2504743 – SAGE Publications, Inc. (US) ©

sis the therapist actively interprets for clients the significance of their statements, behaviors,
and dreams. But Freud cautioned that therapists should not reveal true meanings too early.
Beginning therapists are often tempted to interpret the unconscious meaning behind an act or a
statement as soon as they perceive it. However, this early insight could be threatening for an
unprepared ego, causing the client to construct new and stronger unconscious defenses.

When the timing is right, psychoanalysts interpret statements and dream symbols for their
clients. Freud provided an example of this interpretation in one of his famous cases. Dora was
an 18-year-old patient from an affluent family. She complained of headaches and other physical
problems. One area of trauma for Dora concerned a married couple, who Freud referred to as
Mr. and Mrs. K. Mrs. K. was having an affair with Dora’s father. To make matters worse, Mr. K.
had made sexual advances toward Dora. One day during therapy, Dora related the following
dream:

A house was on fire. My father was standing beside my bed and woke me up. I
dressed quickly. Mother wanted to stop and save her jewel-case; but Father said: “I
refuse to let myself and my two children be burnt for the sake of your jewel-case.”
We hurried downstairs, and as soon as I was outside, I woke up. (Freud, 1901/1953,
p. 64)

To the untrained ear, the dream seems innocent and meaningless enough, similar to dreams we
all have and give little thought to. But for Freud, the dream was filled with clues about the
causes of Dora’s problems. With a little questioning, Freud learned that shortly before the
dream, Mr. K. had given Dora an expensive jewel case as a present. With this information, Freud
had all the pieces to the puzzle he needed. As he explained to Dora,

Perhaps you do not know that “jewel-case” is a favourite expression for the female
genitals.… You said to yourself: “This man is persecuting me; he wants to force his
way into my room. My ‘jewel-case’ is in danger, and if anything happens it will be
Father’s fault.” For that reason in the dream you chose a situation which expresses
the opposite—a danger from which your father is saving you. Mr. K. is to be put in the
place of your father just as he was in the matter of standing beside your bed. He
gave you a jewel-case; so you are to give him your jewel-case.… So you are ready to
give Mr. K. what his wife withholds from him. That is the thought which has had to be
repressed with so much energy, and which has made it necessary for every one of its
elements to be turned into its opposite. The dream confirms once more what I had
already told you before you dreamt it—that you are summoning up your old love for
your father in order to protect yourself against your love for Mr. K. (p. 69)

Freud interpreted several important psychoanalytic concepts for Dora. He identified her use of
symbols and the repression of her true desires. He explained how she used reaction formation
—dreaming the opposite of what she really wanted—and how her repressed desires for her
father affected her behavior. Not surprisingly, Dora had difficulty accepting this interpretation at
first. As this example illustrates, clients must obtain a reasonable understanding of
psychoanalytic theory before they can appreciate the therapist’s interpretation of their dreams,
thoughts, and behaviors.

Ironically, one of the first signs that therapy is progressing is the development of resistance.
For example, clients might declare the sessions aren’t helping and they want to discontinue
therapy. Or they might lapse into long silences, return to material already discussed, miss
appointments, or insist certain topics aren’t worth exploring. These attempts at resistance
could indicate the therapist and client are getting close to the crucial material. The threatened
ego is desperately attempting to defend against the approaching demise of its defenses as
crucial unconscious thoughts are poised to burst into consciousness.

Another necessary step in traditional psychoanalysis is the development of transference. Here
emotions associated with people from the past are displaced onto the therapist. For example,
a client might talk to and act toward the therapist as if the therapist were a deceased parent.
Unconscious emotions and previously undelivered speeches buried long ago are unleashed,
feelings that often lie at the heart of the client’s disorder. Freud warned that handling
transference was a delicate and crucial part of the therapy process. He also cautioned

2504743 – SAGE Publications, Inc. (US) ©

therapists against countertransference, in which therapists displace their own feelings toward
other individuals onto the client.

From the outset, psychoanalysis has been controversial, and the debate about its effectiveness
has never ended (Gabbard et al., 2002). Nonetheless, a large number of practicing
psychotherapists identify their approach as “psychoanalytic” (Cook et al., 2010; Thoma &
Cecero, 2009). Recent reviews of carefully designed studies find evidence that psychoanalytic
therapies are often effective when treating a wide variety of psychological disorders
(Leichsenring, 2007; Leichsenring & Rabung, 2008; Shedler, 2010). However, these claims of
effectiveness have been met with skepticism (Beck & Bhar, 2009; McKay, 2011; Roepke &
Renneberg, 2009). Critics also argue that psychoanalysis, if it works, can often take years and
therefore is not as cost-effective as many short-term therapies. It is probably safe to say, like
most things associated with Freud, the controversies surrounding psychoanalysis are likely to
continue.

ASSESSMENT: PROJECTIVE TESTS

LO 3.4 Explain how psychologists use projective tests to assess
personality.

Psychoanalysts are faced with a unique problem when it comes to measuring the concepts of
interest to them. By definition, the most important thoughts are those the test taker is unable
to report directly. So how do psychoanalytic therapists and researchers measure unconscious
material? The solution is to bypass direct reports altogether.

Projective tests present individuals with ambiguous stimuli, such as inkblots or vague pictures.
Test takers respond by describing what they see, telling stories about the pictures, or somehow
reacting to the material. The tests provide no clues about correct or incorrect answers, which
makes each person’s responses highly idiosyncratic. One person may see a circus and an
elephant, whereas another identifies a cemetery and a woman in mourning. As the name
projective test implies, psychoanalysts consider these responses projections from the
unconscious. The ambiguous material gives test takers an opportunity to express pent-up
impulses. However, as with other expressions of unconscious impulses, the significance of the
response is not apparent to the test taker.

Some Popular Projective Tests

In 1921, Hermann Rorschach published a paper in which he described a procedure involving
inkblots that he used in his work with patients diagnosed with schizophrenia. Although
Rorschach died the next year at age 38, his work stimulated other psychologists who continued
to develop the test that still bears its creator’s name. The Rorschach inkblot test consists of 10
cards, each containing nothing more than a blot of ink, sometimes in more than one color. Test
takers are instructed to describe what they see in the images. They are free to use any part of
the inkblot and are usually allowed to give several responses to each card. Although some of
the cards may be quite suggestive, they are in fact nothing more than inkblots.

2504743 – SAGE Publications, Inc. (US) ©

This psychologist is administering one of the most widely used personality
tests: the Rorschach inkblot test. The participant tells the psychologist what
they see on the card; whether these responses provide a valid assessment of
their personality remains a controversy.

©iStockphoto.com/Oleh Veres

Inkblot test responses can be analyzed with any of several scoring systems developed over the
years. However, most psychologists probably rely on their personal insights and intuition when
interpreting responses. Unusual answers and recurring themes are of particular interest,
especially if they are consistent with information revealed during therapy sessions. For
example, most therapists would take note if a client sees dead bodies, graves, and tombstones
in the ambiguous images. Similarly, clients who see acts of self-inflicted pain or other violent
images probably provide therapists with topics to explore in future sessions.

The Thematic Apperception Test (TAT) is another widely used projective test. The TAT was
designed by Henry Murray (Chapter 7) and consists of a series of ambiguous pictures. Test
takers are asked to tell a story about each picture—who the people are, what is going on, what
has led up to the scene, and what the outcome is going to be. Although most of the pictures
contain images of people, facial expressions and the nature of the relationship between the
people are intentionally vague. Thus, test takers may see love, guilt, anger, or grief in the faces.
The characters may be fighting, plotting, loving, or unaware of each other. They may be in for a
happy, sad, horrifying, or disappointing end to their situation. Although therapists often rely on
their intuition when interpreting test responses, many relatively objective scoring procedures
are available. Examples of how psychologists use these procedures in research are presented
in Chapters 4 and 8.

Yet another projective test used by many therapists is the Human Figure Drawing test. Although
initially developed in the 1920s as a measure of intelligence, psychologists soon recognized
the test also could be used to measure important personality constructs (Handler, 1996). The
ambiguous stimulus in this test consists of a blank piece of paper and instructions to draw a
picture for the psychologist. In many cases, test takers are simply asked to draw a person, but
sometimes psychologists instruct them to draw a family or a tree. Although it has been used in
many ways, most often the Human Figure Drawing test is seen as an indicator of psychological
problems, particularly in children (Bardos & Powell, 2001; Matto, 2002).

2504743 – SAGE Publications, Inc. (US) ©

The notion that children’s drawings provide a peephole into their inner thoughts and feelings
has strong intuitive appeal. Schoolteachers often take note of children who never draw smiles
on the faces of the characters they sketch. Similarly, children who frequently draw monsters or
ghoulish creatures could be expressing some disturbing inward feelings. A glance at the
drawings by emotionally disturbed children presented in Figure 3.2 makes a persuasive case
that children sometimes express through drawing what they otherwise might not put into
words.

Description

Figure 3.2 Human Figure Drawings by Emotionally Disturbed Children

Elizabeth Munsterberg Koppitz. Psychological Evaluation of Children’s Human Figure Drawings. New
York: Grune & Stratton. 1968.

Evaluation of Projective Tests

Hundreds of studies have been conducted with projective tests, most often with the Rorschach
inkblot test. Responses to the inkblots have been used to predict everything from intelligence
to sexual orientation. Unfortunately, psychologists disagree on how to interpret most of this
research (Garb et al., 2005). Critics point to unacceptably low indices of reliability and frequent

2504743 – SAGE Publications, Inc. (US) ©

failures to find evidence for the validity of the test (Wood et al., 2010). One team of reviewers
concluded “there is currently no scientific basis for justifying the use of Rorschach scales in
psychological assessment” (Hunsley & Bailey, 1999, p. 266). Other psychologists challenge
whether the inkblot procedure should be described as a test at all. They argue that the
Rorschach is more accurately characterized as a highly structured interview.

But there are two sides to every controversy, and advocates for the Rorschach test raise
several important points in its defense. First, one needs to separate good studies designed to
test appropriate predictions from poor studies that attempt to tie test responses to any and all
behaviors (Weiner, 1995, 1996). When reviewers look at results from sound studies making
reasonable predictions, they find evidence for the test’s usefulness (Choca, 2013; Gronnerod,
2004; Mihura et al., 2013; Viglione, 1999). Moreover, newer, more rigorous systems for coding
Rorschach responses have proved far more reliable than earlier methods (Erdberg, 2019;
Viglione & Hilsenroth, 2001; Weiner, 2001). Second, establishing good validity data for
projective tests is more difficult than it is for other kinds of personality measures. If a therapist
concludes from an inkblot test that a client has a certain unconscious conflict, what objective
evidence can the therapist provide to establish the validity of this claim? A therapist could
make any claim about unconscious material, and we would have no way to know whether the
therapist is correct. Indeed, if objective indicators of unconscious thoughts existed, therapists
wouldn’t need to use projective tests in the first place.

Despite the controversy, the Rorschach and many other projective tests continue to be widely
used (Wright et al., 2017). And this use extends far beyond psychotherapy. For example,
projective tests are often used by school psychologists to evaluate social and emotional
adjustment in children (Hojnoski et al., 2009) and by psychologists working with law
enforcement and court officials (Gacono & Evans, 2008).

One reason for the popularity of projective tests is they may uncover information not easily
obtained through other procedures. For example, therapists working with children sometimes
allow a child to play with a family of dolls. Imagine a child who acts out a drama in which the
mother and father dolls are cruel to the child doll. The child might be revealing something
about the situation at home that the child cannot easily express through other means.

Then again, many psychologists warn against overinterpreting responses to projective tests.
The child in the previous example could merely be acting out a scene from a recent television
program. Because the validity of projective tests remains open to challenge, psychologists
usually are advised not to rely heavily on the tests when making diagnoses (Wood et al., 2002).
Instead, projective test results should be viewed as but one source of information about a
client. They should be taken into consideration along with information collected through
interviews, observations, case histories, and other psychological tests.

STRENGTHS AND CRITICISMS OF FREUD’S THEORY

LO 3.5 Describe the strengths and criticisms of Freud’s theory.

None of the approaches to personality covered in this book can spark an argument as quickly
as Freudian theory. Every clinical psychologist and personality researcher has an opinion about
the value and accuracy of Freud’s ideas. Although few accept all of Freud’s observations and
postulates unquestioningly, adherents of the Freudian view strongly defend the basic
assumptions Freud made about the nature of human functioning. Critics tend to be equally
passionate in their evaluations.

Strengths

Even if all of Freud’s ideas were to be rejected by modern personality theorists, he would still
deserve an important place in the history of psychology. Freud’s was the first comprehensive
theory of human behavior and personality. Most subsequent personality theorists have found it
necessary to point out where their theories differ from or correct weaknesses in Freud’s works.
Many of these psychologists built their theories on the foundation laid by Freud, borrowing key
concepts and assumptions. As discussed in Chapter 5, many of those who studied with Freud
or were trained in the Freudian tradition went on to develop and promote their own versions of
psychoanalytic theory. In short, Freud’s observations set the direction for subsequent
personality theory and research. Even recent approaches to personality, although far removed
from psychoanalytic theory, are probably influenced in many ways by Freud’s ideas.

Freud also can be credited with developing the first system of psychotherapy. Today, treating
psychological disorders through discussions with a therapist is widely accepted. Although
psychotherapy might have evolved without Freud, it certainly would not have evolved the way it

2504743 – SAGE Publications, Inc. (US) ©

did. Techniques such as free association, hypnosis, and dream interpretation have become
standard tools for many therapists. Indeed, some clients are disappointed to find their therapist
has no couch and does not plan to hypnotize them or interpret their dreams. Nonetheless,
surveys reveal a large number of young as well as experienced psychotherapists identify their
perspective as “psychoanalytic.”

In addition, Freud can be credited with popularizing and promoting many important
psychological concepts. As discussed in Chapters 4, 6, and 16, many of the topics researched
by psychologists today have their roots in one or more of Freud’s concepts, even if they no
longer carry much of the Freudian flavor. By placing these concepts on the menu of
psychological topics many years ago, Freud influenced the subject matter of much personality
research today.

Criticisms

Although Freud’s ideas were so revolutionary that they were rejected by many in the medical
and academic communities at the time, some writers argue Freud’s ideas may not have been
so original or groundbreaking after all. For example, one investigator discovered that between
1870 and 1880 at least seven books were published in Europe that included the word
unconscious in the title (Whyte, 1978). Because the educated elite in Europe was relatively
small, another writer concluded “at the time Freud started his clinical practice every educated
person must have [been] familiar with the idea of the unconscious” (Jahoda, 1977, p. 132).

A couple of points can be offered in Freud’s defense. First, Freud often cited earlier works on
topics similar to the ones he was introducing. Second, Freud was the first person to organize
many loosely related ideas into one theory of human behavior. Although many of Freud’s
contributions may have had precedents in earlier writings, there is a large difference between
introducing an idea and organizing, integrating, and developing many ideas into a
comprehensive model of human behavior.

A second criticism often made of Freudian theory is that many aspects of the theory and
psychoanalysis are not testable. For example, if a Freudian psychologist decides a client has a
strong unconscious hatred for her sister, what sort of evidence would demonstrate the
conclusion is incorrect? What if the client says she is not aware of any negative feelings
toward the sister? The psychologist might say she is repressing them. What if the client
describes how much she loves her sister? Obviously, a reaction formation. The problem is if
there is no way an aspect of the theory can fail to be supported, it cannot be truly tested, and
this makes the theory considerably less useful to scientists.

It would be unfair to say Freud was unconcerned about finding evidence to support his ideas.
However, Freud’s heavy reliance on case studies to support his theory falls short of the
standards required by many scientists. Among other concerns, all the information we have
about these cases was filtered through Freud. It is possible that Freud recognized and recorded
only the statements and behaviors that supported his theory and ignored or failed to notice
those that did not. It also is possible Freud caused his patients to say the things he wanted to
hear. Psychotherapy clients can be highly vulnerable to accepting whatever a person in a
position of authority tells them and may be highly motivated to please that person. It is
interesting to note that when interpreting Dora’s dream, Freud wrote the dream confirmed what
he already knew.

SUMMARY

LO 3.1 Discuss some of the early experiences and discoveries that laid the foundation for
Freud’s theory.

The first comprehensive theory of personality was developed by Sigmund Freud. Aft