Somatic Imagery Test as a tool for Assessment of Hostility and Aggression: Case Analyses

Shubhika Singh and Anand Dubey

(SIS Journal of Projective Psychology & Mental Health, (2021):28:1, 53-57).

The Somatic Inkblot Test (SIT- online version) was administered on two separate clients who had come for therapeutic intervention. The test was done to assess their personality and unique experiences in life. The test also aided the process of rapport formation and helped build a good therapeutic alliance. The inkblot images were helpful in bringing out flared up aggression, relational conflicts and their individual forms of coping (one through spirituality and other through defenses). The responses were analyzed using content analysis and psychoanalytical interpretation.

Personality assessments have always been of prime interest to psychologists and psychotherapists. Projective tools such as the Rorschach Inkblot Test, Holtzman Inkblot Test, Somatic Inkblot Series (SIS), Thematic Apperception Test and Word Association Test are some of the commonly preferred tools for tapping the unconscious material which is often not known to clients. Such repressed or suppressed material becomes the source of undesirable behavior. 

The Somatic Inkblot Series (SIS) is a semi-structured, projective, diagnostic procedure and is an adjunct to psychotherapy. (Cassell and Dubey, 2003). The Somatic Imagery test (SIT) is an online short version of 30 somatic images for quick assessment. It is designed for self-administration after supervised instruction. The subject visited https://dubeyhealingcenter.com with the following instructions, “Most people find this test fun and interesting. First, please relax, and prepare to enjoy it. Please write each in terms of what they resemble or look like to you. Different people see different things in the inkblots. It is important to write whatever the inkblot looks like to you.  Please include everything you see even if it reminds you of something remote, vague, highly personal or even potentially embarrassing. Please include everything you see with as much detail as possible. Also include any outstanding emotional reaction that you might feel in responding to these images. The test may take about 20 minutes to complete. Please be assured that there are no right or wrong answers.”

The present case studies analyze the responses of two separate individual male clients who approached one of the authors (SS) for assessment and psychotherapy. They were assessed on the Somatic Imagery Test (SIT) - the online version (www.Dubayhealingcenter.com), to find out the unprocessed/unresolved unconscious material leading to undesirable aggressive behavior. When such unconscious material is addressed, the client feels relieved and improvement starts. The SIT has been used in several cases with positive results (Dubey, Banerjee & Dubey, 2019, Campagnoni & Dubey, 2020, Singh & Dubey, 2020).

Case A:

Mr. A is a 38 years old, married male with one daughter. He speaks Hindi and English. He holds a bachelor's degree and is working for the central government of India. The client is the oldest amongst three sons. Mr. A has had an arranged marriage followed by marital discord since the beginning of the relationship. He is close to his mother and has a strained relationship with his father. Mr. A is a habitual smoker and reports having anxiety and excessive worry about the future. The SIT was administered to him following the standard procedure (Dubey et al, 2018, Dubey et al, 2019) for understanding his overall personality and unprocessed unconscious materials that needed to be addressed during psychotherapy. He was motivated and cooperative during testing. Normal response to images has not been mentioned below.No images were rejected by the client. The clinically significant responses (given below) were interpreted using content analysis and psychoanalytic interpretation.

Image 6: “Two black ants and it could also be a caricature of God.” The client’s inability to see two persons is indicative of poor interpersonal relationship with the opposite sex. Perception of God – a spiritual symbol in this image and in the previous two images (1 and 2) may indicate his desire to surrender before God to get spiritual strength and solution to his problems.  

Image 8: “Hand coming out of a Fire and a wall is also visible. There are also human beings”. Perceiving a hand coming out of fire may indicate a severe adverse situation and a feeling of helplessness. The Wall symbolizes hurdles which he must cross and the “other human beings” might be the people who have created problems in his life. During therapy sessions he expressed undesirable behavior of his father and his wife.

Image 9: “2 sparrows (mother sparrow feeding the baby sparrow) and heart in the middle with the biggest vein”. The client’s avoidance to see two birds making love or kissing is indicative of interpersonal/ couple conflict. However, seeing a mother and child sparrow is a positive response which symbolizes a good relationship with his mother. It also indicates his attachment/affection towards his daughter. 

Image 10: “Two horses from the side view. And, from front it looks like an Egyptian mummy”. In this response, perceiving 'Horse' may indicate ambivalence towards domination over the partner. The response "Egyptian Mummy" and denial of heart is indicative of aggressive tendencies towards his partner with masked wishful desire to see his partner dead. 

Image 13: “Eagle or bat” and avoided perceiving two children/babies which is a strong indication of a dominant father figure in his life. It also indicates his conflict with father and the wish to get separated from him. It may also indicate deprivation of love and affection from his father during childhood, which was confirmed during therapy sessions. 

Image 14: “From far it looks like a wine-opener kind of screw. But, from near it looks like a stack of human/cat faced caricature.” The perception of “a stack of human/cat faced caricature" is again indicative of aggression towards some female figure in the client's life and negative attitude. The wine-opener is a symbolic representation of male organ and sexual conflict.

Image 15: Instead of female genitalia he perceived “Sikhism Symbol”, in this image, which may indicate conflict with a female. However, perceiving a spiritual/religious symbol is a positive sign of spiritual attitude which is helping in resolving his problems. 

Image 16: “Hanuman ji (Monkey God) with one eye open and one closed.” One eye open indicates lack of trust or suspicious attitude. This may also indicate his suspicious attitude towards his wife. His perception of Monkey God – a God of power may indicate seeking divine intervention / spiritual power to resolve his family issues. Normally, people perceive ‘Fetus’ in this image and rejection of common response may indicate guilt feeling associated with the termination of pregnancy of his wife a few years back. 

Image 19: “Stone statues - One on the left is of a young guy and on the right is of an old man but initially it looked like a child.” The use of the word "stone" indicates a poor and difficult relationship with his father which he shared during therapy. As he narrated, his father was a cruel and hard person and he had experienced constant physical and emotional abuse during childhood and adolescence. 

Image 20: “Dialogue going on / exchange of ideas between an elderly couple.” Even though this is a normal response, seeing an "elderly couple in exchange of ideas" may symbolize his parents having an unpleasant conversation.

Image 21: “Sharp paper or metal weapons aimed at a lady (in pink).” The response on this image indicates uncontrolled aggression/hostility towards some female in the client's life. The client shared his poor relational dynamics with his wife and the anger he feels regarding the same. The projected response is alarming, and the client must be treated with pharmacological intervention and psychotherapy to control his aggression. 

Image 23: “I am in a cave, and there are rocks on the side and in the middle but can see the passage due to light coming in between”. Male sex organ is the common response on this image which he avoided. However, perception of “being in a cave and there are rocks on side” may indicate severe sexual conflict. Perception of “rocks around him” is a painful situation along with constant pressure, which he shared during therapy sessions. “Seeing the passage due to light coming in between” is a good sign of prognosis and the hope of managing his situation.

Image 25: “Pistol after shooting a bullet or a medical instrument/tool used for suction.” Again, a fired pistol is a highly aggressive response. It should be noted that the client must be given pharmacological aid and psychotherapy to control his aggression, otherwise, it might lead to unavoidable/ unlawful activities. 

It can be concluded that the SIT images projected smooth relationship of the client with his mother, affection and care of his daughter, disturbed relationship with his father and wife, sexual conflict and severe aggression towards his wife. Pharmacological aid and psychotherapy will help in the management of aggression and unresolved conflicts. 

Case B:

Mr. B is a 28 years old, unmarried male. He is an engineer by profession. The client has a very troubled relationship with his mother and has been in therapy with another therapist for the past six months. The Somatic Imagery Test (SIT) online version was administered following the standard procedure (Dubey & Dubey, 2018, Dubey et al, 2019) for understanding his overall personality and unprocessed unconscious material that needed to be addressed during psychotherapy. The clinically significant responses were interpreted using content analysis and psychoanalytic interpretation and are given below. The responses on remaining images that aren’t mentioned below were all normal.

Image 3: “Looks like a face, heart shaped lips which talk sweet but inside it is just black and blank. Putting a show. Also, the pink reminds of strawberry cream biscuit?” The client's projection of the heart-shaped lips which talk sweetly but inside it is just black, and blank is indicative of lack of affection and poor interpersonal relationships. The client is projecting a lot of suffering or agony in personal life that he hasn't shared with anyone. The use of the word "black" is indicative of sadness or depressive features. This should be explored during therapy sessions. 

Image 4: “A kid kicking a ball. First view on the right was a mushroom cloud from an atom bomb detonation, now it looks like a stuffed teddy bear toy sitting on the ground lifeless”. The perception of "mushroom cloud from an atom bomb detonation" is indicative of flared up aggression which needs to be addressed in therapy. The use of the word "lifeless" for a non-living object (teddy bear) indicates a depressive feature which is also present in image 3. His overall response is suggestive of unwanted difficult childhood and possible conflict with parental figure(s).

Image 5: The client projcted “Guy dancing towards an apple? Why would one be so happy to find an apple? I would understand if this was an orange.” The client being a male has not been able to perceive “dancing lady”, it may indicate a traumatic experience from a female. The avoidance of the perception of female figure is indicative of poor interpersonal relationship or conflict with the opposite sex. 

Image 7: “Giant ear standing at a door? Reminds me of my mother”. The use of the word "giant" and the entire perception of the image when paired with the memory of the client is indicative of suspicious attitude and lack of trust. 

Image 10: “Chest cavity, X-ray? Or two evil eels/sea creatures with tiny sharp teeth eating meat. Left creature looks very grim for some reason.” The perception of "chest cavity" indicates psychosomatic preoccupation - anxiety about either one’s own health or someone else. The other response indicates aggression. The perception of "grim" looking creature on the left is again indicative of depressive features. 

Image 11: “Very scary, carcass of a rabbit head looking straight. Almost satanic, the heart shaped red makes it scarier and uncomfortable”. The response “very scary- carcass” indicates anxiety and fear from a threatening situation which he is aware of. Seeing a carcass of a rabbit is indicative of interpersonal timidity followed by disgust and feeling of helplessness/hopelessness. The response “Satanic’ indicates conflict between superego and guilt which must be explored during therapy sessions. 

Image 16: “Baby inside a belly but is crying or sleeping. Looks like there can be two faces.” The perception of "two faces" indicates suspiciousness. A crying baby indicates his depressive features and suffering.   

Image 19: “Person looking inside/at an egg. This image is exhausting to look at”. The response on this image is indicative of a difficult relationship with his father. Also, the perception of a person looking inside/at an egg is symbolic of regression. The client is feeling unsafe/ insecure about something in his life and is seeking safety by regressing into a state of fetus. 

Image 21: “Knives flying at something with no escape because the black barbed wires, not clear what they are attacking or cutting.” Perceiving knives thrown at someone/something, being attacked indicates uncontrolled hostility and aggression. The client's current situation is serious where he is finding no resolution or way out of it. 

Image 24: “Looks like a playing card which can be played as an action, something related to heart-breaking because it can’t latch on something. Or a bigger heart consuming other little ones to fix its cracks?” The response is indicative of frustrated relationships and broken affairs, which should be explored during therapy. The client’s response also reflects compensation as a defense mechanism here.

Image 27: “Baby embryo looking at its mirror image?” Two babies is a normal response, but the embryo represents a sign of regression - a repeated theme of defense mechanism.

Image 28: “A version of "the thinker”. Sitting and contemplating”. The client’s avoidance of the common response of the mother hugging the child indicates his disturbed relationship and conflict with the mother/ mother figure.

Conclusion:

On psychodynamic content analysis of both cases, it is evident that both clients have a common theme of flared up aggression, anxious features and disturbed relationship with opposite sex (In the first case, it was with his spouse and in the second case it was with his mother).  The repeated theme in case of Mr. A was of aggression, couple conflict, a sense of helplessness, and spirituality as a way out of one’s misery. Whereas the repeated theme in the case of Mr. B was depressive content, aggressive attitude, distrust and desire to regress as a way out of one’s suffering. Both clients are currently undergoing psychotherapy. It is interesting to notice that the SIT assessment aided the process of rapport formation and a good therapeutic alliance with both clients.

References:

Cassell, W, A. and Dubey, B. L. (2003). Interpreting Inner World through Somatic Imagery: Manual of Somatic Inkblot Series. SIS Center, Anchorage, (USA) (www.somaticinkblots.com).

Dubey, B.L.; Kumar, R. and Dubey, A. (2018) Somatic Inkblot Series and the Journal of Projective Psychology & Mental Health: Inception to Silver Jubilee, SIS Journal of Projective Psychology & Mental Health, 25: 1, 5-34.

Dubey, B.L.; Banerjee, P. and Dubey, A. (2019) Inkblot Personality Test - Understanding the Unconscious Mind. Sage Publication, Delhi.

Compagnoni, N. and Dubey, B.L. (2020) Somatic Imagery Test (SIT) as a Measure of Trauma Resolution in a Case of Abortion, SIS Journal of Projective Psychology & Mental Health, 27:2, 105-111 

Singh, S. and Dubey, B.L. (2020) Therapeutic Intervention through Somatic Imagery Test - A Case Study, SIS Journal of Projective Psychology & Mental Health, 27:2,112-115.