by

Wilfred A. Cassell, M.D., F.A.P.A.

B.L. Dubey, Ph.D., D.P.M.

Published by :

Somatic Inkblot Center,

4501E, 104th Ave, Anchorage, Alaska 99516 (USA)

Home page: http:// www.somaticinkblots.com

Interpreting Inner World Through

Somatic Imagery :

Manual of the Somatic Inkblot Series

reproduced or utilized in any form or by any means, electronic or mechanical,

including photocopying, recording, or by any informational storage and

retrieval system without permission from the authors/SIS Center.

Published by :

Somatic Inkblot Center,

4501E, 104th Ave, Anchorage, Alaska 99516 (USA)

First Edition 1990

First Revision 1997

Second Revision 2003

ISSN 0971-6610

Contents

Foreword i

Preface ii

Acknowledgements iii

List of Tables iv

Chapter 1: Introduction

What is SIS ? 1

Chapter 2 : Historical Development of Inkblot Technique

History of Inkblot Procedure 5

Beginning of Inkblot Procedure 5

Existing Inkblot Tests 6

Chapter 3 : Conceptualization of the SIS Procedure 9

Need for Development 9

Somatic Inkblot Series-I : 20 Cards 10

Somatic Inkblot Series-II : Booklet-62 Images 10

Somatic Inkblot Series-II : Video 11

Body Imagery and Illness 14

Theoretical Postulates 14

Somatic Imagery Theory 14

Theory of Body Symbolism 16

The Cry For Help 17

Chapter 4 : Psychometric Properties 19

Reliability and Validity 19

Reliability 19

Response Consistency 19

Split-Half Reliability 20

Inter-Scorer Reliability 22

Validity 22

Normative Data 32

Chapter 5: Administration 39

Procedure and Instructions 39

Video Procedure 39

Examination Instructions 42

SIS-II Booklet Procedure 43

Benefits 44

Chapter 6: Scoring and Charting 45

Definitions of Scoring Indices 45

Total Number of Responses 46

Human Responses 46

Animal Responses 46

Anatomical Responses 46

Sex Responses 46

Movement Responses 46

Most Typical Responses 46

Typical Responses 47

Atypical Responses 47

Typical and Atypical Responses (SIS-II A) 48

Typical and Atypical Responses (SIS-II B) 51

Rejection of Images 55

Pathological Scales 55

Pathological Anatomy Scale (PAS) 55

Depression Scale (D) 56

Hostility and Aggression Scale (HAS) 56

Paranoia Scale (P) 57

Charting of Responses - an Illustration 57

Clinical Considerations 64

Rejection of Images 65

Chapter 7 : Interpretation and Application of SIS Responses 67

Medical, Psychological and Spiritual Application 67

of SIS Inkblots

Guidelines for Interpretation of SIS Responses 70

Rejection of SIS Images 71

SIS-II/Video Death Scene 73

Hallucinations and Delayed Grief Reactions 74

Dream Programming 76

Releasing Repressed Satanic Memories 76

Stimulating Christian Imagery 78

Case 1 - A Case of Headache and Stammering 81

Case 2 - Police Case “Assault on Policeman.” 93

Case 3 - Police Case “Witnessing an Accident.” 93

Case 4 - SIS in a Case of Alopecia Areata. 96

Case 5 - Bereavement and Hypnosis. 99

Case 6 - SIS in a Case of Somatic Disorder 104

Case 7 - Therapeutic Dream Stimulation 107

Case 8 - The SIS and Hypno-Therapy in a

Case of Marital Problems 120

Case 9 - SIS in a Case of Examination Anxiety 125

Case 10- SIS in Sexually Assaulted Female 131

Case 11- The Use of the SIS and Rorschach in

Releasing Somatised Grief 134

Bibliography 149

Author Index 161

Subject Index 162

Foreword

“Dr. Cassell takes full advantage of new video technology in developing his interesting inkblot technique, the Somatic Inkblot Series. Considerable effort and artistic talent has gone into the development of this method, which clearly deserves further research. In the hands of an experienced clinician, particularly after receiving competent training and supervision from Dr. Cassell or one of his colleagues, the Somatic Inkblot Series is a most welcome new projective technique for the assessment of personality and psychopathology. Unlike many other methods, it is particularly appealing when used by the clinician and subject as an interactive, interpretive mode as a part of the total diagnostic and treatment process. The dynamic nature of the stimulus, when presented by video in full color reaches well beyond the limitations of traditional projective techniques.”

Wayne Holtzman, Ph.D

Hogg Foundation for Mental Health

The University of Texas, P.O.Box:7998,

Austin, Texas 78713-7998

i

Preface

This manual is written for all those who are interested in learning about the many

applications of the Somatic Inkblot Series technology. It is designed for a broad spectrum

of readers. At one pole, this involves those with little or no formal education in the field

of diagnostic assessment. At the opposite extreme are highly trained professionals in

the area of diagnosis, projective testing and treatment. What is offered is the introduction

to a new technology, which clearly has promise in telemedicine, psychology, and for all

professionals in the practice of psychotherapy.

The SIS-Video is the video version of SIS-II Booklet consisting of series A & B each with

31 images. Both the versions are designed for self-administration. The Administration,

Scoring, and Interpretation of both the tests are similar. Responses given by different

groups on both the tests are compatible. The present Manual is an attempt to provide

information regarding Administration, Scoring, Interpretation and application for Both

the Tests. The readers are requested to send their views and comments for further

improvements and revisions.

Wilfred A. Cassell

&

Bankey L. Dubey

ii

iii

Acknowledgement

This Manual is dedicated to Mary A. Cassell, whose support, patience and love have

made this whole project possible.

We are also very thankful and grateful to the many patients/clients who shared their

pain and insights with us and all those involved in the work: to James Chapman,

Seymour Fisher, Marc Hollender, Wayne Holtzman, Walter Klopfer, Alexander Levitan,

Frank Machovec and Teddy Weckowicz whose interest, comments, and encouragement helped the concepts flow.

To Elizabeth Bellamy, Debra Brady, Patrick Brady, Pat Davidson, Padma Dwivedi,

Anand Dubey, Asheem Dubey, Edith Eger, Raymond Fedje, Don Fields, Margaret

Fischer, Jay Fisk, Kristen Gillen, William Kellis, Bruce Livingstone, Paola Nicolini,

Anatoly Khromov, Mridula Mishra, Kumiko Murayama, Jim Murphy, Robert Morgan,

Ann M. O’Roark, Marianne Robinson, Gilbert Roth, George Savage, David Sperbeck,

and all the students, clinicians and researchers who have long been involved in this

labor of love. To Larry and Sharon Moore, Larry Brummer, Sue Close, and the technical

staff at TCS Video Production Center.

A special thanks to Anil Agrawal, N.L. Dosajh, C.B. Dwivedi, K.V. Kaliappan, Nalini

Mishra, Gopa Mitra, Anjana Mukhopadhyay, Rakesh Pandey, D. Pershad, S.

Ramachandra, S.P.Rathee, M. Sahay, D. Saldanha, Amool R. Singh, M.P.Singh and

many excellent professionals in India for help.

Wilfred A. Cassell

&

Bankey L. Dubey

List of Tables

Tables Page No.

Table 1 : Agreement of Responses on Repeat Administration 19

Table 2 : Test Re-test Reliability of the Contents of SIS-II 20

Table 3 : Means and Correlation between Series A and Series B 21

Table 4 : Distribution of Atypical Responses 23

Table 5 : Mean Number of Most Typical Responses 23

Table 6 : Comparison of Healthy Controls With Clinical Groups on 24

Different Categories of Responses on SIS-II Video

Table 7 : Mean Scores and SD on Nine Indices of the SIS-II for 25

Normal and Pathological Groups

Table 8 : Intergroup Comparisons for Different Scoring Categories 27

of the SIS-II

Table 9 : Multiple Discriminant Function Analysis in Terms of 28

U-Statistic and Corresponding F-Ratios for Identifying

the Best Predictors of SIS-II

Table 10 : Percentile Norms Based on the Responses of Normal 29

Control for Nine Scoring Indices of the SIS-II

Table 11 : Comparison of SIS Indices for Alcohol Dependent Group 30

Table 12 : Comparison of SIS Indices for Drug Dependent Group 31

Table 13 : Pathological Indices in Normal and Clinical Groups 31

Table 14 : SIS Images Assessing Different Areas 32

Table 15 : Comparison of Responses on SIS-II and SIS Video in Healthy Normal 33

Table 16 : Comparison of Responses on Series A and Series B of SIS Video 33

Table 17 : Diagnostic Indicators of SIS-II/ Video 34

Table 18 : Successful SIS Indices 35

Table 19 : SIS Video Responses of Executives in India 35

Table 20 : Comparison of Adults with Adolescents 36

Table 21 : Comparison of Series A and Series B in Adolescents 36

Table 22 :Compatibility of SIS-II and Rorschach Indices in Normal 37

and Psychiatric Groups

Table 23 : Kendall’s Coefficients of Concordance between the Nine 37

Scoring Indices of SIS and Rorschach

Table 24 : Comparision of Rorschach Responses on 1st, 2nd, 3rd and 128

4th Testing.

Table 25 : Comparision of a Few Significant SIS-I Responses on 1st, 128

2nd, 3rd and 4th Testing.

Table 26 : Comparision of a Few Significant SIS-Video Responses on 1st, 129

2nd, 3rd and 4th Testing.

iv

About the Authors

Dr.Wilfred A.Cassell is a licensed physician and is certified by

the American Board of Psychiatry. He is also a Fellow of the

American Psychiatric Association, the American Psychological

Society and the Somatic Inkblot Society and a member of the

Alaska State Medical and the American Medical Associations,

Society for Personality Assessment, International Society for

Traumatic Stress Studies, International council of Applied

Psychology and International Council of Psychologists. Presently

he is the President of Somatic Inkblot Society.

He also has an extensive outpatient practice and works with

children, adolescents and adults. He has written more than a

hundred articles in professional journals and the book “Body

Symbolism and the Somatic Inkblot Series.” He is a frequent

speaker at state, national and international conferences. He lives

in Anchorage, Alaska, where he enjoys the outdoors and the

unspoiled beauty of the “last frontier.”

Dr. Bankey Lal Dubey has done his Ph.D. in 1978 on

psychiatric population employing the Rorschach Inkblot Test and

established diagnostic indices for Schizophrenics and Neurotics.

He has also done post-master program in clinical psychology from

National Institute of Mental Health & Neuro Sciences, Bangalore

in 1968 and has undergone training in Hypnosis in USA in 1985

and 1992. Dr. Dubey has published more than 150 research

papers and two books, one on “Pragmatic View of Rorschach

Inkblot Technique”. He is a fellow of Somatic Inkblot Society and a

member of Society for Personality Assessment and International

Rorschach Society.

He started his career in T. N. Medical College, Bombay in 1969

and served Indian Army (Command Hospital) for 8 years and shifted

in 1980 to Panjab University Chandigarh where he is working as

Professor. He was associated with Montari Group of Industries

(1992-1995) where SIS test was used during selection and

promotion interview. He is also associated with Post-Graduate

Institute of Medical Education & Research Chandigarh as Guest

Faculty. Presently he is Editor in Chief of SIS Journal of Projective

Psychology and Mental Health. He has travelled widely and

conducted workshops on the applications of Somatic Inkblot Series

in various countries and lives in Chandigarh India.

SOMATIC INKBLOT SOCIETY is publishing its Journal SIS JOURNAL OF

PROJECTIVE PSYCHOLOGY AND MENTAL HEALTH a half yearly publication

in January and July. It has 2 Awards of $250 employing the use of Inkblot Tests

SIS & Rorschach.

For details please contact :

Wilfred A. Cassell, M.D., FAPA, APC, FSIS, Director, Somatic Inkblot Center,

President, Somatic Inkblot Society and Editor, SIS Journal of Projective

Psychology & Mental Health, 4501E, 104th Avenue, Anchorage, AK 99516

USA.

E-Mail : drcassel@gci.net	Web Site at http: //www.somaticinkblots.com

OR

B. L. Dubey, Ph.D., DPM, FSIS,

Editor in Chief, SIS Jr. of Proj. Psy. & Mental Health,

Director Somatic Inkblot Center India,

P.O. Box 1107, Sector 15 Post Office, Chandgarh-160015 (India)

Tele/Fax : 91-172-710986, Tel. : 91-172-710985

E-mail : sisdubey@rediffmail.com OR sisdubey@hotmail.com

Chapter 1

Introduction