Editor’s Note: In August 2023, the Daily Mail ran a story titled “Inkblot Test Will Reveal If You’re Unable to Move on from the Past and Ever Be Happy,” indicating that the test “can be used to reveal info about your personality.” This story was based on a video from a TikTok content creator and psychology student who was pulling from the book The Body Keeps the Score. That book will be the focus of future content in Skeptical Inquirer, but for now we share an article that critiques the Rorschach Inkblot Test. This article was written prior to the publication of the story in the Daily Mail, but it sheds light on the accuracy of the claims within.
The Rorschach Inkblot Test was developed more than a century ago by Hermann Rorschach, a Swiss psychiatrist who worked with patients with severe mental illness in a hospital for the “insane” (Searls 2017). Rorschach created a set of odd, intriguing inkblots, with some pastel colored and others gray and white. He then showed the blots to his patients and asked them to describe what they saw in the quirky spatters and clouds of color. Rorschach came to believe that his patients’ responses—that is, their descriptions of the blots—revealed their mental disorders and personalities. For instance, he had the impression that patients who reported many responses involving color were emotional and impulsive.
In 1921, Rorschach ( 1964) published Psychodiagnostics, a book that included ten of his inkblots and described how his patients responded to them. Shortly afterward, he died unexpectedly of appendicitis at the age of thirty-seven. Although his book had attracted little attention while he was alive, in the following years Rorschach’s reputation and test gradually spread across Europe and the United States. By 1950, the Rorschach Inkblot Test had become highly popular among American psychologists, who considered it a sort of mental X-ray allowing them to peer deep into the minds and hearts of their patients.
To this day, some psychologists continue to claim that the Rorschach Inkblot Test provides a rich and complete picture of a patient’s personality and psychological problems. Advocates of the Rorschach test like to say that other assessment techniques, such as questionnaires and clinical interviews, reflect merely what patients are willing or able to tell about themselves, whereas the Rorschach test reveals much more. It supposedly has the power to expose emotions, thoughts, and other psychological qualities that are hidden out of sight inside the patient, beyond the patient’s conscious awareness. That is, the Rorschach test is considered a type of projective test.
The Rorschach test is claimed to be highly sensitive for identifying psychiatric symptoms and diagnosing mental disorders. Advocates claim that it has a solid scientific basis and is widely accepted among clinical psychologists as useful in clinical and legal settings. In the past, claim advocates, the Rorschach test was unfairly attacked by a small number of critics who misunderstood its unique potential for providing clinical insight. Advocates concede that a few of the criticisms leveled against the test were legitimate, but they claim that the problems identified have been corrected in present-day versions of the Rorschach test.
Examining the Claims
The Rorschach test is administered one on one. The psychologist, sitting beside the patient, hands them ten Rorschach cards, one at a time, and asks, “What might that be?” Each card is approximately the size of a National Geographic magazine cover and bears one of the intriguing inkblots that Hermann Rorschach created more than a century ago (Exner 2003; Meyer et al. 2011).
The inkblots are intentionally ambiguous. Patients see many things in them, such as bats, lobsters, flowers, monsters, and scenes of people fighting or dancing. Patients typically give about two responses per card or about twenty responses total for the entire test. The psychologist attempts to write down each response in the patient’s exact words. After the patient has responded to all the cards, the psychologist goes through them a second time, asking the patient to clarify exactly what images were seen in the blots and where they appeared.
After the testing session is over, the psychologist scores and interprets the patient’s responses. Scoring the Rorschach test is challenging and time-consuming because there are dozens of scores to be calculated. For instance, one important score indicates the number of responses given by the patient that involve the use of color. Another indicates the number of responses that describe people acting in cooperation with each other (“two women preparing a meal together”). There are also many Rorschach “composite” scores, which are calculated by adding or subtracting two scores from each other or by dividing one score by another. For instance, one composite score is calculated by first adding up the number of responses that describe people moving and then dividing this sum by the number of responses that involve the use of color.
After the Rorschach scores have been calculated, the psychologist interprets their meaning. In most cases, the scores have a straightforward interpretation. For example, as mentioned earlier, if a patient has given a high number of color responses, this will generally be interpreted to mean that the patient is impulsive or tends to act under the influence of strong emotions. As another example, if a patient has given several responses that describe people engaged in cooperative activity, the psychologist will probably conclude that the patient views interactions with other people as being positive and helpful rather than antagonistic.
The Rorschach interpretations made by psychologists are typically used in clinical settings to shed light on patients’ behaviors, personality, and psychological problems and to help guide treatment decisions. The Rorschach test is also used in legal settings, for instance, for child custody disputes, criminal trials, and parole hearings.
Is the Rorschach Test Good for Anything?
Considering the Rorschach test’s long history of scientific controversy, it is sensible to ask whether the test is good for anything. The answer is, “Yes, the Rorschach test can do a few things well.” Specifically, it has some validity for detecting disorders such as schizophrenia that involve perceptual distortion and disorganized thinking. In addition, some of its scores are related to IQ (Mihura et al. 2013; Wood et al. 2015).
When conducting his research with hospital patients, Hermann Rorschach scored each of their responses as having either “good” form quality or “poor” form quality. “Good” form quality indicated that the image reported by the patient fit the shape or “form” of the inkblot, whereas “poor” form quality indicated that the image didn’t fit the blot’s shape. For instance, the shape of one of Rorschach’s inkblots very strongly resembles a bat. For this inkblot, if a patient reported seeing a “bat” or “butterfly,” Rorschach scored the response as having good form quality. If the patient reported seeing a “cat” or “kangaroo,” the response was scored as having poor form quality because the shape of these animals does not fit the blot’s shape.
Rorschach’s book reported that patients with schizophrenia tended to give an unusually high number of responses with poor form quality. Research in the 1950s confirmed Rorschach’s observations, as have more recent studies (Chambers and Hamlin 1957; Little and Shneidman 1959; Mihura et al. 2013). Many people who take the Rorschach test, including individuals without any disorders, may give at least a few responses with poor form quality. However, patients with schizophrenia, a very severe mental disorder involving loss of contact with reality, tend to give substantially more such responses than other people. So do other patients with perceptual distortions, severe mental impairments, or psychoses.
In the late 1940s and early 1950s, researchers demonstrated that patients with schizophrenia also tend to show disordered thinking or disorganized speech when taking the Rorschach test (Kleiger 1999; Kleiger and Mihura 2021). That is, these patients often display illogical reasoning or say odd things when responding to the blots. For instance, a patient might say, “This little red blot looks like a drop of blood. And it looks like an island in the ocean. It must be Haiti, because that’s the island where there’s been a lot of bloody fighting.” Such odd, illogical responses are more frequent not only among patients with schizophrenia but also among patients with borderline personality disorder and other mental disorders with disorganized thinking or speech (Mihura et al. 2013). Although the Rorschach test is a valid measure of disordered thinking or disorganized speech, an interviewer can also detect these problems without the Rorschach test, and so it is not clear how often the addition of a Rorschach test to an interview will result in more accurate diagnoses.
Other Rorschach scores are related to intelligence and mental ability. For instance, studies have shown that individuals with higher IQ scores tend to give more responses on the Rorschach test than other people, and those responses tend to be more complex, with several parts of the inkblot combined and integrated into a unifying image. In addition, research has shown that patients with higher IQs tend to use more sophisticated vocabulary when describing what they see in the blots (Davis 1961; Mihura et al. 2013; Trier 1958).
Rorschach scores often do not measure what they are supposed to measure. The test is generally, but not always, unrelated to other mental disorders, diagnoses, and symptoms (Meyer et al. 2017; Wood et al. 2000). While a recent review of the published scientific literature identified several Rorschach scores as potentially useful for identifying the presence of distressing emotions, impulsivity, dependency, current level of coping ability, or other characteristics (Mihura et al. 2013), the validity and clinical utility of most of these scores has been questioned and remains controversial (Wood et al. 2015; see also Wood et al. 2003, 244; but see Mihura et al. 2015).
Rorschach Test Myths and Problems
As the preceding section has explained, the Rorschach test can do a few things relatively well. The test has been controversial for more than half a century not because it is worthless but because it has so often been promoted with misleading claims and used for purposes for which it has little or no scientific support. Furthermore, under some circumstances use of the Rorschach test can cause serious harm to patients. The present section identifies the myths that are most commonly held forth on behalf of the test and then discusses how the use of the Rorschach test can cause harm.
Claim #1: The Rorschach Test Provides a ‘Rich’ and ‘Complete’ Understanding of Personality
In the 1940s and early 1950s, when the Rorschach test was at its peak popularity, enthusiasts claimed that the test offered a rich source of clinical insight and a complete picture of a patient’s personality and psychological problems. For instance, according to Bruno Klopfer, the most influential Rorschach expert of that era, a skilled interpreter could extract a total psychological understanding of a patient simply by examining the inkblot responses, without any other clinical information about the patient’s history or test scores (Klopfer and Kelley 1946).
Klopfer’s grandiose claims should have awakened serious doubts among the members of the psychological community, particularly because there was no research to support them. Imagine that a pharmaceutical company, without any good scientific evidence, were to announce that it had developed a blood test that could provide a “complete” medical understanding of every patient and thus eliminate any need to conduct additional physical examinations or diagnostic imaging. Such a claim would instantly be recognized as preposterous by the medical community. However, Klopfer’s equally absurd claims were widely accepted by psychologists of the early 1950s. Only in the following years, as hundreds of studies, often by leading researchers, reported disappointing results did the dismal truth about the Rorschach test become clear: Far from giving a “complete” picture of patients’ personalities, it was worthless for most purposes. As summed up by Lee J. Cronbach of Stanford University, one of the most respected psychologists of the twentieth century: “It is not demonstrated that the test is precise enough or invariant enough for clinical decisions. The test has repeatedly failed as a predictor of practical criteria. … There is nothing in the literature to encourage reliance on Rorschach interpretations” (Cronbach 1956, 184). Despite the mainly negative research findings, enthusiasm for the Rorschach test has remained inexplicably high among a minority of clinical psychologists who often show the same unrealistic zeal as in the 1940s. At present, there are two leading approaches or “systems” that these psychologists use when administering, scoring, and interpreting the Rorschach test. The first and more popular approach is John Exner’s “Comprehensive System for the Rorschach,” or “CS” (Exner 2003). The second and newer approach is the “Rorschach Performance Assessment System,” or “R-PAS,” introduced in 2011 (Meyer et al. 2011).
Both systems have been promoted by their creators in extravagant terms. Exner, like Klopfer, has claimed that his Rorschach system, the Comprehensive System, provides a “complete understanding” of a patient (Exner 2003). The R-PAS developers claim that its approach yields “rich, multi-faceted descriptions,” contains “a wealth of idiographic information,” and provides psychologists the means of “observing and measuring personality in action” (Meyer et al. 2011, 1–2, 320).
Such expansive promises are misleading, however. Although both the Comprehensive System and R-PAS include dozens upon dozens of Rorschach scores, these scores do not reveal dozens upon dozens of aspects of personality. In fact, there is no well-accepted scientific basis for believing that these scores reveal much about personality beyond their relation to perceptual distortion, thought disorder, or intelligence. It is true that research has shown that a handful of scores—perhaps eight or so—may have a weak relationship to other aspects of personality. For the practicing clinician, however, these Rorschach scores cannot be interpreted in any way that is both scientifically grounded and useful for guiding clinical work. Psychologists who use the Rorschach test in hopes that its multitude of scores will provide a “rich” and “complete” understanding of their patients are misleading both themselves and the patients.
Claim #2: The Rorschach Test Is Like a Psychological X-Ray
Another famous claim made by Bruno Klopfer in the 1940s was that the Rorschach test is like a psychological X-ray (Klopfer 1940, 26). He promoted the idea that the test has the power to look inside a patient and detect hidden things—problems that psychiatrists and psychologists cannot hope to observe otherwise or that the patient is unaware of and thus cannot describe. According to Klopfer, a psychologist using the Rorschach test has privileged access to information about patients that is simply unavailable to other mental health professionals.
Research in the 1950s and afterward exploded Klopfer’s claim that psychologists using the Rorschach test have special access to insights that their colleagues lack. In fact, studies showed that psychologists who relied on the Rorschach were actually less accurate in their assessments of patients than were psychologists who simply read the patient’s history or used the Minnesota Multiphasic Personality Inventory (MMPI), a psychological test filled out by patients to report their psychological symptoms and problems (Guilford 1948; Kelly and Fiske 1950; Holtzman and Sells 1954; Little and Shneidman 1959; Sines 1959; Whitehead 1985).
The seductive notion that the Rorschach test provides a special window into patients’ innermost unconscious feelings and thoughts is still alive today, however. For example, the creators of the R-PAS, the new Rorschach system, claim that the Rorschach test reveals “implicit” aspects of personality, by which they mean “characteristics that may not be recognized by the respondent him or herself” (Meyer et al. 2011, 1). They also claim that “the Rorschach can provide psychological information that may reside outside of the client’s immediate or conscious awareness” (Meyer and Mihura 2020, 283). For example, according to the creators of the R-PAS, several scores indicate “implicit” distress. Because these negative feelings are “implicit,” claim the R-PAS authors, the patient may be unconscious of them and thus cannot be said to actually feel the distress (Meyer et al. 2017, 76–77).
The R-PAS scores that supposedly indicate “implicit” distress are among the controversial scores we have already discussed. Furthermore, the notion proposed by the R-PAS authors that these scores indicate unconscious distress leads to strange and troubling paradoxes: If a person is psychologically distressed but does not know it, is that person really distressed at all? Isn’t that like claiming that a person feels “unconscious pain,” even though they say they aren’t feeling any pain at all? And what if a patient reports that they feel fine, but their Rorschach test indicates “implicit” distress? Should a psychologist using the Rorschach test disregard what the patient says and conclude that the patient is psychologically in pain, suffering perhaps from “unconscious depression”?
Claim #3: Validation Studies Are Unnecessary; ‘Clinical Validation’ Is Enough
Validity is a scientific term that can be used to describe how well a test measures what it is supposed to. To evaluate the validity of psychological and medical tests, researchers undertake what are called validation studies. For example, in 2002, researchers at Clemson University conducted a validation study of the Beck Depression Inventory–II (BDI-II), a questionnaire used to measure depressive symptoms (Sprinkle et al. 2002). They found that in a sample of therapy patients at a university counseling center, the correlation of BDI-II scores with the number of depressive symptoms reported by the patients during a diagnostic interview was 0.83. This correlation, called a validity coefficient, was very high and indicated that the BDI-II has strong validity. That is, the study showed that the BDI-II has a strong relationship with depression, the disorder it is supposed to measure.
In the 1930s and 1940s, Klopfer contended that such validity studies were unnecessary where the Rorschach test was concerned. Instead, he and his followers proposed to substitute a procedure that they called “clinical validation” (Klopfer 1939, 47). Specifically, they argued that the Rorschach test’s worth could be demonstrated by positive testimonials from the psychologists who used it clinically (Krugman 1940).
Klopfer’s dismissal of systematic validation studies, and his trust in the testimonials of clinicians, ignored the hard-earned experience of the American medical profession during the preceding half century. In the years leading up to the 1930s, bitter experience had shown that testimonials by physicians about the effectiveness of medical procedures could be misleading and downright dangerous (Haines 2002; McCoy 2000; Young 1967). In several highly publicized scandals, prominent doctors enthusiastically promoted scientifically unsupported medical tests and medications that were later found to be harmful and even fatal to their patients.
At the time that most Rorschach test users were uncritically accepting Klopfer’s dubious ideas about clinical validation and the value of testimonials, at least a few perceptive psychologists resisted. For example, Donald Super of Columbia University warned his Rorschach-smitten colleagues: “Unorganized experience, unanalyzed data, and tradition are often misleading. Validation should be accomplished by evidence gathered in controlled investigations and analyzed objectively, not by the opinions of authorities and the impressions of observers” (Buros 1949, 167).
The warnings by Super and other skeptics were eventually vindicated in the 1950s, as we have already described, when the results of systematic validity studies showed that the Rorschach test was largely worthless and that clinicians’ glowing testimonials on its behalf had been seriously in error. One might think that such a debacle would have convinced Rorschach test users of the folly of clinical validation and the value of careful research. But instead, many Rorschach test advocates simply brushed aside the research. For instance, Klopfer advised his followers to ignore the negative scientific findings regarding the test (Klopfer and Davidson 1962, 24). Similarly, Samuel Beck, another prominent Rorschach leader, dismissed the findings as irrelevant: “Let it be said at once and unequivocally that validation such as is sought in a laboratory experiment is not at present to be expected for whole personality findings, whether by the Rorschach test or by any other” (Beck 1959, 275).
The Rorschach tradition of using scores that lack support from systematic validation studies has never disappeared and continues to the present day. The Comprehensive System and the R-PAS both include a substantial number of Rorschach scores with little or no research support. Clinicians who use these scientifically untested scores are showing the same reckless naivete, and running the same risks with patients’ well-being, that Klopfer and his followers did in the 1940s.
Claim #4: The Rorschach Test Is Trustworthy for Identifying Psychological Disturbances
The last and probably most serious problem with the Rorschach test is its tendency to misidentify people as being psychologically disturbed when all other evidence indicates they are psychologically healthy. Researchers first exposed this flaw more than half a century ago. For instance, in one study in the 1950s, the Rorschach test was administered to a group of men previously identified as well adjusted. The researchers were surprised to find that many of these men’s Rorschach scores fell in the abnormal range and falsely indicated maladjustment (Brockway et al. 1954). In another study at the University of California at Berkeley, Rorschach experts evaluated adolescents from the community and identified two out of every three as “maladjusted”—an absurdly high number because, contrary to some stereotypes, most teenagers do not experience marked emotional disturbance (Grant et al. 1952).
As these and other similar findings from the 1950s made clear, psychologists who used the Rorschach test often found psychological disturbance and mental pathology where in fact there was none, a form of bias that is called overpathologizing. Nor has this problem disappeared with more recent approaches to the Rorschach test. Research has shown that the most popular approach to the Rorschach test today, Exner’s Comprehensive System, often makes both adults and children appear psychologically disturbed even when no other evidence suggests that this is so (Viglione et al. 2022, 140). For instance, one study found that psychologists using the Comprehensive System misdiagnosed more than 75 percent of psychologically healthy individuals as disturbed (Mittman 1983; see also Exner 1991, 432–433). Another study found that when psychologically healthy school children were tested with the Comprehensive System, their Rorschach scores often wrongly indicated the presence of grave psychological problems, including distortion of reality, faulty reasoning, and difficulty maintaining interpersonal relationships (Hamel et al. 2000). The consequences of overpathologizing can be devastating, particularly in high stakes settings that involve employment issues or legal decisions. For instance, in a legal case known to the authors of the present article (Wood et al. 2003, 301), an African American man sued his employer for racial discrimination. Although his mental health history was unremarkable, a psychologist testified in court that the man was seriously disturbed and that his Rorschach test revealed paranoia and a tendency to distort reality when under stress. Because of the Rorschach test’s tendency to overpathologize, its use in legal cases or other high-stake settings has the potential to do serious harm.
Summary and Conclusion
Rorschach scores are related to perceptual distortions, disorganized thinking, and intelligence. However, there are much more valid, comprehensive, and efficient ways to assess these traits. Further, the Rorschach test’s relationship to other diagnoses and personality characteristics is highly controversial and has been controversial for more than fifty years. Contrary to myths promoted by its proponents, the Rorschach test does not provide a rich picture of patients’ personalities or reveal hidden secrets about their emotions or thoughts. Worst of all, the Rorschach test has a well-documented bias that causes it to misidentify psychologically healthy people as being psychologically disturbed. Use of the test in educational, employment, or legal settings is strongly discouraged.
In 2003, we published a book titled What’s Wrong with the Rorschach? along with CSI Fellow Scott O. Lilienfeld, and yet the Rorschach test continues to be used to this day, more than two decades later. With a nod to James Randi, when we look at the Rorschach test, we see an unsinkable rubber ducky.
This article originally appeared as a book chapter in Investigating Clinical Psychology: Pseudoscience, Fringe Science, and Controversies (Stea and Hupp, 2023). Thank you to the authors, Jonathan Stea, and Routledge Press for granting permission to reprint the chapter in Skeptical Inquirer as a featured article.
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