Odile Husain. Rorschachiana. Volume 20, Issue 1. 1995.
A few years ago, two Swiss psychologists, Frieda Rossel and Colette Merceron, attempted to blend two previously published articles on the issue of psychopathy and the Rorschach (Merceron, Perron, Rossel, & Viloux, 1978; Merceron, Ponce, & Rossel, 1983) into one. To this day, the revised version remains an unpublished manuscript. Around the same time, I discovered an impressive volume by Reid Meloy, published in USA in 1988, which dealt with the same population. Looking at Rorschachiana as a forum for international exchange and debate, I felt that this was an ideal opportunity to bridge the gaps between European and American literature, all the more so, since both these studies on psychopathy rely heavily on psychoanalytic concepts.
Such a comparison requires to first question the clinical similarity of these two samples, especially since the cases cited by Meloy seem often more severe and impressive than the psychopaths of the Swiss study. One could argue that the existing gap is enhanced by various external factors: differences in conditions of imprisonment, differences in the timing of the forensic evaluation and differences in the amount of coverage given by the media. Nevertheless, the crimes remain vastly similar and the difference may be primarily one of quantity (cf. the presence of several serial killers in Meloy’s sample) rather than one of “quality,” judging by the convergence and complementarity of observations emanating from the two continents.
A Divergence: Where to Place Psychopathy?
On both sides of the Atlantic, authors have adopted a model of psychopathology. The preferred reference for the European authors is the model of Bergeret (1974), which could be described as “stratified”; the reference for Meloy is Kernberg’s (1984) model, which could be described as “two-dimensional.” To a large extent, both these models overlap in their understanding of the notion of personality structure, with its organizational nexi such as object relations, anxiety, defense mechanisms, and thought processes. Differences exist nevertheless, and these have an impact on the manner in which psychopathy is viewed and placed in the spectrum of psychopathology.
Rossel and Merceron understand psychopathy as a form of very archaic personality organization amongst the borderline conditions. Bergeret (1974), like Kernberg (1975), places the psychopathic character amongst narcissistic disturbances. Both authors describe the core narcissistic dynamics of psychopaths, a viewpoint which Meloy agrees to. Yet Kernberg’s model theoretically supposes that any character organization can find its expression within a neurotic, a borderline or a psychotic structure.
Rejecting the case of a psychopathic character within a neurotic structure because of the obvious superego deficiency, Meloy accepts the existence of psychopathic characters both at the borderline and the psychotic level. His book reflects this possible duality of psychopathy. In contrast, the European authors accept the existence of psychopathic traits in psychotic organizations but do not include these subjects in their study, since the underlying psychic processes are of a psychotic nature, hence structurally quite different from those encountered in borderline psychopaths.
As a result, differences in the acceptance (narrower for the Europeans and wider for the Americans) of the notion of psychopathy overlap the sample selection procedure: a selection based on the psychopathic act (i. e., on the behavioral component) for Meloy; a selection based on psychic functioning and personality organization for Rossel and Merceron.
A Disagreement: How to Analyze the Psychopathic Discourse?
Meloy dedicates the greater part of his book to the presentation of rich clinical material, but for the purpose of this discussion, we will focus only on pages 377 to 423, which deal exclusively with the diagnosis of psychopathy on the Rorschach.
Meloy’s first approach follows the Exner Comprehensive System, and the essential part of his analysis consists in testing a series of 32 hypotheses relating to the frequency or value of certain scores in a given “model” psychopathic protocol (T = 0; C > 1; MOR = 0; Ag > 0 etc … ). Accepted and validated results obtained by Exner on a character problem sample (1986) seem to serve as an implicit reference point. Meloy’s second approach aims at revealing the “dynamic properties” of psychopathy. He proceeds onwards with three other analyses, all of which have been conceptualized by projective psychologists of psychoanalytical orientation: the developmental analysis of the concept of the object (Blatt, 1976), an assessment of primitive defenses (Lerner and Lerner, 1980) and a scale of primitive interpersonal modes of relating (Kwawer, 1979, 1980).
In spite of the abundance and diversity of the information gathered by Meloy, a sense of fragmentation reigns. The case study might have benefited from an attempt at synthesizing the obtained results. Indeed, the sometimes dissimilar observations derived from these four analyses do not allow for an integration of data that could result in a unified picture of psychopathic functioning.
As noted by Meloy himself, the Blatt and Lerner and Lerner scales only score human and quasi-human responses, a choice which calls for some reservation and comments. The first remark pertains to the restrictive approach of these scales. Let us take the example of denial: why would denial express itself exclusively through human responses? Denial of likelihood, in a confabulatory arrangement for example, could apply to an assortment of people as much as to a collection of animals or objects. The second remark relates to Meloy’s observation that protocols of psychopaths contain only a small number of human responses, thus invalidating the use of the above-mentioned scales. The “model” protocol of a psychopath, quoted by the author, contains only one quasi-human response. Hence, carrying out the Blatt and Lerner and Lerner scales required the selection of protocols that contain more human responses. As a result, it seems that the prevailing preoccupation with empiricism overrides the psychoanalytic framework and leads, according to a European perspective, to a simplification and impoverishment of the available discourse. Indeed, to achieve a rigorous standardization, the use of these scales means excluding some subjects and data from the analysis.
In total contrast, the Swiss study exposes a minimal, even nonexistent preoccupation with quantitative empirical data and standardization. From an American point of view, this constitutes a major obstacle to the validity of the data. The approach is decidedly qualitative and not quantitative, as a result of which there are no restrictive clauses. Thus the core material for Rossel and Merceron’s analysis derives from the subject’s entire discourse (i. e., a discourse emerging from a test situation apprehended as a totality which simultaneously includes the test instructions, the cards, and the examiner-examinee relationship.)
The manner in which psychopaths apprehend the entire situation, the manner in which they criticize the object, the manner in which they react to the instructions, and the examiner’s status enable the European authors to unfold the major dynamics of psychopathic functioning.
As we shall notice further on, the conclusions from both studies generally converge, overlap, or complement each other; yet it seems that on both sides of the Atlantic, the magnifying glass of the practioner-cum-researcher often lingers on different elements of observation.
Complementarity: Is Psychopathic Functioning the Same on Both Sides of the Atlantic?
Meloy characterized the psychopath’s object relations by the “predominance of aggressive drive derivatives” and “the gratification of aggression as the only significant mode of relating to others.” Relationships are deeply infused with sadism and cruelty that would reveal the presence of persecutory introjects equivalent to Kernberg’s “sadistic superego precursors” (1984, p. 281). Object relations would be marked by cycles of conflict, “intent to deceive,” and feelings of triumph when “victory is perceived.” Parameters of power and control would replace all affective components. Meloy argues this point on the basis that psychopathic protocols are T-less (without texture responses), texture being viewed as an expression of dependency. Therefore it is by default, by the absence of this category of scores that Meloy proposes the existence of a struggle against dependency: “The conscious experience of depression as an affect within the psychopathic process probably does not exist.”
Rossel and Merceron also notice the absence of dependency contents among psychopaths, as opposed to what can be observed in other borderline conditions. According to these authors, the presence of such contents can be explained by an ability to elaborate—even partially—constructs against the anxiety of losing the object, which is typical of the depressive position. By contrast, psychopaths with their minimal capacity for symbolization would have had little opportunity to translate the affect linked with the experience of loss into a mental representation, hence the immediacy of its expression in the form of acting out.
Meloy also notes the extent to which scoptophilia plays a predominant part among the psychopath’s attempts at control. He speaks of a “sexualization of the sensation of looking” and describes a fixity of the stare which he labels “reptilian.” Thus, for the psychopath pleasure derives from the set up and the execution of dominance-submission patterns, within which the object is necessarily apprehended as a prey.
The analysis carried out on another psychopathic protocol with the Blatt scale shows that human and quasi-human perceptions are adequately perceived and that they are essentially intact; nevertheless, the possibility exists of these perceptions deteriorating and becoming suddenly grandiose, menacing, and aggressive. Furthermore, Meloy notices the cathexis of appearance, presentation and form, which would denote the narcissistic quality of these object representations.
In view of the preeminence granted by Meloy to the aggressive and sadistic component of the psychopath’s object relations, a precaution is perhaps called for. Indeed the temptation seems great to establish an equivalence between psychopathy, as established on the basis of clinical evidence (i. e., the behavioral aspect) and the aggressive nature of object relations on the Rorschach. Rossel and Merceron draw our attention to the frequent contrast existing between the abundance of psychopathic facts and the “poverty” of psychopathic protocols, between an existence flourishing with adventures and misadventures and the dearth of their fantasy world. Hence, the psychopathic act would not necessarily translate on the Rorschach into obvious aggressivity and sadism.
Regarding this point, we would like to mention a presentation made at the annual meeting of the French Rorschach Society in Nice (France) in 1985. The theme, that year, was “aggressivity.” Timsit (Timsit & Bastin, 1987) had presented us with two protocols, one laden with aggressive and sadistic contents and the other not. He had asked the audience to guess which of the two protocols could be that of a murderous psychopath. It appeared that the crime was inversely proportionate to the number of aggression responses.
Regarding the psychopath’s interaction patterns, the Swiss study attributes a predominant role to the process of externalization, a process by which the psychopath expresses his need to reject the responsibility of all deeds and imperfections onto the external world. This observation is similar to Meloy’s viewpoint, since the American author looks at psychopathy primarily as a “failure of internalization.” Externalization appears, according to Rossel and Merceron, in the following: The instructions are perceived as a constraint with which they have to comply, the test situation is generally devalued, and the cards themselves are considered “poorly” done and held in contempt. The principal operating mechanism seems to be one of “reversal into the contrary,” the subject trying to actively control what he fears to experience passively, especially his feelings of deficiency and incompleteness. Whereas Meloy focuses on the cathexis of appearance to infer the narcissistic component of psychopaths, Rossel and Merceron underline the same prominence of the narcissistic failure by focusing on this accusation of the external world which they regard as a manifestation of “deficiency denial” (Merceron et al., 1988).
According to Rossel and Merceron, the power play set up by psychopaths expresses itself more specifically in their reactions to the instructions and the examiner, since both incarnate this external rule with which they are asked to comply. Psychopaths’ comments about enforced rules and their submission to them would indicate their burning need to constantly oppose rules and measure themselves against them, in order to experience a feeling of omnipotence, aimed at hiding the underlyling narcissistic wound.
The corollary of this omnipotence relates to the important devaluation of others, an observation which Meloy derives from the assessment of primitive defenses, as proposed by Lerner and Lerner (1980). In the same vein, Rossel and Merceron point towards psychopathic TATs where parental images are disdained and devalued, the emphasis being laid on their strictly functional and utilitarian role.
Neither Meloy nor Rossel and Merceron explicitely refer to the psychopath’s anxiety. On both sides of the Atlantic, one seems to agree on approaching this issue by default. Indeed, according to all authors, the process of externalization replaces the ability to experience the depressive feelings of deficiency and incompleteness. As noted by Bergeret (1974), the anxiety which can be described as “anaclitic” is precisely expressed by totally opposite manifestations.
For Meloy, the absence of depressive affects would appear in the absence of vista responses: indeed, it appears “in only 17 percent of the character problem sample, but 80 percent of the depressed inpatient sample” (Exner, 1986). Meloy also remarks that among the spectrum of emotions felt by the psychopath, boredom ranks high and corresponds to a “pervasive sense of restlessness and emptiness.”
The feeling of emptiness and the struggle against it are inferred by the European authors from the psychopath’s hypercathected references to reality. Rossel and Merceron notice that the psychopath’s style of justification is generally provided by external reality. In fact, the “model” protocol quoted by Meloy presents the same type of justification based on reality (“Iron slag. That’s what it looks like. When you’re welding.” card VII), as if the internal world were empty of representations. This leads the Swiss authors to link psychic and cognitive functioning by showing how this mechanism of externalization goes hand in hand with a paucity of mental representations.
Regarding defense mechanisms in psychopathy, much convergence exists between the two essays. Meloy suggests that denial and splitting should be conceptualized as “genotypic” terms: Such a conception supposes that these mechanisms could be found along a continuum, at the various—more or less evolved—stages of psychoaffective development. Along this developmental continuum, one could encounter more primitive or more mature forms of denial and splitting, an opinion which the European authors also defend in other writings (Merceron et al., 1988).
Meloy views these two mechanisms as predominant in psychopathic organizations. Denial, writes Meloy, would operate “through word and act rather than through fantasy.” This corresponds to the Swiss authors’ remarks about the hypercathexis of action, which short-circuits mental representation. More specifically, Rossel and Merceron mention a form of denial which they label “hypomanic denial,” often accompanied at the behavioral level by frank laughter. It emerges notably in the context of aggression responses. Such a denial participates in the creation of a playful atmosphere in which sadism could always be mastered. The process supposes a grandiose ego, capable of manipulating fantasies of attack in a hypomanic and omnipotent fashion. Hypomanic denial thus serves the purpose of denying any possibility of experiencing helpnessness and weakness. In a way, it corresponds to the experience of triumph described by Meloy.
On both sides of the Atlantic, an important role is attributed to projective identification, a mechanism which operates a projection of aggresive drives onto the object, while simultaneously achieving a control of the object. For Rossel and Merceron, contents of past aggression are the expression of projective identification. Thus the origin of the attack is clearly situated in the external world and the boundaries between aggressor and aggressee remain clear. Since the American study had included in its sample psychopathic characters organized at a psychotic level, it is not surprising that Meloy mentions cases when, to the contrary, the subject loses the notion of a clear boundary between aggressor and aggressee. This would lead to paranoid delusions in which “the individual perversely and aggressively does to others as a predator what may, at any time, be done to him.”
Another area of convergence relates to identification with the aggressor. Regarding the MOR and AG scores (Morbid content and Aggressive content), Meloy remarks how the subject identifies himself with the aggressor rather than with the victim. Rossel and Merceron confirm this point and specify that such an observation is in direct contrast to masochistic personalities in whom one witnesses a reversal of sadism onto the subject himself. The psychopath “insists on the fear he can create in others, thus denying the possibility of experiencing it himself.”
Another function of identification with the aggressor relates to controlling others, for in seeking to generate fear in the relationship with the examiner, the subject actively manipulates sadistic themes. The European authors understand this hypercathexis of aggressivity as the expression of an active defense against dependency by way of perpetuating conflict and struggle for power.
Using the primitive defenses scale of Lerner and Lerner (1980), Meloy underlines the important role played by the mechanism of devaluation in the psychopath’s interactions. We had already mentioned this in the paragraph dealing with object relations. We shall simply add that this devaluation could fit within Melanie Klein’s manic triad, a triad which includes control, contempt, and triumph (Bleandonu, 1985). From this viewpoint, the mechanism of devaluation reported by the Americans would function as a manic defense.
The last area of study is specific to the analysis of the Swiss authors and probably represents the hallmark of their work. This domain relates to the cathexis of thought processes, mental representations, and knowledge in general. Rossel and Merceron indicate how the psychopath’s characteristic enunciations and nuances of verbalization (choice of vocabulary, comments surrounding responses, exclamations etc … ) enable them to infer given particularities of the psychopath’s psychic functioning. For instance, the creation of hybrid classes, which blend human and animal contents (“people with birds’ heads” on card III), while denoting “an aborted attempt at collective representations,” also point towards the need for maintaining omnipotence.
A careful examination of psychopaths’ choice of vocabulary reveals their predilection for “action” verbs. The presence of these actions often manifested towards the cards (to “separate,” to “cut,” to “break” the blot) enables the authors to infer both a deficiency of representation and a submission of the object to the often sadistic drive of the psychopath. As for the devaluation of the testing situation itself, it expresses, according to Rossel and Merceron, the non-cathexis, even the contempt for knowledge in general, as well as the superego deficiency and the reversal of roles, so typical of their underlying narcissistic disturbance.
The special attention to verbalization does not imply that content analysis should be neglected. Let us mention only one example: The careful listing of contents in psychopathic Rorschachs reveals the frequent presence of responses containing an enlargement process (“seen under a microscope”). Such a response is present on card X of the “model” protocol quoted by Meloy but is not commented by him (“Looks like something under a microscope”). Rossel and Merceron postulate that the use of the apparatus implies a manipulation, designed to yield a certain result. This manipulation appears linked to the search for omnipotent control. As for the result of the enlargement, it could correspond to the grandiose self which Meloy describes within the context of narcissistic dynamics.
Conclusion: Psychopaths Are the Same Indeed
When reading both these texts, there is no doubt that Europeans and Americans agree on the notion of psychopathic functioning, with its object relations marked by a search for power and control, its struggle against dependency and anaclitic anxiety, its defense mechanisms such as projective identification, identification with the aggressor, hypomanic denial and splitting of objects, and its non-cathexis of mental life and knowledge in favor of a hypercathexis of action.
The conclusions drawn by the authors on both sides of the Atlantic might be alike, yet the processes used to derive them are quite different, regarding both methodology and choice of analysis. On the American side, the search for patterns enabling prediction of behavior favors a quantitative approach. On the European side, the wish to highlight interrelations and derive meaning from the clinical observations favors a qualitative approach. We are faced here with two forms of testing, two orientations, a psychometric and a clinical one (Duruz, 1979). The distinction proposed by Duruz seems to correspond to the distinction that several American authors make (Smith, 1990; Jaffe, 1991; Sugarman, 1991) between “testing,” a process which tends to classify and isolate traits and behaviors, and “assessment,” a fundamentally integrative task aimed at the understanding of the individual’s complexity.
At a time when several authors speak of integration between the “empirical” and the “psychoanalytic” approach (Weiner, 1994), it might seem old-fashioned to maintain the above distinction, especially when Reid Meloy’s work is clearly less monolithic in its approach than the Swiss study, as it tries to unite data from both the Comprehensive System and psychoanalytically oriented scales. The first problem, to my mind, is that the result is precisely not an integration but an addition of techniques. Further “integration” might be achieved in Gacono and Meloy’s next book on psychopathy and the Rorschach. The absence of integration appears to stem from the absence of a unifying theoretical framework. The second problem is that the application of scales, however necessary for addressing concerns about data validation, always implies “zooming in” on a priori variables, a viewpoint which clearly departs from the “zooming out” of the clinician’s approach. In this sense, I believe that these two forms of testing overlap two quasi-antithetical research models describable as the “experimental” model and the “holistic” model (Husain-Zubair 1992).
Yet, the complementarity and even the similarity of comments in both studies should comfort some clinicians, overwhelmed by the rift which often appears to reign between the projective literature of both continents. Furthermore, this effort of comparing an American and a Swiss study on psychopathy and the Rorschach will have brought to us the following confirmation: Independently of the chosen methodology and validation path, the clinical observation of the trained psychologist remains the cornerstone of all research in psychopathology.