SIS Journal of Projective Psychology & Mental Health

JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH The Official Publication of the Somatic Inkblot Society Volume 9 Number 1 January, 2002 SIS ISSN 0971 - 6610 Vol. 9, No. 1, Pgs. 1-78 SIS JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH 2002

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY & 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. Editor- in - Chief SIS Journal, Post Box 1107, Sector-15 Post Office, Chandigarh 160015 (India). E-mail : sisdubey@hotmail.com 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 $40 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, Editor- in -Chief, (Address given above). Please add $5./Rs. 50 if you are sending subscription through out station 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@hotmail.com and Foreign Members should inform, Anand Dubey, Joint Editor, SIS Journal, Post Box 244045, Anchorage, AK-99524 (USA), E-Mail : adubey@hotmail.com of any change of mailing address. Copyright @ 1994. SOMATIC INKBLOT SOCIETY

STATEMENT SHOWING OWNERSHIP AND OTHER PARTICULARS ABOUT SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH PLACE OF PUBLICATION : T-2/15, Sector-25 Chandigarh - 160014 PERIODICITY OF PUBLICATION : Half Yearly EDITOR'S PRINTER'S Name : Dr. B.L. Dubey PUBLISHER'S NATIONALITY : Indian ADDRESS : T-2/15, Sector 25, Chandigarh - 160015 OWNER : SOMATIC INKBLOT SOCIETY I, Dr. B.L. Dubey, hereby declare that the particulars given above are true to the best of my knowledge and belief. Sd/ Dr. B.L. Dubey, Editor-in-Chief SIS Journal of Projective Psychology and Mental Health Printed and Published by Dr. B.L. Dubey on behalf of Somatic Inkblot Society from T-2/15, Sector 25, Chandigarh - 160014 & Printed at Juneja Trading Agencies Pvt. Ltd. Printing Press, SCO 131-132, Sector 17-C, Chandigarh. Tel. : 702675, 704715. Editor : Dr. B.L. Dubey

SIS Journal of Projective Psychology & Mental Health Volume 9, Number 1, January 2002 Contents Page Nos. 1. Editorial : Intellectual Struggles in Advancing SIS Knowledge Wilfred A. Cassell 2. The Advisability of Routinely Computing Percentages when 2-4 Comparing Groups Across Projective Test Variables. Paul E. Panek., John J. Skowronski and Edwin E. Wagner 3. Application of Somatic Inkblot Series-I : New Scoring System 5-22 Wilfred A. Cassell and B. L. Dubey 4. Profile of Militants : An attempt to study the mind of militants 23-32 Lt. Col. D. Saldanha 5. Somatic Inkblot Series-I : A Meta Analysis 33-37 Ajay K. Srivastava 6. Diagnostic Value of SIS-II among Sub-Groups of Psychotic 38-48 and Neurotic Patients of Armed Forces S. P. Rathee, P.K. Pardal and T. R. John 7. The Reflective Analysis of the Personality Problems of 49-56 the Young Female Subjects : A Cross Cultural Approach Anatoly B. Khromov, Gene Starbuck, Nonie M. Birkedahl and B. L. Dubey 8. Family Intervention in the Treatment of Post-Traumatic 57-61 Stress Disorders Lt. Col. D. Saldanha 9. Rorschach's Response Patterns of Drug Addicts 62-64 Manish K. Verma and Sarita Misra 10. Management of Stress 65-68 Col. Rajinder Singh 11. Membership Directory 69-78

Editorial Intellectual Struggles in Advancing SIS Knowledge Our 4th SIS International conference in November 2000 in Chandigarh India was a tremendous professional success for all those fortunate SIS workers who attended it. Congratulations again to many presenters who stimulated our appetites with an intellectual menu of interesting and highly informative papers. Indian members of our society need special recognition and praise for their hard work and hospitality. They created a socially infectious atmosphere of warmth that was truly contagious. The meeting was not just an outstanding cognitive event in the historical maturing of our international SIS society It also provided an important opportunity for renewing friendships and expanding emotional connections. Stimulated by the leadership of Dr Bankey l. Dubey, one could sense an intangible but highly meaningful element of spiritual bonding developing between participants. Moreover, the active contribution of meaningful material from both sexes, young and old, stimulated an optimally harmonious blending of psyche energy. Members of this society need the healing and supportive power of such occasions. The powerful uncovering aspect of the SIS technology places us at the forefront of the battle between good and evil. In this eternal war between the forces of enlightenment versus repression, those who champion the SIS as an interview technique for releasing suffering the “inner cry” - will always be at risk for secondary emotional trauma. The danger we face in our professional work is comparable to that experienced by health workers in treating patients with infectious disease. We similarly can be exposed to the potentially harmful aspects of empathetically experiencing the released painful SIS images. Opportunities to share experiences through such meetings and this journal can revitalize us. Of course we face other forms of stress. . Frequently there are the professional battles with psychologists who allege that projective testing is not readily quantifiable. Consequently, they erroneously argue, before thesis committees and funding sources, that inkblot techniques are not worthy of serious scientific investigation, financial support etc. In clinical settings where the psychopharmacological treatments often prevail, in-depth psychological assessment may be requested, only as an afterthought. Ironically, if the Rorschach employs Exner’s scoring system applied, as frequently is the case, it is a misnomer. The instrument is not operationally a projective test. In such cases the referring clinician does not gain insight from the richness of content analysis and symbolic interpretation. Apart from these troublesome issues, if the SIS is employed in clinical populations, the release of the “inner cry” may fall on deaf or even hostile ears. Worse still, are the problems faced when those if power over the suffering individual do not like what is exposed. Often this applies when parents, family members or other in charge of a suffering child are in denial about the true source of the emotional pain. Clinical examples of this will be presented in this edition of our journal. Wilfred A. Cassell, M.D., F.A.P.A. 4501 E. 104th Avenue Anchorage, AK. 99516 (USA)

The Advisability of Routinely Computing Percentages when Comparing Groups Across Projective Test Variables. Paul E. Panek, John J. Skowronski and Edwin E. Wagner It has been firmly established that, when significant differences exist among the total number of responses (R) in comparing groups on data obtained from projective techniques (PTs), it is advisable to also compute comparisons based on percentages obtained by dividing individual variable scores by their respective Rs. The purpose of this study was to determine whether different results would be observed on the projective Hand Test (HT) when comparing raw scores versus percentages, even when the Rs do not significantly differ. The HT was administered to 90 individuals seeking treatment at a pain clinic for three distinct physical maladies, arthritis, fibromyalgia, and migraine headaches. Results indicated that there were no significant differences among the three groups for Rs. A 2 (Gender) X 3 (Pain Groups) ANOVA, with age as a covariate, yielded interpretable groups and two gender effects derived from raw scores. The same results were obtained for percentage comparisons with the exception of one-nonsignificant finding for the repetition (REP) variable. REP is a reliable indicator of an organic brain syndrome and, therefore, it was important to authenticate the significance of this variable. The lack of corroborative support for the percentage comparison suggested caution in over interpreting the differences among the raw scores, especially in an exploratory investigation utilizing small samples. The Advisability of Routinely Computing Percentages when Comparing Groups Across Projective Test Variables Various statistical methods have been proposed for dealing with comparisons of category responses between groups when projective techniques are employed (Wagner, McCormick, & Alexander, 1984). A particularly difficult issue has been the question of how to control for response productivity; that is how to partial differences due to R when the total number of responses is not the same for both groups. Chronbach (1949) suggested three basic methods for comparing projective test category responses between groups when response productivity differs. These are: 1) re-score a fixed number of responses per protocol; 2) equate subgroups on number of responses; and, 3) analyze patterns of normalized scores. Chronbach further noted that ratio or percentage scores when applied to categories within individual protocols are generally unreliable due to the small denominators and their variability, which in turn affects the reliability of the percentages obtained. Wagner et al., (1984) suggested that one remedy for this situation was to convert component scores to percentages on a group basis and then make comparisons between proportions using the t or z statistic. Wagner, Prospero, and Alexander (1984) suggested that conversion to percentages is not being advocated as a matter of course but only when the group Rs differ significantly. Thus, in general, it has been established in the literature that, when significant differences exist among the total number of responses (R) in comparing groups on data obtained from projective techniques (PTs), it is advisable to also compute comparisons based on percentages obtained by dividing individual variable scores by their respective Rs.

However, it would be interesting to determine whether different results would be observed on the projective Hand Test (HT) when comparing raw scores versus percentages obtained by dividing individual variable scores by their respective Rs. We would predict that since there was not a significant difference among respective group As results based on raw scores and results based on percentages would yield identical results. Method In order to explore this hypothesis HT protocols from 90 individuals seeking treatment at a pain clinic in the southeastern United States for three distinct physical maladies, arthritis, fibromyalgia, and migraine headaches were analyzed twice. First, a 2 (Gender) X 3 (Pain Groups) ANOVA, with age as a covariate, on the raw scores was conducted. This analysis was followed by the same analysis on percentage scores. Results and Discussion Analysis based on raw scores yielded six significant Pain Groups differences for the HT variables of Exhibition ( p < .01), Active ( p < .01), Passive ( p < .01), Total Environmental ( p < .02), Fear ( p < .01), and Repetitions ( p < .05); two significant Gender differences were observed, Direction ( p < .02) and Acquisition ( p < .02). Analysis based on percentage scores resulted in five significant Pain Groups differences for the HT variables of Exhibition ( p < .01), Active ( p < .01), Passive ( p < .01), Total Environmental ( p < .03), and Fear ( p < .01); two significant Gender differences were observed, Direction ( p < .05) and Acquisition ( p < .01). Thus, the only difference between the analyses was that there was a significant Pain Groups difference for the HT variable of Repetitions using raw scores, and this same variable was not significant with the percentage analysis. Repetitions are a reliable indicator of an organic brain syndrome and, therefore, it was important to authenticate the significance of this variable. The lack of collaboration for the percentage comparison suggested caution in over interpreting the differences among the raw scores, especially in an exploratory investigation utilizing small samples. Finally, the percentage/raw score comparisons could go either way depending on distributional characteristics, i.e., the raw score could be significant and the percentage not. Therefore, the two provide mutual checks on one another. This would be an especially appropriate strategy if there are a lot of significant variables and you want to eliminate the weaker ones, which may have arisen by chance. Finally, in this age of computerization it is a small matter to convert raw scores into percentages and, therefore, this procedure could be recommended as a matter of course. References Paul E. Panek, Department of Psychology, The Ohio State University-Newark, USA, John J. Skowronski , Department of Psychology, Northern Illinois University,USA and Edwin E. Wagner , Emeritus Professor, Department of Psychology, The University of Akron, USA

Chronbach, L. J. (1949). Statistical Methods Applied to Rorschach Scores: A Review. Psychological Bulletin, 46 : 393-429. Panek, P. E., Skowronski, J. J. and Wagner, E. E. (In Press). Differences on the Projective Hand Test among Chronic Pain Patients Reporting Three Different Pain Experiences. Journal of Personality Assessment. Wagner, E. E., McCormick, M. K. and Alexander, R. A. (1984). A Method for Coping with Overall Productivity When Making Between-Group Category Comparisons. Journal of Personality Assessment, 48, 85-86. Wagner, E. E., Prospero, M. K. and Alexander, R. A. (1984). Percentage Conversions as a Method of Enhancing Clinical Discriminations. Journal of Personality Assessment, 48, 617- 619. Portions of this paper were presented at the VIIth European Congress of Psychology, London United (UK) Kingdom, July 1-6, 2001. Requests for reprints should be addressed to: Dr. Paul E. Panek, Academic Dean & Professor of Psychology, The Ohio State University at Newark, University Drive, Newark, Ohio, 43055, USA. Projective Test Variables 3

4 Panek et al 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. E-Mail : wilfredcassel@hotmail.com Web Site at http: //www.somaticinkblots.com OR B. L. Dubey, Ph.D., DPM, FSIS, Editor in Chief, SIS Jr. of Proj. Psy. & Mental Health, Director Somatic Inkblot Center India, P.O. Box 1107, Sector 15 Post Office, Chandgarh-160015 (India) Tele/Fax : 91-172-710986, Tel. : 91-172-710985 E-mail : sisdubey@hotmail.com OR sisdubey@rediffmail.com

Application of Somatic Inkblot Series-I : New Scoring System Wilfred A. Cassell and Bankey L.Dubey The Somatic Inkblot series have attracted researchers and clinicians in various countries and the test has been adopted in English, Russian and Italian. Though the SIS-I is the first test in the series, it always emphasized content analysis for the interpretation of responses. It has now adopted a simple indices based scoring system, which helps researchers and clinicians to find out the changes in pre-and post therapeutic intervention. The new scoring system along with interpretation of SIS responses in a case of pain is presented in the paper. The Somatic Inkblot series have attracted researchers and clinicians in various countries and the test have been adopted in English, Russian and Italian version. Its new scoring system for SIS-II has been used in diagnostic evaluation and to find out the changes in pre and post therapeutic intervention. Keeping the success of SIS-II, the new scoring system for SIS-I was developed and presented as a New Year’s gift to SIS Members, Researchers and Clinicians. Definitions of SIS-I Scoring Indices Mental health professionals with training and experience in projective techniques will have little difficulty integrating the scoring and charting conventions used with the Somatic Inkblot Series. “Body Symbolism” (Cassell, 1980), can be a resource for increasing one’s skill in the interpretation of the original 20 cards SIS responses. Since the procedure conceptually taps into the same stream of imagery as seen in dreams, daytime fantasies and visual hallucinations, a background in interpreting such content, either in a direct or latent symbolic way, is helpful. Clinicians experienced in art psychotherapy will readily adapt to this technique (Kwiatkowska, 1978; Ulman, 1965). They will find the SIS a useful aid, especially for people who cannot draw. In a sense, the SIS employs art as a diagnostic and therapeutic approach for those who cannot engage in traditional art procedures. Other clinicians with experience in dream interpretation, visualization techniques, guided imagery, active imagination therapies and hypnotherapy will also readily adapt to this procedure (Cassell et al,1996,1997,1997a, 1998, 1999). There are variations in test taking, with important clinical applications. People who have difficulty in completing the test and who do not respond to a number of video images may be exhibiting denial, avoidance, blocking or repression. Excessively detailed responses suggest obsessive-compulsive traits. Exaggerated verbal responses, while discussing inkblots least liked, suggest affect-laden content. This should be further explored for relevance and meaning to the individual. In some cases, repressed material can burst into conscious awareness, triggered by the semi-ambiguous inkblots. The underlying dynamics of many somatic complaints and personality traits can become Wilfred A.Cassell, M.D., APC, FAPA, Director SIS Center, 4501 East, 104th Avenue, Anchorage, AK-99516(USA)E-mail: wilfredcassell@hotmail.com and Bankey L. Dubey, Ph.D., DMSP, FIACP, Professor, Panjab University, Chandigarh-160015(India)E-mail:sisdubey@hotmail.com

accessible with this technique (Cassell and Dubey,1998, Dubey et al, 1995,1997,2000). The eleven categories found to be important in understanding and interpreting protocols are: 1. Total Number of Responses 9. Atypical Responses 2. Human Responses 10. Rejection of Images 3. Animal Responses 11. Pathological Scales: 4. Anatomical Responses a. Pathological Anatomy (PAS) 5. Sex Responses b. Depression (D) 6. Movement Responses c. Hostility and Aggression (HAS) 7. Most Typical Responses d. Paranoia (P) 8. Typical Responses Each category is designed to stimulate consistency among the raters, and to afford commonality in acquiring information for research and normative data collection. The Somatic Inkblot Series has a very simple scoring system. It is less complicated than existing inkblot tests, since it emphasizes content analysis. The following scoring categories have been found to be the most important: 1. Total Number of Responses (R) The total number of responses is arrived at by counting all the responses given by the subject on the 20 images of the SIS-I Test. This number suggests imaginative capacity and functioning intelligence of the subject. Psychiatrically ill patients will have a poor imaginative capacity and poor functional intelligence. 2. Human Responses (H) Human responses include the whole human body, or external parts of the human body like face, ear, nose, legs, etc. The category does not include mutilated forms of the whole body or parts of it, such as crushed human being, broken legs or smashed face. These mutilated responses are included in the Anatomical responses. The number of Human responses suggests the patient’s interpersonal relationship with human beings. When responses are low, it might be indicative of a desire to be away from humans and schizoid or social isolation tendencies. 3. Animal Responses (A) Animal responses include living or dead animals such as wild and pet animals, reptiles, birds and sea animals. This category also includes external parts of the animals such as wings, legs, claws, beak, etc., but it does not include mutilated parts of the whole animal such as crushed birds or animals, pulled out wings, etc. Whenever a large number of animal responses are given, interpretation should be that the respondent is less comfortable with people or is psychologically immature. 6 Cassell et al

4. Anatomical Responses (At) Anatomical responses pertain to internal parts of living beings and their mutilated forms both of humans and animals. These responses are consistently high in those who have a poor self-image and who are preoccupied with internal body organs. 5. Sex Responses (Sex) Sex responses pertain to the internal or external reproductive system and to sensuous parts of the body. These responses include thighs, buttocks, breasts, fallopian tubes, ovaries, etc. Heightened anxiety and pathology may be associated with either heightened projections or impaired recognition of imbedded sexual structure. These may signify sexual anxiety and/or dysfunction. 6. Movement Responses (M) Movement responses indicate movement in human beings or animals. Examples include “talking human being,” “flying bird” or “running tiger.” 7. Most Typical Responses (MT) Most Typical responses are those, which are given by, more than 75 percent of normal subjects on a particular image (Dubey and Cassell, 1993). The total number of such responses is limited to 9. A higher number of Most Typical responses are suggestive of coherent, logical thinking, and ability to keep up with the demands of society. It may also be interpreted as a measure of ego strength and team concept. The following is the list of Most Typical responses along with the images eliciting them: Image Responses Card 1 Two Birds Card 2 Heart Card 2 Bird Card 3 Two human beings/ladies Card 4 Apple/fruit Card 4 Dancing Lady Card 9 Kidney/Lungs Card 15 Spinal Column/Rib Cage Card 17 Spinal Column/Pelvis 8. Typical Responses (T) Typical responses are those, which are commonly seen by healthy people on a particular image. 9. Atypical Responses (AT) Atypical responses are those of poor quality and with vague percept, either in structure or verbalization. A response that markedly departs from the category of typical responses Application of SIS-I 7

is also scored under Atypical category. For example, if the viewer gives the response “flower” on image 9 it should be considered as atypical because this image should elicit body anatomy such as kidney/lungs. The number of Atypical responses is proportionate to the degree of psychological or psychiatric disturbance. Perseveration may be a sign of neuropsychological impairment, and is usually absent in normal people. Below is a list of Typical and Atypical responses on each image: Typical and Atypical Responses Image 1 Typical : Two persons Atypical : Lungs Image 2 Typical : Clown; happy person Atypical : Woman; heart; mouth Image 3 Typical : Man and woman dancing; hearts; two men or two women dancing Atypical : Two sets of lines; face; eyes; two ants; two animals Image 4 Typical : Woman dancing; Eve and apple; seductive woman; apple Atypical : Male; pregnant woman; heart; rivers and island; snakes Image 5 Typical : Turtle; flying bird; babies on sides Atypical : Stretched animal skin; man flashing two children; smashed animal showing entrails; spinal disc Image 6 Typical : Two lovebirds; heart Atypical : Two (starving) birds fighting for food; lungs; x-ray of chest; leaves Image 7 Typical : Heart; female genitalia; uterus; animal coming out of heart Atypical : Creature from outer space; atomic bomb exploding; x-ray of brain Image 8 Typical : Chest; ribs; heart; lungs Atypical : Ugly dog; monster looking out at you; gaping open mouth; two catfish looking at evil; Image 9 Typical : Kidneys; lungs; thorax Atypical : Weight lifter (back pain detail); a bush with a spear for roots; brain; ovaries; Testicles; eyes; ears 8 Cassell et al

Image 10 Typical : Lips, mouth (upper area) and Stomach (lower area) Atypical : Non anatomical, Animal Image 11 Typical : Intestine Atypical : An animal Image 12 Typical : Female sex organs (cervix, ovaries, uterus, vagina) Atypical : Skull; top of hammer; dog with large ears Image 13 Typical : Female genitalia, perineal area, buttocks, and heart Atypical : An animal, creature from other space, leaf Image 14 Typical : Vagina Atypical : Stained glass window; crucifix (substituting religious symbolism); cave or tunnel; beetle; Indian oil lamp; eyes Image 15 Typical : Spinal column Atypical : “Mind block” (rape victim repressing male genital symbolism); pots, pans, or plates stacked on each other (neutralizing defense against phallic symbol by rape victim) Image 16 Typical : Eyes, head, tongue, nose Atypical : Bushy plant, Flower Image 17 Typical : Spinal column, Rib cage, Pelvis, Phallus Atypical : Indian lamp, big hammer Image 18 Typical : Oral or Facial region, Crown Atypical : Gate of Hell, Castle Image 19 Typical : Two birds, Hands Atypical : Butchered Animal, Dressed Chicken Image 20 Typical : Face or part of face, Eyes Atypical : Ghost, Fearful face Application of SIS-I 9

10. Rejection of Images (Rej) If the subject is unable to give any response on any of the 20 cards, the response is considered as rejected. Verbalizations like spot or inkblot are not considered as responses, and are treated as Rejections. To determine the percentage of Rejection of Responses, 20 (total number of images shown) divides by the total number of rejected images, then that product is multiplied by one hundred. Rejection of images shows thought blockage and an inability to think properly. 11. Pathological Scales Four pathological scales have been used (Cassell, 1980) for the evaluation of individuals. They are a) Pathologic Anatomy Scale (PAS); b) Depression (D); c) Hostility and Aggression Scale (HAS), and Paranoia Scale (P). Some of these are based on the work of Wayne Holtzman (1956). The scales are as follows: a) Pathological Anatomy Scale (PAS) Subjects who have personal health concerns, or who are pathologically identified with the health of others, may project responses in which the body is seen as diseased. These responses are usually related to specific regions involved in the subject’s body image, and can be appraised by evaluating the qualitative nature of the somatic material projected. The anatomical imagery is similar to that described by De Vos (1952) in Rorschach responses involving “diseased anatomy.” Body parts might be reported as red, inflamed, infected or cancerous. Organs may be sore, painful or hurting. Passages may be blocked or obstructed. Bones may be out of place or broken. It is possible to assess pathologic anatomy by summing up all such responses. All of these responses are scored under PAS. Individuals who project these responses should be further evaluated for either hypochondriac or excessive concern about physical health. This material should be explored, clarified and assessed in the detailed inquiry and follow-up interview, since the subject may still have unresolved anxiety about this alteration in body concept. The total number of such responses is counted to form a score for PAS. b) Depression Scale (D) A depressed subject’s emotional state can be viewed as either overt or covert. Subjects with overt feelings of depression readily admit them, and are good reporters of their own mental state. They usually exhibit nonverbal behaviors, such as sighing, weeping, downcast eyes, etc., which are consistent with the experienced affect. Subjects in a state of masked depression often conceal or deny their feelings. Frequently, they are preoccupied with their bodies hypochondriacally, and project anatomical responses, which are likely to be pathological. A depressed mood can be assessed by inkblot responses with high morbid or depressive content. The severity of these thoughts and feelings can be assessed by a study of their frequency and content quality. 10 Cassell et al

A four-point scale can be used to score the depressive content of inkblot imagery: Score 0: No depressive content Score 1: Slight or mild depressive content in the face of humans or animals (i.e. a sad face) Score 2: Moderate depression associated with the “inkblot’s” expression. An expression with a marked, or strong affect (e.g. a weeping person, a grief-stricken person) Score 3: Sadness or depressed affect associated with an anatomical response. For example a heavy heart, a breaking heart, or a heart with a clamp on it. Something that is suicidal, or hanging from roof, or a dead man. Individuals who are clinically depressed, but fail to recognize it, may have similar difficulty in recognizing content in the SIS. In the absence of neurological disorder, a high number of Rejection responses may signify masked depression. c) Hostility and Aggression Scale (HAS) Hostility and Aggression can be reflected in projective responses involving physical assault or body injury (Cassell, 1977, Cassell, et al,1998, 2001 ) and are scored as follows: Score 1: Animals that are predatory or hostile to humans; an implement of aggression in a dormant state; a human or an animal that is seen as fierce, aggressive, or dangerous; a hostile attitude seen in humans or animals; references to bowel function or defecation with hostile content; a knife or a snake. Score 2: Animals or humans seen as angry or in aggressive struggle, either verbal or physical; furious snakes; or abstract expressions of direct conflict or oral aggression. Score 3: Homicidal scenes and/or anatomical responses involving body destruction. Subjects with histories of acting out hostile impulses have been found to project anatomical responses with murderous themes. d) Paranoia Scale (P) A cardinal projective feature of paranoid ideation involves a heightened awareness of threatening faces that are “looking” at the individual. This may be experienced as an exaggerated sense of self-consciousness in social situations. An emphasis on the eyes” of people or animals may be present in anxiety-laden dreams. It may be clinically indicated in art therapy, with figure drawings emphasizing “eyes.” The patient may hallucinate about images of such staring faces. The paranoid scale quantifies such responses. Clinical Considerations Attention should be given to signs of somatic repression. This is reflected when images with high anatomical structure are left blank or when symbolic responses are projected, disguising the somatic content. An example is the response “Chinese pagoda” instead Application of SIS-I 11

of a spinal cord on Card 15. Another would be seeing a bush instead of kidneys or lungs on Card 9. Individuals suffering from psychogenic pain in a conversion disorder are examples of this group of respondents. In the detailed inquiry, depending on the clinical indications, specific questions may be asked to explore certain areas pertaining to the patient. What may at first seem an abnormal image pattern may prove to be a normal variant under the added scrutiny of detailed inquiry. The response may be a defense against painful reality, a temporarily focused but generalized anxiety or an acquired or learned response from family, job, school, life experience or long-term, chronic medical problems. The therapist should withhold judgment and not share it with the patient until the dynamics are clear. In classical analytic therapy, this delay is intentional and is an integral part of the treatment plan. The therapist waits until the patient has the insight, awareness and coping skills, and thus is ready to understand and process these new learnings. A subject’s therapeutic readiness involves the ability to process affect-laden, repressed material, and unrealistic expectations of him/herself and others. Choosing this moment of truth, i.e. the time to share judgment, is a test of the therapist’s knowledge, understanding and judgment. Another line of inquiry concerning the determinants of SIS responses involves determining if the subject’s projected material reflects inner psychological experiences not directly recorded from past visual experience. These responses may relate to nighttime dreams, daytime fantasies, or, in psychotic individuals, visual hallucinations. Emphasis or sexual avoidance of a structure may suggest conflict in that area. Emphasis on eyes, ears, or hair may suggest paranoid ideation. A higher conformity to Most Typical responses may suggest that the patient or client have group conformity in his/her thought process. High scores on the four Pathological Scales may suggest pathology in the respective area. The greater the percentage of Atypical responses, the deeper the pathology. Rejection of Images It is equally important to understand why a person is unable to perceive on a particular image. Each image is created to depict a particular area, hence rejection of such images has lot of clinical significance. Since these inkblots are highly structured - in the absence of any organic pathology- inability to perceive a particular blot can be highly clinically significant. It may help, in understanding his reactions to different situations presented through inkblot imagery. The avoidance of such images may further be probed to understand the unconscious process. Though responses to different images are quite relevant to understand the personality of the subject but the rejection of images may be equally relevant and may help in peeping through of the inner self of the subject. Because of such relevance rejection, of images has been given much importance while interpreting SIS protocol of a subject. When a person is unable to perceive images in a concrete form, it can be taken as rejection. It has been noticed that people reject images, which depict certain precept related to their traumatized experience or underlying painful memory. For example a 12 Cassell et al

person having poor interpersonal relationship may reject Card 3 and 4, because these images project human content. Poor interpersonal relationship with spouse may also lead to rejection of Card 3, 4 and 14. Images like 14 projects more of erotic content. Since this area is disturbed because of poor relationship, people (he/she) may not feel like responding anything on this card. Similarly, it has been noticed on clinical sample of cardiac cases that persons suffering from heart problems rejects images depicting a heart - for example Card 2,7 and 9. A few patients who have recovered and have accepted their clinical problems bravely do perceive ‘a heart’ on these images. It suggests that they have no fear regarding their heart as they have been properly counseled. Persons suffering from body ailments, for example Kidney problems generally reject Card 9, which depict Kidneys. It has also been noticed that females traumatized sexually find it difficult to perceive Card 15 and 17, which generally project spinal column. The symbolic meaning of these images may relate to male sex organs. Since these persons have undergone traumatizing experience and have unpleasant memories of the precept, they may find it difficult to see anything on these images. Even if they perceive something, often they give poor quality responses and attach a special meaning to it. For example a patient who experienced an unpleasant sexual harassment perceived “A deadly android more like a creepy insect” on Card 15. It should be kept in mind that the material, which follows need to be, assimilated by the experienced clinician with the overall medical and psychiatric history data. Even certain contents from dreams and visual hallucinations may be included. There are two types of interpretation of SIS responses - Clinical and Research. Whenever a protocol is to be interpreted for clinical purposes, interpretation of the images is essential. Whenever interpretation is required for research purposes, the total number of responses, percentages for Movement responses, Animal responses, Anatomical responses, Sex responses and Rejection of images need to be determined. The number of Atypical responses, Most Typical responses and Pathological responses is equally essential. The SIS employs mainly two methods of interpretation: 1. Quantitative Analysis: Analysis of various indices, such as number of responses to images, number of human, anatomical, sex, and animal content; most typical, typical, atypical responses, movement and four categories of pathological responses have been created. These were established for evaluating a series of mental constructs in various normal and clinical groups. If the number of atypical responses and the rejection index, along with the total pathological score becomes elevated, then the prognosis is estimated to be more guarded (Cassell and Dubey, 1997, 1998,1999,2000,2001) 2. Content Analysis: Content analysis is given more emphasis in interpretation since it frequently helps to bring out the unprocessed unconscious material. What is seen through the response profile, along with the affect linkage, may have direct or symbolic significance either in the present or in the viewer’s past. It is quite analogous to assessing such material as the in-depth study of dreams. While Application of SIS-I 13

the professional’s own theoretical frame of reference will strongly influence the interpretative process, it is the authors, viewpoint that in most clinical therapeutic situations, content analysis for any given individual is a richer approach. For better understanding of the system a case of “Past Pain” is presented and the SIS responses are discussed in details: Case 1: Past Pain The case examines how SIS-I and SIS-II imagery project associations to past painful body events. The Rorschach test was also administered and the interpretation of the test is discussed in length. An internist for pain management referred an adult female. She had a history of severe recurrent migraine headaches. The referring physician was concerned about the analgesic medication (Demerol). It was his impression she was experiencing psychological stress from leaving her relatives in the “lower 48” and adapting to an Alaskan lifestyle. Her husband was employed in the oil industry and she had young children to care for through the long winters. When initially interviewed she related that her painful headaches indeed seemed worse since her recent move to Alaska. She denied mental problems. Mental status examination revealed an intelligent, middle-aged woman with some hysterical features but who was essentially intact. She showed no gross evidence of thought disorder and denied auditory hallucinations. Initial diagnostic impression was conversion hysteria with migraine headaches exacerbated by the stress of moving to Alaska. The treatment plan specified psychotherapy to improve coping skills and reduce stress and hypnotherapy for pain control. She avoided the spinal content, instead seeing a “screw on top of an awl”, disguised phallic symbolism. Moreover, she may have repressed the spine as well. She does not want to be independent and stand on her own two feet. An awl is a tool to make holes in leather or wood. Finally, near the top she projected another eye, perseverating this theme. For 17B she gave a normal response. On substituted “a wrench” her second association, “a carnivorous sea creature,” reflected symbolically her negative view of phallic imagery. An oral aggressive quality is readily apparent. For 19B she saw “a sunny day or intense passion”. This is a positive response associating the sun with warmth and emotion. She expresses herself as one who is capable of passion generally but not directly or overtly sexual, love more than sex. For 20B, ordinarily seen as the brain, she saw “an atomic explosion.” Her defensive symbolism served to repress her brain, an area she associated with her inner turmoil. An atomic explosion suggests the magnitude of her rage as in 18A. Her second level of imagery came closer to reality structure in that she saw “ a wig on a Styrofoam headstand with a rose attached”. She allowed herself to see a head but not a brain. Her dream content suggested some degree of splitting that subjectively noted her anxious brain fixation. Response to 4B evidenced a cognitive disorder. Her response to 21B was consistent with her aggressive feeling and previously detected catharsis of guns (12B). She saw “a gun that has exploded”. For 22B she saw “a person dead in the middle of the road”. It was consistent with the theme of body destruction and helplessness. On 23B, instead of seeing anatomical chest structure, she saw “a ladybug, she has broken 14 Cassell et al

the rifle of a would-be killer.” The response of a diminutive female figure (lady bug) with the power to break an attacker’s rifle (phallus? ) is strongly defensive symbolism. It reinforces the optimism and positive orientation of a rifle. On 24B she saw a “a curly mustache” and secondly “a two – headed snake.” Her first response, to a masculine structure may symbolize her perpetrator. It may also symbolize the male genitalia, the moustache as pubic hair, the nose as penis. This seems likely since the next association was to a snake, a well-established phallic symbol. For 25B she saw “An eagle with a crystal body and snakes at the end of its wings trying to see the future in the crystal. It looks like a baby eagle”. The baby eagle signifies regression. She lived at home and was never separated from her family. The snake imagery from 24B continues phallic imagery. Metaphorically this may be a variation of the Little Red Riding Hood theme of the virgin in the forest, a baby bird with the snake near at hand on its very wingtips. 27B evoked a typical response. In the first hypnotherapy session, she proved to be an excellent subject. She was able to learn and apply relaxation techniques and imagery to reduce her headaches. Over the next several months there was a dramatic reduction in her pain and need for emergency room visits. However, as her treatment progressed, her case became much more complex. Following the first hypnotherapy session she recalled a long and traumatic period in her childhood involving sexual abuse by her father. She also became aware of post-amnestic episodes when she would suddenly find herself outside a bar dressed in provocative clothing. Eventually she reported being aware of voices in her head telling her to do socially unacceptable things. At that moment, her voice and behavior changed, adopting one of several multiple personalities. In one therapy session she suddenly spoke in a deep, threatening masculine voice as she assumed the identity of one of her early male abusers. Eventually, she recalled a history of terrifying child abuse in a religious cult where she said she witnessed human sacrifice, mutilation and the burning of babies. She was given the Rorschach followed by the 20-card of the SIS-I. Her Rorschach responses were: I. “A face with eyes and nose. Part of this smile is covered by a black mask.” Here content analysis revealed she has internalized the image of a masked man. Historically, this represented the male leader of the cult that abused her in childhood. II “It’s a face. Above the eyes are red figures. The head must be hurting. He is shouting out in pain.” The person perceived represented a direct projection of one of her male altars personalities who experienced the painful headaches. III “It’s the figure of a person with long black arms. His head is split in two. The eyes are covered with dark sun shades”. In this response sequence, she continued to project one of her male personalities. Seeing the “head split in two, is interpreted as a direct reference to the “splitting” intensity of her headaches at a somatic level. At a psychic level it reflects ego splitting one of her male personalities. IV “Just a very dark looking mask.” Here she was able only to see blackness with weak, undifferentiated mask-like form. Application of SIS-I 15

V “A butterfly. Black. Sad to see a butterfly all black.” These are popular response but with added depressive content mirroring her own feelings of sadness and depression. VI “Two persons sitting with backs turned against each other. Above their heads is another butterfly.” VII “Two elephant faces not looking at each other. Above their heads is another butterfly.” VIII “Two pink cats walking down. Blue butterfly with square wings”. IX “Two narrow eyes being hidden by pink, blue and orange masks. The eyes are sad. He wants out.” The theme of a masked person recurs with added content suggesting depression and a wish to escape or relieve the depression. It represents one of her repressed personalities that is sad for lack of expression in her behavior. She responded in a brooding, threatening masculine voice. X “Every object has a partner, two of everything.” Aspects of the inkblot are personified and split in two. Her responses to the 20 SIS-I cards: 1. “A spook with distorted eyes. Face of animal with eyes and horns. Red looks like birds”. The spook represents the face of a past abuser. She was fearful of birds. In a phobic way she insisted upon the removal of a picture of an eagle from the interviewer’s office. 2. “Somebody’s head has been cut off. Somebody laughing, a get even type of laughter”. She viewed a mutilation scene involving the motive of revenge. This is consistent with childhood cult abuse and certain of her murderous personalities. 3. “Two people. A man and a woman. The red blotches represent pain, close to the chest and heart, hurting pain”. Her perception of the red central objects as pain close to the chest and heart represent a direct projection of her own conversion pain, related more to her chest than her head. 4. “A person, probably a male, and a red apple”. She again projected male identification. For her, female body images were to be avoided because of their threatening association to her long childhood history of sexual abuse. 5. “A swimming turtle, two dots, little children and a heart.” These are unremarkable responses. 6. “An animal trapped in an enclosure. They can’t get out. A person standing on a heart. The reference to an animal trapped reflects a statement of how she feels when multiple personalities speak to her in her head. 7. “An animal sitting with feet. A llama. The heart is red. Some poor animal hurting”. She projected her pain onto the image of the animal hurting. 16 Cassell et al

8. “Seahorses. A rib cage and heart. A heart split in two instead of one." Her reference to the “heart split in two” described her own mental splitting. 9. “Two masses, inside, joined by something in common. The bottom looks like a knife.” She repressed the anatomical content because for her urogenital imagery is especially threatening. Her projection of the response “knife” is clinically significant. Prior to viewing the SIS image she had awakened from sleep on one occasion with a knife in her hand. She was completely unaware of how or why she picked it up. During this phase several of her personalities were both suicidal and homicidal. 10. “Lips, red running from lips. A snake.” 11. “Red colors”. 12. "Someone trapped in a red mask. Two faces on either side, one angry, the other dazed”. Her responses continued the theme of being trapped and masked. She projected anger onto one face and confusion on the other. “A beetle chopping away”. 14. “A dark demon with two eyes” (top). A tiny cross at the bottom. A face with no eyes or eyebrows”. Because of her past sexual abuse she repressed vaginal imagery. Non-anatomical symbolism defended against this aspect of her self and involved negative connotations. The dark demon symbolizes certain of her personalities, which act out sexually. After such episode she would find herself standing out side a bar “dressed like a hooker” and be entirely amnesic about her sexual behavior. Another of her personalities was flirtatious and would attract a large following of men at cocktail parties. 15.“ Little faces staring up at each other. Eyes. The base support” (bottom). She repressed the spinal content because of the association of the spine with sexual activity during intercourse. Non-anatomical defensive material represents projecting of the faces of her multiple personalities. “A face with two eyes and a nose”. 17. “A skeleton part. The vertebrae and pelvic area. There is also a face with white eyes and a mouth.” She added the comment: “I don’t like it. It makes me depressed.” 18. “Mountain cliffs and a man looking over people standing”. The people standing reflect her multiple personalities. 19. “Masks, carnival, Halloween.” The mask theme continues. She introduces the concept of Halloween, with implications of monsters, ghosts, frightening costumes, and a cult ritual holiday she may have associated with her traumatic child ritual abuse. 20. “The Devil himself, eyes and horns, the mouth wide open like he wants to say something or scream at someone.” One of her inner personalities represented the Devil. It was his screaming at her that frequently produced her headaches. Application of SIS-I 17

The Rorschach and 20-card SIS were later re-administered. The second Rorschach yielded these responses: I. “Pumpkin face, Halloween type face. I like it. Feels like I’m being laughed at. A bad feeling of being watched. I see two birds on either side of a pumpkin face”. At this stage of therapy she was working through her incest trauma. The multiple personality disorder had not yet been diagnosed. II. “Face of a man. Eyes are red, mouth white as if opened, tongue hanging out – it’s red”. Her responses again reflect a threatening man’s face. It was reasonable to postulate it represented the face of the perpetrator of her incest trauma, her father or other adult male cult members. III. “Two female images each holding on to someone’s head. Looks as if they’re pulling on the head. Looks like a red heart or two hearts joined between the females. On each side of the female’s head are red falling objects, falling down.” She avoided male content, possibly defensively because of how males have been threatening to her. “Pulling on the head” may reflect past abuse or it could depict the psychic forces splitting her personality and figuratively pulling her head apart. IV “At first I see a monster face coming towards me, black and scary. Next I see two boot-type shoes on either side of a common object. At this stage of her therapy, her multiples were closer to the surface. In the projective test situation she was unable to view the stimulus objectively.It became animated and moved towards her like in dream imagery. Her ego was less intact and she was moving into a border-line or psychotic position as the terrible extent of her past abuse was beginning to emerge. In retrospect, this brought to mind Freud’s original comments about analyzing a patient with hypochondriacal abdominal pains. When terrible problems come into consciousness he mused philosophically that it might be more humane not to pursue psychoanalysis and leave the patient with less physical suffering, the lesser of two evils. V “Black butterfly, but I also see two objects joined in the middle each wanting to pull away." This represents a direct projection of her early splitting her terrible past from memory. VI “The smaller object at top is having to pull the two larger objects on the bottom. Both of these two larger objects are joined in the middle by a common body. The object on top would like to be rid of his companions”. The theme of splitting continued with symbolic representation of the great psychic tension it causes. VII “Two Indian type girls looking at each other. They each have one feather on their head. They are balancing on the edge of butterfly wings. They don’t want to be together.” The theme of splitting continued. VIII “I see two pink rats walking over on three sets of objects or bodies. In the bottom object I see a scary yellow gold face.” The “set of bodies” reflects the early stage of her ego breaking into multiple personalities. 18 Cassell et al

IX “I don’t like this picture, it frightens me. It’s all messed up like me.” She acquired more insight into the extent of her past trauma and resultant psychopathology. X “Everything in this picture is connected by some common link, I see different objects like two gray insect-type objects at the top looking angry at each other. Two blue spiders. Two Green seahorses. I see blue in the middle, a pelvic type skeleton. There is, however, in the middle an orange wishbone type object. Everything’s very scattered.” This response symbolized the anger and conflict between her inner psyche structures. After taking the Rorschach she completed the 20-card SIS-Ifor the second time and these were her responses: 1. “Distorted face, twisted white eyes, crooked, two red hens, the face is sad.” This response parallels her earlier response. 2. “I see red lips, laughing man at bottom holding his arms wide open. Looks like a bird flapping wings at top of picture.” She failed to make a gestalt of the Inkblot configuration. The splitting reflected inner psychic fragmentation. The theme of being laughed at or tormented continued. 3. “Two objects, one man, the other female, red hearts in between the two, sharing.” This response was more positive. The couple was sharing and there is less pain consistent with less conversion pain. 4. “Red apple at top, male figure at bottom, the male is smiling.” She failed to recognize the female figure, consistent with a poor feminine identity and low self-esteem. She was more comfortable talking with men than women. As therapy progressed it became apparent her mother knew of the longstanding sexual abuse. She recalled hearing her mother’s footsteps near her bedroom door when her father was abusing her. 5. “Looks like a black turtle with red heart, two infants on either side. The one on right is upside down. Two red dots above the turtle look like red eyes”. She continued to euphorize her reaction to red color. Eyes are consistent with her paranoia. 6. “Bottom is a heart, red, with a red man walking on it. Two doves connected or trapped that can’t get out or escape. Two reds on top are eyes looking at me.” These responses projected two of her inner personalities seeking expression. The paranoid theme continued. 7. “Large red heart surrounding in the neck of a llama that’s all dark.” This response reflected her clinical improvement. At this stage of her therapy she experienced less physical pain and wasn’t taking analgesic medication as frequently. “Two dark seahorses eating on someone’s heart.” This response reflected the degree of suffering from her childhood history of abuse. Application of SIS-I 19

9. “Two bodies connected to a lower body with a knife at the end of lower body.” She repressed male imagery because of its threatening qualities. The knife relates to human sacrifice by the religious cult. 10. “Red lips at the top, blood running from lips onto a foreign object”. This represented more direct association to her emphasis on red. 11. “Looks like lower intestines, red, on fire, pain.” This reflected her long past history of lower gastrointestinal symptoms.” 12. This card evoked no response. 13. “In the center I see a black scary object looking at me.” This response associated with one of her internalized “bad” objects. 14. “A little girl in the center with arms open”. She repressed the female genitalia, the area of her past trauma. It showed age regression to the time of the incestuous abuse. 15. ‘Looks like stacks of bones, a spine?” She had less anxiety and identified the spine. Experience with a variety of clinical population suggests that there is less somatic repression and less conversation pain as a person focuses from body to psychic conflicts. 16. “Two faces, dog faces, sticking their tongues out at each other.” This symbolized aggressive feelings. 17. “Black atomic cloud with a sad face, with white in it.” This response reflected hostility and sadness. 18. “Scary face with mouth wide open.” This symbolizes a threatening internalized object. 19. “I see a face again with long eyebrows, mouth open, coming from behind two human type objects trying to hide.” Threat theme continued. 20. “This is also a scary, angry face, with mouth wide open. There is a wishbone above the head.” More of the threat theme. Four years later she was again given the SIS-II booklet form. It was apparent that her headaches were not migraines but rather conversion phenomena arising from conflict between her various personalities and emergence of past traumas to full consciousness. Viewing certain SIS images precipitated and intensified her head pain. She saw 5A as “a monster with giant arms, a heart with a cloud above. It makes my head hurt and gives me an uncomfortable feeling.” On 10A she responded: “It makes my head hurt. It’s a face. I see eyes and it leaves me with a painful feeling.” For image 11B she projected “a nose with sinus pain”. She repressed the picture of the brain on 23B. Onto this painful region, which she perceived as the nerve center of her mental conflicts, she substituted “an atomic bomb explosion”. Symbolically this reflected her terrible past traumatic neurosis. Despite earlier brain repression, on 30B she saw “a brain divided up” directly associating her multiple personalities. Also relative to her multiple identities 20 Cassell et al

was her response to 13A as “lots of hands reaching up for help” and 14A, “monsters fighting over a heart,” the effect of her destructive personalities. For 18A she saw “a skeleton skull with the devil inside, scary.” In a follow up interview, she recalled this was a direct projection of “the evil one”, one of her more powerful identities. On 24A, she saw “a group of people with arms connected”. In the detailed inquiry she related these to a group of five inner personalities who had gotten together to fight the evil one. Some responses related to her trauma and sexual anxiety. Instead of seeing a woman on 7A she saw, “a man with an apple above his head. For 20A, depicting kidneys and male urogenital system, she repressed the male sexual content and saw instead “two Lima beans attached by a hair.” For the spinal picture in 23A she refused to respond and said only that she didn’t like what she saw. She related 14A to the ritual abuse by family members and others in the cult: “The fetus, someone killing the baby”. She saw 27A as “A cut-off breast”. A partial determinant of her response to 14A was that she tried to abort her youngest child at four months. This occurred after her father, in a jealous rage, told her he didn’t want her to be pregnant by anyone else. Some of her responses reflected somatic concerns about areas other than the head. To 28A she responded, “Muscle tendon in pain”. For 13B which depicts the female pelvis she saw “three growths on the stomach” referring to colitis. This involved excruciating recurrent abdominal pain with Diarrhoea. It felt like her “insides were on fire.” For 17B, which lacks somatic structure she saw “a heart” relating to palpitations, experienced when upset. Interestingly, responses to the videotape version of SIS-II images accessed much earlier traumatic memories. 24B elicited memory of a burning baby. She recalled that as a child she witnessed cult ritual mutilation, murder, and burning of babies. The video evoked more painful somatic symptoms (headache) than SIS card or booklet versions or the Rorschach and was more psychologically threatening. Conclusion The SIS-I has been adopted in various countries and has English, Russian and Italian version. The new scoring system is simple and helps researchers and clinicians to find out the changes that have taken place before and after the therapeutic intervention. The new scoring system of the Somatic Inkblot series along with a case report is discussed in the paper. References Cassell,W.A.(1977) Aggressive Imagery and Clinical Symptoms in Schizophrenia, British J. of Proj.Techniques, 16:21-31 Cassell,W.A.(1980) Body Symbolism and the Somatic Inkblot Series. SIS Center, Anchorage(USA) Cassell,W.A.(2001) SIS Exploration of Human Consciousness, SIS J. Proj. Psy. & Mental Health: 9:3-14. Cassell, W.A. and Dubey, B.L.(1997) Somatic Inkblot Series Video/SIS-II Manual. SIS Center, 4501E, 104th Ave, Anchorage, AK-99516(USA). Application of SIS-I 21

22 Cassell et al Cassell, W.A, and Dubey, B.L.(1997) Therapeutic Dream Stimulation with SIS- Video, SIS J. Proj. Psy. & Mental Health, 1997, 4: 3-23 Cassell, W.A, Dubey, B.L.and Gilbert J.Roth (1997a) Medical, Psychological and Spiritual Application of the SIS Inkblots. SIS J. Proj. Psy. & Mental, Health, 4: 89-112 Cassell, W.A, and Dubey, B.L. (1998) Application of Somatic Inkblot Series in Personality Assessment, Screening, Diagnosis and Therapy, SIS J. Proj. Psy & Mental Health, 5:3-32. Cassell, W.A, and Dubey, B.L.(1998) Mental Disorders Triggered by Exposure to Violent Imagery in the Media and in Electronic Games, SIS J.Proj.Psy & Mental Health ,5:87-104 Cassell, W.A; Dubey, B.L.; Molchanov, E. and Roth, L (1999) Stimulating Beacon Images for Meditation and Projective Psychotherapy, SIS J.Proj Psy. & Ment. Health, 1999, 6: (2) 7-30 Cassell, W.A; Dubey, A. and Dubey, B.L.(2000) SIS Projective Responses in PTSD and Dissociative Disorder, SIS J.Proj Psy. & Ment. Health, 2000, 7: 93-108 Cassell, W.A; Illardi, F.J.; A. Collins; Mishra, M. and Dubey, B.L (2001) Optimizing Spiritual Healing by Assessing Dream and SIS Imagery, SIS J.Proj Psy. & Ment. Health, 8:75-94 Cassell, W.A, and Dubey, B.L.(1996) The Use of the Rorschach and SIS in Releasing Somatised Grief. J. Proj. Psy. & Mental Health, 3: 3 -32 De Vos (1952) A Quantitative Approach to Affective Symbolism in Rorschach Responses, J. Proj.Tech and Personality Assessment,36:133-150 Dubey,B.L. and Cassell, W.A.(1993)Some Experiences with Somatic Inkblots-II, British J. of Proj.Psychology,38:,1,19-41 Dubey,B.L. and Cassell, W.A.(1997)Clinical Utility of Somatic Inkblot Series- Video. Perspective in Psychological Researches, 20:10-15 Dubey,B.L. and Cassell, W.A.(1997Application of Somatic Inkblot Series in Personality Assessment and Psychotherapy, Indian Journal of Psychology, 72:73-80 Dubey,B.L. and Cassell, W.A.(2000) Inkblot Responses as an Aide to Therapy, SIS J.Proj Psy. & Ment. Health, 7: 3-10 Dubey, B.L., Cassell, W.A, Pershad D. and Dwivedi,P.(1995) Diagnostic Utility of Somatic Inkblot Series. SIS J. Proj. Psy. & Mental Health,2: 77-84 . Dubey, B.L., Cassell, W.A, Pershad, D and Dwivedi,P.(1995) Diagnostic Significance of the Indices of the SIS-II and the Rorschach Inkblot Tests. SIS J. Proj, Psy. & Mental Health, 2: 165-170 . Dubey, B.L., Cassell, W.A, Dwivedi,P. and Mishra, M.(1995) Inner Cry Through Somatic Inkblot Series. J. of Proj. Psy. And Mental Health, 5, 2: 119-128 Holtzman,W.H.(1956)Inkblot Perception and Personality,University of Texax Press, Texas. Kwiatkowska,H.Y.(1978)Family Therapy and Evaluation through Art. Springfield,IL, Charles C. Thomas. Ulman,E.(1965) A New Use of Art in Psychiatric Diagnosis, Bulletin of Art Therapy, 4:91-116

Profile of Militants : An Attempt to Study the Mind of Militants Lt Col D. Saldanha Thirty one militants who were evaluated through Somatic Inkblot Tests (Cassell, 1980; 1984) and personalized interviews were divided into hard core (67.74%) moderate core (22.58%) and soft core (19.68%) types. They were drawn from 8 recognized militant groups operating in the valley. 74.19% were below 30 years. 61.29% showed hostile and aggressive responses on SIS Test. Concordance rates between psychological (SIS) and intelligence reports were as high as 77.77%. Psychological stress was revealed only in 3.22 %. 67.74% were unlikely to benefit from rehabilitative measures. The usefulness of Somatic Inkblot Test in understanding militant psychology is discussed. The manifestation of militant violence is protean like the ancient sea god Proteus and his constantly changing forms. The subcontinent now has a bewildering variety of militant organizations. Today they have become an almost inalienable part of the human situation. In a world frightened by highly disruptive episodes of collective violence, psychiatrists are asked so often to explain such deviant behavior. In developed countries, society also expects them to predict violence and to help prevent/contain it (Halleck 1980). It has become imperative for the psychiatrist to conceptualize the manner in which violence may be viewed as an aspect of emotional disorder. (Zitrin 1976, Sasowsky 1978). However violence is multidetermined. Biological, psychological and environmental (including socio political) factors play a role in the genesis of violent behaviour. Biological research has focused attention on a number of relevant parameters, which include aberrant cortical activity. However any form of violence may be viewed as a political act, and an attempt to attribute the same to an undergoing emotional disorder tends to negate political meaning of such violence (Halleck 1971). No single theoretical framework can explain the phenomenology of violence. A simple economic principle. Postulates that, violence is likely to result when the perceived benefits of a violent action are greater than the perceived risk of violent action (Halleck 1980). While in deliberate professional crime, the risk benefit ratio may be evaluated at the conscious level. Unconscious mechanism too appear to be employed in many violent acts. The perpetrator of violence is not always a rational person, and quite often violence does not serve the interests of the violent person, who may be unable to make an accurate or adequate assessment of the risk benefit factor owing to impaired perception. Impairment of the reality function of the ego perhaps is the single most significant determinant in such a situation. The benefits of violence, real or perceived are; (i) Gratification of emotional needs, (ii) Power and control over others (iii) Territory and wealth (iv) Relief from oppression and (v) Increased self-esteem (Meninger, 1963, Abel et al, 1977, Macdonald 1968, Sullivan 1970, Wolf gang 1961). Biological factors like, higher levels of androgens appear to be Lt. Col. D. Saldanha, Addl. Adviser (Psychiatry), Military Hospital, Meerut-250001

24 Saldanha associated with increased rates of violence (Fields, 1975). Impaired cerebral function resulting in Organic Brain Syndrome (Ellicit , 1978) and drug intoxication often interferes with the individuals capacity to assess external reality and to evaluate the benefits of violence. The high correlation between alcoholic intoxication and violent behaviour is probably in large due to poor risk of perception. The impairment of the reality function thus appears to play a significant role in the genesis of violence. It is in this background that a study was conceived to find out : (a)the unconscious aggressiveness and hostility that is directed towards the Nation in general (b) the mind set of the militants towards rehabilitation (c) predictability of the psychological tests vis- a- vis interrogation reports (d) to suggest possible remedial measures which may help in Anti-National Elements (ANE’s) rehabilitation programme / indoctrinating. Material and Methods Material The study was carried out at Srinagar, (Jammu & Kashmir) from Oct 93 to Oct 94. 1. 31 Militants who were confined to high security prison were taken into the study. 2. Cassell’s somatic inkblot Series -I (20 cards) and Series II Video A and B (62 images) were used to measure their responses. Methods 1. Militants at random in small groups of 5 to 6 were shown SIS series video Images A and B. 2. Those who completed the video test were given SIS series 1-20 cards and then the images were reviewed. 3. A brief psychological history was taken before subjecting the individual to a detailed assessment of the responses given. Their reaction towards the test and rejection of the images was noted. 4. Once the tests were completed the responses were tabulated to see the member of rejection of the cards SIS –I and SIS –II video images A and B on their responses, they were then classified into three groups as under :- Rejection of the cards SIS- Series-I, Series-II A & B core groups. > 10 rejection of the cards in series I > 15 (A) > 15 B HC > 5 to < 10 > 10 < 15 > 10 < 15 MC < 5 < 10 < 10 SC 5. Aggression & Hostility scales were used to find out the aggressive tendencies & their possible reaction towards rehabilitation.

Results and Observations Total number of ANE’s (Anti-National Elements)and the numbers analysed are shown in Table 1 & 2 i.e Their mean age was 28.35 with age range 18 to 68. 74 % were below the age of 30 years. Table 1 Number of Mean of ANE Subjects Total of ANE’s in R & D center : No Volunteered for the tests : Tests completed : Drop outs : Mean age : 28.35 Age Range : 18 to 68 yrs Table 2 Age Profile HC MC SC Total - 09 ] 74.19% 21 – 30 14 ] 31 – 40 - 04 ] 25.81% 04 ] Total Mean 28.6 years 27. 85 yrs 35.66 yrs Table –3 Shows the group affiliation. Majority who underwent psychometric tests were from HM group. Probably they made the largest group among the militants. (38.71%) No. of days in the R & D center ranged between 26 to 341 days within a mean of 149 days. Table 3 & 4 shows the group designation and type of militants. Majority of the hard core type belonged to HM, JKLF and Alzehad (64.52%). Profile of Militants 25

Table 3 Group Affiliation of Militants Group Affiliation : (N= 31) HM : (38.71%) JKLF : (16.13%) Alzehad : (9.68%) JMJT : Harkat Ul Ansar : Jamait Islami : (35.48%) MM : Al Umar : No group : -------- ------- No of days of imprisonment , Mean 149 days, Range 26 – 341 days Table 4 Groups Designation and Type (N=31) HC MC SC HM N = 12 (38.70%) - JKLF N = 05 (16.13%) - Alzehad N = 03 (9.68%) - - Others N = 11 (35.48%) Table 5 Marital Status ( N –31) HC MC SC Unmarried 19 (61.29%) Married 12 (38.71%) HC = Hard Core, MC = Moderate Core SC = Soft Core 26 Saldanha

Their education level is shown in Table-6. 54.84 were below 9th standard, 38.71 % passed 10 th standard and only 6.45% were graduates. 83.89 % were from large families. The family size ranged from 3 to 12 children (Table–7). Table-8 shows the level of motivation that is inherent in the groups. It is as high as 74.129%. 91.67% of HM militants belonged to the volunteer group which clearly shows their dedication to the militancy. Concordance rates ( Table 9) between the intelligence reports and the psychometric tests is 77.77%. If one adds the MC group i.e 11.11 %, then the percentage rises to 88.88 % which is very significant. Table 6 Education Level N = 31 HC MC SC Total Illiterate - - - - 9th Std 17 (54.84%) 10th Std 12 (38.71%) Graduates - - 02 (6.45%) Table 7 Family Size N = 31 HC MC SC Total 4 Sibs 05 (16.13%) 4 Sib & more 26 (83.89%) Range 3 to 12 Table 8 Level of Motivation Groups Volunteers Non Volunteers HM JKLF Alzehad Others Total (74.19%) (25.81%) Profile of Militants 27

Table 9 Concordance Rate Between Psychological and Intelligence Reports Psychological assessment done N=31 Intelligence Reports made available N=18 Concordance rate N=14 ( 77.77 %) Non Concordance N= 04 ( 22.23 % ) MC can Switch to either side N = 2 ( 11.11 % ) The militants show hostility and aggression during the psychometric tests in the form of hostile responses and sexual responses (Table –10 and 11). A significant number is in the HM group (66.67%). Table10 Hostility and Aggression (N=31) Scale Total HC MC SC 6 to 10 19 (61.29%) 3 to 5 09 (29.1%) - Table 11 Hostility and Aggression Group wise 06 to 10 03 to 05 0-03 HM (N=12) 08 (66.67%) 02 (16.67%) 02 (16.67%) JKLF (N = 5) 02 (40%) 02 (40%) 01 (20%) Alzehad (N = 3) 03 (100%) - - Others (N= 11) 06 (54.56%) 05 (45.45%0 - Total 19 (61.29%) 09 (29.03%) 03 (9.68%) Table 12 Psychological Stress HM JKLF ALZEHAD OTHERS Severe - - - - Moderate - - - - Mild - - - Total (3.22%) - - - - 28 Saldanha

Table 13 Rehabilition (N= 31) HM JKLF Alzehad Others Total Unlikely to benefit ( 64.74%) = 21 Likely to benefit - = 10 Table 14 Drug Intake Hard Core (HC) N = 21 Moderate Core (MS) N = 07 - Soft core (SC) N = 03 - Total 02 (6.45%) It is strange that psychological stress is not seen contrary to expectations. It is as low as 3.22 %b (Table –12). The overall picture of psychometric analysis is reflected in the Table – 13 which shows those who are likely to benefit out of rehabilitation (i.e 32.25 %). Drugs don’t seem to play a major role in violent acts with the present militants (Table – 14). Discussion When ever an individual is subjected to a psychological test the immediate reaction is one of non-cooperation. This is more so in the case of militants. A reliable method therefore had to be evolved to make the militants co-operate fully. To achieve this a distant psychometric analysis was undertaken. Cassell’s Somatic Inkblot Test (Cassell, 1980) proved to be useful is assessing their psychological state. Somatic Inkblot images have proved that they can bring out the “ inner cry ” in an individual that is hidden not only from others but often from one's own conscious awareness. This is the unique, distinguishing feature of projective tests so elegantly demonstrated by the genius of Herman Rorschach and Cassell. The Inkblots bring to the fore whatever is buried in the mind closer to consciousness, which is accessible for processing and identifying the personal problems as well as mental disorders. By developing a practiced eye and ear for the imagery, a therapist can directly share the perceptual world of the patients with less interference, fewer variables than the structured interview of the so called “ paper and pencil ” test. If the saying goes 'A picture is worth a thousand words' Inkblots are picture recognition tests and are potentially more powerful than verbal interviews and tests. Rejection of the cards/images was taken as a guide, solely with the idea that an individual who is a militant is suspicious of the intention of the tester. Theoretical Profile of Militants 29

constructs related to the unconscious, symbolism and the body ego is clearly brought out by the somatic inkblots tests. It is difficult to categorise each militant into a black or a white grade type (as done in intelligence reports) as there are some who do not fit in either of these two categories. There are few who fit in a middle group who can switch either to the black (hard core) or the white (soft core) variety. Group affiliation characteristics of militants clearly bring out three groups. They are :- (a) Soft Core : Immature, Dependent, Aimless, Weak ego strength, Suggestible,Likely to breakdown if stressed. Uses gun as a phallic symbol, Increased self esteem through illusion of power. (b) Moderate Core : Emotionally labile, Fantasizing, Romantic, Dependent, Yarning for martyrdom, Rationalizes his acts because of weak ago. (c) Hard Core : Impaired ego, Sociopathic, Hard to Moderate, Fighting for a cause, Power hungry. Cassell’s Inkblot Test helped to delineate the militants into the three groups. This was done solely on the number of rejection of the cards/images and the No. of hostile responses given on the cards (series I & II ) If the number of cards/images rejection were more than 45 out of 82, they were designated as hard core type and those between 35 to 45 were grouped into moderate group, the remaining belonged to soft core type. These were later compared with intelligence reports that had designated each militant into a black (Hard core) and a white (Soft- core) category. The concordant rates were high as 77.77% (Table–9). Hostility can be reflected in projective responses involving physical assault or body injury. The hostility aggression scale is a four –point scale similar to that of Holtzman (1956). This has been used in the current study (Table 10 and 11). The number of sexual responses given by the individuals also supplements it. There is a relationship between sexual and aggressive behaviour and this in most apparent in animals. Neurophysiologically the relationship can be explained by the fact that stimulation of certain areas of the brain causes penile erection and aggressive behaviours (Cassell 1980). For the human male in contemporary society, any such social or sexual behaviour will lead to very serious problems. Suppressed aggressiveness comes to the core in the projective imagery through the SIS. Over all the hostility and aggression in the imprisoned militants is shown to be 61.29 % (Table-11). Table-10 shows that 4/7 and 1/3 moderate and soft core showed significant hostile aggressive responses. It can be predicted that these five (5) militants can switch over to hard core type given the chances (i.e Black type). In similar terms one of the hard core may eventually turn out to be a moderate or soft – core. It is not necessarily true that every individual who is confined to a cell shows mental distress. The fact that only 3.22% showed such mental distress indicates that they are contented with the treatment given by the armed forces. It also shows that they have faith in the system that they will be released. This is a fact, which was brought out in the personalized interviews. 30 Saldanha

This study brought out the following relevant facts. (a) Unemployment & corruption are the driving force behind militancy. (b) Majority of the militants are young below the age of 30 yrs unmarried, under matric, came from a poor socio-economic status and large families. (c) Militants are not psychologically distressed in captivity. (d) Psychological indoctrination following their induction is very good, hence they are unlikely to benefit from rehabilitation measures (67.74%). (e) Most of them talked about corruption, the rich having gotten richer and they having been denied their dues. The gun is found to be emotionally and financially gratfying, as it gives power and relief from oppression. Unlike the foreign mercenaries, fired by Islam who call themselves “holy warriors” , the interviews and the tests showed that religion is not high on the list of motivating factors. (f) Family background shows majority are under matric (54.84%) and with larger families (*3.89%). This has lead to a feeling of being under privileged. The gun has become the compensation mechanism for these. From the manner in which they admitted to killings/involvement in violent acts in interviews, it is clear that they enjoyed the taste of blood/power. (g) Psychological indoctrination, which is shown by motivation factor i.e 74.19% is a matter to be taken note of (23/31). Admitted hardened by violence and criminal activity, indicated militancy had become a profession they were pursuing with zeal. They found more emotional bonding within the militant gangs rather than their families, in the event of their getting arrested or killed. (h) Alienation factor plays an important role in militancy. This is more so due to the attitude shown by para military forces as revealed by some militants. For them the security forces remain the aggressor or tormentor. People being hostile towards security forces to some extent, this serves as a great morale boost to the militants to continue their Terrorist acts. (i) Unemployment seems to be the bane of violence as reflected by the level of education and young age of the militants. (j) Drugs in effect do not play a significant role in perpetuation of violence as is led to believe. (k) The success rate of delineating a terrorist into a black and white is 77.77%. This is significant. (l) Psychometric tests can throw light on various grades of militants. (m) The average Kashmeri militant does not consider himself a holy warrior i.e religion is not an important motivating factor. (n) The gun is primarily seen as a weapon to fight a corrupt system. (o) Financial hardship is a major consideration since militant organization look after the families of those arrested or killed. (p) The Pakistan trained militants are far more hard core than those trained locally. Profile of Militants 31

(q) Family ties have become irrelevant since these men seen to find more emotional bonding within the militant fold. Conclusion To date clinicians and behavioral scientists have had very little success in predicting future criminal or assaultive behaviour’s based on either experience or psychological tests. There appears to be a pressing need for a new assessment technique to improve the predictive aspect of psychiatric and psychological assessment. Somatic ink blots tests used in this study appears to contribute in this direction. Reference Able, G.C., Barlow, D.H., Blanchard, E.B. and Guild, D, (1977) The Components of Rapist’s Sexual Arousal, General Psychiatry. Cassell, W.A., (1980) Body Symbolism and the Somatic Inkblot Series, Ed I. Aurora publishing Co., 213 West Sixth Avenue suite 8 Anchorage, Alska 99501. Cassell, W.A., (1984) SIS-II Video Test. SIS Center, 4501E, 104th Ave, Anchorage, AK99516 (USA). Ellicit, T.A. (1978) , Neurolgical Factors in Behaviour, Violence and Responsibility, Sadoff R Editor, Spectrum, New York,. p 50. Fields, W.S. and Sweel W H, (1975) Neural Basis of Violence and Aggression. Warren & Green ,St Louis. Halleck, S. (1980) Social Violence and Aggression, Comprehensive Text book of Psychiatry . Kaplan HI Freidman AM, Saddock BJ, Editors Willimas & Wilkins Baltimore, p 3149- 3154. Halleck, S. L., (1971) Politics of Therapy. Science House, New York. Holtzman, W.H. (1956) Inkblot Perception and Personality, University of Texas Press, quoted in Body Symbolism by Cassell W A Capter 8 Aggression p 127-128. Mac Donald, J. (1968) Psychiatry and the Criminal, Charles C Thomas Springefield, Illinois. Meninger, K. A. (1963) The Vital Balance, Viking Press, New York. Sasowsky, L. (1978) Crime and Violence among Mental Patients Reconsidered. American Journal of Psychiatry 33: 135. Sullivan, R.T., ( 1970 ) The Economics of Crime An introduction to Literature, Crime and Delinquency, 138 P 23. Wedge, B. (1976) Psychiatry and International Affairs, Science,77 p 157. Wolfgang, M.E., Ferracuti. F. (1961) The Subculture of Violence, Aldine Publishing CO, Chicago. Zitrin, A., Hardesty, A.S. and Burdock, B.L., (1976) Crime and Violence among Mental Patients. American Journal of Psychiatry, 33 : 133-142 32 Saldanha

Ajai K. Srivastava, Ph.D. Psychiatric Social Scientist, Institute of Mental Health and Hospital, Agra. E-mail : imhh@sancharnet.in Somatic Inkblot Series -I : A Meta Analysis Ajay K. Srivastava The findings of the studies on SIS-I was meta analysed with the aim to provide normative data by combining mean and standard deviations of existing studies and to see if SIS-I indices can differentiate various groups. All the studies published in SIS Journal of Projective Psychology and Mental Health from 1994-2001 (January) were considered for the present study. the studies were pulled into four groups on specific inclusion criteria : Normals, Coronary Heart Disease, Generalised Anxiety Disorder and Schizophrenia. Critical ratio were computed on combined mean and standard deviation for intergroup comparison. The results revealed that the SIS-I indices significantly differentiate the comparison groups. Projective test came into existance in 1921 in the form of inkblot tests as a result of Rorschach's innovative efforts. Inkblot is an important projective test being used all over the world by professionals for psychodiagnostic purposes. As an extension of traditional inkblot technique, Cassell (1959) developed Somatic Inkblot Series (SIS). Five forms of the SIS test are available : SIS-I (20 cards set), SIS-II (62 images booklet), SIS-video, SIS-I video and SIS living images. There are many reports reflecting its diagnostic and therapeutic efficacy and clinical significance in understanding the problems of the individuals. Normative data have been prepared for different version of SIS. A review of literature revealed that SIS-I was the least preference among the researchers as compared to SIS-II. Fourteen studies on SIS-I appeared in SIS Journal of Projective Psychology and Mental Health since its inception. The details of the studies are given in Table-1. It is evident from the table that some are case reports and some studies have been done on small samples. Most of the studies have compared two groups. The present study have been planned with following objectives : Objectives i) To provide normative data on SIS-I indices by combining mean and standard deviation of existing studies across groups. ii) To compare the combind mean and standard deviation to see if SIS-I indices can differentiate various groups. Method In 14 studies on SIS-I about 28 groups have been studied. Some of the groups are common in the studies. Out of 28 groups 9 were selected for meta analysis on the basis of following inclusion criteria : 1. Specification of global / specific diagnostic entity for clinical groups. 2. Large sample size after pooling the studies for an entity. 3. Availability of mean and standard deviation and 4. Studies on adults only.

34 Srivastava Table 1 Details of Studies on SIS-I Published in SIS Journal of Projective Psychology and Mental Health from 1994-2001 (January). Sr. Authors Year Page Groups Studied N Whether Whether Code No. No. Reported Reported Mean SD 1. Rathee, Goel 1994 Coronary Cases Yes Yes B Chawala, Normal Adult Yes Yes A Saldanha & Dubey 2. Sahay and 1994 Male Transexual No No R Srivastava 3. Mukhopadhya, 1996 Heroin Addict Yes No R Bannerjee & Brown Sugar Addict Yes No R Mishra Tidigesic Addict yes No R 4. Rathee and 1996 Male normal with No No R Singh Army background Famale Normal with No No R Army background 5. Mitra and 1996 Heroin Addict No No R Mukhopadhya B. Sugar Addict No No R Tidigesic Addict No No R 6. Cassell & Dubey 1998 Psychiatric Case No No R 7. Sguazzin Cinzia 1998 Females with obesity No No R & Ferro Roberto 8. Banerjee, 1998 Heroin Addict Yes Yes R Mukhopadhya Normal Yes Yes A & Singh 9. Khromov, 1999 Normal Russian Female Yes Yes A Cassell & Normal American Male 168 Yes Yes A Dubey 10. Sarkar, Rathee 1999 Generalised Anxiety Yes Yes C & Neena Disorder 11. Mitra & 2000 Drug Addict % Mean % SD R Mukhopadhyay Normals % Mean % SD R 12. Paola Nicolini 2000 Migrain No No R Tensive Cephalgia No No R Normal No No R 13. Kumar, Singh 2001 Schizophrenics Yes Yes D & Mohanty Normal Yes Yes A 14. Khromov 2001 Achondroplasia Yes Yes R Traumatically Shortened 18 Yes Yes R extremties Normal Yes Yes A Code : A, B, C and D are included in meta analysis. R = Rejected C = Generalised Anxiety Disorder A = Normals D = Schizophrenia B = Coronary Case N = Sample Size

Table 2 Combined Mean and SD on SIS Indices among Different Groups A B C D Highest Normal Coronary Heart Disease Generalised Anxiety Schizophrenics to Lowest Indices Mean SD N Mean SD N Mena SD N Mean SD N order 1. Total Response 27.55 7.10 23.18 4.81 20.50 7.16 20.00 3.57 ABCD 2. Movement 5.41 5.46 -- -- -- -- -- -- 1.03 1.38 AD-- 3. Human 4.71 3.14 3.26 1.80 3.98 1.93 3.66 3.48 ACDB 4. Animal 7.42 4.89 4.10 2.02 5.32 3.76 5.78 3.43 ADCB 5. Anatomy 8.69 6.39 6.02 2.45 5.30 3.97 3.31 3.38 ABCD 6. Sex 1.70 1.90 1.72 1.31 2.36 3.21 0.19 0.53 CBDA 7. Rejection of images 2.41 2.85 4.25 2.06 4.90 3.68 2.44 2.46 CBDA 8. Most Typical 7.66 6.97 -- -- -- -- -- -- 1.47 1.44 AD-- 9. Typical 16.56 5.41 -- -- -- 8.76 4.09 10.97 3.42 ADC-- 10. Atypical 6.63 3.77 -- -- - -- -- -- 7.56 4.26 DA-- Meta Analysis 35

Table 3 Comparision of Different Groups on SIS-I Indices Indices Normal Normal Normal CHD CHD GAD Vs Vs Vs Vs Vs Vs CHD GAD Schizo GAD Schizo Schizo (A vs B) (A Vs C) (A Vs D) (B Vs C) (B Vs D) (C Vs D) Total Response 6.33* 5.88* 10.07* 2.31* 3.79* 0.42 Movement -- -- 9.73* -- -- -- Human 5.37* 2.28* 1.64 2.14* 0.62 0.75 Animal 8.97* 3.50* 2.45* 2.10* 2.58** 0.58 Anatomy 5.80* 5.06* 7.69* 1.14 4.11* 2.43** Sex 0.11 1.40 10.79* 1.33 9.00* 4.62* Rejection of Image 5.94* 4.53* 0.06 1.12 1.62 3.62* Most Typical -- -- 11.90* -- -- -- Typical -- 6.61* 4.95* -- -- 2.66* Atypical -- -- 1.18 -- -- -- 36 Srivastava

Table 4 Significant SIS-I Indices in Comparision Groups Comparison Groups Indices Normal Vs Coronary Disease Total Response, Human, Animal, Anatomy and Image Rejection Normal Vs Generalised Total Response, Human, Animal, Anatomy, Anxiety Disorder Image Rejection, Typical Normal Vs Schizophrenic Total Response, Movement, Animal, Anatomy, Sex, Most Typical, Typical Coronary Disease Vs Total Response, Human, Animal Generalized Anxiety Disorder Coronary Disease Vs Total Response, Animal, Anatomy, Sex Schizophrenia Generalised Anxiety Anatomy, Sex, Image Rejection, Typical Disorder Vs Schizophrenia Conclusion The results of meta analysis of different groups clearly indicate that SIS-I can be safely used as a diagnostic tool. It is suggested that more psychiatric disease entities should be studied so that the data may be available for the use of professional in the field. Reference Garrett, H.E. (1966) : Statistics in Psychology and Education. Bombay : Vakils, Febber & Simons Ltd. The groups with code No. A, B, C & D (Table-1) were included in the analysis and the groups with code No. R were rejected. The groups meeting inclusion criteria were pooled into four groups (1) Normal (Code A), (2) Coronary heart Disease (Code B), (3) Generalised Anxiety Disorder (Code C), and (4) Schizophrenics (Code D). For analysis, combined mean and standard deviation of the groups were computed applying formula No. 3 and 17 respectively reported in Garret (1966). For intergroups comparison, critical Ratios were computed on the combined mean and standard deviation. Results and Discussion The combined means and standard deviations of different indices of SIS-I have been presented in Table-2. The results of different indices among various comparison groups are given in Table-3. It is observed from table-3 that most of the SIS-I indices differentiated various comparison groups. It indicates that each individual indice is potent in discriminating the groups. Some of the studies did not report normative data for typical, atypical, most typical and movement responses. These indices are essential for exploring important characteristics of the different diagnostic entities. It is suggested that researchers in future must incorporate the data on these indices. The results of analysis reflects that there is need for normative data on different disease entites on larger sample. Statistically significant indices of SIS-I differentiating various comparison groups are elaborated in Table IV for ready reference. Meta Analysis 37

Diagnostic Value of SIS-II Among Sub-Groups of Psychotic and Neurotic Patients of Armed Forces. S. P. Rathee, P.K. Pardal and T. R. John The present study intends to assess the diagnostic value of Somatic Inkblot Series-II (SIS-II) among sub groups of psychotic and neurotic patients. The SIS-II was administered on each patient individually, following the standard procedures (Cassell and Dubey, 1997). The findings reveal that total number of Responses; Atypical and Pathological responses were able to discriminate among subgroups of Psychotics. Likewise, R, MT, Atypical, Movement, Rejection of Images Human, Animal and Sex responses were able to discriminate among subgroups of Neurotics. The Test Comments of both groups of psychotics and neurotics proved to be more useful to understand their underlying psychopathology. The patients with less disturbances liked the test and felt comfortable while reacting upon it’s images, as compared to patients with more disturbances. The SIS Profile can provide a lot of help in diagnosis of various categories of psychosis and neurosis. The diagnostic and clinical utility of Somatic Inkblot Series among psychiatric and nonpsychiatric patients and normal subjects have been found very high in various studies (Rathee, et.al., 1995, Dubey, et. al., 1995a ).But there are very few studies, where patients suffering from sub-group of Psychosis i.e. Schizophrenia, Affective Psychosis, Paranoid states, Alcoholic Psychosis and Drug Psychosis and Neurosis like Anxiety, Depression and Dissociative Reaction, etc. have been compared. However, few studies have included some major groups like Schizophrenia, Depression, Obsessive Compulsive Disorder and Anxiety (Cassell, 1977; Dubey,1995; Mishra, 1995). There is hardly any study, which has included other groups like Affective Psychosis, Un-specified Psychosis in addition to Schizophrenia in Psychosis and Dissociative Reaction and Anxiety state in Neurosis. Considering the felt need and paucity of such research work particularly in military set-up, the present study was initiated to assess the diagnostic value of Somatic Inkblot Series –II among these sub groups of Psychosis and Neurosis. The present study was planned: 1. To find out the diagnostic value of Somatic profile of SIS -II among three sub groups of Psychosis i.e. Schizophrenia, Affective Psychosis and Un-specified Psychosis. 2. To find out the diagnostic value of Somatic profile of SIS –II among three sub groups of Neurosis i.e. Anxiety State, Depression and Dissociative Reaction. Material and Method The present study consists of 200 patients, 100 each of Psychosis and Neurosis. They were further divided into 3 groups of Psychosis viz Schizophrenia (30) Un-Specified Psychosis (30) and Affective Psychosis (40) and 3 groups of Neurosis viz. Anxiety (30) Depression (30) and Dissociative Reaction (40). They were in the age range of 20 – 50 S. P. Rathee,Ph.D. Clinical Psychologist, P.K. Pardal, M.D. Psychiatrist and T. R. John, M.D. Psychiatrist, Command Hospital, Chandimandir-134107 (India)

years, educated from Middle standard to Graduation level. They were belonging to the ranks of Sepoy to Officer. All of them were fresh and symptomatic cases diagnosed by Psychiatrist, following a standard criterion in vogue. The Psychiatrist initially examined the psychiatric patients satisfying the inclusion criteria. The need and objectives of study were informed. The patients who were found fully co-operative under present conditions were administered SIS-II individually, following standard procedures of administration.(Cassell and Dubey, 1997). The SIS-II protocols were scored on four main categories which were (i) Quality of response, consisting of total Responses, Most Typical, Typical, Atypical, Pathological, Movement responses and Rejection of images (7), (ii) Contents of responses consisting Human, Animals and Sex (4), (iii) Pathological responses which were scored on four rating scales, (a) Pathological Anatomy Scale (b) Hostility Aggression scale (C) Depression Scale and (d) Paranoia Scale (4). (iv) The last category was consisting of Test Comments (a) three images liked the most, (b) three images liked the least (c) perception of the test and (d) feeling after completion of the test (4). Statistical Analysis The Mean and SD of each categories of SIS-II were calculated along with, then percentages of each variable (out of total number of responses). The significance of mean difference was done using CR values of each categories of SIS-II among three sub groups of Psychosis and Neurosis. The results thus obtained are discussed in the paper. Results and Discussion Part - A After scoring of SIS-II protocols of three sub groups of Psychosis and Neurosis on the basis of four major categories i.e. quality of responses (7), contents (4), pathological responses (4) and test comments (4). Their significance of mean difference was seen on the basis of their CR values (t- test) on each variable. The obtained results are shown and discussed ahead. Table I reveals that out of 7 quality of response variables, three were found to discriminate the patients of three groups significantly. The patients suffering from active psychosis were found to give more number of responses (M =61.65) as compared to those of Un- Specified Psychosis; however, most of their responses (26.11%) were atypical in nature, as compared to other two groups i.e. Schizophrenia and Un-Specified Psychosis (18.4 and 18.07 % respectively). The ‘pathological’ kinds of responses were observed to be hardcore indicators, which could discriminate among three groups. In fact, these patients being much away (psychologically) from their normal counterparts produced more of pathological responses due to their behavior pathology. The psychiatric patients have been seen to produces low number of responses due to their disturbed somatic awareness and social withdrawal. The findings are confirmatory to previous observations (Dubey and Cassell,1993; Rathee, et. al., 1995; Kumar, et. al., 2001). SIS-II in Psychiatric Cases 39

40 Rathee et al Table 1 Significance of Mean Difference of Quality of Responses among Three Sub - Groups of Psychosis : Quality of Schizo- Affective Un-Specified Responses phrenia Psychosis Psychosis CR-Values (n: 30) (n: 40) (n: 30) A % B % C % Total M 50.20 61.65 52.8 A&B : 1.43 Responses B&C : 2.29* SD 15.98 15.36 16.4 C&A : 0.81 Most M 10.33 10.87 11.66 A&B : 0.69 Typical (18.38) (17.63) (22.09) B&C : 0.97 Responses SD 3.21 3.30 3.41 C&A : 1.55 Typical M 17.4 20.6 20.46 A&B : 1.64 Responses (30.96) (33.41) (38.15) B&C : .21 SD 8.04 8.15 7.74 C&A : 1.65 Atypical M 10.33 16.1 9.54 A&B : 4.43** Responses (18.4) (26.11) (18.07) B&C :6.20** SD 6.37 3.76 4.8 C&A : 0.54 Path. M 7.93 5.7 4.26 A&B :3.50** Responses (14.12) (9.24) (9.22) B&C : 2.71** SD 2.82 2.39 2.06 C&A :5.76** Movement M 4.26 4.60 3.23 A&B : 0.04 Responses (7.58) (7.46) (6.12) B&C : 1.34 SD 3.26 3.35 4.57 C&A : 1.00 Rejection M 12.2 11.45 14.3 A&B : 0.72 of images (19.68) (18.47) (23.06) B&C : 0.92 SD 12.2 9.94 14.5 C&A : 0.61 ** CR values significant at .01 level , * CR values significant at .05 level. Percentages are from total number of responses and images. Table 2 reveals the diagnostic significance of contents of responses on SIS-II. It can be observed that out of 4. Human and Animal contents were found to discriminate among the three groups of Neurosis. The normal subjects tend to see more of Most Typical, Typical, Human, Anatomical and Sex responses. Since, psychiatric patients are mentally disturbed and keeping unhealthy interpersonal relations they have given low number of Most Typical and Human responses.

Table 2 Significance of Mean Difference of Contents of Responses among Three Sub Groups of Psychosis : Contents Schizo- Affective Un-Specified of Responses phrenia Psychosis Psychosis CR-Values (n: 30) (n: 40) (n: 30) A % B % C % Human M 16.8 17.76 16.9 A&B : 0.51 (29.89) (28.80) (32.0) B&C : 0.42 SD 6.0 9.65 7.35 C&A : 0.05 Animal M 6.4 6.65 6.56 A&B : 0.22 (11.39) (14.03) (12.42) B&C : 0.08 SD 4.4 3.84 4.95 C&A : 0.13 Anatomy M 7.16 8.65 9.23 A&B : 0.30 (16.3) (14.03) (17.48) B&C : 0.37 SD 7.13 6.44 6.45 C&A : 0.04 Sex M 1.46 1.57 1.83 A&B : 0.13 (2.60) (2.55) (3.46) B&C : 0.34 SD 2.58 4.12 2.18 C&A : 0.60 Table 3 Significance of Mean Difference of Pathological Contents of Responses among Three Sub Groups of Psychosis : Path Schizo- Affective Un-Specified Contents phrenia Psychosis Psychosis CR-Values Rating Scales (n: 30) (n: 40) (n: 30) A % B % C % PAS M 3.33 2.4 2 .43 A&B : 0.63 (5.92) (3.89) (4.6) B&C: 0.03 SD 2.08 3.5 3.74 C&A: 0.63 HAS M 0.73 0.85 0.06 A&B: 0.3 (1.30) (1.38) (0.11) B&C: 0.13 SD 1.53 1.81 0.9 C&A: 0.75 D M 2.13 1.3 1.23 A&B: 1.60 (3.79) (2.11) (2.33) B&C: 0.16 SD 2.37 1.83 1.7 C&A: 1.70 P M 1.73 1.15 0.53 A&B: 1.26 (3.08) (1.86) (1.0) B&C: 1.94 SD 2.02 1.78 0.9 C&A: 2.97** SIS-II in Psychiatric Cases 41

Table 3 reveals the differentiating capacity of pathological contents rating scales among three groups of psychosis. No clear cut difference was observed among their pathological thoughts except that patients of schizophrenia showed more of paranoid type disturbances (3.08%) as compared to Unspecified psychosis (1.07%), which is confirmatory to previous observations (Cassell, 1977; Cleveland, 1960, Dubey, et. al.,1982, Rathee, 1996) . Table 4 Significance of Test Comments among Three Sub Groups of Psychosis: Test Image Schizo- Images Affective Images Unspecified Comments & phrenia & Psychosis & Psychosis Remark (n : 30) Remarks (n : 40) Remarks (n : 30) Com- (A) % (B) % (C) % ments Three 5B 36.6 31B 40.0 5B 46.6 Three Images 31A 23.3 5B 37.5 31B 36.6 groups Mostliked 31B 16.6 29B 30.0 29B 20.0 differ Three 12B 13.3 30A&13A 13 32.5 30A 20.0 Three Images 10.0 24A & 2B 6 15.0 19B 16.6 groups Least liked 6.6 22B 12.5 10A&13A 13.3 differ Percep- Positive 76.6 Positive 72.5 Positive 73.3 Three tion of Negative 5 16.6 Negative 22.5 Negative 7 23.3 groups Test Neutral 6.6 Neutral 6.6 Neutral 3.3 differ Feeling Positive 56.6 Positive 70.0 Positive 56.6 Three After Negative 12 40.0 Negative 20.0 Negative 12 40.0 groups Testing Neutral 3.3 Neutral 10.0 Neutral 3.3 differ Table 4 reveals the diagnostic significance of test comments on SIS-II, the test comments in fact, is the first step towards analysis of SIS-II protocol and psychopathology of the patient (Cassell 1980). It can be seen that patients of three sub groups preferred the ‘Human oriented’ images (31A, 5B, 31B) showing interest in other persons. But the vast difference was observed on least liked images, which can be seen on the table itself. More than 70% subjects from Affective Psychosis liked the test very much and felt comfortable where as the same was less among schizophrenics and unspecified psychosis (56% in both groups) . The further investigations in the test comments could add more diagnostic help and to understand their inner cry for help. 42 Rathee et al

Part - B Table 5 Significance of Mean Difference of Quality of Responses among Three Sub Groups of Neurosis : Quality of Anxiety Depression Dissociative Responses Reaction Level of sig. (n : 30) (n : 30) (n : 40) CR – Values (A) % (B) % (C) % Total M 51. 0 47. 56 60. 57 A&B : 1.5 Responses B&C : 5.10** SD 12. 22 10. 80 10. 31 C&A : 3.46** Most M 11 .5 10. 66 12. 25 A&B : 0.98 Typical (22. 56) (22. 44) (20. 23) B&C :1.96* Responses SD 3. 39 3. 26 3. 5 C&A : 0.90 Typical M 21.46 19. 6 21. 37 A&B : 1.0 Responses (42. 08) (41. 23) (35. 29) B&C : 1.22 SD 8. 17 6. 14 5.71 C&A : 0.51 Atypical M M 10.06 8.43 14. 1 A&B : 1.35 Responses (20. 78) (17. 73) (23. 29) B&C : 4.10** SD 6. 17 6. 25 4. 44 C&A : 2.58** Patho. M 3. 99 4. 2 4. 27 A&B : 0.29 Responses (7. 78) (8. 83) (7. 06) B&C : 0.14 SD 1. 99 2. 5 2.07 C&A : 0.61 Movement M 3. 26 3.16 4. 7 A&B : 0.38 Responses (6.99) (6.65) (7.76) B&C: 2.20* SD 1. 98 2.03 3. 25 C&A: 2.11* Rejection M 14. 13 17. 06 10. 5 A&C : 0.97 of (22.79) (27. 53) (16. 93) B&C :2.20* Images SD 11. 08 12. 21 12. 48 C&A : 1.2 The present part of the paper reveals the diagnostic significance of somatic profile of SIS-II among three sub groups of neurosis consisting of Anxiety, Depression and Dissociative Reaction. It can be observed from Table 5, that out of 7 qualities of response variables, 5 were found to be significant and sensitive enough, especially between Depression and Dissociative Reaction. It further depicts that the cases of Dissociative Reaction tend to produce more number of responses (M: 60.57) as compared to those of Anxiety and Depression (M: 51.0 & 47.56). However, most of their responses were of ‘atypical’ type (M : 23.29), which are unexpected or much away from the embedded theme of an image, i.e. they remain in their own unique cell (Cassell et al, 2000). SIS-II in Psychiatric Cases 43

The other variables were ‘movement’ responses and ‘rejection’ of images, the more number of quality responses were produced by subjects of Dissociative Reaction (7.76 %) in comparison to other two groups (6.99 & 6.65 %). The movement responses were capable to discriminate significantly among the patients suffering from Depression and Dissociative Reaction, and Anxiety and Depression (CR:2.20* and 2.11*). The ‘rejection of images’ was more prominent among depressive subjects (27.53 %) as compared to other two groups (22.79 & 17.93 %). The present trend was found to be similar to those of previous studies, when these subjects have been taken as a whole in the category of ‘neurotic’ patients. They have also shown more rejection of images and Atypical responses. Table 6 Significance of Mean Difference of Contents of Responses among Three Sub Groups of Neurosis : Contents of Anxiety Depression Dissociative Responses Reaction Level of sig. (n : 30) (n : 30) (n : 40) CR – Values (A) % (B) % (C) % Humans M 15.36 14. 1 18. 75 A&B : 0.99 (31.12) (29. 66) (30. 9) B&C : 3.03** SD 6. 09 4. 39 8. 49 C&A :1.96* Animals M 7. 13 5. 93 8. 35 A&B : 1.00 (13. 98) (12. 4) (13 79) B&C : 2.66** SD 5.3 4.26 5. 61 C&A : 0.95 Anatomy M 11. 26 9. 00 12. 80 A&B : 1.15 (22. 08) (18. 93) (21. 14) B&C : 1.80 SD 7.80 7. 19 9. 93 C&A : 0.72 Sex M 1.80 1. 40 3.1 A&B : 0.35 (2. 27) (2.94) (5.12) B&C : 1.58 SD 1. 31 3. 48 5. 52 C&A : 2.15* Table 6 narrates the diagnostic significance of somatic profile based on contents of responses on SIS – II among three sub groups of Neurosis. It can be observed that ‘ human’ contents are able to differentiate between Depressive and Dissociative Reaction, and Anxiety and Dissociative Reaction (CR: 3.03** & 1.96*). However, the percentages of human contents in the three subgroups were almost similar. (31.12, 29.66 & 30.9 %). The Animal responses were more in Dissociative and Anxiety group (M: 8.35 & 7.13), as compared to those of Depression (M: 5.93). The CR value (2.66) was found to be significant between the subjects of Depression and Dissociative Reaction only. The Sex responses were the other prominent content, which could discriminate these three groups of neurosis. The Sex oriented contents were more common among Dissociative subjects 44 Rathee et al

(5.12 %), the CR value (2.15*) and was found to be significant among patients suffering from Anxiety and Dissociative Reaction only, which is quite in expected direction particularly in army setup where army personnel live alone for months together away from their family. The present finding are in accordance of previous observations in other studies (Cassell 1990, 1995; Dubey and Cassell, 1993; Rathee et. al. 1995, 1996). Table 7 Significance of Mean Difference of Pathological Contents of Responses among Three Sub Grups of Neurosis Path. Anxiety Depression Dissociative Contents Reaction Level of sig. Rating Scales (n : 30) (n : 30) (n : 40) CR – Values (A) % (B) % (C) % PAS M 2. 2 1. 9 2. 02 A&B : 0.53 (4. 31) (4. 0) (3. 34) B&C : 0.19 SD 2. 29 2. 35 2. 35 C&A : 0.27 HAS M 0. 3 0. 43 5. 40 A&B : 0.72 (0. 59) (0. 96) (0. 79) B&C : 0.20 SD 0. 52 0. 96 2.23 C&A : 0.20 D M 1. 2 1.70 1. 35 A&B : 0.96 (2. 35) (3. 70) (2. 23) B&C : 0.71 SD 1. 72 3. 10 1.76 C&A : 0.71 P M 0. 26 0. 10 0. 46 A&B : 1.60 (0. 51) (0.21) (6. 9) B&C : 4.00** SD 0. 5 0. 3 0. 4 C&A : 3.64** Table 7 - As far as the pathological contents and rating scales/ scores among three groups of Neurosis were concerned, there was no significant difference, except that of Paranoid (P) Scale. Paranoid (P) contents were noticed to be more prominent among hysterical subjects, followed by Anxiety and Depression (6.9, 0.51 and 0.21 % respectively). The mean differences were significant among patients suffering from Depression and Dissociative Reaction, and Dissociative Reaction and Anxiety (CR values 4.00** & 3.64**). No significant difference was seen between Anxiety and Depression. The present observations are un-comparable due to paucity of research work in this field, except those of preliminary work done by Cassell (1977, 1990). However, our present findings are confirmatory to our previous observations (Saldanha et.al. 1993, Rathee et.al.1994, 1995,; Verma et al, 1995). SIS-II in Psychiatric Cases 45

Table 8 Significance of Test Comments among Three Sub Groups of Neurosis Anxiety Depression Dissociative Reaction Test Image Remarks % Image Remarks % Image Remarks %Comments Three 5B&29B 30.0 5B 40.0 5B 52.5 Three Images 31A 26.7 31B 38.3 31B 40.0 groups Most liked 20A 20.0 28B 30.01 29B&31B 13 32.5 differed Three 31A 13.31 30A 26.66 30A 32.5 Three Images 4A 10.0 10A 16.66 4 A. 12.5 groups least liked 18A 6.7 28B 13.3 4 B. 10.0 differed Percep- Positive 73.3 Positive 46.6 Positive 77.5 Three tion of Negative 20.3 Negative 14 46.6 Negative 22.5 groups Test Neutral 6.67 Neutral 6.66 Neutral differed Feeling Positive 73.3 Positive 46.6 Positive Three After Negative 23.3 Negative 14 46.6 Negative 14 groups Testing Neutral 3.3 Neutral 6.6 Neutral differed Table 8 reveals the Test Comments have significance while understanding the interpersonal relationship and psychopathological disturbances among these patients. As far as, the first enquiry was concerned, the human oriented figures like 5B, 31A, 31B, 28B, and 29B, etc. were more common among three groups. But no such homogenous observations were noticed while pointing their least liked images, among three groups. The test was perceived to be difficult and painful by depressive subjects (46.6 %), where as other patients suffering from Anxiety and Dissociative Reaction found the test to be easy, interesting and informative and endorsed their positive remarks (>70%). The same trend was observed on their feelings after completing the test. In addition to it, it was observed that the anxiety cases found them to be more anxiety free and cool emotionally, after reacting on SIS images, which is evident from their frequencies (73.3 %) as compared to other two groups i.e. Depression and Dissociative Reaction (46.6 & 60 %). The patients of Depressive and Dissociative Reaction got tired and tensed after the completion of the test as evident by their frequencies. It can be said that the test comments really possess great significance in understanding their inner psychodynamics and behavior pathology, which is rightly endorsed by previous researchers (Cassell, 1980, 1990, Cassell et. al. 1996, Pandey et al , 1996, and Rathee, 1995). 46 Rathee et al

Conclusion It can be concluded that the Somatic Inkblot Series –II is a sensitive diagnostic test among various groups of Psychosis and Neurosis. Among three sub-groups of Psychosis – Schizophrenia, Affective Psychosis and Un-Specified psychosis, three indices proved to be sensitive enough to discriminate among them. Among three subgroups of neurosis – Anxiety, Depression and Dissociative Reaction Hysteria, eight indices were observed to be highly sensitive to discriminate them significantly. Only one rating scale i.e. paranoia, was found sensitive enough among various sub groups of Psychosis and Neurosis. The test comments proved to be more significant among various sub groups of psychosis and neurosis to discriminate, as well as to understand their inner cry. Majority of the patients from both categories liked the human oriented images and least liked the vague images. Most of the people liked the test very much and felt comfortable while reacting upon it. The SIS-II can serve as a dependable psycho – diagnostic test to discriminate among various sub - groups of psychosis and neurosis of Armed Forces. References Cassell, W.A. (1977) Aggressive Imagery and Clinical Symptoms in Schizophrenia. British Journal of Projective Techniques, 22,21-34. Cassell, W. A. (1980) Body Symbolism: Somatic Inkblot Series. Aurora Publication Company. 213 West Sixty Avenue, suite 8, Anchorage, Alaska- 99501. Cassell, W.A. (1990) Manual: Administration, Scoring and Interpretation, Somatic Inkblot Series. 4045 Lake Otis, suite 101, Anchorage, Alaska 99508. Cassell, W.A. and Dubey, B.L. (1996) The Use of the Rorschach and Somatic Inkblot Series in Releasing in Somatised Grief. SIS Journal Projective Psychology and Mental Health, 3 (1) 3-32. Cassell, W.A. and Dubey, B.L.(1997) SIS-II/Video Manual. SIS Center, 4501E, 104th Avenue, Anchorage, AK-99516 (USA) Cassell, W.A., Dubey, A. and Dubey, B.L.(2000)SIS Projective Ressponses in PTSD and Dissociative Disorder, SIS Journal of Projective Psychology and Mental Health, 7: 93-108 Cleveland, S.E. (1960) Judegment of the Body Size in Schizophrenic and a Control Group. Psycholgical Report, 7,304. Dubey, B.L. (1982) A Pragmatic View of Rorschach Inkblot Techniques. National Psychological Corporation. Bhargava Bhawan, 4 / 230 Kacheri Ghat, Agra, India. 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 through Somatic Inkbklot Series. SIS Journal of Projective Psychology and Mental Health. Vol.2 : 119-128. Dubey, B.L., Cassell , W.A. Pershad, D. and Dwivedi, P. (1995a) Diagnostic Utility of Somatic Inkblot Series. SIS Journal of Projective Psychology and Mental Health. Vol. 2(1) : 77-84. Kumar, S., Singh, R. and Mohanty, S. (2001) A Study of SIS-I in Hospitalized Male Schizophrenics. SIS-II in Psychiatric Cases 47

SIS Journal of Projective Psychology and Mental Health. Vol 8 (1) 31-34. Mishra, M. (1995): Compatibility of SIS-II and Rorschach Indices in Normal, Neurotic and Schizophrenia. Ph. D. Thesis, B.H.U. Varanasi. Pandey, R. Mishra, M. and Dwivedi, C. B. (1996) A Quantitative Analysis of Liked and Disliked SIS-II Images. SIS Journal Projective Psychology and Mental Health. Vol.3, No.2,123- 130. Rathee, S.P., Goel, D.S., Chawla, M.L., Saldanha, D. and Dubey, B.L.(1994) A study of Somatic Inkblot Series-I in Coronary Cases. SIS Journal of Projective Psychology and Mental Health. 1, 51-64. Rathee, S.P., Pandey, V. and Singh, A. (1995) Diagnostic Efficacy of SIS-II amongst Psychiatric Patients of Armed Forces. SIS Journal of Projective Psychology and Mental Health. 2, 61-66. Rathee, S.P. and Singh, A. (1996) A Comparative Study of Male and Female on SIS-I, SIS Journal of Projective Psychology and Mental Health. 3, 43-49. Saldanha, D., Goel, D.S., Rathee, S.P., Chawla, M.N and Dubey, B.L (1993) : Personality Profile of Coronary Cases. Indian Juornal of Psychiatry. Vol. 35, 197-199. Verma , S.K., Pershad , D., Kaur , R and Nehra, R. (1995) : Diagnostic Significance of SIS-II . SIS Journal of Projective Psychology and Mental Health, Vol.2 (1), 51-58. 48 Rathee et al APPEAL Members of Somatic Inkblot Society are requested to kindly send their Annual dues before the 31st of January each year, to enable the Society to meet its expenses and smooth publication of the Journal.

The Reflective Analysis of the Personality Problems of the Young Female Subjects : A Cross - Cultural Approach Anatoly B. Khromov, Gene Starbuck, Nonie M. Birkedahl and Bankey L. Dubey A questionnaire containing 99 questions dealing with different problems of youth were administered to 261 adult male and female students (134 Russians, 40 Americans and 87 Indians). Out of these, 61 were male Russians, 27 male Americans and 54 male Indians. The data thus obtained was compared between male and female subjects. The findings suggest that the Russian young women perceived more problems than American and Indian young women. Their problems in different areas such as uncertainty of future, working hours, housing, inequality of payment, limited role of women in political life and sexual violence have been discussed and compared in three cultures. The level of intensity of problems between male and female vary from culture to culture. Even one can find the reaction of men and women are different towards various situations. In the comparative research we have tried to allocate the basic psychological female problems experienced by youth. The basis of the research was the knowledge of the young people up to the young adulthood age, to determine the character and subjectively experienced personality problems. The problems of a person are not static, but are constantly evolving; developing set of questions is acquired to cope with the demands and dilemmas that face mature individuals. The present study was planned to find out the attitude of young men and women towards perception of self, self-body imagery, problems of working hours, inequality of salary and sexual violence particularly in women. Method The list of the statements, consisting of 99 youth problems obtained during a survey of more than 400 students both male and female between the age of 17 and 22 years. The questionnaire was offered to the female subjects of Kurgan State University in Russia (n= 134), δs College in USA (n= 40) and Panjab University, Chandigarh in India (n= 87). All the statements of the questionnaire were scored using a three-point system of estimation, showing the actual degree of the problem, criterion of which was its emotional importance for every subject in each of the three groups. The estimation of the group data, obtained from the female subjects, were compared to similar parameters of the young male subjects (the n= 61, 27, 54). Results and Discussions The descriptive statistical analysis indicates the distinctions of the problems, which are experienced by the female significantly stronger in comparison with the male subjects of the same age. Also the problems affecting Russian young women are significantly more than those of young American and Indian women. Prof. Anatoly B. Khromov, Dept of Psychology, Kurgan State University, Russia, Prof. Gene Starbuck and Prof. Nonie M. Birkedahl, Mesa State College, USA and Prof. Bankey L. Dubey, Panjab University, Chandigarh-160 014 (India), E-mail : sisdubey@hotmail.com

Khromov et al The Analysis of Primary Problems (99) On the first investigation phase of the study all the subjects were divided on the basis of gender (male and female groups), which helped us to find out the specificity of female and male youth problems in their respective cultures. Table 1 indicates the average estimations of the problems by female subjects (from the list of 99 problems), which were found statistically higher than the estimations of the group of the young male subjects. Table 1 Typical Problems of The Young Women Factors Mean T p Dialogue with a favorite person 2.60 - 3.14 <0.02 Problem of physical appearance 2.40 2.26 < 0.05 Harmony of figure 1.91 2.24 < 0.05 Facial appearance 1.75 2.30 < 0.05 Uncertainty of the future 2.28 2.40 < 0.05 Anxiety that the people frequently begin wars 2.23 2.33 < 0.05 Difficulties in obtaining housing 2.11 2.34 < 0.05 Problem with organizing working hours 2.10 3.33 < 0.02 Unresolved problems of gender equality 2.01 4.91 < 0.001 An inequality in payment in the labor force 2.10 3.71 < 0.001 Limited role of the women in political life 1.95 2.46 < 0.05 of the countries There is not high enough level of culture 2.04 2.61 < 0.05 in this country Limited opportunities of youth in choosing 2.08 2.33 < 0.05 leisure activities The youth is not able to rest 1.81 2.40 < 0.05 Problem with organizing one’s personal life 2.01 2.03 < 0.05 Young women know many cases of sexual 1.96 2.64 < 0.02 violence of women The problems of the young women, which scored significantly higher than estimations of the problems of the young men are represented in table 2, and the level of these problems are identical in all three cultures.

Table 2 Problems which are not Significantly Different among the Groups of the Female Subjects (Problems that Exist among Young Women in all Cultures) Dialogue with a favorite person is important to me Many young men/women have defects of figure There must be equal wages for men and women Women know many cases of sexual violence against them Women insufficiently influence the political life of the country The typical problems of young men are listed and shown below in table 3. Table 3 Typical Problems of the Young Men Reliance that the well-being of a society depends upon the activity of each person (2.17 t - 2.05, P < 0.05) Existing unemployment in this country (2.10 t - 2.34, P < 0.05); Safety of the country (1.98 t - 2.47, P < 0.05); Desire to learn about safe sex (1.71 t - 2.80, P < 0.05);. Lack of physical development of a person (1.68 t - 2.18, P < 0.05); Insufficient financing of science and arts in this country (1.53 t - 5.33, P < 0.001) The psychological distinctions of gender are reflected in the character of realized problems. The vector of the young female relates directly to the female fundamental problem of ensuring the continuation of the human race. The young women focus more on gender-specific tasks, such as family planning, appearance, female independence and self-confidence. The young women are less concerned with problems, which have social, economical and political meaning. They are less worried about a career too, because these are the men with specific problems. Table 4 represents the problems concerning the young women of the three cultures. The results are achieved by a method of statistical comparison, where, the absence of authentic distinctions on criterion of t - Student has formed the basis for allocation of these problems in the special group (from the list of 99 problems). All these problems determine sexual dimorphism to a greater degree than the cultural distinctions and excite equally the young women in all countries. In the analysis of distinctions of the primary personal reflexive estimations of the female subject’s problems in different cultures the following patterns were found: the lower the level of socioeconomic development of the country, the higher the estimated intensity of the problems. Taking the criteria of comparison, the amount of significant differences of the estimations and the level of intensity (from all of 99 problems) in young women is shown below: Refelected Analysis 51

Table 4 Problems Similarly Related to the Young Women in Russia, India and USA Young men/women are concerned about relationships with the opposite sex The cruelty and maliciousness of people existing in the society Young men/women are strongly focused on material things The existence of incurable illnesses on this earth The senior generation condemns sexual freedom among young people Young men/women hasten to experience every facet of life Many of my peers are afraid of catching a venereal disease It is interesting to know if it is posibele to fall in love once more The people perceive me as an impulsive person Table 5 Ratio of Problems in Different Countries Russia and USA 43: 60 Russia and India 12: 46 USA and India 5: 48 The American subjects, in comparison with the Russian and Indian young women, selfreflect the high concern only on the following questions: Table 6 Comparison of Russian and Indian Young Women with Americans on Self- Reflect The fact, that people use alcohol, drugs and smoke tobacco (for the Russian female subjects the problem of drugs was sharper, than for Americans); Adults condemn the early beginning of sexual life, sexual contacts of the young outside of marriage Many of the problems with homosexuality and sexual deviation are distressing to the young women/men (these problems concern the Russian subjects the least). The analysis of the distinctions of the parameters in the groups of the young women has shown that the Russian subjects in comparison with the American subjects are more emotional and jealous; they are more worried with the problems of training (t - 12.86, P < 0.001); they are more concerned with the low level of public morals and culture. The Russian young women are not sure about their future (t - 6.73, P < 0.001); they are afraid of their future independent life (t - 8.75, P < 0.001); they have the problems with one’s family creation. And at the same time, the Russians are more concerned with the problems of self-perfection than the Americans, and with the mankind’s global problems (t - 5.18, P < 0.001). Khromov et al

The Russian subjects in comparison with the American and the Indian subjects have shown low concern towards religion. They demonstrate low moral and increasing jealousy to compensate it. The Russian subjects have more problems of economic and social development of the country than the Indian subjects of the same age. The Russian are afraid of economic difficulties, which they expect to face in the independent life (t - 7.80, P < 0.001); they are concerned with the problems of training (t - 4.94, P < 0.001), the mankind’s global problems (t - 3.28, P < 0.02), the problem of the family making (t - 2.52, P < 0.05). It seems that the problems were caused by the changing socio-economic situation in Russia. The transitive period, experienced by Russia, is reflected on the consciousness of the young people as additional psychological problems. The Russian young women are less concerned with the following problems than the Indian of the same age: the problem of appearance (t - 4.98, P < 0.001); the one’s own problem of innocence (t - 5.31, P < 0.001); the problem of the women’s social passiveness (t - 5.55, P < 0.001); and the problem of the women’s role, which she plays in society (t - 3.97, P < 0.001). It seems, that the women in India are holding higher respect in society than in Russia. The Indian subjects are more concerned with the questions of spiritual and physical perfection of the person and the problem of health, than the Russian. Also they display sobriety and judiciousness more than Russian. On the contrary Russians are more intuitive, sensitive, impulsive and jealous in comparison with the Indian young women. The Factor Analysis of the Primary Problems Factor analysis was used to analyze the data. The 99 items were factor analyzed using Iterated Principal Factor Analysis with Orthogonal Varimax Rotation and Oblique Procrustes Rotation. It has allowed, grouping primary structural components of experimental data, to reveal the internal generalized tendencies, inaccessible to research at the direct analysis of statistical parameters. Factor analysis has allowed identifying these generalized tendencies as the latent personal experiences, received in comparative cross-cultural study. There are three generalized factors of the twenty-four that are the most significant (on percentage size of the explained dispersions) and contently interpreted, taken separately for the female subjects of the three countries. Each factor contains in itself a number of primary components, selected on criterion of the maximum of size factor loading, determining by the pithy affinity interpretation of the generalized attribute of the problem. The first factor in the groups of the Russian and American subjects contains similar primary problems, which, in basic, reflect emotional peculiarities of the person; therefore this factor was interpreted as “ Emotional peculiarities of the person “. The first factor: The first factor of problems of the Russian young women - “ Emotional peculiarities of the person: emotional instability “ (11.8 %). The first factor of problems of the American young women - “ Emotional peculiarities of the person: social activity and domination “ (11.1 %). The first factor of problems of the Indian young women “ Problems of self-perfection “ (12.7 %). Representatives of East culture are more, than the Russian Refelected Analysis 53

and American at the same age concerned with the problems of spiritual, aesthetic and intelligent perfection of the person. The second factor: The second factor of problems of the contents of structure pulls together the American and Indian subjects. It was interpreted as “ the Sexual interdictions of the senior generation “Socio-cultural environment, to which these subjects belong, rigidly regulates sexual behavior of the young people up to marriage. For the Russian young women this problem is less significant: the contents of the second factor are the problems of individual morals. In the group of the Indian female subjects the second factor of problems is interpreted “ the Sexual interdictions of the senior generation and relationship with opposite sex “ (6.5 %). The second factor of problems of the American subjects - “ the Sexual interdictions and relationship with opposite sex “ (6.6 %). The second factor of the problems of the Russian subjects - “ Individual morals and habits harmful to health “ (6.2 %): The third factor: The third factor of the problems of the young women has different components of the contents in all three groups: the Russian subjects - the emotional experience, connected with infancy and innocence, the Indian subjects - the problem of organization of the personal life, the American subjects - the problem of public morals. In the group of the Russian subjects the third factor was interpreted as “ one’s own infantilism and innocence “ (5.3 %). In the group of the Indian subjects - “ Organization of the life “ (5.2 %). In the group of the American subjects - “ Public morals “ (5.6 %). The Analysis of the Generalized Problems (24) On the second investigation phase, proceeding from the data of statistical analysis (factor and correlation), a test questionnaire was designed, intended for revealing the ability of the young men/women of young age to reflect the psychological problems and to determine their level. The 24 generalized (secondary) factors were confirmed. Each of the factors consisting four primary problems (items- from the list of 99 problems), were scored using a three-point system of estimation. During the comparative analysis four significant distinctive parameters of generalized problems appeared in the groups of Russian, American and Indian subjects. In the group of Russian subjects the level of the problems is higher than in the groups of India and USA. Comparatively the Russian females were more than the subjects of the same age in India and USA and were more concerned with the problems shown below: 1. Educational Financial Problems - The economic situation of the country is not quite favorable for life - The low educational level of the country depressing the young people - The young men/women are concerned with existing paid training in the country - Insufficient financing of education (science and art) in our country 2. Family Making Problems - Young men/women worry about their future family life - Young men/women are afraid of the future difficulties in obtaining housing - Education problem of the future children disturbs Khromov et al

3. Economic Difficulties of Independent Life - The young men/women are concerned with existing paid training in the country - The young people are concerned with existing paid medical service in the country - The young men/women are afraid of the future difficulties at purchase of house/ lodging - Many problem of material maintenance of the future family 4. Global Humanity Problems - The fact, that the people frequently begin wars - Ecological problems of the Earth, drug-addiction - The cruelty and maliciousness of people The analysis of cross-cultural distinctions in the estimation of generalized problems between the young women and young men are presented ahead: The analysis of the generalized reflective parameters of the problems, shown by the female and the male subjects allows especially to allocate a problem, that is connected with the women rights in a society (it is further interesting to note that this problem worries young women more than young men in Russia and USA). A according to this scale there is difference between the young women and the young men in Russia and USA (t - 5.68, P < 0.001, in USA t - 2.11, P < 0.05). On this scale the following reflective experience enter: an unsolved problem of equality of women; the requirement of equality in payment of labour of men and women; the confidence that the woman actively influence insufficiently the political life of the country; sensitivity to the information on numerous cases of sexual violence against the women. Despite the significant distinctions, existing in material and social state of the young women in Russia and USA, the reflexive character of this problem for the young women is identical: the women experience an inequality existing in society when compared to young men, which is displayed in social, political and economic spheres - everywhere, where life pushes together women and men. On generalized estimations of the problems, no difference was found between the groups of the young women and the young men in America. In-group of the Russian young women there is one more parameter on the scale of the generalized estimations of the problems, which statistically differentiates the group of the young men and young women. This parameter reflects a problem, connected with financial and material difficulties of independent life. The level of this problem is statistically higher in the group of the Russian women, than in the group of the young men (t - 2.06, P < 0.05). The contents of this scale are given ahead: the young men/women are concerned with paid training existing in the country and paid medical service; the young men/women are afraid of the future difficulties at purchase of lodging; many young men/women are concerned with a problem are financial maintenance of the future family. Character of distinctions of generalized problems of the young women and young men in Indian group are different. The Indian young women are more concerned with the problems of appearance than the young men (t - 3.46, P < 0.02): the young men/women have defects of figure; many of the forms and proportions of the person are not liked; many young men/women do not have good coordination of movements, and also a problem of own inferiority Refelected Analysis 55

(t - 3.98, P < 0.01) that they are not advanced: the young men/women are afraid of the future difficulties of purchase of lodging; the young women should save their innocence; many young men/women expect material support of the parents after the marriage. The Indian young women have less complaints about the sexual interdictions of society than the young men of the same age (t - 3.04, P < 0.05) and the problem of real sexual life (t - 3.45, P < 0.02). Reflective contents of these problems is highlighted ahead: the sex problems; the senior generation condemns freedom of the sexual relationships and the early beginning of sexual life; the sexual relation of the young people outside a marriage; many of them are afraid to catching venereal diseases; a problem of safe sex; discrepancy between conception of the people about ideal love and how their behavior in life; an opportunity to love once again? East culture strictly regulates sexual behavior of the woman up to marriage, thus subjectively experienced problems of the young Indian women are taken off. Conclusions: Research has shown, that in the context of the personality problems experienced by representatives of the weaker sex; peculiarities, describing similarity and distinction of cultures are broadly displayed. The level of intensity of the reflected personal problems of young women is caused by peculiarities of these cultures, because many young women opt for education and family first and careers later. The contents and the character submitted in consciousness of the personal problems pulls together more young women of Russia and USA, than Russia and India, though in an amount of experienced problems and their intensity the Russian and Indian young women are far from American of the same age. The distinctions in intensity of the problems of the young women and young men are caused by the sexual dimorphism and peculiarities of young age in a greater degree, than social and cultural factors. The level of reflection of women problems is higher than men problems, with more in advanced economy than the less advanced economy, socioeconomic status and changes in society determine so many life-style, educational, and work issues that this needs to be examined too. Further research must consider the results within a historical context, taking into account the changes of political, social, and moral values. References K®n I. ‘. Psychology of Early Youth. - Œ., 1989. (in russion) Mukhina, V. S. (1996) The Psychology of Development. - Œ., (in Russion) Rice, F. Philip (1996). The Adolescent: Development, Relationships, and Culture. Simon and Schuster. Ainsle, Meares (1974). The New Woman. Collins, London. Offer, D. et al. (1988). The Teenage World Adolescents, Self-Image in Ten Countries. Plenum Publ. Book N 4. Levy Claude, Leboyer et al. (1996). Determinants of Pro-Environmental Behaviors: A Five-Countries Comparison. European Psychologist, Vol. 1, No. 2, June pp.123-129 Khromov et al

Family Intervention in the Treatment of Post-Traumatic Stress Disorders Lt. Col. D. Saldanha Military Hospital Kirkee is a major Spinal cord injury center in the Armed Forces. A number of spinal cord injury cases are transferred to this hospital for definitive treatment as well as for rehabilitative measures. During the course of convalescence, the individual manifest Post Traumatic Stress Disorders. No studies till date has reflected the problems of these cases. Hence a pilot study was undertaken to study a few such cases incorporating the families of those injured. Five out of six PTSD cases showed significant improvement with the intervention of family members. The significance of the role of families in the care of the mentally ill is discussed. The magnitude of the disability caused by mental and neurological illness in a developing country with inadequate resources and trained manpower is enormous. A broader view of the current models, techniques and services is required to tackle emerging issues and develop models for the future. The strength of the family is often quoted as a favorable factor in long-term outcome of mental illness. It is time to begin addressing these issues in the context of the developing world where families play a major role in the care and management of the mentally ill. The year 1996 has been a significant one for rehabilitation of the mentally ill as it is the year in which mental illness has been included in the category of disabilities by the Ministry of Welfare, Govt of India. Prior efforts in India in rehabilitation of the mentally ill have been isolated. It was left to the efforts of the handful of agencies and has not developed throughout the country. Violence, injury and death can come suddenly and unexpectedly in virtually any situation for the civilian and soldier alike. Development of PTSD in such situations is recognized. Epidemiological statistics of lifetime prevalence of PTSD range from 1 to 9 percent along with high levels of chronicity and co-morbidity (Davidson et al 1991, Breslau et al 1991). A chronic adjustment syndrome akin to PTSD has been reported among Vietnam veterans and 22% of the 64 Falkland war casualties were rated having the complete PTSD at the end of 5 year follow up (Dorien and Hughes 1991). The full syndrome of posttraumatic stress usually develops some time after the trauma. The delay can be as little as one week or as long as 30 years. Symptoms can fluctuate during this time span and may become more intense during periods of stress. Early identification of PTSD followed by intensive crisis management has shown to reduce the development of PTSD at a later stage in a study conducted recently (Saldanha et al 1996). Incorporating family members in the treatment of PTSD has not been tried to date, especially so in the services where in the rehabilitation of the injured is recommended as per the guidelines laid down (GOI 1980). Although these guidelines and subsequent rehabilitative methods give a measure of hope to the traumatized individuals, family psychotherapy and intervention in early stages of PTSD will no doubt, not only prevent long term effects but also help the individual to adjust to the new environment to which Lt Col. D. Saldanha,M.D., Addl.Adviser in Psychiatry, Military Hospital, Meerut-250001 (The study was carried out while posted at Military Hospital Kirkee)

Saldanha he has been an alien. Following five case studies illustrate the importance of incorporating family members in dealing with the Post Traumatic stress symptoms in the early stages of recovery and how incorporating a family member could have helped prevent chronicity of PTSD in the sixth case. Material and Methods Adopted The study was carried out at a major orthopedic based hospital from 10 Feb 95 to 15 Dec 96. Cases who were referred to the psychiatrist were screened for Post Traumatic stress disorder symptoms on the criteria outlined in DSM III (R) (Berthold 1992) supported by use of Somatic Inkblot tests. All six cases met the criteria for PTSD. As a first step the individual’s life history was reviewed and the situational psychic profile was discussed with him to effect a global change in his life style. Family members were incorporated in the treatment wherever possible. Five families actively cooperated in a traumas based cognitive frame work and insight oriented psychotherapy to effect on attitudinal change towards a better life to an extent possible. These patients who recovered from their PTSD were encouraged to motivate other paraplegics and quadriplegics. Following are the illustrative examples of the case studied. Case Study Profiles Case No 1. A 17 years old recruit, only son of a low middle class family while proceeding to Secunderabad EME Centre for training was thrown out of the running train during change over at CST Mumbai on 26-06-95. He sustained grievous injuries to the body and neck. The Railway Police which got him admitted to a civil hospital at Mumbai rescued him. The attending doctors found the Centers call letter and thus transferred him to INSH Asvini for management of his cervical cord injuries. He had developed quadriplegia as a result of fracture of C5-C6. For major orthopedic treatment he was transferred to Military Hospital Kirkee on 21-09-95. Two months after the hospitalization he was referred to the psychiatrist, as the individual was not cooperating with the staff and not sleeping at night. On psychiatric examination he was found to have full-blown PTSD hence intensive treatment was initiated and help of family members was sought. The individual could relate well to his younger sister. Family members were appraised of the disability and the need to intervene and convince the individual that he would recover to an extent that he could look after himself although chair bound. Within six months the individual recovered fully from PTSD symptoms. Case No 2. Militants shot a 38-years old Lieutenant Colonel married and having two young children on 9th Oct 1994 at a militant hide out in Srinagar. Grievously wounded and unconscious, he was taken to a Zonal Hospital where bullet lodged in D12-L4 areas was removed. Intra peritoneal damage was repaired. Paraplegia was discovered soon after and was transferred to Army Hospital Delhi for orthopedic care. He was subsequently transferred to Military Hospital Kirkee for rehabilitative measures & further management. He was referred to the psychiatrist as he continued to complain of pain in the left leg and would not sleep at night. Organic cause for the same was ruled out. He

was put on antidepressants and family intensive insight oriented psychotherapy was given for his PTSD symptoms. This induced considerable improvement both in his mental attitude and outlook. He improved there upon and was able to walk with the help of calipers. He was retained in the service with restrictions on his employability and had no PTSD symptoms on discharge. Case No 3. A 21 years old cadet, undergoing training at IMA, few days before his passing out sustained injury to his neck on 29-4-95 at 17.45 hrs. while doing an obstacle course. He was immediately admitted in a Zonal Hospital at Dehradun, later transferred to Army Hospital Delhi for orthopedic management on 18-5-95. The individual had sustained grievous injury to his C5- C6 vertebrae, which were fractured and avulsed. A month later he was transferred to Military Hospital Kirkee for cervical vertebras fixation and bone graft. He had developed quadriplegia & PTSD by then. He was withdrawn, dull and depressed. Intervention of family members helped to repose faith in him and was able to withstand the negative cognitive thoughts. Besides recovering well, he became a role model for other paraplegic and quadriplegic patients and successfully completed computer course with APTECH. Case No 4 and 5. Two academically brilliant Test Pilots from IAF and Army aged 30 yrs and 31 yrs while test piloting a helicopter crashed on the morning of 28-8-96 at Bangalore airfield, sustaining fracture dislocation of dorsal spine at the level of D9-12 completely transecting the spinal cord resulting in complete paraplegia. They were airlifted to Military Hospital Kirkee on 2-9-96 for intensive orthopedic treatment; Harrington Rod Fixation was done on 18-9-96 and 23-9-96. Both officers are married with small children. Besides having paraplegia, the traumatic events have had their effect on their psyche in the development of posttraumatic stress disorder symptoms. In view of the severity of disability, early intervention of the family, and psychoactive treatment was initiated. Three months of active family support and psychotherapy helped to control the posttraumatic stress disorder. Both the officers are now mobile on wheel chair and look forward towards rehabilitation. Case No 6. A 26 years old young and promising JCO from Navy belonging to a poor socio-economic background sustained injury to his dorsal spine at the level of D6-D7 and complete transaction of the spinal cord as a result of a fall from motorcycle on 16- 3-96 on a rainy day at Madras. He was airlifted to Military Hospital Kirkee on 17-3-96. Besides having complete paraplegia, he had bilateral haemothorax. His physical disabilities caused him enormous mental anguish and helplessness resulting in a suicidal attempt. Severely depressed, he was subjected to antidepressant therapy besides adequate nursing support. His father’s death early that year had put additional stress on him to support his mother and unmarried younger sister. He was craving for sympathy, entertained self-deprecatory ideas and felt helpless in that state. He did not sleep nor looked after his nutrition. He had to be forcefully fed. Intensive treatment with antidepressant drugs and nursing support improved his mental state. However, family support, which was not forthcoming, would have helped the individual to tide over the Family Intervention in PTSD 59

post-traumatic stress symptoms to a great extant. He continues to be under active psychoactive drug therapy. Discussion In most therapeutic approaches, empathetic relating is fundamental. For posttraumatic therapy in particular, empathy can be built by considering how a person has been hurt rather than focussing on the deficiencies of the person (Bloom,1994). As with other psychotherapeutic approaches to PTSD, research on the out-come of group and family therapy has lagged behind clinical application. Surprisingly few studies have systemically evaluated treatment effectiveness. For example in a 1992 review of the efficacy of PTSD treatments, psychopharmacologic interventions received far more attention than psychotherapy techniques (Berthold, 1992). Acute trauma is most damaging to a family system that is already dysfunctional. As is the case with the individual, even a relatively minor stress can precipitate a crisis in a family already burdened by economic stress. For the adult who is the identified patient, the first focus of family intervention should usually be with the family of choice as in the present case 6, whose family could not be incorporated in the treatment programs. Family members need extensive psycho education to provide them with a trauma based cognitive framework within which, they can reframe the family problems as a family challenge and survival mission (case 1,2,3,4& 5 refer). The family members can be instructed toward understanding the role they are playing in a traumatic re-enactment scenario and guided toward a redirection of the family script in a more satisfying direction. It is well known from earlier work in various traumatized groups, that social support is one of the few factors that attenuate trauma. Family therapy sessions can turn the energy of the family from traumatogenic to supportive, once the healthier members of the family join together to provide what the identified patient actually needs rather than playing auxiliary role in patients traumatic re-enactment (Solomon et al 1993). In the case studies mentioned above, in Case No1, the sister of the patient played active role as a healthy member of the family in providing support to the patient. In Case No 3, the mother played the active supportive role and the patient could depend on her for any trauma re-enactment. Case No 2, 4 and 5, the wives of the officers supported their husbands in no small measure to lift their morale and boost their confidence and ego to get well enough to move around in the wheel chairs. This is what lacked in the Sixth Case besides the social & nursing support given by the nursing staff and the psychoactive drugs that could not lift the morale of the patient. Scarfield (1990) found that veterans completing the 12 weeks multi-model treatment program improved their self-esteem and inter-personal relationship and decreased numbing and arousal. The case studies mentioned above bear ample testimony that multi modal PTSD treatment program that combines behavioral cognitive, psychopharmacological and family interventions in the early stages prevent chronicity of PTSD symptoms to a great extent. Absence of family support in Case No 6 further strengthens this assumption. Although group and family therapies currently provide relief and growth for PTSD patients, many considerations remain for the future. For Saldanha

example how can patients be matched with various treatment for optimal results? How should acute and chronic PTSD treatments be similar and different? What is the effectiveness of group and family therapies for PTSD? (Allan & Bloom 1994) As of now little data is available on family interventions therapies. Further research in this area is not only required but it is a necessity to reduce the chronicity of PTSD symptoms in an individual who is already physically disabled for life. The aforesaid case studies perhaps may contribute in evolving a strategy for the treatment of PTSD in the physically disabled. References Davidson, J.A.T., Hughes, D. and Blazer, D.C. (1991). Post-traumatic Stress Disorder in the Community, an Epidemiological Study. Psychological Medicine: 21: 713-73. Breslau, N., Davis, G.C. and Andreski, P. (1991). Traumatic Events and Post-traumatic Stress Disorder in an Urban Population of Young Adults, Arch Gen Psychiatry, 48: 216-22. Dorien, L.C. and Hughes, G.J. (1991). Symptoms of Post-traumatic Stress Disorder in Falklands Veterans Five Years After the Conflict, Br J. Psychiatry 159: 135- 45. Saldanha, D. Goel, D.S., Kapoor, S., Garg, A. and Kochar, H.K. (1996). Post-traumatic Stress Disorder in Poly Trauma Cases. MJAFI. 52, 35-39. Guide, to Medical Officers (1980). Entitlement. General Principles. Chapter 11 p 6 to 9. Government of India New Delhi, Ministry of Defence. Berthold, P.R., Ingrid, V.R.C. (1992). Post-traumatic Stress Disorder. The History of a Recent Concept. Br. J. Psychiatry, 161, 742-8. Bloom, S.C., (1994) Creating Sanctuary. Ritual Abuse and Complex PTSD Treating Survivors of Satanist Abuse. London Routledge Solomon, S.D., Garrity, E.T. and Muff, A.A. (1992) Efficiency of Treatments for Post-traumatic Stress Disorder. JAMA, 268, 633-638. Solomon S.D., Brave M and Rubie Stipec, M. (1993). Effect of Family Role on Response to Disaster. J Trauma Stress, 6: 255-269. Scurfield, R.M., Kenderdine, S.K. and Pollard, R.J. (1990). Inpatient Treatment for War Related Post-traumatic Stress Disorder. Initial Findings on a Long-term Outcome Study. J. Trauma Stress 3: 185- 200. Allen, S.N. and Bloom, S.L. (1994) Group and Family Treatment of Post-traumatic Stress Disorder. Psychiatric Clinics of South America. 17, 2, 425- 437. Family Intervention in PTSD 61

Manish K. Verma, M.A. (Psy) Research Scholar and Sarita Misra, Ph.D., Sr. Lecturer Dept. of Psychology, D.A.V. College, Kanpur (India). Rorschach’s Response Patterns of Drug Addicts Manish K. Verma and Sarita Misra Projective techniques have been used with various populations for the assessment of behavior. The Rorschach InkBlot test is the most popular projective technique widely used as a tool to unearth the deep-rooted emotional conflicts, which has not yet manifested in overt behavior. The test is also used as a tool of personality assessment and diagnosis of different types of mental disorders. The present paper is an attempt to study personality aspects of drug addicts with the help of Rorschach test. The sample of this study includes 7 drug addicts under treatment at drug de addiction centers. Rorschach Inkblot Test has been used to assess personality aspects of these subjects. The responses have been recorded as per Beck scoring system. The findings are discussed in the paper. Drug abuse is a great problem in every society throughout the globe. It has become the problem of universal concern during the past two decades. Drug abuse has psychosocio-medical implications and should be treated in the life situations of the addict. Drug abuse is a multifaceted and multidimensional problem. A variety of socio-economic factors, which have been held responsible for this malady are familial discord, social ostracism, emotional insecurity, stress of modern life and professional anxiety and low values. The term “ Drug” refers to a wide variety of chemical substances consumed by men / women, not merely to narcotics or dangerous drugs. The pharmacological interpretation of a drug is any substance, other than food, whose chemical and physical nature alters structure or functions in a living organism. Drug Addiction as defined by W.H.O. is “ a behavioral pattern of drug use characterized by over whelming involvement with the use of a drug, compulsive drug seeking behavior and a high tendency to relapse after withdrawal.” Besides it is viewed as a continuum relative to the degree where drug use affects the total quality of the drug user and to the range of circumstances in which it controls his behavior. Addiction may be explained with three important concepts: tolerance, physical dependence and psychological dependence. As the user body adapts to the drug, he or she develops tolerance. Such person needs increasingly higher drug in order to become intoxicated. When the user’s body becomes totally dependent on the drug with its prolonged use, the condition is defined as physical dependence. The body becomes so used to functioning under the influence of the drug that it is able to function normally only if the drug is present. Psychological dependence is a state characterized by emotional and mental preoccupation. With the effects of the drug and by a persistent craving for it. the user gets mentally “hooked on” to the drug. If the intake is abruptly stopped, the body becomes ‘confused’ and ‘protests’ discomfort through convulsions, depending on the type of drug abused.

Rorschach in Drug Addicts 63 Classification of Addictive Drugs : The psychoactive drugs most commonly associated with abuse and dependence in our society appears to be. 1. Narcotics - Opium and its derivatives 2. Sedatives - Barbiturates 3. Stimulants - Amphetamines 4. Mild tranquilizers - Meprobamates 5. Hallucinogens - Marijuana Caffeine and Nicotine are also drugs of dependence, but they are not included in the APA classification. Addicts in different countries normally use these drugs. Projective techniques have been used on various populations for behavior assessment. The utilization of vague, ambiguous, unstructured stimulus objects help to elicit the inner world of the subjects. Rorschach inkblot test is the most popular projective technique used as a tool of personality assessment and diagnosis. The Inkblot images have been found successful in hearing the inner cry of the suffering individuals (Cassell and Dubey, 1997). Objective To study the personality aspect of drug addicts. Sample The present study was conducted on 7 male drug addicts. It was an incidental purposive sample of drug addicts who are regularly taking narcotic drugs at least for the last oneyear and are taking treatment at Drug de addiction centers at least for two weeks. They were in the age range of 20 to 30 years. Discussion The Rorschach’s Inkblot test has revealed the inner psychological state of the subjects, which they refuse to acknowledge otherwise. The increase in total number of responses suggests their productivity and imaginative ability. Low number of Popular responses along with increased Animal contents suggests their poor contact with reality, frustration and hostility. However, moderate number of Whole and Detail location responses suggests their organizational ability. The low number of Human contents reveal their poor interpersonal relationship, which is often found in drug addicts. As a whole the protocol indicates their introversive balance. Fear and anxiety are clearly revealed in responses like ferocious animal, a big black cloud covering everything etc. However, they have not lost their hope for better future and have given good responses such as garden, lawns and fountains etc. Blood and vista responses denote their hostility and insecurity. The high number of color responses reflects their poor control over emotional situation and to the extent aggression.

Table 1 Rorschach Responses Summary Chart SUBJECT AGE TOTAL RESPONSES LOCATION W D Dd S — DETERMINANTS F+ F - M FY — C V CONTENTS H A Hh Bl — An Cg — — LS Sx — — Others — — POPULAR Conclusion It can be concluded that the drug addicts in this study are anxious, have poor control over emotional situations and lack of contact with reality. Reference Lemkau P, Kronerberg, Mannual of Rorschach Diagnostic Test (10th Ed.) Cassell, W.A. and Dubey, B.L.(1997) SIS -II / Video Manual. SIS Center, 4501E, 104th Ave, Anchorage, Alaska-99516 (USA). Mitra, G. and Mubhopadhyaya, A. (2000) Psychological Factors in Drug addicts and Normals. A Comparative Study. SIS Journal of Projective Psychology and Mental Health, 53-78. 64 Verma and Mishra

Management of Stress Col. Rajinder Singh Stress has become the part of executive's life. Factors leading to stress may vary from faulty learning, conflicting objectives, unclear philosophy of life, false ego and fast changing values of society. It hampers productivity and interpersonal relationships. Various techniques helpful in the management of stress have been discussed in the paper. With the rapid pace of advancement of science and technology and the advent of modernisation, human life has become very complex, resulting in social tensions and psychological disorders. The present miserable conditions of society and its mental health are alarming. Tension, stress, anxiety and depression have become a part of life. The causes may vary from faulty learning, conflicting objectives, unclear philosophy of life, false ego and fast changing values and norms of the society. When we talk of modern managers, it is disturbing to think of their medical profile. About 30 percent managers are suffering from hypertension and are unable to take care of themselves and their families. On the other hand, life without stress would mean a dull experience. Stress is the spice of life and an optimum level of stress is necessary to live happily. Stress is not always dysfunctional. Some stresses like stress for creative work, entrepreneurial activities and keen competition etc. stimulate better productivity. The present paper aims to discuss the factors leading to stress among the modern executives at their work place and measures to manage the stress. Factors Leadings to Stress Over Ambition : It is good to be ambitious, but being over ambitious in relation to one’s capabilities has many pitfalls and non-achievement of the unrealistic goals set by oneself would result in stress. Type A personality people and those with extremely high work ethics almost burn themeselves out. Work Pressure : You may be achieving outstanding results, which might result in pushing your body too hard. By working for long hours a day would hardly leave any time for rest. This causes energy to draw from your system. Meeting Deadlines : Sometimes we lay down a highly unrealistic and amitious time frame for our tasks. Alternatively by frequent procrastinating, we feel terrible pressure of time to meet deadlines. In both cases, there is an avoidable tension and stress. Inadequate promotion and growth opportunities : It is a natural instinct among employees to look forward to opportunities for growth in their organisation. When the organisation policy hampers promtion and growth opportunities, the result is frustration; leading to stress. Col. Rajinder Singh, MBA, Management Consultant and Visiting Faculty, Panjab University, Chandigarh, 1526, Sector 34-D, Chandigarh.

Inter-Personal Relationship : Today’s employees are enlightened and managing them effectively requires a great skill in inter-personal relationships. Exeuctives lacking in this important art would encounter strained relationship with their sub-ordinates, peers as well as the superiors, resulting in conflict. Cliques' Politics at Work Place : There are cliques among employees in almost every organisation and the executives caught in the whirplool of petty politics, besides causing irreparable damage to their organisation, and peace of mind. Insecurity of Job : The organisation’ policy of hire and fire as “Damocle’s Sword Hanging on the Neck” brings an unavoidable tension among the executives regarding security of their jobs. Change in Environment : It is customary in public as well as private sector organisation for business executives to be transferred from one place to another. There are many executives who are unable to cope with the changed environment and suffer from physical as well as mental symptoms. They develop disturbed sleep, loose their appetite and begin suffering from palpitation and severe headaches. Their performance goes down day by day. Excessive Commuting Time : Unduly long commuting time especially for long distance suburban areas to the office coupled with the noise pollution and erratic trafic also causes tstress, particularly of the who come often late to the office. Coping with stress Stress is the essence of life. It is the noblest of nature’s gifts to man. Executives should, therefore, learn to use stress to their advantage so as to lead a healthy and well-balanced life. Some important aspects for coping with stress are discussed in the succeeding paragraphs. Know Your Ability to Tackle Stress All of us, depending upon our upbringing, childhood, expeirences, nutrition and the type of training we have received can take on varying degree of strees. A rubber strip is elastic up to a point, beyond it, it snaps. Every individual also has a breaking point and should not go beyond it. Therfore, it is essential to recognise the amout of stress and strain we can take in our stride. Positive Thinking : While a great deal of attention is paid to physcial exercises for development of the body, mental exercises for the right mental attitude are given very little importance by most executitives. It is ultimately the mind which controls the body and negative thoughts. Positve thinking helps in controlling and leading to good mental health depressing frustrating and negative thoughts. Goal in Mind : It is essential that all of us should have a goal in mind and pursue it with determination. It is important that the goal should be within one’s reach and one must 66 Singh

never be impatient about trying to reach it. Relaxation: Impact of stress can be overcome by relaxation. This, infact, is one of the greatest luxuries in life and you cannot afford to miss it. Relaxation is a joy of life. How to relax is explained ahead. “Close your eyes and let your concentration go on each part of your body in turn and that would result in relaxation of that part. Begin with the nape of your neck and your head. Pay attention to your jaws and release them. Release your facial muscles - nose,eyes and brows. Relax your shoulders, arms, elbows,wrists, hands,fingers and thumbs. After that relax your chest, your breathing, stomach, your back, spine and buttocks-- than your legs,ankles and the soles of your feet. Once you are so relaxed that you feel your body to be like a sack of potatoes. You could do the above process by sitting in your chair relaxed, remove your shoes with your feet flat on the ground and your hands resting on your knees in a comfortable position. Now turn your attention to your mind. We have to remind ourselves that mental relaxation is a luxury. Do it this way Say to yourself-as I count FIVE; I am relaxing more and more deeply in my mind. One (pause): deep relaxation Two (pause) : deeper Three (pause): very deep Four (pause) : deeper still Five (pause) : deepest, total , profound relaxations Imaging Therapy Another way of mental relaxation is by Imaging Therapy. Close your eyes and imagine your flying in the air like a bird. you are going up and up ; exploring new areas, seeing different places with the world below you. And you feel great. And now you are passing through a beautiful garden with lovely flowers, the kind you have never seen. You imagine yourself as a boy on a beautiful Mediterranean beach in the sun, with lot of people there or imagine yourself as a man fishing in the boat. Management of Stress 67

Some other ways of relaxations are:- 1. Talking 2. Being in good company 3. Careful Living (a) Eating habits (b) Sleeping habits (c) Reading (d) Entertainment /Music - Use the soothing beauty of great music to calm your nerves. (e) Exercise- Walk,work in a garden, play golf; knowing that physical tiredness invites relaxations and sleep. (f) Pursuing Hobbies 4. Meditation/Prayers Meditation has been recognised as a powerful technique for reducing stress. meditation involves quite concentrated inner thoughts in order to rest the body physically and emotionally . Transcendental meditation is one of the more popular practice, meditator tries to meditate for two periods of fifteen to twenty minutes a day, concentrating on the repetition of some mantras like “OM” or “WAHEGURU”. Any meditation essentially involves a relatively quiet environment a comfortable position, repetitive mental stimulus and a passive attitude. Unbutton Your Emotions : Many people deny the expression of joy and pain. The pent up emotions inside need a vent or it may burst out without warning, thus spoiling relationship with others. Conclusion Stress is a part of life and cannot be avoided. One should learn how to manage it. Various relaxation techniques are useful in its management. 68 Singh

Anil Agrawal, MBA President & CEO Telephone Cables Limited SCO 68-70, Sector 17-C, Chandigarh-160017 (India) (LM 99) Tel.: 91-172-704368, 702720 E-Mail : aagarwal@tclindia.com S. Alam, Ph.D. Lecturer, Dept. of Psychology, Women’s College, Aligarh Muslim University, Aligarh-202002 (India) (LM 97) Ms. Zahirunnisa Ali Specialist in Physical Therapy, Plot No. 65, Ayppa Nagar, P.O. Katol Road, Nagpur (India) Tel.: 91-712-539418 (LM 95) Phillip. W. Baker, Ed.D. 4325, Laurel, Suit 215, Anchorage, AK 99508 (USA) Res. : 2305 Susitna Dr. Anchorage, AK 99517 (USA) Tel.: (907) 562-2392(W) (907) 243-8042 (H) (M 95) E-Mail : wcbaker@alaska.net Mrs. Shubhra Banerjee, Ph.D. “Shubhalaya”, 7, Mahaveer Colony, Kamachha, Varanasi - 221 010, (India) (LM 97) Tel. : 91-542-312049 (H) R.S. Basi, Ph.D., 11651, Hill Side Drive, Anchorage, AK-99516 Tel. : (907) 345-6655, LM99 Ms. Jayanti Basu, Ph.D. Reader, AE 692, Salt Lake, Sector 1, Kolkata - 700 064, (India) Tel. : 91-33-3341421, (H) (LM 95) E-Mail : btapas@cal2.vsnl.net.in Saugata Basu, M.Sc, M.Phil. Clinical Psychologist. Surendranath Cooperative, 201, Manikatala Main Road, Flat No.12, Kolkata - 700 054, (India) Tel. : 91-33-3559772 (H) (LM 97) E-Mail : saubasu@cal3.vsnl.net.in J.S. Bedi, Chairman Gian Jyoti Inst. of Mgt. & Technology, Phase-II, Mohali-Chandigarh (LM 99) Tel. : 91-172-671100, 661327 (H) Mahesh Bhargava, Ph.D. Director, National Psychological Corporation, 4/230, Kacherighat, Agra - 282 004 (India) (LM 95) Tel. : 91-562-350 113 (H) D.K. Bhatt, BE Director Mktg., IFFCO, 54, Nehru Place, New Delhi-110019 Tel. : 91-124-6341210 (H), 91-11-6463622 (W) Carina Coulacoglou, Ph.D. Psychologist, University of La Verne, 40E, Esperou Str. Kifissia, Athens 14561 Greece (M99) Telefax : (301) 6252269 E-mail : carina@hol.gr Mrs. Mary Cassell, Executive Director, 4501E, 104th Avenue, Anchorage, Alaska - 99516 (USA). Fax : 907-563-3746 (W) (FM92) E-Mail : marycassell@hotmail.com Wilfred A. Cassell, MD, FAPA, APC, Director, SIS Center, President, Somatic Inkblot Society, 4501E, 104th Avenue, Anchorage, Alaska - 99516 (USA). Fax : 907-563-3746 (W) (FM92) E-Mail : wilfredcassell@hotmail.com Mrs.Rita Chaudhury Deptt. of Psychiatry, AFMC, Pune-411040 Tel:91-20-6835348(H), 91-20-6306052(W) E-Mail: suprakashch@vsnl.net Lt. Col. S. Chaudhury, MD, Ph.D. Deptt. of Psychiatry, Armed Force Medical College, Pune-411040 Tel:91-20-6835348(H), 91-20-6306052(W) E-Mail: suprakashch@vsnl.net Sebestian Chembakam, Ph.D. Consultant Clinical Psychologist, Kalavathu Road, Palarivattom, Cochin-682025 (India) Tel. : 91-484-336162 (LM 96) Alfred Collins, Ph.D. Consultant Clinical Psychologist 615 East, 82nd Ave, Suite 102, Anchorage, Alaska - 99518 (USA) Tel. : (907)-344-3338 (W), Telefax : (907)-346-4084 (H) (LM 95) E-Mail : acollins@alaska.net Somatic Inkblot Society (MEMBERSHIP DIRECTORY - 2001) Membership Directory 69

Laurence Steve Corp. 3000 Doris St. Ancharage, AK 99517 Telefax : (907) 276-7182 (M 99) Email: scorp@ak.net Sanjukta Das, M.Phil. (Cl.Psy.) Flat No.2, 1st Floor, P-32, Moti Jheel Ave, Kolkata-700074(LM2001) Tel:91-33-3508386(H) E-Mail:tubai31@yahoo.com Sonali De, Ph.D. B-1015, Karuna Moyee Housing Estate, Salt Lake, Kolkata - 700091 (India) Tel. : 3590561 (H) (LM 2000) E-Mail : sonali.de@cucc.ernet.in Mrs. Pratibha Dhondia, M.A. 2366, Sector 35-C, Chandigarh - 160 034. Tel. : 91-172-664562 (H) (LM 97) N. L. Dosajh, Ph.D. 1121, Sector 15-B, Chandigarh - 160 015. Tel. : 91-172-772651 (H) (LM 95) Anand Dubey, B.E., MBA Joint Editor, Post Box 244045, Anchorage, Alaska - 99524 (USA). (LM 97) E-Mail : adubey@hotmail.com Asheem Dubey,Joint Editor, 4240 Edinburgh Drive, Anchorage, Alaska - 99515 (USA). (LM 97) E-Mail : batly@hotmail.com Bankey L. Dubey, Ph.D. Director SIS Center India, Vice President Somatic Inkblot Society, Post Box : 1107, Sector 15 Post Office, Chandigarh - 160 015 (India) Tel. : 91-172-710985, Tel./Fax : 91-172-710986 (FM 92) E-mail : sisdubey@hotmail.com, E-Mail: sisdubey@rediffmail.com Rajan Dutta, M.P.M.I.R. Chief HR & TQM, Escotel Pvt. Ltd. H. No. 1348, Sector 17-C, Gurgaon-122001 (India) Tel. : 91-124-343828 (H) (LM 95) E-Mail : rdutta@escotel.net Mrs. Padma Dwivedi, M.A. Gen. Secretary, Somatic Inkblot Society, Social Worker, Dept. of Cardiology, Post Graduate Medical Institute, Chandigarh - 160 012, (India) (FM 92) E-mail : sisdubey@hotmail.com M.Irfan Farooqi, Ph.D. Street Maqbarian, 1/5, Sarahandi Gate, Malerkotla-148023 (LM 2001) Tel: 91-1675-52694(H) Ferro Roberto, Ph.D. Consultant Clinical Psychologist, Via Bernardino Bellincione -14, 20134 Milano (Italy), (M 95) Tel.: 39-2-2154874 (H) E-Mail : csguazzin@fsm.it K. L. Garg, MD Consultant Neuro-Psychiatrist SCO-6, 1st Floor, Sector 17-E, Chandigarh - 160 017 (India) (LM 95) Tel. : 91-172-702281 (W) 564800 (H) Philip Greenway, Ph.D. Faculty of Education, Monash University, Clayton Campus,Clayton, Victoria-3168 Australia. Tel;99052842(W),94585052(H) (M-2001) E-Mail:Phillipgreenway@education.monash.edu.au Ravikant Gunthey, Ph.D. A-111, Shastri Nagar, Jodhpur-342003 (India) (LM 96) Tel.: 91-291-33943 (H) 622755 (W) S.C. Gupta, Ph.D. 1/5, Balda Road Colony, Nishat Ganj, Lucknow-226007 (India) (LM 1996) Tel. : 91-522-386033 E-Mail : sureshcgupta@hotmail.com Miss. Sarita Gupta, M.A. Research Scholar, UBS, Panjab University, Chandigarh, (India) (M 96) Anuradha Jatana, M.A. 118, Sector 8, Panchkula-134109, (LM 2000) Tel. : 91-172-567187 E-Mail : ritzu999@yahoo.com Mukesh K. Jha, M.A. Dept. of Yoga Psychology, Bihar Yoga Bharati, Ganga Darshan, Munger - 811201 Tel. : 91-6344-22430 (W) (LM 97) M. R. Jhanwar, DPM Consultant Neuro Psychiatrist, Deva Institute of Mental Health, B-27/70, Barhal Kothi, Durga Kund, Varanasi - 221 005. (India) (LM 94) Tel. : 91-542-310670 (W) 70 Membership Directory

Lt. Col. T. Rajan John, MD. Dept. of Psychiatry, Command Hospital Chandimandir, Panchkula-134107 (LM 97) R. K. Joshi, DM & SP Consultant Clinical Psychologist, B-27/70, Barhal Kothi, Durga Kund, Varanasi - 221 005, (India) Tel. : 91-542-310670 (W) (LM 94) Maj. Sanjay Kaul, 477 Sector 7, Panchkula (India) Tel. : 561960 (H) (LM 2000) Ms. Harpreet Kaur, M.Phil Clinical Psychologist, Dept. of Psychiatry Govt. Medical College & Hospital, Sector 32, Chandigarh (India) (LM 98) Rajinder P. Kaur, Ph.D. 364, Sector-38A, Chandigarh-160037 (India) (LM 98) Darshan K. Khera, DPM 760, Phase-IV, Mohali (Near Chandigarh) (India) (LM 96) Tel. : 91-172-261415 (H) Anatoly Khromov N6, Micr, VI apt. 163, Kurgan, Russia - 640023 Tel. : 007-352-2-485740 (H) E-Mail : anatolykh@hotmail.com Mrs. Rohini Khullar 22 A, Ring Road, Lajpat Nagar-IV, New Delhi - 110 024 (India) (LM 95) Tel. : 91-11-6434121, 6225695 (H) E-Mail: rohinik3@vsnl.com Mr. Navin Kumar, Dept of Yoga Psychology, Bihar Yoga Bharati, Ganga Darshan, Munger - 811201, Bihar (India) Tel.: 91-6344-22430 (W) (LM 2000) Rakesh Kumar, Ph.D. Sr. Clinical Psychologist, Agra Mansik Arogyashala, Agra-282002 (India) (LM 98) Tel. : 91-562-322650 Fax : 322648 E-mail : imhh@sancharnet.in Vikas Kumar, Dept of Yoga Psychology, Bihar Yoga Bharati, Ganga Darshan, Munger - 811201, Tel.: 91-6344-22430 (W) (LM 2000) A. S. Kundu, Ph.D. Indian Council of Medical Research, Ansari Nagar, New Delhi - 110 029 Tel. : 91-11-653980 (W) (FM 94) Jagdip Singh Lotay, K- 155, AWHO, Complex, Sector 4, Mansadevi, Distt. Panchkula, Haryana (India) (LM 99) Ms.Mamta Malhotra, 908, Gowshalla road, Harbans Pura, Ludhiana-141004 (LM-2001) Tel: 91-161-702085(H) Seema Malhotra, Ph.D. Asst. Prof. in Clinical Psychology, Dept. of Psychiatry, Kasturba Medical College, Manipal-576 119 Karnataka (India) (LM 95) L. Sam Manickam, Ph.D. Director, Center for Applied Psy. Studies (CAPS) Baith Shalom, Thirupuram, Thiruvananthapuram - 695133 (India) (LM 97) Tel.: 91-471-260148 (H), 443587 (W) S. K. Mondal Purbachal, Phase-II, Sector-III, 3R-4 / 7, Salt Lake, Kolkata-700007 Tel. : 91-33-3352554 (H) (LM-2001) Lisa Milne, Ph.D. 266, Middleborough Road, Blackburn South, Victoria-3130(Australia) (M-2001) E-Mail: lcmilne@hotmail.com B. P. Mishra, Ph.D. Dept. of Psychiatry, Dayanand Medical College & Hospital, Ludhiana - 141001 (India) Res. : 481, College Road, Oppo, Kitty Bakery, Civil Lines, Ludhiana - 141001 Tel. : 91-161-471634 (LM 95) Miss. Mridula Mishra, Ph.D. Lecturer, Bihar Yoga Bharti, Fort, Munger-811201, Bihar (India) (FM 92) Tel.: 91-6344-22430 (H)Fax:91-6344-20169 E-mail : yoga@yogavision.net Mrs. Nalini Mishra, Ph.D. Lecturer in Sociology, C/O Advocate Anuj Bhanot Chakia - 232103, Distt. Chandauli Tel.: 91-5413-22267, (FM 94) Membership Directory 71

Mrs. Nishi Misra, DM & SP Scientist ‘C’ 201, Nag Chaudhuri Hostel, DRDO Residential Complex, Lucknow Raod, Timarpur, Delhi-110054 (India) (LM 1995) P. K. Mishra, Ph.D. Reader, Center for Advance Studies in Psychology, Utkal University, Bhubaneswar-751004 (India) (LM 1997) Tel. : 91-674-583286 (H) 581739 (W) P. N. Mishra, Ph.D. Executive Director, Center for Entrepreneur Development M.P. 60, Jail Road, Jehangirabad, Bhopal - 462008 (India) (LM 94) Tel/Fax : 91-755-587987(H) 766437 (W) E-mail : cedmap@vsnl.com Sarita Mishra, Ph.D. 7/157,Swaroop Nagar, Kanpur (LM 2001) Tel: 91-512-552006 Sunil Mittal, M.D. Consultant Psychiatrist, Delhi Psychiatry Center, 35 Defence Enclave, Vikas Nagar, Delhi - 110 092, (India) (LM 95) Tel.: 91-11-2214726 (W) 2222767 (H) Mrs. Reetinder Mohan, Ph.D. 269, Sec. 16-A, Chandigarh - 160016 (LM 97) Tel.: 91-172-770269, 781026 Ms. Anjana Mukhopadhyay, Ph.D. Dept. of Psychology, Women’s College, Banaras Hindu University, Varanasi - 221 005 (India) Tel.: 91-542-310206 (H) (LM 94) Bernard I. Murstein, Ph.D. Dept. of Psychology, Connecticut College, Box - 5581, New London, CT-06320-4196 (USA). (LM 94) Ashima Nehra, Ph.D. 5175/1, Modern Housing Complex, Manimajra, Chandigarh-160001 (India) Tel. : 91-172-553055 (H) (LM 96) Paola Nicolini, MA Via Enrico Fermi 14, Lomagna (LC) 23871, Italy (M 99) Telefax : 039-9220187 (W) E-mail : paola.nicolini@libero.it K. N. Ojha, Assitt. Director, N.I.M.H. Regional Trg. Center, Kasturba Niketan, Lajpat Nagar - II, New Delhi - 110 024, (India) (LM 95) Tel.: 91-11-6831012 (W) 6840233 (H) Ann M. O’Roark, Ph.D. 866, Amelia Coart, NE St. Petersburg, Fl 33702-2784 (USA) (M 98) Tel/Fax : (813) 527-9863 E-Mail: AnnMORoark@aol.com Ravinder S.Palia, MSW.HRD Consultant, 5336 Lucas Court, Mississauga, Ontario, L4Z 4A9, Canada Tel: (905) 890-6286 , (LM 99) E-Mail : ravipalia@hotmail.com Rakesh Pandey, Ph.D., Lecturer, Deptt. of Psychology, DDU. Gorakhpur University, Gorakhpur-273009 (India) (LM 2000) Tel. : 91-551-337361 E-Mail : rpan_in@yahoo.com Col. Vijay Pandey, MD, Psychiatrist, Dept. of Psychiatry, Command Hospital (EC), Alipore Kolkata-700027. (India) (M 95) Tel.: 91-33-4792184 Lt. Col. S. S. Panglia, MD 1446, Phase-10, SAS Nagar, Mohali Tel.: 91-172-675536 (LM 94) Paul E. Panek, Ph.D. Associate Dean, OSU Newark Campus, 1179, Uni. Drive, Newark, Ohio-43055, USA. (M 98) Tel. : (614) 366-9315 E-Mail : panek.1@osu.edu S. Paragadeeswaran Lecturer, Dept. of Business Administration, Annamalai University, Annamalai Nagar - 608002, Chidambaram , India (M-2001) Tel: 91, 4144-38796, Fax: 91-4144-38080 E-mail : pragadeeswar@yahoo.com Suresh Parekh, Prof. Deptt. of Psychology MMG Mahila College, Opp. Moti Bagh, Junagarh-362001, Gujrat (India) (LM 2000) Marisa Porreca, Ph.D. Professor of Psychology Via Valsesia 8, 20152, Milano (Italy) (LM 99) Tel. : 024531624 72 Membership Directory

Sheetala Prasad, Ph.D. Lecturer in Psy., Ewing Christian College, Allahabad-211008 Tel.: 91-532-613363 (H) (LM 95) Rekha Prabhaker, Ph.D. 1071, Sector-20B, Chandigarh-160020 (India) (M 2001) S. Ramachandra, Ph.D. 292, 2nd Main, 3rd Phase, J.P. Nagar, Bangalore 560 078.(India) (LM 94) Tel. : 91-80-6584267 (H) E-Mail : ramas@nimhans.kar.nic.in Dalbir Kaur Randhawa, DM&SP, 1106, Sec. 33-C, Chandigarh(India) Tel :91-172-615774(L.M.97) C.S. Rao, Ph.D, Chief Manager (HRD), IFFCO, 54, Nehru Place, New Delhi -19 Tel. : 91-11-6432844, 91-124-6341034 (H) E-Mail : csrao@iffco.nic.in S.P. Rathee, Ph.D Dept. of Psychiatry, Command Hospital (WC), Chandi Mandir Cantt -134 107. Tel. : 91-172-866574 (W) (LM 94) Gilbert J. Roth, D. Min. 62, Timmerman Drive, Richland, WA-99352 (USA). (M 94) Tel./Fax : (509) 628-2132 (H) E-Mail : gil@owt.com M. Sahay, Ph.D., Clinical Psychologist, 95, Doctors Apartments, 4, Vasundhara Enclave, Delhi -96 (FM 92) Tel. : 91-11-2621789 (H) E-Mail : dr_m_sahay@hotmail.com D. Saldanha, DM Consultant Psychiatrist, Military Hospital, Meerut (India) (LM 94) Tel:696532(W) E-Mail : d_saldanha@yahoo.com Lt. Col. Sudhir Kumar Salujha, M.D. Deptt. of Psychiatry, Armed Force Medical College, Pune-411040(LM-2001) Tel:91-20-634117(H), 91-20-630652(W) Mrs. Amandeep K. Sandhu, MPMIR Tej Form, Manimajra, Chandigarh-160101 Tel. : 91-172-740991 (H) 782135 (LM98) George Savage, M.Sc. Consultant Clinical Psychologist, “Deogratias” 37 Victoria Road, Retreat 7945, South Africa (LM 95) Fax : (27) 21-454-161, 461-7564 Tel. : (27) 21-712-1281 (H) E-Mail : gsav@worldonline.co.za Harish K. Sharma, M.Phil. Lecturer in Psy.,SBS (M) College, Kotkapura, Punjab (India) (LM 97) Hemant K. Sharma, Ph. D. Hemant Mansion, Near Haveli Barkat Sahib, Nai Sarak, Jodhpur -342001 (India) Tel. : 91-291-54088 (H). 22755 (LM 96) Narendra K. Sharma, Ph.D. Dean Academic Affairs, Prof. of Psychology, 4055. Type-IV, P.O.-IIT, Kanpur-208016 (India) (LM 98) Fax : 91-512-590260 E-Mail : doac@iitk.ernet.in Abhayman Sidhu, MBA 120, Sector 9-B, Chandigarh-9 (India) Tel. : 91-172-742105, 743917 E-mail : abhaysidhu@yahoo.com Agyajit Singh, Ph.D. 136, Civil Lines, Patiala. (LM 97) Amool Ranjan Singh, Ph.D., Asso. Professor, RINPAS, Kanke, Ranchi-834006, Bihar (LM 95) Anup K. Singh Bihar Yoga Bharati, Ganga Darshan, Munger - 811201, Bihar (LM 2001) D. P. Singh, HRD Consultant, D.P.Associates, N-17, Green Park Extn. New Delhi -16 E-mail: welcome@dp_associates.org Tel: 91-11-6171298 (W) 9810064647 (LM-95) Lt. Col. Gurpinder Singh, 1098, Sector 8-C, Chandigarh (India) Tel. : 547825 (W) (LM 2000) M. P. Singh, Ph.D. 1329, Sec. 70, Guru Teg Bahadur Complex, Mohali, (Near Chandigarh) (INDIA) Tel. : 91-1675-20583 (W) Tel. : 91-172-223658 (H) (LM 95) Membership Directory 73

Navneet Singh, Vice President, S-20/6, DLF, Phase-3, Gurgaon-122002 (India) (LM 95) Tel. : 91-124-6387544 (H), 9810058444 E-Mail : navnit.singh@hsbcam.com Om Prakash Singh, Ph.D. Reader, Dept of Psychology, Gauhati University, Gauhati-149(India) (LM2001 tel :91-361-670303(H) Col. Rajinder Singh. M.D. Consultant Psychiatrist, 1734, Sec. 33-D, Chandigarh - 160 047 (India) Tel. : 91-172-600694 (H) (LM 96) Col. Rajinder Singh Management Consultant, 1526, Sector 34-D, Chandigarh, (India) Tel. : 91-172-601398 (H) (LM 98) Col. Surinder Singh, 5807, Modern Housing Complex, Manimajra, Chandigarh -160001 (India) Tel. : 91-172-735231 (H) (LM 99) Virender Singh, Vill. & P.O. Bir Banga, Distt. Kaithal, Haryana (India) (LM 98) Kalpana Srivastava, Ph.D. 7/157, Swarop Nagar, Kanpur (M 2001) Tel: 91-512-552006(H) Kalpana Srivastava, M.Phil. Scientist ‘D’ Deptt. of Psychiatry, Armed Force Medical College, Pune-411040 (India) (LM 2000) Seema Tripathi, M.A., Lecturer in Psy., DDU, Gorakhpur University, Gorakhpur-273009 (LM 2001) Tel.: 91-551-273526 (H) Ailo Uhinki, Ps.D., Ed.I., Psykologitoimisto, Synteesi, Linnankatu-37a A 9, Fin-20100 Turku, Finland (LM 98) Tel. : +358-(0)2-232 2001 Fax : +358 - (0)2-232 5007 E-Mail : a.uhinki@synteesi.inet.fi Acharya Vinay Vinekar, Institute of Universal Consciousness, 21, Milton Street, Cooke Town, Bangalore - 560005 (India) (LM 2000) Tel. 91-80-5472603 (W), 5548348 (H) E-Mail:gurujivinay@hotmail.com De-Cicero Emidio Vaz. Ph.D. Av. Lajeado. 969 AP. 301, Porto Alegre, R.S. Brazil, Brazil - 90460-110 (M 96) Tel. : 501-3344235 (W) E-Mail : vaz@pucrs.br S. K. Verma, Ph.D. 5522, Modern Housing Complex Manimajra, Chandigarh - 160 001 (India) Tel.: 91-172-730993 (H) (FM 95) Sanjay Vohra, MA. Psy-Com Services, B-4, 80/2, Safadurjung Enclave, New Delhi-110029 (India) (LM 95) Tel.: 91-11-6106433 Fax : 91-11-6175191 Narendra Singh Yadav, Dept. of Yoga Psychology, Bihar Yoga Bharati, Ganga Darshan, Munger-811201(LM 2000) V.N. Yadav, Ph.D. Head Dept. of Psychology 98, Housing Board Colony, Bhiwani-127021 Haryana, (India) (LM 99) N. Kumar Yaduvanshi, DPM. CMO, TPT Bn. ITBP, Airport, Chandigarh - 160003 (India) (LM 98) Tel. : 91-172-640182 S. Yuvraj, Ph.D. Asstt. Prof. in Psychology 12, NITIE Qrts., NITIE, Vihar Lake Bombay-400087 (India) (LM 99) Tel. : 91-22-857337 Fax : 857325 E-Mail : Prog@nitie.ernet.in Libraries: Psyc INFO American Psychological Association, P.O.Box 91600, Washington, DC 20090-1600(USA) Tel:(202) 336-5682 Fax (202) 336-5630 E-Mail:psycinfo@apa.org Commandant, Command Hospital (WC), Chandimandir - 134107, Haryana (India) (LM 97) Director, Agra Mansik Arogyashala, Agra - 282002 (India) (M 98-2001) 74 Membership Directory

Director, Ranchi Institute of Neuro Psychiatry and Allied Sciences, Kanke, Ranchi-834006 (India) (M99) Librarian Saurashtra University Library, University Campus, Kalawad Road, Rajkot – 360005. Tel: 91-281-78501 to 78512 Dr. Kirit Vyas, Librarian, Bhavnagar University Library, University Campus, Gijubhai Badheka Marg, Bhavanagar - 364002 (India) (M 98) Learning Resource Center (Library), The Ohio State University at Newark, Founders Hall, University Drive Newark, OH 43055 (USA)(M2001) Librarian, Bhaikaka Library, S.P. University, Distt. Kheda-388120, Gujarat, (India) (M 99) Librarian Central Library, J.N.Vyas University, New Campus, Bhagat Ki Kothi, Jodhpur-342001(India) (M 001) Librarian, Gyan Bharati, Bangalore University, Bangalore-560056 (India)(M 99) Dr. Dev Raj Singh, Ph.D, Librarian, Haryana Institute of Public Administration 76, Sector-18, Gurgaon-122001 (M 98) Librarian, H.P. University, Shimla (India) (M 98) Librarian, Technical Library & Documentation, IFFCO, Aonla Unit, PO. IFFCO Township, Bareilly-243403 (India) (M 2001) Librarian, University Business School, Panjab University, Chandigarh-160014 , India (M 98) Assistant Librarian, English Section, National Library, Belvedere Road, Kolkata L.B. Publishers & Distributors Pvt. Ltd., Subscription Department, 91 MG Road, Bangalore-560001 (2000) Tel. : 91-80-5587621, 5587302, E-Mail : lbpdshp@bgl.vsnl.net.in Magazine World, Station Road, Anand-388001 Rekha Mittal, Scientist- E1, Indian National Scientific Documentation Centre, 14, Satsang Vihar Marg, New Delhi-110067 National Library of Medicine , Serral Records S229401, Building 38, Room B1W10, 8600, Rockville Pike, Bethesda MD, MD - 20894 USA (M 98) Principle, K.S. Saket, Post Graduate College, Ayodhyaya, Faizabad-224001 (India) (M 2000) Tel:91-5278-32305 Principal, LAD College, Seminary Hills, Nagpur-440006 (M98) Princial, Rajaury Library, P.N. College, Khurda - 752057 (Orissa), (India) (M 2000) Principal SBAS, Khalsa College, Sandaur, Distt. Sangrur (Punjab) (India) (LM 2000) Principal C.B. Patel Arts College, Nadiad, Distt. Kheda-387001 India (M 2001) Principal Desh Bhagat College, Dhuri, Distt. Sangrur (India) Tel. : (01675) 20583 (LM 2000) B.N. Puhan, Ph.D., Department of Psychology, Utkal University, Bhubaneswar-751004, ( Orissa) Membership Directory 75

Ms. Rama Tejpal, Documentation Officer, Indian Council of Social Science Research, INU Institutional Area, Aruna Asaf Ali Road, P. O. Box No. 10528, New Delhi -110067 (India) The Head, PG Dept. of Psychology, LN. Mithila University, Kameshwar Nagar, Durbhanga-846004 Bihar (India) (M 97-2001) SAARL Universitaets, U-Landesbibliothek, Zeitschriftenstelle, AM Stadtwald, D-66123, SAARBRUECKEN, Germany9 (M-1994-2001) EBSCO Subscription Services, Magzine Divisions, P. O. Box- 1943, Birmingham, Alabama, AL 35201-1943 USA Tel. : (205) 991-6600 Fax : (205) 991-1479 New Members: Deepak Anand University Business School, Punjab University, Chandigarh (India) Raman Bansal, 39-C, Sector 14, PU. Campus, Chandigarh. (India) Tel. : 778214 (LM 2000) Nitesh Bhatia, R-7/B-28, Raj Nagar, Ghaziabad (LM 2001) Tel: 91-120-4719685 Mr.Kaushlendra Batra LU-105, Pitampura, New Delhi-110034(LM2001) Tel: 91-11-7081323(H) Ameet Brar, 2261, sector-19 C, Chandigarh-160019, Tel: 91-172-774466(H) (LM) E-Mail:ameetbrar@hotmail.com Santanu Chatterjee, University Business School, Punjab University, Chandigarh (India) Ram Chander, University Business School, Punjab University, Chandigarh Ankur Dhamija 488, Model Town,Karnal, (India) (M 2000) Dipti 78, Sector-2, Industrial area Kurukshetra(India) (LM2001) Tel: 91-000-30675 Mr.Ankur Dutta 18, East Lane, Sunderpur, RGB Road, Guwahati-781005 (LM 2001) Tel: 91-361-202515 Nitin Girdhar, 1559, Sector 14, Sonepat (India) Tel. : 01264-51202 (LM 2000) Anil Kumar Goel, M/s High Tech. Spring Industries, Gali No.9, 12th Quater Road. Tibba Dana Sher Hisar -125001 (India) (M 2000) Ambreen Kaur Grewal, 471, Sarabha Nagar, Ludhiana (India) Tel. : 91-161-452206 (LM 2000) Abhishek Gupta 140, Sector-19A,Chandigarh-160019 (LM2001) Tel:91-172-773834 E-Mail: abhishekgupta@engineer.com Neha Gupta, E3, Sector 14, P.U. Campus, Sector 14, Chandigarh (India) Tel. : 5422190 H (LM 2000) Priyanka Gupta, A-2, Doctor’s Enclave, Gangawal Park, Jaipur (LM2001) Sapna Gupta, Vidyarthi Prakashan, P.B.No.161,Bhagat Singh Marg, Saharanpur-247001 (LM2001) Tel:91-000-726298 Bhavna Jain, 255, Sector 17, Panchkula - 134109 (India) Tel. : 91-172-561290 H (LM 2000) Ruchika Jindal, Ashok Rice Mill, Industrial Area, Sirsa - 125055 (India) Tel. : 01666-22834 (LM 2000) 76 Membership Directory

Mr.Kabir Julka, 1863, Sector 34-D, Chandigahr-160034 Tel: 91-172-607713(LM 2001) E-Mail: kabirjulka@hotmail.com Vishal Kataria, University Business School, Punjab University, Chandigarh (India) Hridesh Kumar, Ashirvad Building, Sunny Side, Solan-173212 (HP) Tel: 91-1792-20233(H) (LM 2001) Yuvraj Singh Lehl, 106, Sector 8-A, Chandigarh (India) Tel. : 547686 (LM 2000) Tejwinder Singh Lohatia, C/O Parkash Public School, P.O.Kurali, Distt- Ropar(Punjab) India (LM 2001) Tel :91-1888-641922 Jyoti Mahajan, 130, Phase XI, Mohali. Tel: 91-172-211180, (LM-2001) E-Mail: jyotimahajan_80@hotmail.com Puneet Makkar 59, Nyaspuri, Karnal (India) (LM2001) Tel : 91-184-250888 Ankit Markan E1-8, Sector-14, Panjab Univ campus, Chandigarh-160014 (LM2001) Tel:91-172-778236 Nisha Mehta, 6338 B, Rajeev Vihar, AWHO Society, Manimajra Complex, Chandigarh-01 (India) Tel. : 98140-15235 Prabhdeep Mehta, UBS, Punjab University, Chandigarh (India)(LM-2001) Mr.Praveen Mishra, Kaveri House, Sukhraj Rai Road, Bhagalpur-812001 (LM-2001) Atul Naku, UBS,Punjab University, Chandigarh (LM 2000) Ms.Manisha Nayar 484, Sector-20A,Chandigarh (LM2001) Mr.Yash Pal Village & PO- Keharwala, Dist- Sirsa(India) (LM 2001) Tel: 91-1698-86204 Mr.Naveen Prabhaker, 2957, Patel Colony, Rajpura Town, Patiala. Tel: 91-1762-24624 E-Mail: nprabhaker@rediffmail.com Ritesh Ranjan, N-84/5, Telco Colony, Jamashedpur - 831004 (India) Tel. : 0657-281215 (LM 2000) Tushar Roy, 3077, Sector-44D, Chandigarh-160047 (LM2001) Tel 91-172-660733 Sunil Sachdeva 1479, Sector 42-B, Chandigarh (India) (M 2000) Savina 20, Type-5, Power Colony, Kurali Road, Roopnagar-140001 (LM 2001) Tel:91-1881-25250 E-mail: reply_savina@yahoo.com Vivek Shanker, 20, 4th Cross, 4th Main Road,N.S. Palya, BTM II Stage, Banglore-560076 (LM 2000) Shanti P.R., UBS, Panjab University, Chandigarh (LM 2000) Maninder Singh, University Business School, Punjab University, Chandigarh (India) Narinder Pal Singh, C-7, HMT Colony, Pinjore - 134101 (India) Tel. : 01733-64083 H (LM 2000) Randeep Singh, University Business School, Punjab University, Chandigarh Ankur Sood, 676, Civil Lines, Monga (India) Tel. : 91-1636-24773 H (LM 2000) Membership Directory 77

Mr.Rishav Sood, House No.7, Balun Bazar, Dalhousie Cantt(India) Tel: 91-1899-40052(LM 2001) Mr.Pankaj K. Shrirange, Bharkapara, Ward 25, Rajnand Gaon, (Chattisgarh, India ) Tel: 91-7744-22005 E-Mail:spankajy2k1@rediffmail.com Umesh Srivastava Manovaiganic P. Sansthan, UHB 28, Sanjay Nagar Colony, Chowkaghat, Varansi-221001 Tel. : 91-542-210847, Fax : 91-542-200748 Surinder 1574/1, Sector-30B, Chandigarh-160030 (LM 2001) Tel:91-172-657254 Mr.Aditendra Takshak, 2, Canal Colony, Circular Road, Rohtak (LM 2001) E-Mail: addy_takshak@yahoo.com Mr.Varun Yadav, 14/2, Canal Colony-1, Cantt Road, Lucknow (LM 2001) Tel: 91-522-271461 Consultants: J. C. Bubber, General Manager (HRD),P.A.C.L. SCO 125-127, Sector 17-B, Chandigarh, Tel. : 91-172-713823 (W), 742428 (H) Ron Ginsberg 353 Carlton Drive, Chapel Hill, NC 27516 (USA) Tel. : 919-967-9558 (H) Vinay K. Jain, CA, Jain Vinay Kumar & Co., 1280,Vakilpura, Delhi-110006 (India) Tel. : 91-11-3256269 (LM 99) K. V. Kaliappan, Ph.D. Professor, Dept. of Psychology, University of Madras, Madras - 600005 (India) Tel. : 91-44-6260571 (H) Barry A. Ritzler, Ph.D. Dept. of Psychology, Long Island University, University Plaza, Brooklyn, NY11201 (USA) Tel. : (718) 488-1068 (W), (201) 327-1292 (H) Danilo R. Silva, Faculdade de Psicologia e de Ciências da Educação,Universidade de Lisboa, Alameda da Universidade,1649-013 Lisboa Portugal. E-mail: ulfpdani@fpce.ul.pt David Sperbeck, Ph.D. 2530, De Barr Road, Anchorage, Alaska - 99508. (USA) M.S. Thimmappa, Ph.D Prof. Deptt. of Psychology, Bangalore University, Bangalore-560056 (India) Tel.: 91-80-6692075 (H) Yasho V. Verma, Ph.D. Vice President-HR & MS, LG Electronics India (P)Ltd., Plot No. 51, Udyog Vihar, Surajpur-Kasna Road, Greater Noida-201306 U.P., Tel. : 91-11-914569635, 4560900-940, Fax : 91-11-914560926, 4560921 E-Mail : yvverma@lgeil.com 78 Membership Directory

Need & Press Among Children of Working Females Meenakshi Mathur and Ravi Gunthey The present investigation attempts to study the Need & Press, among children of working females. It is hypothesized that children of working females will differ significantly from the children of non-working females on several needs. In the present investigation Child Apperception Test (CAT)- Bellak and Ballak (1949), which was adaptated by Uma Choudhary in 1974 was used. A sample of 80 children of working females and 80 children of non-working females were selected. The children of working females are different significantly from children of non-working females on Child Apperception Test. The need pattern of kindergarten children and found that art products of the artist have their significance in understading of the unconsious mind, ‘inner working of mind that reflects the deep scaled feelings, desires and needs of children’. It also expresses the repressed mysteries and demands of the individual’s which are unsatisfied and unfulfilled. Spontaneous drawings, story writings, paintings, songs and speeches are some of the projective techniques to provide relief and satisfaction to such individuals. He also expressed that art production of normal person must vary in degree from abnormal one. Distorted human figure in story refers to mentally defective individual and arts production is reflection of both past and present of an individual. Bambara (1999) working mothers start out with an irreplaceable bio-emotional advantage in relating to ther infants when they are reared by them. When they are sent to nurseries and daycare centers it does not meet child’s Needs. The extended time in daycare due to mother’s employment is likely to damage a newborn’s development. Leach and Eyer (1997) Needs of the growing child requires the mother to loosen her hold on the child and this task may be easier for the working women whose job is an additional source of identity and selfesteem. Santrock (1996). A comparison of children of working and non-working mothers, on Adjustment, Frustration, Level of Aspiration and Achievement. when made, differences in some personality characteristics such as reaction to frustration and level of aspiration between the two groups of children Jain (1990). Statement of the Problem The present investigation attempts to study the Need & Press, among children of working females. It is hypothesized and children of working women will differ significantly from the children of non-working women on needs like affiliation, Achievement, Dominance and pressure like Dominance, Affiliations, Lack and Loss. The motives, trends and feelings among children of non-working women will differ from the other group becasue of the availability of their mother. Test Child Apperception Test (CAT) In the present investigation Child Appercption Test (CAT)-Bellak and Bellak (1949) which

was adaptated by Uma Choudhry in 1974 is used. It has slight modification in the pictures which were suitable to Indian conditions and culturally relevant. Sample The incidental purposive sampling technique is being used in the selection of a sample 80 children of working women and 80 children of non-working women were selected from by and large similar type of school of Jodhpur city and all of them were from 3rd and 4th standard. Result and Interpretation Categories DM PID IDEN. CAT Mean 68.82 7.45 3.81 79.48 Children working mothers SD 29.74 5.01 1.39 34.15 Mean 61.87 5.36 2.8 70.49 Children non-working mothers SD 34.68 4.36 2.22 38.73 Table 2. Showing ‘t’ value on Child Apperception Test of group among children of working and non-working mothers. Categories D.M. P.I.D. IDENT. CAT Children of working mothers (N=80) V/s 1.36 2.81 3.45 1.56 Childern of non-working NS ** ** NS mohters (N=80) ** P<.01, NS - Not Significant., DM - Defence Mechanism., PID - Phobic, Immature, Disorganized., Ident. - Identification., CAT - Total Child Apperception Test Score. As per Table 2 the children of working mother are different significantly from children of non-working mothers on Child Apperception Test i.e, PID (t= 2.81, p<.01) and Ident (t = 3.45, p<.01). This shows that children of working and non-working mothers are significantly different on Phobic immature disorganized behavior. Their own identification with same sex parent of opposite sex also differs significantly. This means that these two categories children are different in Fear, Anxiety, Regression, Control, being jealous or being loved by parents of same sex or parent of opposite sex. While children of working and non-working mother showed no significant difference in Defense Mechanisms DM (t = 1.36) and Total Child Apperception Test score CAT ( t = 1.56). This reflects that children of both the groups are same on rebellion, stubbornness, isolation, regression, denial deception etc. Though mean value of children of working mother are

slightly higher than non-working mohters on both DM category and Total CAT scores. The purpose of the present study was to see the difference between need pattern of children of working and non-working mothers. The review of the study conducted in this area evidences that parental attitude including child rearing practices and their feeling of acceptance, rejection towards the child plays an important role in the development of the personality of the child. In the present study children of working mothers perceive maternal rejection may be due to their busyness. Motives like ‘Dominance’, ‘Aggression’ and ‘Hetersexuality’ found higher among these children, it may be due to the feeling of perception of rejection, which may lead to frustration and tends to be non-conformist. These children have also expressed violation of maternal norms in their stories. On the other hand children of a non-working mother perceived maternal acceptance higher than the working mother. Motives like ‘Achievement’, ‘Acceptance’, ‘Affiliation’ and ‘Endurance’ were also reported higher among the children of this category. They prefer to put the things in an order as the family norms. Children of working females feels less affiliated with their parents and as a result obtain lesser score on ‘Order’, ‘Abusement’ and ‘Endurance’. Present findings are in the line of study of Mishra (1998) in which he has reported that perceived maternal acceptance- rejection influences the motivational pattern of the child. The significant difference on eight motivational patterns was reported i.e., Achievement, Order, Affiliation, Dominance, Abusement, Endurance, Heterosexuality, and Aggression. However, on Motivational Pattern, Deference, Exhibtion, Autonomy, Intraception, Succourance, Nurturance and Change, the two groups of the subjects were not found to be significantly different from each other. Similarly, findings of Bambara (1999) is also supported by the above views. Reference Bambara, R. (1999). Spontaneous drawing as related to children’s need (Psycho-Linguistic Association of India, Agra, Vol. (29)2. Bellak, L. and Bellak, S.S. (1949). A manual for the Children’s Apperception Test. (Animal Figures). New York, C.P.S. Inc. Choudhry, U. (1974). Indian adaptation of Children’s Apperception test of Bellak. Delhi, Mansayan. Jain, M. (1990). The impact of adjustment, frustration and level of aspiration on the children of working and non-working mothers. Ph.D. Edu. Agra University. Leach, P. and Eyer, D.e. (1997). Women’s behavior : Do mothers harm their Children wehn they work outside the home ? Women and Men and Gender ; On going debates. Walsh mary Roth (Ed.) Yale University Press, New Haven Mishra, R. (1998). Motivational pattern as related to perceived maternal acceptance-rejection. Indian Journal of Psychology, New Delhi, 73 (3 & 4). Santrock, J.W. (1996). Child Development. London, Brown and Benchmark.

THE SOMATIC INKBLOT SOCIETY I wish to be a Member __________ a Life Member ________ of the Somatic Inkblot Society. Please submit this request to the Membership Committee. NAME ____________________________________ Birth date __________________ (Print or type) First Middle Last ________________________________________________ Zip _________________ Business/Office Address : ________________________________________________ ______________________________________________Tel. : (W)_________________ ___________________________________________________(H)_________________ EDUCATION Degree Year Institution Major Field of Study EMPLOYMENT : Current position, employer, dates (Graduate Students indicate area of study and degree toward which you are working). MEMBERSHIP : ________________________________________________________ TRAINING AND EXPERIENCE IN PERSONALITY ASSESSMENT : SPONSOR (S) Name Address Telephone 1. ____________________________________________________________________ 2. ____________________________________________________________________ SIS subscription payable every year in January through Cashier Cheque/Draft I certify that the information provided above is accurate and correct. An APPLICATION FEE Cheque is enclosed for Foreign Members ($40) & Life Membership ($300). For Members in India Rs. 250/- & Life Membership Rs. 1500/- Total Cheque $/Rs._______________Drawn at________________________________ Signature of applicant : _______________________________ Date :_______________ PLEASE RETURN with your cheque to : B.L. Dubey, Ph.D., Vice-President, Post Box No. 1107, Sector 15 Post Office, Chandigarh – 160 015 (India). Tele/Fax : 91-172-710986, Tel. : 91-172-710985, E-mail : sisdubey@hotmail.com OR sisdubey@rediffmail.com Make cheques payable to Somatic Inkblot Society, Chandigarh (India) N.B. : Please add Rs. 50/- as one time registration fee; and $5 / Rs. 50 if you are sending subscription through out station cheque.

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. E-Mail : wilfredcassel@hotmail.com Web Site at http: //www.somaticinkblots.com OR B. L. Dubey, Ph.D., DPM, FSIS, Editor in Chief, SIS Jr. of Proj. Psy. & Mental Health, Director Somatic Inkblot Center India, P.O. Box 1107, Sector 15 Post Office, Chandgarh-160015 (India) Tele/Fax : 91-172-710986, Tel. : 91-172-710985 E-mail : sisdubey@hotmail.com OR sisdubey@rediffmail.com

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY & MENTAL HEALTH (OFFICIAL JOURNAL OF SOMATIC INKBLOT SOCIETY) EDITOR-IN-CHIEF : 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@hotmail.com OR sisdubey@rediffmail.com EDITORS : Anil Agrawal, BE, MBA, Chief Executive Officer, Telephone Cables Ltd., 68-70, Sector 17-C, Chandigarh-160017 Tel. : 91-172-704368 E-mail : aagarwal@teclindia.com : Wilfred A. Cassell, MD, Director, SIS Center, 4501E, 104th Avenue, Anchorage, AK 99516 (USA) Fax: (907) 563-3746 E-Mail: wilfredcassell@hotmail.com : Padma Dwivedi, M.A., Social Worker, Dept. of Cardiology, Post Graduate Medical Institute, Chandigarh-160 012 Tel/fax : 91-172-710986, Tel.: 91-172-710985, : Ravi S. Palia, MSW, HRD Consultant. 5356 Lucas Court, Mississauga, Ontario L4Z 4A9 (Canada) Tel. : 905-890-6286 e-mail : ravipalia@hotmail.com : D. Saldanha, MD, Psychiatrist, Dept. of Psychriatry, Military Hospital, Meerut -250001India, E-mail : d_saldanha@yahoo.com : S. K. Verma, Ph.D., 5522 Modern Housing Complex, Manimajra, Chandigarh-160001. Tel. : 91-172-730993 JOINT EDITORS : S. Chaudhury, MD, Ph.D., Consultant Psychiatrist, Dept. of Psychiatry, Amred Forces Medical College, Pune-411040 Tel. : 91-20-6835348 (H) E-mail : suprakashch@vsnl.net : A. Dubey, MBA, SIS Center, 4240 Edinburgh Drive, Anchorage, AK 99515 (USA) E-Mail: adubey@hotmail.com : Mridula Mishra, Ph.D., Lecturer, Bihar Yoga Bharati, Munger-811201 (India) Tel. : 91-6344-22430 : M.P. Singh, Ph.D, Lecturer, 1329, Sector 70, Mohali-Chandigarh EDITORIAL CONSULTANTS R. N. Agnihotri, M.Sc., India Phillip W. Baker, Ed.D., U.S.A Mahesh Bhargava, Ph.D., India D.K. Bhatt, B.E., India J.C. Bubber, MBA, India Alfred Collins, Ph.D., U.S.A. Carina Coulacoglou, Ph.D., Greece C.B. Dwivedi, Ph.D, India K.V. Kaliappan, Ph.D., India Anatoly B. Khromov, Russia Nalini Mishra, Ph.D., India Vipul Mittra, IAS, India Anjana Mukhopadhyay, Ph.D. India Rakesh Pandey, Ph.D., 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 Barry A. Ritzler, Ph.D., U.S.A. Ferro Roberto, Ph.D., Italy Ann M. 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.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