Harrow Er 1950
Harrow Er 1950
Harrow Er 1950
CLINICAL PSYCHOLOGY
VOL. VI JULY 1950 No. 3
this study may be described as follows: group exist, the test is not advocated for
individuals who are experiencing psycho- screening the normal from the abnormal,
logical difficulties and who are seeking the adjusted from the maladjusted, but
psychiatric assistance in their handling of rather to highlight the type and extent of
them. I n contrast to this, the hundred a given psychological problem and its
individuals who comprise our control manner of expressing itself, this latter
group were persons without overt psycho- providing a clue to other, inter-related
logical symptoms. W e wish to make it psychological processes in all persons.
clear, however, that we are refraining
from presenting statistics on the differ- Instructions for Administration. T o the
ences between “normals” and patients. individuals to whom this test was given,
This is a deliberate omission to focus the instructions were always as follows :
attention on an unsatisfactory state of af- “What is the Most Unpleasant Thing that
fairs in experimental clinical procedure. you can think of?” or, alternatively, “I
Who are “normals” and who should con- want you to think of the Most Unpleasant
stitute “control subjects?” In experi- Thing that you can imagine.” Then, after
mental psychology, the psychology of the a slight pause, the examiner continues,
laboratory and of the academic world, the “And now I want you to draw it for me,”
experimenter can readily divide rats and at this point he hands the subject a
which are to run mazes or persons who drawing pad and a pencil. H e then adds
are to learn under different conditions into the further instructions, “You can draw
“equated groups,” and sit back comfort- it in actuality, schematically, or symbol-
ably in the knowledge of satisfactory sci- ically, whichever you please.” When the
entific procedure-exposing one group to subject returns his drawing, he is asked to
certain controlled variables to which he describe it and to give free associations
does not submit the others. There is a to it.
grave danger, however, that, in order to The paper used in all cases was stand-
find (‘controls” for experimental clinical ard 8% inch by 11 inch. A carbon under-
projects, the too academically trained psy- neath provided a second copy and also gave
chologist will consider all those not in his interesting clues as to pressure, erasing,
particular clinic or hospital or not referred and shading. Originally we also asked
to him for examination as “normal per- for a drawing of the Most Pleasant Con-
sons” or persons without psychological cept, but found in this instance much more
difficulties. trivial, banal, and stereotyped expressions
There are many pitfalls and fallacies in-
volved here, however. If one takes as which rarely, if ever, provided important
“controls” an unselected group of indi- information.
viduals and contrasts them with the par- RESULTS
ticular patient group under study, one Reactiom of the Subject to the Test In-
may well find, on more exhaustive scru- structions. W e may estimate the subject’s
tiny, that among the “controls” are per- readiness to respond on a six point scale.
sons who also have sought or are seeking
expert psychiatric aid elsewhere. There 1. The subject immediately takes the
are individuals who have successfully com- pencil, looks at the examiner in a
pleted or are undergoing an analysis. somewhat accusing or penetrating
fashion, and promptly draws some
Into which group do these persons fall ? idea, concept, or object, as if, by
Do they then cease to be “normals ?” Are the question, the examiner had
they to be classified as “normals” when triggered a response which was
they take the test under some conditions waiting for the word “go.” This
and “abnormals” when they take it under over-speedy reaction is frequently
others? It is not necessary to belabor the accompanied by a spoken or ges-
point, provided that a warning and ex- tured question on the part of the
planation are conveyed. And while cer- patient, ‘‘How did you know I had
tain differences between our especially re- this unpleasant thought ?” The
ferred group and our random sample graphic products of persons who
THE MOST UNPLEASANT CONCEPT TEST 215
respond in this way are frequently thing unpleasant,” and despite en-
of a symbolic type, epitomizing a couragement and finally such sug-
state of mind or psycholo ical expe- gestive questions as, “Are there
2.
f,
rience. (See Figures 4, and 6 . )
Type 2 may be considered the “aver-
really no unpleasant things in the
world ? cannot bring himself to enter
age-speedy’’ type in the sense that into the test situation.
the subject ponders for a few sec-
onds, as though surveying a series No statistics are available at this writ-
of possible alternative answers, then ing on the distribution of our 500 sub-
without ado or conflict, he records jects, since these various types of reac-
his decision, sometimes with some tions emerged slowly in the experiment-
slight apologetic comment that, al- er’s mind in the course of the work with
though he cannot draw well, it will the test. However, one or two general-
be seen what it is that he is attempt- izations are in order. The more normal,
ing. This type of reaction corre- or let us say the performance of persons
lates highly with what have been who are less seriously disturbed (when
determined as “popular” answers in correlated with other test findings and
this test. (See Figure 1.) psychiatric evaluation), correlate with Re-
3. The third type of response may be actions 2 and 3. A certain amount of hesi-
called the “average-slow.” This is tation, a laughing comment on inability to
similar to Type 2 except that the draw with, nonetheless, a courageous at-
subject is more hesitant in making tempt to conform to the test instructions,
his decision; he puts up a greater would seem to equate with a minimum of
barrage of defense in terms of his psychological disturbance at the time of
inability to draw satisfactorily. Fre- the testing. This is also brought out in
quently the lines of the drawings the study of random groups in which this
are tentative here. The subject is unquestionably the prevailing reaction.
requires reassurance in order to con- On the other hand, instantaneous por-
tinue. trayal of an idea which seems to have been
4. Reaction Type 4 may be described waiting for expression, extreme reluctance
as slow and disturbed. Here the to portray an idea because it is too disturb-
subject knows what specific and ing, the inability to find anything unpleas-
personally oriented experience he ant in the world-these have correlated
wishes to portray, but finds its por- with more seriously disturbed individuals
trayal so disturbing that he cannot when, again, they have been appraised by
bring himself to commit it to paper. the total test battery or by psychiatric
Reoeated reassurances are neces- evaluation.
sary, and much encouragement is Content: The Subject Matter of the Most
useful. Unpleasant Concept. What does the sub-
5. This type of delay reaches its ex- ject draw in this test situation? Do we
treme at a point where there is re- find 500 different ideas of unpleasant-
fusal to commit the highly disturb- ness? By no means. Are there types
ing idea to paper. Of our series of of answers which can be considered as
500 cases we found several persons “popular,” psychologically neutral, relat-
who were unable to complete or con- ing to an unbiased and somewhat objective
tinue the test despite all help and appraisal of the unpleasant? It would
pressure. In one instance a mo- seem so. W e have attempted to bring an
ment of panic-like anxiety was initial state of order to our findings by
evoked. Concerning the nature of introducing five major divisions or classi-
this, an interesting account was fications of our material, with various sub-
given the following day by the pa- divisions. We will deal first with a dis-
tient to his therapist. cussion of the major groupings and then
6. Reaction Type 6 is failure, but of consider the subheadings in detail. As a
a different order. The individual starting point, the following diagram may
here literally “cannot think of any- be considered as showing graphically the
216 M. R. HARROWER
I
L-
RELATING TO SEX
Failure
different “directions” in which the un- A further look at the diagram shows
pleasant may lie. that, on the arrow to the left, there is a
We may start from a neutral central large group of answers which may be
area which is highly realistic, impersonal, considered as The Unplensant Within.
logical, and universal. I have called this Here all objectivity and universality are
area : “War, the Atomic Bomb, or Cruelty lost, and the individual is concerned with
of Aggressor Nations.” It is impossible his own particular psychological “hell.”
I have grouped here synzboZic portrayal of
to quarrel with the legitimacy of this area states of mind, bizarre fantasies, recurrent
as a Most Unpleasant Concept. More- dreams, expressions of phobias, etc.
over, it will be noticed that in this in- The arrow to the right in the diagram
stance the word (‘unpleasant” has been points to the Unpleasant as Located Out-
expanded to its maximum capacity to ward but now attached to some specific
mean “terrifying,” “terrible,” and “ter- and definitely non-world-shaking event.
rible to many.” W e have put as an outer Again, there are grades of legitimacy here,
ring to this neutral area those drawings the house on fire having greater validity,
which represent death, pain, or illness. one might say, than a small bug to harbor
While one cannot quarrel with the legiti- or contain human distress and misery.
macy of the unpleasantness of a violent Diagrammatically represented as going in
death, nonetheless this group has a little a different direction from the “neutral
less of the universality of the first group area,” we have listed such examples as
in that the individual is concerned with his “Evasion through the Trivial, Displace-
own death rather than the death of many, ment, Dissociation, and Failure.” And,
or he is concerned with the death of some- in yet another direction, “the Unpleasant
one close to him.’ Located in Sex.” Having diagrammed the
2. It should be noted that merely to consider “direction” in which the unpleasant may
these concepts as the ‘‘popular” does not mean lie, a more detailed breakdown of the find-
that in each and every case specific and inter-
esting associations which may be vitally relevant ings is presented in Table 1.
to the psychological problem may not be elicited. as a starting point to contrast other types of
We are using this block of associations merely reactions.
T H E MOST C N P L E A S A N T CONCEPT TEST 217
1. Cltrssificatioii of veacfioris orr “The Alost liriplcasnrit Concept Tcst” of 500
TABLE.
raws iiridrvgoirig psj~rhotkrvnpy
War, the atomic bomb. cir cruelty as Characteristic responses of “better pcrswiality
expressed hy aggressor nations iiitegration” as reflected in the Rorschach
Test, lack of distortion of thought prucesses
as reflected in the Siniilarities test of the
Wechsler-Rellevue. In the caw of the ma-
jority. tlrawii siiniewhat crudely hut realis-
tically : does not correlate with the psychiatric
cvaluation uf borderline psychosis.
Death .\ssociatiiins herc are much less iieutral and u n -
By plane versa1 than to the abovc. A41i1011gthis group
By drowning are the drawings of extremely disturbed per-
By hanging b o n s . as well as those with less acute prob-
By gashing IC.n1s,
Death of a specific person
Coffin as symbol
By automobile accident
Pain and illness Gi\-en hy individuals with actual, distressing
Ihysical symptoms and pains (i.r. from Boeek
sarvoid) by conversion hysterics, hypochon-
driacal individuals. Apparently of no diag-
nostic value.
Bizarre fantasies and dreams Again. some similarity with the synibolic par-
trayal of a state of mind. Often extremely
rcvealing in the uncovering of crucial ma-
terial. Closely related to the type of free
association which may be elicited to original
or bizarre answers oii the Rorschach Test.
TABLE
1. Coiiclrrdcd
Classificatioir Rriiitrrfis
FIG. 1. Showing a n imaginative presentation of w a r and the atomic bomb by a gifted 13-year-old girl.
220 M . R. H A R R O l V E R
FIG. 2. A symbolic representation of war and the atomic bomb drawn by a person with on acute
sexual problem.
THE MOST UNPLEASANT CONCEPT TEST 221
FIG. 3. Drawings of snakes, bugs and octopi, showing neurotic preoccupation with the Unpleasant
Without. Fin. 30. Introduction of a bizarre feature in a borderline case "Rat eating a baby's face."
222 M . R. HARROWER
FIG. 4. Symbolic portrayal of a mental state representing psycho!ogical isolation (the Unpleasant Within).
T H E MOST UNPLEASANT CONCEPT TEST 223
FIG. 5. Drawings of "soft, clutching, learing shadow" epitomizing fear to the person.
224 M. R . HARROWER
FIG. 8. Drawing interpreted by patient as "A mechanized octopus with tentacles of steel and naked
light bulbs for claws. The circles in his body seem to be subway straps, and now that I can see it again,
the pattern of the tentacles also form a brightly-lit corridor, bare-walled and bleak."
T H E MOST UNPLEASANT CONCEPT TEST 227
FIG. 9. This drawing was described by the subiect as follows: "Disintegration of the personality-
loss of selfhood. Would mean loss of vision. The head within the circle signifies recession-more than
recession-submersion of consciousness. of sensation. of feeling. limbs, helter skelter and any-which-way
signifies destruction of purpose and direction; excentric to the circle to show existence of movement and
contact, but indiscriminate and uncoordinated movement, and blind, unfeeling contact."
228 M. R . HARROWER
Y '7 \
FIG. 11. Drawing representing the phantasy "the eyes of God in which a r e reflected the burning of
souls in hellfire."
FIG. 12. Drawing representing the paranoid idea of "others laughing a t me and rushing my downfall."
230 M . R. HARROWER
- :-
rcr,
FIG. 13. Drawings portraying the state of mind called "psychological imprisonment." Drawing C,
reflecting early schizophrenia, represents "an ice cube in which I am imprisoned, unable to reach my
children." Drawing D was drawn by a mon who had defrauded the government of over one million
dollars in taxes.
THE MOST UNPLEASANT CONCEPT TEST 231
FIG. 14. Drawings representing fears of various forms of aggression. Drawing B by a girl terrified
by her own homosexual desires: drawing C by a latent homosexual; drawing D by a patient rated by his
therapist as "the most masochistic person I have ever treated," who accepted unbelievable humiliations
from his wife and considered the Most Unpleasant Thing to be a Woman attacking a man (note the
enormous index finger, possibly a phallic symbol, on the woman).
232 M. R . HARROWER
FIG. 15. Drawings portraying unpleasant mutilation concepts reloted to homosexuality. Drawing A
i s an overt expression, while B and C reflect the repeated occurrence of castration feors shown by persons
locking a n arm or leg.
T H E MOST UNPLEASANT CONCEPT TEST 233
ILLUSTRATIVE
MATERIAL terms of guilt in connection with homo-
sexual activities.
The illustrations which follow have 3. The portrayal of bizarre fantasies
been selected as expressing as well as pos- seems, in some instances, to provide relief
sible the material epitomized in the above to the individual concerned. It is sonie-
tables, Needless to say, it has been pos- how a sharing of a state of mind which has
sible to reproduce only a fraction of those eluded description. Now both the exam-
which would have made the reading of iner (in his role of therapist) and the pa-
this paper more interesting. Moreover, in tient can refer objectively to “my state
making our reproductions as simple line of tension.”
drawings, we have lost a great deal of the 4. Progress in therapy is most interest-
interesting variation of shading and qual- ingly revealed in longitudinal sections as
ity of line. the individual passes from one buried un-
pleasant experience to another. In con-
SUMMARY
A N D CONCLUSIONS
nection with this, the test may frequently
A new five-minute projective device foreshadow material which is subsequently
called “The Most Unpleasant Concept brought to life.
Test’’ is described. Based on a qualitative 5 . One of the advantages of this test is
analysis of the results obtained from 500 its diagnostic value. By and large, our
subjects undergoing psychotherapy, a point of view in regard to “diagnosis” is
tentative classification is outlined showing that it is the least important part of the
the basic types of concepts portrayed in contribution of the projective techniques.
this collection of drawings. It is concluded Nonetheless there are certain cases where
that this test would make a valuable addi- an underlying schizophrenic process must
tion to a diagnostic personality appraisal be confirmed or ruled out before further
battery for the following reasons : treatment can be decided upon. Inclusion
1. This procedure, when imbedded in of this test in the battery has, we feel,
a series of other projective techniques strongly reinforced our objective evidence
which are less direct, has the interesting in such cases. W e refer here to the sym-
effect of shock or surprise. Frequently, bolic portrayal of states of mind as rein-
completely forgotten experiences are re-
covered and recorded, to the subject’s forcing the “borderline” diagnosis and,
own surprise. For example, an early conversely, to the “small animal” draw-
memory of incestuous relations with a ings as consistent wtih the neurotic pic-
parent was an unexpected psychological ture.
discovery in the sense that it had been REFERENCES
completely repressed for a long period. 1. FRANK, K. Projective methods.
LAWRENCE
Drawing two people in bed, the individual (A Monograph in Ameriwn Lecture Series
suddenly stated, “Oh, that is me and my in Psychology) Ed., Molly Harrower;
father !” Springfield : Charles C. Thomas, 1948.
2. This test allows a deeper insight to 2. HARROWEX, MOLLY.The unplewant con-
cept test. (A monograph in American Lec-
be gained from answers given to some of ture Seriks in Psychology) Ed., Molly Har-
the other projective techniques. For ex- rower. Springfield : Charles C. Thomas.
ample, a subject who gave a highly un- (In preparation.)
usual answer to the butterfly on Card 111 3. MACROVER, KAREN. Personality projection
in the dramkg of the hummt jigure. (A
of the Rorschach, namely, “two doors at Monograph in American Lecture Series in
the end of a long corridor,” made a very Psychology) Ed., Molly Harrower. Spring-
similar drawing in the Unpleasant Con- field: Charles C. Thomas, 1948.
cept Test, but added two prison cells at 4. SPITZ, RJZNE.The role of training in psy-
choanalvsis in the develomnent of research
the near ends of the corridor in which he in clini&l phychology. T>aining ilz Cli&cal
and a friend were incarcerated. Associa- Psychology. New York: Josiah Macy Jr.
tions to this were highly revealing in. Foundation, 1947.