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REFERATE GENERALE / GENERAL STUDIES
Utilizarea tehnicilor proiective n evaluarea riscului apariiei unor ur-

gene psihiatrice la copii i adolesceni
The use of projective techniques in risk assessment of psychiatric emer-

gencies in children and adolescents
Cornea Ioan Gabriel

Rezumat:_______________________________________________________________________________________________________
Unele dintre tehnicile proiective i-au dovedit de-a lungul timpului utilitatea n diagnosticarea riscului apariiei unor urgene psihiatrice. n acest articol
vor fi abordate modalitile de evaluare a riscului suicidar i a descrcrilor paroxistice de agresivitate cu ajutorul a 3 tehnici proiective: Inventarul
Psihodinamic Roerich, Testul de Apercepie Tematic i testul Szondi.
Utilizate corect, aceste 3 tehnici ofer indicii concludente privind riscul suicidar, fapt care permite evitarea unor tentative suicidare.
n ce privete descrcrile paroxistice de agresivitate, acestea pot fi anticipate destul de precis cu ajutorul testului Szondi. Formulele care indic tendina
de distrugere a celorlali, structura sadic, slabul control al afectelor i al agresivitii, iminena descrcrilor paroxistice de agresivitate, sunt indicii certe
c o descrcare paroxistic de agresivitate poate avea loc n orice moment. Acest lucru permite o intervenie eficient care s stabilizeze emoional i
comportamental persoanele aflate n aceast situaie.
Cuvinte cheie: tehnici proiective, Testul de Apercepie Tematic, Testul Szondi, suicid, descrcare paroxistic de agresivitate.
Abstract:_______________________________________________________________________________________________________
Some of the projective techniques have proven their utility over time in diagnosing the risk of psychiatric emergencies. This article will focus on ways
of assessing suicidal risk and that of paroxysmal discharges of aggressive energy. with the help of three projective techniques: Roerich Psychodynamic
Inventory, Thematic Apperception Test and Szondi Test.
Used correctly, these three techniques provide conclusive indications of suicidal risk, which allows avoiding suicide attempts. In the paroxysmal discharges
of aggressive energy, they can be predicted quite accurately by using the Szondi test. The formulas to indicate the trend of destruction of others, sadistic
structure, the weak control of emotions and of aggressiveness, the imminent paroxysmal discharges of aggressive energy., are clear indications that a
paroxysmal discharge of aggressive energy. can occur at any time. This allows an effective intervention to stabilize emotionally and behaviourally the
persons who are in this situation.
Keywords: projective techniques, Thematic Apperception Test, Szondi Test, suicide, paroxysmal discharge, aggressiveness
Chiar dac tehnicile proiective nu permit realiza- Nu se poate face un prognostic privind apariia tu-
rea unui prognostic foarte exact al momentului apa- turor tipurilor de urgene psihiatrice, dar, cel puin n
riiei unei situaii/tulburri care constituie o urgen cazul riscului suicidar/autolitic i al descrcrii paro-
psihiatric, unele dintre aceste tehnici ofer informaii xismale a agresivitii, unele dintre tehnicile proiecti-
foarte importante privind riscul apariiei unor astfel ve aduc informaii decisive.
de urgene. Acest lucru nseamn c se poate stabili c Faptul c unele dintre tehnicile proiective ofer ast-
exist un risc major c o anumit situaie/tulburare se fel de informaii este datorat codrii mult superioare
va declana, dar nu se poate preciza cu exactitate n ct n raport cu celelalte instrumente diagnostice concu-
timp (n cte zile sau ore) se va ntmpla acest lucru. rente, ceea ce diminueaz considerabil riscul simulrii.
Psiholog specialist psihologie clinic, Liceul Special Sfnta Maria Arad, e-mail: Psychologist specialist clinical psychology, School Special "Saint Mary" Arad,
corneaioan@yahoo.com e-mail: corneaioan@yahoo.com
Revista de Neurologie i Psihiatrie a Copilului i Adolescentului din Romnia Decembrie 2014 vol. 20 nr. 4 47
Cornea Ioan Gabriel Utilizarea tehnicilor proiective n evaluarea riscului apariiei unor urgene psihiatrice la copii i adolesceni REFERATE GENERALE
n ceea ce privete prognosticul riscului de de- antisociale). Metodele de simulare sunt determinate
clanare a unui episod psihotic, utilizarea exclusiv a de nivelul de inteligen, de experiena de via cu
tehnicilor proiective este contraproductiv deoarece ct nivelul de inteligen al subiecilor este mai ridicat/
unele rspunsuri atipice pot fi considerate ca fiind experiena acestora de via este mai mare, cu att ten-
psihotice, acest lucru fiind total eronat. tativele de simulare sunt mai rafinate -, i, mai rar, de
Tehnicile proiective care pot fi utilizate n evalua- informaiile pe care subiecii le au despre testele folo-
rea riscului suicidar/autolitic i de descrcare a agresi- site. Totui, dat fiind faptul c tehnicile proiective sunt
vitii sunt: testul de Apercepie Tematic (TAT), tes- mai bine codate, posibilitile de simulare sunt limitate
tul Szondi, Inventarul Psihodinamic Roerich (RPI), (acestea fiind descrise pentru fiecare test abordat).
Testul Luscher i testul Rorschach. Aceste teste pot n cazul subiecilor cu risc auto i heterolitic pre-
fi completate la nevoie i cu alte tehnici proiective, de venia se face particularizat pentru fiecare caz, avnd
exemplu cele de desen. ca linii directoare:
Este de dorit utilizarea unei baterii de tehnici pro- - eliminarea sau diminuarea cauzelor (acolo unde
iective cel puin din 3 considerente: este posibil) care au condus la apariia problemei,
- rezultatele obinute la un singur test sunt de cele acest lucru putnd rezolva n mare parte problema;
mai multe ori insuficiente n realizarea unui prognos- - intervenie psihologic (care s vizeze i eventu-
tic exact; ala patologie asoceat), extins i la membrii familiei/
- interpretarea corect a rspunsurilor atipice sau a persoanele apropiate acolo unde este necesar i po-
formulelor simptomatice; sibil. Intervenia psihologic este inutil n cazul co-
- reducerea riscului unor interpretri eronate cau- piilor/adolescenilor cu trsturi sadice;
zate de posibile tentative de simulare. - monitorizarea psihologic la anumite intervale
n cazul n care din raiuni de timp nu exist posibi- de timp, aceste intervale fiind stabilite n funcie de
litatea aplicrii mai multor tehnici proiective, se va ale- tipul i severitatea problemei;
ge testul cu cea mai mare relevan pentru cazul respec- - supraveghere, chiar i permanent n cazul copi-
tiv. n aceast situaie se va ine cont de motivul pentru ilor/adolescenilor cu ideaie suicidar/de autodistru-
care se efectueaz evaluarea, de nivelul de dezvoltare gere, dar care nu prezint risc ridicat de acting-out;
intelectual i de nelegere al subiectului, de datele - urmarea unui tratament psihofarmacologic, n
existente despre acesta i de timpul avut la dispoziie. special pentru diminuarea agresivitii i tratarea pa-
Datele obinute n urma aplicrii tehnicilor pro- tologiei asociate;
iective trebuie coroborate cu celelalte date despre su- - internarea de urgen n spital pentru cazurile
biect obinute prin alte metode. mai grave de exemplu n cazul iminenei unei des-
n cele mai multe situaii, n urma aplicrii tehni- crcri paroxistice de agresivitate sau a suicidului, evi-
cilor proiective, n special cnd exist indicii certe de tndu-se astfel acting-out-ul.
risc auto i heterolitic (risc suicidar, descrcare paro-
xismal a agresivitii, etc), este obligatorie solicitarea Interviul psihodinamic Roerich (RPI)
unor informaii suplimentare de la subiect, apar- Adaptat dup Roerich M. R. 2002
intori, coal, etc care s ajute la stabilirea unui A fost introdus n anul 2002 n SUA de ctre Ro-
diagnostic corect, i totodat la realizarea unei inter- bert M. Roerich - membru al Asociaiei Americane
venii/prevenii adecvate. pentru Studiul Imageriei Mentale (New York) - ea
n timpul aplicrii testelor, o atenie deosebit tre- fiind o tehnic proiectiv de imagerie mental.
buie acordat tentativelor de simulare. Tentativele de n Romnia este cunoscut sub denumirea de
simulare au la baz 5 cauze: dezinteresul fa de eva- Interviul Drumului.
luare, nencrederea n evaluator/respingerea acestuia, Aceast tehnic a fost construit cu scopul de a
teama de rezultatele obinute n special de faptul c evalua 5 subteme:
subiectul ar putea fi diagnosticat cu o boal psihic - o vedere de ansamblu a subiectului asupra vieii
sau c se va face de rs teama de pierdere a contro- sale dezvluind totodat i starea spiritual n general,
lului asupra situaiei i dorina de a induce n eroare dificultile i problemele cu care el se confrunt;
evaluatorul (aceast cauz apare n special n cazul su- - sentimente legate de sexualitate i/sau intimitate
biecilor agresivi, mai ales dac prezint i trsturi cu ceilali;
48 Revista de Neurologie i Psihiatrie a Copilului i Adolescentului din Romnia Decembrie 2014 vol. 20 nr. 4
REFERATE GENERALE Utilizarea tehnicilor proiective n evaluarea riscului apariiei unor urgene psihiatrice la copii i adolesceni Cornea Ioan Gabriel
- imaginea interioar de sine, stima de sine, siste- 5. Cum arat apa?

mele suportive i relaiile cu prinii, fora sistemelor 6. Ct de repede curge apa?
de susinere i a conexiunilor emoionale; 7. Este ceva n ap ? Dac da, ce anume?
- relaiile de fidelitate i sinceritatea dintr-o relaie. Casa sprijinului:
Acest aspect nu poate fi luat n calcul la copii, el avnd Ai traversat rul i continuai s mergei. Ajungei
relevan doar la persoanele care experimenteaz sau la o cas. Uitai-v bine la cas. Observai impresia pe
au experimentat o relaie de cuplu; care v-o face.
- problema actual sau trecut care l deranjeaz 8. Ce culoare are casa?
pe subiect, cu impact major asupra vieii, modul n 9. n ce stare este casa?
care poate fi ea depit, precum i credina c viaa se 10. Locuiete cineva acolo? Dac da, cine?
va schimba sau va rmne la fel. Aici poate fi evaluat Percepia fidelitii:
riscul suicidar, dar acest lucru se va face doar corobo- Ne continum n minte cltoria i ajungem la un
rndu-se datele obinute la descrierea drumului i la spaiu deschis. Pe pmnt se afl un vas i ne oprim
casa sprijinului. s-l examinm. Poate avea orice dimensiuni i forme.
Tehnica poate fi utilizat att ca prob de evalua- Descriei vasul. Concentrai-v asupra aspectului,
re, ct i n intervenia psihologic, ea fiind acceptat asupra strii n care se afl i asupra coninutului.
foarte uor de ctre subieci deoarece nu este percepu- 11. Ce culoare are vasul?
t ca ntruziv. 12. n ce stare este vasul?
13. Este ceva n vas?
Descrierea probei Obstacolul:
Exist dou tipuri de ntrebri: cele standard (n Continuai s mergei de-a lungul drumului i dai
numr de 15) i cele obionale care sunt abordate n peste ceva care v blocheaz calea. V oprete n loc i
manual, fr a fi cuprinse ns n inventarul standard. v mpiedic s naintai. Acesta este obstacolul.
n funcie de descrierea/rspunsurile subiectului (unii 14. Ce obstacol este?
subieci descriu fr probleme ceea ce i imagineaz, Putei depi obstacolul? Dac da, n ce mod?
alii rspund strict la ntrebrile care li se pun) pot fi 15. Ce vedei dincolo de obstacol?
puse i alte ntrebri clarificatoare. n cazul copiilor cu dificulti de exprimare, indi-
Instruciunile se dau pe tot parcursul probei. ferent din ce motiv, acetia pot desena drumul, dar cu
Instruciuni i ntrebri standard: creioane colorate.
Percepia general a drumului: Indicii de suicid:
Imaginai-v c mergei de-a lungul unui drum... Este necesar cumularea urmtoarelor indicii:
nregistrai tot ceea ce vedei i auzii, precum un Drum negru, gri sau rou care este foarte dur, n-
aparat de filmat. Survolai peisajul, observnd ce se trerupt sau cu prpstii, gropi adnci, perei nali
afl n deprtare, fundalul, i ceea ce v nconjoar. indiferent de tipul lor -, peste care se poate trece cu
Simii pmntul sub picioare. Suntei cel ce contem- greu sau nu se poate trece;
pl cltoria. Cas n care nu locuiete nimeni/prsit, eventual
1. Ce culoare are drumul ? n stare proast;
2. Cum este suprafaa drumului ? ncapacitatea de a trece obstacolul (obligatoriu)
3. Care este fermitatea drumului ? i absena unui drum dincolo de acesta. n absena
acestui element riscul suicidar este foarte sczut sau
Percepia sexualitii: absent. Un alt indiciu suicidar l constituie obstacolul
Continuai s mergei i ajungei la un ru care care este o poart. Acest tip de obstacol este aproape
trebuie traversat. tot la fel de relevant ca i incapacitatea de a trece ob-
n faa voastr este un ru; limea i adncimea stacolul i absena drumului dincolo de obstacol.
rului sunt alegerea voastr. Nu putei s-l ocolii, tre- n condiiile n care obstacolul nu poate fi trecut,
buie s v imaginai o modalitate de a-l traversa. Tot dar casa este locuit i eventual n stare bun, riscul
ceea ce avei nevoie pentru a-l traversa se afl deja n suicidar este sczut deoarece exist persoan de acro-
mintea voastr, doar imaginai-v cum vei proceda. aj, n aceast situaie nefiind ns excluse parasuicidul
4. Cum traversai rul? sau riscul de vtmare corporal.
La aceast tehnic sunt posibile dou modaliti peste 14 ani; MF imagini destinate bieilor i fetelor
de simulare: fie, din diferite motive, subiectul nu i peste 14 ani. Imaginile notate doar cu cifre sunt desti-
imagineaz ceea ce i se cere i rspunde formal la nate tuturor vrstelor i ambelor sexe.
toate ntrebrile, fie subiectul spune altceva dect i
imagineaz. Modul de aplicare
Simularea poate fi contracarat prin ntrebrile Subiectului i se cere s elaboreze o povestire des-
suplimentare puse pe parcursul desfurrii probei, pre fiecare plan care i se ofer, povestire care so-
deoarece n cazul dorinei de simulare vor aprea ne- licit subiectului urmtoarele aspecte: ce se ntmpl
concordane ntre rspunsuri sau n relatarea cltori- n plana respectiv, evenimentele care au precedat
ei. Refuzul de a-i imagina ceea ce i se cere este consi- situaia respectiv, ce simt i gndesc personajele din
derat modalitate de simulare doar n condiiile n care plan i cum se ncheie povestirea respectiv.
subiectul nu prezint retard mental. n cazul subieci- n funcie de ceea ce spune subiectul, pe parcur-
lor care prezint retard mental, utilizarea probei este sul povestirii pot fi puse i ntrebri clarificatoare/care
contraindicat deoarece conduce la concluzii eronate. s-i permit subiectului extinderea povestirii. ntreb-
n practic, subiecii nu simuleaz la aceast prob, rile trebuie astfel formulate nct s nu sugereze vreun
considernd-o neintruziv. rspuns i s nu implice judeci morale.
Dup ce subiectul i ncheie povestirea este de
Testul de Apercepie tematic (TAT) dorit s i se pun urmtoarele ntrebri:
Henry A. Murray Ce-i vine-n minte cnd priveti imaginea?, Ce
TAT este o tehnic proiectiv ce urmrete s eva- simi cnd priveti imaginea?, Asemeni cu cineva perso-
lueze modelele de gndire, atitudinile fa de sine i najele din imagine?, ultima ntrebare nu se adreseaz
fa de ceilali, rspunsurile emoionale ale subiectului, n cazul planelor n care nu sunt personaje.
defensele, nevoile i paternurile sale de reacie (inclu- Unii autori recomand dou faze n aplicarea tes-
siv nivelul agresivitii) la un material slab structurat. tului: faza de asociere (de aplicare propriuzis a testu-
Cu ajutorul lui se pot obtine informaii semnificative lui) i faza de anchet n care subiectul este ntrebat
despre nivelul riscului suicidar i despre eventuala sa care este sursa povestirii.
motivaie. Dup aplicarea planelor este necesar discutarea
Un alt scop al testului l constituie utilizarea lui n cu subiectul a rspunsurilor, aceste discuii avnd rol
intervenia psihologic. clarificator. (Aronow; Weiss; Reznokoff, 2001; Bellak,
1991; Brelet- Foularde, 2003; Popescu, 2011 )
Descrierea testului. Nivelul de agresivitate este evaluat n principal cu
Materialul TAT-ului const din 30 de ima- dou plane: 8BM i 9BM. Totui, n practic rs-
gini, n alb i negru, i o plan complet alb. punsuri care s conin un nivel ridicat de agresivita-
Imaginile conin personaje de diferite vrste i de am- te se pot obine i la alte plane, de exemplu 13MF
bele sexe. sau 17GF, de aceea este util aplicarea ntregului test.
Aciunile n care sunt angajate personajele, ex- Acest lucru este necesar pentru c rspunsuri agresive
presiile feelor sunt redate ntr-un mod ambiguu, se pot obine la acele plane a cror imagini subiec-
astfel nct s poat fi interpretate prin prisma tul le asociaz cu diferite situaii care au legtur cu
trebuinelor, intereselor, emoiilor, conflictelor carac- experiena lui de via sau fa de care el are anumite
teristice vrstei subiecilor i experienei lor de via. fantasme agresive.
Din cele 30 de imagini (plus plana alb), 10 sunt va- Se consider c subiectul prezint un nivel ridi-
labile pentru toate categoriile de subieci, iar celelalte cat de agresivitate doar dac personajul cu care el se
au un caracter mai specific. Simbolurile din codurile identific (cel despre care se vorbete cel mai mult,
planelor au urmtoarele semnificaii: B - imagini des- ale crui sentimente i idei subiective sunt cele mai
tinate baieilor pn la 14 ani; G - imagini destinate discutate) are manifestri agresive (de exemplu bate
fetelor pn la 14 ani; M - imagini destinate bieilor sau omoar alte personaje, distruge lucrurile, etc), la
peste 14 ani; F - imagini destinate fetelor peste 14 ani; care se pot aduga manifestri agresive ale subiectu-
GF - imagini destinate fetelor sub 14 ani i de peste lui n timpul testrii (de exemplu bate cu pumnul n
14 ani; BM - imagini destinate bieilor sub 14 ani i mas). Dac pe parcursul testrii subiectul are mani-
festri agresive, descrcarea paroxistic de agresivitate psihiatric.

este iminent, mai ales dac aceste manifestri sunt - Povestiri n care personajul se sinucide sau do-
coroborate cu s+! la testul Szondi. Nu se consider rete s o fac din cauza unei situaii cu care subiec-
c subiectul este agresiv dac personajul cu care el se tul se confrunt la momentul testrii. Aceti subieci
identific este agresat, abuzat, etc. prezint risc suicidar major, suicidul putnd avea loc
Riscul suicidar este mult mai bine evaluat cu aju- n orice moment, aceste cazuri reprezentnd urgene
torul TAT-ului. psihiatrice - mai ales dac datele obinute cu ajutorul
Planele de baz sunt: 3BM, 14 i 17BM, dar rs- TAT-ului sunt confirmate i cu ajutorul altor teste.
punsuri care s conin ideaie suicidar pot exista i - Povestiri n care personajul se sinucide datori-
la alte plane, de exemplu la plana 15 la aceast t autodevalorizrii/a faptului c se simte singur. n
plan putndu-se obine ambele tipuri de coninu- aceste situaii suicidul nu este iminent, dar poate avea
turi, att ideaie suicidar, ct i agresive - de aceea, i loc n orice moment, acest lucru depinznd i de ali
n aceast situaie este bine s fie aplicat tot testul, la factori, de exemplu situaii pe care subiectul nu le
baz stnd aceleai considerente ca i n cazul evalu- poate gestiona emoional. Subiecii care ofer astfel
rii agresivitii. de povestiri sunt de cele mai multe ori depresivi.
Ideaia suicidar const n faptul c personajul din - Povestiri n care eroul principal dorete s se si-
imagine cu care subiectul se identific, fie se sinucide, nucid, dar nu o face, iar povestirea se ncheie aa cum
fie dorete s o fac. i dorete subiectul. n aceast situaie, nu este vorba
n funcie de situaiile care conduc la sinuciderea de ideaie suicidar real, ci, eventual, de un risc de au-
personajului principal sau la dorina acestuia de a o tovtmare superficial. Mobilul eventualei autovt-
face, povestirile pot fi clasificate astfel (fr ns a avea mri l constituie de cele mai multe ori impresionarea/
pretenia c aceast clasificare este complet): antajarea emoional a persoanei vizate pentru a-i
- Povestiri n care sunt descrise situaii care nu au atinge scopurile. Acest lucru este cu att mai probabil,
corespondent n realitate (de exemplu, femeia se si- cu ct subiecii prezint o personalitate cu structur
nucide pentru c i-a fost rpit copilul de ctre extra- hystrionic.
teretrii). n ultimele dou situaii, trebuie stabilit dac pe
Ideaia suicidar din acest tip de povestiri este lng ideaia suicidar nu exist i alte tulburri psi-
neconcludent, necesitnd cel mult investigaii supli- hice.
mentare, riscul suicidar fiind absent. n special n cazul tipului 4 de povestire, n eva-
- Povestiri n care personajul se sinucide sau do- luarea riscului suicidar trebuie s se in cont i de ali
rete s o fac din cauza unor situaii cu care subiectul factori:
s-ar putea ntlni de-a lungul vieii i la care el se a- Teama de moarte: dac subiectul are o team pu-
teapt (de exemplu pierderea unui printe). ternic de moarte, suicidul este puin probabil, cu ex-
n aceste cazuri ideaia suicidar este structurat i cepia situaiei n care acesta prezint explozii afecti-
indic de obicei situaiile n care subiectul ar putea s ve, eventual dublate i de comportament histrionic. n
se sinucid. Dei n aceste situaii riscul suicidar este aceast situaie, comportamentul subiectului este im-
sczut, intervenia psihologic este necesar, ea avnd predictibil, suicidul putnd avea loc n orice moment.
scop preventiv. Exploziile afective: dac subiectul prezint explozii
- Povestiri n care personajul se sinucide sau dore- afective, riscul suicidar este potenat, comportamentul
te s o fac din cauza unei situaii prin care subiectul subiectului fiind impredictibil, mai ales dac acestea
a trecut. n aceste situaii ideaia suicidar este consis- sunt dublate i de un comportament histrionic.
tent, riscul suicidar depinznd de depirea sau nu a Comportamentul histrionic: acesta poteneaz riscul
situaiei dac situaia a fost depit, riscul suicidar parasuicidar. Acest comportament are dou scopuri:
la momentul testrii este sczut, n caz contrar, riscul fie ca subiectul s atrag atenia asupra sa, fie pentru
este crescut. Indiferent de situaie, subiectul rmne a obine de la persoanele vizate comportamentele do-
cu potenial suicidar, orice eveniment traumatic pe rite.
care nu-l va putea depi, putnd conduce la suicid. n Instabilitatea emoional: este un factor care crete
aceste cazuri este necesar, att o evaluare psihologic nivelul riscului suicidar deoarece subiectul poate ca
mai profund i evident psihoterapie, ct i evaluare ntr-un anumit moment s neleag i s aib capa-
citatea de a depi problema cu care se confrunt, iar Testul Szondi

n urmtorul moment s triasc starea contrarie i s Leopold Szondi
treac la acting-aut. Scopul testului
Nivelul voinei: dac subiectul prezint o voin Evaluarea pulsiunilor i a dinamicii pulsionale.
puternic, riscul suicidar este potenat. n aceeai si- Descrierea testului
tuaie, n cazul unei voine slabe, riscul suicidar este Testul este conceput pentru a evalua 4 pulsiuni, fi-
diminuat deoarece este extrem de probabil ca, chiar ecare avnd cte dou tendine:
dac subiectul i-a construit un plan de a se sinucide, Vectorul Sexual (S)
el nu va avea resurse s-l pun n aplicare. Reflect intensitatea i modul de manifestare a
Este indicat ca, att n cazul riscului suicidar, ct trebuinelor sexuale i agresive ale subiectului. De aici
i n cazul agresivitii, rezultatele de la TAT s fie rezult identificarea sexual a individului, pe cei doi
coroborate cu rezultatele de la alte tehnici proiective. versani ai si: feminitatea i masculinitatea. Femini-
n cazul TAT-ului, posibilitile de simulare con- tatea este asociat cu un spirit mai blnd, mai pasiv,
stau, fie n faptul c subiectul povestete altceva dect cu blndee i tandree, n timp ce masculinitatea este
vede sau gndete, fie povestete incomplet ceea ce asociat cu spiritul incisiv, activ, dominator, agresiv.
vede i gndete. La anumite plane simularea poate Orice persoan conine un aliaj format din ambele
apare din cauza jenei sau discomfortului pe care su- elemente, dar unul este predominant. Analiznd acest
biectul le resimte cnd privete acele plane, fie din vector putem afla intensitatea trebuinelor sale eroti-
cauza unor emoii foarte puternice pe care i le evoc co-sexuale, agresive, dar i capacitatea de sublimare a
planele i pe care el dorete s i le reprime sau s le libidoului. Factorul h (reprezentat de fotografiile cu
ascund. homosexuali) reflect trebuina de tandree, de ero-
Modalitile de contracarare a simulrii constau n tism, iar factorul s (reprezentat de fotografiile cu sa-
adresarea unor ntrebri clarificatoare subiectului n dici) msoar nevoia de activism fizic, de dominare i
timpul aplicrii planelor i n monitorizarea compor- de manipulare efectiv a obiectelor din mediu.
tamentului i a strii psihice a acestuia pe parcursul Vectorul Paroxismal (P)
testrii. Indic gradul de labilitate sau de rigiditate al cen-
Dac pe parcursul povestirii uneia sau mai multor zurilor afective, adic modul de control al manifes-
plane subiectul prezint agitaie motorie, i mic trilor emoionale. Factorul e ne arat n ce masur
privirea sau evit contactul vizual cu examinatorul, subiectul dorete s i controleze afectele dure, gen
zmbete, dar zmbetul nu concord cu ceea ce el po- furie, iritabilitate i s adopte o atitudine etic de in-
vestete, este evident faptul c dorete s ascund anu- trajutorare. Factorul hy reflect intensitatea cenzurii
mite lucruri. n aceast situaie i se pot pune ntrebri morale, respectiv controlul exprimrii emoiilor tan-
suplimentare subiectului i i se poate sugera faptul c dre, neagresive.
v-ai dat seama c el dorete s ascund ceva i c este Vectorul EULUI (Sch)
n avantajul lui s renune la aceast tentativ. Dac Arat forta Eului, gradul de complexitate al me-
sunt abordai cu tact, subiecii i schimb atitudinea canismelor de aprare, controlul general al compor-
i devin cooperani dac realizeaz c nu pot ascunde tamentului subiectului. Factorul k reflect tendina
ceea ce gndesc i c examinatorul nu le este ostil. Pot organismului de a se diferenia de ambiana, de a fi
fi puse i alte ntrebri care s-i determine pe subieci independent, iar factorul p reflect tendina de fuziu-
s spun tot ceea ce gndesc legat de o anumit plan- ne afectiv cu mediul i de spargere a granielor Eului,
, dar aceste ntrebri trebuiesc formulate n funcie ntr-un contact care s anuleze distana dintre obiect
de context, ne existnd o reet standard.n aceste si- i subiect.
tuaii, copii i adolescenii simt nevoia s se reasigure Vectorul de Contact (C)
de confidenialitatea psihologului, unii dintre ei avnd Arat ct de stabile i de satisfctoare sunt
nevoie i de suport emoional la povestirea unor plan- relaiile obiectuale ale individului. Factorul d se refer
e, de obicei a planelor care au un puternic impact la trebuina de cutare n mediu a obiectelor care s fie
emoional asupra lor. investite afectiv, iar factorul m se refer la tendina de
acroare de aceste obiecte.
Materialul testului
Const n 48 de fotografii, fiecare fotografie pre- lorlali, structura sadic, slabul control al afectelor i
zentnd figura unui bolnav mental. Ele sunt reparti- al agresivitii, iminena descrcrilor paroxistice de
zate n ase serii de cte opt fotografii. Fiecare serie agresivitate, sunt indicii certe c o descrcare paro-
prezint un homosexual, un sadic, un epileptic, un is- xistic de agresivitate poate avea loc n orice moment.
teric, un schizofren catatonic, un schizofren paranoid, Aceste situaii nu constituie urgene psihiatrice, dar
un maniaco-depresiv n faz depresiv, un maniaco- este imperios necesar, att terapia psihofarmacologi-
depresiv n faz maniacal. c, ct i psihoterapia pentru ameliorarea strii aces-
Aplicarea i codarea testului tor persoane. n absena terapiei psihofarmacologice,
Are dou faze: de alegere propriuzis i de asocie- orice alt tip de intervenie este inutil, persoanele cu
re, la copii cea de asociere nefiind aplicabil. nivel ridicat de agresivitate nu sufer, ci i fac pe cei-
n faza de alegere propriuzis i se cere subiectului lali s sufere, astfel c nu au nici un motiv plauzibil
s aleag dou persoane simpatice, apoi dou antipati- s-i doreasc vindecarea.
ce (pentru profilul de faad), apoi nc dou persoane Sunt 3 situaii n care profilele szondi sunt nule:
antipatice (pentru profilul de culis). Subiectul alege dup un anumit algoritm, adic
Persoanele simpatice (inclusiv cele dou rmase) alege pozele situate n aceleai poziii. Aceast situaie
se noteaz cu +, iar cele antipatice se noteaz cu -. are 4 cauze posibile: anxietate foarte puternic fa de
Exist formule i indici Szondi utili n evaluarea testare/examinator, un posibil blocaj psihic, nenele-
agresivitii i riscului suicidar (Tabelul 1). gerea instructajului i dorina de simulare.
Subiectul alege fotografiile fr s le priveasc.
Tendine sadice (agresivitate foarte Aceast situaie este cauzat de dorina de simulare i
s+!
ridicat) de dezinteresul fa de testare, ADHD, i, mai rar, de
s-! Tendine masochiste nenelegerea instructajului.
h+/s+! ncrcare sexual cu agresivitate Aparent persoana alege pozele respectnd instruc-
tajul, dar alegerile sale nu sunt conform cu ceea ce el
H0/s+! Tendin de distrugere a celorlali gndete i simte. Aceast situaie este o form evi-
H0/s-! Tendin spre autodistrugere dent de simulare. Subiecii care procedeaz astfel au
un nivel ridicat de inteligen i de obicei doresc s
Slab control al afectelor; echilibru
ascund nivelul foarte ridicat de agresivitate sau chiar
e- afectiv instabil indicat de fregvena cu care
e- trece n e0 comportamentul antisocial/patologic. Este foarte greu
de depistat o astfel de situaie, singurele indicii fiind
Descrcare paroxistic de agresivitate;
s+/e-
lipsa de control a agresivitii
date de neconcordana profilelor cu datele existente
despre subiect i cu rezultatele obinute la alte probe
Dorina de a iei n eviden; comporta-
Hy+
ment histrionic
i eventual de posibile manifestri comportamentale
din timpul testrii care s indice un comportament
k-! Tendin suicidar
simulant, de exemplu evitarea contactului vizual, o
m- Comportament antisocial anumit stare de anxietate, etc. (Adaptat dup Szon-
di, 1952, Deri, 1949,Melon 1997, Dumitracu 2005,
s+/d0/m- Comportament antisocial
www.szondiforum.org)
h0/s+!/e- Iminena descrcrii paroxistice de
sau e0/m- agresivitate
Poveste slavon de dragoste-2
S+/e-/m- Structur de personalitate antisocial Traducere dup Djos V., 2011
h0/s- Pe malul unui ru nvolburat locuia o fat pe nume
Risc suicidar major
!/k-!/d0 Luba (L). Ea era la vrsta la care i atepta marea
h0/s-!/
Risc major de parasuicid iubire, dar n jurul ei locuiau doar brbai nsurai, al-
hy+/k-!/d0
h0/s-!/ coolici sau cu dizabilitai. Dac ar fi fost de acord s
Risc suicidar
k+/p- i ncerce norocul cu vreunul dintre ei, soarta ei poate
Tabelul 1 Formule i indici Szondi utili n evaluarea agresivitii i ar fi ajuns s fie diferit. Oricum, ea nu vroia s i
riscului suicidar. iroseasc visurile pe ceva mai puin dect spera.
Formulele care indic tendina de distrugere a ce- Dmitry (D), vecinul ei care cunotia i se bga n
vieile celorlali i care i-a oferit diferii pretendeni, i lor s steie departe de mine. Luba a simit ca i cum a
l-a recomandat i pe Sergey (S), care locuia pe partea fost lovit n cap cu un ciocan greu. i-a pierdut ntreg
opus a rului. Sergey a vzut-o ntr-o zi notnd n viitorul. Viaa ei i-a pierdut sensul. n timp ce umbla
ru i de atunci vroia s fie prietena lui. El a trimis-o de-a lungul rului, i-a amintit c pentru a trece podul
pe btrna Maria (M), o peitoare, care i-a dat toat napoi ar trebui s treac pe lng Eugene, aa c s-a
silina s l laude pe Sergey i s o fac pe Luba s aruncat n ru i s-a necat.
cread c el este cel menit s i fie so. Dorina de a fi Precizare: se aplic de la vrsta de 14 ani dar este
cu el, cretea tot mai mult, dar ntre ei curgea rul care contraindicat aplicarea ei la persoanele cu retard
era i grani de stat. mental sau cu intelect de limit deoarece nu o neleg
Exista totui un pod ngust peste ru. Konstantin Interpretare
(K), grnicerul sttea la datorie i permitea doar tre- Dup citirea povetii i se cere subiectului s ordo-
cerea persoanelor pe care el le plcea. Luba l-a rugat neze toate personajele n ordinea vinoviei ncepnd
s o lase s treac peste ru, dar lui nu i-a plcut de ea, de la cel mai vinovat pn la cel mai nevinovat.
aa c a refuzat-o. Atunci Luba a apelat la vecinul ei, Cotarea: se puncteaz toate personajele n ordinea
Dmitry, care cunotea pe toat lumea i pentru care, notat de subiect ncepnd cu un punct pentru cel mai
sincer vorbind, parc nu existau frontiere. Dmitry i-a vinovat, pn la 8 puncte, pentru cel mai nevinovat.
promis c va gsi pentru ea o modalitate de a trece Sunt de interes 2 indici:
rul. Au trecut zile i sptmni. 1 Indicele de criminalitate (IC): acesta indic o
Disperat, fata a alergat la Colonelul Petrov (P), eventual predispoziie de a comite o crim.
comandantul grnicerului i l-a rugat s o lase s trea- Modul de calcul: CI=e+hy/k+p.
c pe partea cealalt. Acesta a fost surprins i a ru- Un indice situat ntre 0 i 1 este considerat normal,
gat-o s-i explice de ce dorea s ajung acolo. Ea i-a peste 1, cu ct IC este mai mare,cu att subiectul pre-
povestit despre dragostea ei. Era noapte i povestirea zint un potenial criminogen mai ridicat, aceast din
ei i-a amintit colonelului de tinereea lui, de o dragos- urm situaie ndicnd i nivelul ridicat de agresivitate
te nefericit care i-a distrus csnicia. El i-a comandat al subiectului.
lui Konstantin s o lase pe Luba s treac. Totui voia 2. Raportul (indicele) de orientare spre trecut sau
s se mai gndeasc. Vznd c colonelul ncepea s spre viitor (O): indic preponderena orientrii per-
ezite, ea s-a grbit pe pod spre partea cealalt nainte soanei, fie spre trecut, fie spre viitor. O persoan ori-
ca acesta s se rzgndeasc. entat preponderent spre trecut are risc suicidar mai
De cealalt parte a podului era un alt grnicer, pe ridicat dect una orientat preponderent spre viitor.
nume Eugene (E). El tocmai suferea adnc deoarece Modalitate de calcul: O=k+p+d+m/h+s+e+hy.
cu o zi n urm, soia s-a l-a nelat. Dac Luba ar fi Un indice situat ntre 0 i 1 arat o o persoan
umblat ncet, poate c nici nu o observa. Dar ea alerga. orientat spre trecut, iar unul situat peste 1, indic
Eugene a oprit-o i a ntrebat-o la cine se grbea la o orientarea persoanei spre viitor. n acest ultim caz, cu
or aa trzie. Ea i-a spus despre dragostea ei. Eugen ct indicele este mai mare, cu att persoana este mai
s-a enervat pe faptul c Sergey era iubit att de mult, orientat spre viitor.
n timp ce pe el soia l nela.
Nu e corect!, a gndit el. Eugene a prins-o pe Cazuistic
Luba i a violat-o. Dup ce s-a simit puin mai bine, Precizare: Fiecare caz va fi analizat doar n ceea ce
i-a dat drumul. Era ntuneric. Nu i-a vzut nimeni. privete riscul suicidar, nivelul de agresivitate i aspec-
Dar Istratiy (I), care tocmai i fcea obinuita sa tele conexe legate de acestea.*
patrul de sear, a auzit ceva cnd trecea pe pod, i a
vzut-o pe Luba aranjndu-i hainele. El le-a spus tu- Exemplul 1
turor, inclusiv lui Sergey, colornd i adugnd attea Fat de 16 ani provenit dintr-o familie cu un ni-
detalii acestui episod sexual, nct, prea ca o aventu- vel material foarte precar i cu norme morale absen-
r slbatic. Luba s-a dus la Sergey s i explice totul te. Ea s-a prostituat de la 13 ani, fiind ncurajat de
spernd c va gsi nelegere i protecie la el. Sergey mam creia i ddea din banii obinui. A renunat
ns, a ntmpinat-o cu ur. El a spus: Eu te voiam * n text ntrebrile puse de psiholog vor fi evideniate prin
ntreag, nu am nevoie de resturi.Voi cere prostituate- caractere bolduite iar rspunsurile pacienilor prin italice
definitiv la acest lucru n urm cu un an i jumtate Comportament, att feminin, ct i masculin, s

datorit nceperii unei relaii cu un biat. avnd ambele tendine i + i -.
Interviul Psihodinamic Roerich S+e-: slab control al agresivitii, mai ales c s+
Tipul de drum se transform de fiecare dat n s0, fapt care indic o
1. Ce culoare are drumul? Negru. descrcare paroxistic de agresivitate.
2. Cum este suprafaa drumului? Dreapt, neted. Desele fluctuaii ale factorului e indic un con-
3. Care este fermitatea drumului? Este tare. trol slab al afectelor.
Casa sprijinului Hy+/+-: structur histrionic. n 8 din cele 10
8. Ce culoare are casa? Roz. profile hy este + sau +-. Acest lucru coroborat cu
Din ce material este casa? Din bolari. slabul control al afectelor conduce la un comporta-
9. n ce stare este casa? n stare bun. ment imprevizibil care poate consta, att n descrcri
10. Locuiete cineva acolo? Dac da, cine? Nu paroxistice de agresivitate, ct i n autovtmari su-
locuiete nimeni. perficiale.
Obstacolul Desele fluctuaii ale factorilor din vectorul Sch
14. Ce obstacol este? A czut un pom mare i nu indic o slab structurare a eu-lui i riscul apariiei
mai pot trece. unui posibil proces patologic.
Putei depi obstacolul? Dac da, n ce mod? M-: absena persoanei de ataament, m+ apare
Nu pot pentru c este prea mare. doar n 3 profile consecutive, acest lucru indicnd o
15. Ce vedei dincolo de obstacol? O cas. form tranzitorie de ataament. Acest lucru este nt-
Mergei mai departe i ajungei la alt obstacol. rit de faptul c m- este acompaniat de d+ i d0.
Ce obstacol este? Mi-am rupt piciorul. Existena lui s+e-m- indic riscul apariiei per-
Putei depi obstacolul? Dac da, n ce mod? sonalitii antisociale, acest lucru fiind ntrit i de
Nu pot. prezena lui m- n 7 din cele 10 profile. Acest risc
Ce vedei dincolo de obstacol? Un spital. depinde foarte mult de mediul social n care fata se va
Precizare: n acest caz, interviul conine i alte n- afla de acum nainte.
trebri dect cele standard. Concluzii:
Interpretare: absena riscului suicidar, dar risc de Fat cu comportament, att masculin, ct i femi-
autovtmare pentru a primi ajutor, pentru a fi n nin, cu un slab control al afectelor i al agresivitii,
atenia celorlali i pentru a obine de la persoana vi- cu un comportament histrionic, n condiiile absenei
zat comportamentul dorit. (casa care se afl dincolo persoanei de ataament, prezint potenial de descr-
de primul obstacol semnific nevoia de sprijin, iar spi- cri paroxistice de agresivitate, de dezvoltarea perso-
talul de la al doilea obstacol semnific nevoia de ajutor nalitii antisociale i de autovtmare ea se autova-
material i de a fi n centrul ateniei) tm doar n condiiile n care dorete s obin de la
S P Sch C persoana vizat un anumit comportament.
Aplicaia H S E hy K P D m Testul de Apercepie Tematic
3BM. Un biat s-a desprit de prietena lui c
I + - - + +- - 0 -
prietena lui l-a nelat cu cel mai bun prieten al lui i
II + - +- +- + 0 - - el cnd s-a desprit de ea, pe strad a vzut un stlp
III + - 0 +- + - + - cu o piatr, s-a aezat acolo, a pus capul pe piatr i a
IV + + - + - + - +
plns. Ce mai este n imagine? Un cuit. De ce se afl
cuitul acolo? A vrut s se omoare c de ce l-a nelat
V + 0 - +-! +- - + +
prietena lui. Ce se ntmpl mai departe? Biatul
VI + - 0 + +- 0 + + a hotrt s i mai dea o ans la fat i s fie din nou
VII + + - +- + +- + - mpreun i s uite tot i s fie fericii, dei asta nu se
VIII + 0 + + - 0 + -!
poate uita niciodat. Ce i vine n minte cnd priveti
imaginea? Pe Flavius c eu nu l-am nelat pe el, dar el
IX + 0 +- - + + 0 -!
m-a nelat, nu este cea mai bun prieten a mea, cu o fat
X + - + 0 + - 0 - i el tot mi zice c nu te-am nelat. Ce simi cnd
Interpretare: priveti imaginea? Tristee. l asemeni cu cineva pe
biatul din imagine? Da, cu mine. stins) l asemeni cu cineva pe brbatul din imagi-
3GF. Un biat care st la u. Biatul vrea s des- ne? Poate cu mine seamn, dar eu nu sunt drac.
chid ua plngnd pentru c mama lui este bolnav la
pat, ea a vrut s se sinucid i a nchis ua s nu o gseasc Interpretare:
nimeni, pentru c doamne feri avea cancer i nu a vrut s Povestirea de la plana 3BM este ncadrat n tipul
sufere nici ea, nici copilul ei i s-a gndit c poate este mai 6, ea fiind de fapt o reproducere fidel a relaiei ei cu
bine aa i pentru copilul ei. Ce se ntmpl mai depar- partenerul. n aceast situaie nu este vorba despre un
te? Mama lui pn la urm s-a hotrt s se omoare c a risc suicidar real i nici de ideaie suicidar, ci des-
suferit prea mult i nu mai vrea s sufere nici ea nici copi- pre un eventual risc de autovtmare pentru a antaja
lul. A reuit s se sinucid? Da. Ce i vine n minte emoional persoana vizat.
cnd priveti imaginea? La moarte. S neleg c i Povestirea de la plana 3GF se ncadreaz n tipul
este team de moarte? Da. S-ar putea s motenesc? 2. Ideaia suicidar este legat de situaia n care ea ar
Bunicul a avut cancer i mtua Viorica a avut cancer suferi de o boal care nu i-ar mai permite s se ngri-
i a murit. Ce simi cnd priveti imaginea? Tristee jeasc. n aceast situaie este extrem de probabil ca ea
mare. l asemeni cu cineva pe biatul din imagine? s recurg la suicid.
Da, cu unchiul meu. Din povestirile de la planele 8BM i 15 se de-
8BM. Sunt 4 oameni. Unul este pe mas ntins pe celeaz un nivel foarte ridicat de agresivitate, predis-
spate i un brbat l taie cu cuitul. Cellalt brbat din poziie pentru comportament antisocial i activiti
spate se uit ctre ei iar brbatul stalalt st trist c de ilicite.
ce l taie pe sta. Unde se afl ei? ntr-o camer. Lng Concluzie: persoan cu risc suicidar doar n situ-
brbatul de pe mas este o puc. Cine i de ce l taie? aia unei boli incurabile, cu risc de autovtmare cor-
Nu tiu, poate a fcut ru. Ce ru a fcut? A fost cu ei n poral, dar i cu un nivel foarte ridicat de agresivitate,
gac i el a vrut s ias i tia au zis c nu, s nu ias, s predispoziie pentru comportamentul antisocial i ac-
rmn cu ei. n ce gac este? ntr-o formaie de mu- tiviti ilicite.
zic. Ce se ntmpl mai departe? Brbatul care vrea
s l taie i spune Vrei s rmi cu noi sau te omorm? Concluzii generale:
i brbatul i-a zis Rmn cu voi, dar cu o condiie: s Fat cu slab control al afectelor i al agresivitii,
mi luai i fratele i i spune brbatul care vrea s l taie cu predispoziie spre comportamentul antisocial i ac-
Da l lum i pe el dar s fac ce spun eu. Ce vroia s tiviti ilicite, pe fondul unei personaliti cu structur
i spun s fac? S-l asculte, s cnte ce muzic vrea histrionic.
el, s mearg unde l trimite. De ce vor s l omoare Risc suicidar doar n situaia unei boli care nu i-ar
dac nu mai vrea s fie n formaie cu ei? Pentru c mai permite s se ngrijeasc.
tie multe: c au omort nainte, c se ocup cu droguri. Risc de autovtmare, dar numai pentru a-i im-
l vor lua i pe fratele lui? Da, i fratele biatului i presiona/antaja emoional partenerul (de care nu este
spune: Tu te ocupi doar cu droguri Ce i vine n minte ataat).
cnd priveti imaginea? Nimic. Ce simi cnd pri- Acest caz nu este o urgen psihiatric, fata ne-
veti imaginea? Nimic. Asemeni cu cineva vreounul cesitnd psihoterapie de lung durat i monitorizare
dintre personajele din imagine? Nu. psihologic, n caz contrar, evoluia ei va fi extrem de
15. (rezisten) Un brbat mbrcat n negru merge nefavorabil.
la 12 noaptea n cimitir i rupe crucile. El este satanist,
merge n cimitir, se drogheaz, face porcrii pe acolo. (of- Exemplul 2
tat). Ce s-a ntmplat nainte? El a fost un om bun, Biat de 18 ani, provenit dintr-o familie mono-
muncitor, tria la ar, da cnd a venit - s-a mutat la parental, mama neavnd niciodat autoritate asupra
ora - a vzut cum este viaa aici, s-a mprietenit cu nite sa i a fratelui su. Prezint un nivel ridicat de agresi-
sataniti, s-a luat dup ei i a ajuns ca ei. Ce stare su- vitate pe care caut s i-o mascheze n faa cadrelor
fleteasc are? De drac. Ce se ntmpl mai departe? didactice. Dup prima aplicare i dup ce i-a fost ofe-
Tot aa rmne, va sta tot lng prietenii lui, se va muta rit interpretarea elevul nu s-a mai prezentat la urm-
cu ei. Ce i vine n minte cnd priveti imaginea? toarea aplicare.
Nimic. Ce simi cnd priveti imaginea? Nimic. (voce Profil Szondi
- s-!: structur masochist. n 8 din cele 10 profile

S P Sch C
s- este cu minim un !, ceea ce arat c este o structu-
h S e hy k p D M r masochist bine conturat.
- h0s-!: tendina de autodistrugere care conine de
+ +! - - + - 0 -
obicei ideaie suicidar.
Interpretare: - s-!e- din primul profil indic furie ntoars m-
H+s+!: ncrcare sexual cu agresivitate (acest lu- potriva propriei persoane, acest comportament fiind
cru n condiiile n care din anamnez a rezultat c potenat i de structura hystrionic.
ultima relaie sexual a avut-o n dimineaa testrii); e+-: ambivalen n controlul agresivitii i al
S+!e-: descrcri paroxistice de agresivitate; emoiilor; comflict afectiv care poate duce la crize co-
S+!e-m-: structur de personalitate antisocial; leroase periodice, dar nu la manifestri antisociale;
s+e-hy-: puin interesai de modul n care aciunile hy+-: conflict resimit contient; tensiune intrapsi-
lor i afecteaz pe ceilali; urmrirea propriului avantaj hic, care reflect nehotrrea de a-i exprima senti-
egoist. mentele; componenta hy+ din structura lui hy+- in-
Precizare: ulterior aplicrii probei, n aceeai zi b- dic o personalitate histrionic, mai ales c hy+- se
iatul i-a agresat fizic partenera. regsete n 7 din cele 10 profile.
Concluzie: descrcare paroxistic de agresivita- Concluzie: persoan cu tendine spre autodistru-
te pe fondul urmririi propriului avantaj egoist i al gere i momente de ntoarcere a furiei mpotriva pro-
structurii de personalitate antisocial. priei persoane,pe fondul unei personaliti cu structu-
r masochist i histrionic. n aceast situaie exist
Exemplul 3 un risc suicidar real, dar numai n situaii limit, pe
Fat de 17 ani i jumtate cu inteligen peste me- care nu le poate gestiona emoional, iar autocontrolul
die, provenit dintr-o familie n care tatl i bunica se emoional i al agresivitii este absent.
comport arbitrar i autoritar cu ea pretextnd c-i Testul de Apercepie Tematic
vor binele. Att comportamentul celor 2, ct i pro- 3BM. Aa! Este un om care st nu ntins pe jos, aa
blemele de vedere au condus la absena stimei de sine pup i cu capul sprijinit de scaun. Este singur. Hmmm.
i la un complex de inferioritate. n condiiile n care Ce mai este n imagine? Este o banc, un scaun, st
tatl consum alcool, acesta devine dezinhibat, de cele necjit(agitaie motorie). Se gndete ce o s fie cu el, adic
mai multe ori ameninnd-o, i, foarte rar, agresnd-o, dac tot o s fie bine mai departe cu el, ce o s-ajung, dac
chiar i fr un motiv real. Mama vitreg este singura o s aib o familie frumoas. Dar jos ce este? Nu este
persoan de ataament din cas, iar cu mama natural nimic. (Ulterior rde). Uit-te cu atenie i spune-mi,
nu mai ine legtura. mai observi ceva n imagine? Este un cuit. De ce se
Profile Szondi afl cuitul acolo? L-a uitat pe jos. Cu ce scop se afla
S P Sch C cuitul acolo? A vrut s-i tatueze venele. Bleg eti m!
Aplicaia H s E Hy K P D m Nu tii ce vrei de la via? (Rde). Din ce cauz a vrut
I + -! - +- 0 + + 0
s-i tatueze venele? A crezut el c aa-i bine, dar s-a
oprit la timp. Ce l-a determinat s cread astfel? C
II + -! +- +- 0 0 +! 0
aa a crezut el c-i mai bine, dar i-a dat seama c are tot
III 0 - +- +- 0 + +- 0 viitorul n fa i i-a dat seama c n-ar fi rezolvat nimic
IV + - +- +- 0 0 + 0 i ncearc s fie mai optimist. Poi s fii mai explicit
de ce a crezut el c aa e mai bine? (Ezitare) N-a avut
V 0 -! +- +- 0 + + 0
pe cineva aproape de el. Ce se ntmpl mai departe?
VI + -!! +- - + 0 + 0 (Agitaie motorie) Va realiza c totul o s fie bine i
VII 0 -! +- - + + + +- va fi foarte optimist. S fi optimist! (Pe tot parcursul
VIII + -! +- - 0 + 0 0 rspunsului a persistat agitaia motorie). Nu asemn cu
nimeni imaginile, are o stare bun, optimist (afirma-
IX + -! +- +- 0 + 0 0
ii fcute mecanic). Nu-mi place TAT-ul acesta! Nu pot
X + -! +- +- 0 + + 0 s cred! (Testul a fost aplicat la solicitarea elevei) Ce i
Interpretare: vine n minte cnd priveti imaginea? Nimic. C-i
prost (rde). Dar legat de tine, ce-i aduci aminte? C tura masochist i hystrionic de personalitate.
am fcut, fceam mare greeal dac fceam chestia Din punct de vedere raional, fata realizeaz pe-
asta cnd a fost s fie. Ce simi cnd priveti imagi- ricolul acestor pulsiuni i faptul c suicidul nu este o
nea? (Tcere lung, rezisten) Prostie legat de el c rezolvare n nici o situaie, fapt care i produce un pu-
gndete aa (Rezisten, uoar tristee). Ce ai vrut s ternic sentiment de disconfort.
spui cnd ai afirmat c am fcut? Cnd m-am certat Se pare c, pulsiunile suicidare apar la anumite pe-
cu tati de umblam prin baruri (acest lucru s-a ntmplat rioade de timp n contiin, sursa acestora fiind sen-
pe parcursul clasei a IX-a), tati, n loc s vorbeasc frumos timentul de singurtate i absena stimei de sine, toate
cu mine, a dat n mine i m-am enervat i am vrut s fac acestea pe fondul structurii masochiste.
chestia asta. Ce ai vrut s faci? Am luat cuitul i am n urma aplicrii probei a reieit faptul c ntr-o
vrut s-mi tai venele. Eram nervoas. Dac eram mai situaie limit s-a autovtmat, iar n alta a avut o ten-
nervoas o fceam, pentru c nu realizam ce fac, dar aa tativ suicidar.
am realizat i m-am oprit. A mai fost o chestie: nu mai Concluzie: Persoan cu pulsiuni suicidare datorate
tiu despre ce a fost faza, el n loc s m cread pe mine a sentimentului de singurtate i a absenei stimei de
crezut-o pe aia (pe o fat din sat) i eu m-am certat cu ei sine, risc suicidar real, dar numai n situaii pe care
i am dat cu pumnul n geam i l-am spart i mi-am fcut ea nu le poate gestiona emoional. Ea contientizeaz
praf mna. Cnd l-am spart n-am realizat ce-am fcut, raional situaia n care se afl i c suicidul nu este o
dup ce m-am tiat la mn am realizat ce-am fcut. rezolvare n nici o situaie, dar n momente cu ncr-
Faza asta a fost n clasa VI-a sau a VII-a. Lcri (sora ctur emoional negativ puternic, emoiile subor-
tatlui) este mai ru ca mine. Cnd se enerveaz sparge doneazz gndirea, astfel nct numai realizeaz con-
foarte des geamuri, cni, vase. secinele faptelor sale i trece la acting-out.
14. O camer ntunecat cu geamul deschis (rde) i Concluzii generale:
unul pus pe otii la geam -c st cocoat pe geam nesim- Persoana prezint un slab control al afectelor i al
itul- o vrut s vad cum e vremea de sus(rde cu poft). agresivitii, tendine spre autodistrugere, ntoarcerea
St pe geam de sus i se uit, el este singur n camer. Ce furiei mpotriva propriei persoane, pe fondul persona-
stare sufleteasc are? (ezitare). Puin suprat. Din litii histrionice i masochiste.
ce cauz este suprat? C nu are pe nimeni alturi n situaiile pe care nu le poate controla emoio-
de el i c are o impresie cam proast despre el. ce motiv nal, ea i pierde controlul emoional i al agresivit-
ar avea s stea cocoat pe geam. St pup. Nu i ce credei ii, gndirea fiindu-i subordonat afectelor, acest fapt
dumneavoastr, nu mai insistai! De prost, nu vrea s se putnd conduce la acting-out lucru care nseamn un
arunce(rde) aa c nu mai insistai! Nu vrea c se opre- risc suicidar/risc de autovtmare real, mai ales pe
te. Ce se ntmpl mai departe? i d seama c dac fondul structurii masochiste i histrionice de perso-
face chestia asta o s fie cel mai mare prost din lumea asta nalitate i a tendinelor de autodistrugere.
i c nu merit s i sacrifice viaa pentru toate tmpeni- Dei prezint un potenial risc suicidar/autolitic,
ile. Sau pentru prostia din capul lui c el crede c aa e mai fata nu constituie urgen psihiatric, dar necesit psi-
bine i tie c asta nu e o rezolvare, n primul rnd, aa c hoterapie de lung durat, monitorizare psihologic i
ar trebui s termine cu zpcelile astea din creieraul lui mediu familial suportiv.
i ar trebui s se bucure de via aa cum i c face parte
din ea. Nu asemn cu nimeni personajul. Ce simi cnd Exemplul 4
priveti imaginea? C merit s i mai deie o ans s Feti de 9 ani i jumtate cu o inteligen peste
nu fac prostia. medie, care provine dintr-o familie monoparental cu
situaie material precar i locuiete ntr-o zon n
Interpretare: care agresivitatea fizic i verbal i consumul de alco-
Pulsiuni suicidare evidente cu risc major de ac- ol sunt extrem de fregvente.
ting-out n situaii limit, pe care nu le poate gestiona Mama prezint n antecedente tulburri psihice,
emoional, iar autocontrolul emoional i al agresivi- fapt pentru care a fost internat n clinica de psihia-
tii este absent. Acest lucru este dublat i de faptul trie, dar n ultimii ani, nu a mai avut nici o internare.
c n aceste situaii, ea nu mai realizeaz consecinele Profile Szondi
aciunilor sale. Acting-outul este potenat i de struc-
S P Sch C cauza mediului n care fetia se dezvolt.

Aplicaia Data H S E hy K p D M Testul de Apercepie tematic
I 24.04.2014 - + - + + - - - 3BM. Este o doamn care st i plnge. St n pat.
II 28.04.2014 0 0 0 + - +- - + Plnge c i-a murit soul. Din ce cauz i-a murit so-
III 30.04.2014 - - - 0 +!! 0 + - ul? A fost bolnav. Ce boal avea? Cancer. i s-a dus la
IV 05.05.2014 - +! +- - 0 - + + mormnt la el. i ea a vrut s sar peste mormnt la el dar
V 08.05.2014 +- + + - 0 + 0 - ea n-a putut pentru c n-o lsase nimeni. De ce a vrut
VI 12.05.2014 0 +! - 0 +! 0 - -
s sar peste mormnt? Pentru c l iubea foarte mult
VII 15.05.2014 - + + - +- 0 - +-
i vroia s l lase acolo ngropat. Ce mai este n imagi-
VIII 19.05.2014 +- +! + - - - - +
IX 21.05.2014 0 +!! - -! + - 0 +
ne? Un covor. Dar pe covor? Un cuit parc. De ce se
X 26.05.2014 + 0 + - + -! + + afl cuitul acolo? Atunci nseamn c ea i-a omort
singur soul. De ce l-a omort? Pentru c a enervat-o
Interpretare: sau nu a vrut s fac ce a vrut ea. Cu ce a enervat-o?
- s+: structur masculin cu un comportament (agitaie motorie) C nu a vrut s se duc la spital la
agresiv, mai ales c din cele 7 profile unde este prezent copil. De ce era copilul internat n spital? Pentru c
s+, 4 sunt s+! ceea ce indic un nivel foarte ridicat de era bolnav. Ce boal avea? Era rcit foarte tare,avea
agresivitate i nclinaii sadice. Aceast structur mas- ap la plmni. Ce nu o fi fcut ce vroia mama? S-o
culin este ntrit si de h- i h+- care mai atenuiaz duc pe ea la spital la copil cu maina. Ce se ntmpl
ntr-o oarecare msur nivelul foarte ridicat al agre- mai departe? A venit copilul acas de la spital i mama
sivitii. e bucuroas. i spune c ea a omort tatl i c de ce l-a
- s+e-: descrcare paroxistic de agresivitate, aceas- omort. i copilul i spune: Mam dar nu trebuia s l
t situaie fiind ntrit de faptul c s+e- din profilul omori! Va pi mama ceva pentru c l-a omort pe
II s-au transformat n s0e0 n profilul III. Totui, tre- tatl? Nu. Ce i vine n minte cnd priveti imagi-
buie precizat faptul c, de-a lungul celor 10 profile, a nea? C e trist s-i omori soul i cnd vine copilul s i
existat o singur descrcare paroxistic de agresivitate spui. Este o tragedie. Ce simi cnd priveti imaginea?
(provocat de faptul c eleva a fost agresat verbal), De ru aa c nu e bine s i omori soul. O asemeni cu
i acest fapt pe fondul unui nivel destul de ridicat de cineva pe femeia din imagine? Nu.
agresivitate. 7BM. Doi brbai care vorbesc despre nite fete. Dup
- Schimbarea fregvent din factorul e indic un ce au vorbit despre fete s-au dus acas fiecare s-au pus n
control slab al emoiilor. pat, s-au culcat, a doua zi iar s-au ntlnit i au vorbit
- Desele fluctuaii ale factorilor din vectorul Sch c au gsit dou fete frumoase care sunt bune s lucreze,
indic o slab structurare a eu-lui i riscul apariiei s mture, s spele pe jos. Le-au luat pe alea dou fete, le
unui posibil proces psihotic. violase n primul rnd, n al doilea rnd le pusese s le
- Desele fluctuaii ale factorilor din vectorul C fac lucrul n fiecare zi. Ce se ntmpl mai departe?
indic o perturbare a acestuia, inclusiv a relaiilor de Tot alte fete, tot alte fete i fetele se vor aduna. Unde se
ataament. vor aduna? La serviciul la care le-a pus bieii tia. La
- Faptul c n dou din cele 10 profile se ntlnete ce serviciu? Ca un fel de tragedie de omort, dar ca i
combinaia s+e-m-, indic un risc major de dezvoltare cum ei se duc la serviciu i omoar oameni i femeile stau
a personalitii antisociale, acest risc fiind potenat de acas, fac de mncare, au lucru. Ce i vine n minte
mediul nociv n care se dezvolt. cnd priveti imaginea? C nu e bine, e foarte, foarte,
Concluzii: foarte ru s le pui pe aceste femei violate s fac lucrul
Feti cu un nivel ridicat de agresivitate cu unele s munceasc pn nu mai pot. Ce simi cnd priveti
descrcri paroxistice (descrcrile paroxistice apar imaginea? Nimic. i asemeni cu cineva pe brbaii
doar dac este supus unei agresiviti fizice i ver- din imagine? Nu.
bale) pe fondul unui slab control al afectelor. Nivelul 9GF. Este o femeie care se ascunde dup un copac i
ridicat de agresivitate este atenuat uneori de prezena o urmrete pe cealalt femeie de dup copac. i femeia
de-a lungul profilelor a lui h-, e+ i hy-. 2. Risc major care sttea dup copac o prinsese. i a dus-o la nchi-
de dezvoltare a personalitii antisociale, mai ales din soare. Dup ce a dus-o la nchisoare a spus c vrea s-o
omoare. i a omort-o i bineneles c ia i-a fcut si-
criu i a nmormntat-o fr nimeni, a vorbit numai Interpretare: din rspunsul la toate planele pre-
cu groparii i a ngropat-o. Exist vreo legtur ntre zentate reiese un nivel foarte ridicat de agresivitate,
cele dou femei? Numai ele au fost la aceiai coal, nclinaie spre un comportament antisocial (fapt indi-
de-aici i s-au certat la coal i cea care st dup copac cat i de rezultatele la testul Szondi), absena remu-
a vrut s-o omoare. La nimeni din familia noastr nu crilor i a contientizrii consecinelor legale. Aceast
li s-a ntmplat, poate n alte familii. Din ce cauz situaie este cel mai probabil cauzat de mediul social
s-au certat cele dou? Pentru nite bani. Au venit n n care triete, deoarece n acel mediu au loc fapte
prima zi la coal. Erau n clasa V-a i fata asta mic indezirabile social, dar care nu sunt sancionate legal.
i-a cerut nite bani la femeia cea mai mare de la coal Concluzii generale:
i i-a spus OK, i dau dar i vreau napoi mine cnd Feti puternic afectat negativ de mediul social n
ne ntlnim la coal! i i-a zis fata c bine. A doua care triete, prezentnd un nivel ridicat de agresivi-
zi s-au ntlnit i i-a spus acum hai d-mi banii dac tate cu descrcri paroxistice pe fondul unui slab con-
ne-am ntlnit, pn nu mergem la ore! i i-a spus ce trol emoional, a absenei remucrilor pentru faptele
bani?, c eu n-am de la tine nici un ban! Ce bani i comise i a necontientizrii sanciunilor legale ale
trebuie de la mine?. Ziua anterioar ea i ceruse 100 acestora, cu risc major de dezvoltare a personalitii
de lei. i ea a zis: dac nu-mi dai banii, o s te spun la antisociale.
maic-mea c i-am dat atia bani i mie mi trebuiau Chiar n condiiile unui nivel ridicat de agresivi-
banii s-mi iau haine de botez!. Ea i-a spus: ce bani?, tate cu descrcri paroxistice, fetia nu constituie ur-
c eu nu i-am cerut nici un ban!, aa-i spusese fetia. gen psihiatric i nici nu necesit tratament psiho-
i atunci fetia s-a gndit s o omoare i aa a omort-o. farmacologic, la acest moment fiind foarte utile doar
Ce se ntmpl mai departe? A venit mama fetiei monitorizare i consiliere psihologic.
care a murit la coal i a spus c de ce a omort-o i a
spus c de la nite bani, c n-a vrut s-i deie banii. Va Cazul 5
pi ceva fata care-a omort-o? Nu. Ce i vine n Biat de 19 ani provenit dintr-un centru de pla-
minte cnd priveti imaginea? C e bine s-o omori sament, ieit din sistemul de protecie social la 18
pe cineva dac nu-i d banii i te minte i a doua zi ani, nediagnosticat psihiatric anterior, dar prezentnd
i a treia zi. Ce simi cnd priveti imaginea? C e o evident tulburare de personalitate Borderline i un
bine s omori pe cineva (uor zmbet) dac-i face cine- intelect liminar. Despre familia sa se cunoate c tatl
va ceva. Le asemeni cu cineva pe vreouna din fetele este alcoolic, iar mama i-a rejectat toi copii, abando-
din imagine? Nu. nndu-i n sistemul de protecie a copilului. 2 dintre
17GF. Este o cas cu nite rzboinici care se bat. fraii elevului (un frate i o sor) au fost diagnosticai
Dup ce s-au btut au murit toi. N-a mai rmas ni- cu tulburri comportamentale, fratele lui fiind ameli-
meni dect o femeie i femeia i-a dus pe toi la mormnt orat semnificativ, despre sora acestuia nu avem date,
i dintr-o dat a aprut o lumin aa mare, mare! N-a dar la momentul abandonului colar (n clasa XI-a,
vzut-o nimeni c toi se duceau la mormnt. Ce lu- prezenta tulburare de conduit medie i o cert pre-
min era? De soare? De ce s-au btut ei? Pentru c dispoziie spre tulburarea de personalitate antisocial.
tot timpul se certau. Din ce cauz se certau? Din ca- Rezultate Poveste Slavon de Dragoste
uza banilor c nu erau n stare s i mpart. De unde
aveau bani? Furau. Femeia are vre-o legtur cu Ordinea
h1 s2 k3 P4 e5 hy6 d7 m8
ei? Nu, dar s-a gndit s fie amabil s-i duc. Ce se vinoviei
ntmpl mai departe? I-a ngropat i a venit acas Ordinea
m8 d7 hy6 E5 p4 k3 s2 h1
factorial
i rzboinicii care au mai rmas- dect doi- femeia se
CI=e+hy/k+p=5+6/3+4=11/7=1,57,indice cres-
certase cu ei. De ce s-a certat cu ei? Pentru c cei doi
cut care indic un potenial criminogen
erau din echipa cealalt pentru c ei i-au omort i erau
O = k + p + d + m / h + s + e +
cei mai buni. Ce se ntmpl dup ceart? Femeia
hy=3+4+7+8/1+2+5+6=22/114=1,57, persoan orien-
i omoar i pe ei. Ce i vine n minte cnd priveti
tat spre viitor
imaginea? Nimic. Ce simi cnd priveti imaginea?
Precizare: dup cum se observ, indicele de crimi-
Tristee. Asemeni cu cineva vreounul din persona-
nalitate (CI) este foarte crescut, ceea ce indica la acel
jele din imagine? Nu.
GENERAL STUDIES The use of projective techniques in risk assessment of psychiatric emergencies in children and adolescents Cornea Ioan Gabriel
moment un potenial criminogen semnificativ. La 5 criminogen ridicat i cu tulburare de personalitate

luni de la aplicarea probei, elevul a avut o tentativ de Borderline, biatul nu constituie la acest moment o
a-i rni sau ucide partenera, el fiind oprit de colegi, urgen psihiatric, dar necesit, att tratament psiho-
fapt pentru care aceasta nu a fost nici mcar rnit. farmacologic, ct i psihoterapie i monitorizare psi-
Trebuie avut n vedere faptul c, un CI crescut va hologic. n cazul absenei tratamentului psihofarma-
fi ntotdeauna potenat de tulburarea de personalitate cologic, orice alt intervenie este inutil, el neavnd
Borderline, precum i de alte tulburri psihice. contiina bolii, putnd astfel deveni n orice moment
Concluzie: Dei cu CI care indic un potenial o urgen psihiatric veritabil.
*
* *
Even if projective techniques do not allow a very techniques for at least three reasons:
precise prognosis of the moment a situation / disorder - The results obtained from one test are most
that constitutes a psychiatric emergency appears, often insufficient for achieving a precise prognosis;
some of these techniques provide very important - Correct interpretation of atypical responses
information on the risk of such emergencies. This or of symptomatic formulas;
means that one can establish that there is a serious - Diminished risk of misinterpretation due to
risk for a given situation / disorder to trigger, but one possible attempts to simulation.
cannot specify exactly when (how many days or hours If, for time reasons, there is impossible to apply
will pass until) it will happen. several projective techniques, the most relevant
One cannot make a prediction on the occurrence test to the respective case will be chosen. In this
of all types of psychiatric emergencies, but at least for situation, one will take into account the reason for
suicidal / autolytic risk and for paroxysmal discharge carrying out the assessment, the subjects level of
of aggressive energy. some of the projective techniques intellectual development and understanding, the
provide decisive information. existing data about the subject and the available time.
The fact that some of projective techniques provide Data obtained from the administration of projective
such information is due to clearly superior coding as techniques should be corroborated with other data on
compared to other concurring diagnostic tools, which the subject obtained by other methods.
reduces considerably the risk of simulation.
Regarding the prognosis of the risk of triggering In most cases, following the administration of
a psychotic episode, the exclusive use of projective projective techniques, especially when there are
techniques is counterproductive because some definite clues of auto and heterolytic risk (suicidal
atypical responses may be considered psychotic, risk, paroxysmal discharge of aggressive energy., etc.)
which is totally wrong. the request for additional information is mandatory -
from the subject, the carers, the school, etc. - helping
Projective techniques that can be used in assessing to establish a correct diagnosis, and also to achieve
suicidal / autolytic risk and that of aggressive adequate intervention / prevention.
discharge are Thematic Apperception Test (TAT),
Szondi Test, Roerich Psychodynamic Inventory During the administration of the tests, special
(RPI) Luscher Test and Rorschach Test. These tests attention should be given to simulation attempts.
can be supplemented as needed with other projective Attempts to simulation are based on five factors:
techniques, e.g. drawing tests. lack of interest in evaluation,
It is desirable to use a battery of projective lack of trust in/rejection of the evaluator,
Journal of Romanian Child and Adolescent Neurology and Psychiatry December 2014 vol. 20 nr. 4 61
Cornea Ioan Gabriel The use of projective techniques in risk assessment of psychiatric emergencies in children and adolescents GENERAL STUDIES
fear of results - in particular the fact that the time revealing the spiritual condition in general, the
subject could be diagnosed with a mental illness or difficulties and problems that he/she faces;
that he/she will be open to ridicule, - Feelings about sexuality and / or intimacy with
fear of losing control of the situation others;
desire to mislead the evaluator (this issue appears Inner self image, self-esteem, support systems
particularly in aggressive subjects, especially if they and relationships with parents, strength of support
have antisocial traits). Simulation methods are systems and of emotional connections;
determined by the level of intelligence, life experience The relationship of fidelity and honesty in a
- the higher the level of intelligence/ experience of relationship; this cannot be considered in children, it
living of the subjects, the more refined the simulation being relevant only in people who are experiencing or
attempts are - and, less often, information that have experienced a couple relationship;
subjects have about the tests used. However, given Current or previous problem that bothers the
that projective techniques are better coded, simulation subject, having major influence on his/her life, how
possibilities are limited (they are described for each it can be overcome, as well as the belief that life will
test presented here). change or stay the same. Here the suicide risk can be
In the case of subjects with auto and heterolytic assessed, but this will only be done by corroborating
risk, prevention is customized for each case, according the data obtained during the description of the road
to the following guidelines: and at the house of support.
Elimination or reduction of the causes (where The technique can be used both as assessment
possible) that led to the problem, this could largely evidence and as psychological intervention, because
solve the problem; the subjects accept it easily, as it is not perceived as
Psychological intervention (aimed at the eventual intrusive.
associated pathology), extended to family members Description of the test
/ close persons - where necessary and possible. There are two types of questions: the standard
Psychological intervention is useless in children / ones (15 in number) and the optional ones, which are
adolescents with sadistic traits; addressed in the manual, but without being included in
Psychological monitoring from time to time; these the standard inventory. According to the description /
intervals are set depending on the type and severity of replies of the subject (some subjects smoothly describe
the problem; what they imagine, others respond only to questions
Surveillance, even permanent in children / they have been asked) other clarifying questions can
adolescents with suicidal / self-destruct ideation, but be asked further, too.
which does not show a high risk of acting out; Instructions are given throughout the test.
Following a psychopharmacological therapy, Instructions and standard questions:
especially therapy for reducing aggressive energy. and The general perception of the road:
that of the associated pathology; Imagine that you are driving along a road
Emergency admission to hospital for more Record everything you see and hear, like a
serious cases - for example in case of an impending camera. Overfly the landscape, noting what you see
paroxysmal discharge of aggressive energy. or of in the distance, the background, and what surrounds
suicide, thus avoiding the acting-out. you. Feel the earth under your feet. You are the one
Roerich Psychodynamic Interview (RPI) who contemplates the journey.
Adapted after R. M. Roerich, 2002 1. What colour is the road?
Robert M. Roerich - member of the American 2. What is the road surface like?
Association for the Study of Mental Imagery (New 3. What is the firmness of the road?
York), introduced this projective technique of mental The perception of sexuality:
imagery in 2002, in the USA. Keep walking until you reach a river that has
In Romania is known as the Road Interview. to be crossed.
This technique has been built to evaluate five sub- In front of you, there is a river; the width and
themes: depth of the river are your choice. You cannot by-pass
An overview of the subject on his life at the same it, you have to imagine a way to cross it. Everything
62 Journal of Romanian Child and Adolescent Neurology and Psychiatry December 2014 vol. 20 nr. 4
you need to cross the river is already in your mind just but the house is inhabited and possibly in good
imagine how you will proceed. condition, the suicidal risk is low because there is a
` 4. How do you cross the river? support person, but, in this situation, parasuicide is
5. What does the water look like? not excluded or the risk of self-injury.
6. How fast is the water flowing? In this technique, there are two possible ways of
7. Is there anything in the water? If so, what simulating; either, for various reasons, the subject
is it? does not imagine what he/she is asked and answers
House of support: all questions formally, or the subject says something
You have crossed the river and you continue different from what he/she imagines.
walking. You arrive at a house. Take a good look at Simulation can be countered by additional
the house. Note the impression that you have on it. questions asked during the interview, because in
8. What colour is your house? case of a desire of simulation mismatches will appear
9. In what state is the house? between answers or while describing the journey. The
10. Does anyone live there? If yes, who? subjects refusal to imagine what he/she is asked is
Perception of fidelity: considered a form of simulation only if the subject has
We continue our mental journey and come to no mental retardation. In subjects who have mental
an open space. On the ground, there is a vessel and retardation, use of this test is contraindicated because
you stop to look at it. It can have any size and shape. it leads to erroneous conclusions.
Describe the vessel. Focus on its appearance, on its In practice, the subjects do not simulate at this
condition and on its content. test, considering it nonintrusive.
11. What colour is the vessel?
12. In what state is the vessel? Thematic Apperception Test (TAT) Henry A.
13. Is there anything in the vessel? Murray
The obstacle: TAT is a projective technique that aims to assess
Keep walking along the road and you come across patterns of thinking, attitudes toward self and others,
something that blocks your way. It stops you and the subjects emotional responses, defences, his/her
prevents your walking forward. This is the obstacle. needs and response patterns (including the level of
14. What obstacle is it? Can you overcome aggressiveness) to a softly structured material. With
the obstacle? If so, how? its help, one can get significant information about the
15. What do you see beyond the obstacle? suicidal risk and about its possible motivation.
In children with speech difficulties, for whatever Another aim of the test is its use in psychological
reason, they can draw the road, but with coloured intervention.
pencils.
Indices of suicide: Description of the test
Cumulating the following clues is necessary: TATs material consists in 30 black and white
- Black, grey, or red road, which is very picture cards and one completely blank card.
rough, broken or with ravines, deep pits, high walls The pictures contain characters of different
- regardless of their type - which can be crossed with ages and both sexes. The actions that characters are
difficulty or not at all; engaged in and the facial expressions are rendered
- A house where no one lives / is abandoned, ambiguously, in a way so that they can be interpreted
possibly in disrepair; in terms of needs, interests, emotions, conflicts
- Inability to pass the (obligatory) obstacle characteristic to the age of the subjects and to their
and the absence of a road beyond it; without this life experience. Of the 30 picture cards (plus the blank
element, the suicidal risk is very low or absent. card), 10 are valid for all categories of subjects while
Another suicidal clue is the obstacle in the form of a the others are more specific. The symbols from the
gate. This type of barrier is almost as relevant as the picture codes have the following meanings:
inability to move beyond the obstacle and the absence B - pictures for boys aged up to 14 years;
of the road behind the obstacle. G - pictures for girls aged up to 14 years;
- Since the obstacle cannot be overcome, M - pictures for men over 14 years of age;
F pictures for women over 14 years of age; he/she identifies (the one who is most spoken about,
GF - pictures for girls under 14, and women over whose subjective feelings and ideas are the most
14; discussed) has aggressive manifestations (e.g. it beats
BM - pictures for boys under 14 and men over 14; or kills other characters, destroys things, etc.). To
MF pictures for men and women over 14. these, the subjects own aggressive manifestations
Pictures marked only with numbers are for all ages during testing can be added (e.g. pounding his fist on
and both sexes. the table). If, during the test, the subject has aggressive
The administration of the test manifestations, the paroxysmal discharge of aggressive
The subject is asked to develop a story about each energy. is imminent, especially if these symptoms are
card that is offered; the subject should include in combined with s +! in Szondi Test. The subject
the story to the following aspects: what happens in is not considered aggressive if the character he/she
the respective scene on the picture card, the events identifies with is assaulted, abused, etc.
that have preceded the respective situation, what the The suicidal risk is much better assessed using
characters on the picture feel and think and how that TAT.
particular story ends. Depending on what the subject The basic picture cards are 3BM, 14 and 17BM,
says, clarifying questions may be asked throughout but answers that contain suicidal ideation may exist
the story, which would allow the subject to expand in other cards, too. For example, card 15 with this
the story. Questions should be such that they do not picture both types of content may be obtained - both
suggest an answer and do not involve moral judgments. suicidal ideation and aggressive energy. - therefore, in
After the subject ends the story, it is advisable that he/ this situation, it is better to administer the complete
she would be asked the following questions: What test, based on the same considerations as for the
comes to your mind when you look at this picture?, assessment of aggressiveness.
How do you feel when you look at this picture? Suicidal ideation consists in the fact that the
Do you associate the characters in the picture with character from the picture, which the subject identifies
anyone? The last question is not addressed in case of with, either commits suicide or is willing to do so.
pictures where there are no characters. Depending on the circumstances leading to the
suicide of the main character and his/her desire to
Some authors recommend two stages in do so, the stories can be classified as follows (without
administering the test: association stage (actual claiming that this classification is complete):
administration of the test) and the investigation stage 1. Stories describing situations that have
in which the subject is asked about the source of the no equivalent in reality (e.g., the woman commits
story. After the administration of the picture cards, it suicide because her child was kidnapped by aliens).
is necessary to discuss the responses with the subject, Suicidal ideation in such stories is inconclusive
these discussions having a clarifying role. (Aronow; and require further investigation, at most, as the risk
Weiss, Reznokoff, 2001; Bellak, 1991; Brelet- of suicide is absent.
Foularde, 2003; Popescu, 2011) 2. Stories where the character commits
The level of aggressiveness is assessed mainly suicide or is willing to do so due to situations that the
with the help of two picture cards: 8BM and 9BM. subject might meet along his/her life and that he/she
However, in practice, responses that contain a high expects (e.g. loss of a parent).
level of aggressiveness can be obtained from the In these cases, suicidal ideation is structured and
other pictures, for example 13MF or 17GF, so it is it usually indicates situations where the subject may
useful to administer the entire test. This is necessary commit suicide. Although in these cases suicidal risk
because aggressive responses may be obtained from is low, psychological intervention is necessary, having
those cards whose pictures the subject associates with a preventive goal.
different situations related to his/her experience of 3. Stories where the character commits
life or towards which he/she has some aggressive suicide or is unwilling to do so due to a situation
fantasies. that the subject has lived in. In these situations, the
It is considered that the subject has a high level suicidal ideation is consistent, suicidal risk depending
of aggressive energy. only if the character with which on whether the situation is overcome or not. If the
situation has been overcome, the suicidal risk at the obtain desired behaviours the from persons concerned.
time of testing is low, otherwise, the risk is increased. - Emotional instability: a factor that increases the
Whatever the case, the subject remains potentially suicidal risk because at a certain moment, the subject
suicidal, any traumatic event that will not be overcome, may understand and be able to overcome the problem
could lead to suicide. In these cases, both a deeper he/she faces and the next moment he/she may change
psychological assessment accompanied obviously by into the opposite mood and go further to acting - out.
psychotherapy and psychiatric assessment is necessary. - The level of self-control: if the subject has strong
4. Stories in character commits suicide or self-control, suicidal risk is amplified. In the same
unwilling to make due to situations where the subject situation, in case of weak self-control, suicide risk is
is facing at the time of testing. This topic describes diminished because it is highly probable that even if
major suicide risk, suicide may occur at any time, these the subject has built a plan to commit suicide, he/she
cases represent psychiatric emergencies - especially if will not have the resources to implement it.
the data obtained with TATs are confirmed by other It is advisable that both for suicidal risk and
tests. for aggressiveness, the results from TAT should
5. Stories where the character commits be corroborated with results from other projective
suicide due to self- depreciation /the fact that he/she techniques.
feels lonely. In such cases, suicide is not imminent, In the case of TAT, simulation may consist either
but it may occur at any time, this depends on other in that the subjects tell something different from
factors, such as situations where the subject cannot what they see or think, or they tell incomplete stories
handle emotionally. Subjects who offer such stories about what they see and think. Some picture cards
are often depressed. facilitate simulation because of the embarrassment or
6. Stories where the main hero wants to discomfort that subjects feel when they look at them
commit suicide, but does not, and the story ends as or because of very strong emotions that the pictures
it the subject wishes. In this situation, it is not real evoke, which the subjects wish to repress or hide.
suicidal ideation, but possibly a risk of superficial The methods to counteract simulation consist
self-harming. The motivation of the possible self- in asking the subjects clarifying questions during
harming is the most often the emotional blackmail the administration of the cards and in monitoring
of the person concerned in achieving the subjects the subjects behaviour and psychological condition
goals. This is especially true with subjects who have a during the test.
histrionic personality structure. If the during the storytelling of one or several
In the last two cases, it has to be established pictures, the subjects have motor restlessness, move
whether there are also other mental disorders besides their eyes or avoid eye contact with the examiner, smile,
suicidal ideation. but their smile is not consistent with what they say, it
Especially with type 4 story, in suicidal risk is evident that they want to hide certain things. In this
assessment one must take into account other factors, situation, the examiners can ask the subjects further
too: questions and can suggest that they have realized that
- Fear of death: if the subject has a strong fear the subjects want to hide something and that it is to
of death, suicide is unlikely, unless it presents their advantage to give up the attempt. If they are
emotional explosions, possibly doubled by histrionic approached tactfully, subjects change their attitude
behaviour. In this situation, the subjects behaviour is and become cooperative if they realize that they
unpredictable and suicide may occur at any time. cannot hide what they think and that the examiner
- Emotional explosions: if the subject displays is not hostile. Other questions may be asked, too, to
affective explosions, suicidal risk is amplified, the determine the subjects to say whatever they think in
subjects being behaviour being unpredictable, connection to a particular picture, but these questions
especially when such explosions are doubled by should be formulated according to the context, there
histrionic behaviour. is no standard recipe. In these situations, children and
- Histrionic conduct: it amplifies the parasuicidal adolescents feel the need to reassure themselves on
risk. This behaviour has two purposes: either the the confidentiality of the psychologists, some of them
subject wants to draw attention on him/her or to needing emotional support when they tell the story
of certain pictures, typically of those pictures have a It shows how stable and satisfying the object
strong emotional impact on them. relationships of the individual are. d Factor refers to
Szondi Test the necessity to search objects in the environment
Leopold Szondi that should be invested emotionally, and the m factor
Aim of the Test refers to the tendency to cling to objects.
Assessment of Pulsions and of Pulsional Test material
Dynamics. It consists of 48 photographs, each showing the
Test Description face of a mentally ill patient. They are displayed into six
The test is designed to assess four pulsions, each groups of eight each. Each group contains the photo
having two tendencies: of a person whose personality had been classified
1. Sexual Vector (S) as homosexual, a sadist, an epileptic, a hysteric, a
It reflects the intensity and the expression of sexual catatonic schizophrenic, a paranoid schizophrenic,
and aggressive needs of the subject, hence the sexual a manic-depressive in the depressive phase and a
identification of the individual, on his two facets: manic-depressive in the manic phase.
femininity and masculinity. Femininity is associated Test administration and coding
with a softer, more passive spirit, with gentleness It has two stages: the stage of the actual choice
and tenderness, while masculinity is associated and the stage of association, the association stage in
with incisive, active, domineering, aggressive spirit. children is not applicable.
Any person contains an alloy composed of the two In the stage of actual choice, the subjects are
elements, but one is predominant. Analysing this asked to choose two most appealing, then two most
vector, one may find the intensity of the persons repulsive photos from each group (for the foreground
erotic-sexual, aggressive needs as well as the ability of profiles), and then another two repulsive photos (for
sublimation of libido. h factor (represented by pictures the background profile).
of homosexuals) reflects the need for tenderness, The appealing photos (including the two
eroticism, and the s factor (represented by pictures remaining ones) are denoted + and the repelling
of sadists) measures the need for physical activity, ones are denoted by -.
effective domination and manipulation of objects in
the environment. Useful Szondi formulas and indices in assessing
2. Paroxysmal Vector (P) aggressivveness. and suicidal risk
It shows the degree of imbalance or stiffness in s+! Sadistic tendencies (very high energy.)
affective censorship, i.e. the modality of control
of the emotional manifestations. e factor shows s-! Masochistic tendencies
to what extent the subjects want to control their h+/s+! Sexual drive with aggressiveness
harsh emotions, like anger, irritability and to adopt
an ethical attitude of helping others and do good. H0/s+! Tendency to destroy the others
hy factor reflects the intensity of moral censorship,
H0/s-! Tendency towards self-destruction
respectively the control of expressing gentle, non-
aggressive emotions. e- Poor control of emotions; unstable emo-
tional balance indicated by the frequency
3. Schizophrenic, or Ego Vector (Sch) with which e- factor switches to e0
It shows the ego strength, the complexity of the s+/e- Paroxysmal discharge of aggressive en-
defence mechanisms, general control of the behaviour ergy; lack of aggressiveness control
of the subject. k factor reflects the tendency of the Hy+ The desire to stand out; histrionic behav-
iour
body to differentiate from the environment, to
k-! Suicidal tendency
be independent and p factor reflects the trend of
emotional fusion with the environment and the burst
of ego boundaries, within a contact that should annul m- Antisocial behaviour
the distance between object and subject.
4. Contact Vector(C)
s+/d0/m- Antisocial behaviour contact, a certain anxiety, etc. (Adapted from Szondi,
1952 Deri, 1949 Melon, 1997 Dumitracu 2005
h 0 / s + ! / e - Imminence of paroxysmal discharge of www.szondiforum.org)
sau e0/m- aggressive energy.
S+/e-/m- Antisocial personality structure Slavonic Love Story -2
h0/s-!/k-!/ Serious risk of suicide Translation after Djos V., 2011
d0 On the side of a full-flowing impetuous river,
h 0 / s - ! / Major risk of parasuicide there lived a girl, Luba (L) by name. She was ripe for
hy+/k-!/d0 a great love, but only married, disabled, or alcoholic
h 0 / s - ! / Risk of suicide men lived around her. Had she agreed to throw in her
k+/p- lot with one of them, her fate might have turned out
The formulas to indicate the tendency to destroy to be different.
the others, the sadistic structure, the weak control of However, she did not want to squander her dream
emotions and of aggressiveness, the imminence of on substitutes.
paroxysmal discharges of aggressive energy, are clear Demitry (D), her ubiquitous neighbour, who
indications that a paroxysmal discharge of aggressive offered her various candidates, also acquainted her
energy can occur at any time. These statements do with Sergey (S), who lived on the opposite side of the
not constitute psychiatric emergencies, but both river. Sergey once saw her swimming in the river and
psychopharmacological therapy and psychotherapy wanted to take possession of her. He sent old Marya
are absolutely necessary to improve the state of these (M), the matchmaker, and she did her best praising
people. In the absence of psychopharmacological Sergey and made Luba believe that Sergey was the
therapy, any other type of intervention is useless, only intended husband for her. The desire to be with
since people with high levels of aggressiveness do not him was getting stronger, but the river was flowing
suffer, but make others people suffer, so they have no between them; besides, it was also the state border.
good reason to want to be healed. There was a narrow footbridge across the river.
There are three situations where Szondi profiles Konstantin (K), the frontier guard, was staying there
are null: on point duty and allowed only those he liked to cross
1. The subject makes choices after a certain the bridge. Luba asked him to let her go to the opposite
algorithm, i.e. choose the pictures located in the same side. But he did not like her and he refused. Then
positions. This has four possible causes: strong anxiety Luba applied to her ubiquitous neighbuor Dmitry, for
at the test / examiner, a possible mental blockage, whom, frankly speaking, no frontiers existed. Dmitry
misunderstanding of the instructions and desire to promised to find the way for her to get onto the other
simulate. side of the river. Days and weeks passed.
2. The subject chooses the pictures without looking In despair, the girl rushed to Colonel Petrov (P),
at them. This situation is caused by the desire to the guards commander and asked him to let her go
simulate and the disinterest in the test, ADHD, and, to the other side. Colonel Petrov was surprised and
less often, by the misapprehension of the instructions. asked her to explain why she was striving to get there.
Apparently, the person chooses the pictures in She told him about her love. It was night and her
compliance with the instructions, but his choices are story reminded him of
not according to what he thinks and feels. This is an his youth, his unhappy love that destroyed his
obvious form of simulation. Subjects who do so are marriage and he ordered Konstantin to let Luba go;
highly intelligent and usually want to hide a high however, he wanted to think everything over first.
level of aggressiveness or of antisocial / pathological Seeing that the colonel started hesitating, she rushed
behaviour. It is very difficult to detect such a situation. to the other side before he could change his mind.
The only clues come from the inconsistency of the
profiles with existing data on the subject and with On the other side of the bridge, there was another
results obtained from other tests and eventually from guard, Eugene (E). He was deeply suffering as the
possible behavioural manifestations during the test day before his wife was unfaithful to him. Had Luba
showing a simulated behaviour, such as avoiding eye walked slowly he might have not noticed her. But she
was running. Eugene stopped her and asked whom Calculation formula: CI = e + hy / k+ p.
she was hurrying to An index between 0 and 1 is considered normal; if
at such a late hour. She told him about her love. more than 1, the higher the CI is, the higher criminal
Eugene felt anger that Sergey was loved so much and potential the subject has; the latter situation indicates
that his own wife was unfaithful. the subjects high level of aggressiveness.
Its not fair! he thought. Eugene fell upon 2. The orientation rate (index) - to the past or
Luba and using force raped her. After that, he felt a the future (O): it indicates the predominance of the
bit better and let her go. It was dark and no one saw subjects orientation, either to the past or to the future.
it. However, Istratiy (I), who was making his usual A person who is oriented mainly towards the past
evening stroll, heard something while walking past has a higher risk of suicide than one mainly oriented
the bridge and even saw Luba putting her clothes towards the future.
in order. And he told everyone, including Sergey, in Calculation: O = k + p + d + m / h + s + e + hy.
vivid colours, adding so many details to this sexual An index between 0 and 1 shows a person oriented
episode that it looked like wild lechery. Luba went to towards the past, and one located above 1 indicates a
Sergey to explain everything hoping that he would person oriented towards the future. In the latter case,
understand and protect her. But Sergey met her with the higher the index, the more the person is future
hatred. He said, I needed all of you, I dont want oriented.
any leftovers! I would ask prostitutes to stay away
from me! Luba felt as if a heavy hammer fell down Case studies
onto her head. She lost the future. Her life lost its N.B.: Each case will be considered only in terms of
meaning. While she was walking along the river, she suicide risk, the level of aggressiveness and associated
recalled that she would have to pass by Eugene and matters related to these issues.
she jumped, plunging into the river, and was drowned.
Case 1
Who, in your opinion, is the most guilty out of A 16-year-old girl coming from a family with a
the 8 participants in the tragedy described above? very poor background and with absent moral norms.
Write down the first letter of the characters name She became a prostitute since she was 13 years old,
into the first cell of the table below: being encouraged by her mother whom she gave some
Now, who among the remaining characters is the the money thus earned. The girl gave up this practice
guiltiest? Write down the first letter of the characters one year and a half before because she has started a
name into the second cell of the above table, and so on, relationship with a boy.
until all the participants of the tragedy are analysed. Roerich Psychodynamic Interview
(Write down only the first letter of the characters The Road
name.) 1. What colour is the road? Black.
2. What is the road surface like? Straight, smooth.
N.B.: the test should be administered to persons 3. What is the firmness of the road? It is hard.
whose age is 14 or older, but it is contraindicated in House of support
persons with mental retardation or borderline intellect 8. What colour is your house? Pink.
because they do not understand it. What material is the house made up of? From
Interpretation bricks.
After reading the story, the subject is asked to 9. In what state is the house? In good condition.
arrange all the characters according to their culpability, 10. Does anyone live there? If yes, who? No one
starting from the most guilty to the most innocent. lives there.
Scoring: all the characters are scored in the order The obstacle
noted by the subject from one point for the most 14. What obstacle is it? A large tree fell and cannot
guilty to 8 points for the most innocent. move further.
Two indices are of interest: Can you overcome the obstacle? If so, how? I
1. The crime index (CI): This indicates a possible cannot because it is too large.
predisposition of the subject to commit a crime. 15. What do you see beyond the obstacle? A house.
Go ahead and you arrive at another obstacle. What occurs only in 3 consecutive profiles, this indicating
is that obstacle? I have broken my leg. a transient form of attachment. This is reinforced by
Can you overcome that obstacle? If so, how? I the fact that m- is accompanied by d + and d0.
cannot. - The existence of s + e- m- indicates the risk of
What do you see beyond the obstacle? A hospital. antisocial personality, and this is also reinforced by
N.B.: in this case, the interview also contains more the presence of m- in 7 of the 10 profiles. This risk
questions than the standard ones. depends very much on the social environment where
Interpretation: the absence of suicidal risk, the girl will live from that moment on.
but risk of self - harm in order to receive help, to
capture the attention of others and to get the desired Conclusions:
behaviour from the person concerned. (The house Girl with both male and female behaviour, with
that lies beyond the first obstacle signifies the need poor control of emotions and of aggressiveness, with
for support, and the hospital from the second obstacle histrionic behaviour, in the absence of attachment
means the need for material aid to be in the centre of person, has the potential for paroxysmal discharges
attention.) of aggressive energy, development of antisocial
personality and self-harm - she harms herself only
Szondi Profile if she wishes to obtain certain behaviour from the
S P Sch C person concerned.
Aplicaia H S E hy K P D m
I + - - + +- - 0 - Thematic Apperception Test
II + - +- +- + 0 - - 3BM. A boy broke up with his girlfriend because
III + - 0 +- + - + -
she cheated on him with his best friend and when
he broke up with her, in the street, he saw a pillar
IV + + - + - + - +
with a stone, sat there, put his head on the stone, and
V + 0 - +-! +- - + +
wept. What else is there in the picture? A knife. Why
VI + - 0 + +- 0 + +
is a knife there? He wanted to kill himself because
VII + + - +- + +- + -
his girlfriend cheated. What happens next? The boy
VIII + 0 + + - 0 + -! decided to give another chance to the girl and be
IX + 0 +- - + + 0 -! together again and forget everything and be happy,
X + - + 0 + - 0 - although this can never be forgotten. What comes to
your mind when you look at the picture? I think of
Interpretation: Flavius, but I have not deceived him, it was he who
- Both female and male behaviour, s having both cheated on me, she is not my best friend, with a girl
+ and -, tendencies. and he still keeps telling me I have not cheated on
- S+e-: poor control of aggressiveness, especially you. What do you feel when you look at the picture?
since s + transforms each time into s0, which indicates Sadness. Do you liken the boy in the picture with
a paroxysmal discharge of aggressive energy. anyone? Yes, with me.
- Frequent fluctuations factor e indicates poor 3GF. A boy is standing at the door. The boy wants
control of emotions. to open the door, he is crying because his mother is
- Hy + / + -: histrionic structure. In 8 out ill in bed, she wanted to commit suicide and closed
of the 10 profiles hy is either + or + -. This, in the door so that no one could find her, because, God
conjunction with the poor control of emotions, leads forbid, she had stomach cancer and did not want to
to unpredictable behaviour, which may consist both suffer, neither she nor her child and thought that
in paroxysmal discharges of aggressive energy, and in maybe it was better like that for her child, too. What
superficial self - harming. happens next? His mother finally decided to kill
- Frequent fluctuations of factors in the Sch herself because she has suffered too much and does
vector indicate a weak ego structure and the risk of not want to suffer any longer, neither she nor her child.
the possible emergence of a pathological process. Did she manage to kill herself? Yup. What comes to
- M-: the absence of attachment person, m + mind when you look at the picture? Death. I take it
that you are afraid of death? Yup. Is it possible that I Interpretation:

may inherit anything? My grandfather had eye cancer - The story of 3BM card is placed into group 6, it
and Aunt Viorica had in the belly and died. What do is actually a faithful reproduction of her relationship
you feel when you look at the picture? Great sadness. with a partner. In this situation, it is not a real risk
Do you liken the boy in the picture to anyone? Yes, to of suicide or suicidal ideation, but a potential risk of
my uncle. self-harm for the emotional blackmail of the target
8BM. There are 4 people. One is on the table, lying person.
on his back and a man cut him with a knife in the - The story in 3GF card is placed into group 2.
belly. The other man from the back is looking at them Suicidal ideation is related to the situation in which
and this other man is sad because why does this guy she would suffer from a disease that would not allow
cut that mans belly. Where are they? In a room. Near her to care for herself. In this situation, it is highly
the man on the table there is a rifle. Who cuts him likely for her to resort to suicide.
and why ? I do not know, maybe he did something - From the stories of the pictures 8BM and
evil. What evil has he done? He was with them in 15 one can see very high levels of aggressiveness,
the gang and he wanted to come out and they said predisposition to antisocial behaviour and criminal
no, he should not go away, he should stay with them. activities.
What gang is that? In a music band. What happens Conclusion: It is a person with suicidal risk
next? The man who wants to cut him says: Will you only in the situation of an incurable disease, risk of
stay with us or we kill you? The man said, I remain self-harming the body, but with a very high level of
with you, but on one condition: you take my brother, aggressiveness, a tendency to antisocial behaviour and
too. and tells the man that wants to cut says: Yes, we criminal activities.
take him, too but he must do what I say. What did
he want to tell him to do? To listen to him, to sing General conclusions:
what music he wants, to go wherever he sends him. 1. Girl with poor control of emotions and of
Why would they kill him if he does not want to be aggressiveness, tendency to antisocial behaviour and
in the same gang with them? Because he knows a lot, susceptible to illicit activities on the background of a
that they killed before, that they are drug dealers. Will histrionic personality structure.
they take his brother, too? Yes, and the boys brother 2. Suicidal risk only in case of an illness that would
says, You shall deal only with drugs What comes to not allow her to care for herself.
mind when you look at the picture? Nothing. What do 3. Risk of self-harm, but only to impress / as
you feel when you look at the picture? Nothing. Do you emotional blackmail of the partner (to whom she is
liken the characters in the picture to anyone? No. not attached).
15. (resistance) A man dressed in black goes to the 4. This case is not a psychiatric emergency, the girl
cemetery at midnight and breaks the crosses. He is needs long-term psychotherapy and psychological
Satanist, goes to the cemetery, takes drugs, does crap monitoring, otherwise, her evolution will be extremely
out there. (sigh). What happened before? He has unfavourable.
been a good man, labourer, lived in the countryside,
but when he came - he moved in town - he saw what Case 2
life is like here, befriended some Satanists, he took Boy of 18, from a single-parent family, his mother
after them and got like them. What is mood like? Of has never had authority over him and his brother. He
a demon. What happens next? He will remain the has a high level of aggressiveness, which he tries to hide
same, he will still stand by his friends, will move with in front of teachers. After the first administration and
them. What comes to mind when you look at the after the interpretation was offered to him, the student
picture? Nothing. What do you feel when you look has never come back for the next administration.
at the picture? Nothing. (low voice) Do you liken the Szondi Profile
man in the picture to anyone? Perhaps he is like me, S P Sch C
but Im not a demon. h S e hy k p D M
+ +! - - + - 0 -
Interpretation: - h0s- !: self-destructive tendency which usually

H + s + !: sexual drive with aggressiveness (this contains suicidal ideation.
thing considering that the inquiry revealed that the - s-! e-: from the first profile indicates rage turned
last sexual relationship happened in morning of the against ones own self, this behaviour is enhanced by
testing); histrionic structure.
S +! e: paroxysmal discharges of aggressive energy; -e + -: ambivalence in controlling aggressiveness
S +! e-m-: antisocial personality structure; and emotions; affective conflict that can lead
s + e-hy-: less interested in how their actions affect to periodic choleric crises, but not to antisocial
others; pursuing of their own selfish advantage. manifestations;
N.B.: after the administration of the test, the same - hy + -: consciously perceived conflict; intra-
day, the boy physically assaulted his partner. psychic tension, reflecting indecision to express her
Conclusion: paroxysmal discharge of aggressive own feelings; the component hy + from the structure
energy, against the background of following his own h+ - indicates a histrionic personality, especially that
selfish advantage and of his antisocial personality hy + - is found in 7 of the 10 profiles.
structure. Conclusion: It is a person with tendencies
towards self-destruction and moments of directing
Case 3 the anger against her own self, against a background
Girl, aged 17 years and a half, above average of masochistic and histrionic personality structure.
intelligence, coming from a family where the father In this situation, there is a real risk of suicide, but
and grandmother behave arbitrarily and in an only in extreme situations, which she cannot manage
authoritarian manner with her, claiming that they emotionally, and emotional self-control and that of
want to protect her. Both the behaviour of two aggressiveness is absent.
relatives and her problems with her eyes have led to Thematic Apperception Test
her lack of self-esteem and inferiority complex. Since 3BM. So! There is a man who lies - not lying
the father drinks alcohol, he becomes uninhibited, there on the ground, but in a squat position - and
most often threatening her, and, very rarely, assaulting with head resting on the seat. He is alone. Hmmm.
her, even without a real reason. Stepmother is the only What else is there in the picture? It is a bench, a chair,
attachment person in the house and she no longer he is upset (motor restlessness). He thinks about what
keeps in touch with her natural mother will happen with him, that is, if everything will be
fine with him as before, what will become of him,
Szondi Profile if he is going to have a beautiful family. But, whats
S P Sch C down there? There is nothing. (Later laughs). Look
Aplicaia H s E Hy K P D m carefully and tell me, do you notice anything else in
I + -! - +- 0 + + 0 the picture? There is a knife. Why is there a knife? He
II + -! +- +- 0 0 +! 0 has forgotten it on the ground. On what purpose is
III 0 - +- +- 0 + +- 0
the knife there? He wanted to tattoo his veins a little.
Arent you stupid! Dont you know what you want
IV + - +- +- 0 0 + 0
from life? (Laughs). Why did he want to tattoo his
V 0 -! +- +- 0 + + 0
veins? He thought its good that way, but he stopped
VI + -!! +- - + 0 + 0
in time. What caused him to believe so? That way he
VII 0 -! +- - + + + +-
thought it is better, but he realized that he has all the
VIII + -! +- - 0 + 0 0 future in front of him and he realized that he would
IX + -! +- +- 0 + 0 0 not have solved anything and he is trying to be more
X + -! +- +- 0 + + 0 optimistic. Can you be more explicit why he thought
it is better like that? (Hesitation) He had no one close
Interpretation: to him. What happens next? (Motor restlessness)
- s-!: masochistic structure. In 8 of the 10 profiles, He will realize that everything will be fine and
s- is at least with a !, which indicates that the he will be very optimistic. You shall be optimistic,
masochistic structure is well defined. you stupid! (Throughout the whole interview, the
motor restlessness persisted). I do not liken anyone do you feel when you look at the picture? That he
with anyone else, he is in a good, optimistic mood, deserves another chance not to do that stupid thing.
(statements made mechanically). I hate this TAT! I
cant believe it! (The test was performed at the request Interpretation:
of the student) What comes to mind when you look - Obvious suicidal impulses, high risk of acting
at the picture? Nothing. That hes stupid (laughs). But out in extreme situations, which she cannot manage
what about you, what do you remember? That I made, emotionally, and emotional self-control and that of
I would have made a big mistake if I did that thing aggressiveness ares absent. This is doubled by the
when it was to happen. What do you feel when you fact that in these situations, she no longer recognizes
look at the picture? (Long silence, resistance) Stupidity the consequences of her actions. The acting-out
on his part, because he thinks so. (resistance, slight is enhanced by the histrionic and masochistic
sadness). What did you mean when you said That I personality structure.
made? When I quarrelled with Daddy and I started - In terms of rational thinking, the girl is aware of
to go to bars (this happened while I was in grade IX), the danger of these impulses, of the fact that suicide
Daddy, instead of talking nice to me, he hit me and I is not a solution to any situation, which produces her
got angry and I wanted to do this stuff. What did you a strong sense of discomfort.
want to do? I took the knife and wanted to slit my - Apparently, suicidal impulses arise from time to
wrists. If I were nervous, I would have done it, because time in her consciousness, their source is the feeling
I did not realize what I was doing, but as I realized of loneliness and lack of self-esteem, all these on the
and I stopped. There was another thing, too: I do not background of her masochistic structure.
know what was phase about, he, instead of believing - The test showed that in an extreme situation she
me, he believed that one (the girl in the village) and harmed herself and in another she had an attempt at
I quarrelled with them and hit the window with my suicide.
fist, I broke the glass and I smashed my hand. When Conclusion: It is a person with suicidal impulses
I broke it I did not realize what I did, after I cut my related to the feeling of loneliness and lack of self-
hand I realized what I did. This phase was in grade VI esteem, real suicidal risk, but only in situations that she
or VII. Lacri (fathers sister) is worse than me. When cannot handle emotionally. She weighs the situation
she gets angry, very often she breaks windows, cups, where she is in rationally and concludes that suicide is
pots. not a solution in any situation, but in strong negative
14. A dark room with the window open (laughs) emotional moments, emotions rule the thinking so
and one guy playful because he is perched on the that she no longer realizes the consequences of her
window, the asshole! - he wanted to see what the actions and moves on to acting-out.
weather is like from the top (laughs heartily). He sits
up on the window and looks down, he is alone in the General conclusions:
room. What mood is he in? (hesitation). A little upset. 1. The person presents a weak control of emotions
Why is he angry? Because he has no one with him and of aggressiveness, tendencies towards self-
and he has a bad feeling about him, why would he destruction, turning anger against herself amid
sit perched on the window? He is crouching. It is not histrionic and masochistic personality.
what you think, stop insisting! Because he is a fool, he 2. In cases that she cannot control herself
does not want to jump (laughs) so do not insist about emotionally, she loses her emotional control and that
this! He does not because he stops himself. What of aggressiveness, her thinking being subordinated to
happens next? He realizes that if he does this thing, he affections; this could lead to acting out. This means a
is gonna be the biggest fool in this world and that its real risk of suicide / self-harm risk, especially in the
not worth sacrificing his life for all that bullshit. Or context of her histrionic and masochistic personality
for the stupidity in his head, because he thinks thats structure and of her self-destructive tendencies.
better and knows that this is not a solution, firstly, so 3. Although there is a potential suicidal / autolytic
that he should put an end to these stupid thoughts risk, the girl is not a psychiatric emergency, but she
from his little brain and should enjoy life as he is part requires long-term psychotherapy, psychological
of it. I do not liken this character to anyone. What monitoring and supportive family environment.
Case 4 - The fact that in two out of the 10 profiles there

It is a nine-and-a-half -year-old girl, above average is the s + e-m- combination indicates an increased
intelligence, who comes from a single-parent family risk of developing antisocial personality, this risk is
with precarious financial situation and lives in an area amplified by the harmful environment in which she
where physical and verbal aggressiveness and alcohol grows.
consumption are highly frequent.
Mother is with a history of psychiatric disorders for Conclusions:
which she had been admitted to the psychiatric clinic, 1. She is a girl with a high level of aggressiveness,
but in recent years, she has had no hospitalization. with some paroxysmal discharges (paroxysmal
discharges occur only if she is subjected to physical
Szondi Profile and verbal aggressiveness.) against a weak control
S P Sch C of emotions. The high level of aggressiveness is
Application Date H S E hy K p D M sometimes mitigated by the presence of h-, e + and
I 24.04.2014 - + - + + - - - hy- along the profiles.
II 28.04.2014 0 0 0 + - +- - + 2. High risk for antisocial personality development,
III 30.04.2014 - - - 0 +!! 0 + - especially because of the environment in which the
IV 05.05.2014 - +! +- - 0 - + +
girl grows.
Thematic Apperception Test
V 08.05.2014 +- + + - 0 + 0 -
3BM. There is a lady who sits and cries. She stays
VI 12.05.2014 0 +! - 0 +! 0 - -
in bed. She is complaining that her husband has died.
VII 15.05.2014 - + + - +- 0 - +-
Why did her husband die? He was sick. What disease
VIII 19.05.2014 +- +! + - - - - +
did he have? Cancer. And she went to his grave. And
IX 21.05.2014 0 +!! - -! + - 0 + she wanted to throw herself over the grave but she
X 26.05.2014 + 0 + - + -! + + could not because no one had let her. Why did she
want to throw herself over the grave? Because she
Interpretation: loved him very much and wanted to let him buried
- s +: masculine structure with aggressive there. What else is there in the picture? A carpet. And
behaviour, particularly since out of 7 profiles where on the carpet? A knife, it seems. Why is a knife there?
s +is present, 4 are s +!, which indicates a very high Then it means that she murdered her own husband.
level of aggressiveness and sadistic inclinations. This Why did she kill him? For he annoyed her or he did
male structure is also reinforced by h- and h + - not want to do what she wanted. What annoyed her?
which soften to some extent the very high level of (motor restlessness) The fact that he did not want to
aggressiveness. go to the hospital to see the baby. Why was the baby
- s + e-: paroxysmal discharge of aggressive energy, in hospital? Because it was sick. What disease did it
this situation is reinforced by the fact that s + e- from have? It had a very bad cold, it had water on the lung.
profile II turned into s0e0 in profile III. However, it What could have been that he did not do as mother
should be noted that over the 10 profiles, there was wanted? To take her to the hospital to her child by
a single paroxysmal discharge of aggressive energy car. What happens next? The child came home from
(caused by the fact that the student was assaulted the hospital and mother is happy. She says that she
verbally), and this against a fairly high level of has killed the father and why she killed him. And the
aggressiveness. child says, Mom, but you should not have killed him!
- Frequently changing the factor e indicates poor Will anything happen to mother because she killed
control of emotions. his father? No. What comes to mind when you look
- Frequent fluctuations of factors in vector Sch at the picture? Thats sad to kill your husband and tell
indicate a weak ego structure and a possible risk of this to your child when he comes home. It is a tragedy.
psychotic process. What do you feel when you look at the picture? I feel
- Frequent fluctuations of factors in vector C bad, so its not good to kill your husband. Do you
indicate its disturbance, including a disturbance of liken the woman in the picture with anyone? No.
attachment relationships. 7BM. Two men are talking about some girls. After
talking about girls they went home, each sat on the girl who killed her? No. What comes to mind when
bed, went to sleep, the next day they met again, talked, you look at the picture? Thats good to kill someone
and found two beautiful girls that are good to work, if they do not give you money back, not even the next
to sweep, to wash away. They took on those two girls, day and third day. What do you feel when you look at
raping them first, secondly they made them to do the picture? Thats good to kill someone (easy smile)
their work every day. What happens next? All the time if they do you harm. Do you liken any of the girls in
other girls, other girls and the girls will gather. Where the picture with anyone? No.
will they gather? At the job that these guys gave them. 17GF. There is a house with some warriors that
What job is that? Like a sort of tragedy to kill, but as fight. After they fought, they all died. All thats left
if they go to their job and kill people and women stay is a woman and the woman put all of them into the
at home, they cook, they work. What comes to mind grave and all of a sudden a light appeared so big, big!
when you look at the picture? Thats not good, its Nobody saw it because everybody went to the grave.
very, very, very bad to put these raped women to work What light was it? The sun? Why did they fight?
and work until they are exhausted. What do you feel Because they were always arguing. Why were they
when you look at the picture? Nothing. Do you liken arguing? Because of the money, that they were not
the men in the picture with anyone? No. able to share it. Where was the money from? They
9GF. It is a woman who hides behind a tree and stole it. Has the woman any connection with them?
she is chasing the other a woman behind the tree. No, but shethought to be kind enough to take them.
And the woman who was behind the tree caught the What happens next? She buried them and she came
first ones. And took her to jail. After she took her to home and warriors who were left, no more than two,
jail she said she wanted to kill her. And of course she woman has argued with them. Why did she quarrel
killed her and she made her a coffin and buried her with them? Because the two were in the other team,
without anyone, she spoke only with the gravediggers because they killed them and they were the best.
and buried her. Is there any connection between the What happens after the fight? Woman kills them,
two women? Only they were at the same school, from too. What comes to mind when you look at the
here, and they quarrelled at school and the one that picture? Nothing. What do you feel when you look at
stayed behind the tree wanted to kill her. No one the picture? Sadness. Do you liken the characters in
of our family had this happened to them, perhaps the picture with anyone? No.
in other families. What caused the two women to Interpretation: From the answer to all the
quarrel? Over some money. They came on the first presented pictures, one may conclude that there is
day at school. They were in grade V and this little girl a very high level of aggressiveness, tendency toward
asked for some money from the oldest woman at the antisocial behaviour (as indicated by Szondi test
school and said, OK, I give you but I want it back results), lack of remorse and awareness of legal
tomorrow when we meet at school! And the girl said consequences. The social environment, in which the
good. The next day they met and she said Now, subject lives, most likely causes this because in that
come on, give me the money cause we met, before we environment socially undesirable acts occur, but are
got to the class and she said what money?, I have not sanctioned legally.
not any money from you! What money do you need General conclusions:
from me? . The previous day she had asked for 100 1. The little girl is strongly negatively affected by
lei. And she said, if you dont give me the money, Ill the social environment in which she lives, showing
tell you to my mother that I gave you so much money a high level of aggressiveness, with paroxysmal
and I needed the money to buy myself clothes for the discharges amid poor emotional control, a lack of
baptism ceremony. She said, what money?, I asked remorse for her deeds and her not realizing their legal
for no money from you! , So the little girl her. And sanctions .
then, the little girl thought to kill her and so she did. 2. High risk for antisocial personality development.
What happens next? The mother of the girl who died 3. Even with a high level of aggressiveness,
came to school and said why she killed her and she with paroxysmal discharges, the girl is not a
said that from some money, that she did not want to psychiatric emergency, nor does she require
give her the money back. Will anything happen to the psychopharmacological treatment; at this time is only
monitoring and psychological counselling are very 1.57, increased index, showing a criminal potential
useful. O = k + p + d + m / h + s + e + hy = 3 + 4 +
7 + 8/1 + 2 + 5 + 6 = 22/114 = 1.57, future oriented
Case 5 person
A Boy aged 19 years came from an orphanage, N.B.: As can be seen, the crime index (CI) is very
out of the social protection system at 18, previously high, indicating at that time a significant criminal
undiagnosed psychiatrically but showing an obvious potential. 5 months after sample administration, the
Borderline Personality Disorder and a liminal student had attempted to injure or kill his partner, he
intellect. About his family we know that the father was stopped by colleagues, so that the partner was not
is an alcoholic, and his mother has rejected all her even hurt.
children, abandoning them to social protection It should be considered that an increased CI
system. Two of the students siblings (a brother and will always be potentiated by Borderline Personality
a sister) were diagnosed with behavioural disorders, Disorder, and other psychiatric disorders.
his brother has improved significantly, but we have no Conclusion: Although with a CI indicating a high
data about his sister, but at the moment of the dropout criminal potential and with Borderline Personality
(grade XI, she had average conduct disorder and a Disorder, the boy is not a psychiatric emergency at the
certain predisposition to antisocial personality disorder. moment but requires both psychopharmacological
treatment and psychotherapy and psychological
Results for Slavic Love Story monitoring. In the absence of psychopharmacological
Guilt h1 s2 k3 P4 e5 hy6 d7 m8 treatment, any intervention is useless, because the
Order subject is not aware of the disease, thus he may
Factorial m8 d7 hy6 E5 p4 k3 s2 h1 become a genuine psychiatric emergency at any time.
Order
CI = e + hy / + k p = 5 + 6/3 + 4 = 11/7 =
*
* *
BIBLIOGRAFIE / BIBLIOGRAPHY
1. Aronow E; Weiss K.A; Reznokoff M, A Practical Guide to the tura Trei, Bucureti, 2005
Thematic Apperception Test: The TAT in Clinical Practice, Ro-
utledge, 2001; 7. Melon,J.,Course on Szondi,1998, 2006 ,www.szondiforum.org
2. Bellak Leopold, T.A.T., T.A.C. i T.A.B. n utilizarea clinic, New 8. Popescu S., Stanciu C., Practica testelor proiective, Editura Riso-
York-1991, Editura Profex, Bucureti, 2008; print, Cluj-Napoca, 2011
3. Brelet- Foularde, F.; Chabert C. , Noul manual TAT abordare psih- 9. Roerich,M.R.,The Road:Why You Feel How You Feel,Centrul
analitic, Dunod, Paris, 2003, Editura Trei, Bucureti, 2004 pentru Studii Psihosociale,Bucuresti,2002
4. Deri S, Introducere n testul Szondi: teorie i practic, Grune & 10. Szondi,L, Testul Szondi-Manual practic,1952, www.scribd.com,
Stratton, inc., 1949, editura Paideia, Bucureti, 2000 2010
5. Djos V., Slavonic love story, www.szondiforum.org, 2011 11. Sexuel Profils http://www.szondiforum.org/t474.htm
6. Dumitracu N., Tehnici proiective n evaluarea personalitii, Edi-

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REFERATE GENERALE / GENERAL STUDIES

Utilizarea tehnicilor proiective n evaluarea riscului apariiei unor ur-

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citatea de a depi problema cu care se confrunt, iar Testul Szondi

definitiv la acest lucru n urm cu un an i jumtate Comportament, att feminin, ct i masculin, s

- s-!: structur masochist. n 8 din cele 10 profile

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moment un potenial criminogen semnificativ. La 5 criminogen ridicat i cu tulburare de personalitate

that you are afraid of death? Yup. Is it possible that I Interpretation:

Interpretation: - h0s- !: self-destructive tendency which usually

Case 4 - The fact that in two out of the 10 profiles there

6. Dumitracu N., Tehnici proiective n evaluarea personalitii, Edi-

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