. (1997). Somatic Inkblot Series - II /Video Manual. Anchorage, SIS Center, Alaska. Cassell, W.A., & Dubey, B.L. (1998). Application of Somatic Inkblot Series in Personality Assessment, diagnosis, screening and therapy, SIS Journal of Projective Psychology & Mental Health, 5, 3-32. Davis, R.U. (1987). Scale Construction. Journal of Counseling Psychology, 34, 481-489. Dubey, B.L., Cassell, W.A., Pershad, D., & Dwivedi, P., (1995). Diagnostic utility of Somatic Inkblot Series, SIS Journal of Projective Psychology & Mental Health, 2, 77-84. Kubiszyn, T. & Borich, G. (1993). Educational testing and measurement; classroom application and practice. Harper Collin College published, New York, NY. Nunnally, J.C. (1978). Psychometric Theory, McGraw Hill, New York, NY. Pandey, R., (1995). Projective measure of Alexithymia and the SIS. SIS Journal of Projective Psychology & Mental Health, 2, 145-152. Pandey, R., Mishra, M., & Dwivedi, C.B. (1996). A Quantitative analysis of liked and disliked SIS-II Images, SIS Journal of Proj. Psy. & Ment. Health, 3, 123-130. Pershad, D., & Dubey, B.L., (1994). Reliability and validity of Somatic Inkblot Series in India. SIS Journal of Projective Psychology & Mental Health, 1, 34-39. Reliability of SIS-II 37

Validation of Weiner's Signs in Schizophrenia S. Chaudhury, T.R. John & S.G. Jyothi The Rorschach test by Klopfer's method was administered to 50 schizophrenia patients and an equal number of age and sex matched neurosis patients and normal control subjects. Color stress sign was present in 30 schizophrenia patients, five neurosis patients and five normal controls. Deviant tempo sign was positive in 24 schizophrenia patients, nine neurosis patients and seven normal control subjects. The differences were highly statistically significant. Wiener's signs were found a valid diagnostic aid for the diagnosis of schizophrenia. Among the two signs the color stress sign was comparatively more useful as compared to the deviant tempo sign for the diagnosis of schizophrenia. The initial development of the Rorschach test had as one of its objectives the identification of serious psychopathology, and a substantial number of Hermann Rorschach's normative subject group consisted of schizophrenia patients. Over the years, a number of signs have been described for the Rorschach diagnosis of schizophrenia. Weiner (1961, 1962, 1964) developed two separate sets of Rorschach signs for the diagnosis of schizophrenia. The first was the 'color stress' sign, which represents a minimal use of chromatic color without any use of achromatic color. Color stress excludes those subjects who either use color freely, thus presumably demostrating primary reliance on repressive defenses, or who avoid the use of color, thereby indicating strong reliance on intellectual defenses. Although there are obvious exceptions, Weiner's reasoning is that subjects with color stress are manifesting one of the characteristic features of schizophrenic disturbances, namely, unstable defenses and inconsistent resources for integrating affective experience (Weiner, 1965; Orme, 1966; Goldfreid et al, 1971). The second sign is "deviant tempo' which is based on normative expectancies for the relative distribution of responses to the cards. Since all of the comparisons involve successive cards, both of which are either chromatic or achromatic, the effect of color is minimized. The rationale for the deviant tempo sign is that deviations from normative response tempo are likely to reflect the kinds of disturbances in the rate and flow of associations that characterize schizophrenia. Weiner's signs have been validated for western subjects (Weiner, 1965; Orme, 1966; Goldfried et al, 1971). However, no validation studies have been carried out in India, which prompted us to undertake the present study. Material and Method The study was carried out at MH Meerut and Command Hospital, Northern Command during the period Feb 95 to Aug 98. Fifty consecutive male inpatients Suprakash Chaudhury, MD, Ph.D., Head Department of Psychiatry, Command Hospital, Northern Command c/o 56 APO, T. Rajan John, MD, Psychiatrist Command Hospital, Western Command, Chandimandir and S.G. Jyothi, DPN, Specialist, Sister (Psychiatry), Millitary Hospital, Meerut.

with schizophrenia were the subjects of the study. An equal number of age and sex matched inpatients with neurotic disorders were included in the study as a control group. A second control group consisted of age and sex matched subjects without any physical or psychiatric illnesses. Psychiatric diagnoses were made as per ICD 10 criteria (WHO, 1992). The Rorschach test was administered individually to the subjects and scored by Klopfer's method (Klopfer et al. 1954). Weiner's color stress sign is scored when either two of the following four indicators appear in the record viz. (i) The presence of one or two CF responses. (ii) Sum C is between 1.5 & 3. (iii) the presence of atleast one CF or C response without any C' response. (iv) the presence of one or more C responses. Weiner's deviant tempo sign is scored when any one of the following indicators appears in the record viz. (i) More responses are given to card V than to card IV. (ii) More responses are given to card V than to card VI. (iii) More responses are given to card IX than to card VIII. (iv) More responses are given to card IX than to card X. The Rorschach tests were administered individually to the patients while they were symptomatic but under appropriate medications. It was ensured that ECT was not given on the day of the test or the day prior to the test. After completion of the study the scorer went through the individual Rorschach protocols of the three groups and marked the presence or absence of each indicator and if the color stress sign and the deviant tempo sign were present or not. Statistical comparisons were performed using the chi square test (with Yates correction) and the phi test. Results The demographic characteristics of the three groups of subject is shown in Table 1. No significant differences were observed among the three groups of subjects on these demographic variables. Color stress sign was positive in 30 schizophrenia patients, 5 neurosis patients and 5 normal subjects (Table 2). The difference was statistically significant (X2 = 25.32; df = 1; P < 0.01). Deviant tempo sign was positive in 24 schizophrenia patients, nine neurosis patients and seven normal control subjects (Table 3). The difference were highly statistically Weiner's Signs in Schizophrenia 39

significant (Schizophrenia Vs normals: X2 = 13.51; df = 1; P< 0.01. Schizophrenia Vs neurosis: X2 = 10.17; df = 1; P<0.01. At least one of Weiner's signs was positive in 37 schizophrenics, 13 neurosis patients and 12 normal control subjects. The differences were statistically significant (schizophrenia Vs normals : X2=25.01; df=1; p<0.01 schizophrenia Vs neurosis patients: X2 = 23.04; df = 1; P <0.01). Both of Weiner's signs were present in 17 schizophrenia patients, but in none of the neurosis patients or normal control subjects. The difference was statistically significant (X2 = 18.41; df = 1; P<0.01). The sensitivity, specificity and predictive power of Weiner's signs are shown in Table 4. Table 1 Demographic Characteristics of Schizophrenia Patients, Neurosis Patients and Normal Controls. Characteristics Schizophrenia Neurosis Normal Chi-square Significance Patients Controls Control Value (n=50) (n=50) (n=50) Age (in years Mean 28.96 30.5 29.09 Range 19-56 19-42 19-51 Distribution 10-19 20-29 30-39 5.03 P>0.70 40-49 NS 50-59 Education 0-5 Class 6-10 Class 7.76 P>0.10 > 10 Class NS Marital Status Married 4.98 P>0.80 Unmarried NS Domicile Rural 0.26 P>0.80 Urban NS Religion Hindu Sikh 3.84 P>0.50 Christian NS Muslim 40 Chaudhury, et al

Table 2 Frequencies of Different Groups Positive for Various Color Stress Indicators Group N Color Stress Indicators Color Stress CF Sum C CF/C C sign positive 1.5-3 without C' Schizophrenia Patients 30* Neurosis Patients Normal Subjects * Significantly different from neurosis and normal subjects. Table 3 Frequencies of Different Groups Positive for Various Deviant Tempo Indicators. Group N Deviant tempo indicators Deviant tempo V>IV V>VI IX>VIII IX>X sign positive Schizophrenia Patients 24* Neurosis Patients Normal Subjects * Significantly different from neurosis and normal subjects. To determine whether the color stress sign and deviant tempo signs are independent, the phi coefficient between them was calculated which was 0.21 (X2 = 2.21; df = 1; P> 0.20) indicating that the two signs are related and there was no significant difference between them. Discussion The major finding of the study was that Weiner's signs had high sensitivity and specificity for the diagnosis of schizophrenia. The utility of a diagnostic test or evaluation can be determined by using the concepts of sensitivity and specificity. Weiner's Signs in Schizophrenia 41

If the total of both is 100 this is a chance result and the test is virtually worthless, while if the sum total is 200 it is perfect. No available test or evaluation is perfect, but using this concept is seen that Weiner's signs compare favourably with the other diagnostic tests used in clinical medicine. However, the color sign is obviously more useful that the deviant tempo sign (Table 5). Table 4 Diagnostic Utility of Weiner's Signs in the Diagnosis of Schizophrenia Terms Both sign Deviant tempo Color stress Either sign positive sign positive sign positive positive Sensitivity Specificity False positive Rate False Negative Rate Positive predictive 77.4 85.7 75.5 Power Negative Predictive 60.2 62.3 69.2 74.5 Power Overall diagnostic Power Table 5 Sensitivity and Specificity of Various Diagnostic Tests Test of evaluation Sensitivity Specificity Total Physical exam for hepatomegaly Blood alcohol level for alcohol liver disease History, blood pressure, ECG & X rays for heart Disease or hypertension Clinical exam and presence of both of Weiner's signs for schizophrenia Clinical exam and Weiner's color stress sign for schizophrenia CPK, SGOT & LDH for myocardial infraction in cardiac care unit * Adapted from Galen, R.S. (1982) Application of the predictive value model for the analysis of test of effectiveness. Clin Lab Med 4:685. 42 Chaudhury, et al

In Weiner's original cross-validating samples (Weiner, 1961), which included 49 schizophrenia patients and 92 non-schizophrenia psychiatric patients, the color stress sign without the C criterion yielded a percentage of accurate diagnosis ranging from 65% to 81%. However, although false negatives in these samples were 13% to 18%, the false positive rates ranged from 30% to 56%. Subsequently, when C was added as a separate color stress criterion, the accuracy achieved in additional cross-validating samples ranged from 60% to 76%. The false positive rates remained high at 32% to 42%, while false negatives ranged from 11% to 41% (Weiner 1964; Weiner, 1965; Orme, 1966; Goldfried et al, 1971; Lambley, 1973). The findings of the present study are broadly in agreement with the foregoing with sensitivity of 60% for color stress sign. However, the false positive rate was low at 10% though the false negative rate was rather high at 40%. In studies of the deviant tempo index, the accuracy of schizophrenianonschizophrenia judgement has ranged from 67% to 72% with 26-46% false negatives. These are in agreement with our findings with the deviant tempo index having a diagnostic power of 67%. However, the false positive rate was lower at 14% but the false negative rate was rather high at 52%. When color stress and deviant tempo were examined jointly the false positive rate was 0% but false negative rate was rather high at 66%. These findings are only partly in agreement with Weiner (1965) who reported 11% false positive rate and 21% false negative rate. The finding of high phi coefficient in present study indicating that the color stress sign and the deviant tempo sign is correlated is not a agreement with Weiner (1965). Further investigation on this aspect is indicated. The implications of research findings for clinical application of the Rorschach are often debated. It must be strongly emphasized that there is no single definite Rorschach or personality picture typical of schizophrenia as a whole, variability being one of the characteristics of the disorder. Therefore, the Rorschach picture of a group of persons all labeled schizophrenia may be tremendously varied. It is too much to expect that any known method of investigation, if applied indiscriminately to all members of the group, will ever show any definite results. No one case will present all of the signs and many will present only a few. In addition, it is also clear that statistical significance does not automatically indicate clinical utility. Studies with Weiner's signs have yielded replicable differentiation between diagnostic groups, but often without sufficiently precise discrimination Weiner's Signs in Schizophrenia 43

to justify its application to a single patient in a diagnostic situation (Goldfried et al, 1971). On the other hand, it should be noted that a lack of statistical significance does not necessarily preclude clinical utility. A system based on relatively infrequent signs may occur too infrequently in usually appropriate samples to allow any possibility of statistically significant differences. Yet such a rare sign may be pathognomonic and thus of considerable diagnostic utility should it happen to appear. Examining the false negative rates can identify this type of utility. A sign that produces a great many false negatives but virtually no false positives are likely to be one of the rare but pathognomonic indicators. It is obvious therefore that by these criteria also the Weiner's signs are found clinically useful. In conclusion we may state that in the present study Weiner's signs showed a fair degree of accuracy, yielding a low incidence of false positives but a moderate number of false negative results. Weiner's signs were found to be a valid diagnostic aid for the Rorschach diagnosis of schizophrenia among Indian subjects. Further study of the test in various subtypes of schizophrenia would be of interest. References Goldfried, M.R., Striker, G. & Weiner, I.B. (1971) Rorschach Handbook of clinical and research applications. New Jersey: Prentice-Hall Inc. pp301-303. Klopfer, B., Ainsworth, M.D., Klopfer, W.G. & Holt, R.R. (1954) Developments in the Rorschach technique. Vol. 1. New York: World Books. Lambley, P. (1973) Rorschach scores and schizophrenia: An evaluations of Weiner's signs in clinical practice. Journal of Projective Techniques & Personality Assessment, 37:420- 423. Orme, J.E. (1966) A further comment on Weiner's Rorschach color indicators. Journal of Clinical Psychology, 22:223-227. Weiner, I.B. (1961) Three Rorschach scores indicative of schizophrenia. Journal of Consulting Psychology, 25:436-439. Weiner, I.B. (1962) Rorschach tempo as a schizophrenic indicator. Perceptual and Motor Skills, 15:139-141. Weiner, I.B. (1964) Pure C and color stress as Rorschach indicators of Schizophrenia. Perceptual and Motor skills, 18: 484-487. Weiner, I.B. (1965) Follow-up validation of Rorschach tempo and color use indicators of schizophrenia. Journal of Projective Techniques and Personality Assessment, 29:387- 91. World Health Organization (1992) The ICD-10 classification of Mental and Behavioural Disorders. 10th ed. Geneva: W.H.O. 44 Chaudhury, et al

Psychogenic Symptoms in Learning Disabled Children Sheetala Prasad and A. N. Srivastava This paper reports differences in psychogenic syndromes of 29 learning disabled children who were divided into three subgoups (trainable, sever and profound) on the basis of their learning disablity quotient (LDQ). The Rorschach Inkblot Test was individually administered on these children in their home environment. The Rorschach indices showed that the three subgroups of LD children were evincing specific patterns of psychogenic syndrome. Details of there syndrome for the trainable, severe and profound subgroups of learning disability have been discussed. Learning disability (LD) phenomenon refers to such children who are average or above average in intelligence but are regularly lagging behind in their academic achievement. D S M- IV has explained LD in terms of academic skill disorders. It has defined this concept as “LD children are otherwise normal or even gifted in their overall functioning. The inadequate development may be manifested in academic language, speech or motor skills areas and it is not due to any demonstrable physical or neurological deficit”. The delay in the diagnosis and treatment of LD may give rise to various psychological problems in such children and childhood which may turn them into problematic adolescents. Researchers like Brinckeroff (1997), Bruck (1987) and Saracouglor et. al. (1989) have described various clinical features of LD children who had many psychological problems and were also drop outs. With available research literature, the psyche of the LD children may be classified in four groups : Conduct disorder, anxiety disorder, immaturity and social aggressiveness. LD children, due to ever present frustration of poor academic performance have many difficulties in their personal life and due to effect of these they may also suffer from many psychogenic problems. In this paper psychogenic symptoms of some learning disabled children have been studied. Objective Objective of the present study is to search out hidden psychogenic syndromes in different category of L D children. Material & Method This study was carried out on 29 LD children who were screened out of 1053 primary school children of Gorakhpur city and suburban areas. They were Sheetala Prasad, Ph.D., Lecturer in Psychology, EWing Christian College, Allahabad and A. N. Srivastava, Ph.D., Department of Psychology, Gorakhpur University, Gorakhpur (UP).

studying in various advantaged and disadvantaged schools and their age ranged between 8 to 11 years. The screening of these 1053 children comprised the following : 1. Rating of students by their teachers specially in the area of academic and social behaviour. 2. Parent’s report about their children from prenatal to early childhood period and academic achievement till present time. 3. Two intelligence tests, the Wechsler's Intelligence scale for children (WISC) and draw - a- man test were administered on all subjects. The academic achivement of the subject was ascertained on the basis of their reading, writing and arithmetic tests. Based on these three criteria 29 subjects were identified as learning disabled. The extent of learning disability was ascertained by a specially formulated procedure. On the basis of which the learning disabled children were classified into trainable, severe and profound subgroups. All LD subjects received the Bender Visual Motor Gestalt Test for diagnosing the minimal brain dysfunction in them. However none of the subjects was found with such dysfunction syndrome. Procedure Rorschach test was administered in the home environment. Analysis and comparison of the responses were done between the categorised groups of learning disability. Results Subjects responses were recorded and analysed in the theme and systems of Rorschach Inkblot Test. It was found that different categories of the LD subjects had different types of psychogenic symptoms. A list of such symptoms is given in Table 1: 46 Prasad & Srivastava

Table 1 Psychogenic Symptoms in Different Categories of LD Psychological Symptoms Trainable Severe Profound Mood disorder * * * Imaginativeness * * * NEUROSIS Depression * Phobia * * * Nervous Exhaustion * Obsessive Compulsive * * Neurotic Style * * PSYCHOSIS Dementia * * * Delusion * * * Hebephrenia * * * Catatonia (Motor excitation * * and scattered performance) Discussion Rorschach responses indicated that LD subjects were loaded with various types of psychogenic symptoms. Which are discussed below under different subgroups of LD. Trainable LD and Psychogenic Symptoms The trainable group of LD was found with the symptoms of phobia, dementia and hebephrenia. Rorschach showed highest frequency of the F responses (88% to 96% Av. 92%) and poor number of the CF responses in comparison to others. They showed abstract association with the LD and the total number the 0 responses (27% to 39%, Av. 33%) explain the concept of LD. This indicated the concrete and imaginative mode of thinking , also supported by the total number of D responses (21% to 29% Av. 25%). It also showed the emotional adaptability and dementia and phobia specially patho, pyro and algo were generally found in LD ( based on case history report). Kaufman (1973) reported that loaded with these symptoms serious problems were located in decision making situation and it may be called as decidophobia, which is caused by stressful life changes. The scattered nature of the responses and a fantasy mixed output Learning Disabled Children 47

focussed the egocentricity. Standard responses focussed the inability to make intellectual rapport with others. Fantasy type responses as sea, sun, cloud focussed the motor excitement. On the basis of these responses it may be said that LD subject had catatonic schizophrenia. These responses when compared with their daily life behaviour (observational records) showed motor excitement and distance from reality in general activity. These evidences supported the finding of Perris (1992) that this type of behaviour loaded child has the flight of ideas and may experience fantasies that are racing through his brain. Severe LD and Psychogenic Symptoms Severe LD children were found with mood disorder, neurotic style, obsessive compulsive and hebephrenic symptoms. The symptoms of emotional instability, mild cylothemia and hypomanic mood (responses of the primary colours) showed that these LD subjects were loaded with irritable sensitivity and instability features. The reasons behind this may not be a lack of intelligence in LD subjects who were poor in their performance owing to emotional instability (Prasad 1998). This also supported the findings of Grunebaum and Perlman (1973). Who have reported that failure and inferiority affected the personality of LD children and their daily life behaviour because of emotional instability. It was found that LD children suffered from obsessive compulsive behaviour and hebephrenia. The higher frequency of M and C focussed on the compulsive act. Greater number of the CF responses in this category clearly pointed to a conflict, suggestibility and mistrust among others. Due to this compulsive neurosis, the LD child suffers from irritability and some inhibition patterns are also observed in these LD children. Profound LD and Psychogenic Symptoms This group is the most affected group and training of this group is very problematic because of greater discrepancy in these potential and performance. Such children were found to suffer from mood disorder, depression, nervous exhaustion, obsessive – compulsive neurosis, hebephrenia and catatonia. The major reaction was found from those subjects who showed a colour shock and even though they experienced a real joy and freedom in reporting the colour, their explanations were very ambiguous. High frequancy of F (65%) and animal (A) responses (48%) indicated emotional instability in these subjects. It also showed egocentricity and full of desire to participate in talk and live in active life. Although, they lived in depression, they rarely projected it. These results are in agreement with the previous findings. The psycho dynamics of these children revealed them as more aggressive. From the psychoanalytic point of 48 Prasad & Srivastava

view these symptoms were manifested by the unconscious motivation of destructive tendencies in their lives. The composite symptommatology is that of frequent mood disorders in these subjects. The conceptual aspect of F, O, D and C responses indicated symptoms of hebephrenia (disintegrated personality) in their life. Physical appearance of these children was very pleasant but in real life they showed hostile and aggressive behaviours. This observation was also proved by response frequencies of F, A (as mentioned above), O (25%) and C (18%) which indicated motor excitement and flight of ideas the indicators of manic excitement. Poor number of M responses indicated depression in such LD children. The response styles also indicated that this group of subjects were loaded with obsessive compulsive, catatonia and neurotic symptoms. It was found in response styles of these children that high responses of parent oriented style reflected the catatonic symptoms in these children. The psychological explanation of these children emphasized that they keep shifting between two poles of withdrawal reaction and sudden excitement. They are highly suggestible and show automatic obedience or immitatory action of others or mimic their phrases (echolaeia). Their shifting behaviours are also caused by their uncomfortable life patterns. Tieneri et, al. (1985) have reported that this was due to poor adaptation to the environment. On the basis of the repetitive response style and limited word information, it is theorised that obsessive compulsive symptoms as well as faulty perception produced delusions in their personality. Contacting difficulties are also observed. The rigid behaviour has been reported in LD children by Meissner (1978) and Swansan et. al. (1970). There was a logical complexity in LD children, leading to a rigidity in their behaviour. References Brinckeroff, L.C. (1997) Self advocacy :A critical skill for college students with learning disabilities. Family and Community Health, 16, 23- 23. Bruck, M (1987). Social and emotional adjustments of learning disabled children . In S. J. Ceci (Ed.) Handbook of cognitive, social and neurology aspects of learning disabilities, Hillsdale, N. J. : Erbaum. 361- 380. Gruneaum, H. and Perlman, M. S. (1973). Parania and naivete. Arch. General Psychiatries, 28, 30- 32. Kaufman, W. (1973). Without guilt and justice ; From decidophobia to autonomy. New York: Petro H. Wyden. Learning Disabled Children 49

Meissner, W. W. (1978). The paranoid process. New York : Jason, Arason. 375- 388. Perris, S. (1992). Biopolar – unipolar destinction, In E. S. Paykel (Ed) Handbook of affective disorders (2nd Ed.) New York : Guilford, 350- 352. Prasad, S. (1998). Learning capabilities, performances, confidence and hesitation of expression in LD and NLD children. Journal of Community Guidance and Research, 15, 87- 96. Saracouglor, B., Minden, H. and Wilchesky, M. (1989). The adjustment of students with learning disabilities to university and its relationship to self, esteem and self-efficacy. Journal of Learning Disabilities 22, 590- 592. Swanson, D. W., Bohnert P. J. and Smith, J. A. (1970). The paranoid . Boston : Little Brown. 106- 109. Tienari, P., Lahati, I, Sorri, A., Naarala, M., Wahlberg, K., E. and Pohyola, J. (1985). Inter action of genetic and psychological factors in schizophrenia. Acta Psychiatrica. Scandian (Supply No. 319), 71, 91- 30. Appendix – 1 Learning Disability Quotient Index Grade - 2 Grade – 3 IQ PASS 1 1 0 1 2 0 1 1 0 1 2 0 5 . .946 .951 .955 .959 .946 .951 .956 .959 1 0 . .891 .902 . 9 1 1 .918 .892 .903 .912 .919 1 5 .837 .853 .866 .877 .839 .854 .864 .879 20. .783 .804 .821 .836 .785 .806 8.23 .834 25. .726 .755 .777 .795 . 7 3 1 .757 .778 .797 30. .674 .706 .732 .754 .677 .706 .735 .756 35. .620 .657 .688 . 7 1 3 .623 .660 .690 . 7 1 5 40. .565 .608 .643 .672 .569 .612 .646 .675 45. . 5 1 2 .559 .598 .631 .516 .563 .602 .634 50. .457 .510 .554 .590 .462 . 5 1 5 .557 .594 55. .402 .461 .509 .549 .408 .466 . 5 1 3 .553 60. .348 .412 .460 .500 .355 .417 .469 . 5 1 2 65. .293 .363 .419 .469 .301 .369 .424 .472 70. .293 .314 .375 .426 .247 .320 .386 .431 75. . 1 8 5 .265 .330 .385 .194 .272 .336 .390 80. .130 .206 .286 .344 .139 .223 .292 .349 85. .076 . 1 6 7 .241 .303 .086 . 1 7 5 .247 .309 90. .022 . 1 1 8 .196 .262 .032 .126 .204 .268 95. -.033 .069 .152 .221 .022 .078 .159 .228 -.087 .019 .107 .180 -.075 .029 . 1 1 5 .186 50 Prasad & Srivastava

EFFECT OF AGE AND SEX ON SIS-II RESPONSES M.P. Singh, A. Singh and B.L. Dubey The present study was conducted on 480 subjects , half of them male and half female in four categories to find out the effect of age and sex on the projection of Total number of responses, Human responses, Animal responses, Anatomical responses, Sex responses, Movement responses, Most-typical responses and Rejection of images. The Total number of responses were found to be within the normal range of 61 to 65. Significant differences on R,Most-Typical and Rejection of images were also found in normal range. Males and females of this study show high human responses which indicates their healthy inter personal relationship. Animal responses were found to be higher in males and females of adolescent and adult age as compared to later adult and old age persons. It is also observed that females give higher animal responses than males. Anatomical responses were higher in later adult and old age group, it may be due to the over body consciousness in this age. Male Ss gave more sex responses than female Ss. Similarly, later adult and old age subjects showed higher sex responses as compared to adolescents and adults. Females showed higher movement responses than males. Pathological responses were almost negligible in all the age groups of males and females. All the SIS-II indices were found to be positively correlated except the Rejection of images. The most liked and the least liked images were found to be 31B and 29A respectively. The concept of projection, as used in projective tests now a days is generally credited to Freud who had used this term as early as 1896 (Freud, 1927) and defined it as a defensive process in which impulses, wishes and ideas of aggressive and sexual in nature are internalised because their conscious recognition would be painful to the ego. The subject matter used in this procedure serves as lens of projection and the recorded material of elicited behaviour, is the screen with the picture projected on it (Rapaport, Gill and Schafer, 1968). Since projective tests are not based on verbal communications, they more effectively penetrate a person’s ‘outer shell’ of defences and surface behaviour. Unlike personality questionnaires and intelligence tests, projective tests do not require reading questions or manuals, so they more directly assess mental processes. They use the language of dreams, visual imagery and symbolic thought, the most basic forms of thinking and expression. Projective tests speak the M.P. Singh, Lecturer in Psychology, Desh Bhagat College, Dhuri -148024 (India), A. Singh, Ph.D., Head, Deptt. of Psychology, Punjabi University, Patiala and B.L. Dubey, Ph.D., Director SIS Center India, P.O. Box 1107, Sector 15 Post Office, Chandigarh-160015 (India).

language of repression and bring whatever is buried in the mind closer to consciousness, so it is accessible for processing (Cassell, 1990). Projective techniques were born as a revolt against the paper and pencil tests of the first half of the twentieth century, which were extremely susceptible to ‘social desirability’ effects, or the tendency of test-takers to present themselves in the most positive light. Projective techniques were envisioned by their creators as depth instruments which could penetrate the individuals defences, and would thereby provide a royal road to the unconscious. (Murstein, 1995) Though there is no dearth of those who have criticised projective tests. Two main criticisms were, firstly that the techniques did not correlate highly with overt behaviour, and secondly that they did not correlate highly with other paper and pencil tests, and were, therefore, invalid. The critics failed to grasp that these techniques were exactly those techniques, not tests in the psychometric sense. As techniques, they were highly dependent on the skill of the examiner. Just as stradivarius violin in the hands of a chimpanzee would not result in rhythmical music, an unskilled, or insufficiently trained examiner should not be expected to utilise projective techniques to their full potential (Murstein, 1995). There are three major standardised tests based on inkblots. The pioneer amongst them was the Rorschach Inkblot Test published in 1921. Use of this test to explore the subject’s psychopathology and basic personality structure is well known. A research publication by Reynolds and Sundberg (1976) ranked the Rorschach test as number one. They based their findings on Buros Mental Measure Year Book. A survey conducted on the members of The American Psychological Association Division-12, and The Indian Association of Clinical Psychologists showed concern from respondents about the limitations of the test (Wade et al. 1978; Sharma, Ojha and Vegrecha, 1975; Dubey, 1982). Zubin et. al. (1965) have pointed out seven major failures as follows: 1. Failure to provide an objective system, free of arbitrary conventions, and showing high inter score agreement. 2. Lack of satisfactory internal consistency, or test-retest reliability. 3. Failure to provide cogent evidence for clinical validity 4. Failure of individual Rorschach scoring categorised to relate the diagnosis. 52 Singh, et al

5. Lack of prognostic, or predictive validity with respect to the outcome of treatment, or later behaviour. 6. Individual differences between groups of normal subjects. 7. Failure to find any significant relationship between Rorschach scores. In 1953, Fiske and Baughman reported that practitioners feel that the variation in the total number of responses is too much to be able to interpret the ratio scores adequately. Also, the meaning if indices changing depending upon the length of protocol, because the relationship between Rorschach scores and total number of responses is complex and curvilinear. Many workers compute percentage ratio in an effort to control the length of the protocol. Holtzman (1956) pointed out that such procedures were very unsatisfactory, not only because of the non-linear relationships between R and other Rorschach’s scores, but also because of the crude, unstable and metric qualities of most Rorschach variables. Wayne Holtzman developed an inkblot test to overcome some of the limitations of the Rorschach. The main limitation of the Rorschach, as experientially determined, was the problem of variation in the length of the protocol (Fiske and Baughman, 1953; Dubey, 1979, 1982). As Fiske and Baughman pointed out, the relationship between Rorschach scores and the total number of responses are complex and curvilinear. Consequently, the usual effect of R linear regression methods for removing the confounding effect of R will generally fail. Dubey, (1982), in a study of 300 subjects, found that most of the Rorschach indices are dependent upon the number of responses. When the groups of Normal, Neurotics, and Schizophrenics were divided, on the basis of number of responses, into high productivity and low productivity, many indices which were found to be significant lost their significance. It further strengthened the findings of Fiske and Baughman, and supported the intention of Holtzman. The advantage, which Holtzman introduced in his test, was to offer an alternate series of the inkblot stimuli test for reassessing the personality after some type of intervention. Holtzman provided 45 cards in each series. The subject is required to give one response per card. The Holtzman test has wide application and is popular . However the research output is not as fruitful as that of the Rorschach test. Effect of Age & Sex on SIS 53

Somatic Inkblot Series The Somatic inkblot series, SIS, is a structured, projective , diagnostic procedure and is an adjunct to psychotherapy and counseling . The SIS is structured by a sequential presentation of intentionally designed and field - tested inkblot - like images. These images demonstrate typical and atypical response potentials. The SIS procedure is projective because it is based on spontaneous, individually generated responses to semi-ambiguous figures, which elicit intra-psychic association specific to the person presented with them. The SIS is a diagnostic procedure as a consequence of the interaction of structure and stimuli. These stimuli evoke symbolism and meanings unique to the responding individual. These can be differentiated from typical and atypical peer norms, and can be analysed according to internationally recognised diagnostic criteria. The procedure is an adjunct to therapy because responses can be further explored to create more effective treatment plan and discussing each inkblot during or after formal presentation provides an opportunity to further probe deeper, more defended material. During the administration of the SIS procedure patients and students may abreact emotional conflict raised to consciousness by the images, which can be a therapeutic experience in itself. The somatic inkblot series is a recent extension of the traditional inkblot projective techniques. The test was developed specifically to understand the manifestation of problems through somatization, and to hear the suffering individual’s “inner cry.” The test images viewed on a television using a video-cassette recorder (VCR). The subjects are recorded on a separate response sheet. The procedure can be done while the patient waits for his/her turn at a clinic or a hospital. IN some cases where the individual has good ego strength, the procedure can be completed at home. Need of the present study Somatic Inkblot series is a comparatively newer test, though it has successfully attracted attention of practising psychologists and researchers throughout the world, yet the volume of research is not very high. Though the test has attracted researchers world wide and people are working in different setup. One can see the outcome of the research work done at Cape Town, Africa, Moscow, Japan, United State, India, Italy etc. The Journal of Projective Psychology and Mental Health was started by Somatic Inkblot society to report international research findings on projective psychology in general and Somatic Inkblot Series in particular. Still the volume of the literature is comparatively less than Rorschach. A few doctoral work have been carried out (Mishra, 1996 ; Rathee, 1997). The test has attracted psychologists and norms on various groups such as 54 Singh, et al

executives, students, adolescents, old age and clinical norms on schizophrenics, neurotics, depressives and anxiety neurosis have already reported (Dubey and Cassell, 1993 ; , Dwivedi, Mishra and Dubey, 1995 ; Rathee, 1997). However there is paucity of research on norms on different population/cultural groups. Such norms would help in better understanding of personality profile. Most of 26 the published work have been carried out on a smaller population. One finds difficult to draw inference on the basis of a study carried out on smaller population. The present study was tried out on a very large population. It will also take care of varying age group and perceptual differences, if any, between male and female. The present study is a modest attempt in this direction. Objective Keeping the above problems in view the present study was conducted to see the “EFFECT OF AGE AND SEX ON PROJECTIVE RESPONSES OF SOMATIC INKBLOT SERIES-II” Material and method: Sample To investigate the effect of age and sex, 480 subjects(240 male and 240 female) were taken on the basis of random sampling. The subjects belonged to four age groups i.e.13 to 15 years, 2o to 22 years, 50 to 52 years and 60 to 62 years . All the age groups were comprising 120 cases (60 for male and 60 for female). In all there were eight subgroups as shown in table 1. Table - 1 Distribution of the Sample Age wise and Sex wise Age Male Female Total 13-15 years 20-22 years 50-52 years 60-62 years Total Grand Total 480 Adolescents male and female were taken from IX, X and +1 classes and adults were taken from B. A. final, M. A. I and II years classes from colleges and universities. Later adult and old age subjects were taken from different area of Punjab. All were educated persons. Effect of Age & Sex on SIS 55

Tool The SOMATIC INKBLOT SERIES-II is a eight page paper booklet self administered test. It consists of 62 images in two series A and B each consisting of 31 images. Place for brief health history and personal data is also provided on last page of the booklet. At the completion of the test the subject issued to select three images which he liked the most and three images which he liked the least. Administration The SIS-II can be administered in a variety of ways but was designed for self administration after supervised instructions. Instructions are printed on page 8, the last page of the booklet. Some clinicians use the booklet with the patient or to unobtrusively observe the self administration to observe reaction times and significant verbal and non-verbal responses for each inkblot (delays, over reaction, content, shock). Others prefer to allow the patient to take the test booklet home and write in responses whenever they have the time to relax and review the figures (intermittent administration), or if they prefer, at one time (continuous administration). Some have found it useful to have the patient complete the test booklet before going to bed, to stimulate the unconscious to process repressed materials in dreams during sleep. Interviews may be scheduled the next morning to ascertain which SIS images, if any, become enmeshed in the individuals dream content, either directly, or in latent symbolic form. Self administration saves therapy time, reduces evaluation apprehension (test anxiety), minimises potentially contaminating and/or inhibiting effects of the examiner’s presence. It may be done in the privacy of one’s home at a relaxed time, producing deeper, more personally meaningful references. It employs the principle long used in traditional hypnotherapy; namely, that is assessing deeply repressed painful memories, patients/ clients sometimes are able to write their recollections, or signal through hand movements, material that they could not verbalise because of the painful nature (Cassell,1990). The SIS-II test was administered to all subjects by the first author in single session. Scoring All the SIS-II protocols were scored for Total number of Responses, Human, Animal, Anatomical, Sex,Movement, Most Typical, Rejection,and Pathological responses, following the standard procedure as described by Cassell (1980). Statistical Analysis 56 Singh, et al

Means and SDs were calculated for comparision of the data. The Chi-Square was calculated using combined median for each SIS variables to find out the difference amongst the group and their level of significance. Percentage scores were calculated on the basis of the total number of responses (except Rejection of images, which was calculated on the basis of 62 images of the SIS-II). Coefficients of correlation were also calculated for all the SIS -II indices to find out the inter-relationship among all the indices. Ranking of all the most liked and least liked images were made after working out their frequencies. Percentage of these images was also calculated for each group separately. All the obtained results have been shown ahead. Results Mean and SD’s of all SIS indices of different groups are shown in Table 2. Means and SDs of the total number of responses for the total sample were found to be 63.75+ 4.14, for human responses 19.18 + 5.14 and for animal responses 7.63+ 3.07. The result shows high animal responses than human responses in total Ss. Means and SDs of anatomical responses were found to be 10.27+4.69, sex responses 1.78+1.96, movement responses 6.82+ 4.11, most typical responses 14.36+1.86 and rejection of images 0.42+0.76 respectively. It further indicates that out of four age groups of males and females, male adolescents were found to be different from female adolescents for the total number of responses. Thus female adolescents showed high number of responses than their male counterparts. The males of adolescent, adult, later adult and old age group together showed lower human responses than females. Results indicate that adolescent females show higher animal responses than their male counterparts. It further reveals that the males of all the four age groups combined show higher anatomical responses than females. Male adolescents gave more sex responses than their females counterparts Difference on sex responses were also observed between males and females of adult, later adult and old age persons. The results indicated higher number of sex responses in males as compared to females.The females gave higher movement responses than males in all the age groups. The Most Typical responses were found to be more than 14 in all the age groups of males and females. The “Most-typical” responses are the responses seen by more than 75% people in a population. The rejection of images in males and females of all the four age groups were found to be very low. Rejection is another important criteria of assessing normality/abnormality. So the age or sex of a person is not affecting the number of rejection of images. Effect of Age & Sex on SIS 57

58 Singh, et al Table-2 Mean Scores and Sds of Twelve Indices of the SIS-II for Male and Female of four Age Groups Scoring Adolescents Adults Later Adults Old Age Total Total Indices M F M F M F M F M F (n=60) (n=60) (n=60) (n=60) (n=60) (n=60) (n=60) (n=60) (n=240) (n=240) (N=480 Total M 63.03 64.51 63.13 62.60 65.06 64.45 62.60 64.62 63.45 64.05 63.75 Response SD 1.62 4.02 1.78 1.47 4.93 7.56 2.15 4.45 3.09 4.95 4.14 Human M 18.92 21.93 18.65 17.48 18.98 18.07 19.77 19.65 19.08 19.28 19.18 (30.92) (33.99) (29.54) (27.92 (29.17) (28.04) (31.58) (30.41) (30.07) (30.10) (30.09) SD 4.59 3.60 5.05 4.74 5.67 4.35 5.48 5.95 5.23 5.04 5.14 M 7.70 9.42 6.73 8.27 5.88 8.02 7.77 7.32 7.02 8.25 7.63 Animal (12.22) (14.60) (10.66)) (13.21) (9.04) (12.44) (12.41) (11.32) (11.0) (12.84) (11.97) SD 2.58 2.75 2.30 3.38 3.52 2.93 3.35 2.13 3.08) 2.98 3.07 M 8.10 8.32 9.82 8.73 12.57 9.43 11.48 13.72 10.49) 10.05 10.27 Anato,ical (12.85) (12.90) (15.56) (13.94) (19.32) (14.63) (18.34) (21.23) (16.53) (15.69) (16.12) SD 3.57 3.24 3.82 3.54 4.85 3.56 5.92 4.92 4.93 4.43 4.69 M 2.15 0.98 1.31 0.85 3.43 1.07 2.87 1.58 2.44 1.12 1.78 Sex (3.41) (1.52) (2.07) (1.36) (5.27) (1.61) (4.58) (2.45) (3.85) (1.75) (2.79) SD 2.06 1.05 1.00 1.45 2.65 1.22 2.42 1.26 2.27 1.28 1.96 M 7.75 8.15 5.85 7.62 5.06 6.22 6.27 7.65 6.23 7.41 6.82 Movement SD 3.02 3.27 3.74 5.82 2.92 3.56 4.05 4.63 3.60 4.49 4.11 M 14.25 14.63 14.93 13.73 14.30 14.28 14.48 14.33 14.49 14.24 14.36 Most typical SD 1.92 1.82 2.27 1.49 1.73 1.60 2.08 1.58 2.04 1.66 1.86 Rejection of M 0.22 0.22 0.32 0.35 0.32 0.63 0.78 0.50 0.41 0.43 0.42 Images (0.35) (0.35) (0.52) (0.56) (0.52 (1.02) (1.26) (0.81) (0.66) (0.69) (0.68) SD 0.45 0.58 0.64 0.67 0.49 0.89 1.02 0.94 0.72 0.80 0.76 M 0.01 0.16 0.10 0.03 0.05 0.08 0.06 0.07 0.15 Pathological (0.16) ().26) (0.15) (0.04) (0.08) (0.12) (0.09) (0.11) (0.11) Anatomy SD 0.30 0.45 0.30 0.18 0.22 0.27 0.24 0.28 0.52 Hostility & M 0.35 0.18 0.15 0.20 0.22 0.08 0.07 0.12 0.19 0.15 Agression (0.54) (0.29) (0.24) (0.31) (0.34) (0.13) (0.10) (0.19) (0.30) (0.24) SD 0.96 0.46 0.44 0.51 0.52 0.38 0.25 0.40 0.61 0.52 M 0.18 0.35 0.05 0.05 0.15 0.17 0.03 0.07 0.08 0.14 0.12 Depression (0.29) (0.54) (0.08) (0.08) (0.23) (0.26) (0.05) (0.10) (0.13) (0.29) (0.19) SD 0.28 0.96 0.22 0.22 0.40 0.41 0.18 0.24 0.28 0.38 0.34 M 0.03 0.02 0.12 0.15 0.12 0.23 0.12 0.08 0.09 0.12 0.11 Paranoia (0.05) (0.03) (0.19) (0.24) (0.18) (0.36 (0.19) (0.12) (0.14) (0.19) (0.17) SD 0.18 0.13 0.32 0.36 0.32 0.49 0.32 0.28 0.29 0.35 0.32

Pathological Anatomy score, Hostility and Aggression score, Depression score and Paranoia scores were almost negligible in all the sub groups. In the male and female adolescents their means were found to be zero. Males and females of other age groups also showed negligible pathological anatomy which indicates the normality and high adjustment of the person in the environment. Difference among various groups on basis of Age and Sex on SIS-II indices : The χ2 test of significance was used to find out whether the males and females of four age groups could be differentiated for each of the SIS-II variables separately. Non parametric statistics is the proper choice for the analysis of inkblot indices. In the inkblot test productivity usually varies because the subject is free to give as many responses as he likes. As early as in 1949, Cronbach has warned about the uses and abuses of statistics in Rorschach. In an interesting and illuminating paper Fiske and Baughman (1953) have tried to see the correlation coefficients between ‘R’ and various Rorschach indices. They concluded that though ‘R’ is related with other Rorschach indices, yet the exact nature of relationship and its psychological significance is not properly understood. In an edited book Goldfried et al. (1971) have also emphasised this point. Many of the significant Rorschach scores give sharply skewed distribution for most population (Beck, 1945 ; Rapaport, 1945). Skewness is usually found where many subjects earn zero, 1 or 2 points. There is no way of demonstrating equality of units unless one has some knowledge of the true distribution of the trait scores. Though, this is a problem of all the psychological tools yet other tests yield normal distributions which are assumed to represent the true spread of ability. For the use of chi-square, a combined median has been used to avoid bias and confusion. Many statistician and researchers have set arbitrary rule for this purpose (Cronbach, 1949; Siegal, 1959; Maxwell, 1971; Dubey, 1982). Thus the results of χ2 obtained have been analysed hereafter. The combined median cut-off points for the Total number of responses were found to be > 64 and < 63. Significant differences between males and females of adolescent, adult and later adult were observed, as their chi-square were found to be 12.12, 7.5 and 5.08 respectively. No significant difference between males and females of old age was observed (χ2= 0.30 NS). Adolescent and old Effect of Age & Sex on SIS 59

age females showed higher total number of responses than their male counterparts whereas adults and later adult females showed lower total number of responses than their male counterparts. No significant difference was observed on the total number of responses among the four groups of male ands female subjects as shown in Table 3. Table 3 Chi-square of Males and Females of Four Age Groups on Total Number of Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female >64 <63 χ2 = 1.22** 7.5** 5.08* 0.30 ns * Significant at 0.05 level ** Significant at 0.01 level. ns Not Significant Table 4 Chi-square of Males and Female of Four Age Groups on Human Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 20 < 19 χ2 = 16.74** 0.12 ns 4.24* 2.76 ns * = Significant at 0.05 level, ** = Significant at 0.01 level, ns= Not Significant Table 4 reveals the effect of four age groups in both male and female groups on human responses. No significant effect of age (χ2= 3.8 ns) was observed. It shows that human responses were more or less same in all the males of four age groups. 60 Singh, et al

Table 5 Chi-square of Males and Females of Four Age Groups on Animal Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 8 < 7 χ2 = 4.24* 8.54** 10.70** 0.14 ns * = Significant at 0.05 level, ** = Significant at 0.01 level, ns= Not Significant Table 5 shows that combined median cut-off point for the animal responses were found to be > 8 and < 7. Significant differences between males and females of adolescent (χ2=4.24, P< 0.05), adult (χ2 = 8.54 P<0.01), later adult (χ2= 10.70, P< 0.01) were found out whereas no significant differences were observed between males and females of old age (χ2=.14 ns). Females of three age groups showed higher number of animal responses as compared to males. Table 6 Chi-square of Males and Females of Four Age Groups on Anatomical Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 11 < 10 χ2 = 0.06 ns* 0.62 ns 5.64* 6.09* * = Significant at 0.05 level, ** = Significant at 0.01 level, ns= Not Significant The results indicate the effect of male/female difference on f anatomical responses in later adult and old age, male later adults and old age persons give higher anatomical responses than their female counterparts. Males and females Effect of Age & Sex on SIS 61

of adolescents and adult age group gave more or less same number of anatomical responses. Table 7 shows that combined median cut off point for the sex responses were found to be > 2 and < 1. Significance differences between males and females of adolescent (χ2 = 6.80 P < 0.05), adult (χ2 = 13.27, P < 0.01), later adult (χ2 = 22.56, P < 0.01) and old age Ss ( χ2 = 15.48, P < 0.01) were found out. Males of all the four age groups showed higher sex responses than their female counterparts. Table 7 Chi-square of Males and Females of Four Age Groups on Sex Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 2 < 1 χ2 = 6.60 ns* 13.27 ** 22.56** 15.46** * = Significant at 0.05 level, ** = Significant at 0.01 level No significant effect of age was observed in the projection of sex responses by females of four age groups (χ2 = 7.13 ns). Table 18 shows that higher age groups give more sex responses that lower age groups. Table 8 reveals effect of four age groups i.e. male adolescents, male adults, male later adults and male old age on the projection of movement responses. Significant effect of age (χ2 = 27.04, P < 0.01) was observed on the movement responses. The results show high movement responses in adolescents as compared to other age groups. Table 8 further suggests that females of all the four age groups i.e. adolescents, adults, later adults and old age were significantly different on the projection of movement responses (χ2 = 15.24, P < 0.01) Adolescent females showed higher movement responses than other age groups. 62 Singh, et al

Table 8 Chi-square of Males and Females of Four Age Groups on Movement Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 7 < 6 χ2 = 1.2 ns 0.14 ns 5.18* 9.20** * = Significant at 0.05 level, ** = Significant at 0.01 level, ns= Not significant Table 9 Chi-square of Males and Females of Four Age Groups on Most - Typical Responses Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 15 < 14 χ2 = 3.34 ns 6.9 ** 1.24 ns 0.30 ns ** = Significant at 0.01 level, ns = Not Significant Table 9 shows that the females of all the four age groups were significantly different (χ2 = 12.76, P < 0.01) on the most -typical responses. It shows the effect of age in the projection of most -typical responses by female subjects. Table 10 Chi-square of Males and Females of Four Age Groups on Rejection of Images Median Adolescent Adult Later Adult Old Age Cut of Points Male Female Male Female Male Female Male Female > 1 < 1 χ2 = 6.52 ns 0.06 ns 0.92 ns 4.26* * = Significant at 0.05 level, ns = Not Significant. Effect of Age & Sex on SIS 63

Males and females of adolescent did not differ significantly on the rejection of responses. Only males and females of old age (χ2 = 4.26, P < 0.05) were found to be significantly different. Rejection of images were found to be higher in males of old age but in females later adults were found to be higher. Table 11 Correlation Matrix of Total Males on Eight SIS-II Indices Indices No. of Human Animal Anato- Sex Move- MT Rej. of Respomical ment Images ses No. of 1.00 .31** .19* .07 -.04 .05 -.01 -.31** Responses Human - 1.00 .06 .10 .35** .34** .32** -.01 Animal - - 1.00 -.29** -.15 .29** -.05 -.002 Anatomical - - - 1.00 .21* .24* .17 .05 Sex - - - - 1.00 .07 .07 .05 Movement - - - - - 1.00 .07 .12 Most Typical - - - - - - 1.00 .06 Rej. of - - - - - - - 1.00 Images * = Significant at 0.05 level, ** = Significant at 0.01 level Table 12 Correlation Matrix of Total Females on Eight SIS-II Indices Indices No. of Human Animal Anato- Sex Move- MT Rej. of Respomical ment Images ses No. of 1.00 .19* .28** -.06 -.02 .04 .35** .36** Responses Human - 1.00 .27** .07 .29** .49** .28** -.38** Animal - - 1.00 -.25** -.11 .27** .15 -.07 Anatomical - - - 1.00 .31** -.06 .15 .05* Sex - - - - 1.00 .23** .11 -.09 Movement - - - - - 1.00 .06 -.30** Most Typical - - - - - - 1.00 -.15 Rej. of - - - - - - - 1.00 Images * = Significant at 0.05 level, ** = Significant at 0.01 level 64 Singh, et al

Table 13 Correlation Matrix of Total Females on Eight SIS-II Indices Indices No. of Human Animal Anato- Sex Move- MT Rej. of Respomical ment Images ses No. of 1.00 .25* .24* .06 -.05 .06 .18 -.34** Responses Human - 1.00 .16 .09 .29** .42** .30** -.19* Animal - - 1.00 -.28** -.19* .29** .02 -.03 Anatomical - - - 1.00 .24* -.15 .16 .05 Sex - - - - 1.00 .07 .09 -.01 Movement - - - - - 1.00 .05 -.12 Most Typical - - - - - - 1.00 -.04 Rej. of - - - - - - - 1.00 Images * = Significant at 0.05 level, ** = Significant at 0.01 level High and positive correlation coefficients were observed among the various indices of SIS-II except rejection of images. Because rejection of images was found to be negatively correlated with number of responses and other indices. Significant positive correlation coefficients were observed between number of responses, human responses, animal responses, anatomical responses, sex responses, movement responses and most-typical responses. It means that if number of responses increases, then there is a possibility that responses on other indices such as total number of human, animal, anatomy, sex, movement and most-typical responses will also increase. Increased responses will automatically lower down the number of rejection, because it is negatively correlated. Thus it further helps in retaining another hypothesis that there would be significant and positive correlation among various indices of SIS-II. The responses were highly correlated with sex responses ( r = .24 P < 0.05). It suggests that one who gives more anatomical responses is likely to give high sex responses. Ranking of three most liked and three least liked images Table 14 shows the most liked and the least liked images in male adolescents. Image 31 B is the most liked image as 19 adolescents liked it the most i.e. Effect of Age & Sex on SIS 65

31.67% following image 28B and 12A with the frequency of 15 and 11 i.e. 25% and 18.33% respectively. Table 14 also indicates that image 29A, 12B and 10A were the least liked images with the frequencies 26, 20 and 14 (43.34%, 33.33% and 23.34%) respectively. This is all, on the basis of responses given by male adolescents. The same table depicts the most liked and the least liked images perceived by female adolescents. Again the image 31B is the most liked image by this group with 23 frequencies and 38.34%, following images 16A and 5A with 12 and 11 frequencies (20% and 18.33%), out of 60 adolescent female in this group. The least liked image of this group was found to be 30A with frequencies 13 (21.67%) followed by 29A and 12B (frequencies 9 with 15% for both the images). Table 14 suggests ‘most liked’ preference of images in male adults as the image 31B (with the frequencies of 19 i.e. 31.67%) followed by the images 5A and 13A (with the frequencies of 14 and 11i.e. 23.33% and 18.33%) respectively. The least liked image by this group was found to be 29A (with the frequencies of 9 i.e. 15%) followed by 19A and 12B (with the frequency of 6 i.e. 10% for both the images) respectively. The same table also shows that the female adults also liked the most image (31B frequency was observed to be 26 with 43.33%) followed by image 10A and 28B (which were liked at number second and third with frequency 17 and 15, percentage 28.33 and 25.00) respectively. The least liked image of this group was 14B which was followed by 29A and 10A with the frequency and percentage of 15,14,11 and 25%, 23.33%, 18.33% respectively. Table 14 also shows that the most liked image of the male of later adult age was found to be image 31B followed by 28B and 31A with the frequency 30,11 and 10 and percentage 50,18,34 and 16.67 respectively. The least liked image of this group was found to be 12B followed by 10A and 29A with the frequency of 13, 10 and 10; and percentage of 21.67, 16.67 and 16.67 respectively. The same table shows that the females of later adult age also liked the image 31B the most with frequency of 27 (45%) followed by image 13A and 3B with the frequency of 19 and 14 (31.67% and 23.33%) respectively. The least liked image was found to be 29A followed by 12B and 2B with the 22,16 and 14 frequency (36.67%, 26.67% and 23.33%) respectively for this group. 66 Singh, et al

Table 14 Frequency and Percentage of Three Most liked and three Least liked Images in Eight Subgroups, Total Male, Total Female and Total Sample. Subgroups No. of Three most like images Three least like images Sample Image Frequency % age Image Frequency % age Male 31B 31.67 29A 43.34 adolescents 28B 25.00 12B 33.33 Female 31B 38.34 30A 21.67 adolescents 16A 20.00 29A 15.00 Male Adults 31B 31.67 29A 15.00 5A 23.33 19A 10.00 13A 18.33 12B 10.00 Female Adults 31B 43.33 14B 25.00 10A 28.33 29A 23.33 28B 25.00 10A 18.33 Male Later 31B 50.00 12B 21.67 Adults 28B 18.34 10A 16.67 31A 16.67 29A 16.67 Female 31B 45.00 29A 36.67 Later Adults 13A 31.672 10A 26.67 3B 23.33 12B 23.33 Male Old 7A 43.34 30A 20.00 Age 31B 40.00 29A 16.67 31A 18.34 3A 13.33 Female Old 31B 38.34 10A 30.00 Age 5A 23.34 12B 13.33 3B 16.67 25B 13.33 Total Male 31B 38.34 29A 22.92 7A 17.50 12B 16.25 28B 17.08 10A 10.00 Total Female 31B 41.25 29A 18.75 28B 17.50 10A 18.75 5A 14.17 12B 12.92 Total Sample 31B 39.79 29A 20.83 5A 17.50 12B 14.58 28B 17.29 10A 14.38 Table 14 also indicates that the most liked image of male old age was found to be 7A (Dancing woman) with 26 frequency and 43.34% . So the most favorite Effect of Age & Sex on SIS 67

image of old age male was dancing woman followed by 31B (a family) and 31A (man and woman) with frequency of 24 and 11 and percentage of 40 and 18.34 respectively. The least liked image of this group was found to be 30A (skull) followed by 29A and 3A with the frequency of 12, 10 and 8 and percentage 20, 16.67 and 13.33 respectively. In the same table, the most liked image of female old age group was found to be 31B (A family) with the frequency 23 and percentage of 38.34 followed by 5A and 3B with the frequency 14 and 10 and percentage of 23.33 and 16.67 respectively. The least liked image was found to be 10A (Weeping eyes) followed by 12B (man squinting hard) and 25 B (pelvis of woman) with the frequency of 18, 8 and 8; and percentage of 30, 13.33 and 13.33 respectively for this group. Table 14 also shows the most liked image of total 240 male i.e. male of all the four sub groups was found to be 31B (A family of four) with 92 frequency and 38.34% followed by 7A (Dancing Lady) and 28B (Mother and Child) with frequency of 42 and 41 and percentage of 17.50 and 17.08 respectively. The least liked image of total 240 male was found to be 29A (Blank) followed by 12B (Man squinting hard) and 10A (Weeping eyes) with the frequency of 55, 39 and 24 and percentage of 22.92, 16.25 and 10.00 respectively. Table 14 also indicates that the most liked image of total 240 female was found to be 31B with the frequency of 99 and percentage of 41.25, followed by the images 28B and 5A with the frequencies of 42 (17.50%) and 34 (14.17%) respectively. The least liked image of total female was found to be 29A followed by 10A and 12B with the frequencies of 45 (18.75%), 45(18.75%) and 31(12.92%) respectively. In the same table, the most liked and the least liked image of total 480 sample is depicted. Results show that image 31B is the most liked by almost all the sub groups as well as on total sample with 191 frequency and 39.79% followed by 5A (Clown) and 28B (Mother and child) with 84 and 83 frequency for both the images with 17.50% and 17.29% respectively. The least liked image was found to be 29A followed by 12B and 10A with the frequency of 100, 70 and 69 and percentage of 20.83, 14.58 and 14.38 respectively. Result show that the 31B is the most liked image whereas 29A is the least liked image. Discussion Findings of the present study were discussed in the light of earlier studies. 68 Singh, et al

Effect of age and sex was observed and discussed on the basis of SIS-II indices, such as number of responses, human responses, animal responses, anatomical responses, most-typical responses, and rejection of images. Pathological responses such as pathological anatomy score (PAS) hostility and aggression score (HAS), depression(D) and Paranoia (P) were found to be almost absent in all the subgroups as the sample were taken from normal population (Cassell 1991, 1994, 1996; Cassell and Dubey, 1996, 1997; Dosajh 1996,1997; Dubey, 1996). The effect of age and sex was observed on the projection of number of responses. All the male adolescents, adults, later adults and old age persons were compared with their female counterparts and found that sex has influencing effect on the projection of responses, except in the case of old age. However, age has been found as influencing factor on the responses amongst female subjects. No effect of age was observed on male counterparts. Adolescents gave more responses as compared to adults and later adults. Thus the effect of age and sex was observed on the total number of responses. The total number of responses suggest imaginative capacity and functioning intelligence of the subject. Normal subjects have been found to gave 61 to 65 responses on SIS-II whereas psychiatric patients give low response, ranging from 51 to 65 as reported in earlier studies (Dubey, Cassell, Pershad and Dwivedi 1995). Thus the findings support the hypothesis of the present study that there would be effect of age and sex on total number of responses. The number of human responses normally depicts the inter-personal relationship. The SIS images are found to depict various areas such as relationship with mother, father, family, peers and opposite sex relationships and those having disturbed relationship either reject particular image assessing that area or perceive non-human contents/non-specific content on these images. Interestingly, the pattern of human contents suggest that subjects in the present study have healthy interpersonal relationship. Various schizophrenics and other psychiatric patients are known to have poor inter personal relationship and they show low human content on most of the inkblot test (Dubey, 1982, Dubey, Cassell, Pershad and Dwivedi, 1995; Rathee, Sarkar and Singh, 1996; Mishra, 1996; Singh and Dwivedi , 1998). In the present study sex differences were found on human responses in case of adolescents and later adults, but not in the case of adults and old age persons. Female adolescents and male later adults have given more responses than their counterparts. The effect of age was observed in case of females on Effect of Age & Sex on SIS 69

human responses whereas adolescents females have given high human responses than other age groups. Since the subjects of present study were normal hence high human contents were but natural. Animal contents are indicative of adjustment maturity and even frustration. Increased animal contents indicate high level of frustration, aggressive behaviour, poor interpersonal relationship and immediate need for gratification. The SIS does not depict more of animal contents. In the present study findings are similar to earlier studies reported on normal population (Dwivedi, Mishra and Cassell, 1994; Dubey et al, 1995, Mishra and Dwivedi, 1997). However it is interesting to note that female subjects by and large have given more animal contents than their male counterparts except in the case of old age. These differences were found to be highly significant. The plausible explanation to such observation could be the underlying repressive phenomena in female subjects. In Indian societies males have dominate role and females taught not to argue with male. Such behaviour might give rise to frustration, aggressive and hostile attitude and repression. Since Somatic Inkblot helps the subjects to bring out their inner cry on surface, it might have given rise to more animal contents. However, the mean of animal contents in both the cases, male and female were within normal range. The effect of age on animal responses was observed both in males and females. Adolescent males and females gave higher animal responses than other age groups. One who is more preoccupied with anatomical responses might be having problem with body imagery or (s)he is suffering from lot of physical symptoms. It has been reported that those suffering from backache/spondilities or injured backbone area may reject image 22A and 23A. Effect of age and sex was observed in the projection of anatomical responses. Males of later adult and old age showed high anatomical responses as compared to males of adolescent and adult age. Similarly, males of later adult and females of old age showed high anatomical responses than their counterparts. Males and females of later adult and old age were found to be significantly different. It may be that old males and females are more conscious with their body imagery. (Dubey, Cassell, Pershad and Dwivedi, 1995; Cassell, 1979; Dosajh, 1997). The other explanation for old age subjects may be that they are preoccupied with their body imagery and compare with their earlier health. They have not yet accepted the phenomena of normal health deterioration due to increasing age. Comparatively, their health has been 70 Singh, et al

deteriorated due to aging which they have not accepted happily. Such phenomena might have given rise in anatomical responses in aged. Comparatively old age subject have given more anatomical responses than other age groups. Rejection of anatomical responses may also suggest problem area particularly the area depicted by such SIS images. This needs further probing to help the person in developing insights of healthy body imagery. Significant effect of age and sex was observed on the projection of sex responses. Male adolescents, adults, later adults and old persons were significantly different from their female counterparts in the projection of sex responses. Significant effect of age was also observed in the projection of sex responses. Males show higher sex responses than their female counterparts because female in India are very closed to respond towards images showing sexual organs or sensitive parts of the body. They hesitate in verbalizing/giving sex responses. Indian subjects particularly women very rarely express vagina on image 25A, even after they know, as confirmed from many cases during this research. They also avoid perceiving male genital organ on 18B, though it is a common response in American population (Cassell, 1980).Similar avoidance has been noticed on image 8A where people perceive genital organ. Lot many people hesitate to view female breasts in first instance on image 27A and perceive it only during inquiry. This clearly suggests that by and large Indian population, particularly female and young adults hesitate to say though, they perceive it and reveal during probing. Significant effect of age and sex was observed in the projection of movement responses. In case of later adult and old age females showed high responses than their male counterparts. Similarly, adolescent showed high movement responses than other age groups. Thus age and sex were found to be important variables which effected the projection of movement on SIS images. Significantly higher movement responses were observed in female as compared to their male counterparts, why females have given more movement responses than males, needs further explanation. As such it is difficult to say that females of this study are more active than males, or females of this study have immediate need for gratification. Plausible explanation to some extent can be attributed to their repression and suppressed behaviour which is very common in Indian society where females are less privileged than males. Effect of Age & Sex on SIS 71

As the sample was taken from the normal population so the most-typical responses were found to be more than 12, which indicates the normality level and healthy adjustment in their environment. No significant effect of sex was observed in adolescents, later adults and old age subjects. Only adult males and females were found to be significantly different on most-typical responses. Similarly, no effect of age was observed on males of all the four age groups. Four age groups of females were found to be significantly different on the projection of most-typical responses, female adolescents gave more most-typical responses than other age groups. Most-typical responses are the strong criteria of distinguishing normal from abnormal. Most-typical responses indicate broader view and common perception. It has been observed that neurotics give mosttypical responses in the range of 8 to 12 and psychotics give less than 8 mosttypical responses (Cassell and Dubey, 1997). Since psychotics are away from reality, they fail to perceive most-typical responses and neurotics see slightly less than normal. The Ss of this study were normal so high responses on mosttypical responses was but natural. It proves another hypothesis of the present study. The low responses on most-typical indices have been reported on psychiatric population (Dubey, Cassell, Pershad and Dwivedi, 1995; Mishra & Dwivedi, 1997; Rathee, 1997; Singh and Dwivedi, 1998). Rejection of images were found to be very low in the male and female of all the four age groups. No effect of age was observed in adolescents, adults and later adults on the rejection of images. However, old males showed significant higher rejection of images than their female counterparts. Males and females of all the four age groups were found to be significantly different on the rejection of images. This suggests the effect of age and sex on the rejection of images. However, the rejection of images were found to be negligible in all the sub groups as they belong to normal population. Rejection of images show thought blockage and an inability to organize a percept (Cassell, 1980; Cassell and Dubey 1997, Singh & Dwivedi, 1998). High and positive correlation coefficients were observed among the various indices of SIS-II except rejection of images. Because rejection of images was found to be negatively correlated with number of responses and other indices. Significant positive correlation coefficients were observed between number of responses, human responses, animal responses, anatomical responses, sex responses, movement responses and most-typical responses. It means that if number of responses increases, then there is a possibility that responses on other indices such as total number of human, animal, anatomy, sex, movement and most-typical responses will also increase. Increased responses will automatically lower down the number of rejection, because it is negatively 72 Singh, et al

correlated. Thus it further helps in retaining another hypothesis that there would be significant and positive correlation among various indices of SIS-II. On the basis of frequencies and percentage, it was tried to see the rank order of the most liked and the least liked images. The most liked image of all the subgroups was found to be 31 B (A family or a family of four) followed by 5 A (Clown) and 28 B (Mother and Child). The tendency of liking is slightly different in four subgroups but image 31B was found to be the choice of all the subgroups. The least liked image was found to be 29A (Blank) followed by 12 B (Man squinting hard a dangerous face) and 10A (Weeping eyes). The trend of the least liked images is the same in all the sub-groups with negligible variations (Mishra & Dwivedi, 1997). Since 31B is the last image and the author has placed this image at the end of the test with a view that the viewer should carry home “happy family concept.” Most of normal people like happy family life. It is a neurotic who finds problems in viewing it as a happy family. In the present study the people have found this image the most liked which suggests their healthy family life. The findings further support the contention of the author. (Cassell & Dubey,1997). Image 29A was ranked as the least liked image followed by 12B and 10A. image 29A is a blank image like TAT blank card. In practice Dr. Cassell has found that people project something even on this image though lot many people find difficulties to imagine a particular response on 29A (Blank) and 14B (Blank). The findings of the present study go in the expected direction. Similarly image 12B is non-specific and does reveal any thing particular. People find this image also difficult to reply. On image 10A many people see swollen eyes, weeping eyes, crying person, sad person etc. and such depressive contents are hardly liked by people in most of the studies. Hence, the least like images 29A,12B and 10A go in the expected direction Conclusion Thus the present study suggest that there is effect of age and sex on the projection of Total no of responses, Human responses, Animal responses, Anatomical responses, Sex responses, Movement responses, Most-typical responses and Rejection of images. However, variation in the Total number of responses was found to be within the normal range of 61 to 65 (Dubey et. al., 1995). Total number of responses, Most-typical responses and Rejection of images are reported to be the hard core indicators of normality. Significant differences on these indices have been reported in normal and psycho-pathological cases (Dubey, Effect of Age & Sex on SIS 73

Cassell, Pershad and Dwivedi, 1995; Rathee,1997). Males and females of this study show high human responses which indicates the healthy inter-personal relationship in the Ss of the present study. Animal responses were found to be higher in males and females of adolescent and adult age as compared to later adult and old persons. It is also observed that females give higher animal responses than males. Anatomical responses were higher in later adult and old age group, it may be due to the over consciousness regarding body in this age. Male Ss gave more sex responses than females Ss. Similarly, later adult and old age persons showed higher sex responses as compared to adolescents and adults. Females showed higher movement responses than males. Negligible pathological responses were observed in all the age groups of males females as all the subjects were taken from the normal population. All the SIS-II indices were found to be positively correlated except the rejection of images. The most liked and the least liked images were found to be 31B (A family of four, a happy family) and 29A (Blank) respectively. Results of the present study were compared with previous studies and found that the total number of responses were higher in previous studies whereas most-typical, movement and human responses were higher in the present study. Rejection of images were observed to be less than one in both the studies. Thus the rejection of images were found to be negligible in all the subgroups as the Ss of the present study belong to normal population. References Beck, S.J. (1945) : Rorschach Test : A variety of personality pictures (Vol. II) New York, Grune and Stratton. Brady Deorah (1995) : A Study of Somatic Inkblot Series : Application in Medical setting. SIS Journal Psychology and Mental Health. Vol. 2(2): 129-134. Cassell, W. A. (1964) : A Projective Index of body interior awareness. Psychosomatic Medicines, 26, 172-177. Cassell, W.A. (1965): Body perception and symption and symptom localisation. Psychosomatic Medicines, 27, 171-176. Cassell, W.A. (1965): Body perception and symption and symptom localisation. Psychosomatic Medicines, 27, 171-176.80). Body Symbolism : Somatic Inkblot Series. Aurora Publication Company. 213 West Sixty Avenue, Suite 8, Anchorage, Alaska-99501. Cassell, W.A. (1979): Anatomical Rorschach Responses and death symbolism British Journal of Projective Technique and Personality Study, 24, 7-16. Cassell, W.A. (1980) : Body Symbolism : Somatic Inkblot Series. Aurora Publication Co. 213 West Sixty Avenue, Suite 8, Anchorage, Alaska-99501 (USA). Cassell, W.A. (1990): Manual, Administration, Scoring, Interpretation, somatic inkblot series. 74 Singh, et al

4045Lake Otis, Suite 101, Anchorage, Alaska 99508. Cassell, W.A. (1991): Art therapy using the SIS-II video, Japanese Bulletin of Arts therapy. 22, 131 - 135. Cassell, W.A. (1994): The Somatic Inkblot Series continuing Rorschach's Conceptualisation. SIS Journal Projective Psychology and Mental Health. Vol. 1(1), 3-14. Cassell, W.A. and Dubey, B.L. (1996) : The use of the Rorschach and Somatic Inkblot Series in releasing Somatic Grief. SIS Journal of Projective Psychology and Mental Health. 3(1) 3-32.. Cassell, W.A. and Dubey, B.L. (1996) : Efficacy of the Booklet and Monochromatic version of the SIS in a case of Repeated Mis Carriages. SIS Journal Projective Series-Video. SIS Journal of Projective Psychology and Mental Health. 3(2). 131-145. Cassell, W.A. and Dubey, B.L. (1997) : Therapeutic Dream stimulation with the Somatic inkblot Series - Video. SIS Journal of Projective Psychology and Mental Health. 4(1). 3-23. Cassell, W.A., Dubey, B.L. and Roth, G.J. (1997) : Medical Psychological and Spiritual Application of the SIS inkblots. Journal of Projective Psychology and Mental Health, 4, 1, 89-112. Cronbach, L.J. (1949) : Statistical methods applied to Rorschach scores : A review. Psychological Bulletin, 46, 393-429. Dosajh, N.L. (1977) : 'D' test. Proceedings of 8th All India Convention of Clinical Psychologist, Lucknow. Dosajh, N.L. (1996) : Projective Technique with particular reference to Inkblot Tests. SIS Journal of Projective Psychology and Mental Health. 3(1), 59-68. Dosajh, N.L. (1997) : Some Experience with Somatic Inkblot Series-II. SIS Journal of Projective Psychology and Mental Health. 4(1), 25-33. Dubey, B.L. (1979) : Rorschach Indices of Psychiatric Patient's in army, Indian Journal of Clinical Psychology, 6(2), 175-179. Dubey, B.L. (1982) : A Pragmatic view of Rorschach Inkblot Techniques. National Psychological Corporation. Bhangava Bhawan, 4/230, Kacheri Ghat, Agra, India. Dubey, B.L. (1996) : SIS as a projective psychotherapeutic tool for the 21st century. Presidential Address. Journal of Projective Psychology and Mental Health 3, 2, 95-107. Dubey, B.L. and Dosajh N.L . (1979) : Rorschach Responses in Normal Army Persional . Indian Journal of Clinical Psychiology. Dubey, B.L. and Cassell, W.A. (1993) : Some Experience with SIS-II. British Journal of Projective Psychology, 38, 1, 19-41. Dubey, B.L., Cassell W.A.,Dwivedi, P. and Mishra, M.(1995) :Inner cry though Somatic Inkblot Series. SIS Journal of Projective Psychology and Mental Health . Vol .2(2) : 119- 128. Dubey B.L., Cassell ,W.A., Persahad D., and Padma Dwivedi (1995) :Diagnosis utility of Somatic Inkblot Series. SIS Joournal of Projective Psychology and Mental Health. Vol . 2 (1) : 77-84 . Dubey B .L., and Pershad, D. and Cassell, W.A. (1992) Diagonstic utility of somatic inkblot series - Video . Proceedings of 25th International Comngress pf Psychology, Brussells, belgium. Dubey B . L ., Pershad D . (1994) : Reliablity and validity of Somatic Inkblot Series - India , SIS Journal of ProjectivePsychiolgy and Mental Health . 1; 33-38 . Dubey, B .L . Mishra M . Dwivedi C . B . and mishra , N . (1994) : Diagbistic and Therapeutic utrility of SIS -11 and Rorschach SIS Journal of Projective Psychology and Mental Effect of Age & Sex on SIS 75

Health . vol . 1 (1) 19-26 . Dubey , B .L ., Pershad , D . and Cassell, W .A . (1993) :Somatic Inkblot Series : Evaluation and Current Status . The Mind 19 (2 & 3) 22-32 . Dwivedi, C.B., Mishra , M ., and Dubey B . L . (1995) : Diagnostic signbificance of the indices of the SIS -11 and the Rorshach Test .SIS Journal Projective psychology and Mental Health Vol . 2 (2) : Dwivedi, P., Mishra M, and Cassell , W .A . (1994) :SIS -Video in Adolescents. SIS Journal Projective psychology and Mental Health Vol.1 (1) 27-32. Exner J .E . Jr. (1969) : The Rorschach systems . Grune and Stratton Inc. New York. Exner , J .E. Jr .(1989) : Rorschach Interpretation. paper presented at the anual meetings of the Society for Personality Assessment, New York . Fisher S. and Cleveland S.E. (1968) : Body image and personality princeton NJ : Van Nostrand. Goldfried, M .R . Stricken , G. and weiner , I . B . (1971) : Rorschach hand book of clinical research application . Englewood clifts N . J . Prentice - Hall . Hertz MR . (1959) : The use and misuse of Rorschach method . Variation in Rorschach procedres. Journal of Projective Techniqes,23 : 33-48 . Holtzman W . H . (1956) : Inkblot perception and Personality . Universityof Texas press , Texas. Holtzman WH , Thorpe JS , Swartz J . D . and Herron EW (1965) : Inkblot Perception and personality . Holtzman Inkblot Technique, University of Texas . Press Austin . Mishra, M (1996) : Compatiblity of SIS-11 and Rorschach Indices in Normal , Neurotic and Schizophenia . PHD thesis , . Mukhopadhaya, A . Banergee, S . and Mitra , G . (1996) : A comprehensive Projective Psychology and Mental Health . Murstein B L (1995) : The relationship of stimulus , Projection and Pathology in Projective techinques and the “Levels effect” . Journal of Projective Psychology and Mental health 2: 41-52. Pandey, R (1995) : Projective measure of Alexithymia and SIS . SIS Journal of Projective Psychology and Mental Health . Vol . 2 (2) 145-152 . Pandey, R. Mishra, M. and Dwivedi C. B . (1996) : A Quantitative analysis of linked and dislinked SIS-11 image . SIS Journal Projective Psychology and Mental Health . Vol . 3, No. 2,123-130 . Rapaport D ., Gill M and Schafer , R (1968) : Dignostic Psychological testing . International pren inc , New York . Rathee , S.P. and Agyajit Singh (1996) : A comparative study of male and female army subjects on SIS-1 . SIS Journal of Projective psychology and Mental Health . Vol . 1(1) 43-49 . Reunold , W. M . and Sundberg, N.D. (1976) : Research trend in testing . Journal of Personality Assessment , 40 : 228-233 . Rorschach , H . (1921) : Psychodiagnostic . Ernst Bircher , Bern . Sharma V. P. Ohja , K.N. and Vagrecha, Y.S. (1975) : Clinical Psychology in India , Indian Journal of Clinical Psychology, 2 :73-76 . Zubin., J. Eron , LD and Schumer , F (1965) : An Experimental Approach to projective techniques John Wiley & Sons Inc. New York . 76 Singh, et al

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SIS JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH (OFFICIAL JOURNAL OF SOMATIC INKBLOT SOCIETY) CHIEF EDITOR : B.L. Dubey, Ph.D., Director SIS Center India, Post Box 1107, Sector 15 Post Office, Chandigarh-160 015 [Res. : T2/15, Sector 25, Chandigarh-160014 (India)] Tel/fax : 91-172-710986, Tel.: 91-172-710985, E-Mail: sisdubey@ch1.dot.net.in OR sisdubey@hotmail.com EDITORS : Wilfred A. Cassell, MD, Director, SIS Center, 4501E, 104th Avenue, Anchorage, AK 99516 (USA) Fax: (907) 563-3746 E-Mail: drcassell@corecom.net : N.L. Dosajh, Ph.D., 1121, Sector 15-B, Chandigarh (INDIA) : C. B. Dwivedi, Ph.D., Prof. Dept. of Psychology, Banaras Hindu University, Varanasi-221005 (INDIA) Tel. : 91-542-317430 : Gilbert J. Roth, D. Min., 62 Timmerman Drive, Richland, WA-99352 (USA). Tel./Fax : (509) 628-2132 (H) E-Mail : gil@owt.com : S. K. Verma, Consultant in Clinical Psychology, Govt. Medical College and Hospital, Sector 32, Chandigarh. JOINT EDITORS : Padma Dwivedi, M.A., Social Worker, Dept. of Cardiology, P.G.I.M.E.R., Chandigarh-160 012 : A. Dubey, MBA, SIS Center, 4501E, 104th Ave, Anchorage, AK 99516 (USA) E-Mail: adubey@hotmail.com ASST. EDITORS : M.P. Singh, Ph.D, Lecturer, 1329, Sector 70, Mohali-Chandigarh Tel. : 91-172-223658 (H) E-mail : drmps@usa.net : Mridula Mishra, Ph.D., Lecturer, Bihar Yoga Bharati, Munger-811201 (India) Tel. : 91-6344-22430 EDITORIAL CONSULTANTS R. N. Agnihotri, M.Sc., India Anil Agrawal, MBA,India Phillip W. Baker, Ed.D., U.S.A K.R. Banerjee, FAPA., India Mahesh Bhargava, Ph.D., India D.K. Bhatt, B.E., India J.C. Bubber, MBA, India S. Chaudhury, M.D., Ph.D., India Alfred Collins, Ph.D., U.S.A. Anna L. Comunian, Ph.D., Italy Carina Coulacoglou, Ph.D., Greece D.S. Gujral, MBA, India K.V. Kaliappan, Ph.D., India Anatoly B. Khromov, Russia Raj Kumar, I.A.S., India Nalini Mishra, Ph.D., India Vipul Mittra, IAS, India Anjana Mukhopadhyay, Ph.D. India Les Nyman, MD. U.S.A. Executive Director : Mrs. Mary Cassell, SIS Center, 45 01E, 104th Avenue, Anchorage, AK-995 16, (USA) Fax: (907) 563-3746 E-Mail : drcassell@corecom.net; web site at : http://www.owt.com/sis/ Ravi Palia, MSW, India Paul E. Panek, Ph.D., U.S.A. Marisa Porecca, Ph.D., Italy S. Ramachandra, Ph.D., India C.S. Rao, Ph.D., India S.P.Rathee, Ph.D, India Barry A. Ritzler, Ph.D., U.S.A. Ferro Roberto, Ph.D., Italy Ann C. O'Roark, Ph.D., U.S.A. M. Sahay, Ph.D., India Abhayman Sidhu, MBA, India B. P. Singla, LL.B., India Amool R. Singh, Ph.D., India David Sperbeck, Ph.D., USA M.K. Tewari, MS, M.Ch., India M.S. Thimmappa, Ph.D., India Ailo Uhinki Ps.D., Finland De-Cicero E. Vaz, Ph.D., Brazil Yasho V. Verma, Ph.D., India Abstracted in “APA’s Psychological Abstract” Regd. No. 71632/99, RNI Delhi