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STILL CRAZY AFTER ALL THESE YEARS: THE MMPIAND RORSCHACH INKBLOTS: MEASURING

NORMALITY IN AN ABNORMAL WORLD.

W. Dennis Duggan, F.C.J.© NOVEMBER 2006

Harlan Howard, Country Music Hallof Famer, wrote such hits as“I fall to Pieces” and“ H e a r t a c h e B y T h eNumbers.” He once saidthat country music is “threechords and the truth.”Validating that observation,Waylon Jennings sang thathe had always been crazybut it kept him from goinginsane. So, what does itmean to be normal orinsane? Can you measureit with a test? Can youprove it in a court of law?

Se ve ra l t im e sthroughout history theCourts have gone off the deep end. Mostoften it had something to do with humanrelations—how those who hold powerview and treat persons who hold nopower. For example, in 1857, in the DredScot decision, the Supreme Court held1

that black people were private property.

(“[The Negro] had no rights which thewhite man was bound torespect.”) In 1896, in thePlessy case, the Court held2

that separate but equal didnot violate a black person’sconstitutional rights In 1928,in Buck v. Bell, they held3

that the forced sterilization ofa woman was constitutionallypermissible. In 1944, inKorematsu v. UnitedStates, the Supreme Court4

held that the governmentcould intern AmericanCitizens in concentrationcamps. Until 1954, it wasconstitutionally permissible

to force black children to go to all blackschools. That policy was ended withBrown v. Board of Ed. It would take5

another thirty years of litigation (andoccasionally the intervention of the 101st

Airborne Division) to implement Brown.Segregated courtroom seating was

Hermann Rorschach

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permitted until 1963, when it wasdisallowed by the holding in Johnson v.Virginia. Up to 1967, it was a felony in6

many states for a black person and whiteperson to marry. Loving v. Virginia7

determined that was a violation of equalprotection. All of the propositions of lawhighlighted above, when in effect, wouldhave had the support of the large majorityof the American people. Today theywould be considered either reactionary orracist.

In each of the cases justmentioned, the persons beingdiscriminated against were all consideredless worthy human beings. In the earlydays, their less worthiness was just takenfor granted because God had deigned itthat way. The irony implicit in thosebeliefs would be lost on those who wouldprofess that the United States wasfounded on Judeo-Christian values. Theyskipped over the fact that Jesus ofNazareth was a man of the downtroddenand powerless who would preach thatevery person was created in the imageand likeness of God. Later on, when thebest efforts of biblical interpretation werenot sufficient to support the policies ofdiscrimination, the courts and the lawturned to the the psychiatric andpsychological industries for support. Insome cases, the psychiatric industryturned to the courts for validation.They—the courts and the law, andpsychology and psychiatry—wouldbecome symbiotic parasites. No exampleof this symbiosis was more harmful tomore people than the eugenicsmovement.

The father of the eugenicsmovement was Sir Francis Galton (1822-1911). Galton was Charles Darwin’scousin and it would be the misuse ofDarwin’s theories, advanced moststrongly by Social Darwinist, HerbertSpencer (1820-1903), that would propelthe eugenics movement deeply to thedark side. It was Herbert Spencer who

would declare that God ordained thesurvival of the fittest—Carles Darwinnever used those words. The SocialDarwinists would provide the intellectualand scientific support for unimaginableforms of discrimination up to andincluding Nazi policies that led to theHolocaust

Eugenics, in Greek, means goodbirth. The goal of the movement was toupgrade the stock of humanity byimproving breeding, sort of like what wehave been doing for years to get fasterhorses—with little success. If societycould only get men of distinction andwomen from the upper class to breedmore exclusively and more often, societywould indeed improve, according to theeugenics movement.

Both the law and the psychiatricindustry (which signed on to thismovement with great fervor) needed atest case. They needed the imprimatur ofthe Courts to validate their plan to forciblysterilize “feeble” minded women. Theyfound a helpless victim in Carrie Buck.

In Buck v. Bell, Justice OliverWendell Holmes authored his mostignominious decision. He wrote that theVirginia sterilization law was a justifiableact of the police power of the statebecause “three generations of imbecilesis enough.” Holmes, a thrice wounded8

Civil War veteran, reasoned that if wecould ask a soldier to risk his lifedefending his country, we could certainlyask a retarded women to give up herfertility so that more “imbeciles” would notbe born. The forced sterilization of menand women considered to be the dregs ofsociety would continue apace. Over50,000 Americans would become thevictims of this intersection of junk sciencewith junk law. The Nazi’s would useBuck v. Bell in their defense at theNuremberg trials. If you think that any ofthis is an exaggeration, listen to astatement made in 1911, by the PublicEducation Association of New York:

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“Feeble-minded womena r e s o u r c e s o fd e b a u c h e r y a n dlicentiousness whichpollute the lives of youngboys and youth in thecommunity, disseminatedisease, and bring youngchildren into the world torepeat their destiny.

Hermann Rorschach was born inZurich in 1884. After witnessing his firstautopsy in medical school he had adream that he saw his own head cutopen. He viewed this as a sign to turn histalents to the unlocking the secrets of thehuman personality. At age 25, Rorschachwas working at a mental hospital and henoticed how expressive some patientscould be when given the chance to drawor paint. Rorschach took this a stepfurther and showed them incongruentpictures such as a green cat or a red frog.He then came upon the idea of using aprop from what was then a commonparlor game, inkblots. He noticed thatpersons suffering from schizophrenia haddistinctive responses to the inkblotscompared with other patients.

Rorschach thought he had comeupon a compelling diagnostic device. In1917, he published his findings in“Psychodiagnostics.” The book would notbe translated into English until 1942.However, that did not seem to hinder thepopularity of the Rorschach Test.Rorschach died in 1922 at age 38 but hiswork was carried on by others. It is apiece of historical irony that Rorschachperformed his tests with fifteen inkblots ofhis own devising. His publisher told himthat it was too expensive to reproduce allfifteen diagrams in the book and theycompromised on ten. Those ten inkblotsare still the standard. (What would theother five have revealed?)

The proponents of the RorschachInkblot Method made grandiose claims asto its diagnostic power. Some called it apsychological microscope, others afluoroscope into the psyche, still others anx-ray of the personality. The Rorschachtest was subject to at least five differentinterpretive methods but that did notseem to diminish its popularity. It gotunder full sail after World War II whenDouglas Kelly, the chief psychiatrist forthe Army in Europe, brought back theresults of the “Nazi Rorschachs.” Kellyhad been given full access to theNuremberg defendants such as HermannGoring and Rudolf Hess. Kelly expandedhis interviews with the Nazis in a booktitled “22 Cells in Nuremberg” andextrapolated his findings to a generaldescription of German Society.

The Rorschach test is one of themost popular psychological testsadministered by psychologists andpsychiatrists. But are the resultsadmissible in evidence? Under the Fryetest, it no doubt meets the generalacceptance test but can it meet theDaubert rate of error test?

Starke Hathaway was born in 1905in Marysville, Ohio. While working at theUniversity of Minnesota Mental Hospital inthe 1930's, he noticed a need to classifymentally ill patients to determine theirsuitability for treatment. At that time, twoof the most popular methods for treatingthe mentally ill were electroshock therapyand insulin coma therapy. ICT involvedusing a high dose of insulin to induce acoma in the patient. This treatment wasfound to improve the condition ofschizophrenics. The downside was that ithad a 10% mortality rate. This was anextremely risky procedure to administer toa patient, especially if the patient was notsuffering from schizophrenia. How tomake a solid diagnosis was the problem.Hathaway decided to let the patients vote.

To design the “ballot,” Hathawaywaded through every source he could find

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to assemble a list of the varioussymptoms that manifested themselves inmental disorders. He then put together alist of questions, the answers to which hethought would reveal the symptoms ofany given mental disorder. He startedwith over a thousand questions which hepared down to some 500. With his test inhand, he started administering it to thepatients but what to measure it against?

All tests need an answer sheet butwhat were the “correct” answers toHathaway’s test. He needed to give thetest to “normal” people to get a baseline.How to find normal people in Minnesotawhere most of the women are strong, themen handsome and the children aboveaverage? Why, of course, give it to thefriends and family members coming tovisit patients in the medical hospital. Thiswas the control group. It consisted of 724people. They were all Minnesotans, allwhite, mostly married, protestant andScandinavian with eighth gradeeducations. They became known as the“Minnesota Normals” and their normalcywould be the American Standard ofmental health for the next fifty years.

Hathaway named the test theMinnesota Mulitphasic PersonalityInventory. By giving it this name,Hathaway unintentionally assured that histest would be used far beyond what wasoriginally intended. Hathaway was hopingfor a tool that would diagnose personswith mental illness into broad categoriesthat would then be used to administersuitable treatment; for example, forschizophrenia or depression. However,the MMPI ended up becoming a true“personality inventory” used to classify thepersonalities of normal people. Itsadvantage over other tests, such as theRorschach, was that it was gradable andquantifiability. It could be interpretedmechanically. It was comprised of 504true-false questions that could be gradedby a chart and eventually a computer. Itwas sort of like having your blood work

done, which shows if your white bloodcount, potassium or creatinine levels areout of the normal range.

Over the next fifty years the MMPIwould be administered to millions ofpeople. However, while the baselineinformation for those tested dramaticallyincreased, the “normals” were thosesame old 724 Minnesotans from the 1938survey. Were they still sane after allthese years? Efforts to update the MMPIwere the psychological equivalent ofwriting the King James Bible. A newcontrol group of 2400 normal people weresurveyed and a new test questionnaire,the MMPI-2, was issued in 1989.However, of the 504 original questions(now 567), over 400 remained the same.They must be read to be believed. Hereis a sample of some of the true falsequestions on the test.

1. I like mechanics magazines.

20. I am very seldom troubled by constipation.67. I like poetry.

72. My soul sometimes leaves my body.74. I would like to be a florist.

80. I would like to be a nurse.

86. I like to go to parties where there is lots of loud fun.111. I have a great deal of stomach trouble.117. I have never vomited blood or coughed up blood.119. I like growing flowers or growing house plants.128. I like to cook.

132. I believe in the life hereafter.

133. I would like to be a soldier.

139. I would rather win than lose a game.143. I am neither gaining nor losing weight.149. The top of my head sometimes feels tender.

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171. I am against giving money to beggars.176. I have very few headaches.

191. I would like to be a journalist.

193. In walking, I am very careful to step over sidewalk cracks.282. I have been told that I walk during sleep.294. My neck spots with red often.

340. I love to go to dances.

343. I enjoy children.

370. I like parties and socials.

392. Lightning is one of my fears.

397. A windstorm terrifies me.

401. I have no fear of water.

404. I have no trouble swallowing.

407. I deserve severe punishment for my sins.416. I have strong political opinions.

417. I would like to be an auto racer.

426. I used to play hopscotch and jump

rope.

427. I have never seen a vision.

435. I am often afraid of the dark.

438. I dread the thought of an earthquake.453. I have no fear of spiders.

462. I am not afraid of mice.

465. I like repairing a door latch.

467. I like to read about science

533. I forget where I leave things.

Let’s assume for the moment thatboth the MMPI and the Rorschach Testare valuable tools—for the use bypsychologists and psychiatrists—for thediagnosis and treatment of mental illness.Does that mean that they are equallyvaluable to judges to help them determinethe best dispositions for juveniledelinquents, persons in need ofsupervision, parents found to haveneglected or abused their children or toallocate child custody rights? Hold on I

say.9

To determine the results of anypsychological test requires the opinion ofan expert. Expert opinion is governed bythe rules of evidence. These are to foundin three main places. The body of lawformulated under the seminal cases of (1)Frye v. U.S. (293 F. 1013 [1923]) and(2)Daubert v. Merrill Dow (509 U.S. 579[1993]) and (3) Federal Rules of EvidenceSection 702. Frye was a two pagedecision from the D.C. Court of Appeals.It held that the results of a lie detector testthat measured only blood pressure werenot admissible because the test did nothave general acceptance by scientists.The general acceptance test ruled theroost for seventy years, despite the factthat it would not have accepted, if theytestified at the time, the findings ofCopernicus, Galileo, and Keppler aboutplanetary motion. Nor would it have givena friendly ear to Einstein trying to explainE= mc .2

Daubert modernized the law ofevidence as it applied to expert opinionsby formulating a rule of flexibility thatmade the judge the “gatekeeper.” UnderDaubert, general acceptance would notbe the only test. The court could look atseveral factors, including the rate of errorof the test results, whether the scienceinvolved had been peer reviewed andwhether the underlying science could betested. How would the MMPI and the10

Rorschach measure up if challengedunder Daubert? No doubt, both testswould pass the general acceptance Fryetest, but what are each test’s rate of error.Can the underlying science of either testbe tested. If they work, why do theywork? Let’s start with the rate of errorand show me the data!

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1. Dred Scott v. Sanford, 60 US 393 [1857]

2. Plessy v. Ferguson, 163 US 537 [1896]

3. Buck v. Bell, 274 US 200 [1927]

4. Korematsu v. United States, 323 US 214 [1944]

5. Brown v. Board of Ed., 347 US 483 [1954]

6. Johnson v. Virginia, 373 US 61 [1963]

7. Loving v. Virginia, 388 US 1 [1967]

8. The decision in Buck v. Bell rested on lies, fraud, concocted and suppressedevidence and blatant conflicts of interest. For starters, the Plaintiffs hired and paid CarrieBuck’s lawyer. Carie Buck was not feeble minded but that evidence was suppressed.However, she was a vulnerable defendant for a test case. She was in the mental institutionafter being abandoned by her foster parents after their nephew raped and impregnatedCarrie. Neither was Carrie’s daughter, Vivian, an imbecile. Her third grade report cardshows that she received all A’s and B’s. After being sterilized, Carrie Buck would bechildless—as would Justice Oliver Wendell Holmes, Jr. and his wife.

9. For a complete discussion of the MMPI, the Rorschach and other tests see: The Cult of Personality, Annie Murphy Paul, Free Press, New York, 2004. See also, OpeningSkinner’s Box: Great Psychological Experiments of the Twentieth Century, LaurenSlater, W.W. North and Company, New York, 2004.

10. The Daubert decision mentions the principle of “falsifiability,” to test the demarcationbetween real science and junk science. This principle originates primarily with Austrianborn British philosopher, Karl Popper (1902-1994). For Popper, a proposition could beclassified as scientific if it was falsifiable. That is, could it be tested and subject itself tobeing proven wrong? For example, the statement, “There is a white crow,” is not ascientific proposition because it can not be proven wrong. No matter how many blackcrows one found, there could always be a white crow yet to be found. However, thestatement, “There are no white crows,” is scientific because it can be proven false by thefinding of one white crow.