Somatic Inkblot Test in a Case of Marital Conflict and Mild Depression

Renu Sachdeva, Anand Dubey & B. L. Dubey

(SIS Journal of Projective Psychology & Mental Health, (2023):30:2, 110-114).

The somatic Inkblot Test (SIT online version) was administered to 32 years divorced female who was referred for psychological assessment and psychotherapy. The responses on SIT indicated   her preoccupation with bodily process and health issues (HPV and cervical cancer risk), which is confirmed by her case history. Slightly high sex responses on SIT have indicated sexual trauma/conflict. This is validated through clinical findings and her dissatisfied physical/intimate relationship for 10 years with her husband.  As she narrated, her sexual relationship with her husband was unfulfilling and she has been a victim of sexual abuse on two separate occasions involving two different men. She has sexual trauma and unmet sexual desires which she is now trying to explore with other men after her divorce. The SIT responses helped her to release unprocessed material and the client is feeling better after two sessions of psychotherapy.

Introduction:

Marriage, as a basic institution, exists in every society. It is a culturally, religiously and socially recognized union, between a man and a woman. This union establishes rights and obligations between spouses, their children and between their family (Olugbenga, 2018). The relationship between couples gets better as time goes by, incrementally day after day. 

Conflict in a marriage is inevitable. Whenever two people get together and interact, their belief system and personal habits may be a cause of difference between them. They have to develop liking and understanding for each other.  Normally, in healthy relationships couples tend to accept and resolve conflict. However, a little thing, if not tackled properly, can slip into the relationship, can cause friction and separation between the couples. Marital conflict may lead to various personal, familial, physical, and psychological consequences, resulting in anxiety, depression, eating disorders, psychosomatic problems and many more issues (Manickam & Suhani, 2014, Singh & Dubey,2020,2021).

The present paper is a case study of a 32 years divorced female who was referred for psychological assessment and psychotherapy. She took Somatic Inkblot Test online (SIT) and the responses were interpreted using content analysis and psychoanalytic interpretation (Gilbert, 1977, Cassell & Dubey,2003, 2014, Dubey et al, 2019, Shafer, 1954).  

The Case: 

The client, a 32-year-old, female, undergraduate, recently divorced from her husband of 10 year. She has had troubled relationships with her past boyfriends. She was also having a tense relationship with her father. She has consulted a psychiatrist who diagnosed her with a case of anxiety with mild depression. She has been to two therapists for psychotherapy with no improvement. The Somatic Imagery Test was administered online to understand her personality and deep-rooted psychological issues.  

Results & Interpretation:

After initial responses on Somatic Inkblot Test, further probing was done in a one-on-one session. Her responses to 16 of the 30 images were explored due to atypical responses and because they suggested relationship conflict and issues related to sexual abuse and trauma. 

On the basis of the one-on-one session, her responses have been clustered into 3 broad areas given below: 

1. Childhood & relationship with parents
2. Relationship with men / Sexuality / relationships / Sexual trauma 
3. Reproductive issues / abortion / miscarriage

1. Childhood & relationship with parents: 

Image 1:

Client: “sinister (black colour)”, “distorted figures”, “falling and in disarray”, “disintegration”, “awkward limbs”, “discomfort/ pain” 

Therapist: On probing, client stated that it triggered a memory from her adolescence when she was extremely distressed when her family “lost trust” in her because of an online relationship she had with a man much older to her.

Image 4.

Client: “a grumpy teddy bear” being “cheered up” by a boy 

Therapist: On probing, client said it reminded her of her childhood when she was unhappy because of relocation abroad and her “cousins / friends broke close bonds with her” – she often felt “depressed” and needed others to cheer her up.

Image 8.

Client: “creepy and sad…. like the hand of someone who is dying and trying to reach out…” 

Therapist: Further exploration revealed that this reminded client of her unhappiness in childhood and marriage – fighting alone without support from family.

Image 28.

Client: “a baby holding on to mother - both looking sad….. Mother has helpless look on face”. 

Therapist: This image reminded client of the times when she felt unsupported by family members, other than her mother, who was quite powerless. The response indicates her loving relationship with mother, being uncomfortable with father whom she perceived to be very domineering, critical and indifferent to her. 

Image 30.

Client: “a hairy” family…“The parents were kissing, and the kids holding hands”. 

Therapist: Client felt pained that she and her brother never had this feeling because their father was very tough on them and never expressed his love. Perception of “a hairy” (T) may also indicates painful affective experience which is usually related to infantile needs particularly the erotic needs of the infantile period (Beck,1949)

2. Relationship with Men / Sexuality:

Image 6.

Client: client saw “two fat female calligraphy letters falling in love…”.  

Therapist: This is a kind of rejection of male & female figures and may indicate conflicting relationships with males. Further interrogation revealed that all her personal relationships with men have been troubled – father, boyfriends, ex-husband and brother.

Image 7.

Client: “someone’s ear…gross….. Weird penis coming out of ear….disgusting”.  

Therapist: Digging deeper about her sexual relationships indicated that she has not felt sexually pleasured by her husband and wants to experience sexual pleasure. Also, that she has experienced sexual abuse on two occasions - was forcibly kissed as a teenager and recently she had sex with a man without fully consenting.

Image 14.

Client:  “a morbid insect….mutation…sinister” 

Therapist: Not perceiving “spine” (common response) in this image may indicate that the perceiver has deep rooted sexual conflict or sexual trauma. A morbid insect may further symbolise sexual abuse. Which was validated (as mentioned earlier).

Image 15: 

Client: “a grey, spongy, sad vagina”.

Therapist: On interrogating on why the vagina is sad, she said her sex life had not been great and that she had not been prioritizing her own sexual pleasure….but that she wants to do so now.

Image 10.

Client: “Two seahorses - angry and hostile but have red hearts that seem to be meeting….This image is a little anxious”.

Therapist: Probing indicated her troubled relationship with husband - reminded client of herself & her husband – can’t do with each other, can’t do without each other.

Image 18.

Client: “Two people fighting. Their brains are red – from anger. The left one looks like a woman, the right one a younger man.  Not evoking positive emotions”.

Therapist: Reminded client of constant fights / arguments with my ex-husband. It made her feel sad.

Image 23.

Client: “Fish trying to go up in the sea & Image 25 looks like a watering can. The water is coming out in a thick stream and splashing. 

Therapist: Both these responses indicate client’s erotic desires for an intimate relationship. 

The response “looks like a watering can – indicate Freudian symbol of male genitalia. “The water is coming out in a thick stream and splashing” may further symbolize female genitalia in active involvement” (Gilbert, 1977). The response indicates her erotic desire to have an intimate relationship. Client confirmed that she has recently started dating after her divorce.

3. Reproductive issues / abortion / miscarriage

Image12.

Client:  “An ultrasound….baby less uterus”

Therapist: This response may indicate reproductive issues or abortion in the client. On probing, she said, she had recently been diagnosed with HPV and has cervical cancer risk that is being investigated. Doctor said the prognosis was good, so having a baby would not be an issue. Also, that the image made her anxious because she was worried about HPV.

Image 16.

Client: “looks like Mother Teresa kind of a woman”.  

Therapist: Not seeing a fetus (common response) is a kind of rejection that could indicate past abortion. Probing indicated that there had been three abortions in her close family / friends’ circles.

Image 27.

Client:  “Two babies/foetuses looking at each other. One alive – one a shadow. Maybe he couldn’t make it to the world”. 

Therapist: The theme of image 12 and 16 is brought back again on this image. This also indicates the pain and sufferings of abortion which she has observed in family and close friends. 

Conclusion:

SIT analysis suggests that the client is a creative, intelligent person with good interpersonal relationships. She has contact with reality and has interactions with the external world. She has high human responses coupled with high on Most Typical responses and high human movement which may indicate that the person is keeping a smooth interpersonal relationship with other people. It is also an indicator of high self-esteem and good interpersonal skills. However, a slightly high anatomical score may indicate her preoccupation with bodily processes and health issues (such as HPV and cervical cancer risk), which is confirmed. The latter also suggests poor self-image which is clinically validated in the discussion with the client.

Slightly high sex responses on Somatic Inkblots have indicated sexual trauma/conflict. This is validated through clinical findings. As she narrated, her sexual relationship with her husband was unfulfilling and she has been a victim of sexual abuse on two separate occasions with other men. She has sexual trauma and unmet sexual desires which she is now trying to explore with other men after her divorce.

She is currently suffering from anxiety and moderate depression (DS count is high as is other response count). Her previous psychiatrist and therapist had diagnosed her with depression, but the client has not taken medication as she does not believe she has depression.

Some of the responses on Somatic Inkblot images brought several core issues such as domineering father, traumatic interpersonal relationship with her husband, erotic conflict, issues related to abortion and miscarriage, needs to be addressed during psychotherapy sessions. This may help in releasing the stress laden issues and painful memories. The role of her mother has been very positive and supporting.  She has a cold and conflicted relationship with her father. This has also brought on the surface which must be addressed and resolved. She needs counselling for her traumatic intimate relationship with her husband and some affairs before and after the marriage. She has been in love several times, but all relationships have ended with unpleasant notes. Client needs to explore and understand what she has been seeking through these romantic relationships and why they failed. And, also to explore the kind of marriage and partnership she has in her mind. Her conflicting relationship with her father might be an additional reason leading to her dislike towards her husband. All such issues must be addressed during several therapy sessions. The client felt better after discussion and exploration of various issues.

References:

Beck, S. J. (1949). Rorschach Test: Basic Process. (2nd Ed.). New York: Grune & Stratton. 

Cassell, W.A. & Dubey, B.L. (2003). Interpreting Inner World Through Somatic Imagery, SIS Center, Anchorage, Alaska (USA)

Cassell, W, A. & Dubey, B. L. (2014). Dream and SIS Symbolism in Bereavement. SIS Journal of Projective Psychology and Mental Health, 21:3-10

Dubey, B.L., Banerjee, P. & Dubey, A. (2019). Inkblot Personality Test -Understanding the Unconscious Mind, Sage Publications Inc. New Delhi.

Gilbert, J. (1977) Interpreting Psychological Test Data. Van Nostrand Reinhold Co. New York

Manickam, L.S.S. & Suhani B.T. (2014). Marital Conflict: An Exploration of Relationship Issues in Couples through SIS-II. SIS Journal of Projective Psychology and Mental Health, 21: 37-41

Schafer, R. (1954). Psychoanalytic Interpretation in Rorschach Testing, New York, Grune

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

Singh, S. & Dubey, A. (2021). Somatic Imagery Test as a tool for Assessment of Hostility and Aggression: Case Analyses. SIS Journal 

Projective Psychology & Mental. Health, 28: 1, 53-57.