AotD: Changing While Remaining the Same – Self-Representation Confronted With Aging

Article of the Day:

Changing While Remaining the Same – Self-Representation Confronted With Aging

by Verdon, B. (2013)

(Rorschachiana 33. 145–168. DOI: 10.1027/1192-5604/a000033. )

Background & Research

Psychoanalysis and the psychodynamic tradition used to view aging quite fatalistically, especially early on. Carrying out psychoanalysis for elderly or aging people was thought to be fruitless, and a decline in overall mental functioning was understood to be an unavoidable direct result of aging. The deficiencies and inabilities connected with advanced age were supposedly obvious in Rorschach protocols, too.

In the 1980s however, researchers within this tradition questioned these ideas, pointing out that research on elderly people had often been carried out in geriatric institutions, and no assessments of the participants’ cognitive or color discrimination abilities had been carried out. When studying healthy people who have aged “normally”, the quantitative differences between the Ro protocols of young and elderly adults do not appear so significant. In the last decades, plenty of psychoanalytical papers have examined more qualitative features of aging, concentrating in particular on narcissistic wounds, the revival of conflicts and anxiety, regression and ego tensions. “Each individual ages according to his/her  own mental resources and fragilities”, the author here summarizes.

In the author’s view, the fundamental challenge of aging lies in dealing with social, cognitive and physical (generally negative) changes by modifying one’s self-perceptions to take these losses into account while remaining the same to a sufficient degree. In psychoanalytic language, the process of aging psychologically means dealing with changes related to “castration, passivity, flexibility of masculine and feminine identifications”, and the “porosity of the limits caused by intense narcissistic fragilities”.

The author sees the Rorschach Test as a valuable tool for investigation changes in self-representation. He studied the Rorschach protocols of 110 50-90-year old healthy men and women qualitatively, also looking at the dynamics of test administration and succession of answers, as well as the quality of discourse and the responses. Form quality and movement responses were of particular interest here, as well as human contents, sexual identifications, anatomical responses, symbolic contents relating to possible changes in body representations and responses to card V, thought to best allow for a unitary body representation response. Through the diverse responses, the author hoped to arrive at information about the “quality, diversity and specificity of the problems” related to individuation and sexual identifications as linked to self-representation. Numerous example responses are given in the article for each finding.

Results & Discussion

As expected, Card V responses often provided unitary body representations, some neutral, some narcissistically oriented. However, some subjects found the card too compact and had trouble finding a clear form differentiated from the background, ending up with depressed, morbid or ruined body representations.

In Card III, quite a few subjects paid unexpected attention to the breaks in the human body forms, even as these split up forms remained quite alive and even libidinous (M responses). Usually, it is not too difficult to picture the figures as integral wholes in this card. The author relates this is to the splitting up or devitalization of human forms revealing narcissistic weaknesses.

The author also identified plenty of self-representations transferred onto botanical or object contents. For those elderly subjects with a likely borderline/narcissistic personality structure, these transferred representations appeared to be “recurrent, even morbid.”, “betraying an intense narcissistic wound”. Overall, a predominance of body-related responses seems to highlight narcissistic fragility, part of  which may be due to the challenges of aging. The author also identified responses related to castration problems, thus dealing with more neurotic structures.

Particularly in older middle-aged but not elderly subjects, the author saw responses emphasizing diffuse and non-consistent limits, as if the limits were unable to contain, protect, differentiate or guarantee inner vitality. Such protocols with many damaged self-representations illustrate that narcissistic fragility may be mobilized independently of real-life (very) old age, and are more typical again of borderline of narcissistic personality structures.

Based on this qualitative study, the author concludes that previous personality organization seems more important to the challenge growing old poses to self-representations than age or sex. Aging seems to emphasize identity fragilities for borderline and narcissistically organized personalities. On the other hand, for neurotically organized personality, though producing damaged representations and impairments in partial representations, aging seems to contribute to only minor disorganization, and better capacities of “self-protection, displacement and symbolization” still appear.

Aging means facing loss, incompleteness, finitude and disenchantment. Still, in many aging adults, libidinal forces can apparently still be mobilized, and mental functioning is not necessary wholly weakened. Based on the Ro responses studied here, for some elderly people, depressive de-idealization does seem to occur, but others are able to give symbolic sexual responses of high quality and “authentically libidinous objectal M responses”, even as they represent themselves as less powerful and more incomplete.

Commentary

I chose this article for reading and commenting on mainly to peek at the kind of research that takes place deep within the Rorschach community and to see how much of it and its possible value I could understand or appreciate, seeing as I have clinical skills in administering and scoring Rorschach as per Exner CS, but quite little background knowledge in psychoanalytical and other alternative ways of reading Ro protocols.

The research carried out here was qualitative by nature. Further, the author provides little to no detail on how the qualitative study was actually carried out, and what if any established methods of qualitative study were used. As such, it is nigh-on impossible to comment on the methodology or validity of the research.  Case studies and qualitative research certainly have their place within psychology and can be very helpful in understanding the experiences of individual people more deeply. However, not detailing at all how the qualitative analysis was carried out makes one wonder whether the illustrative examples in the article might not have been just cherry-picked to fit the arguments the author wanted to make. This may well not be the case, but it’s quite impossible to know. The author also does not appear to have used any of the developed more formal methods of Rorschach interpretation, but employs rather more “old-school”, psychoanalytical ways of interpreting responses (more or less at face value, it feels). With 110 protocols (of probably more than 15 answers each), formalized analysis and quantitative methods could have well been used, too, so this is all probably a conscious choice.

The Rorschach Test itself, of course, is quite a controversial method. For my part, I am relatively convinced of its usefulness and validity in certain, limited use cases, one being differential diagnosis of psychoses in clinical practice. It is, however, used for a variety of other purposes in many countries, especially in France, Finland, the US and Japan. Is it a useful or valid tool for studying self-representations in the way it’s used in this article? It’s difficult to say. In any case, this article fails to convince me one way or the other.

As for the results, stripped of their somewhat opaque psychoanalytical formulations, they make intuitive sense and do not disagree with other findings. People age quite differently, and there is much less “automatic”, inevitable cognitive decline than often thought. I also agree that the personality structures and other individual features of each individual probably affect older adults’ self-perceptions and the ways they adjust those perceptions to fit (or otherwise) their changing bodies and minds more than simply their age or gender. Further, it is understandable that for individuals more inclined to narcissistic thought, confronting the losses and limits of aging would be a more dramatic experience and lead to greater fragility and depressive developments.

The research and the conclusions drawn from it in this article remain entirely within the psychoanalytic tradition. Indeed, its author hails from the strong French tradition of psychoanalysis, of which I understand little beyond the fundamentals set by Freud and the very basics of Lacanian thought. As such, it is difficult for me to critically evaluate an article like this. Such articles may have their value for those well-steeped in psychoanalytical Ro interpretation. However, it must be said that as presented in this article, this is not much of a scientific study, and remains more at the level of speculative musings on the qualitative features of (some of) the collected responses. Still, an interesting read, and I will certainly go back to the Rorschachiana journal later for another look or two.

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