The circulation of blood within the body has been a subject of study for many thousands

of years. In ancient times, the Chinese recognized the fact that blood circulated through
the blood vessels and developed theories on how such systems worked. Evidence also
suggests that scholars in India had developed some knowledge of the circulatory
system, with an emphasis on the pulse and its dynamic nature. (1)

A broader understanding of circulation and the circulatory system was developed in the
early 1600’s by a doctor named William Harvey. He began teaching about circulation in
1615 and later published his work in 1628 entitled Exercitatio Anatomica de Motu Cordis
et Sanguinis in Animalibus (On the Movement of the Heart and Blood in Animals). His
work became a foundation for the study of the circulatory system, and is still highly
regarded even to this day. (1)

Once the correlation between heart rate and pulse was discovered, it was possible to
determine blood volume and blood pressure. In 1733 Reverend Stephen Hales
recorded the first blood pressure measurement on a horse. He did this by inserting a
long glass tube upright into an artery, observing the increase in pressure as blood was
forced up the tube. (2)

In 1881, the first sphygmomanometer was invented by Samuel Siegfried Karl Ritter von
Basch. It consisted of a rubber bulb that was filled with water to restrict blood flow in the
artery. The bulb was then connected to a mercury column, which would translate the
pressure required to completely obscure the pulse into millimeters of mercury. (3)
This image shows a Riva-Rocci sphygmomanometer with cuff used by Korotkoff, who later
discovered systolic and diastolic blood pressure.

In 1896, the device was further improved by Scipione Riva-Rocci. Improvements

included a cuff that could be affixed around the arm to apply even pressure to the limb
that would become the standard design for such devices going forward. (4)

Modern blood pressure measurement was not developed until 1905, when Dr. Nikolai
Korotkoff discovered the difference between systolic blood pressure and diastolic blood
pressure. These pressures corresponded to the appearance, and disappearance of,
sounds within the arteries as pressure was applied and then released. Known as
Korotkoff sounds, the use of systolic and diastolic sounds is now standard in blood
pressure measurement.

Since that time, further advances have been made to sphygmomanometers. Now
available in a variety of styles ranging from mercurial to aneroid and electronic versions,
blood pressure measurement has become more accurate and widely accepted as an
important vital sign when diagnosing a patient.

References

1. 1. William H. McMicken, M.D. (n.d.). Hardening of the Arteries, Inevitable or

Preventable? Retrieved from http://familydoc.tripod.com/ascvd1.htm
2. 2. (n.d.) The History of Blood Pressure Monitoring. Retrieved
from: http://www.healthperfect.co.uk/Index/dphistry.htm
3. 3. Georgia Alton. (n.d.) The History of Sphygmomanometers. Retrieved
from: http://www.ehow.com/about_5339926_history-sphygmomanometers.html
4. 4. Sphygmomanometer. (8 January 2013 at 15:32). Retrieved from
Wikipedia: http://en.wikipedia.org/wiki/Sphygmomanometer
 Phone: 1-800-ADC-267

a short history of blood pressure

It is Galen in ancient Greece who first proposed the existence of a circulatory system in
the human body. However, building on ideas conceived by Hippocrates and because
the arteries stopped bleeding when death occurred, Galen believed that this circulatory
system was composed of an interconnected set of arteries filled with “pneuma” (life
giving force) or air. He maintained that the human body was comprised of three
systems. Nerves and the brain were responsible for sensation and thought, the heart
filled the body with life-giving energy (pneuma) and the liver provided the body with
nourishment and growth. Galen believed that the heart was like a fountain, constantly
giving the needed pneuma and blood to the system.

Harvey

In 1616 William Harvey announced that Galen was wrong in his assertion that the heart
constantly produced blood, like a fountain. Harvey proposed that there was a finite
amount of blood that circulated the body in one direction only. Harvey's views were
initially met with a lot of skepticism and resistance. The idea that blood was not
constantly produced in the body raised doubts about the benefit of bloodletting, a
popular medical practice at the time. As a matter of routine, bloodletting was used as a
universal panacea for just about every symptom known to man.

First blood pressure

The first recorded instance of the measurement of blood pressure was in 1711 by the
Reverend Stephen Hales. Hales inserted a glass tube into an artery of a horse and
observed the rise and fall of blood in the tube and concluded that this must be due to
fluctuating pressure in the arteries of the horse. However, Hales’ technique was not
suitable for testing with humans, as it was very invasive and highly inappropriate for
clinical use. The horse died every time...

Human blood pressure measurement

In 1856 Faivre recorded human blood pressure for the first time during a limb
amputation. Faivre used Carl Ludwig's recently invented kymograph with catheters
inserted directly into an artery. Ludwig's kymograph consisted of a U-shaped
manometer tube connected to a brass pipe canula plugged directly into the artery. The
manometer tube had an ivory float onto which a rod with a quill was attached. This quill
would sketch onto a rotating drum hence the name “kymograph” (wave writer in Greek).

However, at this time, blood pressure could still only be measured by invasive means.
The race was now on to find a suitable way to measure blood pressure non-invasively.
In 1855, Karl Vierordt discovered that with enough pressure the arterial pulse could be
obliterated. Vierordt introduced the sphygmograph, based on this principle of
obliteration. Vierordt used an inflatable cuff around the arm to constrict the artery.
However, Vierordt’s device was huge and unwieldy (168 cm tall) and produced very
uneven results.

The sphymograph

Etienne Jules Marey, a French physician (also a cinematographer who is considered to

be the father of modern photography) developed this idea further in 1860. His
sphygmograph could accurately measure the pulse rate, but was very unreliable in
determining the blood pressure. Yet this design was the first that could be used clinically
was some degree of success. In 1882, Robert Ellis Dudgeon simplified and refined the
Marey sphygmograph, rendering it eminently portable and easy to use. At the time,
Dudgeon's device was so successful that it became standard equipment for the U. S.
Navy.

The sphygmomanometer

In 1881, Samuel Siegfried Karl Ritter von Basch invented the sphygmomanometer. His
device consisted of a water or mercury-filled rubber ball connected to a manometer. The
rubber ball was then pressed against the radial artery until the pulse was obliterated and
the blood pressure was then estimated using the manometer and palpation was used to
determine when the arterial pulse disappeared.

However von Basch's design never had the success it deserved, many physicians of the
time being skeptical of this new technology, claiming that it sought to replace traditional
ideas of diagnosis based on palpation. The real problem was however that most doctors
questioned the medical usefulness of blood pressure. This did not stop some from
attempting to produce a more useful device, such as the sphygmometer by Bloch, which
was essentially a spring-loaded tire-gage that was applied to an artery to see how much
pressure was necessary to obliterate the pulse.

In 1889, Potain improved all of the compression devices available by replacing water
and mercury in the devices with air, thus substantially improving their accuracy. From
this moment on, air became the compression medium of choice.

Riva-Rocci

1896 was a decisive year in the history of blood pressure. Scipione Riva-Rocci
developed his first mercury sphygmomanometer. This design was the forerunner of the
modern mercury sphygmomanometer. An inflatable cuff was placed over the upper arm
to constrict the brachial artery. This cuff was connected to a glass manometer filled with
mercury to measure the pressure exerted onto the arm.

Riva-Rocci's sphygmomanometer was then spotted by the American neurosurgeon

Harvey Cushing while he was traveling through Italy. Seeing the potential benefit of this
device, he returned to the US with the design in 1901. After the design was modified to
be more adapted for clinical use, the sphygmomanometer became commonplace. This
year really marks the beginning of modern sphygmomanometry.

Korotkoff

However, it is useful to remember that this sphygmomanometer was then only used to
determine the systolic blood pressure. The importance of the diastolic pressure had not
yet been clearly defined at this time. In 1905, a young Russian surgeon, Nikolai
Korotkoff, observed the sounds made by the constriction of the artery, using a
stethoscope. Korotkoff found that there were characteristic sounds at certain points in
the inflation and deflation of the cuff. These Korotkoff sounds were caused by the
passage of blood through the artery, corresponding to the systolic and diastolic blood
pressures. The technique that we still use today to measure systolic and diastolic blood
pressure was born.

A crucial difference in Korotkoff's technique was the use of a stethoscope to listen for
the sounds of blood flowing through the artery. This auscultatory method proved to be
more reliable than the previous palpation techniques and thus became the standard
practice.

Modern blood pressure

In 1974, Panasonic released the first digital oscillometric device. These

sphygmomanometers measure the pressure imparted onto the cuff by the blood
pushing through the constricted artery over a range of cuff pressures. This data is used
to estimate the systolic and diastolic blood pressures.
In the 1980's, home monitoring of blood pressure becomes commonplace.

https://www.bloodpressurehistory.com/blood-pressure-history

for pulsre rate: https://www.hindawi.com/journals/crp/2011/164832/

for psych +bp, pulse rate http://www.hsj.gr/medicine/hypertension-and-psychological-health-in-the-

21st-century.php?aid=23547

Effects of High Blood Pressure

High blood pressure can damage your health in many ways. It can seriously hurt
important organs like your heart and brain.

Fortunately, you can control your blood pressure to lower your risk for serious
health problems.

Decreased Blood Flow to the Heart

High blood pressure can harden your arteries, which decreases the flow of blood
and oxygen to your heart and lead to heart disease. In addition, decreased blood
flow to the heart can cause:

 Chest pain, also called angina.

 Heart failure, a condition when your heart can’t pump enough blood and
oxygen to your other organs.
 Heart attack, which occurs when the blood supply to your heart is blocked
and heart muscle begins to die without enough oxygen. The longer the
blood flow is blocked, the greater the damage to the heart.

The Brain
High blood pressure can burst or block arteries that supply blood and oxygen to
the brain, causing a stroke. Brain cells die during a stroke because they do not
get enough oxygen. Stroke can cause serious disabilities in speech, movement,
and other basic activities, and a stroke can kill you.
 The Kidneys
Adults with diabetes, high blood pressure, or both have a higher risk of
developing chronic kidney disease than those without these diseases.
Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood
pressure have chronic kidney disease.

Effects of Low Blood Pressure on the Body

It is important for a patient to properly understand the symptoms of this problem. It
has varied effects on the body, one important effect being that the heart rate is lower
than normal.

 Heart/Kidney Problems: The kidney does not eliminate wastes from the body
efficiently. This malfunction then results in a build-up of toxins in the body, which
can lead to any related sickness. This condition also adversely affects the heart and
tends to cause various heart diseases, and can ultimately also result in a heart attack.
 Brain/Nerve Damage: A lower blood pressure can lead to nerve damage. It will also
damage the brain due to insufficient oxygen, thus causing a stroke.
 Dizziness: This is experienced by many people suffering from low blood pressure. It
occurs when a person suddenly stands up, or gets out from the bed after sleeping
very soon. It also tends to affects people more with advancement in age.

Bradycardia: Slow Heart Rate

Bradycardia is a heart rate that’s too slow. What’s considered too slow can depend on
your age and physical condition. Elderly people, for example, are more prone to
bradycardia.

In general, for adults, a resting heart rate of fewer than 60 beats per minute (BPM)
qualifies as bradycardia.

But there are exceptions. Your heart rate may fall below 60 BPM during deep sleep.
And physically active adults (and athletes) often have a resting heart rate slower than
60 BPM.

Complications of bradycardia
Left untreated, severe or prolonged bradycardia can cause:

 Heart failure
 Fainting (syncope)
 Chest pain (angina pectoris)
 Low blood pressure (hypotension)
  High blood pressure (hypertension)

Tachycardia: Fast Heart Rate

Tachycardia refers to a heart rate that’s too fast. How that’s defined may depend on
your age and physical condition.

Generally speaking, for adults, a heart rate of more than 100 beats per minute (BPM) is
considered too fast.

Symptoms and complications

Some people with atrial or supraventricular tachycardia may have no discernible
symptoms. Others may experience:

 Fainting (syncope)
 Lightheadedness or dizziness
 Rapid heartbeat or palpitations
 Fluttering in the chest
 Bounding pulse
 Chest pressure, tightness or pain (angina)
 Shortness of breath
 Fatigue

In extreme cases, those suffering with atrial or SVT may also experience:

 Unconsciousness
 Cardiac arrest

Range of symptoms
Symptoms for ventricular tachycardia vary. Common symptoms include:

 Dizziness
 Palpitations
 Shortness of breath
 Nausea
 Lightheadedness
 Falling unconscious
 Cardiac arrest, in extreme cases

https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/tachycardia--fast-heart-rate

Relaxation Theory: Theory and Practices

1506 words (6 pages) Essay in Psychology

26/05/17 Psychology Reference this

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work produced by our Essay Writing Service. You can view samples of our professional
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those of the authors and do not necessarily reflect the views of UK Essays.

Relaxation Therapy is a program which emphasizes a wide variety of strategies and

techniques for dealing with stress and health disorders. Relaxation techniques can
benefit almost any person by reducing stress and tension in muscles, lowering blood
pressure and heart rate, and creating internal coping skills to handle anxiety.

Muscle relaxation therapy involves learning how stressful circumstances can cause the
body’s nervous system to activate. When some type of emotional or physical stimulation
connected with stress occurs, this system will kick into action. The result is that the heart
begins to beat faster, breathing becomes more rapid, and blood vessels around the
body begin to dilate. While a reaction of this type is beneficial when there is a need to
defend the body from some type of adversary, most of the time stress has a negative
effect on the mental, physical, and emotional state of a person (Klimes, 2010).

By employing relaxation therapy, it is possible to begin reversing the stimulation to the

nervous system and restore the body and mind to a more balanced state. The key to the
therapy is consciously regulating the breathing. This means becoming aware of the
current rate of the inhalation and exhalation phases of the breathing process and
making a conscious effort to incrementally slow them down to a more acceptable pace.
As the individual is able to slow the breathing rate, this also has a calming effect on
rapid heartbeat and other physiological processes. It has been proven that when an
individual learns how to self-initiate the relaxation response some of the negative effects
of chronic stress may be counter-balanced (Ost, 1987).

There are many different approaches used to achieve a relaxed state. In the early stages
of learning to relax, it can be difficult for the person to become fully relaxed. A long or
deep relaxation method is more effective to induce a relaxation response. Some of these
deep methods include autogenic training, cue-controlled deep muscle relaxation (CC
DMR), progressive muscle relaxation (PMR), and meditation. The Jacobson Method of
progressive muscle relaxation involves flexing specific muscles, holding that position,
and then relaxing the muscles. This technique often involves progressing through the
muscle groups of the body one at a time, beginning with the feet, spending
approximately one minute on each area. Progressive relaxation may be practiced while
lying down or sitting. This approach has been suggested for pain relief, to ease physical
tension, to relieve anxiety, and to overcome psychosomatic disorders (Jacobson, 1987).
Progressive muscle relaxation (PMR) is said to require several months of practice at least
three times per week in order to be able to evoke the relaxation response quickly in a
time of crisis.

Some forms of relaxation exercises are shorter and do not require daily time
commitment that many people find too demanding. These brief methods include self-
control relaxation, paced respiration, and deep breathing. Brief methods generally
require less time and often represent an abbreviated form of a deep method. The Laura
Mitchell Simple Relaxation approach involves reciprocal relaxation or moving one part
of the body in the opposite direction from an area of tension, and then letting it go.
Applied relaxation involves imagination of relaxing situations with the intention of
inducing muscular and mental relaxation (Ost, 1987).

Relaxation therapy may include other elements along with the controlled breathing.
Seeking a quiet spot to begin the process can also help expedite the achievement of a
calm state. For some people the use of aromatherapy in conjunction with relaxation
therapy techniques is also helpful. Music or relaxation tapes of nature sounds like a
waterfall may also help enhance the effect of the therapy. Other common relaxation
techniques include guided imagery, deep breathing, passive muscle relaxation, and
refocusing.

Because there is no formal credentials required for relaxation therapy, relaxation

techniques may be taught by almost anyone. Among those who employ these
techniques are medical practitioners, physicians, psychotherapists, hypnotherapists,
nurses, clinical psychologists, and sports therapists (Lang & Stein, 2001).

Clinical studies suggest that relaxation techniques may be beneficial in patients with
generalized anxiety, obsessive compulsive disorder, social phobias, or panic disorders,
although these approaches do not appear to be as effective as psychotherapy. Many of
the studies show that relaxations techniques were more effective when used in
conjunction with cognitive or behavioral therapy techniques (Ost L., 2000). Relaxation
has also shown some effectiveness in treating individuals with anger, hostility, and
aggressive behavior. It is not clear if effects of relaxation therapy are long-term. If a
person stops practicing the deep-breathing exercises, the symptoms of stress may
return. While relaxation techniques may be used for conditions related to stress
management, there is not enough evidence to form firm conclusions about the
effectiveness of relaxation for other, more severe mental conditions (Ost L., 2000).

In the medical arena, relaxation has been suggested in patients after surgery to speed
up recovery, require less pain medication, lower blood pressure, and reduce
postoperative complications. Relaxation techniques are sometimes used by people with
insomnia or other sleep disorders. Other medical disorders that are positively improved
with relaxation therapy are tension headaches, Fibromyalgia, Irritable Bowel Syndrome,
Asthma, and Diabetes (Lang & Stein, 2001). Relaxation can help individuals cope with
stress management, proper blood circulation, and body pains. It also helps to calm the
nervous system, to direct energy flows, and to interpret behavioral changes.

Most relaxation techniques are non-invasive and are generally considered safe in
healthy adults. Serious adverse effects have not been reported. It is theorized that
anxiety may actually be increased in some individuals using relaxation techniques and
that sudden, unexpected emotional experiences including pain, heart palpitations,
muscle twitching, crying spells, or increased blood pressure may occur rarely. People
with psychiatric disorders such as schizophrenia or psychosis should avoid relaxation
techniques unless recommended by their primary psychiatric healthcare provider. It is
suggested by practitioners that techniques requiring inward focusing may intensify
depressed mood in some people, although research and scientific evidence is limited in
this area (Lang & Stein, 2001).

Relaxation therapy is not recommended as the sole treatment approach for potentially
serious medical conditions, and it should not delay the diagnosis of the condition or
treatment with more proven techniques. If the person is only experiencing stress and
anxiety without any other mental condition, then they could benefit from learning
relaxation techniques. For a person with mental illness it is not a stand-alone mode of
therapy, but rather a beneficial treatment to be used with other forms of therapy.

In the high school setting, most of students will be normally functioning adolescents.
With the increased standards and testing present in schools, even average students
experience stress and anxiety during the course of the school day. Many studies have
been done on the effects of relaxation therapy on children and adolescents. The results
of one such survey are that the calming effects are short-term (Tatum, 2006). In other
words, if I want to teach Progressive Relaxation to a group of students experiencing test
anxiety in order to give them the focus and confidence to tackle the state benchmark
exam, I would need to do so in the weeks preceding the test. Another prevalent
condition in children that has seen proven benefits from relaxation techniques is that of
hyperactivity or Attention Deficit Disorder. With a brief relaxation method used daily,
these students showed marked improvement in their ability to remain calm and focused
in the classroom (Klien-Hessling & Lohaus, 2002).

Often, in the midst of a stressful situation, it is difficult to relax. Sometimes doing

something simple like, sitting in a comfortable chair, listening to soothing music, or
taking a warm bath is enough to help a person to unwind. In other instances the levels
of anxiety and tension may be so overwhelming that a person may have to turn to a
professional for help. Whether a person’s stress is spiraling out of control or they have
already got it tamed, learning one of the various relaxation techniques can be beneficial.
When practiced regularly, these activities lead to a reduction in everyday stress levels
and a boost in feelings of joy and serenity. What’s more, they also serve a protective
quality by teaching you how to stay calm and collected in the face of life’s curveballs.

Since stress is a part of many people’s lives today and since there are different ways to
treat stress, it is helpful to study various methods in order to help them with stress
reduction. A study of relaxation therapy not only can teach models of relaxation but also
can teach several relaxation exercises which can be useful in helping patients relax.
Coping techniques of relaxation therapy can benefit people in many situations, and it is
imperative that the counselor has knowledge of them and also realizes that an ongoing
study of relaxation techniques can be beneficial to a successful practice. This study has
shown benefits that would help anyone in the stress-filled world in which we live today.

Cite This Work

Essays, UK. (November 2018). Relaxation Theory: Theory and Practices. Retrieved from
https://www.ukessays.com/essays/psychology/the-theory-and-practice-behind-relaxation-therapy-
psychology-essay.php?vref=1

JPMR
This technique was developed at the beginning of the 20th century by Edmund
Jacobson, a medical doctor who also practiced psychiatry and psychology. Currently, it
could be said that this technique is one of the most used among therapists in order to
create a state of mental and physical relaxation. In addition, in my clinical experience, I
consider it to be one of the most simple ways people can use to relax on their own, and
in doing so obtain excellent results.

This technique is based on the idea that our mental and emotional states affect levels of
muscular response, which in doing so illustrates the relationship between our muscles,
our thinking, and our emotions.

Progressive Relaxation turns out to be especially useful for sleep disorders, since it can
easily produce a deep sense of muscluar relaxation, which is essential for falling asleep.
In addition, it is recommended to relieve the stress of daily life and to control anger and
aggression.
The essence of the technique consists of tensing certain parts of the body and then
immediately relaxing them. Paying attention to the sensations of tension followed by
relaxation helps a person experience a pleasant sense of well-being which carries over
into their emotional and mental state.

It is very important to really feel these sensations. It’s not just about tensing and
relaxing, but rather learning how to become deeply aware of the sense of contraction
and release that are produced during these movements. And in order to make this
technique even more powerful, many therapists give their clients phrases that help them
mentally relax.

Before beginning to explain this technique, we should take in account the minimum
requirements: it can be carried out in any comfortable seated position, but for the first
few times we try it, it is better to be laying down somewhere comfortable, where we
know we won’t be interrupted. At the same time, it is important to take care that our
clothing is not too tight, because it might end up bothering or distracting us.

During the practice, we should try to make an effort to say the phrases we are using to
guide ourselves in a steady and rhythmic manner to insure that our mind is completely
focused on whatever phrasing we might have chosen to tell ourselves.

Furthermore, we shouldn’t put too much pressure on ourselves the first few times of we
do this technique, since it’s safe to say that it’s a learning process that takes time, with
mastery coming as we gain more experience.

So, now we can jump in and get started with these simple steps:

1. Find a comfortable position for your body, with your arms extended along your sides.
Bit by bit you will start relaxing different groups of muscles, following the instructions
below.

2. Start breathing deeply, slow and steady. Take in the air through your nose and then
release it slowly through your mouth. Keep this rhythm going for about two mintues
before getting started with the progressive muscle relaxation.

3. Focus on your feet. Tense them for about 20 or 30 seconds while imagining that all of
the tension in your body is now located there. Mentally tell yourself, “All of the tension in
my body is located in my feet,” and repeat this phrase during the time when you are
tensing these muscles.
4. Now slowly release the tension in your feet. Very slowly, in such a way that it will take
you 20 to 30 seconds to fully relax these muscles. While you are releasing the tension
in this group of muscles, you should mentally be repeating the sentence, “ I feel how all
of the tension in my body is leaving through my feet,” which you can alternate with the
phrase, “My feet are feeling very light.”

5. Once you have relaxed these muscles, you should move your focus to your thighs.
The procedure is the same: Contract them while saying to yourself, “All of the tension in
my body is located in my thighs,” and then relax them while alternating “I can feel all of
the tension of my body leaving through my thighs,” along with the phrase “My legs and
thighs feel very light.”

In this way slowly go through the following muscle groups: Your abdomen, hands,
forearms, shoulders, neck, and facial muscles, paying extra-special attention to the
space between your eyebrows. Why pay special attention there? Because once we
have relaxed our entire body the last remains of tension often hide out in the space
between our eyebrows. In addition, normally our shoulders and space between our
eyebrows are the places most likely for stress to accumulate in the first place, which is
why it is important to spend more time relaxing the muscles in these areas.

The times suggested for doing this technique are merely suggestions. With practice,
each person will discover the amount of time just right for them in order to relax each
group of muscles.

6. Once completely free of tension, a person can give themselves messages such as, “I
am totally relaxed,” “Nothing is bothering me,” “I am confident in myself,” “I have self-
control.”

Practicing this technique before going to sleep is particularly relaxing and I dare say that
it is very effective against insomnia 80% of the time. But of course it can also be
practiced any point during the day. Because of its systematic nature, eventuallyit will
take less and less time for you to move throughthe different muscle groups, although
occasionally, and depending on the amount of stress you’re dealing with, it couldbe that
the time it takes you to achieve full relaxation will vary.
https://psychology-spot.com/jacobson-muscular-relaxation-techinque/

Progressive muscle relaxation (PMR) is a non-pharmacological method of deep muscle

relaxation, based on the premise that muscle tension is the body's psychological response
to anxiety-provoking thoughts and that muscle relaxation blocks anxiety.[1] The technique involves
learning to monitor the tension in specific muscle groups by first tensing each muscle group. This
tension is then released, as attention is directed towards the differences felt during tension and
relaxation.[2]
 Contents

 1History
 2Training
 3Applications
 4Insomnia
 5Pain relief
 6Sport
 7Schizophrenia
 8Other
 9Long term effects
 10See also
 11References

History[edit]
It was developed by American physician Edmund Jacobson and presented first in 1908 at Harvard
University.[3] In 1929, Jacobson published the book Progressive Relaxation, which included a
detailed procedure for removing muscular tension. His work led to the use of the word "relax", in the
sense of "to become less tense, anxious or stressed, to calm down".[citation needed] He continued to work
on this topic throughout his life and wrote several books about it.

Rorschach Inkblot Test

By Jane Framingham, Ph.D.
Last updated: 13 Oct 2018

~ 7 MIN READ

Pages: 1 2All

The Rorschach Inkblot Test is a projective psychological test consisting of 10 inkblots

printed on cards (five in black and white, five in color) created in 1921 with the publication
of Psychodiagnostik by Hermann Rorschach. During the 1940s and 1950s, the test was
synonymous with clinical psychology. Throughout much of the 20th century, the Rorschach
inkblot test was a commonly used and interpreted psychological test. In surveys in 1947
(Louttit and Browne) and 1961 (Sundberg), for instance, it was the fourth and first,
respectively, most frequently used psychological test.
Despite its widespread use, it has also been the center of much controversy. It has often
proven to be difficult for researchers to study the test and its results in any systematic
manner, and the use of multiple kinds of scoring systems for the responses given to each
inkblot has led to some confusion.

History of the Rorschach

Hermann Rorschach did not make it clear where he got the idea from the test. However, like
most children of his time, he often played the popular game called Blotto (Klecksographie),
which involved creating poem-like associations or playing charades with inkblots. The
inkblots could be purchased easily in many stores at the time. It is also thought that a close
personal friend and teacher, Konrad Gehring, may have also suggested the use of inkblots
as a psychological tool.
When Eugen Bleuler coined the term schizophrenia in 1911, Rorschach took interest and
wrote his dissertation about hallucinations (Bleuler was Rorschach’s dissertation
chairperson). In his work on schizophrenia patients, Rorschach inadvertently discovered
that they responded quite differently to the Blotto game than others. He made a brief report
of this finding to a local psychiatric society, but nothing more came of it at the time. It wasn’t
until he was established in his psychiatric practice in Russia’s Krombach hospital in Herisau
in 1917 that he became interested in systematically studying the Blotto game.
Rorschach used about 40 inkblots in his original studies in 1918 through 1921, but he would
administer only about 15 of them regularly to his patients. Ultimately he collected data from
405 subjects (117 non-patients which he used as his control group). His scoring method
minimized the importance of content, instead focusing on how to classify responses by their
different characteristics. He did this using a set of codes — now called scores — to
determine if the response was talking about the whole inkblot (W), for instance, a large
detail (D), or a smaller detail. F was used to score for form of the inkblot, and C was used to
score whether the response included color.

In 1919 and 1920, he tried to find a publisher for his findings and the 15 inkblot cards he
regularly used. However, every published balked at publishing all 15 inkblots because of
printing costs. Finally in 1921, he found a publisher — the House of Bircher — willing to
publish his inkblots, but only 10 of them. Rorschach reworked his manuscript to include only
10 of the 15 inkblots he most commonly used. (You can review the 10 Rorschach inkblots on
Wikipedia; the rest of the Wikipedia entry on the Rorschach is full of significant factual
errors.)
The printer, alas, was not very good at being true to the original inkblots. Rorschach’s
original inkblots had no shading to them — they were all solid colors. The printer’s
reproduction of them added shading. Rorschach reportedly was actually quite pleased with
the introduction of this new addition to his inkblots. After publishing his monograph with the
inkblots, entitled a Form Interpretation Test, he died in 1922 after being admitted to a
hospital for abdominal pains. Rorschach was only 37 years old and had been formally
working on his inkblot test just four years.

The Rorschach Scoring Systems

Prior to the 1970s, there were five primary scoring systems for how people responded to the
inkblots. They were dominated by two — the Beck and the Klopfer systems. Three other
that were used less often were the Hertz, Piotrowski and the Rapaport-Schafer systems. In
1969, John E. Exner, Jr. published the first comparison of these five systems entitled The
Rorschach Systems.
The findings of Exner’s ground-breaking analysis were that there actually weren’t five
scoring systems for the Rorschach. He concluded that the five systems differed so
dramatically and significantly, it was as if five uniquely different Rorschach tests had been
created. It was time to go back to the drawing board.

Given Exner’s disturbing findings, he decided to undertake the creation of a new,

comprehensive Rorschach scoring system that would take into account the best
components of these five existing systems, combined with extensive empirical research on
each component. A foundation was established in 1968 and the significant research began
into creating a new scoring system for the Rorschach. The result was that in 1973, Exner
published the first edition of The Rorschach: A Comprehensive System. In it, he laid out the new
scoring system that would become the new gold standard (and the only scoring system now
taught).
What the Rorschach Measures
The Rorschach Inkblot test was not originally intended to be a projective measure of
personality. Instead, it was meant to produce a profile of people with schizophrenia (or other
mental disorders) based upon score frequencies. Rorschach himself was skeptical of his
test being used as a projective measure.

The Rorschach is, at its most basic level, a problem-solving task that provides a picture of
the psychology of the person taking it, and some level of understanding the person’s past
and future behavior. Imagination is involved most often in the embellishment of a response,
but the basic process of the task has little to do with imagination or creativity.

https://psychcentral.com/lib/rorschach-inkblot-test/

Rorschach Inkblot Test

THE ORIGINS OF THE RORSCHACH TEST

Hermann Rorschach

Hermann Rorschach wrote Psychodiagnostikin 1921. It outlines the methods of the psychological
projective test the Rorschach Inkblot Test. The Rorschach Test is an experiment that measures the
interpretation of inkblots. The test consists of ten figures printed on ten separate cards, all of which
“fulfill certain special requirements as well as general ones.” (Rorschach, 1921). Five cards are black and
white, while the other five cards are colored. The procedure involves presenting a subject with the ten
cards and asking them what they see as well as the specific features that made the subject draw the
conclusion that they did. The subjects interpretation of the forms is perception, not imagination.
 Scoring is dependent upon the quality of the answers (i.e. how common or unusual, attention to detail,
to whole versus part responses, etc). (Thorne & Thorne, 2005, p. 505).

Rorschach’s original study consisted of 405 individuals. Rorschach divided individuals who were non-
patients into two categories: educated and not educated. Rorschach stressed the need for further
experimentation and study. In 1922, he died before achieving this.

While the Rorschach test can help provide descriptions, it is not a diagnostic test. The descriptions help
form an understanding of a patient’s individual personality.

INKBLOTS
Wikipedia sparked controversy in the psychology community when the entire set of Rorschach images
appeared on the website, altering the outcome of future tests where patients are already exposed to
the inkblots. On the website, each image appears with a set of popular responses. “Because the
copyright for the test images has expired, efforts to remove the images are in vain, making them a part
of the public domain.” (Butcher 2010).

THE RORSCHACH IN THE UNITED KINGDOM

Established in 1920, the Tavistock clinic in London is one of the first outpatient clinics to utilize
psychotherapy inspired by the psychoanalytic theory. In 1933, Theodora Alcock—a child
psychotherapist—brought the Rorschach technique to the Tavistock clinic. Later, while working under
the Tavistock Insitute of Human Relations, Alcock began training others to administer and score the
Rorschach technique. In 1963, she published The Rorschach in Practice. (McCarthy Woods, 2006).

While not a diagnostic tool when it was first introduced in the United Kingdom, the Rorschach test was a
tool for diagnosing whether a “patient’s difficulties were psychotic, neurotic, or organic in nature.”
(McCarthy Woods, 2006). After World War II, many psychologists working with the Ministry of Defense
utilized the Rorschach—along with other tests—for the selection and monitoring of military personnel.

Founded by Dr. James Earl in 1942, the British Rorschach Forum—renamed the British Society for
Projective Psychology and Personality Study in 1970—helped popularize the Rorschach technique as
well as maintain the integrity and standards of the test. The Rorschach’s popularity in the United
Kingdom began to decline around the 1970s when the techniques were attacked as “unscientific.”
During this time, behavioral therapy grew in popularity. (McCarthy Woods, 2006)

THE RORSCHACH TEST IN THE UNITED STATES

While studying in Switzerland, David Levy stumbled upon Rorschach’s inkblot test, and brought it to the
United States when he returned home. In 1934, Samuel Beck, a student of Levy’s at Columbia
University, studied children’s responses to the Rorschach Test as his dissertation. Marguerite Hertz,
another student at Columbia, followed Beck’s example by studying the Rorschach using another sample
of children. Neither Beck nor Hertz added much to the Rorschach. Both both published articles on their
studies, however, and aroused interest in the Rorschach test in the United States. (Million, Grossman, &
Meagher, 2004).
In 1934, Bruno Klopfer—a research associate at Columbia University—took a seminrar that introduced
him to the Rorschach test. Finding Rorschach’s scoring system inadequate, Klopfer began adding new
codes in 1935. A year later, Klopfer created “The Rorschach Research Exchange” (later renamed the
“Journal of Projective Techniques” and again the “Journal of Personality Assessment”), a newsletter
dedicated to the Rorschach test and new developments. (Million, Grossman, & Meagher, 2004). Zygunt
Piotroski, part of Klopfer’s research group, independently conducted research with the Rorschach on
brain-injured patients. (Weiner & Greene, 2008).

In 1946, David Rapaport worked with Roy Schafer to develop the Rapaport-Schafer system as an
alternative scoring system for the Rorschach. (Weiner & Greene, 2008). By 1950, there were five
separate scoring systems for the Rorschach. It was not until 1974 that John Exner published the
Rorschach Comprehensive Scoring System, which is the scoring system commonly used today.

THE EXNER SCORING SYSTEM

In the early 1960s, John Exner and his associates reviewed the five individual scoring techniques for the
Rorschach to discover which was superior. Exner’s research created the foundation for the creation of
the Comprehensive System for the Rorschach. Exner found three issues with the previous five scoring
techniques:

“a. the disagreement among system authors about how and what to score

b. the lack of common interpretative procedures

c. the lack of psychometrically sound norms equivalent to those that accompany measures of cognitive
abilities” (Flanagan, 2006).

In 1974, Exner published his Comprehensive Scoring System which unified and organized the previous
five individual scoring techniques. (Flanagan, 2006). The CS (Comprehensive System) is specific and
detailed in its instructions on coding, which ensure that patient responses are coded the same way in
each instance. (Weiner & Greene, 2008)

http://projectivetests.umwblogs.org/popular-tests/rorschach-inkblot-test/

The Origins Of The Inkblot Test

The Rorschach inkblot test was created in 1921 by Swiss psychoanalyst and psychiatrist Hermann
Rorschach. The inspiration came for the test came 10 years before while he was writing his
dissertation on hallucinations in people with schizophrenia. During his work with schizophrenic
patients, he noticed that people with schizophrenia responded differently from those without while
playing an inkblot charades game known as Blotto or Klecksographie.

Once he had established his psychiatric practice, Rorschach developed 40 inkblot cards to test his
theory further. However, only 15 of the inkblot cards were regularly used with patients as his
research developed and only ten of the inkblot cards ended up being printed and distributed due to
printing costs.

His studies produced a personal system of scoring in which he classified responses using letters:
"W" for those who had a response based on the whole inkblot; "D" for those who focused on smaller
details of the inkblot; "F" for the form of the inkblot; and "C" for if the inkblot included color. This
scoring system split into five different systems after Rorschach's death in 1922. These scoring
systems included the popular Beck and Kopfler systems and the lesser-known Piotrowski, Hertz,
and Rapaport-Schafer systems.

Source: commons.wikimedia.org

Until 1973, these scoring systems were the primary systems used to score the results of the
Rorschach inkblot test. However, one John E. Exner challenged the systems in 1969 and noticed
that the five systems varied so dramatically that it would be impossible to get a clear reading from
any patient. Exner published a new scoring system in 1973 that became the sole scoring system of
all psychologists for the inkblot test.
The Use Of The Rorschach Inkblot Test In Psychology: How Does It Work And What Does It
Do?

To put it simply, the Rorschach is a projective psychological test that evaluates the answers of a
patient to conclude their personality. Ironically, Rorschach did not create the inkblot test for
personality testing. The test was developed to identify serious mental illnesses such as
schizophrenia, depression, and anxiety. It became clear over time, however, that the test was more
useful for identifying personality traits rather than mental illnesses, although the test can still produce
these results.

When the test is administered to a patient, the patient's brain begins trying to identify any patterns in
the inkblots. Each of the inkblots has a common shape that is identified by most patients. These
common shapes are used to determine whether or not a patient is projecting their personalities onto
the inkblots or not. After one round of all ten cards, the patient is typically brought through another
round in which they are asked to explain more about the inkblots. This is when the personality of the
patient tends to bleed into their interpretation of the cards.

Once the test is finished and the responses are recorded, the psychiatrist who administered the test
will begin to evaluate the patient's response. Much of the interpretation comes from the psychiatrist's
understanding of the patient's answers. Although the cards do have common interpretations, the
patient's response will tell the psychiatrist about their past, their personality traits, and the way that
they function in the world.

https://www.betterhelp.com/advice/psychologists/the-use-of-the-rorschach-inkblot-test-in-psychology/

The History of the Rorschach Inkblot Test

Rorschach was certainly not the first to suggest that a person's interpretation of an ambiguous
scene might reveal hidden aspects of that individual's personality. He may have been inspired to
create his famous test by a variety of influences.

As a boy, Rorschach had a great appreciation for klecksography or the art of making images
from inkblots. As he grew older, Rorschach developed a mutual interest in art
and psychoanalysis. He even published papers analyzing the artwork of mental patients,
suggesting that the art they produced could be used to learn more about their personalities.

One game created in 1896 even involved creating inkblot monsters to use then as prompts for
stories or verse. Alfred Binet had also experimented with the idea of using inkblots as a way to
test creativity and originally planned to include inkblots in his intelligence tests.
Inspired perhaps by both his childhood hobbies and his studies of Sigmund Freud's dream
symbolism, Rorschach began to develop a systematic approach to using inkblots as an
assessment tool.

How Did Rorschach Create the Inkblot Test?

Rorschach developed his approach after studying more than 400 subjects, including over 300
mental patients and 100 control subjects. His 1921 book Psychodiagnostik presented ten inkblots
that he selected as having high diagnostic value. The book also detailed his approach to scoring
responses to the test. His intention when creating the test was not to develop a general use
projective personality test. Instead, his goal was to create a test that could be used in the
diagnosis of schizophrenia.

Rorschach's book found little success, and he died suddenly at age 37 just one year after the
text's publication. Following the publication of the book, however, a wide variety of scoring
systems emerged. The test has grown to be one of the most popularly used psychological tests.

How Does the Rorschach Inkblot Test Work?

In order to understand how the inkblot tests work, it is important to understand how what it
consists of and how it is administered.

 The Rorschach test consists of 10 inkblot images, some of which are black, white, or gray
and some of which are color.
 A psychologist or psychiatrist who has been trained in the use, scoring and interpretation
of the test shows each of the ten cards to the respondent. During the test, the subject is
provided with each of the ten cards, one by one.
 The subject is then asked to describe what he or she thinks the card looks like.
 Test-takers are allowed to hold the cards in any position they may want, whether it is
upside down or sideways.
 The respondents are free to interpret the ambiguous image however they want.
 They may also respond in any way that they want. They may say that they see one thing,
several different things, or even nothing at all.
  Test-takers can focus on the image as a whole, on certain aspects of the image, or even on
the white space that surrounds the image.
 Once the subject has provided a response, the psychologist will then ask additional
questions to get the subject to further elaborate on his or her initial impressions.
 The psychologist also rates the reactions on a large number of variables such as whether
the subject looked at the whole image. These observations are then interpreted and
compiled into a profile of the individual.

How Are Inkblot Interpreted?

So what exactly do interpreters of the Rorschach test look for when they are analyzing responses
to the inkblots? The actual content of the responses is one thing, but other factors are essential as
well. Some of the things that interpreters are looking at include:

 How respondents describe the image. Certain responses are common on each card, so
scorers include a code that identifies such responses.
 How long they take to respond. Taking a very long time before offering a response
might indicate that the respondent is "shocked" by what they see.
 Factors are known as determinants, which can include location, form, color, and
shading, that generate a response.
 Extra or unrelated comments. Any additional comments that are made that are no part
of the main response.
 The popularity or originality of the responses given. Some responses are quite
common, while others may be much more unique. Highly atypical responses are notable
since they might indicate disturbances in thought patterns.

Interpretations of the Inkblot Test

The first card in the Rorschach test is a black and white symmetrical image that respondents
frequently describe as a bat, butterfly, or moth. Seeing animal or human shapes is a common
response to each of the 10 cards.

The third inkblot, for example, is often described as being two human figures engaged in some
type of interaction. Responses to this card are thought to provide information about how the
individual interacts with other people. A relatively fast response might indicate being at ease
with others and comfortable with social relationships. A delayed response, however, might
reveal that the individual struggles with social interactions.

Certain inkblots contain the color red, which is sometimes perceived as blood. Responses to such
cards can be an indication of how people cope with threats of harm or how they deal with anger.
Sexual imagery is also often seen in many of the cards.

How Is the Inkblot Test Used as a Diagnostic Tool?

While the Rorschach has long been a popular psychological test, its value has also been heavily
questioned. Surveys have suggested that between 43 and 77 percent of clinical psychologists use
the Rorschach as an assessment tool. However, one review concluded that the Rorschach test had
little validity as a diagnostic instrument.

Research suggests that certain responses to the inkblots might be indicative of schizophrenia and
possibly bipolar disorder and schizotypal personality disorder. However, studies suggest that
responses to the inkblot do not appear related to posttraumatic stress disorder, anxiety disorders,
conduct disorder, major depressive disorder, dependent personality disorder, narcissistic
personality disorder, conduct disorder, or antisocial personality disorder.

Criticisms of the Rorschach Test

Despite the popularity of the Rorschach test, it has remained the subject of considerable
controversy. Many of the criticisms center on how the test is scored and whether the results have
any diagnostic value.

Concerns Related to Scoring the Inkblot Test

The test was criticized extensively during the 1950s and 1960s for its lack of standardized
procedures, scoring methods, and norms.

Before 1970, there were as many as five scoring systems that differed so dramatically that they
essentially represented five different versions of the test. In 1973, John Exner published a
comprehensive new scoring system that combined the strongest elements of the earlier systems.
The Exner scoring system is now the standard approach used in the administration, scoring, and
interpretation of the Rorschach test.

Concerns Over Poor Validity and Reliability

In addition to early criticism of the inconsistent scoring systems, detractors note that the test's
poor validity means that it is unable to accurately identify most psychological disorders. As you
can imagine, scoring the test can be a highly subjective process.

Another key criticism of the Rorschach is that it lacks reliability. In other words, two clinicians
might arrive at very different conclusions even when looking at the same subject's responses.

Concerns Over Diagnoses

The test has shown some effectiveness in the diagnosis of illnesses characterized by distorted
thinking such as schizophrenia and bipolar disorder. Some experts caution, however, that since
the Exner scoring system contains errors, clinicians might be prone to over-diagnosing psychotic
disorders if they rely heavily on Exner's system.

Inkblot Tests Can Provide Useful Information

The test is primarily used in psychotherapy and counseling, and those who use it regularly often
do so as a way of obtaining a great deal of qualitative information about how a person is feeling
and functioning. The therapist and client can then further explore some of these issues during
therapy.

Despite the controversies and criticisms over its use, the Rorschach test remains widely used
today in a variety of situations such as in schools, hospitals, and courtrooms.

Some skeptics have been more critical, suggesting that the Rorschach is nothing more than
pseudoscience. In 1999, some psychologists called for a complete moratorium on the use of the
Rorschach inkblot for clinical purposes until researchers could better determine which scores are
valid and which are invalid.

A later report had a more mixed finding of the usefulness of the inkblot test. The researchers
concluded that while the test possessed problems, it did have established value in identifying
thought disorders. "Its value as a measure of thought disorder in schizophrenia research is well
accepted," the researchers suggested. "It is also used regularly in research on dependency, and,
less often, in studies on hostility and anxiety. Furthermore, substantial evidence justifies the use
of the Rorschach as a clinical measure of intelligence and thought disorder."

A Word From Verywell

Today, some psychologists dismiss the Rorschach as merely a relic of psychology's past, a
pseudoscience on par with phrenology and parapsychology. Some experts suggest that while the
Rorschach is certainly worthy of criticism, it is not without merit. The test's use in the
identification of thought disorders had been well established and the available research does
suggest that the test's validity is greater than that of chance. While the inkblot test may not be a
perfect tool, it can play a useful role in identifying certain psychiatric conditions as well as a
psychotherapeutic assessment.

https://www.verywellmind.com/what-is-the-rorschach-inkblot-test-2795806

What does the Rorschach Test measure?

The test wasn’t originally founded to be a projective test for personality. The original purpose of
the test was to produce a profile of people suffering from mental disorders, like schizophrenia,
based on the scoring. Even Rorschach himself was not completely satisfied with the idea of using
the test as a projective test for personality.
At the simpler level, Rorschach is merely a problem solving task that portrays the psychological
analysis of the subject. Also, it aids in figuring out the past and future behavior of the subject up
to some degree. Although it takes quite a bit of imagination to procure a response, the basic
process of the task is almost irrelevant with the imagination or creativity of the subject.
https://www.psychestudy.com/general/personality/rorschach-inkblot-test

Rorschach test
From Wikipedia, the free encyclopedia

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"Rorschach Test" redirects here. For the band, see Rorschach Test (band).
The Rorschach test is a psychological test in which subjects' perceptions of inkblots are recorded
and then analyzed using psychological interpretation, complex algorithms, or both. Some
psychologists use this test to examine a person's personality characteristics and emotional
functioning. It has been employed to detect underlying thought disorder, especially in cases where
patients are reluctant to describe their thinking processes openly.[4] The test is named after its
creator, Swiss psychologist Hermann Rorschach. In the 1960s, the Rorschach was the most widely
used projective test.[5]
Although the Exner Scoring System (developed since the 1960s) claims to have addressed and
often refuted many criticisms of the original testing system with an extensive body of
research,[6] some researchers continue to raise questions. The areas of dispute include the
objectivity of testers, inter-rater reliability, the verifiability and general validity of the test, bias of the
test's pathology scales towards greater numbers of responses, the limited number of psychological
conditions which it accurately diagnoses, the inability to replicate the test's norms, its use in court-
ordered evaluations, and the proliferation of the ten inkblot images, potentially invalidating the test
for those who have been exposed to them.

History

Hermann Rorschachcreated the inkblot test in 1921.

Using interpretation of "ambiguous designs" to assess an individual's personality is an idea that goes
back to Leonardo da Vinci and Botticelli. Interpretation of inkblots was central to a
game, Gobolinks,[8] from the late 19th century. Rorschach's, however, was the first systematic
approach of this kind.[9] The ink blots were hand drawn by Rorschach.[10]
It has been suggested that Rorschach's use of inkblots may have been inspired by German
doctor Justinus Kerner who, in 1857, had published a popular book of poems, each of which was
inspired by an accidental inkblot.[11] French psychologist Alfred Binet had also experimented with
inkblots as a creativity test,[12] and, after the turn of the century, psychological experiments where
inkblots were utilized multiplied, with aims such as studying imagination and consciousness.[13]
After studying 300 mental patients and 100 control subjects, in 1921 Rorschach wrote his
book Psychodiagnostik, which was to form the basis of the inkblot test (after experimenting with
several hundred inkblots, he selected a set of ten for their diagnostic value),[14] but he died the
following year. Although he had served as Vice President of the Swiss Psychoanalytic Society,
Rorschach had difficulty in publishing the book and it attracted little attention when it first
appeared.[15]
In 1927, the newly founded Hans Huber publishing house purchased Rorschach's
book Psychodiagnostik from the inventory of Ernst Bircher.[16] Huber has remained the publisher of
the test and related book, with Rorschach a registered trademark of Swiss publisher Verlag Hans
Huber, Hogrefe AG.[17] The work has been described as "a densely written piece couched in dry,
scientific terminology".[18]
After Rorschach's death, the original test scoring system was improved by Samuel Beck, Bruno
Klopfer and others.[19] John E. Exner summarized some of these later developments in
the comprehensive system, at the same time trying to make the scoring more statistically rigorous.
Some systems are based on the psychoanalytic concept of object relations. The Exner system
remains very popular in the United States, while in Europe other methods sometimes
dominate,[20][21] such as that described in the textbook by Evald Bohm, which is closer to the original
Rorschach system and rooted more deeply in the original psychoanalysis principles.[citation needed]
Rorschach never intended the inkblots to be used as a general personality test, but developed them
as a tool for the diagnosis of schizophrenia. It was not until 1939 that the test was used as a
projective test of personality, a use of which Rorschach had always been skeptical.[22] Interviewed in
2012 for a BBC Radio 4 documentary, Rita Signer, curator of the Rorschach Archives
in Bern, Switzerland, suggested that far from being random or chance designs, each of the blots
selected by Rorschach for his test had been meticulously designed to be as ambiguous and
"conflicted" as possible.[23]

Applications
The test is also controversial because of its common use in court-ordered evaluations.[citation needed] This
controversy stems, in part, from the limitations of the Rorschach, with no additional data, in making
official diagnoses from the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).[112] Irving
B. Weiner (co-developer with John Exner of the Comprehensive system) has stated that the
Rorschach "is a measure of personality functioning, and it provides information concerning aspects
of personality structure and dynamics that make people the kind of people they are. Sometimes such
information about personality characteristics is helpful in arriving at a differential diagnosis, if the
alternative diagnoses being considered have been well conceptualized with respect to specific or
defining personality characteristics".[113] In the vast majority of cases, anyway, the Rorschach test
wasn't singled out but used as one of several in a battery of tests,[114] and despite the criticism of
usage of the Rorschach in the courts, out of 8,000 cases in which forensic psychologists used
Rorschach-based testimony, the appropriateness of the instrument was challenged only six times,
and the testimony was ruled inadmissible in only one of those cases.[80] One study has found that use
of the test in courts has increased by three times in the decade between 1996 and 2005, compared
to the previous fifty years.[114] Others however have found that its usage by forensic psychologists
has decreased.[115]
Exner and others have claimed that the Rorschach test is capable of detecting suicidality.
https://en.wikipedia.org/wiki/Rorschach_test

another article: https://www.seabhs.org/poc/view_doc.php?type=doc&id=8215

Limitations of the Rorschach as a diagnostic tool: A reply to Garfield (2000),
Lerner (2000), and Weiner (2000)

Abstract
In “The Rorschach Test in Clinical Diagnosis: A Critical Review, With a Backward Look at Garfield (1947),” we have shown
that the Rorschach has little validity as a diagnostic tool. In the present piece, we respond to comments by Garfield (2000),
Lerner (2000), and Weiner (2000). Until very recently, Rorschach proponents have claimed that the test is useful for diagnostic
purposes. It is striking, therefore, that the commentators on our article do not dispute strongly its conclusion that Rorschach
scores generally are unrelated to psychiatric diagnoses. Instead, one commentator argues that the test's true usefulness consists in
identifying symptoms and predicting behavioral outcomes. However, only three specific examples are given to support this
assertion. Although the Rorschach may be useful for these other purposes, the burden of proof falls squarely on the test's
proponents to document such claims. © 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 441–448, 2000.

Wood, James & Lilienfeld, Scott & Garb, Howard & Nezworski, M.. (2000). Limitations of the Rorschach
as a diagnostic tool: A reply to Garfield (2000), Lerner (2000), and Weiner (2000). Journal of clinical
psychology. 56. 441-8. 10.1002/(SICI)1097-4679(200003)56:33.3.CO;2-H.

1. HISTORY & DEVELOPMENT • Rorschach primarily wanted to establish empirically based

discriminations among different groups and was only minimally concerned with the
symbolical interpretation of contents. • 1940s and 1950s, the name Rorschach was almost
synonymous with clinical psychology. • Unfortunately, Rorschach died at age 37, shortly after
the publication of his major work, Psychodiagnostik (1921/1941).
2. 4. • One of the early difficulties in establishing the psychometric properties of the Rorschach
was in making meaningful comparisons across various studies. • By 1957, five Rorschach
systems were in wide use, the most popular being those developed by Beck and Klopfer. •
The wide range of often competing approaches resulted in numerous detrimental practices.
3. 5. Cont.. • Beck emphasized that the response to the Rorschach involved primarily a
perceptual- cognitive process in which the respondents structure and organize their
perceptions into meaningful responses. • B. Klopfer emphasized the symbolical and
experiential nature of a respondent’s Rorschach contents.
4. 6. Cont… • Exner (1969) for the first time provided a comparative analysis of these different
systems. • The general conclusion, based on these findings, was that the research on and
the clinical use of the Rorschach were seriously flawed. • The final product was first
published in 1974 as The Rorschach: A Comprehensive System.
5. 7. RELIABILITY AND VALIDITY • Establishing the validity of the Rorschach as a whole has
been complicated by the many scoring categories and quantitative formulas, each of which
has varying levels of validity. • Early meta-analyses indicated that validity ranged from .40 to
.50 • With the exception of a few disorders (schizophrenia, borderline personality, bipolar
disorder), the Rorschach has not been very effective at assisting with making formal
psychiatric diagnosis, according to a few analysts.
6. 8. PRINCIPLE • Stimuli from the environment are organized by a person’s specific needs,
motives, and conflicts, and by certain perceptual “sets.” • This need for organization
becomes more exaggerated, extensive, and conspicuous when subjects are confronted with
ambiguous stimuli, such as inkblots.
7. 9. Cont.. • The process by which persons organize their responses to the Rorschach is
representative of how they confront other ambiguous situations requiring organization and
judgment.
8. 10. Purpose • Cognitive structuring • Thematic imagery • Motivations • Response tendencies
• Cognitive operations • Affectivity • Personal and Interpersonal perceptions
9. 11. ADVANTAGES • High resistance to faking. • Can be used with an individual from any
age group. • Can be used even when no relatives or attendants are available to substantiate
or give history. • Cross cultural researches on basic personlaity structures.
10. 12. Cont…. • Evaluate the therapeutic efficacy ( before and after application of a specific
therapy) • Can be used to explore the unconscious motives for the behavior. • For cases of
compensation neurosis for disability who intentionally pretend to have more disability. • One
frequently noted asset is that the Rorschach is considered to be excellent at bypassing a
person’s conscious resistance.
11. 13. LIMITATIONS • Scoring and interpretation are often quite complicated and time-
consuming. • It is one of the most complex psychological tests in current use, error can
potentially be introduced from many different directions. • Reliability and validity studies
performed on one system did not necessarily mean that the findings from these studies could
be generalized to any of the other systems.
12. 14. LIMITATIONS • With the exception of a few disorders (schizophrenia, borderline
personality, bipolar disorder), the Rorschach has not been very effective at assisting with
making formal psychiatric diagnosis. • Time required to analyze results. • Learning curve is
very long. • Often been considered to have limited use with children.
13. 15. APPARATUS • Complete set of 10 Rorschach plates • Rorschach location charts (Mini
Plates) • Plain paper, pencil and pen • A decent, comfortable and naturally or artificially lit
room is very important.
14. 16. THE TESTING PLACE • Test MUST ALWAYS be administered in a very peaceful
environment. • Test should be administered in privacy and in a non disturbing area. • The
entry of unknown people while testing is in progress should be avoided. This is very crucial.
15. 17. INSTRUCTION TO THE TESTER • Exner recommends that the examiner hand the
subject the first card and ask, “What might this be?” • Commentary on, or discussion of the
cards by the examiner, should be avoided as much as possible. • The main objective is to
give the subject maximum freedom to respond to the stimuli in his or her own manner.
16. 18. • The tester must have a clear idea in his mind as to what is the purpose of the
administration of this test to a certain patient.
17. 19. INTRODUCING THE TEST TO THE RESPONDENT • Rapport formation. • Clear
introduction to the testing procedure, obtaining personal history, answering questions. •
Emphasize relatively neutral words such as inkblot, interests, or imagination, rather than
potentially anxiety-provoking words such as intelligence or ambiguous.
18. 20. Cont.. • Any specific information regarding what subjects should do or say is to be
avoided.
19. 21. SAMPLE INTRODUCTION
20. 22. • You will be taking an interesting test of thinking and imagination ability today. • It
requires about an hour or sometimes more. • This test would help me in understanding your
problems, strong and weak points in your personality. It would be helpful in overall
management of the treatment plan. • I shall be giving you one by one a series of 10 plates
made of inkblots. Some of them are in black and white and some are multicolor.
21. 23. • On seeing the plate, you’re supposed to tell me everything what you see on the plate. •
You are to tell me everything that might be represented by these blots. • People see all sorts
of things on these inkblot pictures. Tell me what it might be for you, what it looks like, what it
resembles with. • There are no right or wrong answers. So, you are free to tell me whatever
comes to your mind on seeing the plate without feeling embarassed if its right or wrong. •
You are free to ask any question.
22. 24. THE TEST PROPER
23. 25. THE RESPONSE (ASSOCIATION) PHASE • Time the interval: 1) First see the card and
ends when they make their initial response. 2) total time they spend with each card. •
Recording of time should be done as inconspicuously as possible. • The average number of
 responses is 22.32 • The testee should be encouraged regularly to tell whatever comes to
his mind.
24. 26. • The encouragement should be reduced progressively and after the 5th or 6th plate, the
encouragement should be stopped. • After that, if the testee returns back any plate without
any response before 1min, then and only then the tester should try to encourage.
25. 27. Cont… • A client who produces an extremely brief protocol (fewer than fourteen
responses) should be immediately retested and provided with a clearer request to provide
more responses. • If a client provides six or more responses to the first inkblot, the examiner
should remove the inkblot. • All responses must be recorded verbatim.
26. 28. Cont… • A set of abbreviations used throughout all the Rorschach systems consists of
the symbols (V, > ,ᴧ, < ) in which the peak indicates the angle of the card. • Note any odd or
unusual responses to the cards.
27. 29. INQUIRY • Most important phase for scoring and interpretation. • The inquiry should
begin after all 10 cards have been administered. • It is intended to clarify the responses that
have already been given, not to obtain new responses. • Any questions should be as
nondirective as possible. • Tester should repeat the original response given.
28. 30. Cont.. • In this phase, responses can be recorded either verbatim or in the abbreviated
style whichever is suitable. • An additional feature of the inquiry is to test the subject’s
awareness of his or her responses. • Thus the emphasis is on: location and determinants for
each percept. • It is critically important to prepare the respondent. • Thorndike’s law of
recency.
29. 31. SAMPLE INTRODUCTION
30. 32. • Now we are going to go back through the cards again. It won’t take very long. I want to
see the thing that you said you saw and make sure that I see them like you do. • We’ll do
them one at a time. I’ll read what you said and then I want you to show me where it is in the
blot and then tell me what there is there that makes it look like that to you, so that I can see it
too, just like you did. • Is that clear?
31. 33. PLATE 1
32. 34. PLATE 2
33. 35. PLATE 3
34. 36. PLATE 4
35. 37. PLATE 5
36. 38. PLATE 6
37. 39. PLATE 7
38. 40. PLATE 8
39. 41. PLATE 9
40. 42. PLATE 10
41. 43. REFERNCES • A practical manual for the rorchach test by Dwarka Pershad and Suresh
Parekh. • Handbook of psychological assessment 4th edition by Gary Groth Marnat. •
En.wikipedia.org/ • http://oink.elrellano.com/desastre/rorschach_ inkblot_test.html

Method

The Rorschach test is appropriate for subjects from the age of five to adulthood. The administrator and
subject typically sit next to each other at a table, with the administrator slightly behind the subject. Side-
by-side seating of the examiner and the subject is used to reduce any effects of inadvertent cues from
the examiner to the subject. In other words, side-by-side seating mitigates the possibility that the
examiner will accidentally influence the subject's responses.[24] This is to facilitate a "relaxed but
controlled atmosphere". There are ten official inkblots, each printed on a separate white card,
approximately 18 by 24 cm in size.[25] Each of the blots has near perfect bilateral symmetry. Five
inkblots are of black ink, two are of black and red ink and three are multicolored, on a white
background.[26][27][28] After the test subject has seen and responded to all of the inkblots (free
association phase), the tester then presents them again one at a time in a set sequence for the subject
to study: the subject is asked to note where they see what they originally saw and what makes it look
like that (inquiry phase). The subject is usually asked to hold the cards and may rotate them. Whether
the cards are rotated, and other related factors such as whether permission to rotate them is asked,
may expose personality traits and normally contributes to the assessment.[29] As the subject is
examining the inkblots, the psychologist writes down everything the subject says or does, no matter
how trivial. Analysis of responses is recorded by the test administrator using a tabulation and scoring
sheet and, if required, a separate location chart.[24]

The general goal of the test is to provide data about cognition and personality variables such as
motivations, response tendencies, cognitive operations, affectivity, and personal/interpersonal
perceptions. The underlying assumption is that an individual will class external stimuli based on person-
specific perceptual sets, and including needs, base motives, conflicts, and that this clustering process is
representative of the process used in real-life situations.[30] Methods of interpretation differ. Rorschach
scoring systems have been described as a system of pegs on which to hang one's knowledge of
personality.[31] The most widely used method in the United States is based on the work of Exner.

Administration of the test to a group of subjects, by means of projected images, has also occasionally
been performed, but mainly for research rather than diagnostic purposes.[24]

Test administration is not to be confused with test interpretation:

The interpretation of a Rorschach record is a complex process. It requires a wealth of knowledge

concerning personality dynamics generally as well as considerable experience with the Rorschach
method specifically. Proficiency as a Rorschach administrator can be gained within a few months.
However, even those who are able and qualified to become Rorschach interpreters usually remain in a
"learning stage" for a number of years.[24]

Features or categories

The interpretation of the Rorschach test is not based primarily on the contents of the response, i.e.,
what the individual sees in the inkblot (the content). In fact, the contents of the response are only a
comparatively small portion of a broader cluster of variables that are used to interpret the Rorschach
data: for instance, information is provided by the time taken before providing a response for a card can
be significant (taking a long time can indicate "shock" on the card).[32] as well as by any comments the
subject may make in addition to providing a direct response.[33]

In particular, information about determinants (the aspects of the inkblots that triggered the response,
such as form and color) and location (which details of the inkblots triggered the response) is often
considered more important than content, although there is contrasting evidence.[34][35] "Popularity"
and "originality" of responses[36] can also be considered as basic dimensions in the analysis.[37]

Content

The goal in coding content of the Rorschach is to categorize the objects that the subject describes in
response to the inkblot. There are 27 established codes for identifying the name of the descriptive
object. The codes are classified and include terms such as "human", "nature", "animal", "abstract",
"clothing", "fire", and "x-ray", to name a few. Content described that does not have a code already
established should be coded using the code "idiographic contents" with the shorthand code being "Idio."
[38] Items are also coded for statistical popularity (or, conversely, originality).[39]

More than any other feature in the test, content response can be controlled consciously by the subject,
and may be elicited by very disparate factors, which makes it difficult to use content alone to draw any
conclusions about the subject's personality; with certain individuals, content responses may potentially
be interpreted directly, and some information can at times be obtained by analyzing thematic trends in
the whole set of content responses (which is only feasible when several responses are available), but in
general content cannot be analyzed outside of the context of the entire test record.[40]

Location

Identifying the location of the subject's response is another element scored in the Rorschach system.
Location refers to how much of the inkblot was used to answer the question. Administrators score the
response "W" if the whole inkblot was used to answer the question, "D" if a commonly described part of
the blot was used, "Dd" if an uncommonly described or unusual detail was used, or "S" if the white
space in the background was used. A score of W is typically associated with the subject's motivation to
interact with his or her surrounding environment. D is interpreted as one having efficient or adequate
functioning. A high frequency of responses coded Dd indicate some maladjustment within the
individual. Responses coded S indicate an oppositional or uncooperative test subject.[25][38]

Determinants

Systems for Rorschach scoring generally include a concept of "determinants": These are the factors that
contribute to establishing the similarity between the inkblot and the subject's content response about it.
They can also represent certain basic experiential-perceptual attitudes, showing aspects of the way a
subject perceives the world. Rorschach's original work used only form, color and movement as
determinants. However currently, another major determinant considered is shading,[41] which was
inadvertently introduced by poor printing quality of the inkblots. Rorschach initially disregarded
shading,[42] since the inkblots originally featured uniform saturation, but later recognized it as a
significant factor.[43][44][45]

Form is the most common determinant, and is related to intellectual processes. Color responses often
provide direct insight into one's emotional life. Movement and shading have been considered more
ambiguously, both in definition and interpretation. Rorschach considered movement only as the
experiencing of actual motion, while others have widened the scope of this determinant, taking it to
mean that the subject sees something "going on".[46]

More than one determinant can contribute to the formation of the subject's perception. Fusion of two
determinants is taken into account, while also assessing which of the two constituted the primary
contributor. For example, "form-color" implies a more refined control of impulse than "color-form". It is,
indeed, from the relation and balance among determinants that personality can be most readily
inferred.[46]

Symmetry of the test items

A striking characteristic of the Rorschach inkblots is their symmetry. Many unquestionably accept this
aspect of the nature of the images but Rorschach, as well as other researchers, certainly did not.
Rorschach experimented with both asymmetric and symmetric images before finally opting for the
latter.[47]

He gives this explanation for the decision:

Asymmetric figures are rejected by many subjects; symmetry supplied part of the necessary artistic
composition. It has a disadvantage in that it tends to make answers somewhat stereotyped. On the
other hand, symmetry makes conditions the same for right and left handed subjects; furthermore, it
facilitates interpretation for certain blocked subjects. Finally, symmetry makes possible the
interpretation of whole scenes.[48]

The impact of symmetry in the Rorschach inkblot's has also been investigated further by other
researchers.[47]

Exner scoring system

The Exner scoring system, also known as the Rorschach Comprehensive System (RCS),[49] is the
standard method for interpreting the Rorschach test. It was developed in the 1960s by Dr. John E. Exner,
as a more rigorous system of analysis. It has been extensively validated and shows high inter-rater
reliability.[6][50] In 1969, Exner published The Rorschach Systems, a concise description of what would
be later called "the Exner system". He later published a study in multiple volumes called The Rorschach:
A Comprehensive system, the most accepted full description of his system.

Creation of the new system was prompted by the realization that at least five related, but ultimately
different methods were in common use at the time, with a sizeable minority of examiners not
employing any recognized method at all, basing instead their judgment on subjective assessment, or
arbitrarily mixing characteristics of the various standardized systems.[51]

The key components of the Exner system are the clusterization of Rorschach variables and a sequential
search strategy to determine the order in which to analyze them,[52] framed in the context of
standardized administration, objective, reliable coding and a representative normative database.[53]
The system places a lot of emphasis on a cognitive triad of information processing, related to how the
subject processes input data, cognitive mediation, referring to the way information is transformed and
identified, and ideation.[54]

In the system, responses are scored with reference to their level of vagueness or synthesis of multiple
images in the blot, the location of the response, which of a variety of determinants is used to produce
the response (i.e., what makes the inkblot look like what it is said to resemble), the form quality of the
response (to what extent a response is faithful to how the actual inkblot looks), the contents of the
response (what the respondent actually sees in the blot), the degree of mental organizing activity that is
involved in producing the response, and any illogical, incongruous, or incoherent aspects of responses. It
has been reported that popular responses on the first card include bat, badge and coat of arms.[31]

Using the scores for these categories, the examiner then performs a series of calculations producing a
structural summary of the test data. The results of the structural summary are interpreted using existing
research data on personality characteristics that have been demonstrated to be associated with
different kinds of responses.

With the Rorschach plates (the ten inkblots), the area of each blot which is distinguished by the client is
noted and coded—typically as "commonly selected" or "uncommonly selected". There were many
different methods for coding the areas of the blots. Exner settled upon the area coding system
promoted by S. J. Beck (1944 and 1961). This system was in turn based upon Klopfer's (1942) work.

As pertains to response form, a concept of "form quality" was present from the earliest of Rorschach's
works, as a subjective judgment of how well the form of the subject's response matched the inkblots
(Rorschach would give a higher form score to more "original" yet good form responses), and this
concept was followed by other methods, especially in Europe; in contrast, the Exner system solely
defines "good form" as a matter of word occurrence frequency, reducing it to a measure of the subject's
distance to the population average.[55]