SIS Journal of Projective Psychology & Mental Health

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH is a refereed journal and 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, counseling, 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 behavior. The journal includes (a) research articles (b) book reviews (c) brief reports (d) news about conferences and letters to the editor. MANUSCRIPTS PREPARATION: Manuscripts should be prepared in accordance with the format of the Journal of Personality Assessment/ SIS Journal of Projective Psychology and Mental Health. The manuscript should be prepared only in MS Word. No other formats are acceptable. An MS Word Template for preparing manuscript can be downloaded from the SIS Website. MANUSCRIPTS SUBMISSION: The typewritten manuscript in MS Word should be submitted only through email to the Editor Emeritus or Editor-in-Chief. The print version of the manuscript is not considered. The manuscript should be emailed on following Email IDs. (1) Dr. Bankey L. Dubey, Ph. D. Editor Emeritus, SIS Journal of Projective Psychology and Mental Health. Email: bldubey@gmail.com (2) Dr. Naveen Gupta, Ph.D. Editor-in-Chief, SIS Journal of Projective Psychology and Mental Health. Email: dr_naveengupta@yahoo.com Note: The Editorial Board of SIS Journal of Projective Psychology and Mental Health have full rights to accept/reject or require a re-submission of submitted manuscripts. Minor additions/ deletions/ changes can also be made in the manuscript at the level of Editors. JOURNAL SUBSCRIPTION: The SIS Journal of Projective Psychology and Mental Health is delivered to the members of the Somatic Inkblot Society as a membership privilege according to the nature of the membership and opted preference for Print Version or Soft Copy. We encourage the individuals and Institutions to become member of the Somatic Inkblot Society on the prescribed Membership Application Form available in this issue of the Journal to receive a copy of the journal. Non-members may purchase any single issue in print version or soft copy on the prevailing rates which are quoted in the latest issue of the journal. Current Rates: Foreign: $45 and Indian Rs. 600/- per issue. (1) All online payments or direct cash deposit for the journal should be made to following bank account: Name of Account: SIS Journal of Projective Psychology and Mental Health Bank Name: State Bank of India Branch Address: Krishna View Plaza, Marble Market, Plot # 20, Sector 20, Dwarka, New Delhi-110075 Account No. 32297525238 IFS Code: SBIN0011361 (2) All payments through Cheque or Demand Draft for the journal should be payable to “SIS Journal of Projective Psychology and Mental Health” sent to the following address by Registered/Speed Post. Dr. Naveen Gupta, Ph.D., Director, Hindustan Institute of Management and Computer Studies, Farah, Mathura-281122 U.P. (INDIA) Email: dr_naveengupta@yahoo.com, Cell: 91-9627182913 CHANGE OF ADDRESS: Any changes in address should be submitted to us through email for updating our records and seamless receipt of the Journal and other communications. Email: bldubey@gmail.com Copyright ©1994. SIS Center, India/Anchorage SIS Website: http://www.somaticinkblots.com

EDITORIAL Wilfred A Cassell

If all goes well with my aging body, in about four months after publication of this issue of our SIS journal I will turn 82 years old age. As I prepare this editorial, I still am living in Victoria Canada where frequently I go to Butchard Gardens. There I meditate, receive renewal and spiritual healing from the magical, mystical experience of incredibly beautiful Nature images. In that peaceful setting there are vast seas of breeze blown moving colorful flowers and magnificent towering trees - .many of which in October are proudly dressed in their bright fall colors. WHEN I SIT WITH MY LOVING GOLDER RETREIVER "MAGGIE", HIDDEN FROM THE CROWDS peering into a hidden reflection pool I truly feel ".God's Love". With this spiritual support I then am more able to contemplate the imminent reality of my aging body's DEATH. In 1960 when I was in my psychiatric residency I benefited from the intellectually stimulating lectures of a professor of anthropology Ernest Becker. He won the Pulitzer book prize for publishing "THE DENIAL of DEATH". The theme essentially was that most people cope with their personal fears of dying by employing the mental mechanism of Denial. In his classes he tended to avoid other stress reducing defensive techniques such as involve religious dogma, humor etc. I would like to begin with the following statement of a comedian about his own death as follows: "DEATH DOESN'T BOTHER ME...I JUST DON'T WANT TO BE THERE WHEN IT HAPPENS!" "I now invite each serious thinking reader to contemplate how a woman who was a remote public health nurse in Manitoba Canada assisted dying people in her professional role" Her interview while administering SIS 62 images Video is given ahead in this issue of the SIS Journal and hope it will serve as SPIRITUAL STIMULATOR during therapeutic intervention.

Wilfred A Cassell, M.D., FAPS, APC. Editor Emeritus, SIS Journal of Projective Psychology & Mental Health Director, SIS Center, 4501 E, 104th Avenue, Anchorage, AK 99507 (USA) Email: siswilfredacassell@yahoo.com

A SIS-II Projective Case Study of Becker’s Concept “Denial of Death” Wilfred A. Cassell and Bankey L. Dubey “Everyone is going to die, it doesn’t bother me – I just don’t want to be there when it happens!” – Woody Allen People worldwide face their own ultimate mortality with a wide range of culturally/emotionally colored reactions. Like the comedian Woody Allen, some use humor to defend against potentially disturbing feelings when contemplating the ultimate demise of the anatomical structure in which they locate their sense of self, or “Body Ego” Yet ultimately as one ages, Death Dysphoria tends to surface in daytime conscious awareness, as well as sometimes directly or symbolically in affect charged dreams directly. A central portion of the dogma proposed by theologians of the world’s great religions consist of “so-called reality” historical facts. For true believers, these may provide emotional comfort by claiming death overcoming miracles that purport to overcome “The sting of death”! In 1959 one of the authors (Cassell) had the opportunity of attending lectures by an anthropologist Ernest Becker based upon his Pulitzer Prize winning book “The Denial of Death”. This is a case history report illustrating the psychological defense system of a 100 year old woman who at assessment was “Happy and Healthy” while “Never Thinking about Her Own Death” Dr. C: Thanks for coming today. M: Well, you know what, I completely forgot, and then I realized and I dropped everything and I had okay. So where would you like me to sit? Dr. C: I think right here in this comfortable chair. M: Right here? Right here? Dr. C: Right here. M: Okay. Dr. C: Okay. And I'll be interviewing you. M: You know that I'm not good at this, eh? Dr. C: Okay. You don't have to do anything with the computer. I just want to ask you a few questions. Dr. C: So are you having a good day? M: Pardon? Oh, yes, really good. So many of my family are popping in and they're -- so I've been sort of busy. Dr. C: I guess so. Everybody wants to recognize the special occasion of your 100th birthday. M: So tell me, like, what is it for and – DR. C: Oh, yes. Well, we have a journal in India, and we’re interested in a lot of things. And we make -- write papers, but we have some special ink blot sort of things, that can be useful for taking histories and actually treating people. M: Okay. Dr. C: And I know that -- M: That sounds good. Dr. C: you were formerly a public health nurse. M: M'mm-hmm. Yes. Dr. C: And I was so impressed by your history, you know, in the newspaper. I said it would be good to interview you. M: Okay. Dr. C: Yeah. And I liked your philosophy. Tell us your philosophy about HAPPINESS. M: You know what, I had 13 brothers and sisters, and we had a beautiful home and my dad had a good job. He only came home weekends and so we poured over him when he came, and we just loved him. Anyway, we were very HAPPY. DR. C: That was quite a consideration with the stresses in a big family. Wilfred A. Cassell, M.D., FAPS, APC, (Email: siswilfredacassell@yahoo.com) and Bankey L. Dubey, Ph.D., D.M.S.P. (Email: bldubey@gmail.com), SIS Center, Anchorage (USA). Key Words: Denial of Death, SIS in ream Symbolism, Dream Interpretation

M: I know. We had, I don't know what it was, we – my dad had got -- we had a beautiful home. It was great a big house. Dr. C: Where was that now? M: We had five bathrooms upstairs, and -- not – five bedrooms, you know -- Dr. C: And what city was that in? M: In Winnipeg. Dr. C: Nice town. M: Yeah. Dr. C: And you survived some cold winters. M: Oh yes. It was so cold in the winter, but you know, we got so used to it. I would be way up north, with the -- with my work, you know, and -- Dr. C: Tell us about your work. M: Pardon? Dr. C: Tell us about your work. M: Well, I was a Public Health Nurse, so – you think -- you know. Dr. C: Yes. I remember when we talked in the hallway the other day, you -- you told me the story right away that was interesting about the pregnant lady. M: We had lots of stories! Dr. C: Can you tell us that one about the man, brought his wife in, and they overcame you. Do you remember that, what was-- M: There's lots of those. And I -- and it was cold and had been a horrible night, and this was like, 2:00 o'clock in the morning. And I had put a blanket on the floor and I was lying on it. And anyway, then I heard this car, it was a buggy of some sort. He came in, so I went to see, and I asked him what he wanted. So he told me, he said "My wife is having a baby." And I said "No, she can't have a baby here. There is snow, and rain." And he said, "Well, I'm going now, because I don't want to lose my ride." So he left her. And I had never seen her before, I didn't know what stage she was on. Dr. C: How did you feel at that point? M: I felt like killing myself!! Dr. C: Oh, well, yeah. M: Oh my God, I knew that I couldn't do that. So I had a look at her, she had grey hair, and it was hanging like this, and she was like this, and she was like that. And I said "How far are you? When are you expecting your baby?" She said "This afternoon." Dr. C: You didn't -- you did well not to faint on the floor. M: I thought, well, there is nobody I could call. There's no one because I'm all by myself on the Indian reservation. And so I said, well, that's not a big deal, she'd pop out the baby and, you know. So anyway, she said -- I said, "Well, how many and when do you expect?" She said "Right now!" Dr. C: Oh, come on. M: So I got ready to -- I got some towels and stuff that I kept by, you know, and so I told her to lie down. And I had put some stuff for her to lie down. And so she could hardly lie down because she was so big, you know. So I say, "Well, don't push. Don't push right now. Wait until I get there." She said "But I can't help it." And so, one whoosh, and there was a baby (laughing). Dr. C: Oh my. It's good you have a sense of humor. Okay. Well, I want to show you some things here, Okay? M: Yes, you bet. Dr. C: You'll find this pretty interesting, I think. There you go. M: Okay. Dr. C: Now, this is a series of electronic pictures which I made over the last 20 years, years. And this technique is used to help us understand people that have various problems, and is a way of helping them. M: Okay. Dr. C: You know, called a somatic image series. M: Okay. Dr. C: We shorten it, to somatic SIS. M: Well, I -- what's that? Dr. C: Do you want me to read that? "This viewing procedure is to be administered under the direct supervision of a trained professional, who had explained its risk, benefits, clinical relevance, and so on. If at any time questions or difficulties would arise during this proceeding, please feel free to call the person administering." Then we had

some pictures to relax people. Aren't they nice? M: Oh, that's gorgeous. Dr. C: Just focus on those pictures for a while. You know, I love Butchart Gardens. That's where I go in Victoria to get relaxed. M: I go there very seldom, but I do go. Dr. C: Well, when I go next time, if you want to go, I'll -- I'll take you. M: I'd love it. These are beautiful. Dr. C: Aren't they? M: What a variety. Gorgeous colours. Dr. C: And the music too. The soundtrack, right now, isn't as loud as it should be, but the soundtrack is pleasant too. M: Beautiful pictures. Dr. C: I'm going to show you how to respond to some test images shortly. I'm sure you could have used these flowers to relax that night when it was so stressful with the woman in labour having a baby! M: That's right. Yes. They're beautiful. And they are relaxing [indiscernible]. Dr. C: This is -- Someone is going to tell you how to respond to the DVD (SIS-II). Can you hear it? ”. MALE RECORDING “It is not a picture. It's an image, and everyone sees images differently. A few weeks ago, a friend and I spent a few moments reacting to images, and to what she saw in the image you're seeing now”. FEMALE RECORDING: “It's like a butterfly, but it's a butterfly upside down. But this long image takes on a human shape too. A very narrow man with long legs. And his head comes down as well, like a butterfly. And it looks like a mushroom cloud of an atomic bomb” MALE RECORDING: “It's a fun and interesting way to pass a few moments. Dr. C: That's a picture of the Alaska mountains, by the way. Aren't they lovely? Then, like them, tell me what you see. Everyone sees something different. And then tell me. Tell me what you see. Ordinarily we have -- sometimes they write them down, but I want you -- sort of, we're making a training tape for young people. M: I see. Dr. C:-- so when you see this, tell us what you see there, and any feelings. This is the first image. What does it remind you of? M: Trying to think. The colours are coming through so pretty. I see a little dog. Dr. C: Okay. Now we're going to see the third one. M: Not really. Dr. C: After each picture we'll have a flower. What about number 4? Does that look like anything? M: A flower. Now, what's -- a streak in the middle? Dr. C: That's what I asked you to see. Does it bring anything to mind? You saw -- M: It seems like an animal, it's sticking -- it's just sticking out, and looking worryingly. Dr. C: And now we have the fifth one. What do you see there? M: Well, it looks like a pink heart 5A. Dr. C: Right. And how about the sixth one? M: And let me see. “There's a little dog.” And it's somebody showing off, putting their feet -- both their legs out, like this. And that little dog, it's so sweet right there. Dr. C: And then we've got number 7. M: Okay. Where is number 7? It's someone putting on a show of some sort, to show off something. "See what -- see me, or look at me", or something like that. To me, that's someone to get your attention. Dr. C: And who is that someone, a man or woman or..? M: I think it's a lady, in a way. Dr. C: How about this one? This is A 8. M: I don't know. I -- well, he seems to wonder, he's wondering whether to pee or not. Dr. C: How about this one, 9A? M: And that's two -- well, they're not people, but they're two -- they're trying to put on a dance of some sort. There's two of them and they're not sure what they're doing. Dr. C: Does it remind you of anything at all? M: Uhh .. Dr. C: Okay. Here comes 10A. M: I can't figure out what that is. Dr. C: 11.

M: I want to see -- oh, she is trying to tell you something. And going up in the air like this, trying to tell you something. Dr. C: What would that be? M: I think it has something to do with a -- he's caught in the back somewhere, and yet he's different. These are little birds in the flowers, and -- Dr. C: 12A. M: Now, that one. Hmm, I think they're trying to prepare to speak in a -- in a thing. And not sure what to say. Dr. C: 13A, yeah. M: -- Hmm. It's someone– something surrounded, quite surrounded. Dr. C: Okay. 14A. M: Yeah, image 14 is -- It's reaching –for the sky or something. But he's not alone. Dr. C: Okay.And 15A? How about that one? M: Well, I don't think -- I don't think that's an animal, but it could be a long -- a longbeaked bird of some sort. But he's being, held up either by a tree or -- but he's ... Dr. C: 16A. M: Okay. Oh, 16. Let me see now. That's a hard one. it's either a woman or a man. There is something in there and they're trying to put on a jacket, and it's sort of stuck in here somewhere. Dr. C: 17A. M: Now, those are ribs. Dr. C: A18. M: What is this? I'll sit back, maybe. So much -- I made -- I made a dress and the top of it was just like that. Dr. C: Okay. 19A. M: Now, I got to figure out who he is first of all --what it is. Hmm. Dr. C: Any idea? Okay. We'll go on to another one. This is 20A. M: Now, this one, if I was at church, I think that this part here would be part of the front of the --and these things are -- they go around. Dr.C: Okay. Part of the church structure? M: Yeah. Dr. C: All right. Now we've got A21. M: Now, this, this is just an image, and they're just putting a law out, you know, you gonna have -- this is what you have to do. And – then someone I don't think is very happy about it. So they're -- Dr. C: What way do you think they're unhappy? M: Oh, put it back on again, or can you do that? Dr. C: Maybe later. M: Okay. Dr. C: 22A. M: Hmm. This is very -- Hmm. I have a -- at the cottage I have a big bowl, and in the centre of it, it's a -- something as part of the bowl, and it looked a little bit like that. Dr. C: 23A. M: Yeah. That, that also looks like a little child, and they're wanting help, and they've climbed up to this as far as he could go and he's calling, and he's waving his arms. Dr. C: 24A. M: Okay. It's an animal of some kind. Let me see. Or maybe it isn't. Dr. C: Okay. That's 25A. M: Oh, that looks like it could be fur around her.Well, it -- like, I made an outfit that looks a lot like that. Dr. C: Okay. M: And it was a two-piece. The outside is like that. Dr. C: This is 26A. M: Hmm. You know, it's someone asking for help. They've got their arms out like this. Dr. C: 27A. M: Now, what in the world is that? Well, it looks like a big fire cracker that they took off, and it's gone. Dr. C: Okay. Any feelings when you look at that fire cracker? M: Well, you know, the other day they were doing fire crackers at my cottage. (July the st or Canada Day) Dr. C: Oh, yeah, On Canada Day, right? M: Yeah. Dr. C: 28A. M: This image is hard to say anything about this one, somehow.

Dr. C: All right. 29A. M: Okay. I can't hardly see that one. Oh, it's coming. No, it's got my image in it, I'll put my head out here. Dr. C: Okay. 30A. M: I don't think I was very helpful. That looks like a tea pot, and that's the handle, and that's the pot. Dr. C: Okay. A31. M: And that's a bird. And I don't know -- I know that he's over there with his head, and he might be taking off, but there's something behind that shouldn't be there. But right there. Oh, and there's a lady here. She is watching this, or a man, but there is the two eyes and a mouth, and he's looking back, saying "What's going on" or something. There is action there anyway, of some kind. Dr. C: Any feelings looking at that one? M: It feels warm. Dr. C: This is 1B, oh, we went by it. Okay. Do you -- M: Beautiful. Dr. C: This is 2B. M: That looks like somebody who lost their head, and they're just walking about trying to find out how to -- but his head is gone. Dr. C: Okay. Any emotions looking at that? M: I think there is anxiety, very much so. Dr. C: A little scary. M: Very, very sure. Yeah, you've been beheaded. Dr. C: Okay. (At the period in history when she worked as a Public Health Nurse, she was working in essentially more of a male world. The reference to “beheaded” in Freudian terms symbolically reflected her body image lacking a penis and her unconscious feeling of symbolic social castration.) Dr. C: Now we've gone to 3B, sorry. M: No, I can't visualize that one. It looks like dark fur. And ... Dr. C: 4B. M: Oh, that the -- Oh, and that could be -- yeah. It's an animal of some kind, with her child. It seems like it's -- it's -- maybe it's not an animal, but it's a vision of some sort, where it's a baby, or a child, and an older person on the back. Like, the baby is small. Dr. C: 5B. M: I think that's just a man and a woman, and they are trying to decide something. And the three objects above are concerned about what -- something in there, and she is on the left, and he is on the right. He's sitting in his chair. Dr. C: This is 6B. M: Hmm. Like, to me, he looks like an animal, but just a -- or else it could be -- it's a shell of some sort, but it's quite large. That's part of a tree, I think, or it's a flower. Dr. C: And this one, 8B? M: I can't -- I know there is two sections to it, and the right is sort of a browny, and the other is a deep blue, on the left. Dr. C: 9B. M: Yeah. It looks like my embroidery work. That's what it looks like. Dr. C:10B. M: But it's -- my goodness. I love that blue. Dr. C: This is 11B now. M: I don't know what that -- it looks like a hat, or a cap of some sort. Dr. C: 12B. M: My goodness. Well, it's spread out, but I can't make out what it's trying to do. Almost like a person. Dr. C: Now. 13B. M: Oh, I've got something like that, it's a collar that comes like this. Dr. C: 14B. M: Oh my goodness. Oh, it's a bowl, but there is something in it. It looks like somebody has poured something into this jug. Dr. C: Okay. Here's 16B. M: That must be held up -- holding up to something. Although it seems like two people discussing something, at the very top. Dr. C: B17. M: It's a heart. Dr. C: Okay. Now we got 18B. M: That's -- My goodness , it's a hard one to put a name to it.

Dr. C: 19B. M: This is some sort of a bug. Dr. C: Okay. Anything else there? M: And there is a heart, and it must have something to do -- it must be some sort of an animal, or a fly, or a bug. Dr. C: 20B. M: It is a wedding ring. It was lying in a mess of something and was found. It is unfinished. Dr.C: 21B M: Something started. It didn’t finish. They just pitched it. Dr.C: 22B M: I see a little boy who fell. He is blowing bubbles. (Here it is significant that instead of seeing a dying person’s body with the spirit leaving, she substituted an image of a little boy and bubbles leaving. This is an important example of the mental mechanism of repression in her mentally receiving visual input denoting death and dying.) Dr.C: 23B. M: Someone was blurry. He was not in school or anything. He just seems to be there. It is windy. An area has opened up at top. The area is really disturbed like someone came along and gave it a kick. The circle has disappeared. (Although she was trained in anatomy and worked as a nurse, instead of correctly recognizing the somatic content in 23B, she projected symbolic material of a defensive nature. The emotional charge of the imagery is “really disturbed.” In my opinion, the disturbance reflects a response to the previous SIS ink blot where she failed to recognize the content but it produced age regression and emotional turmoil.) Dr.C: 25B. M: A puff of wind. It is rolling stuff on the highway in dust. Dr.C: 26B. M: It is very cloudy. Something is falling and trying to get out. It doesn’t make sense. (Here again, the emotional content of falling, trying to get out, captures a continuation of some of the anxiety triggered by 22B.) Dr.C: 27B. M: A child who is angry trying to make sense to the person next with his hands. (Note the continuation of the disturbed affect, in this case, anger.) Dr.C: 28B M: Someone who is angry. He is all covered with hair. You can see his face. He has a lot of hair. He looks with his mouth open that he doesn’t like what he is doing. (Again the anger and turmoil surfaced on this.) Dr.C: 29B. M: He is frustrated or angry, and he is walking really fast like he is determined. He looks pleasant but determined. It’s like a person walking away to escape from someone. (The theme of being angry and escaping reflects the change in mood which began with visualizing 22B.) Dr.C: 31B. M: They are confiding. Her hand is touching his. They are definitely together, two people, two adults, angry about something. Two adults are trying to hold on to the back of their legs. Two kids trying to reach out for their father’s leg.Two parents loving and kissing and two children trying to get affection. Dr. C: It's too busy, or too much stuff in it? M: But there's light, there's a light that's there. It's -- it's very, very visible. And it's, it's telling you something. And the hearts, have something to do with it, too. Dr. C: I'll have to just see what it says. M: I think I've got it. Windows? Dr. C: It's a problem with the computer. I'm just going to see if I can correct it. M: Window media. See if you can see. Dr. C: We had a little problem with the computer. M: Well, look at the time. My son was supposed to meet me. Dr. C: We're almost done here. So I guess we'll have to be done. What time is your son coming? M: It was supposed to be at 3:30. What time is it?

Dr. C: Well, it's got to be after 2:30, I think. I guess we won't be able to see them all if -- that's too bad. M: I wanted to see it. Dr. C: I don't quite know that ... M: Don't think we can -- he's used to me being late, so I can be a few minutes late. I'm going to rest my neck here while you find it. Dr. C: That's fine. That's fine. Well, did any of those remind you of anything in the real world that we haven't talked about? M: Yeah. Dr. C: What were some of the things that they reminded you of? M: Well, you know, the wilderness, where I have spent a lot of time in northern Manitoba, and this-- some in there reminded me of things I-- that I went through, and it reminded me of the anxiety that I had trying to find how to solve this. Dr. C: The anxiety that you had in northern Manitoba, what was that like -- what brought on the anxiety? M: Pardon? Dr. C: What was the anxiety, like, that you had in northern -- M: Oh, well, you know, there was a reason for the anxiety, because there was no one around, and I had a responsibility. The woman was in labour, the baby's head was showing, and I thought, well, what am I going to do? You know, like, the anxiety through that about the baby being born alive, and my part in -- and there is no other people around for miles, you know. Dr. C: That's the burden of responsibility. M: Oh, yeah. Dr. C: You had to deal with life and death issues. M: Yeah, lots, lots of it. Yeah. But I got -- I don't know. I wasn't worried, and I -- well, this one night, it was so cold and miserable. It was -- the wind outside was unreal. So there was – I was lying down on the rug and I had my house coat on, and I was all alone, and this is in the wilderness up north. And so this man comes

in, and he's

got a woman in front of him, and she's, like, her head down so I couldn't see her. And I said, "What's the matter with your wife?" He said "That's not my wife." And I said "Well, tell me, what's the matter with her." "She is going o have a baby." And so I knew then the baby was coming out. So anyway, I had to stop talking and do something. So I delivered the baby, and I told him, "You're not going out. You're going to stay here." But he said "My" -- I think it was a horse or something he had waiting with him. I know he didn't have a car. But he did have a horse and buggy, so maybe that was it. Anyway, I said "You have to stay here with me and -- " not that it would have helped, because there is no way he'd have got to a doctor or anything. I just knew I had to deliver the baby. And so anyway, that was one of the nights that was -- I was very worried about, you know, and concerned. And -- but everything turned out all right. The baby was named after me, and that was it. Dr. C: Well, congratulations on that. Did you have any dreams about things? M: No. It never bothered me. Once I was at work, got to my room, I was able to shut the door. Dr. C: And leave it all behind you. M: It saved my life, really. By being -- not worrying, you know, after. But I still do it. Dr. C: How do you mean you still do it? M: Well, I worry sometimes about things. Dr. C: Like what? M: Oh, let me see. One of those would be what? Oh, yeah, this couple were coming with two children to visit us here, and so we waited and we waited and nothing happened and so they did -- we waited and we waited, and nothing happened. And my husband said "Let's go and see. We know what road they're going to be on, so let's go and see." So we drove, I guess, about 50 kilometres, it was quite a distance. And they were stalled. And you know, they were in very bad shape because there's nowhere else -- no one else would be coming by that time of

the night. So that was one time that I worried about -- anyway. Dr. C: I bet. Did you have much experience with dying people and death? M: Yeah. You know, I stayed a lot of times with a person who was dying. Dr. C: What was that like? M: Well, I'm going to talk about this lady that I was with, and she said "You know, it's so hard to die." And so I said, "Yes, it is." And we were talking. I knew she was dying, but she wasn't in pain. So we were able to talk. Dr. C: What was she dying of? M: Well, it -- her heart. Yeah. And the doctor had said -- Dr. C: And how old was she? M: She was in her -- I think she was 54. Dr. C: And what was her attitude towards dying? M: Well, we talked about it. I was a Catholic, and she was a Catholic. So I said, "Do you want to talk about religion? Do you want to talk about God?" She said, "Oh, I would just love it if you would." So we talked about that, I talked. And told her about the after -- and, I mean it's hard to – Dr. C: What did you say about the afterlife to her? M: Oh, well, I said, "You know, I don't know what you are -- what you think about, you know, after you die." And she says "Well, I know that God is waiting for me, and I know that he'll be there." And so I went along with her, and so -- Dr. C: How did she react when you told her that? M: She relaxed so well. And I held her hand. She fell sound asleep. That was the end of it. And she died about two hours later. Dr. C: So she died peacefully? M: Yeah. Dr. C: Well, good for you. Do you think about your own death at age 100? Do you think about that ever? M: Pardon? Dr. C: Do you think about your own dying? (Notice the question had to be repeated. This is the third time I asked the question, reflecting the fact that this is a source of anxiety for her that she’s repressing.) M: I never think of that, but I'm with dying -- I was with dying people almost all the time. Because I was nursing in hospitals where, you know, it was for seniors. And so I was with people before they died, and we were able to talk about anything and everything. Dr. C: This would be a lot of Native people? M: Yes. Dr. C: And how do the Native people accept death? Do you -- compared -- M: They're wonderful. They're way better than we are. Dr. C: Tell us about that. M: Well, they accept death, and they know that it's -- that they're going to go to a better place with no more pain. And you know, that type of thing. Dr. C: Is that part of the Natives' culture? M: Oh, yes. Dr. C: What does the Native culture -- the Indian culture say about that? M: Well, they know that there's a hereafter. They feel. And they feel that their life – they don't want to steal, or kill anybody, and they know that they want to be good to people and lead a good life, you know. Dr. C: M'mm-hmm. M: And the hereafter -- there is a lot of the Indian people that I've looked after, a lot of them were different religions, you know. They were really, really nice people. Dr. C: How do they accept physical pain? M: Not as good as we do. Dr. C: Tell us about that. M: They sort of -- if they have pain, like, it's - it's a, like, yeah. They don't accept it as well2 as we do, I don't think, the pain. But I never have pain, so I couldn't tell. Dr. C: What do they say about pain when they have it?

M: Oh, I just talked them out of it. I don't really like talking about that. "What are we 7 talking about pain for", I would say to them, you know. "Why are we talking about pain? Do you want pain?" "Well, I would like to know that I'm not going to die and have pain." And so I'd have lots of fun with them too, you know. They had a sense of humour, like we do. And -- hey, one of my earrings is missing. Oh my gosh. Dr. C: Well, we'll have to help you find that at the -- M: It's only a small thing. Dr. C: What about-- do you remember any dreams you had during that period when you were all stressed out? M: I wasn't stressed out. Dr. C: -- with all that responsibility, and dealing with death and dying? M: No. No. I just took it. I'm going to do as much as I can -- as much as I can do, you know. And I knew that I -- that there is no way that I was going to have a miracle of some kind. So I did my best, you know. And so -- and afterwards, you know, I'd meet them in a store, maybe in Eaton's or somewhere, and they would -- if they saw me in somewhere, they'd come and have a visit with me, and their English wasn't great, but I could understand pretty well everything. But they were good. They were very good. But I'm not very good, because I got to go back home. Dr. C: Okay. We'll just say one more question. Now did you ever make mistakes that you regretted? M: Oh, yes, very much so. Dr. C: Like what? M: Like I should have done something more. Like it's mostly in the field of nursing and working with older people, and well, trying to make them feel comfortable when there is no hope, you know. And you don't want to lie about it, but you have to have a way of plaining, you know, that you've got pain, and your pain is going to go away when you die. And I hope hat you won't have any pain, but I guess if they talk -- Dr. C: And that's physical pain? M: -- If a person can talk to you, you know, about this, I don't feel good if they're holding it all inside, and they're lying there and counting the days and -- I say "Talk about your life", and "What did you do", and then they'd talk about their family, and you know, I found it helped. Dr. C: M'mm-hmm. M: It helped me too, you know. Dr. C: Yes. Yes. Well, that's very comforting to know, and the -- were there -- you say you never had many dreams about your work then? M: No. Never. Never. Dr. C: M'mm-hmm. (It is hard to imagine that with all the stressful events that she had at work that she never experienced posttraumatic stress imagery in her creams.) M: And I was -- the 13th -- I had 13 brothers and sisters. Dr. C: Where did you fit in the family? M: I was in the middle. And I was the spoiled one. My brothers used to say "You're spoiled rotten." So I had -- I had six – Dr. C: What influence did a large family have on you growing up? M: Well, my mom and dad where from Quebec. Dr. C: Uh-huh. M: And somehow they moved to Winnipeg, or St. Boniface. Dr. C: What year? M: Well, it must be over 50 years ago, something like that. Dr. C: M'mm-hmm. M: So anyway, yeah. It would be over, maybe 55 or 60 years ago, maybe longer. Anyway, we had a really good life. I had ten brothers and sisters. And my dad had a wonderful job, and only came home weekends, and we all grab him and love him and everything. Dr. C: What did he work at? M: He worked for a company that -- manufacture company. I forget what it was now. But he only came home weekends, and we just ate him up when he arrived. I know I would just go and grab him. But

anyway, he was glad. He was happy. He spent the weekend. And like, there were 13 of us, you know, and we'd all take off so mom and dad would have time with them on Sunday, and so we managed somehow, you know,

there

was older

-- younger -- older sisters and older brothers. And they -- I would like my life over again exactly the same. Dr. C: It's wonderful to be able to say that. M: Yeah. Dr. C: What would you advise for young people today in terms of how to live their life? M: Oh, well, I -- I go -- I do -- I do work with young people, you know, in spite of my job. I tell them about what it's like, you know, once --"You're in school right now, and doing all this and all that, but once you think about what you're going to do", then we talk about it, you know. And so I think sometimes it helps, you know. But right now I've got to go, darling. Dr. C: Well, thank you very much. M: Oh, I enjoyed this. I enjoy being with you. Dr. C: Well, thank you. I enjoyed it too. M: So maybe we can do it again someday. (Here she expressed interest and enthusiasm and a desire to speak more about her interesting life.) Final comment: Like this aged public health nurse, SIS clinicians in the various mental health disciplines have occupational exposure to much “Secondary Empathetic Traumatization”. The power of the SIS technology to bring dysphoric affect charged stressful imagery into clinical diagnostic/psychotherapeutic interviews is well documented. Please always keep in mind the risk/benefits of these powerful projective techniques! References: Cassell, W.A. (2011a) Editorial: Dissolving Death Anxiety with Yoga Empowered. SIS Journal of Projective Psychology & Mental Health, 18: 123- 128. Cassell, W.A. (2014) Editorial: A Spiritual “Afterlife” Death Dream, SIS Journal of Projective Psychology & Mental Health, 21:1 1-2. Cassell, W.A. and Dubey, B.L. (2012a) Spiritual Warfare and SIS Spiritual Symbols, SIS Journal of Projective Psychology & Mental Health, 19:2, 80-90. Cassell, W. A. Dubey, B. L. and Roth, G. J. (1997) Medical, Psychological and Spiritual Application of the SIS Inkblots. SIS Journal of Projective Psychology & Mental Health, 4, 89-112. Cassell, W.A., Dubey, B.L., Charles, T. and Dwivedi, P. (2013) Perceiving One’s Own Dead Body and Death Anxiety Dissolving SIS Spiritual Symbols, SIS Journal of Projective Psychology & Mental Health, 20:1, 3-1 SIS Doctoral Research Award Somatic Inkblot Society announces an award to the Research Scholars who have employed any version of Somatic Inkblot Series as a tool in their doctoral dissertation. The award carries a Citation and a cash award of Rs. 5000/- to the research scholars. Submit a soft copy of your doctoral dissertation to claim your award on Email ID: bldubey@gmail.com. The Award will be delivered in the next International Conference of SIS. Bankey L. Dubey Director, Somatic Inkblot Centre

Comparison of the Correlates’ Structure of the Rorschach, SIS-I and SIS-II Projective Techniques with the MMPI Test and Factorial Analysis of the Indicators Anatoly B. Khromov and Bankey L. Dubey The correlation of Rorschach, SIS-I and SIS-II inkblot tests were measured to find out the mutual empirical validity with MMPI test. The three tests were administered to 98 subjects. The results were ciphered on identical forms containing 54 categories which were correlated with MMPI test. The structure of correlation in each pair matrix of three inkblot tests was calculated and has been compared. Сronbach has commented that projective techniques give wider strip of information and lower reliability in comparison with objective psychometric tests whereas Cassell (1980) emphasized that increased structure of projective stimulus have raised level of reliability of projective tests. The present research revealed, that psychometric properties of inkblots tests increased after increasing the stimulus from Rorschach to SIS-I 20 images and from SIS-I to SIS- II (62 images). However, it was not able to increase the ability to differentiate subjects’ specific mental disorders. Correlation between ambiguity and projection of properties of the person has nonlinear character, and the moderate level of ambiguity gives an optimum variant at displaying. 1. Comparison of the correlates’ structure of the Rorschach, SIS-I, SIS-II with the MMPI test: 1.1 The structure of correlation of the Rorschach and MMPI tests showed 93 significant correlations, reflecting a unique way of vision of inkblots indicate the following: • The rarely seen whole response of Rorschach test (W) may correlate with the MMPI’s Low level of development of Сonscientiousness. • The Confabulatory whole (D-W) of Rorschach test (W) may correlate with the MMPI’s low level of Hypomanias, Impulsivenesses, Conscientiousness, and higher level of Self-control. • More usual details of Rorschach test (d) may correlate with the MMPI’s Invalidity, Paranoia, Psikhopatiya, Psikhasteniye; The White Space of Rorschach (S) may correlate with MMPI’s Schizophrenia and Hypomania. • The White Space with a Dark spot Rorschach test may correlate with the MMPI’s high parameters of Invalidity and Psychopathy scales; • The dark detail, and the form is marked in a combination with it on Rorschach test may correlate with the MMPI’s that the examinee possesses good Selfcontrol; • The response with good form on Rorschach (that is when the image is well identified) may positively correlate with high values on a scale Paranoia of MMPI test; • Percept with dark detail, and use of form in combination may correlate with good Self-control the MMPI ; • Uncertain images in examinee’ response on Rorschach may correlate with the higher level of Sensitivity scales of MMPI test. Anatoly B. Khromov, Ph.D.,Professor of Psychology, Kurgan branch of the Ural Institute of Economics, management and law, Kurgan, (Russia) Email: Anatolykh1@hotmail.com, and Bankey L. Dubey, Ph.D., SIS Center, New Delhi Email: bldubey@gmail.com Key Words: Correlates’ Structure of the Rorschach, SIS-I and SIS-II, Comparision of Inkblots test and MMPI,

• Movements of an animal on Rorschach may correlate with the higher Skill of Communication.; • Movements of may correlate with the Dependence of the examinee is higher; • If the examinee marks the color of stimulus more often, with form as secondary, it means that the person’s Will, Self-checking and Self-control are worse developed; • If the inkblot stimulus has good form with color mentioned only as in the subordinated role, it means, that the examinee has the higher value of Depression, Paranoia and Psikhasteniye of the MMPI test, and, accordingly - lower the Social status; • If the examinee more often mentioned achromatic colors on Rorschach it indicates that the examinee have higher Self-control, but may indicate low level of MMPI’ Impulsiveness and Conscientiousness; • When achromatic colors are combined with the form on Rorschach, it means that low level of the Depression and Psikhasteniye, but Affectivity is higher; • If on RORSHACH test we have the description of the surface’s spot or the surface’s structure of object – it means that higher the Communication Skills; • If stimulus is uncertain image like «x-ray picture» type (and absence of any form), may indicate that the examinee has the lower values of Animosities and Suspiciousness; • If the human figures is seen more often as a caricature, cartoons, - it means that the examinee with the MMPI test has higher Conscientiousness and Dependence; • If the examinee emphasizes the details of human figures represented as a caricature - it is mean the low Conscientiousness; • Figures of animals responses on Rorschach - means that low Will and Conscientiousness, and higher Psikhopatiya often identified; • Figures of animals responses on Rorschach - means that low Will and Conscientiousness, and higher Psikhopatiya often identified; • If the examinee gives response identified like the figures of mythological animals, it means that the person’ Will is better developed; • If parts and spots of the animal’s body are identified on Rorschach, it means that the examinee has the

Sexual deviations, Psikhasteniye and Rigidity more expressed; • If Anatomic body parts of the person are often mentioned - low Impulsiveness and higher Self-Control is identified; • If the spot of images are containing anatomic internal bodies of an animal, it means that the person needs medical help or he has the medical simulation, and his Psikhasteniye, Intellectual parameter, female character, Rigidity are highly identified; • If the blots are perceived as the genitals on the Rorschach it is often identified – the low value of Invalidity scale of MMPI test; • If the images are identified as food – it may indicate that more often one feels Necessity of Treatment, has higher Intellectual index, has like the Female character and higher Rigidity; • If the image reminds children's figure, it mean higher level of Insincerity, Correction scale, Medical Simulation; and the examinee also subjective Needs for Treatment, has higher level of intellect, Female character, Introversion and Rigidity is more expressed; • If the response to images has the blood, it means that Schizophrenia, Paranoia, Introversion, Alarm, and Affectivity are higher and Skill to Communication is raised as well; • More often the response with fire

indicates that the examinee has low level of Hypomania scale, the Will, Impulsiveness and Conscientiousness is worse developed also; • More often perception of Clouds indicates, low value of Conscientiousness by MMPI test; • Perception of Popular on Rorschach, it means that Suspiciousness, Selfchecking, Animosities, and Skill of Communication are high domination; • Many original response on Rorschach test may indicate, low value Invalidity and Insincerity scales, but medical simulation and need for treatment are higher, gloomy Depression, introversion, more Expressed female character and Rigidity higher as well 1.2 The correlates’ structure of SIS-I with MMPI test: The analysis of significant correlations (89) images of projective stimulus of SIS-I and MMPI test shows examinee’s unique way of vision the inkblots and dependence the vision on personal features: • Fewer use of whole spot in perceiving the responses on SIS-I has positive correlations with Psikhopatiya of the MMPI test; • If the perceptual image is under construction (more with support of any detail) - the examinee show higher level of Insincerity and Emotionality scales, but lower level of Hypomania, Impulsivenesses, Conscientiousness, Communicative skill and Needs for Treatment; • If the examinee use the fine details during the construction of the perceptual image more often, and these details are perceived well, has positive correlation with the basic scales of MMPI test observed as: Invalidity, Paranoia, Psikhasteniye, Schizophrenia, Hypomania, and also, the Alarm, Suspiciousness, Conscientiousness, Dependence, Impulsiveness are higher; Communicateve Skills and Sexual Deviations are higher , Intellect is better, but the Social Status of the examinee is lower; • Perception of usual details on SIS means the Medical Simulation and Emotionality are

lower, Characteristics of Self-Control and Self-Estimation are worse as well; • If the perceptual image constructed with support on white space with the combination of the dark spot - mean, that the Hypomania and Communicative Skills are higher; • If the perceptual image has bad form – it mean the Introversion is high; • If the Images of Movement at SIS-I are singular – mean Medical Simulation is higher but Self- Control is lower by MMPI test; • Animal Movements are often marked - the Hypochondria of the examinee is higher expression; • If there is more response of movement attributed to inanimate objects, it means Hypomania, Impulsiveness, Conscientiousness, Animosities and Sincerity of the MMPI test are higher. • Colors are rarely seen indicates, Communicative Skill is advanced; • If the good form is marked, and color is mentioned only in the subordinated role – the Invalidity, Psikhopatiya, Self-Estimation of the examinee are higher; • If the Color is emphasized, and the form is present only on the second plan - Hypochondria is higher with Introversions; • If at the description of the percept the surface or a structure of object is more often mentioned, the examinee with greater probability can have Sexual Deviations, higher Hostility,

Introversion, but low Intellectual level; • If during perception of image the surface or structure is mentioned rarely, the Social Status and Emotionality is advanced; • If the objects with the uncertain form are less marked, - it means that level of the Accentuation and Female Character are higher; • If various shades of color are more often used – it means advanced Intellectual, Will and Introversion; • If there are seldom response like «x- ray picture», or the images of certain anatomic bodies – it means of higher level of the Psikhopatiya and Animosities, but Self-Checking is lower; • If the response contains «x-ray picture» and this image often identified in a spot – it mean that the Invalidity, Depression, Introversion, Schizophrenia, Intellectuality, Sensitivity, Uneasiness and Dependence are higher, but the Communicativeness is worse; • If during the estimation of inkblots the human images are mentioned – it mean the Self-Control is higher, but Medical Simulation is lower; • If human figures are crude marked,the Hypochondria is higher, but Conscientiousness is lower; • If the spots like the human or animal anatomic internal parts of the body are often identified, may indicate higher level of Depression, Introversion, Suspiciousness, but Low Social Status; • If the inanimate objects is less often marked – the Conscientiousness is advanced; • If more often for construction of a visual image the subjects executed from an animal material – the Hypochondria complex and intellectual factor are higher; • More often perception of Landscape means Hypomania is more often mentioned; • The image named as an simple "card" means Conscientiousness is higher; • If plants, trees, vegetables are more often perceived, means higher Rigidity, but low Depression; • If the images remind children's figure, means the enhanced of the Will; • There are images in which the blood is mentioned, it indicate the Invalidity, Introversion, an Intellectual Parameter and Anxiety are higher, but Communicative Skill is worse; • If more often the Popular response are given – the Suspiciousness and Animosities are higher; • If Original responses with good quality are given more often, - Hypochondria complex and Psikhasteniye are higher; • Bad Original response – that mean Invalidity, Paranoia and Self Control scales of MMPI are higher; 1.3 The correlate’s structure of SIS- II with MMPI test: The analysis of correlates of parameters of Projective Test SIS-II and ММРI (119 significant correlates) reflect steady laws in a unique way of vision by examinees of figures of a projective technique: • If for creation of a visual image the examinee uses all spot, it mean that the level of Hypochondria, Rigidity, Depression and Animosities are higher; • If for creation of a visual image the examinee uses all spot, it mean that the level of Hypochondria, Rigidity,

Depression and Animosities are higher; • If the spot of SIS-II is reduced - Hysteria, Psikhopatiya, Schizophrenia, an Intellectual Parameter are higher and the Will is better developed and more often used; • If the Response is made on the basis of fine, unusual details – the Impulsiveness,

Schizophrenia, Introversion,

Intellectual Parameter are higher, but lower Skill Of Communication; • If we see that examinees described the blots using the vague and uncertain images, it correlates positively with Sexual Deviations, Hypochondria,

Hysteria, Psikhasteniye, the Social Status are higher; and better Intellectual Parameter, Female Character, and the best parameter of Will; • If Animal Movement responses are fewer – the Will is advanced; • If there are inanimate movements that mean the positive correlation with Hypochondria is observed; • When the form dominates more, and color acts in the subordinated role - An Intellectual Parameter is higher; • If color dominates, and the form is uncertain,– the Hypomania and Conscientiousness are higher; • If the achromatic colors are more often mentioned, the Independence is advanced; • If shapeless and diffuse images prevails – the probability of Sexual Deviations, Paranoia, Psikhasteniye, the Will, Sincerity, Female Character, Intellect are better developed, but lower Hypomania and Introversion; • If the images of "a x-ray picture" are more often given – they have the positive correlations with Sexual Deviations, with an Intellectual Parameter and Female Character, with Insincerity and Introversion; • Images of the whole human figures, may correlate to Insincerity, Hypochondria and Skill to Communicate; • If the human figures represented not as real characters, but as caricatures – mean the Sexual Deviations; • If the Animal responses are more dominating – means Hypochondria, Depression, Hysteria, Psikhasteniye, the Intellectual Parameter, the Social Status are higher, Female Character and Sexual Deviations are more often happen; • If anatomic bodies of the person are more often mentioned – the Hypochondria and Introversion are higher; • Images of genitals are more often mentioned - More often Sexual Deviations, Female Character, and social status are higher; • If the response of inanimate objects dominate it correlates with Hypochondria,

Schizophrenia, Hypomania, Introversion, Rigidity, Impulsiveness Suspiciousness, Alarm of MMPI; • The responses executed from an animal material are less mentioned - means Insincerity, Sexual Deviations, Female Character are higher, but lower the Introversion; • The responses executed from an animal material are more dominate – the Parameter of Will, Conscientiousness, and the Social Status are higher; • Images of food are more often perceived – the Emotionality and Self- Control are higher, but Introversion, Conscientiousness and Sensitivity is lower; • If the responses of landscape more

dominates - Hypochondria and Dependence are higher; • Plants, trees are more often mentioned - Rigidity is more often referring from MMPI test; • Images of children's figures - above Sexual Deviations, Female Character, The Will, and the Social Status are higher and more often mentioned, but lower Introversion; • If abstract responses are given more often it correlates with Invalidity scale by the MMPI test; • More often if fire response is mentioned - Medical Simulation, Hypochondria, Sensitivity, Alarm and Dependence are higher; • If the Images with clouds dominate - Psikhasteniye, Female Character, Intellect and The Social Status are higher, but lower Hypomania and Introversion; • If Original response with good quality are present, correlates with the Higher Self-Estimation; • If the Original response with bad quality are present may correlate with Sexual Deviations Prevail and the Social Status are higher, and the Will is better developed. 2. Factorial Analysis of Indicators of the Rorschach, SIS-I, SIS-II Projective Techniques’ indicators: 2.1 The factorial structure of Rorschach test: The first factor (the factor’s name: UNCERTAIN FORM) assembled with following of the correlation items: • Unusual details (Dd) 0.9853; • The detail is the basic of the image’s determinant, and the white space perceived only as a combination with it (DS) 0.8552; • A determinant "color" - responses, which are accented on color of a spot (C) 0.7756; • Shades chromatic or achromatic images owing to which depth is created, structure or prospect (c) 0.6953; • The responses mentioning something diffused, shapeless "fog", "smog"(К) 0.5954; • Abstract concept like "authority", "love", "beauty", etc. (Аbs) 0.5753; • Blood (Вl) 0.4782. The second factor (SUBJECTS AND THE UNCERTAIN FORM): • Responses used to white free space as a figure (S) 0. 8552; • Аchromatic color responses leaning to black, white and grey fragments of spots (C’) 0.8953; • Responses of type «x-ray picture» (k) 0.7952; • Inanimate objects (Оbj) 0.7523; • The subjects executed from an animal material (Аоbj) 0.5753; • Plants, trees, parts of plants, vegetables, fruit, fruits (Рl) 0.4557. The third factor (MOVEMENT OF ANIMALS): • Complete responses (W) 0.7953; • The Animal Movements (FМ) 0.7665; • The superficial effect in the response is poorly differentiated, and combined with object of the uncertain form (сF-) 0.6652; • Figures of animals (And +) 0.6444; • A card, islands (Gео) 0.5773; • The Popular responses(P) 0.5554. The fourth factor (IMAGE OF THE PERSON) is made with such responses: • Responses with person’ movement (M) 0.8953; • Human figures, whole or almost whole (Н +) 0.8953; • The parts of the human figure presented as caricature or the detail

of fantastic humanoid figures (Hd) 0.6689; • Anatomic (internal) bodies of the person (Аt) 0.5733; The fifth factor (MYTHOLOGY): • The white space is perceived in a combination with dark fragments of a spot, and all spot (WS) is considered 0.7953; • The Certain form is included in the concept of diffusion. Example: "clouds similar to people" (КF) 0.7565; • Figures of mythological animals, monsters, caricatures of animals (А-) 0.6645. The sixth factor (FINE DETAILS AND ARCHITECTURE): • Responses to fine usual details (d) 0.7795; • The responses transferring impression of a surface or a structure, an example: "the woman in a transparent skirt", "teddy bear" (Fс- ) 0.7522; • Architectural objects (Аrch) 0.6321; • The most original good responses (O +) 0.5558. 2.2 Factorial Structure of the SIS-I: The first factor of test SIS-I (the factor’s name: UNCERTAIN FORM) contains following variables: • Responses to white space when the spot represents itself as a background (S). • If the detail is primary, and the white space is perceived only in a combination with it (DS) 0.7758; • The bad form inexact and uncertain images: "cloud", "any animal", "any card" (F-) 0.6572; • Аchromic color responses leaning black, white, grey fragments of spots which also can act in combinations with the form (С’) 0.6333, • The subjects executed from an animal material (Аоbj) 0.5672; • Bad original responses (O-) 0.5444. The second factor (HUMAN’ MOVEMENT) build from: • Movements of the person (M) 0.8844; • A determinant "color" (C) 0.7581; • A card which does not correspond with any country, or x-ray picture which does not specify the certain anatomic formation (kF) 0.74442; • Human figures (Н +) 0.6695; • Anatomic bodies of an animal (Ааt) 0.63333; • Food (except for fruit and vegetables (Food) 0.5881; • Plants, trees, parts of plants, vegetables, fruit, fruits (Рl) 0.5687; • Clouds (Сl) 0.5443; The third factor (MOVEMENT OF ANIMALS): • The confabulatory intact response (DW) 0.7955; • The white space is perceived in a combination with dark fragments of a spot (WS) 0.7666; • There are attributes transmit of colors at responses, but there are no maintenances (Сn) 0.6653; • The parts of human figure presented as a caricature or a detail of fantastic humanoid figures (Hd) 0.5522; • Subjects (Оbj) 0.52223; • The most rare (original) good responses (O +) 0.5002. The fourth factor (MOVEMENT OF ANIMALS AND OBJECTS OF THE UNCERTAIN FORM, CONCERNING THE NATURE): • The movements peculiar to an animal (FМ) 0.8953; • The surface or a structure are

precisely expressed, or the response together with superficial, textural qualities transfers the concrete form (the woman in a transparent skirt) (Fс) 0.8885; • The superficial effect in the response is poorly differentiated, combined with object of the uncertain form (сF) 0.8343; • Responses in which shades transfer effect of depth, a combination of several measurements, the difference in shades between which creates the certain image (trees in water, the objects, being one before another) (FК) 0.7735; • A Card, islands (Gео) 0.6433; • Children's figure without the concrete maintenance (Аrt) 0.5535. The fifth factor (COMPLETE IMAGES OF THE CERTAIN OBJECTS): • Complete responses (W +) 0.8333; • Movements of inanimate objects, abstract and symbolical forces (M) 0.7923; • Responses surfaces transferring impression or structures (Fс) 0.7335; • Responses transferring images of the certain objects (a backbone, a thorax and edges, a card of the concrete country (Fk) 0.6335; • Fragments of a body of animals (Аd) 0.6222; • Fire (Ti) 0.5895. The sixth factor (THE BAD FORM AND MYTHOLOGICAL PERSON): • Truncated from whole response (W-) 0.7856; • The responses mentioning something diffused, shapeless: "fog", "haze", "smoke" (K); 0.7775 • The response of type "x-ray picture" (k) 0.6488; • Human figures, unreal characters, caricatures, cartoons, or mythological, fantastic essences, monsters, witches (Н-) 0.6555; • A landscape, a kind of height (N) 0.5889; • Architectural objects (Аrch) 0.5553. 2.3 Factorial Structure of the SIS-II The first factor of test SIS-II (UNUSUAL DETAILS, THE CONTENT CONCERNING TO THE ANIMAL) named from following variables: • Unusual details (Dd) 0.8953; • The white space is perceived in a combination with dark fragments of a spot (WS) 0.8779; • The movements belong to an animal (FМ) 0.8556; • A determinant "color" (C) 0.7931; • Inventory of colors, without taking into account the content (c) 0.7882; • The response mentioning something diffused, shapeless: "fog", "haze", "smoke" 0.7345; • Human figures in the form of unreal characters, caricatures, cartoons, mythological and fantastic essences, monsters, witches (Н-) 0.7252; • Fragments of a body of animals (Аd) 0.6997; • Anatomic bodies of an animal (Ааt) 0.6724; • A landscape, a kind from height (N) 0.6585; • Abstract concepts: "authority", "love", "beauty", etc. (Аbs) 0.6138; • Blood (Вl) 0.5677; • The most rare, original, good responses (O +) 0.5557. The second factor (STRUCTURE OF A SURFACE): • Аchromatic response allocating the form first, then specifying on black, white or grey fragments (FС’) 0.8953; • The surface or a structure are precisely expressed, or the response

transfers the form together with superficial, textural qualities (the woman in a transparent skirt) (Fс) 0.7456; • Shades and effect of a surface, for example: "snow", "something metal" (c) 0.6689; • Responses of x-ray picture or the inkblot representing certain object (a backbone, a thorax, edges, or a card of the country) (Fk) 0.6245; • Architectural objects (Аrch) 0.5433. The third factor (MOVEMENT OF INANIMATE OBJECTS): • Response of movement (M) 0.87858; • Movements of inanimate objects, abstract, mechanical, symbolical forces (m) 0.8576; • The superficial effect in the response is poorly differentiated and combined with object of the uncertain form (сF) 0.7455; • Plants, trees, parts of plants, vegetables, fruit, fruits (Рl) 0.6363; • Fire (Ti) 0.5552. The fourth factor (COMPLETE RESPONSES WITH THE GOOD FORM): • Complete responses (W +) 0.8882; • The truncated image from the whole (W-) 0.8255; • The confabulatory complete response (DW) 0.7736; • The good form (F +) 0.6955; • Responses in which the leading part plays color, and the form though is present, but is uncertain and is present on the second plan, for example: "red socks" (СF) 0.5595. The fifth factor (BAD FORM, FOOD, PLANTS) 0.8953: • Responses to usual details in which large, well appreciable details are perceived (D) 0.8753; • Responses with the bad form (cloud, any animal (F-) 0.8351; • Responses, in which shades and the difference in shades transfer effect of depth (trees in water, the objects, being one before another) (FК) 0.7952; • Figures of mythological animals, monsters, or caricatures of animals (А-) 0.6572; • Food (except for fruit and vegetables) (Food) 0.5966; • Bad original responses (O-) 0.5553. The sixth factor (DIFFUSION OF THE BAD FORM): • Responses in which the certain form in the concept of diffusion (the clouds similar to people) (КF) 0.8758; • The parts of a human figure presented as a caricature or as a detail of fantastic humanoid figures (Hd) 0.7955; • The subjects executed from an animal material (Аоbj) 0.7752; • Bad original responses (O-) 0.6956. Conclusions: Comparison of the correlation coefficients’ values, obtained in three groups for each pair of matrixes of projective test and psychometric test demonstrate the gradual dynamic increase of average correlation coefficient values from the matrix group including Rorschach and MMPI test, to the matrix group of SIS-I and SIS-II projective techniques. This increase correlation coefficients observed in each pair of parameters (each projective test + each psychometric test from Rorschach to SIS-II) can be regarded as increasing affinity of the phenomenon under study, and as connection between the projective technique and psychometric test; it may also be treated as increase of structural characteristics inside the projective test or as the increase of test

construct validity. This regularity proves the hypothesis of psychometrical characteristics increase of SIS-I and SIS-II projective tests, that can be revealed due to the greater structuring degree of stimulus images and their increase in number, as compared to Rorschach test. In this case, the individual variety of responses given to the standard stimulus meanings are turned to be of greater diagnostic value disclosing not only actual affective and drive states, but mainly steady personal features, including deviants References: Cassell, W. A. (1980) Body Symbolism and the Somatic Inkblot Series. Anchorage, Alaska. Aurora Publishing. Khromov, A.B. (2009) Comparison of Psychometric Characteristics of Rorschach and Cassell’ Projective Techniques. SIS Journal of Projective Psychology & Mental. Health, 16:32-36. Khromov, A. B., Cassell, W.A. and Dubey, B.L. (1999) A Comparative Study of Personality Problems of Russian and American Female Adolescents. SIS J. of Proj. Psychology & Mental Health, 6:29-33. Khromov, A. B., Cassell, W.A. and Dubey, B.L. (1999) Some Personality Correlates of Selected SIS Variables: Russian Experiments. SIS Journal of Projective Psychology & Mental Health, 6: 35-46. Note: The paper is a part of earlier publication of correlations research A.B. Khromov. (2009) cited in reference. SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH (An Official Publication of Somatic Inkblot Society) Published Regularly Twice a Year in January and July First Volume Published in 1994 All Volumes of the SIS Journal are also available in PDF Format Individuals/Institutions can become Member of Somatic Inkblot Society by Submitting Membership Application Form Given in the Journal and Receive Print Version/Soft Copy of the Journal Published After the Date of Membership Free of Cost Bankey L. Dubey, Ph.D., DPM, DM&SP, Editor Emeritus, SIS Journal of Projective Psychology and Mental Health, E-mail : bldubey@gmail.com

Personality of Children with Emotional Disorders: A Psychodynamic Study Anindita Mukherjee, Soheli Datta, Atri Sanyal, Atanu K.Dogra and Sanjukta Das The promotion of healthy child development has become a major focus of world attention over the last three decades. However, children are often afflicted by emotional disorders in the recent years. These are exhibited by undue thoughts and disrupted behaviors as opposed to the cultural expectations. The present study is aimed to find out the comparison among children with Externalizing/Internalizing disorder and their Peer Control with respect to the nature and degree of underlying dynamics of personality. The sample include children with externalizing disorder, internalizing disorder and peer control. Each group consists of 15 participants. On each of the groups, a semi structured socio-demographic proforma, consent letters by parents and clinical data sheet were administered to the children. The criterion for clarification of externalizing and internalizing disorder group was assessed using the Devereux Scales of Mental Disorders (Naglieri et al., 1979) and followed by the CAT- Human Version (Bellak & Bellak, 1965). The findings indicated that, externalizing children have poor impulse control and intense need for autonomy and power, internalizing children have intense need for affiliation and moral values and take decision on the basis of ethical judgments and normal peer control group have more balanced ego as compared to the other two clinical groups. At the beginning of the 21st century, the field of child development appears with a paradox and the understanding of abnormal child behavior from a developmental perspective requires an appreciation of the science of child psychopathology as it exists today. Whilst over the last half century there has been tremendous improvement in the overall health of children, but with no parallel improvement in children’s psychological functioning or mental health (Rutter & Smith, 1995) and on the contrary, there has been a considerable increase in the frequency of psychosocial disorders in Indian children (Kapur, 2011). The mental disorders that children can develop are classified in different ways, however, considering the emotional aspect of children, it is commonly divided into two groups: Externalizing behavioral disorders and Internalizing behavioral disorders. Externalizing behaviors include a number of highly visible, disruptive, and disturbing behaviors and can be extremely disturbing to others in their environment. Children with externalizing problems can be aggressive, engage in destructive behaviors, and demonstrate high activity levels and impulsivity. Their behaviors can often be physically and verbally intimidating to others. These children act out their emotions instead of holding them, exhibiting behaviors such as fighting, bullying, cursing, and other forms of violence. The externalizing disorders consist of Attention Deficit Hyperactivity Disorder, Conduct Disorder, and Oppositional Defiant Disorder. The latter two are both considered disruptive behavioral disorders, although typically considered together. Internalizing behaviors are characterized by subjective distress in the child which includes feelings of inferiority, selfconsciousness, social withdrawal, shyness, anxiety, crying, hypersensitivity, depression and sadness (Quay, 1979). A child with internalizing disorder is said to be suffering from depression or anxiety, and experience loss of interest in activities including social activities, work, and life. Miller’s (1983) classification is a helpful guide for understanding internalizing disorders, which includes: Anindita Mukherjee, Clinical Psychologist, Institute of Neuroscience, Kolkata, Soheli Datta, Clinical Psychologist, Atri Sanyal, Clinical Psychologists, Atanu Kumar Dogra, Asst. Prof. and Sanjukta Das, Asso. Prof. Dept. of Psychology, University of Calcutta, Kolkata. Key words: Externalizing and Internalizing disorder, Dynamics of personality.

• Anxietyrelated

condition- Anxiety reaction, Obsessive-compulsive neurosis, Hysterical

(conversion/ dissociated) reaction, Traumatic reactions, Phobia (physical injury, natural events or social anxiety) • Depression (masked and manifested) • Social withdrawal • Somatization (headache, stomachache and others). The conditions designated as ‘externalizing disorders’ are ones whose central feature is dysregulation of behaviors. In contrast to this, ‘internalizing disorders’ refer to conditions whose central features are disordered mood or emotion. Childhood emotional disorder can be caused by various components

like

biological predisposition, environment or a combination of both. Personality is one of the crucial factors which influence children’s mental health. According to Freudian psychoanalysis id, ego, and superego play dynamic role in developing one’s personality. Each subsystem is striving for different goals which lead to intra-psychic conflict. This conflict ultimately produces inner anxiety. Often the ego can cope with the anxiety by rational measures but if these do not suffice, the ego defends itself through immature ways. These excessive intrapsychic conflicts and inner anxiety lead to psychopathology among individuals, including children. Although childhood disorder is an important area, very few studies have been conducted in Indian context on relating childhood personality and psychopathology (Sanyal and Dasgupta, 2005; Ghosh and Sinha, 2012). So, in this study, researchers focus on the comparison among children with externalizing and internalizing disorder and the peer control with respect to nature of dynamic mechanism of personality. Method: Sample: It was a purposive sampling, comprised of 45 subjects (including 15 subjects diagnosed as children with externalizing disorder, 15 subjects diagnosed as children with internalizing disorder and 15 normal Children). The 3 groups matched one to one criterion. The subjects were obtained from OPD of Government Hospitals in different localities of Kolkata. After initial consultation with the Psychiatrists attending their respective OPDs and clarification of provisional diagnosis of Externalizing and Internalizing Disorder, a Clinical Interview & Devereux Scales of Mental Disorders (DSMD) were administered to each child. The subjects in the age group of 8-10 years, Bengali speaking, Minimum 4 years of formal education and confirmed diagnosis of Emotional Disorders were included in the study. Description of the tools: Devereux Scales of Mental Disorders (DSMD) (Naglieri et al., 1979): DSMD is a 111-item behavior rating scale designed to evaluate psychopathology in children and adolescents (Naglieri et al. 1994). The child form (age between 5 to 12 years) was used. The DSMD assesses psychopathology along continuous dimensions. There are three composite scores obtained from the DSMD scales: Externalizing (conduct disorder, attention deficit), Internalizing (depression, anxiety), and Critical Pathology (autism and acute problem) and a total composite score. DSMD instrument has high internal consistency, as well as excellent test-retest reliability. Inter-rater reliability, when examined across parent and teacher raters, was adequate (range, 0.44–0.66; all p < 0.01) (Naglieri et al. 1994). Children Apperception Test (Bellak & Bellak, 1965): The (CAT- H) consists of 10 pictures is suitable for children 3 to 10 years of age. It

is used to assess dynamic of personality among children. Procedure: Subjects were selected on the basis of the inclusion/exclusion criteria and after getting consent from the parents. A semi structured socio-demographic proforma and clinical data sheet were administered to the subjects. Criterion with the externalizing and internalizing disorder group was assessed using the Devereux Scales of Mental Disorders- Parent rating form (Naglieri et al., 1979) and followed by the Children Apperception Test (Bellak & Bellak, 1965). Assessment was completed in two sessions. Analysis of the data was done by three Clinical Psychologists, separately with the help of third edition of the Bellak Manual. Final results were considered on the basis of consensus from five evaluators. Results: Qualitative analyses with respect to nature and degree of unconscious structure and needs, their conception of the world and perception of significant persons, significant conflict, nature and strength of anxieties, presence and strength of defenses against anxieties and conflict, their adequacy of superego as manifested by punishment for crime, degree of ego integration was found out among the children with Externalizing and Internalizing disorder and the Peer Control. The CAT record was interpreted on the basis of above 9 areas of interpretations (Bellak & Bellak,1965) and shown in Table 1. Table 1: Domain of CAT in Three Groups Domain of CAT Externalizing Group Internalizing Group Normal Control Main Hero Sad, deprived but defiant at times. Lonely, deprived, perceived sufferer of the situations Adequate and stable Main needs or drives of the hero. Need for autonomy, need for affiliation and need for power. Need for affiliation. Need for succorance. Need for achievement and affiliation. Conception of the environment. Demanding and noncongenial. Demanding& punitive. Supportive and acknowledging their need. Perception towards others Demanding and not supportive Not supportive in the time of crisis. Demanding. Democratic and supportive. Understand the view point. Sometimes parental figure acted as demanding, but can communicate properly. Conflicts Autonomy vs. compliance. . Id .vs. superego Achievement vs. pleasure. Autonomy vs. compliance Achievement vs. pleasure. Autonomy vs. compliance. 6.Anxieties Of loss or lack of love. Of being loss of love. Being punitive. Of being Lack or loss of love. But it is lesser than another two groups. Defenses Rationalization. Introjections and reaction formation. Rationalization Adequacy of superego. Unjust and immediate gratification of requirement. Severe, follows the moral root. Tries to suppress the desire. Just and adequate Integration of ego. Poor impulse control, egocentric and narcissistic. Passive Striving but using a proper channel. Satisfied with others. Discussion: Although there is a disparity among the behavioral expression of children with externalizing and internalizing disorder, underlying feeling and core perception toward self and environment are more or less similar. Both the groups have same core feelings of sadness, loneliness, deprivation

and perceived similar style of excessive parental demand, specially, when the child is unsuccessful to gratify parental demands. The punitive and non-supportive behavior of parents resulted in painful frustration, selfdevaluation and feelings of deprivation, and in extreme cases, it might result to emotional disorders in children. This was supported by the findings of Mein et al. (1990) who also observed demanding and hostile parenting as a factor of emotionally disturbed children. The test findings have shown that generally externalizing children have ‘poor impulse control’ and intense ‘need for autonomy and power’. Due to this, they cannot tolerate excessive domination and demanding attitude of authority figures which leads to conflict between ‘autonomy of the self-versus compliance to authority figure’. Besides impulsive id, due to the narcissistic ego and inadequate superego, the only way to resolve their conflict (between their need and parental demands) is by using aggressive behavior. This aggression is ventilated through different forms of reactions which are established as externalizing behaviors. Followed by this, they use ‘rationalization’ as a defense mechanism to defend their self and deal with the ego. Therefore, after committing any moral injustice they have their own explanation of doing the act and try to justify their view point through rationalization. This behavior is continued and increased by instrumental learning because they get more negative attention from parents after showing disobedient and violent behavior which acts as a negative reenforcer within them. On the other side, internalizing children have intense need for affiliation and moral values and take decision on the basis of ethical judgments. Due to this, they always try to comply with excessive demand of their parents even though they do not like it. This situation leads to conflict between ‘autonomy of the self-versus compliance to authority figure’ and ‘achievement versus selfpleasure’; although, resolved through complying parental demand. But this process continuously degrades the self and psychic pain is then manifested through internalizing behavior. Followed by this, they use ‘reaction formation’ and ‘introject’ the thought to defend their self. This is in line with the findings by Lehmann (1959), Desousa (1952) and Ghosh and Sinha (2012), on emotionally disturbed children as compared to the welladjusted group. They further found that feeling of inferiority and rejection, parental deprivation and hostility are other reasons behind development of childhood emotional disorder. In contrast to internalizing and externalizing children, stories of the peer control group revealed that they perceive their parents as demanding but not intense. These parents also justify their demand and easily communicate to their children. So the demands from the parents do not create compliance on them. Personality wise, their basic needs are need for achievement and affiliation. Their balanced ego helps them to gratify their needs in the proper channel. As a result, they are more hopeful about their future and get satisfaction on fulfillment of their needs. The need for affiliation is also fulfilled because they feel protected by their parents and have lesser anxiety of love than the clinical groups. However, when the ego feels threatened, they also have an innate tendency to justify their own point through rationalization. The overall satisfactory supportive environment and satisfaction of needs help them to get hopeful future. Conclusion: The externalizing children were found to have poor impulse control and intense need for autonomy and power and after committing any moral injustice they have their own rational ways of explaining them and ventilate through different form of reactions as compared to this, internalizing children have intense need for affiliation and moral

values and take decision on the basis of ethical judgments, which degrades the self continuously, manifesting as internalizing behaviors. Normal peer control group have more balanced ego as compared to the other two clinical groups, making them much more hopeful towards their self and future. It was found that children across cultures show diversity in their emotional reactions and behaviors. Thus the present study determined the dynamics of personality among children with emotional disorders embedded in the current socio-cultural context. With the obtained information some culture specific psychotherapeutic programs, preventive measures and intervention strategies could be planned and executed during the developmental phases of childhood and adolescence. References: Bellak, L. and Bellak, S. (1965). The C.A.T.H- A human modification. Larchmont, N.Y., C.P.S .Inc. DeSousa, T. (1952). A comparison of the responses of adjusted and maladjusted children on the Thematic apperception test. Unpublished master’s thesis, Loyola University, Chicago. Freud, S. (1923). The ego and the id. In the standard edition of the complete psychological works of Sigmund Freud, Vol.XIX, London: The Hogarth Press, Published in 1961. Ghosh,S and Sinha, M., (2012) “ADHD, ODD, and CD: Do They Belong to a Common Psychopathological Spectrum? A Case Series,” Case Reports in Psychiatry, vol. 2012. International Classification of Diseases (ICD), (November,2010) World Health Organization. Lehmann, I. (1959). Responses of kindergarten children to the Children’ Apperception Test. Journal of Clin.. Psychology. 15:60-63. Malavika, K (2011) Counseling Children with Psychological Problems. Pearson Education, New Delhi. Miller, L.C. (1983). Fear and anxiety in children. In C.E. Walker & M.C. Roberts (Eds.), Personality process. New York: Wiley series. Naglieri J.A, LeBuffe P.A, (1994) Pfeiffer SI: Devereux Scales of Mental Disorders. San Antonio (Texas), The Psychological Corporation. Sanantonio. Psychological disorders of childhood, New york: Wiley. Naglieri,J.A, LeBuffe, P.A, & Pfeiffer, S.I(1979).Devereux Scales of Mental Disorders; The Psychological Corporation, Sanantonio. Psychological disorders of childhood (2nd edn). New york: Wiley. Quay, H. C. (1979). Classification. In H.C. Quay & J.S. Werry (Eds.). Rutter, M and Smith, D.J., (1995) psychosocial Disorders in young people: Time trends and their causes; Joun Wiley, Chichester. Sanyal. N. and Dasgupta, M. (2009). Diagnostic value of the Fairy Tale Test as compared to Children’s Apperception Test: A case study. SIS Journal of Projective Psychology and Mental Health, Vol. 16, No. 2, July, 160-165. PRICE LIST OF SOMATIC INKBLOT SERIES SIS ID SIS Version Indian Users Foreign Users SIS-I: Card Form INR: 12000 US $200 SIS-II: Booklet Form INR: 12000 US $200 SIS-II: Video INR: 18000 US $300 SIS-I Video INR: 18000 US $300 SIS Living Images INR: 18000 US $300 All Versions INR: 60000 US $1000 Place Your Orders through Email to: Dr. Bankey L. Dubey, Ph.D., Director SIS Centre, 4406 Forest Rd, Anchorage, AK 99517, E-mail: bldubey@gmail.com

A Comparative Study of Emotional Characteristics of Children with and without ADHD by “Draw a Man Test” Moon Moon Dutta and Nilanjana Sanyal The present research investigated the emotional characteristics of children diagnosed with Attention Deficit/ Hyperactivity Disorder (ADHD) in comparison with control group. For this purpose, 30 children with ADHD and 30 children without any psychiatric morbidity age ranging from 5 to 10 years were selected. Sample was matched based on the demographic variables. Draw a Man Test was administered individually to both the groups. Drawings were analyzed both qualitatively and quantitatively, utilizing a list of emotional indicators proposed by Koppitz. Two judges were appointed to assess the psychological functioning of the drawing profiles. For data analysis, Chi square test, Binomial test and Pearson’s product-moment correlation coefficient (r) were considered using SPSS software (16th version). Results revealed significantly more emotional indicators were found in the clinical than in the control group (χ2 = 17.46, p<.01) Judgements regarding psychological functioning rated by the two judges on a 5-point scale found to be significantly correlated (r=0.524; p<0.01). Clinical group has poorer psychological functioning compared to the control group. These results suggest that the Draw-A-Man test could be useful as a developmental screening device, to assess the child’s emotional maturity and to indicate any possibility of developing psychopathology. Drawing is a natural language to express one’s self. Children’s drawings have been used as projective measures of personality (Oster and Montogomery, 1996), which has its roots in the psychoanalytic traditions. Glazer (1999) describes art as having an inherent therapeutic value, constituting the symbolic speech of suppressed feelings. Children who were given the opportunity to draw revealed more information than the children who were merely asked to talk (Gross and Haynes, 1998). Moreover, when applied in the clinical settings, it is likely to reduce the child’s anxiety about the situation. Maturation in the drawing of details of the human body with increasing age also gives an idea about child’s concept formation ability which might act as an indicator of intellectual maturity. According to Goodenough (1926) and Venger (2003), emotional problems and general emotional state is expressed primarily through external signs on drawings such as pencil pressing, the diversity of lines and crosses, the size of the figures, the location of the figures on paper, then through the content of the drawing. Hence, drawing acts also as an indicator for the development of psychological abilities. Continually a question arises, ‘Why most people cannot draw what they see?’ According to Cohen and Bennett (1997), drawing is not a simple act of copying; there are four possible sources of inaccuracies in drawing: 1. Misperception of the object. 2. Unable to make representational decisions. 3. Deficits in motor skills. 4. Misperception of the drawing; unable to assess the inaccuracies. In 1926, Goodenough published, “Measurement of intelligence by drawings” and presented a first version of using children’s human figure drawing abilities to estimate their intelligence which was revised and updated by Harris (1963). Poor performance in Draw-A-Man test (DAM) suggests impairment in cognitive functioning, however, such test is also able to detect emotional or behavioural disorders in children not having any cognitive problems (Ireton et al. 1971). Koppitz’s (1968) theory states that drawings can be used to reveal the child’s own emotional disturbances. Very few studies were conducted using Draw A Man test on children with Attention Deficit Hyperactivity disorder (ADHD). Statistics Moon Moon Dutta, M.Sc., M.Phil in Clinical Psychology. Asst. Professor of Psychology. Email: moonmoon2nov@yahoo.co.in. Nilanjana Sanyal, Ph.D., Professor, Dept. of Psychology, University of Calcutta, 92 A.P.C Road, Kolkata-700009. Key words: ADHD, emotional indicators, Draw a Man test

show that about 3 to 5 percent of school age children are affected by ADHD (Cantwell, 1996); boys are affected by ADHD as much as triple than girls (Klassen et al. 2004). Despite the threatening statistics, the need for remedial assistance is still scant. Poor mental health awareness, ignorance, social stigma and lack of trained health care providers in India, makes the outcome more pitiable. Moreover, the child’s symptoms of ADHD are considered as intentional and manipulating. Hence, such misconceptions, left the pathology undiagnosed and the suffering left unnoticed. Exposure to such stressful, negative affective involvement and conflicting conditions results in psychological distress which adversely affects child’s emotional and overall personality development. The present research focused on discovering the emotional characteristics of children with ADHD and then compared with children without ADHD using Draw A Man test. Here, drawing is not viewed as physical or perceptual or cognitive process rather as affective involvement. Human drawings are used as a projective technique on the assumption that the child will project his own self-image into his drawings (Bender, 1948). The present research utilized Koppitz’s 30 emotional indicators (EIs) list to understand the emotional characteristics and used to discriminate between the control and the clinical group. In order to have a holistic impression, qualitative analysis of the drawings by the experts is also incorporated. Objectives: 1. To determine the emotional characteristics of children diagnosed with ADHD. 2. To compare the emotional characteristics of children with ADHD and its control. Methods: The participants were 60 five-to-ten-year-old students attending regular schools. Out of 60, 30 children were diagnosed with ADHD according to DSM-IV (APA, 1994) based upon a clinical interview with their parents, behavioral questionnaire completed by their parents and 30 normal controls matched for age and gender. All children had no history of grade retention and they were performing adequately in school and were believed to be of at least average intellect. Children were tested individually. They were all asked to draw a ‘whole person’. Initially children with AD/HD were identified; those with a co-morbid neurological disorder, pervasive developmental disorder, or emotional/ behavioural disorder were then excluded from the study. Children with specific learning disability were also excluded from the study. This process resulted in identification of 30 children with pure AD/HD; with Predominantly Inattentive type and 12 with Combined Type. The children were under treatment in private outpatient mental health clinics at Kolkata and also diagnosed as ADHD by the psychiatrists. All children were under medication at the time of testing. The drawings were analyzed utilizing a list of emotional indicators using the Koppitz Draw A Person (DAP) System (1968). Koppitz proposed 30 individual emotional indicators, derived from the work of Machover (1949) and from his own clinical experience. Koppitz (2004) defined emotional indicators (EIs) as objective signs that reflect children’s worries or anxieties. Koppitz devised a list of EIs which reflected the emotional maturity. Total scores on the Koppitz DAP System were obtained by summing the number of emotional indicators present. According to Koppitz, presence of three or more EIs differentiates the D.A.M’s drawing profiles of groups of children with and without emotional and behavioural problems (Koppitz, 1968). Koppitz admitted that the appearance of only one indicator in a drawing should not be considered clinically significant. Chi square analysis was conducted to compare the clinical and the normative group for the frequency of occurrence of emotional indicators in drawings.

For qualitative, integrative and holistic evaluations of the drawings, two judges were selected who were experienced in scoring and evaluating projective drawings. Judges were asked to discriminate 30 pair of drawings; each pair containing a drawing from a disturbed child and one from normally adjusted group. No criteria were given for making the discriminations; only age of each child was informed. A scale from 1 to 5 was used to measure psychological functioning. In this scale, 1 denotes the absence of psychopathology (i.e., healthy psychological functioning), and represents severe psychopathology. Then, judges were individually interviewed on the integrative features of the drawings that had influenced their ratings and differentiations. Tools: Draw A Man (D.A.M): The test was developed by Goodenough in 1926 and was later revised by Harris (1963). For the administration of the D.A.M, the children were given a white sheet of paper and a pencil with an eraser. Following instruction was given: “On this piece of paper you have to draw a whole person. It can be any kind of person you want to draw”. ADHD Symptom Checklist – 4 (ADHD - SC4): It is a screening instrument for the behavioural symptoms of attention-deficit/hyperactivity disorder (AD/HD), developed by Kenneth et al (1997). For the present research, Parent completed Checklist was used. The testretest reliability ranged from r = 0.64 to r = 0.72. Statistical analysis: The data thus collected was analyzed using Statistical Package for Social Sciences (Version 16). Correlational analysis, Chisquare test and binomial test were computed to find the relationships. Results: Table 1: Frequency and Percentage of Demographic details in the selected sample VARIABLES FREQUENCY PERCENTAGE AGE 5 yrs 13.33% 6 yrs 16.67% 7 yrs 20.00% 8 yrs 26.67% 9 yrs 06.67% 10 yrs 16.67% GENDER BOYS 90.00% GIRLS 10.00% Table 2: Showing difference in the chi square values for frequency of occurrence of Emotional Indicators (EIs) in both the Clinical and Normal Groups EMOTIONAL INDICATORS χ2/ Fisher’s Exact Test Level of Significance All 30 emotional indicators. 17.46 P<.01 Table 3: Showing Chi-Square analysis for frequency of EIs in each drawing of both the groups Emotional Indicators Drawings with one or no indicators Drawings with two indicators Drawings with three indicators Drawings with four or more indicators χ2 / Fisher’s Exact Test p Normal group 48.9 P<0.01 Clinical Group

Table 4: Showing frequency and percentage of EIs (based on Koppitz, 1968) in both groups SNo. Emotional indicators WITHOUT DISORDER WITH DISORDER Response frequency % Response frequency % Poor integration of parts 3.80 Shading of face. Shading of body and/or limbs Shading of hands and/or neck Gross asymmetry of limbs. 5.00 Slanting figures 7.60 Tiny figure 18.99 Big figure Transparencies 3.80 Tiny head Crossed eyes Presence of one or more teeth. 2.53 Short arms 3.80 Long arms Arms clinging to body 5.00 Big hands 1.27 Hands cut off Legs pressed together 2.53 Genitals Monster or grotesque figure Three or more figures drawn Clouds No eyes 2.53 No nose 7.6 No mouth 2.53 No body 2.53 No arms 7.60 No legs 2.53 No feet 7.6 No neck 12.66 TOTAL Table 5: Showing number of judges (N=2) correctly (√) and incorrectly (×) identifying the 30 Clinical D.A.Ms, with Binomial Test results. DAMs √ × DAMs P value Level of Significance (2-tailed) √ 0.043 P< 0.05 ×

Table 6: Pearson’s r to show the agreement of the 2 judges on the degree of psychopathology of clinical D.A.Ms judged on a 5-point rating scale DAMs J 1 J 2 DAMs Mean SD r Level of Significance J 1 3.73 0.94 0.524 P < 0.01 J 2 2.70 1.08 Table 7: Holistic impression over the drawings by the judges NORMAL D.A.Ms CLINICAL D.A.Ms Each body parts correctly drawn Poor organization. Clearly gave the expression of the particular sex Absence of proper sequence. Has adequate idea of space. Inadequate idea of form perception. Expressed emotions generally Improper emotional expressions. Location of figure and size is proper. Improper utilization of space. Accuracy and symmetry maintained. Slanted figures. Discussion: The present research aim to delineate the emotional characteristics of children with ADHD. Now, the question is why it is so important? ADHD is a disorder that affects multiple facets of personal and social life. A child with ADHD not only encounters stigmatizing attitudes that aggravates the sufferings of the child but also causes high risk to experience peer rejection; academic failures which lowers child’s self-esteem. Thus, such negative affective involvement has detrimental effects on the child’s overall growth and development. Hence, a comprehensive treatment process should not only focus on the child’s cognitive and conative damages but also the affective impairments. In this research, the emotional characteristics of children with ADHD are identified. In Table 1, it shows that the sample consisted of 60 children, both sexes are included. In the present sample, 90% constitutes boys and only 10% were girls. Children’s age ranges between 5 and 10 years. Roughly, 27% of the subjects were 8 years old and 17% of the sample constituted children of 10 and 6 years of age. The percentage obtained reflects that ADHD is more commonly diagnosed in boys and it even persists with increasing age. Table 2 indicates Chi square analysis (as some cell values are less than 5, Fisher’s Exact Test was used) which is conducted to compare the drawings of clinical and normal groups for the frequency of occurrence of emotional indicators, findings reflect significant difference in frequency of occurrence of emotional indicators between both the groups with calculated χ2 = 17.46 , p<.01. In Table 3 the clinical group showed significantly more EIs than the control group.

Koppitz (1968) admitted that presence of three or more emotional indicators are clinically significant, thus, represents psychopathology. Chi-square as well as Fisher’s Exact Test results indicated significant differences in frequencies of occurrence of EIs in Normal and clinical group (calculated χ2 = 48.9 , p<.01). As more EIs reflect more pathology, the table shows that Clinical group scored more EIs compare to the Normal group. Hence, such finding suggests that this simple tool can be used as a screening device to identify children who needs special care and has possibility of developing disorders. Catte and Cox (1999) found that emotionally disturbed children did draw significantly more indicators than control groups, but the number of indicators was low. Individual analyses of each EI in the Clinical group revealed an interesting finding which suggests that, 19% of the total response frequency scored on ‘tiny figure’; 13% on ‘no neck’; 8% drawn ‘slanting figure’; ‘no feet’; ‘no nose’; ‘no arms’ and 5% drawn ‘arms clinging to body’ and ‘gross asymmetry in limbs’ (Table 4). The drawing offers the following interpretation of their emotional profile: Slanting figures: Implies feelings of inadequacy, imbalance and lack of secure footing (Di Leo, 1973). Tiny figures: Implies shyness, insecurity and withdrawal tendencies (Di Leo, 1983; Koppitz, 1968). Short arms: implies fear of power or feeling weak or ineffective (Klepsch and Logie, 1982). Arms clinging to body: implies that the child may have rigid inner controls and that it is difficult for the child to reach out to others (Koppitz, 1968). No nose, arms, feet, neck: Omitting the nose may signal feelings of powerlessness, shyness or withdrawal; difficulty in communicating with others (Di Leo, 1983, Koppitz, 1968). Omitting the arms means feeling lack of power and ineffective (Klepsch and Logie, 1982). Omitting feet on a figure typically signals that the child lacks security and feels helpless (Di Leo, 1973; Koppitz, 1968). Omitting neck may imply poor affective inhibition, attentive control of expressive emotions (Di Leo, 1973). Thus, presence of poor affective inhibitions leads to impulsiveness, which negatively affects child’s control over expressive emotions. Poor emotional control impairs communication skills which in turn affects interpersonal functioning. Poor interpersonal functioning might causes self to perceive as inadequate, weak and powerlessness. Thus, negative perception towards self and others lead towards feeling of rejection and withdrawal tendencies. Such rejection, in turn, causes less stimulation leading to a condition of ‘stimulus hungry’ thus more tendencies to seek stimulation, hence, increasing restlessness. Two judges were appointed to assess how successfully they could discriminate the drawings from a clinical and normal group. In Table 5, 2-tailed binomial test is used for determining if the proportion of accurate and inaccurate judgments given by the two judges differed from a specified amount. The obtained p value (0.043) suggests that the proportion of inaccurate judgment is much lower than the test proportion. Hence, the judges could significantly differentiate (p<0.05) the drawings of the two groups. To measure the psychological functioning, judges were asked to rate on a 5 point scale to indicate the degree of psychological functioning of children based on the total 60 drawings. Table 6 indicated that the two judges significantly correlated (r=0.524; p<0.01) in their judgments. Both judges rated the clinical group with poor psychological

functioning. In Table 7, both the judges gave their holistic impression about the drawings. When judges were individually interviewed about the integrative features of the drawings that had influenced their ratings and differentiations, they suggested that drawings of children diagnosed with ADHD have difficulties in organization, maintaining proper sequence, poor form perception, improper emotional expressions, and improper utilization of space and directions. Thus the present research used drawing as a form of natural expression and the amount of detail involved in a child’s drawing enabled us to use it as an effective tool to reflect the underlying emotions, personality traits and intellectual maturity. Conclusion: Clinical group have higher number of emotional indicators (EIs) compared to the normal group, suggesting greater psychopathology. Qualitative analyses of the drawings based on the frequency of the occurrence of EIs indicated poor attentive control of expressed emotions, poor affective inhibition; feeling of powerlessness and ineffective in drawings of children with ADHD. References: American Psychiatric Association. (1994). Diagnostic and statistical manual (4th ed.). Washington, DC: APA. Bender, Lauretta, & Silver, A. (1948). Body image problems of the brain injured children. J. Soc. Issues 4, 84-89. Cantwell DP. (1996). Attention deficit disorder: a review of the past 10 years. J. of American Academy of Child Adolescent Psychiatry, 35(8):978-87. Catte, M and Cox, M. V. (1999). Emotional indicators in children’s drawings. European Child and Adolescent Psychiatry, 8, 86–91. Cohen, D.J and Bennett. S. (1997). Why can’t most people draw what they see?. Journal of Experimental Psychology: Human perception and performance. Vol.23; No.3; 609-621. Di Leo, J.H (1973). Children’s drawings as diagnostic aids. New York. Brunner/Maze! Di Leo, J.H (1983). Interpreting children’s drawings. New York. Brunner/Maze! Gadow, K.D and Sprafkin, J (1997). ADHD Symptom Checklist-4 Manual. Checkmate Plus, ltd. printed in the United States of America. Glazer, H.R. (1999). Children and play in the Holocaust. J.of Humanistic Counseling, Education and Development, 37, 194-200. Goodenough, F. L. (1926) Measurement of intelligence by drawings. Chicago: World Book Company. Gross, J. & Hayne, H. (1998). Drawing facilitates children’s verbal reports of emotionally laden events, J. of Exp.Psych., 4, 163-179. Harris, D.B. (1963). Children's drawings as a measure of intellectual maturity. New York: Harcourt, Brace & World. Ireton, H.; Quast, W. and Gantcher, P. (1971). The draw- A-Man Test as an index of developmental disorders in a pediatric outpatient population. Child Psychiatry and Human Development. Vol. 2 Issue 1. pp. 42-49. Klassen AF, Miller A., Fine S. (2004). Health related quality of life in children and adolescent who have diagnosis of attention-deficit/hyperactivity disorder. Pediatrics, 114(5):e541-7. Klepsch, M. and Logie, L. (1982). Children draw and tell. An introduction to the projective uses of children’s human figure drawings. New York: Brunner/ Maze! Koppitz, E. M. (1968). Psychological evaluation of children's human figure drawings. New York: Grune & Stratton. Koppitz, E. (2004). El dibujo de la figura humana. [Human figure drawing test]. Buenos Aires: Editorial Guadalupe. Machover, K., (1949). Personality Projection in the Drawing of the Human Figure. C.C. Thomas. Springfield, III Oster, G., & Montgomery, S. (1996). Clinical uses of drawings. Northvale, NJ: Jason Aaronson. Venger, A.L. (2003). Psychological drawing tests.

Self-Esteem and Emotion Regulation as Determinants of Mental Health of Youth Sinto P. Anto and C. Jayan The present study examined the role of self- esteem and emotion regulation on the mental health of youth. 121 college students were administered Self Esteem Inventory, DERS scale and Mental Health Scale. Statistical analysis was done using Two Way ANOVA. The findings revealed significant difference between high, moderate and low self- esteem groups on mental Health. No difference was found between high, moderate and low Emotion Dysregulation Groups on Mental Health. No significant interaction of emotion regulation and selfesteem on mental health was found in the study. The transition to adulthood is an extremely challenging period of life in which young people are maturing physically, psychologically and socially. It’s a critical time in which lot many issues related to mental health takes place. It is normal for youth to experience various types of emotional distress as they grow and get mature. While most youth are healthy, physically and emotionally, one in every five youth in the general population develop mental health problem. The mental health is not just the absence of mental illness. It is defined as a state of well-being in which every individual realizes his or her own potentials, can cope with normal stresses of life, can work productively, and is able to make a contribution to community (WHO, 2014). Good mental health can enhance one's life, while poor mental health can prevent someone from living an enriching life. According to Richards, et al (2010) "There is growing evidence that is showing emotional abilities are associated with pro- social behaviors such as stress management and physical health". It was also concluded that people who lack emotional expression are inclined to anti-social behaviors. These behaviors are a direct reflection of their mental health. Self-destructive acts may take place to suppress emotions. Some of these acts include drug and alcohol abuse, physical fights or vandalism. Evidence from the World Health Organization suggests that nearly half of the world's populations are affected by mental illness with an impact on their selfesteem, relationships and ability to function in everyday life. An individual's emotional health can also impact physical health and poor mental health can lead to problems such as substance abuse (WHO, 2014). Emotion regulation (i.e., the attempts people make to modify their emotional responses; Gross, 1998) is critical for well-being .Healthy emotion regulation is a cornerstone of mental health and adjustment, whereas unhealthy emotion regulation lies at the core of many mental disorders (Kokkonen and Kinnunen, 2006; Vingerhoets, et al, 2008). Emotion regulation refers to ‘extrinsic and intrinsic processes responsible for monitoring, evaluating, modifying emotional reactions, especially their intensive and temporal features, to accomplish one’s goals’ (Thompson, 1994). Emotion regulation skills develop over the course of infancy and childhood and continue to mature during adolescence. These skills are critical to mental health, academic achievement, and good social relationships. Poor emotion regulation skill (called emotional dysregulation) is viewed as a core feature of emotional problems and maladjustment. Such dysregulation has been linked to problems like depression, substance abuse, poor performance and aggressive behavior. The capacity to alter how we experience and express emotions is Sinto P. Anto, FDP Research Fellow, and C Jayan, Professor, Department of Psychology, University of Calicut, Calicut Key Words: Emotion Regulation, Mental Health, Self-Esteem

a key contributor to mental health and problems with effectively regulating emotions is a cardinal feature of many psychiatric disorders. The inability to effectively regulate emotions poses serious risks to a person’s mental health (Berking,2014). Emotion Dysregulation is believed to be a key factor in anxiety disorders.(Carthy, et al 2010). Siener and Kerns (2012) conducted a study on 87 children and found that children with depressive symptoms experience a wide range of difficulties with emotion dysregulation. Maslow (1987) stated that psychological health is not possible unless the essential core of the person is fundamentally accepted, loved and respected by others and by self. Self-esteem allows people to face life with more confidence, benevolence and optimism, and helps in achieving their goals and self-actualization. Self- esteem is defined as the evaluative aspect of self-knowledge that concerns the extent to which people like themselves (Brown and Marshall, 2006). Self - esteem is considered to be a relatively enduring characteristic that possesses both motivational and cognitive components. Selfesteem reflects the evaluative component of self –concept. Self-esteem refers to the global appraisal a person makes of his or her own as a competent and worthwhile person. People with high self-esteem tend to be satisfied with their lives and hold a positive attitude toward selves. They display a genuine sense of self-acceptance, self-worth and self-respect (Rosenberg, 1985).In contrast, people with low self-esteem evaluate the self as unworthy and incompetent. Thus, self-esteem can have a profound influence on a person’s cognitions, emotions and responses to stressful life events. Mental health has been reported to be associated with self-esteem in the past. Several studies (Miyamoto et al., 2001; Bolognini, et al., 1996; Rosenberg, et al., 1995; Brown and Mankowski, 1993) have been conducted in this field, and associations have been found between self-esteem and depression and between self-esteem and anxiety. Self-esteem has been also reported to be related to eating disorders (Stice, et al., 2002) and aggression (Donnellan et al., 2005; Baumeister, et al., 1996). However, the relationship between self-esteem and aggression is currently being debated by researchers. Some authors argue that low selfesteem is related to aggression (Donnellan et al., 2005), whereas others indicate that high self-esteem is linked to aggression (Baumeister, et al, 1996). Surprisingly, less attention has been paid to the connection between personality dimensions and self-esteem (Robins et al., 2001) though self-esteem is an influential factor in both physical and mental health (Mann et al, 2004). The present study aims to analyze the role of self- esteem and emotion regulation on mental health. Method: Forty five males and 75 females in the range of 18-25 yrs from 3 districts of Kerala participated in the study. Tools: 1. Self- Esteem Inventory: It is developed by Immanuel Thomas and Sam Sananda Raj (1985).It is a 5 point interval scale, consisting of 20 items pertaining to wide variety of behavioral domains including academic, social, physical and emotional aspects. There are 10 positive and 10 negative items in random order. This inventory is reported to have a split half reliability of .95, Test retest reliability coefficient of .90 and a content validity correlation of .41. 2. Mental Health Status Scale: Mental Health Status Scale developed by Sam Sananda Raj and P.Gireesan (1998) is used to determine the mental health status of youth. The scale constitutes 6 subscales which measures attitude toward the self, selfactualization, Integration, autonomy,

perception of reality, environmental mastery of youth. Each subscale has 12 items which has both positive and Negative scale. 3. DERS Scale: DERS Scale (Gratz and Roemer, 2004) measures various aspects of emotion regulation. It has six subscales- (Non acceptance): Non acceptance of emotional responses, (Goals): Difficulties engaging in goal directed behavior,(Impulse): Impulse control difficulties, (Awareness): Lack of emotional awareness, (Strategies): Limited access to emotion regulation strategies,( Clarity): Lack of emotional clarity. Higher scores in each of these subscales indicated having a more difficult in component measured. Procedure: Before the administration of the questionnaire, the participants were briefed about the purpose of their study and requested to reply each items. After getting their consent the questionnaires were administered as per standard instructions. Self- esteem inventory and DERS scale were used for classifying the participants into different groups. The calculated mean was treated as the cut-off point and the scores below the means minus half SD constituted low self- esteem group and low DERS group; the scores between mean minus half SD and mean plus half SD constituted the moderate self- esteem group and moderate DERS group; and the high self- esteem and high DERS group constituted mean plus half SD and above. After classification of the whole sample into three groups of self- esteem and emotion dysregulation, their mental health dimensions and overall mental health status were examined. Result and Discussion: The role of self-esteem and emotion regulation on mental health is analyzed through classifying the data into different categories and the significance of difference in mental health and its dimensions and the scores of the respondents in the different categories are tested by Analysis of variance (ANOVA). The details of the results of the ANOVA performed on the scores obtained by the subjects are shown in table 1. Since selfesteem influences the mental health, it is decided to consider three groups of selfesteem separately for all the analyses to be carried out here. Thus self-esteem forms one of the factors in the ANOVA. Emotion regulation is considered as the second factor influencing mental health. Table 1 shows the results of the Two way ANOVA of levels of self-esteem and levels of emotion dysregulation on mental health and its dimensions. Table 1: Results of the Two Way ANOVA of levels of self-esteem and gender on mental health and its dimensions Variables Main Effects 2 way interaction Self- esteem (A) F value Emotion Vs regulation (B) F value A-B F value Attitude towards self 3.55* .37 .60 Self-Actualization .813 .76 1.41 Integration 6.66** 4.36** .99 Autonomy 7.12** .05 .46 Perception of reality 6.51** .89 1.30 Environmental mastery 9.92** 2.20 .33 Overall mental health 12.17** 1.27 .59 *Significant at .05 level., ** Significant at .01 level. Main Effects (One Way Interaction): (a) Selfesteem on mental health and its dimensions: Participants have been divided into 3 groups (low, moderate and high) on

the basis of their self -esteem and these three groups have been tested for their mean values for each of the mental health dimensions. Results indicate that the overall mental health of low, moderate and high self-esteem groups differ significantly value obtained for overall mental health is 12.17 which is significant at .01 level. From the F value, it is clear that the overall mental health of low, moderate and high self -esteem groups differ significantly. While analyzing the dimensions of mental health, it is revealed that all mental health dimensions except self-actualization differ significantly between low, moderate and high self-esteem groups value of attitude towards self is 3.55 (p .05 level). F value obtained for self- actualization is .813 and it is not significant at .05 and .01 levels. F values of integration ,autonomy, perception of reality and environmental mastery are 6.66,7.12,6.51 and 9.92 respectively which are significant at .01 level .Findings confirmed that there is significant difference between low, moderate and high selfesteem groups on mental health dimensions such as attitude towards self, integration, autonomy, perception of reality and environmental mastery .Mental Health dimension of self- actualization do not show significant difference between three groups of self- esteem. Table 2: Mean and SD of low, moderate and high self- esteem groups on overall mental health and its dimensions. Variables Self- esteem Low Moderate High Mean SD Mean SD Mean SD Attitude towards self 39.60 4.85 5.16 41.86 4.07 Self Actualization 42.34 5.25 44.18 5.88 44.24 5.03 Integration 41.69 5 .42 44.57 4.96 47.07 4.56 Autonomy 5.29 42.55 5.51 44.64 4.36 Perception of reality 42.3 5.95 43.89 4.46 46.83 5.17 Environmental mastery 40.63 4.31 43.93 6.55 47.05 5.82 Overall mental health 246.29 17.23 258.11 20.92 271.69 19.58 It can be observed from the Table 2 that mean values of overall mental health of low, moderate and high self- esteem groups are 246.29, 258.11 and 271.69 respectively which suggests that high self- esteem group has better mental health than low selfesteem group. While focusing on each dimension of mental health, it can be seen that mean value of attitude towards self for low, moderate and high self- esteem groups is 39.60,39 and 41.86 respectively. Mean values suggest that high self- esteem groups score higher in the dimension of attitude towards self. The above mean scores indicate that high self- esteem group has knowledge of self, self -concept and self- acceptance. Mean value of selfactualization for low, moderate and high selfesteem group is 42.34, 44.18 and 44.24 respectively. This suggests that high self - esteem groups utilize their abilities and have more capacity of self -actualization than low self- esteem groups even though its F value is not significant. Mean values of autonomy for low, moderate and high self- esteem

groups are 40, 42.55 and 44.64 respectively. Mean values suggest that high self- esteem group is reliant in decision making than low self- esteem group. Mean values of mental health dimension of perception of reality is 42.03, 43.89 and 46.83 respectively. Mean values indicate that high self- esteem groups’ perception of reality is better than low selfesteem groups and they are free from need distortion. Mean values of mental health dimension of environmental mastery for low, moderate and high self- esteem group is 40.63, 43.93 and 47.05 respectively. Mean values show that environmental mastery of high self- esteem group is better than low self- esteem group. High self-esteem can, love, work, play adequately in interpersonal relations and are efficient in problem solving. (b) Emotion regulation on mental health and its dimensions: Participants have been divided in to three groups (low, moderate and high) on the basis of their level of emotion dysregulation and these three groups have been tested for their mean values for each of the mental health dimension. On examining the F values, it is clear that the overall mental health of low, moderate and high emotion dysregulation groups did not differ significantly. F value of overall mental health is 1.27 and it is not significant at .01 and .05 levels. While considering each of the dimensions of mental health, integration is found to differ significantly between three groups of low, moderate and high emotion dysregulation groups. F value of integration is 4.36 and it is significant at .01 level. F values calculated for attitude towards self, self -actualization, autonomy, perception of reality and environmental mastery are .37, .76, .05, .89 and 2.91 respectively. These F values are statistically non- significant. Table 3: Mean and SD of low, moderate and high DERS groups on overall mental health and its dimensions Variables Emotion Dysregulation Low Moderate High Mean SD Mean SD Mean SD Attitude towards self 40.36 5.46 40.57 4.41 39.62 4.62 Self –actualization 44.17 5.40 43.38 5.88 43.43 5.18 Integration 47.02 5.17 44.38 5.18 42.38 4.52 Autonomy 43.19 5.28 42.76 5.40 41.69 5.42 Perception of reality 46.17 5.16 43.89 4.44 43.00 6.22 Environmental mastery 46.19 5.97 42.68 6.46 43.14 5.84 Overall mental health 267.10 24.18 257.65 18.53 253.26 20.09 From Table 3, it is clear that mean values of integration for low, moderate and high emotion dysregulation groups are 47.02, 44.38 and 42.38 respectively. This suggests that integration value is high in low emotion dysregulation group and low in high emotion dysregulation group. Even though, the overall mental health and all mental health dimensions except integration are not statistically significant. Two-Way Interaction: Self-esteem and Emotion Regulation on mental health and its dimensions: Analysis is carried out to examine the difference in scores on mental health and its dimensions on the basis of their Self- esteem and Emotion regulation.

A Two-way ANOVA was conducted to find out the independent effect and interaction effects of gender Self -esteem (low, moderate and high self- esteem groups) and Emotion Regulation on overall mental health and its dimensions. From Table 1, it is very clear that the interaction effect of levels of Self- esteem and Emotion Regulation is not significant on overall mental health and its dimensions. Findings reveal that self- esteem and emotion regulation together do not make much influence on mental health. The results show that low self - esteem leads to low mental health and high self -esteem leads to higher mental health. Studies conducted by Harter (1990) and Hirch (1991) explained that self- esteem of an adolescent is an important contributor of mental health. Bhatti (1992) and Battle (1990) found that low self- esteem can lead to various problems including depression, delinquency, self-inflicted injuries and aggression. Smart and Walsh (1993) identified relation between self- esteem and depression. The present study also analyzed the role of emotion regulation on the mental health of youth. The findings suggest that the emotion regulation do not influence mental health which is contradictory to the most of the studies which stress the role of emotion regulation on mental health. The findings further revealed that interaction between emotion regulation and self- esteem on mental health is quite insignificant. Conclusion: The study contributes to the growing selfesteem literature by showing that positive selfesteem promotes mental health. Therefore, teaching youth effective selfesteem development strategies will enhance their mental health. References: Battle, J. (1990). Self-Esteem:The New Revolution.Alberta,Canada:James Battle & Associates. Baumeister, R.F., Smart,L.,Boden,J.M.(1996).Relation of threatened egotism to violence and aggression:The dark side of high selfesteem.Psychological Research.Psychological Review.Vol.103,N0.1,5-33. Berking,M. & B. Whitley(2014). Affect Regulation Training: A Practitioners’ Manual, Springer Science+Business Media New York. Bologini,M.,Plancharel,B.Bettschart,W.,Haflon,O.(1996). Self-esteem and mental health in early adolescence: Development and gender differences..Journal of Adolescence, June 19(3) :233-245. Brown,J.D.,& Mankowski,T.A.(1993).Self-esteem, mood and self-evaluation: Changes in mood and the way you see.Journal of personality and social psychology. Brown, J. D., & Marshall, M. A. (2006). The three faces of self-esteem. Self-esteem issues and answers: A sourcebook of current perspectives, 4-9. Bhatti,B.,Derezotes,D.,Seung,O.&Specht,H.(1992).Asso ciation between Child maltreatment and Self Esteem:The Social Importance of Selfesteem.Berkeley:U.C. Carthy,T.,Horesh,N.,Apter,A., & Gross,J.(2010).Patterns of emotional reactivity and regulation in children with anxiety disorders.J Psychopathology Behavior Assessment.32;23-36 Donellan, M.B., Trzsnieinswski, K.H., Robins, R., Moffitt, T.E.,& Caspi, A.(2005).Low self-esteem is related to aggression, antisocial behavior, and delinquency. Psychological Science,16,328-335. Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J.of Psychopathology and Behav. Assessment, 36, 41-54. Gross ,J.J.(1998).The emerging field of emotion regulation:A integrative review.Review of General Psychology,2(3),271-299. Harter, S. (1990). Identity and self-development. In S. Feldman and G. Elliott (Eds.), At the threshold: The developing adolescent (pp. 352-387). Cambridge, MA: Harvard University Press. Hirsch, B., & DuBois, D. (1991). Self-esteem in early adolescence: The identification and prediction of

contrasting longitudinal trajectories. Journal of Youth and Adolescence, 20, 53-72. Kokkonen, M., & Kinnunen,M.L.(2006).Emotion Regulation and Wellbeing. In Pulkkinen,L,Kaprio,J.,& R.J.Rose (Eds).Socioemotional development and Health from Adolescence to adulthood. Cambridge Studies on Child and Adolescent Health.(pp.197-208). Camridge University Press: NewYork Mann, M., Hosman, C. M., Schaalma, H. P., & De Vries, N. K. (2004). Self-esteem in a broad-spectrum approach for mental health promotion. Health Education Research, 19, 357-372. Maslow.(1987).Self-esteem- Retrieved from Wikipedia,the free encyclopedia. En.wikipedia.org/wiki/self-esteem. Miyamoto, R. H., Hishinuma, E. S., Nishimura, S. T., Nahulu, L. B., Andrade, N. N., Goebert, D. A., & Carlton, B. S. (2001). Path models linking correlates of self-esteem in a multi-ethnic adolescent sample. Personality and individual differences, 31(5), 701-712. Richards, K.C.; Campania, C. & Muse-Burke J.L (2010). "Self-care and Well-being in Mental Health Professionals: The Mediating Effects of Selfawareness and Mindfulness". Journal of Mental Health Counseling 32 (3): 247. Robins, R. W., Tracy, J. L., Trzesniewski, K., Potter, J., & Gosling, S. D. (2001). Personality correlates of self-esteem. Journal of Research in Personality, 35, 463–482. Rosenberg,M.(1985).Self-concept and psychological well- being in adolescence.The development of self.Academic Press:Newyork. Rosenberg,M.Schooler,C.& Schoenbach,C and Rosenberg,F.(1995). Global Self-esteem and specific self-esteem-Different concepts, different outcomes. American Sociological Review,60,141-156. Sam Sananda Raj,H. & Gireesan,P.(1988).Mental Health Status Scale,Department of psychology,University Of Kerala,Trivandrum. Siener,S & Kerns,K.(2012).Emotion regulation and Depressive symptoms in Preadolescence.Child Psychiatry Human Development.43:414-430. Smart,R.G. & Walsh,G.W(1993).Predictors of depression in street youth.Adolescence.28:41- 53. Stice,E.,Presnell,K.,& Spangler,P.(2002).Risk factors for binge eating onset in adolescent girls: A 2 year perspective investigation.Health psychology,21:131-138. Thomas,I. and Sam Sananda Raj,H.(1985).Self-esteem Inventory Revised.Department of Psychology,University of Calicut,Trivandrum. Thompson,R.A.(1994).Emotion Regulation :A theme in search of definition.Monographs of the Society for research in Child development,59,25-52. Vingerhoets, A. J., Nyklícek, I., & Denollet, J. (2008). Emotion Regulation. New York. The Springer press. W.H.O. (2014).Retrieved from WHO/Mental Health: Wellbeing.www.who.int/features/factfiles/mental_ health/en/. APPEAL Dear Life Members, We are thankful to you all for the continued support and association with SIS. We are encouraging our esteemed Life Members with 10 years membership to upgrade their Membership to the level of Fellow of the Society by submitting Membership Application Form accompanied by payment of Rs. 2500/- only. Bankey L. Dubey

Elements of Drawing and Depression among Adolescents in Kerala, South India: An Explorative Study using A Person Picking a Mango from a Tree L. S. S. Manickam and V. Sajani Advances in art based assessments in art therapy in clinical settings led to the development of objective measurements of various elements in drawing. The present study was aimed at assessing the elements that are related to depression manifested in the drawing task of “Person Picking a Mango from a Tree” (PPMT). The sample consisted of 60 adolescents in two groups-the depressive group of 30 with high scores of depression and 30 with low scores of depression, who served as the non-depressive group. The PPMT drawings were assessed using Formal Elements of Art Therapy Scale (FEATS) by two raters who had established high interrater reliability. The two groups had significant difference on 3 of the 14 subscales. Art based assessments had formed part of clinician’s armature of tools since the time Goodenough (1926) developed Draw-A- Person test (DAP). Later several other variants of art based assessments like Draw House- Tree -Person Test (Buck, 1964) and Human Figure Drawing (Kahn & Jones, 1965) were introduced. In India, Pathak (2002) had used Draw-A- Man Test in the 1960’s to assess intelligence. Fairy Tale Test (Coulacoglou & Kline, 1995) was recently introduced in India (Sanyal and Dasgupta, 2011). “The Picking A Mango from a Tree” is a projective test and assessed different emotional states such as aggression, anxiety, depression and morality. From a clinical perspective some of these tools are being used as projective tests in order to assess the clinical variables. On the other hand as the field of art therapy developed, more art based tools were introduced and assessed from different modalities and Silver Drawing Test (SDT) of cognition and emotion was one of them (Silver, 2003). Another art based task that was developed by Gantt (1990) is the Person Picking an Apple from a Tree (PPAT). PPAT has been extensively used in art therapy and art based assessments. PPAT was introduced in India recently and was assessed for its cultural adaptability (Kruthi & Manickam, 2014). Adult population as well as adolescents in South Asian countries tend to somatise depressive mood and communicate their low mood through their bodily symptoms than verbally reporting the affect (Grover et al. 2013). Identifying depression among adolescents at an early stage facilitates successful treatment. Therefore art based tasks may be effectively engaged to identify affective states of depression, aggression and anxiety (Sajani & Manickam, 2000). PPAT involves a simple task of drawing and colouring and it may help children and adolescents to express themselves since they may view the task as ‘interesting’. However when PPAT was administered to children and adolescents in India, the participants reported their difficulty in drawing an ‘apple tree’ since many of them had not seen the tree (Kruthi & Manickam, 2014). Therefore Kruthi et al. (2014) recommended ‘Mango’ tree instead of ‘Apple’ tree to be used in Indian setting and the task was to ‘Draw a Person Picking a Mango from a Tree’ (PPMT). While the projective drawings were being assessed through subjective measures, Gantt (1990) developed Formal Elements of Art Therapy Scale (FEATS), a rating system for assessing specific variables based on the drawing tasks given to the participants, L. S. S. Manickam, Ph.D., MMSP, Professor in Clinical Psychology, JSS University, Mysore (India). Lssmanickam @gmail.com, and V. Sajani, M.Phil CP, Clinical Psychologist, District Hospital, Pathanamthitta District, Kerala sajaniv@rediffmail.com Key words: PPAT, PPMT, FEATS, Art based assessments, Depression

including that of PPAT. The FEATS has 14 subscales, namely, Prominence of color, Color fit, Implied Energy, Space, Integration, Logic, Realism, Problem Solving, Developmental Level, Details of Object and Environment, Line Quality, Person, Rotation and Perseveration. Extensive studies were conducted using FEATS and all the sub scales had established reliability and validity on different clinical and nonclinical populations. Most of the sub scales of FEATS had inter- rater reliability of more than .90 (Gantt, 1990). Gantt (1990, 2001) validated the scales with Problem solving scale and it distinguished four diagnostic groups and a control group from every other one. Normative studies of drawing of children (Deaver, 2009) and several studies are in progress to establish the reliability and validate of the scales. In India, inter rater reliability in using FEATS assessing PPAT and PPMT was established for all the sub scales by two raters (Kruthi & Manickam, 2014). Whether the art based assessments can differentiate clinical conditions is a question which intrigued the researchers. Savina et al. (2012) assessed impulsivity and motivated aggression, fear of aggression, anxiety and depression using PPAT. On the other hand, Wallace et al. (2004) used ‘subject art’ of pediatric and young adults who were renal transplant recipients and analyzed the art by art therapists using seven of the 14 elements of the FEATS, to assess depression. They found the sensitivity for FEATS and CDI were 22% and 50% respectively and concluded that FEATS lacked sufficient sensitivity to warrant its use in identifying depression among renal transplant recipients. However, Wallace et al. (2004) used ‘subject art’ instead of PPAT and used the sub scales of FEATS to evaluate depression. To assess depression, Wallace et al. (2004) had used Children Depression Inventory (Kovacs et al. 1990) and the cut-off score of 20 and above was considered as those with depression. In several studies, the cut off score on CDI considered for depression varied (Friedberg & Sinderman, 2011; Bang et, al., 2015). Timbremont et al (2004) while assessing depression using CDI, found that a score of 16 correlated with the clinical depression which was assessed through interview. The present study was aimed at exploring the feasibility of using FEATS in our cultural context. It was hypothesized that there will be significant difference in the mean scores of all the 14 subscales of FEATS of those with high scores of depression and low scores of depression. Other objectives of the study were 1. To assess the utility of PPMT as an art based assessment and 2. To assess the utility of the Formal Elements of Art Therapy Scale (FEATS) in evaluating the PPMT. Method: Two thousands (2000) adolescents, male and female, in the age group of 11-16, studying in class 6 to 10, were from seven schools in the educational district of Patthanamthitta District of Kerala State, were selected for the study. However, only 485 parents gave assent for the adolescents to take part in the study- to undergo evaluation and participate in 8 sessions of integrative art therapy meant for those who had high depression scores. For the present study the following two groups were considered. Group I: The Depressive Group, consisted of 30 (16 boys and 14 girls) participants who had scores of 20 and above on CDI, formed the experimental group. Their age ranged from 12 to 15 years and their mean age was 13 years and the mean CDI score was 21.8. Group II: The non-depressive group had 30 participants (14boys and 16 girls) whose CDI scores were 13 and below formed the control group. Their age ranged from 12 to 15 years and their mean age was 13. 45 years and the mean CDI score was10.33. Tools: Child Depression Inventory (Kovacs et al. 1990) is a 27 item self- rated, symptom

oriented inventory, in which the subject chooses one of the three alternatives that best describes one’s feelings or ideas experienced during the past two weeks before the time of assessment. The Cronbach alpha for the scale was found to be .80 and the inter-rater reliability was found to be .82, when assessed after an interval of two weeks. Regarding the validity, the tool had high convergent and discriminate validity. Though CDI can successfully distinguish between clinical and nonclinical groups, the authors had cautioned that it should not be used as the sole basis for arriving at a clinical diagnosis. Malayalam translated version of the tool was used (Sajani and Manickam, 2012). Formal Elements of Art Therapy Scale (FEATS) (Gantt and Tabone, 1998) has 14subscales and they are Prominence of color, Color Fit, Implied Energy, Space, Integration, Logic, Realism, Problem solving, Developmental level, Details of object and environment, Line quality, Person, Rotation and Perseveration. Procedure: Participants of both the groups met in small groups of 8-12, at the therapy center, where the integrative art therapy was provided. Each participant was given A3 size white thick paper and one set of sketch pens with 12 colors. Gantt and Tabone (1998) recommended the set of ‘Mr. Sketch Scented Water Colour Markers’, which has a set of 12 pens with different colors. Since Mr. Sketch brand was not available in Indian markets, sketch pens with 12 different colors was used on an experimental basis in consultation with Deaver (2014). The instructions in the manual (Gantt & Tabone, 1998) were modified to include ‘mango’ and was given as follows, “Draw a person picking a mango from a tree”. If the participants asked whether to draw a boy or a girl, the same words were repeated with emphasis on the word person. Care was taken so that each participant could complete the task without copying the drawing of other participants. Though no time limit was given, participants on an average took about 30 minutes to complete the task. Two raters independently rated the drawing on 14 subscales of FEATS using the Manual (Gantt & Tabone, 1998). Both the raters had established inter-rater reliability on using FEATS scale in a previous study (Kruthi & Manickam, 2014) and one of the raters was blind to the participants of both the groups. Results: The inter-rater reliability of the two raters on the 14 subscales is shown in Table 1 and for all the subscales the reliability was highly significant. Table 1: Inter rater reliability between two raters in the 14 subscales of FEATS Sub Scales Rater 1 Rater 2 r Prominence of color 3.10 2.62 .672** Color fit 3.44 3.49 .722** Implied Energy 3.16 3.08 .780 ** Space 3.38 3.31 .821** Integration 3.66 3.82 .757** Logic 3.83 4.08 .645** Realism 3.76 3.78 .694** Problem Solving 3.36 3.41 .852** Developmental Level 3.42 3.24 .778** Details of Object and Environment 3.33 3.43 .882** Line Quality 3.62 3.51 .493** Person 4.04 4.07 .853** Rotation 4.56 4.68 .671** Perseveration 4.41 4.34 .821**

Among the inter-rater reliability, the lowest was for the subscale of Line quality (.49) and the highest was for the subscale of Details of Object and Environment and Rotation (.88). The socio-demographic variables of gender and age and the scores on the subscales of FEATS and CDI are shown in Table.2. The gender was found to affect the subscales of Line quality (‘t’, 2.1, significant at .05 level) and Rotation (‘t’, 2.50, significant at .05 level). The lower age group had less Implied Energy, Integration, Developmental Level and Details of Object and Environment (Table 2). Comparing FEATS scores of the Depressive group and Non-depressive group, the subscales of Implied energy, Details of Object and Environment and Rotation was significantly low in the control group (Table 3.). However, the depression score was positively and significantly correlated with Rotation and negatively and significantly correlated with Implied energy, Problem solving and Details of Object and Environment (Table 3.). None of the other scales showed any correlation with the depression score. Table 2: Comparison of Gender, Age group and FEATS subscales Gender t Age t Sub Scales Male Female Low (11-13) High (14-15) Prominence of color 4.28 (1.34) 4.48 1.07) -.62 4.28 (1.41) 4.54 (.84) -.86 Color fit 5.02 (1.32) 5.28 (1.01) -.86 4.95 (1.28) 5.44 (.88) -1.71 Implied Energy 4.56 (1.33) 4.79 (1.26) -.68 4.34 (1.43) 5.10 (.97) -2.38* Space 5.16 (1.08) 4.97 (.97) .71 4.71 (1.15) 5.39 (.69) -2.75** Integration 5.66 (1.23 ) 5.51 (.97) .51 5.23 (1.20) 5.92 (.77) -2.63* Logic 5.78 (.88) 5.59 (.82) .88 5.48 (.97) 5.85 (.64) -1.77 Realism 4.89 (1.84) 5.17 1.42) -.64 4.70 (1.79) 5.47 (1.22) -1.92 Problem Solving 4.89 (1.84) 5.17 1.42) -.64 4.70 (1.79) 5.47 (1.22) -1.92 Developmental Level 5.22 (1.32) 4.94 1.09) .90 4.66 (1.31) 5.46 (.87) -2.75** Details of O_E 5.10 (1.21) 5.01 1.05) .30 4.72 (1.30) 5.40 (.71) -2.49* Line Quality 5.11 (.79) 5.53 (.73) -2.1* 5.28 (.84) 5.48 (.69) -1.01 Person 6.01 (1.62) 6.11 (.69) -.33 5.89 (1.35) 6.28 (.78) -1.36 Rotation 7.19 (.48) 6.75 (.75) 2.50* 6.88 (.77) 6.95 (.60) -.39 Perseveration 6.49 (.91) 6.63 (.87) -.60 6.46 (.99) 6.69 (.73) -1.016 Table 3: Correlation of CDI scores and Comparison between Depressive & Non-depressive with subscales of FEATS Sub Scales R, CDI Mean: Dep. group Mean: Non-dep. group t Prominence of color -.15 2.94 (.34) 2.82 (1.1) .47 Color fit -.19 3.72 (.27) 3.34 (1.02) 1.71 Implied Energy -.29* 3.44 (.44) 2.88 (1.06) 2.30* Space -.16 3.49 (.37) 3.21 (.91) 1.33 Integration -.06 3.93 (.36) 3.97 (.69) -.25 Logic .04 3.71 (.37) 3.84 (.67) -.84 Realism .11 3.70 (.37) 3.84 (.67) -.84 Problem Solving -.36** 3.67 (.78) 3.12 (1.19) 1.89 Developmental Level -.06 3.42 (.46) 3.27 (1.06) .63 Details of Object and Environment -.27* 3.67 (.35) 3.15 (.96) 2.42* Line Quality -.03 3.60 (.43) 3.63 (.58) -.21

Discussion: Art based assessments are increasingly used in clinical situations in our sociocultural context. However there are not many published research papers on the same. Though PPAT had been in use since 1990, it was introduced only recently in India (Kruthi & Manickam, 2014). Since Kruthi, et al. (2014) had recommended the use of Mango tree instead of Apple, an attempt was made to study the usefulness of the task in differentiating participants with low scores and high scores of depression. Identifying depression among adolescents at an early stage is important for the effective treatment either through pharmacological methods or non-pharmacological methods including art therapy. In contexts where adolescents are not able to identify their mood changes on their own and report for treatment, art based assessments can be easily administered (Sajani & Manickam, 2000). Further, the task of PPMT is simple and the adolescents find it easier and interesting to express themselves in the drawing and coloring tasks. Gender was found to affect the subscales of Line quality and Rotation, which is not found in any of the previous studies. The lower age group had less Implied Energy, Integration, Developmental Level and Details of Object and Environment and the findings are in consonant with the observed cognitive development of the adolescents. Though the subscales of FEATS- Implied energy, Details of Object and Environment and Rotation differentiated the depressive group from the non-depressive group, the fact that the depression score was significantly correlated to the variables of Rotation and Implied energy, Problem solving and Details of Object and Environment indicated that the PPMT is an effective task that can be used in clinical conditions too. Studies conducted elsewhere also found that FEATS assessments identified a subset of patients who were not identified using the self-report measures (Wallace et al 2004). Eytan and Elkis- Abuhoff (2013) also found that participants with depression obtained low scores on the FEATS scale. Though Gantt and Tabone (1998) favored the use of scented markers, the present study used ordinary sketch pens, with 12 colors, which may have affected the rating. Regarding the use of pens Gantt and Tabone (1998) opined that using ‘Mr. Sketch’ would help the rating tasks easier for the raters to count the number of colors used. However (Deaver, 2014) opined that the scented sketch pens might, ‘be distracting to children who always want to sniff and identify the scents’. In view of the color being a subscale of FEATS, Mr. Sketch scented markers may be used with PPMT too, in order to find out whether it makes a difference in the scoring. Further, in order to validate the subscales, those participants who had elevated scores on the four subscales may be clinically evaluated for depression to ascertain the specificity of the tool. Similarly the PPMT may be administered to those participants who are diagnosed to be having clinical depression and other psychiatric disorders to find out whether any other scales are related to depression or any other psychiatric disorders. While assessing the inter-rater reliability, though the correlation was significant in all the subscales, it was low in line quality, logic, rotation and prominence of color in comparison to the correlation of other subscales. Conclusion: In conclusion, rating PPMT using FEATS, Rotation was positively correlated with depression scores and Implied energy, Problem solving and Details of Object and Person .07 4.03 (.43) 4.10 (.96) -.29 Rotation .31* 4.50 (.39) 4.81 (.37) -2.91** Perseveration .20 4.30 (.57) 4.54 (.58) -1.47

Environment were negatively correlated with depression scores. PPMT may be used as an art based task in identifying those with depression and the FEATS may be used as an effective scale for validating the elements of drawing. References: Bang, Y. R., Park, J. H., & Kim, S. H. (2015). Cut-Off Scores of the Children’s Depression Inventory for Screening and Rating Severity in Korean Adolescents. Psychiatry Investigation, 12(1), 23–28. doi:10.4306/pi.2015.12.1.23 Buck, J. N. (1964). The House-tree-person (HTP) Manual, Western Psychological Services. Coulacoglou, C. & Kline, P. (1995) The Fairy Tale Test: A novel approach in projective assessment. British Journal of Projective Psychology, 40, 2, 10-32 Deaver, S. (2014, Jan 24). Personal Email Communication with the first author. Deaver, S. P. (2009). A normative study of children's drawings: Preliminary research findings. Art Therapy, 26(1), 4-11. Eytan, L., & Elkis-Abuhoff, D. L. (2013). Indicators of depression and self-efficacy in the PPAT drawings of normative adults. The Arts in Psychotherapy, 40(3), 291-297. Friedberg, R. D., &Sinderman, S. A. (2011). CDI scores in pediatric psychiatric inpatients: A brief retrospective static group comparison. Depression Research and Treatment, Article ID 134179, pagesdoi:10.1155/2011/134179 Gantt, L.M. (1990). A validity study of the Formal Elements Art Therapy Scale (FEATS) for diagnostic information in patients’ drawings. Unpublished doctoral dissertation, University of Pittsburgh, Pitts burgh, PA. Gantt, L.M., & Tabone, C. (1998). The Formal Elements Art Therapy Scale: The rating manual. Morgantown, WV: Gargoyle Press. Gantt, L. M. (2001). The Formal Elements Art Therapy Scale: A measurement system for global variables in art. Art therapy, 18, 50-55. Goodenough, F.L. (1926). The measurement of intelligence by drawings. New York: Yonkerson- Hudson, World Book Co. Grover, S., Avasthi, A., Kalita, K., Dalal, P. K., Rao, G. P., Chadda, R. K., ... &Deka, K. (2013). IPS multicentric study: Functional somatic symptoms in depression. Indian journal of psychiatry, 55(1), 31. Kahn, M., & Jones, N. (1965).Human figure drawings as predictors of admission to a psychiatric hospital. J. Projective Techniques and Personality Assessment, 29, 319-322. Kovacs, M., Iyengar, S., Goldston, D., Stewart, J., Obrosky, D. S., & Marsh, J. (1990). Psychological functioning of children with insulin-dependent diabetes mellitus: A longitudinal study. Journal of Pediatric Psychology, 15(5), 619-632. Kruthi, M. & Manickam, L.S.S. (February, 2015) Mango Tree or Apple Tree to be used for FEATS in India – An exploratory study. 41st National Conference of Indian Association of Clinical Psychologists. Gandhinagar, Gujarat. Kruthi,M.,Basavarajappa& Manickam, L.S.S. (November, 2014) Person Picking a Fruit from the Tree Test: Identifying the appropriate one for Indian context. 21st National Conference of the Indian Asso. for Social Psychiatry, Mysuru. Pathak, P. (2002). Draw-A-Man Test for Indian children: Revision and extension, IV Edition. Pune: Anand Agencies. Sajani, V. &Manickam, L.S.S. (2000). Integrative Art Therapy in Adolescents: An Experiential Study. Teens: Journal of Teenage Care & Premarital Counseling, 1, 35-40. Sajani, V. and Manickam, L. S. S. (2012) Child Depression Inventory: Malayalam translated version. Unpublished Manuscript. Sanyal, N., &Dasgupta, M. (2011). Personality Profiles of Indian Children: An In-depth Exploration of Projective Responses. Indian Journal of Clinical Psychology, 38(1), 17-29. Silver, R. A. (2003). The silver drawing test of cognition and emotion. In C.A. Machiodi ( Ed.), Handbook of art therapy, (p 410-419). New York. Guilford Press. Timbremont, B., Braet, C., & Dreessen, L. (2004). Assessing depression in youth: relation between the Children's Depression Inventory and a structured interview. Journal of Clinical Child and Adolescent Psychology, 33(1), 149-157. Wallace, J., Yorgin, P. D., Carolan, R., Moore, H., Sanchez, J., Belson, A., & Arrington, D. (2004).The use of art therapy to detect depression and post‐traumatic stress disorder in pediatric and young adult renal transplant recipients. Pediatric Transplantation, 8, 52-5

Sociometric Method of the Research of Hidden Conflicts in the Small Professional Groups on the Basis of Zondi Deep Inducements N.V. Zhukova, A.I. Lozhkin and I.S. Guseva Hidden conflicts are caused by the actual needs of the individual, which can be steady using the Zondi test. On the basis of the incentives formula of the person, which includes the root promptings, situational and manifested factors in the procedure sociometric research method in small professional groups "open" personality conflicts can be anticipated. Sociometric method of research aimed at identifying interpersonal relationships in small groups suggests that each member of the group answers a question about preferred’ members of the group in certain situation and to produces a consistent selection and ranking of the other group members. However, the nature of these preferences in such studies is not detected. In small occupational groups where the efficiency of each employee depends on the emotional comfort and well-being of all members of the group, united by a common goal, it is important to anticipate the possible hidden conflicts. Procedure: The Sociometric method of research was used in the small professional groups with deep inducements of Zondi test which based on the perception of human face. Stimulus material of the Zondi projective test consists of 48 pictures, each of which is represented by mentally ill persons. Cards are divided into six series, with eight items in each, according to the basic needs of the individual motives. The extreme expression of a tendency according to Zondi, indicate pathology in the form of a disease, and so obvious, that it is manifested in the facial expression of the patient, and therefore, its photo can serve as a diagnostic criterion. The Zondi test procedure is a kind of "psychological shock" for the one who looks at the sick faces, "one by one", so in the projection they reflected their deep pathological impulses. This phenomenon is likely to create a "resonance" between photography and test, as a kind of "psychological mirror" where the subjects in the photographs of stimulus test "see" reflected image of self. Photo of patient reflects the deep needs of the subject, "forcing" him emotionally (positively or negatively) to respond to the face of the person. At the same time the rate of the disease is not shared by "the abyss of qualitative differences", barely discernible the quantitative boundaries, which allows you to see and catch test. Consequently, the healthy and the sick, according to L. Zondi share the common structure of the personality, which is revealed in the dynamics of the implementation of the following basic factors of motives: • Factor h (portraits of homosexuals)- expressed the need of the subject to personal affection or collective, universal love; • Factor s (portraits of sadists) - reflects the need to use their physical activity, aggressive manipulation of the object, or the ability to use the energy of others, as well as subordination and obedience; • Factor e (portraits of epileptics) - reveals a feature of the subject to control N.V. Zhukova, Ph.D., Professor and Head, A.I. Lozhkin, Ph. D, Asst. Prof. and I.S. Guseva, Senior Lecturer, Dept. of Psychology, The Ural Institute of Economics, Management and Law, Kurgan, Russia Key words: symptomatic reaction, internal conflict, interpersonal conflict.

or, on the contrary, to express their aggressive passions (attack or hold back); • Factor hy (portraits of hysterics) - shows the features of the person to show or hide their erotic experience; • Factor k (portraits of catatonic) - the need for egoistic separation themselves from the outside world, through the dominance of the material side and the desire to acquire or preserve their identity and integrity, through the rejection of superfluous and unnecessary; • Factor p (portraits of paranoid) - the need to expand the "I" by its omnipotence or the desire to dissolve the Selves, "crush" his "I" in the significant objects of the world; • Factor d (portraits of depressive patients) - the need to find new objects or in faithfulness and preservation of old; • Factor m (portraits of manic patients) - the need for attachment to the object or to the freedom, tireless activity and enterprise (Zondi, 1947, 1963, 1984). Psychological research of projective Zondi test consists in presenting to the subject six times alternately eight photographic portraits of mentally ill person. In all cases, the subject is required to choose five of pleasant and three of unpleasant portrait. Expert captures the reaction of choice in the report, called "profile of motives" and analyses it to find the state of the actual needs of the individual. For example, if the tested subject in each series selects as nice portraits of homosexuals and epileptics (positive), the relevant factors are the choice of (h) and (e) are positively tense. This means that the data coincide with the unconscious needs; conscious objectives approved and show potential willingness to implement them. In this case, the individual feels the need for personal love (h +) and control their aggressive impulses via ethical regulator such as conscience (e +). If the individual chooses the same portraits as unpleasant (negative), then the corresponding to the selection factors are considered to have a negative tense (h-, e-). This means that the implementation of these trends is not compatible with the aspirations of the individual conscious, even though they are very powerful dynamic. In this case, the individual suppress his need for love to the object (h-), accumulating it rude aggressive affects, such as anger, hatred, jealousy, vindictiveness (e-), which belong to the "experience of Cain." Accordingly, the factors that are constantly positively or negatively strained, called the root, and point to the dissatisfaction of the needs. If the test subject does not pick portraits as pleasant or unpleasant it is called as zero reaction (0). This indicates that these requirements are not relevant to the subject, because he was able to realize them in one form or another (behavior, illness). Such reactions in the test are called symptomatic. One of the methods for the analysis of test results is the quantification of each factor of indigenous and symptomatic reactions. So he got the name - a quantitative method of analysis. On the basis of the ranked series, allowing the test to share the deep needs of indigenous and symptomatic, a psychologist receives an important diagnostic component, wherein Zondi designated as - meaning the individual formula. If for the healthy personality the symptomatic factors are the psychological indicators of its strength and potential for development in a certain area, for example, the implementation in the professional sphere and personal growth, and on the contrary for the patients they are a manifestation of disease or its painful symptoms. At the same time, indicators of symptomatic and indigenous factors can be used not only in the context of individual psychological work, but also as a forecast of the dynamics of intra-group relations. In this case, similar in individuals symptomatic treatment group

factors are, respectively, the rate of genetic relationship manifestations of reactions to stimuli of the surrounding world, and, therefore, identical figures of human behavior will be equally responsive to external and internal changes. In this logic, these individuals generally will show respect, sympathy and friendship relations for each other (Zondi, 1947, 1963, 1984). For example, the psychology manifestations of symptomatic factor (h0) will reflect the need for tenderness in relation to partners of the opposite sex (sexual love). In this case, the most favorable professional sphere of activity for the factor (h) will work with children (nurse), or professions related to tactile stroking client (hairdresser, etc.). Accordingly, to Zondi theory (1947) fundamental factors are not able to normal realization of inducements ("discharge"), so they are the causes of disease, trauma, or prohibitions on the implementation of a basic need. Consequently, in interpersonal relations identify any differences in individuals in the manifestation of the root factors will reflect the hidden, the deep form of psychological conflicts, which for the time being are not recognized and are not controlled. Procedures and stages of the research potential conflicts in small groups on the basis of professional motives underlying of Zondi: The study was conducted in three phases, the logic of which is due to the procedure and the arrangement of the Zondi test, every other day (eg, Monday, Wednesday, Friday). Each step involves a study of three techniques with a certain sequence and instructions. The first stage (first day): The Zondi technique was conducted, after that given the deck with the pictures of the of research subjects and sociometry. 1. Instructions for the Zondi technique: "Before you see a board with photos of persons of different ages and gender. Your task is, to choose 5 most pleasant photos and 3 most unpleasant photos starting with the most pleasant first. " The researcher records the number of each picture in the form of answers. 2. Instructions for the deck with the people’ photos: "Here is a set with pictures of the men and women faces. Your task is to place men and women on the basis of a deck of pleasant persons, unpleasant and neutral. Quantity of photos of men and women in each pack must be approximately equal. While the subject performs the task, a researcher in the meantime records the number of each photo on each deck to the table recording the results. 3. The subjects were presented cards with the names of the employees. Their task was to position himself and his colleagues in the sequence, how and with what frequency; there is a dialogue and cooperation with them (7 +/- 2). Instructions for the method of sociometry: "Before starting the job, please, imagine a sheet of A4 mentally put yourself in the center, and the rest as you can see their location relative to you." Second stage (second day): 1. Carry out with the projective rapid diagnostic Zondi techniques using the same instruction as during the first day. 2. The subjects were asked to remember the location of yourself and employees on a piece of paper and compare them with those photos from the deck. Instructions: "Using a deck with the faces photos of men and women select themselves and their employees." The investigator writes at the back of the card with the names of employees to which it

relates pole (signed on the back side (+, 0, -). The researcher records all of this in the forms for answers and in a protocol, and he must be assured from which of the deck the faces were selected. He makes the numbers, gender and which the pole was assigned by the subject (+, 0, -). The third stage (the third day): 1. Caring out the procedure of Zondi techniques with the same instructions as for the first day. 2. The subjects were asked to identify the photo (and its employees), which was selected in the previous phase of the study. Instructions: "You need to remember, and to find the deck of photos with faces of men and women themselves and employees, as they have been selected on the second day of the study (14 of these people)." Researchers are recorded in the minutes and form responses. Participants of the study: The sociometric study in the small occupational groups took place from 2014 to 2015 on the basis of "organization №1" (Automobile Salon) and "organization №2” (hairdresser). persons(both sexes) including Boss, 2 heads of divisions, senior managers, administrators, ranging 22 to 51 years (mean 28 years), participated in study "№1". 7 persons (both sexes) the Head, administrators, hairdressers, master of manicure and master of pedicure, ranging 23 to 31 years (mean 28 years), participated in study "№2"). The total numbers of the subjects were 23 persons. Results, Discussion and Interpretation: During empirical research we studied the deep motivation, which can be the cause of the latent conflicts. The interpretation (as an example) of the hidden internal conflicts based on an analysis of the motives' formulas of the personality. "The organization №1" The Boss is the 37 years old man. The relation to self is neutral. He chose "the" picture of people who do not belong to any "pleasant" (+) or to the "unpleasant" (-) and got to the section "neutral" (0). In his deepest impulses manifested factors (hy-! d-! m +!), He prefer to administer the democratic style. The relation with the staff is indifferent, prevail neutral positive, he openly does not evaluate employees with negative position. However, he manifested the hidden negative attitudes to the following employees: • Manager 1. She is 25 years old woman, the depth of the needs characterizes her as an introverted person, with inner tension and with some unresolved unconscious internal conflict (hy- d-! m +); • Manager 2. She is 36 years old woman, with deep impulsive motives and she controlled their emotions poorly (hy-! d-! m +!); • Manager 3. He is 25 years old man, with depth needs corresponds to the chosen profession (h +! p + d-!). The deep motives show that he is an emotional leader of the staff. He shows overdeveloped need to demonstrate masculinity. The inner conflict of the Boss to these employees is hidden in the root factor of the motives' formulas of the personality. The Boss has an internal unresolved conflict, which manifests itself as prohibited and is due to the following trends: a) modesty, secrecy, shame of dominance (hy- !); b) desire to preserve the old, refusal to search for a new (d-!); c) desire for attachment, it is assumed to lasting contact (m +!). These trends are also identified as the fundamental factors in the formula -

motives of his employees, but the Boss does not accept them. They had neutral attitude towards him +. The Boss would not like to admit he does not want "to see similar" in himself. The Staff’s relationship to the Boss is primarily positive. However, some point should be highlighted when we see the negative attitude of some persons of the staff towards the Boss at that time as his attitude towards them is positive or neutral: • The Division’ Head is 25 years old woman with the deep needs (h- m +!). She prefer to use the authoritarian style, understands the strictly regulated orders and business relationships; • Manager 4 is a 25 years old man with deep impulses (h +) engaged in the business and knows what to do using their "natural" quality. The leadership style of the Boss (to teach, take care, to control) is not consistent with his internal expectations. • Manager 5 is 26 years old female. She has deep motives (hy-! d-! m +!), impulsivity, and poor control of her emotions. She cannot keep a distance in relationship to the Boss. Thus, based on the analysis of a single case can be concluded that the latent conflicts in small occupational groups may be due to roots (genetic) factors of the formula motives, which does not meet the needs, and which can lead to the direct "open" conflict situations. The interpretation (as an example) of the hidden internal conflicts based on analysis of the motives' formulas of the personality. "The organization №2" A. The Head is 31 years old male: He has positive attitude toward self since chose the "self" from the deck of persons previously estimated "positive" (+) at the deep motives does not take itself on the floor, the presence of sex-role conflict and its discharge by means of professional activity barber (h +/-), so in depth corresponds to the promptings of the selected profession. He takes himself as a leader (k +/-), by managing the organization on a democratic style. The relation of the Head to the staff is primarily positive. However, it should highlight the negative attitude towards the E. and neutral to B. and R. E. The depth " manifest " needs is, as well as A. (Head ) does not take itself on the gender, likely to experience gender role conflict (h +/- ), has administrative ability, the ability of the head (k +/-), she has masculine qualities, active (s +), presumably for this reason A. may negatively treats E. (h +/-, k +/-). B. The depth "manifest" needs is as well as have the ability of A. (Head) (k +/-), she is modesty tends to show and hide true feelings of love (hy + and -),and she is a person with creative thinking (p +). R. Her depth of needs is completely opposite of A (Head). R. is kind, altruistic (e0, +), has low self-esteem (hy-, k-), not public hen, modest (hy-), shows not realize "fear of relationship" especially to the opposite sex. Unlike A, who realizes himself, both in personal and professional terms, R. does not take itself. In spite of his kindness and closeness, R. needs A, prone to domination and desire for power. The relation of staff to Head – in general are neutral (E., D. and R.). E. refers to A. supposedly neutral because the possibility to go into opens conflict with A, in response to its aggression. A - is an evil man, hide himselvels (hy-, e-). The conflict between them is possible because on deep motives E. manifests itself "male pattern” (h + / -, -), it is characterized by aggression and straightness (s +). In addition, she, like A. has the ability to head (k +/-), which can also

serve as a reason for his failure, and the possible development of conflict. D. The deep motives, too peculiar aggressive reaction (s +), which can act aggressive response reactions to impulsive display A. R. The deep impulses in response to impulsive display A, can also respond to rudeness and anger (e-). So, the reason for the negative or neutral attitude of employees to each other lies in their underlying motives no matter where they are located in the manifesto or in the roots. This conclusion brings together both the first company employees, and the second, despite the fact that the specificity of professional work and the requirements for professional qualities they differ. Thus, in a small professional group hidden deep (potential) conflicts can be caused, first of all, the experience of internal conflicts of members. Indeed, personality conflicts occur as a result of the denial of their underlying motives, identified on the basis of the root factors of the formula motives L. probes or are dependent on the characteristics of emotional discharge due to its manifest factors. Recommendation: The recommendations have been given to all employees, to restore the integrity of the individual by the exercise “The Inclusion of the “I” (Juttner, 2002) described below: Take a notebook and write every day, one or more pages. Everything that comes to your mind at that moment, when you sit in front of a blank page. This can be thought of yesterday, the last dream, an excerpt from the newspaper that you read. Anything. Just sit down and ask yourself; "What I am thinking?" Or "What I feel now; good or bad to me?" or "What is the mood I had when I was worried about what I write today?"Record all the way comes to mind. Now you can say to yourself, "These thoughts and the feelings belong to me. Even if they make me ashamed - it is my thoughts, my feelings." This wording will help you all to weigh carefully, and then make a decision. "Although I have these thoughts in my life I never will do. I will not allow this position in life and my relationship to other people. " As a result, you can increase your self-esteem, able to control aggression and take a humanistic solution. Fixing their thoughts and feelings allows us to stay in reality, clearly and honestly perceive his inner world. References: Szondi L. Lehrbuch der experimentellen Triebdiagnostik. Bern: Huber, 1947. Szondi L. Schicksalsanalytiche Therapie. Bern: Huber, 1963. Szondi L. Integration der Trieb. Die Triebvermischten. Bern: Huber, 1984. Juttner F. Schicksalsanalyse in Zusammenfassungen. Stiftung Szondi-Institut, 2002. SIS CERTIFICATION Be a certified trainer and practioner of Somatic Inkblot Series. The Participants will be certified by International Somatic Inkblot Society. The certificate program is open to Psychiatrists, Clinical Psychologists, Psychologists, Psychiatric Social Workers, and HR Professionals. Prof. Bankey L. Dubey, Ph.D., Director SIS Centre, 4406 Forest Rd, Anchorage, AK 99517, E-mail: bldubey@gmail.com

Anxiety, Loneliness, Adjustment, Shame and Depression of Hearing Impaired with respect to Marital Status of Parents Anitha Kumari,T.T. & Rakhee, A.S. Hearing is one of the major sensory ability of an individual. Hearing of spoken language is most important in the process of developing human life. Hindrance in the process of hearing can cause hearing impairment or deafness. A sample of 300 hearing impaired adolescents including both males and females, between 11 to 19 years of age were selected for the present study using purposive sampling. The aim of the study was to investigate anxiety, loneliness, adjustment, shame and depression with respect to marital status of parents. The examinees were administered ADS inventory to obtain the scores of anxiety, loneliness, adjustment, shame and depression. The results show that anxiety in deaf has a significant relationship with marital status of parents. Deafness refers to a total or partial loss of hearing ability. It may result from a great variety of causes, like congenital factors, lifestyle factors, environmental time factors etc. Diagnosing hearing losses in infants and young children is not always easy. The undetected factors may cause serious problems, including language learning (Benjamin and Jack, 1987). For deaf, living in a world where one's language is known by a few and understood by even fewer influences how deaf people view themselves. For centuries, deaf people had to undergo the treatment of being viewed as incomplete person because of their hearing disability. Research in the area shows that such people have more mental health problems than general public. About seven per 10,000 people worldwide are severely deaf, with onset of deafness before language development. It is estimated that about 25 percent of deaf students have other disabilities, such as learning difficulties, developmental delay, visual impairment and autism (Health.usnews.com, 2012). They face many psychosocial problems including anxiety, depression and maladjustment. The deaf as a minority has to face a lot of problems in today’s competitive world. The adolescent stage is most vulnerable periods in their life. Along with the changing physical and mental status as grownups, they have to face various other problems. If these problems are left unaddressed, they will not be able to deal effectively with the challenges in day today living. Attention to the mental health of these adolescents will improve their life standard and will make positive impact on their academic and personal achievements. The present investigation is an earnest attempt to investigate anxiety, loneliness, adjustment, shame and depression with respect to marital status of parents. Method: The sample consists of 300 hearing impaired adolescents of both sexes from different districts in Kerala, including parents living together, divorce or separated, widow and widower. It was a purposive sampling. Tools: a. ADS inventory b. Personal Data schedule The data obtained was analysed using Statistical Package for Social sciences (Version 21). One way ANOVA was computed to find the results. Results and Discussion: The aim of the study was to investigate anxiety, loneliness, adjustment, shame and depression with respect to marital status of parents. The parents are divided in to 4 groups viz parent living together (130), Anitha kumari T.T, Res. Scholar in Psy,, Kerala University Library, University of Kerala, Trivandrum, Email::aktt1987@gmail.com and Raakhee, A.S, Asst. Prof. in Psych, Sreenarayana College, Chempazanthy, Trivandrum, Email: raakheeajithas@gmail.com Key Words: loneliness, adjustment, hearing impaired, marital status of parents.

divorced or separated (74), widow (62) and widowers (34). The result of one way ANOVA shows that anxiety in deaf adolescents is significantly related to the marital status of parents. And there exists no significant difference between the remaining variables such as loneliness, adjustment, shame and depression and marital status of parents. In order to find out which of the comparison showed significant differences Post Hoc Duncan procedures was used. Post-hoc result shows more anxiety among widow parent Table 1: Data and Results of ANOVA for the Five Variables. Variables Sum of Squares Df Mean Square F Sig. Anxiety Between Groups 245.598 81.866 4.182 .006 Within Groups 5793.932 19.574 Total 6039.530 Loneliness Between Groups 12.431 4.144 .201 .896 Within Groups 6108.956 20.638 Total 6121.387 Adjustment Between Groups 66.224 22.075 .964 .410 Within Groups 6775.413 22.890 Total 6841.637 Shame Between Groups 48.709 16.236 .715 .543 Within Groups 6718.571 22.698 Total 6767.280 Depression Between Groups 68.070 22.690 1.080 .358 Within Groups 6216.517 21.002 Single parenthood is stressful and can have many emotional effects on children, including low self-esteem, increased anger and frustration and an increased risk for violent behaviour. Other emotional effects of growing up in a single parent household may include feelings of abandonment, sadness, anxiety, loneliness and difficulty in socializing. Effects vary from child to child, however, and the individual parenting style of the single parent is also a big influence on the child’s development. So the children experience too much anxiety while interacting with others. The results of Anova obtained by comparing the four groups of deaf adolescent (living together, separated, widow and widower) are shown in table 1. The significant F ratio obtained for the variable Anxiety suggested the need for further analysis using Duncan procedure and the results are shown in table 2. The results did not show significant difference among the four groups for the variables- Loneliness, Adjustment, Shame and Depression.

Paperless Policy of SIS The Members of SIS are invited to Contribute to the Paperless Policy of Somatic Inkblot Society by opting for Soft Copies of SIS Journal of Projective Psychology and Mental Health instead of Print Version. The soft copies of every issue will be delivered directly on members Email. This will not only save our trees and be environment friendly but also would be time efficient. Write to me directly for opting out print version of SIS Journal on my Email ID: bldubey@gmail.com Bankey L. Dubey Table 2: Results of Duncan test for the Variable Anxiety Sl.No. Group Mean N Group 1. Living together 49.02 * 2. Separated 50.04 3. Widower 53.34 4. Widow 50.59 Significant difference was found between the deaf adolescents living with both the parents and those living with fathers only due to loss of their mothers. The means score (M: 49.01) obtained by the deaf adolescents living with both mothers and fathers lower than the means score obtained by deaf adolescents who are living with their father only. Other groups did not show any difference. Conclusion: The findings of the study are helpful in understanding the problems faced by the deaf adolescents. Parents, educationalists, teachers, and the government should act in such a way as to reduce the problems faced by the deaf adolescents and to enhance their mental health. Parents should also take care not to pressurize their children to achieve beyond their capabilities. Even if the deaf person has a supportive family and friends, it is likely that they are the only deaf person in the family or group of friends. This may lead the feelings of loneliness and community programs for deaf can help to overcome such feelings. The appropriate authorities should try to reorganize the policies to maximize the potentials of such adolescents to make them productive citizens. References: Benjamin, T.L and Jack, H.R. (1987). Exceptional children (3rd edition). Macmillan Publishing Company, Inc. Health.USnews.com/ health-news/articles (2012) /03/16/

Factors Associated with Self-esteem in Patients with Chronic Schizophrenia Sudhir Kumar and Sandhyarani Mohanty Self-esteem is an important component of psychological health. Self-esteem refers to an individual’s sense of value or worth, or the extent to which a person appreciates, or likes himself. Treatment failures, functional loss, demoralization and stigmatization may lower self-esteem in patients with severe mental illnesses. Low levels of self-esteem have been implicated as both a cause and a consequence of severe mental disorders. Low selfesteem contributes in both the development of delusions and the maintenance of psychotic symptoms. The present study aimed at exploring the self-esteem and its associated factors in persons with chronic schizophrenia. This is a cross-sectional correlational study conducted at Institute of Mental Health and Hospital, Agra. The sample consisted of 50 persons with chronic schizophrenia in the age range of 20-55 years. Rosenberg Self-esteem Scale, PANSS and Schedule for Assessment of Insight (SAI) were administered on the participants. The results revealed significant association of the level of insight, Current functioning of the patient, positive symptoms, negative symptoms and general psychopathology with the self-esteem. Self-esteem refers to an individual’s sense of value or worth, or the extent to which a person appreciates, or likes himself (Taylor et al, 2000). It is often found to be compromised among persons with mental illnesses (Van Dongen1996). Low selfesteem is considered as a possible consequence and a possible cause of psychiatric symptoms (Greenberg et. al.,1992; Karatzias et. al, 2007; Blairy et al. 2004). Link et al. (2001) reported that stigmatization and self-stigmatization may lower self-esteem in persons with mental illness. Previous researches also indicated that lowered self-esteem frequently accompanies or became an etiological factor in many psychiatric conditions (Robson, 1998; Silverstone et al, 2003). The risk of psychiatric disorders such as depression, eating disorders and substance abuse increases due to low self-esteem (Silverstone & Salsali, 2003). Some studies reported that low self-esteem has a key role in developing delusions (Bentall et. al, 2001; Barrowclough et.al., 2003) and the maintenance of psychotic symptoms (Garety et. al. 2001). One study showed that the contents of patient's delusions were consistent with patient's global self-esteem and suggested that low self-esteem accounted for the persistence of delusions (Bowins & Shugar, 1998). Studies also reported significant correlations between negative self-evaluation and a wider variety of positive symptoms i.e hallucinations and delusions in schizophrenia (Barrowclough et. al. 2003). It has been found that patients with a low level of self-esteem and more depressive symptoms had more intense auditory hallucinations with a more negative content (Smith et. al., 2006). The theory proposed by Crocker & Wolfe (2001) suggested that self esteem is a trait and state measure and it varies based on the self-judgments and interpretation of the events or circumstances, and its relevance to his or her contingencies of self-worth, as well as social feed-back. Link et al (2001) found 24% of the people with schizophrenia scored below the mid-score (reflecting low score and low self-esteem). Silverstone et al., (2003) also found that patients with schizophrenia had intermediate levels of self-esteem. Schizophrenic patients have significantly low self-esteem in comparison to other psychiatric conditions and they are expected Sudhir Kumar, M.D. Director and Sandhyarani Mohanty, Ph.D.,Research Officer; Institute of Mental Health and Hospital, Agra – 282002 Email: imhh.agra@gmail.com Key Words: Self-esteem, Schizophrenia, Psychotic Symptoms.

to have a compromised quality of life and poor psychosocial functioning (Breeke et al., 2001; Gureje et al., 2004). There are a few studies to show correlation between self-esteem in people with schizophrenia with any socio-demographic factors. In one study, female patients were found to have higher self-esteem than their male counterpart (Sorgaard. et al, 2002). Brekke et al (2001) studied executive functioning as a moderator of the relationship between psychosocial functioning and the self-esteem. They found that patients with impaired executive functioning displayed a positive and statistically significant association between psychosocial functioning and self-esteem but those with intact executive functioning showed negative association. Aims: The study aims to determine the level of selfesteem and the factors that are associated with the level of self-esteem in patients with schizophrenia. Method: This is a cross-sectional correlational study conducted at Institute of Mental Health and Hospital, Agra. The sample consisted of 50 persons with chronic schizophrenia. The following inclusion and exclusion criteria were adopted while selecting the sample. • The age ranges of the patients were 20-55 years. • ICD-10 DCR criteria were followed for diagnosing the patients. • The minimum duration of illness was 2 years. • Patients with any comorbid condition and major physical and neurological abnormalities were excluded from the study. The following tools were individually administered on each subject by the research staff. Rosenberg Self-Esteem Scale: The scale is a ten item Likert scale with items answered on a four point scale – from strongly agrees to strongly disagree. It measures general feelings about own self. Higher scores indicate higher self-esteem. The maximum score is 30. Positive and Negative Syndrome Scale (PANSS): It is developed by Kay et al. (1987). It is used for measuring symptom severity of patients with schizophrenia. It measures positive symptoms, negative symptoms and general psychopathology. 7 point ratings are used for each symptom. Higher score reflects more psychopathology. Schedule for Assessment of insight (SAI): It is developed by David et al. (1992). It is a three-item rating scale used to evaluate insight in psychotic illness. It evaluates insight on three dimensions (a) Recognition of mental illness (b) the ability to recognize abnormal mental events (c) Treatment compliance. Responses are scored on a 0 to 2 scale. Higher score reflect better insight. Results: Table 1 reveals that there is no mean difference in self-esteem across following variables – Marital Status, Socio-economic status and Domicile. However, significant mean differences are observed in the patients having family history of psychiatric illness and having occupational involvement. Age, Education and Duration of illness do not have significant correlation with self-esteem. GAF and Insight have significant negative association with self-esteem whereas three forms of psychopathology have positive significant correlation with self-esteem. The mean scores on Rosenberg Self-esteem Scale was 18.30 having an S.D. of 3.72.

Table 1: Mean, S.D., t-values and Pearson Correlations with Self-esteem Variables n Mean (S.D) t-value / Pearson r/ p value Marital Status Unmarried 17.87 (3.27) t=.349 NS Married 18.38 (3.83) Socio-economic Status Low 19.09 (3.80) t=.431 NS Middle 18.07 (3.72) Domicile Rural 18.16 (3.91) t=.333 NS Urban 18.52 (3.48) Family H/O Psychiatric Illness Yes 16.00 (3.39) t=2.11 p<.05 No 18.80 (3.64) Working Status No 21.55 (2.81) t=6.11 p<.01 Yes 16.46 (2.82) Age (in years) 38.02 (7.00) r=.04 NS Education (in years) 7.66 (5.50) r=.128 NS Duration of Illness (yrs) 8.02 (2.72) r=.132 NS SAI Scores 7.24 (4.18) r= -.820 p<.01 PANSS Positive 16.28 (5.36) r=.886 P<.01 PANSS Negative 12.00 (5.09) r=.833 P<.01 PANSS General 33.38 (9.01) r=.768 P<.01 Discussion: The results revealed a significant positive between three forms of psychopathology (a) positive (b) negative (c) general vis-à-vis selfesteem. Apparently at a superficial level this may appear to be contradictory to what is expected. But a thoughtful consideration would depict a different picture. While schizophrenic patients are symptomatic they have a distorted view of themselves. Their views of themselves do not correspond to the reality. Under the influence of psychopathology they may tend to consider themselves high yielding a statistically positive relationship with the self-esteem. As the severity of psychopathology increases their ratings on the measure of psychopathology too increases. Upon resolution of the symptoms they come into contact with reality and revaluate themselves more or less in pursuance of the reality which is reflected in the lowered self-esteem. They become aware of their limitations, psychopathology and the disturbances that caused in their family, occupational and social life. The decreased level of psychopathology is associated with a critical and lowered view of oneself. This scenario of decreased psychopathology coupled with lowered self-esteem may partly explain the depressive pathology seen in post-psychotic episodes. There is an internal consistency in the results of self-esteem and psychopathology as obtained in this study. Upon resolution of the symptoms the patients tend to show improvements in their global functioning as well as their insight will also show therapeutic gains. The higher levels of insight again pose a risk of critical view of one’s functioning and behavioural disturbances during the active phase of the pathology. This causes a toll on their sense of self. Hence, the gain in insight is associated with decreased self-esteem. This is reflected in the significant negative correlation between scores of Schedule of Assessment of Insight and self-esteem measure.

The implications of it are far reaching. The obvious goals of treatment are the resolution of psychopathology and improvements in the level of insight. But these improvements are associated with lowered self-esteem which is likely to have a link with depressive features in the schizophrenic patients. This situation warrants the need for psychosocial intervention with the patients in order to manage their self-esteem and also to manage resulting depression. Apart from the risk of depression, the negative self-esteem is also associated with very high risk of relapse in schizophrenic patients (Holding et al. 2013). Erickson & Lysaker (2012) while investigating the role of insight and self-esteem in symptoms of schizophrenia concluded that self-esteem is significantly associated with psychopathology in schizophrenia. The lowered self-esteem may be an outcome of a number of variables like stigma and discrimination associated with mental illness, impaired psychosocial functioning due to the illness, early childhood experiences, premorbid personality and the like. In the present study, it was found that the patients who have a family history of psychiatric illness have significantly lower self-esteem as compared to the patients without such history. The patients who were engaged in gainful occupations also showed lowered self-esteem than the non-working persons. This again may be a reflection of the compromised capacities to carry out the job related responsibilities and a stigmatizing attitude. We need to look into various dimensions of self-esteem as this is a significant variable that is implicated in the mental illness at both pre morbid and post morbid level. The lowered sense of self-esteem makes a person more vulnerable to the mental illness and the onset of illness further cause injury to the self-esteem. While taking up self-esteem as the target of intervention, we need to work out comprehensively so that the patients come up with a reasonable view of oneself and deal effectively with the issues that are likely to hurt their sense of self. Conclusion: Self-esteem is significantly associated with psychopathology, insight and other variables. The improvement in psychopathology and insight has potentials for compromising the self-esteem in the patients with schizophrenia. The lowered self-esteem can increase the probability of relapse and depression. This aspect of the being need be addressed explicitly in the patients particularly when they are recovering from active phase of their psychopathology. Future research should consider delineating various factors that are antecedent to the decreased self-esteem in the persons with schizophrenia. References: Barrowclough, C., Tarrier, N., Humphreys, L., Ward, J., Gregg, L. & Andrews, B.(2003) Self-esteem in schizophrenia: relationships between selfevaluation, family attitudes, and symptomatology. Journal of Abn.Psychology, 112,92-99. Bentall, R.P., Corcoran, R., Howard, R., Blackwood, N.& Kinderman, P. (2001) Persecutory delusions: a review and theoretical integration. Clinical Psychological Review, 21,1143-1192. Blairy, S., Linotte, S., Souery, D., Papadimitriou, G.N., Dikeos, D., Lerer, B., et al. (2004) Social adjustment and self-esteem of bipolar patients: a multicentric study. Journal of Affective Disorder 79, 97-103. Bowins, B.& Shugar, G. (1998) Delusions and selfesteem. Canadian Journal of Psychiatry 43,154- 158. Brekke, J.S., Kohrt, B. & Green, M.F. (2001). Neuropsychological functioning as a moderator of the relationship between psychosocial functioning and the subjective experience of self and life in schizophrenia. Schizophrenia Bulletin 27, (4): 697-708. Crocker, J.& Wolfe, C.T.( 2001) Contingencies of selfworth. Psychological Review, 108,593-623.

David, A., Buchanan, A., Reed, A., et al (1992) The assessment of insight in psychosis. British Jour of Psychiatry, 161, 599 -60 Erickson, M.A., Lysaker, P.H. (2012) Self-esteem and insight as predictors of symptom change in schizophrenia: a longitudinal study. Clinical Schizophrenia and Related Psychoses. 6(2):69- 75. Garety, P.A., Kuipers, E., Fowler, D., Freeman, D.& Bebbington, P.E.(2001) A cognitive model of the positive symptoms of psychosis. Psychological Medicine, 31,189-195. Greenberg,J., Solomon, S., Pyszczynski, T.& Rosenblatt, A., Burling, J., Lyon. D, et al. (1992) Why do people need self-esteem? Converging evidence that self-esteem serves an anxietybuffering function. Journal of Personality and Social Psychology 63,913-922. Gureje, O., Harvey, C. & Herrman, H. (2004). Self- Esteem in patients who have recovered from psychosis: profile and relationship to quality of life. Australian and New Zealand Journal of Psychiatry 38, 334-338. Holding JC1, Tarrier N, Gregg L, Barrowclough C. (2013) Self-esteem and relapse in schizophrenia: a 5-year follow-up study. Journal of Nervous and Mental Diseases.201(8):653-8. Karatzias, T., Gumley, A., Power, K.& O'Grady, M. (2007)Illness appraisals and self-esteem as correlates of anxiety and affective comorbid disorders in schizophrenia. Comprehensive Psychiatry 4,371-375. Kay SR, Fiszbein, A, Opler, L.A.(1987) The positive and negative syndrome scale (PANSS) for schizophrenia.Schizophrenia Bulletin. 13(2):261-76. Link, B.G., Struening, E.L., Neese-Todd, S., Asmussen, S.& Phelan, J.C.( 2001) Stigma as a barrier to recovery: The consequences of stigma for the self-esteem of people with mental illnesses. Psychiatric Services 52,1621-1626. Robson, P.J. (1998). Self-Esteem- A Psychiatric View. British Journal of Psychiatry 153,6-15. Silverstone, P.H.& Salsali, M. (2003) Low self-esteem and psychiatric patients: Part I - The relationship between low self-esteem and psychiatric diagnosis. Annals of General Hospital Psychiatry 2,2. Smith, B., Fowler, D.G., Freeman, D., Bebbington, P., Bashforth, H., Garety., P, et al. (2006) Emotion and psychosis: links between depression, selfesteem, negative schematic beliefs and delusions and hallucinations. Schizophrenia Research 86,181-188 Sorgaard, K.W., Heikkila, J.& Hansson, L.,. (2002). Selfesteem in persons with schizophrenia. A Nordic multicenter study. Journal of Mental Health 11, 405-415 Taylor, S. E., Peplau, L. A., & Sears, D. O. (2000). Social psychology .10th Ed. Upper Saddle River, NJ: Prentice-Hall Van Dongen, C.J. (1996) Quality of life and self-esteem in working and nonworking persons with mental illness. Community Mental Health Journal 32,535-548. SIS Abstracts Download The soft copies of published papers of all issues in SIS Journal of Projective Psychology and Mental Health commencing from Volume 1 (Launching year 1994) to the current year can be downloaded free of cost from the website of Somatic Inkblot Society on following URL: SIS Abstracts: http://somaticinkblots.com/abstracts/ Copyright ©1994. SIS Center, India/Anchorage

Association of Hypnotizability and Suggestibility in Young Adults Ruchi Jain and Rakesh Kumar Hypnotizability is a key variable of interest which is being studied with reference to several psychological and physiological variables. In the present study we explored the relationship between Hypnotizability and Suggestibility in young adults. A correlational design was used. The sample consisted of 100 healthy participants (50 male and 50 female) from Agra, India who were screened through GHQ-12. Stanford Hypnotic Susceptibility Scale (SHSS) and Hyp-Nova Suggestibility Scale were administered individually on the participants. Data was analyzed through product moment correlation. The results indicated a positive association between physical suggestibility and hypnotizability and a negative association between emotional suggestibility and hypnotizability. The implications of using Stanford Hypnotic Susceptibility Scale (SHSS) are drawn which should guide not only the assessment of hypnotic susceptibility but also the application of hypnosis based interventions in psychological problems. Hypnotizability is an important individual variable that has interested researchers considerably. ‘Hypnotic susceptibility’ and ‘hypnotizability’ are used interchangeably. Hypnotizability refers to the degree of responsiveness to hypnotic suggestions administered under standardized conditions (Hilgard, 1981). Individuals differ in the degree to which they respond to hypnotic suggestions. A small number of people are very susceptible to hypnotic suggestions and respond to almost every suggestion while some tend not to respond to any suggestion at all. The majority of people are responsive to some suggestions but not to others. Because of this the measurement of individual differences in hypnotic responsiveness is central to the application of hypnosis based interventions (Heap, Brown and Oakley, 2004). Suggestibility on the other hand, is responsiveness to suggestions, determined by the subjective willingness to submit to the suggestions or a person’s willingness to change his/her behavior not on account of rational, logical arguments or motives, but on a single request or suggestion coming from another person or a group of people. Weitzenhoffer (1974) defined suggestibility more specifically as the "capacity to produce the classical suggestion effect that is, a nonvoluntary (or avolitional) response relevant to the content of a communication intended to be a suggestion". The suggestibility element is a part of personality. Every individual is more or less suggestible. The individual’s suggestibility determines how they perceive the world around them and how they communicate. Kappas (1987) identified two primary types of suggestibility – Emotional and Physical Suggestibility. (a) Emotional Suggestibility is a suggestible behavior characterized by a high degree of responsiveness to inferred suggestions that affect emotions and restrict physical body responses. Thus the emotional suggestible persons learn more by inference than by direct, literal suggestions. (b) Physical Suggestible persons receive and interpret information literally. The persons of these two types of suggestibility handle their emotions in different ways. While emotionally suggestible Km. Ruchi Jain, M.A., PGDCP. Research Scholar; Dr. Rakesh Kumar, Ph.D., Visiting Expert, Mewar University, Gangrar, Chittorgarh, Rajasthan-312901 Key words: Hypnotizability, Emotional Suggestibility, Physical Suggestibility

place more emphasis on thinking, the physically suggestible are guided more by their emotions. Physicals are more regulated by their hearts and emotions. They react to the life by what they feel rather than by what they think. The emotions come first then the logic. De Pascalis (1998) observed that hypnotizability and suggestibility reflect different underlying psycho-physiological activities. McGeown (2015) explored whether self-reported depth of hypnosis and suggestibility are associated with individual differences in neuroanatomy and/or levels of functional connectivity. The patterns of results suggested that hypnotic depth and suggestibility cannot be construed as synonym. AIM: The present study was designed to explore the association between hypnotizability vis-à-vis physical and emotional suggestibility in young adults. Method: Sample: A sample of 100 psychologically healthy adult persons in the age range of 18- 35 years was drawn through non-probability sampling from Agra, India. There were 50 male and 50 female participants. Mean age of the participants was 25.21. Tools General Health Questionnaire (GHQ)-12: This questionnaire was developed by Goldberg (1972). It consists of 12 items. The questions are based on behavioral and psychological functioning. This test is used to screen out persons with possible mental health issues. In this study only those adults falling in category of ‘healthy’ were included. Hyp-Nova suggestibility Scale: This scale is based on the work of John Kappas (1987). It consists of two sets of questionnaire – physical suggestibility and emotional suggestibility. Each set has eighteen yes or no questions. The score of the questionnaire can range anywhere between one and one hundred. Test measures physical and emotional suggestibility of the subjects. Stanford Hypnotic Susceptibility Scale: The Stanford Scale was developed by Weitzenhoffer and Hilgard in 1959. The Scale consists of 12 items of progressive difficulty. Participants’ behaviors are scored on following dimensions: (1) Hand lowering (2) Moving hands apart (3) Mosquito hallucination (4) Taste hallucination (5) Arm rigidity (6) Dream (7) Age regression (8) Arm immobilization (9) Anosmia (10) Hallucinated voice (11) Negative visual hallucination (12) Posthypnotic amnesia Each of the twelve items is scored pass-fail in terms of objective behavioral criteria. Procedure: The prospective participants were identified, approached and briefed about the nature of the study. Suggestibility Questionnaire and Stanford Hypnotic Susceptibility Scale (SHSS) were administered on the participants. Scoring was done for individual subjects with respect to each of the variables in accordance to the standard procedure of scoring. Data Analysis: Mean, S.D. and Product Moment Correlation Coefficients were computed to analyze the data. Results: Table-1: Mean and S.D. of SHSS and Hyp-Nova Scores Measures Mean S.D Hypnotizability 5.68 1.15 Physical Suggestibility 55.66 10.58 Emotional Suggestibility 44.34 10.58 Table-1 suggests that physical suggestibility was greater in the sample than the emotional suggestibility. To explore the association between hypnotizability and suggestibility, the total scores of Hyp-Nova suggestibility Scale and SHS Scale were correlated in whole sample as well as across gender.

Table-2: Correlation Coefficients between SHSS and Hyp-Nova Scores Correlates Total Sample Female Male Physical Suggestibility .669** .742** .575** Emotional Suggestibility -.669** -.742** -.575** ** Significant at .01 level Table-2 reveals significant correlation coefficient between hypnotizability and two aspects of suggestibility. A significant and positive association was observed between Hypnotizability and Physical Suggestibility in total sample as well as across gender. A significant and negative association was observed between Hypnotizability and Physical Suggestibility in total sample as well as across gender. Discussion: The results clearly indicate that suggestibility is significantly associated with hypnotizability. Hypnotizability is a construct that taps responsiveness to suggestions under hypnotic trance whereas suggestibility taps the responsiveness to suggestions without trance. However, the matter does not appear to be as straightforward as it is construed. The results warrant a deeper level of understanding into the dynamics of suggestibility. Under hypnotic trance, a person tends to exhibit behaviors that correspond to physical suggestibility instead of emotional suggestibility. A physically suggestible person responds to suggestions literally. It also means that physically suggestible persons are likely to have deeper level of trance than the emotionally suggestible persons. For example, the trance phenomena such as eye lock, arms rigidity, waxy flexibility, amnesia, positive hallucinations and negative hallucinations will be demonstrated by the persons who are experiencing deeper level of trance and have greater amount of physical suggestibility. They will be showing the trance logic and are likely to show uncritical openness and acceptance of suggestions. On the other hand, the emotionally suggestible do not respond to the suggestions at literal level. They tend to infer meaning of the suggestions and respond differently. Since, emotionally suggestible persons do not respond to the suggestions literally, they are unlikely to demonstrate all the trance phenomena. The higher scores on SHSS, then would indicate potentials for physical suggestibility and lower scores would mean more of emotional suggestibility instead of low hypnotizability. This differential responding to suggestions would obviously warrant a tweaked approach to using hypnosis for therapeutic purposes. When a person is high on SHSS and physical suggestibility, the approach to hypnosis based intervention would be to deliver direct suggestions for achieving the goals of treatment. And when a person is low on SHSS and high on emotional suggestibility, the suggestions will have to be formulated in such a manner that will allow the person to infer meaning and respond to the suggestions which serve the therapeutic goals. The direct and literal suggestions are likely to be unhelpful even counter-productive in this type of suggestibility. The construct of John Kappas on two types of suggestibility seems to be a valid one which will facilitate comprehensive and individually tailored application of hypnotherapeutic management. Erickson and Rossi (1979) and Lankton & Lankton (1983) also recommended that the effects of indirect rather than direct suggestions should have a stronger impact on hypnotic responsiveness. But their observation could further be refined to the extent that emotionally suggestible would respond more favorably to indirect suggestions.

Graham et al. (2003) observed that Students who scored low in susceptibility showed significantly less participation in activities than others who were either moderate or high in susceptibility. Their observation also suggests that the persons who score lower on the hypnotic susceptibility scale would need a different approach to assimilate the suggestions. The results further indicate an identical type of relationship between suggestibility and hypnotizability across gender. This counters the commonly held belief that females are more open to direct and literal suggestions. Conclusion: The results of the present study underline the importance of assessing nature of suggestibility in addition to hypnotic susceptibility for doing hypnotherapy. Instead of ignoring and rejecting the persons who score lower on hypnotic susceptibility, they should be viewed as having more of emotional suggestibility and be handled accordingly. References: De Pascalis, V. et al (1998) EEG activity and heart rate during recall of emotional events in hypnosis: relationships with hypnotizability and suggestibility. International Journal of Psychophysiology. 29 (3), 255-75. Erickson, M.H. & Rossi, E.L. (1979). Hypnotherapy: An Exploratory Casebook. New York: Irving Publishers. Goldberg, D. (1972). The detection of psychiatric illness by questionnaire: A technique for the identification and assessment of non-psychotic psychiatric illness. London, New York: Oxford University Press. Heap M, Brown RJ, Oakley DA. (2004). The Highly Hypnotizable Person: Theoretical, Experimental and Clinical Issues. Hove: Routledge. Hilgard, E.R. (1981). Hypnotic susceptibility scales under attack: An examination of Weizenhoffer’s criticisms. International Journal of Clinical and Experimental Hypnosis, 29, 24-41. Kappas, J.G. (1987) Professional Hypnotism Manual: Introducing Physical and Emotional Suggestibility and Sexuality. Panorama Publishing Company. Graham K.R, Marra L.C, Rudski J.M. (2003) Hypnotic susceptibility as a predictor of participation in student activities. American Journal of Clinical Hypnosis;46(2):139-45. Lankton & Lankton (1983) The Answer Within: A Clinical Framework of Ericksonian Hypnotherapy. New York: Brunner/Mazel. McGeown, W. J. et al (2015) Structural and functional correlates of hypnotic depth and suggestibility. Psychiatry Research, 231, (2) 151-9. Weitzenhoffer AM (1974) When is an ‘instruction’ an ‘instruction’? International Journal of Clinical and Experimental Hypnosis. 22: 258–69. Weitzenhoffer, A. M. & Hilgard, E. R. (1959). Stanford Hypnotic Susceptibility Scale: Forms A and B. Palo Alto, CA: Consulting Psychologists Press USE SIS JOURNAL TO SUPPORT US Insert Your Messages and Wishes In Half-Page: Rs. 5000/- In Full Page: Rs. 10000/- Get in Touch with either of us: Dr. Bankey L. Dubey Director, SIS Email: bldubey@gmail.com Dr. Naveen Gupta Editor-in-Chief Email: dr_naveengupta@yahoo.com Cell: 91-9627182913

SOMATIC INKBLOT SOCIETY Membership Application Form Membership Type: Full Name: Correspondence Address including PIN/ZIP: Email: Cell with Country Code: Date of Birth 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). Training and Experience in Personality Assessment Sponsor (Name Address cell and Email) Mention whether you need Print Version of the Journal or Only Soft Copy (Go Paperless and Environment Friendly) Types of Memberships and Fee Details Individual Annual Membership (Foreign) US $50 Individual Life Membership (Foreign) US $300 Fellow Member- After 10 Years Life Membership (Foreign) US $150 Institutional Annual Membership (Foreign) US $100 Individual Annual Membership (Indian) Rs. 1000/- Individual Life Membership (Indian) Rs. 5000/- Fellow Member-After 10 Years Life Membership (Indian) Rs. 2500/ Institutional Annual Membership (Indian) Rs.1500/- Institutional Life Membership (Indian) Rs. 10,000/- Pay Membership Fee through Bank Deposit Bank Name and Address: State Bank of India, Krishna View Plaza, Marble Market, Plot # 20, Sector 20, Dwarka, New Delhi-110075 (India) Name of Account: SIS Journal of Projective Psychology & Mental Health Account No. 32297525238 IFS Code: SBIN0011361 Pay Membership Fee through Cheque payable to SIS Journal of Projective Psychology and Mental Health Submit Membership Application Form through Email Dr. B.L. Dubey, Ph.D. Editor Emeritus, Email:bldubey@gmail.com Copy to Prof. Naveen Gupta,Ph.D., Director. Editor in Chief, Email: dr_naveengupta@yahoo.com Or Submit Print Version of Membership Application Form by Speed Post to Prof. Naveen Gupta, Ph.D. Director, Hindustan Institute of Management and Computer Studies, Farah, Mathura-281122, India Mention Fee Deposit Details: Declaration by Applicant: I certify that the information provided above is accurate and correct. Signature of the Applicant with Date: Affix Your Photograph

Somatic Inkblot Society Office Bearers: President: Bankey L.Dubey, Ph.D. Vice President: Brig. D.Saldanha, M.D. Editor-In-Chief: Naveen Gupta, Ph.D. Gen. Secretary: Nalini Mishra, Ph.D. Joint Secretary: Abhilasha Singh, Ph.D. Treasurer: Padma Dwivedi, M.A. Executive Editor: Rakesh Kumar, Ph.D. Executive Members : Mary Cassell, M.A. Wilfred A Cassell, M.D. Anand Dubey, MBA. S. D. Dwivedi, M.Phil. M.P.Singh, Ph.D. Greesh Sharma, Ph.D. Riju A Singh, MBA. Ajay K.Srivastava, Ph.D. Sandhyarani Mohanty, Ph.D. Pragya Tiwari, MBA. Past Editors-in-Chief: B.L.Dubey, Ph.D. Director SIS Center, 4406 Forrest Road, Anchorage, AK 99517 (USA) Email: bldubey@gmail.com (1994-2005) Amool R. Singh, Ph.D., Prof. & Head, Clin.Psychology, RINPAS, Kanke, Ranchi-834006 (India) E-mail:sisamool@yahoo.com (2006-2011) Rakesh Pandey, Ph.D. Prof. & Head, Dept of Psychology, Banaras Hindu University, Varanasi-221005 Email: rpan_in@yahoo.com (2012-2015) STATEMENT SHOWING OWNERSHIP AND OTHER PARTICULARS ABOUT SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH Place of Publication: Mathura-281122 Periodicity of Publication: Half Yearly Editor: Dr. Naveen Gupta Nationality: Indian Address: Hindustan Institute of Management and Computer Studies, Farah, Mathura-281122 U.P. Owner: Somatic Inkblot Society Printer’s/Publisher’s Name: Mr. Sunny Kushwah I, Dr. Naveen Gupta, hereby declare that the particulars given above are true to the best of my knowledge and belief. Sd/ Dr. Naveen Gupta, Editor-in-Chief SIS Journal of Projective Psychology and Mental Health Published by Dr. Naveen Gupta, on behalf of Somatic Inkblot Society at Prem Graphics and Printers, Block No. 57/2, Shop No. 16, First floor, Kaberi Center, Opp. Azad Petrol Pump, Sanjay Place, Agra-282002 Cell. 9760021701

SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH: ACHIEVEMENTS Journal in WHO Listing Members of Somatic Inkblot Society will be glad to know that SIS Journal of Projective Psychology and Mental Health has been listed by World Health Organization (Global Forum for Health Research) among 25 indexed journals that have published the highest number of articles on mental health from LMICs in Latin America, Africa and Asia (Medline and PsycINFO). Extract from table-6 of “Research Capacity for Mental Health in Low - and Middle - Income Countries: Results of a Mapping Project “(www.globalforumhealth.org) is given below:

Rank Journal Country Language Revista de Psicoanalisis Argentina Spanish Revista de Neurologia Spain Spanish Revista Brasileria de Psiquiatria Brazil Eng.,Spani.,Portuguese Arquivos de Neuro-psiquiatria Brazil Portuguese Acta Psiquiatrica y psicologica de Amercia Laina Argentina Spanish Journal of the Medical Association of Thailand Thailand English, Thai 7 British Journal of Psychiatry UK English Acta Psychiatrica Scandinavica Denmark English Salud Mentale Mexico Spanish Vertex Argentina Spanish Journal of Personality and Clinical Studies India English Social Psychiatry and Psychiatric Epidemiology Germany English Revista Medica de Chile Chile Spanish South African Journal of Psychology South Africa Afrikaans, English Psychological Reports USA English South African Medical Journal South Africa Afrikaans, English The Australian & New Zealand Jr. of Psychiatry Australia English International Journal of Social Psychiatry U. K. English Psychiatry Research Ireland English Social Science & Medicine U. K. English Revista De Saude Publica Brazil Portuguese International Journal of Geriatric Psychiatry U. K. English SIS Journal of Projective Psychology and Mental Health India English Journal Brasilerio de Psiquiatria Brazil Portuguese Psychiatry and Clinical Neurosciences Australia English

Journal in ProQuest Listing: We are glad to inform you that SIS Journal of Projective Psychology & Mental Health has been listed in academic research database ProQuest Psychology Journals™. ProQuest is a company in Michigan, United States. It is a leading provider of electronic databases for academic libraries. Databases are used in over 20,000 academic libraries around the country and around the world including some of the most prestigious higher education institutions such as Harvard, Yale, Princeton, Oxford etc. ProQuest provides abstracts and indexing for more than 640 titles, with over 540 titles available in full text. Users get access to charts, diagrams, graphs, tables, photos, and other graphical elements essential to psychological research.

Abstracted in “APA” Psyc INFO “ Regd. No. 71632/99, RNI Delhi SIS JOURNAL OF PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH

January 2016

EDITORS EMERITUS : Wilfred A. Cassell, MD, FAPA, Director, SIS Center, 4501E,104th Avenue, Anchorage, AK.99516 (USA). E-Mail: siscassell2@yahoo.com

Bankey L. Dubey, Ph.D., Director SIS Centre,4406 Forrest Rd, Anchorage, AK 99517, E-mail: bldubey@gmail.com

EDITOR-IN-CHIEF : Naveen Gupta, Ph.D., Director, Hindustan Institute of Management & Computer Studies, Farah, Mathura-281122, Email: dr_naveengupta@yahoo.com Cell: 91-9627182913

EXECUTIVE EDITOR:

Rakesh Kumar, Ph.D. Senior Clinical Psychologist Institute of Mental Health and Hospital, Agra-282002 U.P. Email: jain.imhh@gmail.com EDITORS : Anand Dubey, MBA, 4406 Forrest Road, Anchorage, AK 99517 Email: anand.dubey@gmail.com L. Sam S. Manickam, Ph.D., Professor Clinical Psychology. Department of Psychiatry, JSS University, Mysore-570004, Email: lssmanickam@gmail.com Nilanjana Sanyal, Ph.D., Prof. Department. of Psychology, University of Calcutta, 92 A. P. C Road, Kolkata-700009 Email: sanyal_nilanjana2004@rediffmai.com

EDITORIAL CONSULTANTS : Abhilasha Singh, Ph.D., India Ailo Uhinki, Ps.D., Finland Ajay Tiwari, Ph.D., India Amool R.Singh, Ph.D., India Anand Prakash Singh, Ph.D., India Anatoly B. Khromov, Ph.D., Russia Antonio Cervigni, M.A., Italy Arvind K. Keshary, Ph.D., India Barry A. Ritzier, Ph.D., U.S.A. Brig. D. Saldanha, M.D., India Carina Coulacoglou, Ph.D., Greece Edward M. Petrosky, Ph.D., U.S.A. H. Kumar, Ph.D., USA Jayanti Basu, Ph.D., India Kaptan Singh Sengar, Ph.D., India Lisa Milne, Ph.D., Australia M.P.Singh, Ph.D., India Manisha Dasgupta, Ph.D., India Nalini Mishra, Ph.D., India Padma Dwivedi, M.A., USA Paola Nicolini, M.A., Italy R.N.Singh, Ph.D., India R.P. Gupta, M.A., India Radhe Shyam, Ph.D., India Rakesh Pandey, Ph.D., India Ranjeet Kumar, Ph.D., India Robert B. Williams, Ph.D., Canada Sandhyarani Mohanty, Ph.D., India Stefano Reschini, M.A., Italy Sudhir Kumar, M.D., India Suprakash Chaudhury, M.D., Ph.D. Umed Singh, Ph.D., India Yasho V. Verma, Ph.D., India Yogesh K. Arya, Ph.D., India