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Journal of Projective
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To cite this article: Stephen A. Appelbaum & Philip S. Holzman (1962) The Color-
Shading Response and Suicide, Journal of Projective Techniques, 26:2, 155-161, DOI:
10.1080/08853126.1962.10381091
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Downloaded by [Central Michigan University] at 09:59 10 October 2014
The Color-Shading Response and Suicide’
STEPHEN AND PHILIP
A. APPELBAUM S. HOLZMAN
The Menninger Foundation
Menninger Foundation have had the and color of an iris; the velvety in-
impression that a particular combina- sides because of the shading.”
tion of shading and color determin- Scored FC (C) .
ants of responses on the Rorschach 2. Card 8, upper center blue: “Bluish
Test is associated with suicidal ten- crocheted material, nubby knit or
dencies in patients.2 None of us was boucle.” In inquiry, the texture
bold enough to base any pronounce- was attributed to the shading.
ments of suicidal tendencies on the Scored C (C) F.
appearance of this one sign because
we were averse to a blind sign ap- 3. Card 10, center pink detail: “Some
proach to tests. But, as we continued kind of tissue, skin; it’s burned at
to amass testing experience, the color- the edges.” Inquiry brought out
shading determinant appeared with both color and shading as deter-
insistent regularity in cases of patients minants. Scored C (C) .
who had attempted suicide, some- Over several years of unsystematic
times in the absence of any other observation, the impression grew that
alerting sign in a battery of tests. regardless of the degree of morbidity
Curiosity about this consistency led of the response’s content the color-
us to test this hunch by systematic shading determinant was the crucial
search. variable indicating suicidal tenden-
The responses under consideration cies.
combine color and shading as deter- METHOD
minants whether form is a primary or
a secondary determinant. In scoring If the color-shading determinant
the Rorschach Test, following Rapa- and suicidal proclivity are associated,
port’s notation (Rapaport, et al, the color-shading combination occurs
1946), the responses were denoted as more often among people who either
FC (C) , F/C ( C ) , C (C) F, C (C) /F, or attempted or committed suicide sub-
C (C) . As used here, (C) refers to sequent to testing, or who unsuccess-
~
was not a psychiatric patient, but a actions, eleven anxiety reactions, six
subject in another study. Five sub- obsessive-compulsive neuroses, two
jects were patients in another hospital adjustment reactions of adolescence,
and their diagnoses were not avail- and one chronic brain syndrome.
able. T h e mean age was 33; the mean Patrol. Fifty-three members of the
I Q was 120.4 Kansas Highway Patrol, all male, the
Suicide Attempts. Thirty-nine Ss, “normal Ss” used in the diagnostic
thirty-two female, seven male, who testing studies by Rapaport, et a1
made at least one suicidal attempt (1946) . These Ss are of a lower socio-
prior to being tested. All were pa- economic status than the other Ss in
tients in psychiatric hospitals. Their our study. At the present time, none
diagnoses included twenty character of the Patrol has committed or at-
disorders, five neurotic depressions, tempted suicide. T h e mean age was
four psychotic depressions, and nine 35; the mean IQ was 116.
schizophrenic reactions; one subject’s Thyroid Ss. Fifty-two Ss, all fe-
diagnosis was not available to us. Be- male, in a study investigating thyroid
cause physicians differ in what they gland dysfunction in women between
are willing to call an attempt, a his- the ages of 19 and 44. Twenty-four
trionic display, or a gesture, our cri- of these fifty-two were chosen from a
terion was simply that the patient midwestern city of 100,000 popula-
had made a motoric act of a suicidal tion by a stratified sampling techni-
nature. Consequently, the suicidal at- que. All twenty-four were without
tempts of the patients in this group demonstrable medical or surgical
varied considerably i n their appear- pathology. Thirteen others were
ance of seriousness. I t is a safe as- volunteer Ss for the thyroid study.
sumption, however, that all patients These thirteen were also without
in this group knew that their actions significant medical or surgical patho-
may well have been lethal. We did logy. T h e remaining fifteen Ss were
not include in this group patients referred to the thyroid investigation
who thought about suicide, whether by physicians who suspected thyroid
fleetingly or profoundly, if they did dysfunction. All subjects were given
not act upon these thoughts. T h e a battery of psychological tests and in-
mean age was 32; the mean IQ was terviewed by a senior psychiatrist at
119. T h e Menninger Foundation. T h e
wish to thank Dr. Arthur Kobler of mean age was 34; the mean IQ was
Seattle, Washington for allowing us to study 115.
the Rorschach protocols he obtained in a Psychiatric Residents. Fifty physi-
West Coast Hospital from patients who sub-
sequently committed suicide and from pa- cians, two female and forty-eight
tients who had made a suicidal attempt. male, who had been accepted in the
‘All IQ’s were determined from the Wechs- Menninger School of Psychiatry and
ler-Bellevue Intelligence Scale. who were tested as part of the school’s
AND PHILIPS. HOLZMAN
STEPHENA. APPELBAUM 157
selection procedure. T h e mean age of miss). In both suicidal groups, more-
29 was significantly younger than all over, the sign occurs with greater
except the woman college student than chance frequency, while in the
group. The mean IQ was 129 which control groups it occurs with less than
is significantly higher than all other chance frequency. A Chi-square Test
groups. indicates that the difference between
College Students. Seventeen stu- the combined experimental groups
dents, all female, between 19 and 21 and the combined control groups
years of age, youngest of all the could occur by chance less than once
groups. They were originally Ss in an in a thousand times (Chi-square=
investigation of cognitive function- 111.76) . These results obtain in spite
ing. Wechsler-Bellevue Intelligence of the as yet unknown effect of the
scores were not available for these high IQ and lower age of the resid-
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subjects, but we presumed that they ents, and lower age of the college
were at least of bright normal intelli- students.
gence. While one might have anticipated
The Rorschach Test responses of that the experimental groups would
all subjects in all experimental and show fewer color responses with form
control groups were read and scored as the primary determinant (FC)
than the control groups, all groups
separately by each author. T h e au-
thors then compared their judgments used C (C) F proportionately more
and reconciled their differences in often than FC (C) and C (C) , with no
the few cases of disagreement. One significant difference between the
author was unaware of what groups combined experimental and com-
bined control groups (Chi-square=
the test protocols were drawn from
while he was scoring. T h e color-shad- 2.417, p<.30).
ing determinant was scored when the T h e incidence of color-shading re-
subject specifically mentioned the sponses with “morbid” content (e.g.,
shading as well as the color as a de- “decaying flesh”) is greater in the
terminant, or when the scorers were combined experimental groups
(seven out of 69 color-shading re-
satisfied from the content that shad-
ing had been used, but the subject sponses) than in the combined con-
had not been specific in verbalizing it trol groups, including non-suicidal
or inquiry was not adequate to elicit patients (two out of 51 color-shading
an unequivocal statement by the sub- responses). T h e low frequency in all
groups of such “morbid” responses,
ject (“soiled wallpaper” in the mot- however, indicates that the content of
tled green area of Card IX) .
the color-shading responses is not a
RESULTS
Multiple appearance of the de- TABLE I-Incidence of the Color-
terminant was no more often associat- Shading Determinant in Suicidal
and Non-Suicidal Subjects
ed with suicide than single occurrence
Color-Shading
(Chi-square=0.224) . Therefore, the Present Absent
single occurrence of the sign was Experi- Suicides 27 3
given the same weight as multiple mental
occurrence. Table I shows the in- Groups Attempted Suicides - 32 7
-
cidence of the color-shading determin- Sum 59 lo
ant in the suicide, attempted suicide Non-Suicidal Patients 18 78
Thvroid
and control groups. There is a greater Control Study Subjects 9 43
incidence of the sign among the suc- Highway
Groups Patrol Subjects 5 48
cessful suicidal patients (9 hits for
every miss), than among the suicide
- Psychiatric Residents 12
College Students 7
38
13
attempt groups (4.5 hits for every - -
Sum 51 220
158 The Color-Shading Response a n d Suicide
good distinguishing measure between twenty-eight per cent as the base rate
the experimental and control groups. of suicidal actions in our hospital pa-
For both experimental and control tients. Table I indicates that the test
groups the color-shading responses sign correctly identifies eighty-six per
appeared in descending order on cent of suicidal patients, a significant
VIII, IX, X, I1 and 111, perhaps on increase in predictive power beyond
the basis of the structure of the card. the twenty-eight per cent base rate.
Use of the sign incorrectly labels
Thus, the significant link is be- nineteen per cent of the control popu-
tween suicide or attempted suicide lation as potential suicides. For our
and the simple presence of the color- hospital population the test sign is
shading determinant, irrespective of clearly an alerting signal of suicidal
the number of instances in an in- behavior. Absence of the sign in our
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ing may turn the capacity to pene- and history, the momentary situation
trate beyond the obvious toward an of travail becomes everything. Vari-
inquiry into their own existence, and ous alternatives and possibilities of
the purpose of their own being. They achieving change for the better seem
may then ask what they want from unavailable. Data on suicide further
life, whether and how they can get it, support our belief that the experience
and whether the struggle is worth it. hypothesized here leads to a short-
They face the problem of Sisyphus, sighted perspective of one’s historical
who could endure the physical strug- continuity and to a feeling that one
gle of continuing to push the rock u p has run out of alternatives: suicide
the hill, but who was tortured by the rates decrease significantly during
recognition that it was all without times of national crisis, when there
purpose, for the rock immediately are socially imposed purposes and
tumbled down again. T h e price of goals, and the rates increase during
such near-sighted clarity is probably times of surplus leisure and personal
high for it seems to lead to a loss of idleness. These patients would be
perspective, a “centration,” in Piaget’s better served if they were buffered by
terms, upon his feelings in the im- the refuge of greater generality, less
mediate present. (Piaget, in press) involvement, and an increased ability
Note Freud’s insight into the height- to “let it go at that.”
ened awareness of people in misery as We do not suggest that there is
he describes the puzzling astuteness of only one kind of suicide, either from
melancholiac patients: . . . he has a the standpoint of dynamic motivation
“
keener eye for the truth . . . When in or descriptively. Shneidman and Far-
his heightened self-criticism he de- berow (1957) have detailed varieties
scribes himself as petty, egoistic, dis- of suicides, and a study by Dublin
honest, lacking in independence, one and Bunzel (1933) shows the multi-
whose sole aim has been to hide the ple roots of self-destruction. Presum-
weakness of his own nature, it may ably, suicides can occur as “pure”
be, so far as we know, that he has ritual acts or as a sensible alternative
come pretty near to understanding to intractable pain. Or, perhaps the
himself; we can only wonder why a experience of exquisite sensitivity re-
man has to be ill before he can be flected in the color-shading response
accessible to a truth of this kind.“ may be present in admixture even in
(Freud, 1917) these situations, for there remains the
question of why some people do not
What Freud knew, but merely sug- commit suicide under apparently the
gested in his faintly ironic, rhetorical same conditions obtaining when
question, is that this terrible clarity others do. T h e state of mind we have
of detail issues from a distortion of suggested here to explain our results
one’s perspective of himself in rela- is complementary to motivational
STEPHENA. APPELBAUM
AND PHILIP
S. HOLZMAN 161
theories of suicide (viz., Menninger, dicator of suicidal tendencies signifi-
1938). This state of mind provides cantly improved predictions of sui-
what might be a structural condition, cide or attempted suicide over those
which, regardless of the precipitating made from the base rate in that popu-
motivation or circumstances bringing lation. T h e color-shading determin-
about the distraught condition, leads ant occurred significantly more often
the person to view existence in such a among the suicide and attempt
way that suicide appears his only groups than among five control
available course of action. groups. We offered speculations about
We offer these speculations as psychological processes that may be
plausible maps to direct our search involved in the color-shading deter-
for the processes underlying the color- minant, and about some consequences
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