A MANUAL FOR THE i CHILDREN’S APPERCEPTION TEST (ANIMAL FIGURES) by LEOPOLD BELLAK, m.p. Clinical Professor of Psychology, Postdoctoral Program in Psychotherapy, New York University. Glinical Professor of Psychiatry, Albert Einstein College of Medicine. and SONYA SOREL BELLAK TWENTY-FIRST PRINTING — 1982 SEVENTH AND REVISED EDITION — 1980 Copyright by LEOPOLD BELLAK, M.D., 1949 Published by C.P.S. Ine., P.O. Box 83, Larchmont, N.Y. 10538THE CHILDREN’S APPERCEPTION TEST (C.A.T.) HISTORY OF THE CAT. ‘The original idea of the C.A.T. was produced by Emst Kris in a discussion of theoretical problems of projection and of the T.A.T. with the senior author. Dr. Kris* pointed out how we could expect children to identify themselves much more readily with animals than with persons, a fact we have known ever since Freud wrote his story of little Hans in “The Phobia of a Five Year Old.” The present authors, after think- ing the whole problem over for nearly a year, specified ‘a number of situations fundamental to children which might conceivably be expected to expose the dynamic workings of a child’s problems as against the manifest material available. It seemed that the T.A.T., a wonder- ful instrument for adults, could not entirely fuifill the needs with young children, and similarly Symonds could not recommend his Picture-Story Test for use prior to adolescence. Theoretically, we had reason to assume that animals might be preferred identification figures from three years up to possibly ten, and thus, we set out to create, pictorially, situations vital to this age range. ‘Violet Lamont, a professional illustrator of children’s books agreed to draw the pictures according to our sug~ gestions, adding a few of her own liking. She presented us with eighteen pictures, some of somewhat anthro- pomorphized nature, some entirely in animal-fashion. ‘These we had photostated, used some sets ourselves, and distributed others to a number of psychologists working with small children. The majority of these psy- chologists were known to the senior author in connec- tion with his T.A.T. courses and therefore had an ac- quaintance with projective procedures and their use. They were good enough to use the original pictures of the C.A.T. and to send us protocols with additional in- formation about subjects’ background, etc., as well as their own impressions of the problems of the test. ‘On the above basis, and on the basis of our own ex- perience with records, we reduced the number of cards from eighteen to the ten most useful ones, and developed the data described herein NATURE AND PURPOSE OF TEST ‘The C.A.T. consists of ten pictures depicting animals in various situations. It is to be used with children of both sexes primarily between the ages of three and 10 for maximal usefulness. After establishing appropriate rapport with the child, the cards are presented as out- lined under the section Administration.” The responses are recorded verbatim and later analyzed as discussed under section “Interpretation.” The C.A.T. is a projective method or, as we pre- fer to call it, an apperceptive method: a method of investigating personality by studying the dynamic mean- ingfulness of the individual differences in perception of ‘standard stimuli The test is a direct descendant of the Henry Murray ‘Thematic Apperception Test. It does not compete with the T.A.T. nor substitute for it. Unsurpassed as we believe the T.A.T. is for adult personality investigation, it is nevertheless relatively unsuited for young children to the same degree that C.A.T. is unsuited for adults. Ideally, we should like to see the C.A.T. used for chil- dren from three to 10; Symonds Picture-Story Test, for adolescents; and the T.A.T. for adolescents “and adults. The C.A.T. was designed to facilitate understanding of a child's relationship to his most important figures and drives. The pictures were designed to elicit responses to feeding problems specifically, and oral problems gen- erally; to investigate problems of sibling rivalry; to il- Tuminate the attitude toward parental figures and the way in which these figures are apperceived; to learn about the child’s relationship to the parents as a couple = technically spoken of as the oedipal complex and its culmination in the primal scene: namely, the child's fantasies about seeing the parents in bed together. Re- lated to this, we wish to elicit the child’s fantasies about aggression; about acceptance by the adult world, and his fear of being lonely at night with a possible relation to masturbation, toilet behavior and the parents’ re-~ sponse to it. We wish to learn about the child's structure + We are extremely grateful to the late Dr. Ernst Kris for having provided the stimulus and inspiration for our own work +The senior author is greatly indebted to Dr. Murray who introduced him to the T.A.T. in its early days A Human Version of the CAT. has been published (C.AT-H) by Bellak and Bellak, C. P. S. Ine, 1965 For relevant reference, see also: Bellak. L. THE THEMATIC A PERCEPTION TEST, THE CHILDREN'S APPERCEPTION TEST and THE SENIOR APPERCEPTION TECHNIQUE IN CLINICAL USE, 31d, rev. ed. New York: Grune & Stratton, 1975. Neuringer, C. and Livesay, R.C. Projective Fantasy on the CAT and CAT-H. Journal of Projective Techniques & Per- sonality Assessment, Vol. 34, 1970, No. 6, pp. 487-491 Myler, B., Rosenkrantz, A. and Holme Journal of Personality Assessment, Vol. 36, 19° Neuringer and A Comparison of the TAT, CAT and CAT-H Among Second Grade Girls. No. 5, pp. 440-444. ivesay’s study suggests that the CAT and the CAT-H are equivalent forms. Myler, er al. report the same and find in addition that the CAT and CAT-H were more useful for second grade girls than the TAT. A third edition of The TA.T., CA.T: and $A. in Clinical Use was published by Grune & Stratton, Inc. in 1979and his dynamic method of reacting to — and handling — his problems of growth. ‘This test, like T.A.T. was once primarily concerned with the content of production (3, 5), An analysis of apper- ceptive behavior is usually concerned with what one sees and thinks in distinction to an examination of ex- pressive behavior, which is concerned with how one sees and thinks. We have discussed this relationship of adap- tive, expressive, and apperceptive aspects of psycholog- ical productions in a previous publication (4) in which we pointed out that the Rorschach is primarily a study of the formal organization of expressive factors. Since then ego psychology. as well as cognitive psychology, has developed a great deal and structural, dynamic, and cog- nitive facets are studied in both Rorschach and the TAT. and the C.A-T. Elsewhere inthis manual, the study of ego functions in test behavior, as well asin test data, is recorded. Still, he T.A.T. and the C.A.T. are likely to be especially useful for depicting the dynamics of interper- sonal relationships. of drive constellations, and the nature of defenses “Thus we believe that the C.A.T. may be clinically useful in determining what dynamic and structural factors right be related to a child's behavior and problems in a group, in school or kindergarten, orat home. The C.A.T. ‘may be profitable in the hands of the psychoanalyst, the psychiatrist, the psychologist, the social worker, and the teacher as well as the psychologically trained pedia- trician, It may be used directly in therapy as a play tech~ nique. After the original responses have been given, one may wish to go over them with the child in the form of play and make appropriate interpretations. Furthermore, the C.A.T. should lend itself to much needed longitudinal research studies on child develop- ment: if the C.A.T. were administered to children at half-year intervals from the third year, we might learn much about the developmental fate of a number of psy- chological problems thus far studied only in psycho- analytic investigation or other cross-sectional studies. ‘These latter are by necessity reconstructions and infer- ences which heed further confirmation and/or elabora- tion (33). In research studies and clinical use alike it should be helpful that the C.A.T. is relatively culture- free. Since we deal with animal pictures, itis used equally well with white and black children, and other groups as, well, except, of course, those groups which might not be familiar with some of the inanimate objects such as bi- eyeles, ete Lack of familiarity with the animals depicted does not seem to constitute a problem since the c! simply substitute animals they are familiar with, ADMINISTRATION In the administration of the C.A-T., account must be taken of the general problems of child testing. Good rapport must be established with the child. This will, in general, be considerably more difficult with the younger children as well as with the more disturbed ones. When- ever possible, the C.A.T. should be presented as a game, not as a test. In cases of children who are obviously aware that it is a test — whether from previous experi- ence with such procedures or sophistication, etc. — it will be advisable to fully acknowledge this fact, but to explain most carefully that it is not @ challenging kind of test in which the child must face approval, disap- proval, competition, disciplinary action, etc. For the actual instruction, it may be best to tell the child that we are going fo engage in a game in which he has to tell a story about pictures; that he should tell what is going on, what the animals are doing now. At stitable points, the child may be asked what went on in the story before and what will happen later. It will probably be found that much encouragement and prompting may be necessary; interruptions are pe: mitted. One must be certain not to be suggestive in one’s prompting. After all stories have been related, fone may go over each of them asking for elaboration fon specific points such as: why somebody was given a certain name, proper names of places, ages, ete., and feven questions regarding the particular type of out- come of a story. Ifa child’s attention span does not per- mit this procedure, it would be well to attempt it at a date as soon after administration as possible Al side remarks and activities should be noted, in relation to the story being told. A difficult situation to deal with may arise if the child wants the examiner to tell a story; this is primarily a request to be given some thing rather than to have to give, and is best dealt with in that light. While it may help 10 explain that we want to hear what the particular child can make of the pi ture, it may be necessary to promise (and to adinere toi) to tell story later, or to leave off testing until one can establish a relationship with the child by a giving of ‘one kind or another, then to resume again. It is helpful to keep all the pictures out of sight ex- cept the one being dealt with, since the younger ch dren have a tendency to play with all pictures at onc choosing them at random for story telling. These pic tures have been numbered and arranged in a partic sequence for particular reason administered in the order inciIf, however, a child is particularly restless and one has Some indication as to what problems its current dis- turbance may be related, one may restrict the test to only those few cards which are likely to illuminate those specific problems. Thus, a child who apparently has sibling rivalry problems might be given cards 1 and 4 particularly, ete. It will be very useful to keep the twelve ego functions (see p. 7) in mind while observing test behavior and recorded as the manifestly observable ego functions. These then should be compared to ego function ratings based on the evaluation of the stories, DESCRIPTION OF, AND TYPICAL RESPONSES Below, we present typical themes seen as responses, to the various pictures. Picture #1: Chicks seated around a table on which is a large bow! of food. Off to one side is a large chicken, dimly ouatined. Responses revolve around eating, being or not being sufliciently fed by cither parent. Themes of sibling ri valry enter in around who gets more, who is well-be- haved and not, etc. Food may be seen as a reward or, inversely, its withholding seen as punishment; general problems of orality arc dealt with: satisfaction or frus tration, feeding problems per se Picture #2: One bear pulling a rope on one side while another bear and a baby bear pull on the other side, It is interesting to observe whether the baby here identifies the figure with whom he cooperates (if at all) 1s the father or the mother. It may be seen as a serious fight with accompanying fear of aggression, fulfilment of the child’s own aggression oF autonomy. More be- nignly, this picture may be seen as a game (tug-of-war, for example). Sometimes the rope itself may be a source of concern, ie, breakage of the rope as a toy and fear of subsequent punishment; or again, purely as a symbol concerning masturbation with the rope-breaking, repre- senting castration fears, Picture #3: A lion with pipe and cane, sitting in a chair: in the lower right corner a title mouse appears ina hole. This is usually seen as a father figure equipped with symbols as pipe and cane, The latter may be seen either as an instrument of aggression or may be used to turn this paternal figure into an old, helpless one of whom one need not be afraid, This is usually a defensive process, If the lion is seen as a strong paternal figure, it will be important to note whether he is a beni dangerous power The mouse is seen by the great majority of children, TO PICTURES and often taken as the identification figure. In such a case — by tricks and circumstance — the mouse may be turned into the more powerful one. On the other hand, it may be totally in the power of the lion. Some children identify themselves with the lion and there will be sub- jects who will switch identification one or more times, giving evidence of confusion about role, conflict be- tween compliance and autonomy, etc Picture #4: A kangaroo with a bonnet on her head, carrying a basket with a milk bottle; in her pouch is @ baby kangaroo with a balloon; on a bicycle, a larger kangaroo child. ‘This usually elicits themes of sibling rivalry, or some concern with the origin of babies. In both cases, the relation to the mother is often an important feature. ‘Sometimes a child who is an older sibling will identify himself with the pouch baby, thus indicating a wish to regress in order to be nearer to the mother. On the other hand, a child who is in reality the younger one, may identify himself with the older one, thus signifying his wish for independence and mastery. The basket may tive rise to themes of feeding. A theme of flight from danger may also occasionally be introduced. Our ex- perience thus far suggests that this can be related to unconscious fear in the area of father-mother relation ship, sex, pregnancy, ete, Picture #5: A darkened room with a large bed in the backround; a crib in the foreground in which are two baby bears Productions concerning primal scene in all variations are common here; the child is concerned with what goes ‘on between the parents in bed. These stories reflect a good deal of conjecture, observation. confusion, and emotional involvement on the part of the children. The two children in the crib lend themselves to themes of ‘mutual manipulation and exploration between children, Picture #6: A darkened cave with two dimly outlined 03]bear figures in the background; a baby bear lying in the foreground. This again is a picture eliciting primarily stories con- ‘cerning the primal scene. It is used in addition to #5 since practical experience has shown that #6 will enlarge frequently and greatly upon whatever was held back in response to the previous picture. Plain jealousy in this ‘triangle situation will at times be reflected. Problems of masturbation at bedtime may appear in response to either #5 or #6. Picture #7: A tiger with bared fangs and claws, leap- ing at a monkey which is also leaping through the air. Fears of aggression and manners of dealing with them are here exposed. The degree of anxiety in the child often becomes apparent, It may be so great as to lead to rejection of the picture, or, the defenses may be good enough (or unrealistic enough) to turn it into an in- nocuous story. The monkey may even outsmart the tiger. The tails of the animals lend themselves easily to the projection of fears or wishes of castration. Picture #8: Two adult monkeys sitting on a sofa drinking jrom tea cups. One adult monkey in foreground sitting on a hassock talking t0 a baby monkey. Here one often sees the role in which the child places himself within the family constellation. His interpreta- tion of the dominant (foreground) monkey as either a father or mother figure becomes significant in relation to his perception of it as a benign monkey or as an admonishing, inhibiting one. The tea cups will, on occa- sion, give rise to themes of orality again Picture #9: A darkened room seen through an open door from a lighted room. In the darkened one there is a child's bed in which a rabbit sits up looking through the door. ‘Themes of fear of darkness, of being left alone, de- sertion by parents, significant curiosity as to what goes fon in the next room, are all common responses to this picture, Picture #10: A baby dog lying across the knees of an adult dog: both figures with a minimum of expres- sive features. The figures are set in the foreground of a bathroom. ‘This leads to stories of “crime and punishment,” re- vealing something about the child’s moral conceptions. ‘There are frequent stories about toilet training as. well as masturbation. Regressive trends will be more clearly revealed in this picture than in some others INTERPRETATION OF THE C. A. T. When one approaches the interpretation of an ap- perceptive method such as the C.A.T.., itis best to keep some basic principles firmly in mind. The subject is asked to apperceive — that is, to meaningly interpret = a situation. The subject's interpretation of the stim- ulus in following our instruction to tell a story ex- ceeds the minimal “objective” stimulus value. He does 50, by necessity, in his own way which must be a func- tion of continually present psychological forces which at that moment manifest themselves in relation to the given stimulus material Tf one accepts a motivational continuity of the per- sonality structure one may use the following analogy for a testing procedure as well as psychotherapeutic free association: If a river is sampled at various reta- tively close intervals, the chemical analysis of the content will be highly similar. Any pailful will be repre~ sentative of the total content. This procedure is com- monly followed in public health assays. Now, if a new tributary joins — (as compared to a new situational factor in psychological sampling), it 4) may of course add factors about which the assayer has to know in order to account for changes in content, A primarily genetic theory of personality, like psycho- analysis, maintains that the main contents of the stream will remain the primary matrix which, after a certain point, tributaries can only modify to a greater or lesser Segree. ‘To leave the dangers of further analogies, we believe (and by now, ample experimental literature supports this belief) that interpretations of stimuli in our test material give us a valid sample of the subject’s psychic continuum known as personality. Still in its formative stage, it is, of course, more changeable in childhood. We can learn about the motivational forces from the fact that any individual response is meaningful for that person; we can furthermore increase our insight by comparing one individual's responses to those of others. To that extent, we are really studying individual differ- ences and making inferences about a given subject by this comparison. To facilitate interpretation and analysis of the C.A-T.wwe are suggesting the study of ten variables discussed below, and we have designed the C.A.T. Blank and Analysis Sheet, (Fig. 1). 1. THE MAIN THEME To recapitulate: We are interested in what a child makes of our pictures and then we will want to know why it gives this particular story (or interpretation). Rather than judge by one story, we will be on safer ground if we can find a common denominator or trend ina number of stories. That is, for example, if the main hero of several stories is hungry, and resorts to stealing in order to satisfy himself, it is not unreasonable to conclude that this child is preoccupied with thoughts of not getting enough — food literally, or gratification gen- erally — and in his fantasy wishes to take it away from others. Interpretation then, is concerned with the find~ ing of common denominators in behavioral patterns (4, 3), In this sense we can speak of the theme of a story or of several stories. A theme may, of course, be more or less complex. We find that particularly in our younger subjects of three and four it is usually very simple. In our first sample (p. 13) one may simply say that little S. Qs theme in the lion story is: “I do not want any clothes and wish to be dirty, and behave like a small child, because then apparently one gets more affection.” On the other hand, themes may be more complex as in subject M. I’s (p. 13): “I'm powerful and dangerous but in order to be liked and to live in peace with myself, I must give up my aggressive and acquisitive wishes.” The theme in such a ease is simply a restatement of the moral of the story. A story may have more than one theme however, and they may some- times be complexly interrelated. 2. THE MAIN HERO ‘A basic assumption behind our reasoning thus far was, of course, that the story which our subject tells is, in essence, about himself, Since there can be a number of people ina story, it becomes necessary to state that we speak of the figure with which our subject mainly identifies himself as the hero, We will have to specify, for this purpose, some objective criteria for differentiat ing the hero from other figures: The hero is the figure about whom the story is woven primarily. He resembles, the subject most in age and sex, and itis from his stand- point that the events are seen, While these statements hold true most of the time, they do not always do so. There may be more than one hero and our subject may identify with both, or first with one and then with another. There may be a deviation in that a subject may identify with a hero of a different sex; it is important to note such identifications. Sometimes an identification figure secondary in importance in a story may represent more deeply repressed unconscious attitudes of the subject. Probably the interests, wishes, deficiencies, gifts and abilities with which the hero is invested are those which the subject possesses, wants to possess, or fears that he might have. It will be important to observe the ade- {quacy of the hero; that is, the ability to deal with what- ever circumstances may exist, in a way considered ade- ‘quate by the society to which he belongs. For instance, subject C. C. (p. 16) in our sample, though identify- ing herself primarily with the mouse, must be considered adequate in the context of that story (#3). The ade- quacy of the hero serves as the best single measure of the ego strength; that is, in many ways, of the sub- ject’s own adequacy. An exception is, of course, the case of the story which is a blatant compensatory wish fulfillment. Careful serutiny will usually show in such cases that the real inadequacy becomes apparent. See for example, story #3 of case M. [., in which the hero is a mighty lion, but he does not like his body and in the end can be happy only by giving up his omnipotence. Selfimage. By self-image we mean the conception which the sub- ject has of his body and of his entire self and social role. Schilder first described body image as the picture ‘of one’s own body in one’s mind. Case 3, —M. instance, tells us about his own body image in unusually ‘overt terms when he says, “he didn’t have a beautiful body,” and then proceeds to tell us how he would like his body to be, what fantasy self-image he would like to have — namely, that of a big, powerful, all-possess- ing person. 3. MAIN NEEDS AND DRIVES OF THE HERO Behavioral needs of the hero (as in the story). The story behavior of the hero may have one of a variety of relationships tothe story-teller: The needs expressed may correspond directly to the needs of the patient: These needs may be at least in part, expressed behaviorally in real life, or they may be the direct opposite of real life expression and constitute the fantasy complement, In other words, very aggressive stories may be told some- times by a very aggressive child, or by a rather meek, passive-aggressive one who has fantasies of aggression. AC least 10 a certain extent the needs of the hero may not reflect so much the needs of the story-teller as they do the drive quality which he perceives in other figures. In other words, he may be describing the aggression feared from various objects or referring to idealized ex- pectations, such as brilliance and fortitude, aseribed to significant figures in his life and only, in. part, inter- nalized in himself. In short, the behavioral needs of the hero expressed in the story have to be examined and understood in the light of all the varieties and vissici- 5)BELLAK RECORDING AND ANALYSIS BLANI Story No. 1 Story No. 2 Main Theme: (diagnostic level: if descriptive and interpretative Tevels are desired, use scratch sheet oF page 5) 2. Main hero: age sex __ vocation _ interesta__ traite____ body image. adequacy (V/.//+//\/) and/or sel! 3. Main needs and drives of hero: a) behavioral needs of hero (as in story) implying: oo b) figures, objects, or circumstances introduced: — ©) figures, implying need for or to: 4. Conception of environment (world) as: — 5. a) Parental figures (m__. f _) are seen as and subject's reaction to a is So b) Contemp. figures (m_—_, f _) are seen ap — | and subject's reaction to b ig — . c) Junior figures (m_—_. f _) are seen as — | 6. Significant conflict 7. Nature of anxieties: (/) of physical harm and/or punishment af dimpprowal of lack or loss of love of illness or injury of being deserted — of deprivation of being overpowered and helple of being devoured "other —— 8. Main defenses against conflicts and fears: (//) reaction-formarion —__| — denial introjection | undoing. eee rationalization other. 9. Adequacy ; ‘ppropriste inappropriate {Op setere also indicated by immediey of panishmeni) | inconsistent too lenient — also:—_ ac is delayed initial response or pauses 10. Integration of the ego, manifesting itself im: (Vw VV) stammer. “other manifestations of superego interference | Hero: adequate inadequate a outcome: happy unhappy drive control cacsaaiaaae thought processes as revealed by plot being: (V. VV. VV) Stereotyped “original appropriate complete incomplete inappropriate —— syneretie —eonerete Contaminated Tsetligenese ire errrSat E Maturational level TET eet fo superego as manifested by “punishment” for “erime” beings | (9) |SHORT FORM Where you find need for more extensive notations on any story (e.g. the main theme) please use this page for this purpose. (The pages on which the C.A.T. stories were recorded may be enclosed or attached to this Blank) Also in analyzing the stories, it will be helpful to keep the adaptive level of the following ego functions in mind. (For a discussion of these functions, see THE SCHIZOPHRENIC SYNDROME, L., Bellak and L, Loeb eds., Grune & Stratton, New York 1969, THE T.A-T., C.A.T. and S.A.T. in CLINICAL USE, L, Bellak, 3rd and revised edition, Grune & Stratton, New York, 1975, and EGO FUNCTIONS IN SCHIZOPHRENICS, NEUROTICS, AND NOR- MALS, L. Bellak, M. Hurvich, and H. Gediman, John Wiley & Sons, New York, 1973.) -|=|B| 2]>/5 *|x|R[z & lal# o/ 22/2 & |E2 S)zlg|2 = |3\é £l4|2/6 at a aig flelsle|ait a |= B | 7 2 7 u | 3 10 - z He i Plealee Zz ah 6 | 5 aol 4 vs 3 = i J iff} 4 Ego functions r Roe bebuvinaleve(.) a inert eel or str ad compat eens vmA Scnepute oF Apaptive MECHANISMS IN CAT Responses MARY R. HAWORTH, Ph.D. Name Ba: Date: Age: Critical Scores: TOTALS DEFENSE MECHANISMS. A. Reaction formation (only one check per story) 1. Exaggerated goodness or cleanliness (ay 2 Oppositional attitudes, rebellion, stubbornness B=B) Lu. & Story tone opposed to picture content B. Undoing and Ambivalence (only one check per story) L. Undoing 2. Gives alternatives; balanced phrases (asleep-awake; hot—cold, etc.) ) 31 Indecision by $ oF story character © # Restates (eg, “that RO UhiS. co nni” "he Was Boing 10, BU en") ©. Kolation Detached attitude, (“it couldn't happen, Literal (“it doesn’t show, so T can’t tell”) Comments on story or picture (“That is hard”; “I told a good one.") Laughs at card, exelamations Use of fairy-tale, comicbook, or “olden time Describes in detail, logical; “the end”; give Specific details, nan tharacter gets lost Character runs away due 10 anger 10, § aligns with parent against “naughty” child character; disapproves child's actions it’s a cartoon") Gy themes or characters itle to sto D. Repression and Denial 1 Child character waits, controls et, conforms, is good, latned leon 6 * Aecepis fates didnt want Ht nysy 2 5) Prolonged or remote punishments 4, "Teas ust a drean 5, Forgets, or loses something 8 Omnis figures or objects from story (on #10 must omit mention of toilet end tub or washing) No fantasy or story (describes card blandly) Refuses card F. Deception 1, Child superior to adult, laughs at adult, is smarter, tricks adult, sneaks, pretends, hides @* from, steals from, peeks at or spies on adult (only one check per story) 2, Adult tricks child, is noc what appears to be (only one check per story) F. Symbolization 1. Children play in bed @ 2 See parents in bed (#5) 3. Open window (#5, #9); Dig, or fall in, a hole 4. Babies born 5. Rope breaks (#2); chair or cane breaks (#3); balloon breaks (#4); tail pulled or bitten (#4, 7); crib broken (#9) Rain, river, water, storms, cold Fire, explosions, destruction Sticks, knives, guins 9. Cuts, stings, injuries, actual killings (other than by eating) 10. Oral deprivation G. Projection and Introjection 1, Attacker is attacked, “eat ancl be eaten” @ 2 Innocent one is eaten or attacked 3. Child is active aggressor (bites, hits, throws; do not include verbal or teasing attacks) 4: Characters blame others 5. Others have secrets or make fun of somebody 6. Sadds details, objects, characters, or oral themes 7. Magic or magical powers (* oF 2 both ate 2 responses is]PHOBIC, IMMATURE OR DISORGANIZED H. Fear and Anxiety set 1. Child hides from danger, runs away due to fear 3) 2. Fears outside forces (wind, ghosts, hunters, wild animals, monsters) ou 3. Dreams of danger 4. Parent dead, goes away, or doesn't want child 5. Slips of tongue by S 1. Regression ss 1. Much affect in telling story @ 2. Personal references 8. Food spilled 4. Bed or pants wet, water splashed 5, Dirty, messing, smelly; person or object falls in toilet 6. Ghosts, witches, haunted house J. Controls weak or absent 1. Bones, blood a sommes 2. Poison 3. Glang or nonsense words 4, Perseveration of unusual content from a previous story 5. Tangential thinking, loose associations 6. Bizarre content IDENTIFICATION Adequate, same-sex 1. § identifies with samesex parent or child characer L: 2 Child jealous of, scolded or punished by, same-sex parent or >K) 3. Child loves, or is helped by, parent of opposite sex L. Confused, or oppositesex 1. § identifies with opposite-sex parent or child character 2 Child fears, or is scolded or punished by, opposite-sex parent 3. Misrecognition by § of sex or species 4, Slips of tongue with respect (0 sex of figures This checklist has been designed primarily as an aid stories: ie can also be used to furnish a rough quantitative measure for making comparisons between subjects nd groups. The Schedule provides a quick summary of the number and kinds of defenses employed as well as the content of items used most frequently. The categories are arranged as neatly as possible on a con- Ungum from indicators of high control and constriction to suggestions of disorganization and loosening of ties 10 reality. the squalitayive evaluation of children’s CAT Directions for Scoring: In the blank preceding each item, indicate with a check mark (or the card number, for future reference) any occurrence of such a response. A story may be “scored” in several categories and excep here iicate 4 sory may recive ees oh ote tah de item under amy one eatery ‘Afterall stories have been scored, record the total number of checks for each category in the blank pro- cided, “The number in parentheses under each of these blanks indicates the minimum number of checks re garded as a “critical score” for that category For the Identification measure, the equivalent of a critical score is secured by comparing the relative number of checks for categories K and L. If the sum of checks for L is equal to or exceeds the sum for K, identification is considered to be “confused” and contributes one unit to the total of ertical scores. The final quantitative measure consists of the number of categories receiving critical scores. (and not the total number of checks for all categories On the basis of research findings.* five or more critical scores would indicate enough disturbance to warrant clinical intervention fMtaiy K. Haworth, PhD. Schule forthe Analysis of CAT Responses, Journal of Projective Techniques & Personal Asieviment, Vol. 27, 1468, No. 2, 181-184, = 7 sia 5 pItudes of drive modification and subsumed under the broader concepts of projection or apperceptive distortion. Tt is the difficult task of the interpreter to determine to what extent the manifest needs of the hero correspond to various constituents of the story-teler’s personality, and in addition what the relationship of these constitu tents is to the narrator's manifest behavior. It is here that comparison with the actual clinical history is most useful and entirely appropriate under clinical circum- stances (as distinct from a research setting). If a child is reported to be particulary shy, passive and withdrawn, and the C.A.T. stories overflow with aggression, the compensatory nature of the fantasy material is obvious. On the other hand, it must remain a goal of psychologi- cal science to develop more and more criteria for in- creasingly valid. predictions — by relating the fantasy material to actual behavior and to discernible behavior patterns. The study of ego functions is particularly use- ful in this respect. The relationship of drives expressed, within the story, together with their vissicitudes may often serve as one clue; that is, if the story sequence shows an initial aggressive response with this aggression becoming controlled by the end of the story, chances are that this is a person who does not translate fantasy y. This assumption may then ble behavioral data. There are other criteria helpful in attempting predictions about what might be called “acting out”. The high degree of detail and realism in the description of needs may sug- gest a direct likelihood of their expression in reality Vaguely structured needs of the hero are less likely to be related to realty Figures, objects or circumstances introduced: A child who. introduces weapons of one sort or another in a ‘number of stories (even without using them in context) for who has food as an integral part (even without cat- ing it) may be tentatively judged on such evidence as having a need for aggression or oral gratification re- spectively. And since the introduction of a figure or circumstance not pictorially represented 15 extremely Significant, this should be noted, possibly by adding an exclamation mark to the analysis sheet. External cit- cumstances such as injustice, severity, indifference, de- privation, and deception (included with the figures and objects introduced), help to indicate the nature of the world in whieh the child believes himself to be living. Figures, objects or circumstances omitted: Similarly, if one or more figures in the picture are omitted or ig- nored in the story related, we must consider the possi bility of dynamic significance. The simplest meaning is usually an expression of the wish that the figure or ob- ject were not there, This may mean plain hostility, or See: p Review of ihe Syndrome, edited by L. Bell Brief Psvehotherapy, Grune & Stratton, Ine. Inc 1969. that the figure or object is severely conflict-arousing, pos- sibly because of its positive value. Of course, this level of inference can only be a tentative one; Bt present we do not have a large enough sample of norms, so that expectations regarding objects themselves, introduced and/or omitted, are available. 4, THE CONCEPTION OF THE ENVIRONMENT ‘This concept is, of course, a complex mixture of un- conscious self-perception and apperceptive distortion of stimuli by memory images of the past. The more con- sistent a picture of the environment appearing in the C.AT. stories, the more reason we have to consider it ‘an important ‘constituent of our subject's personality ‘and a useful clue to his reactions in everyday life. Usu- ally, two or three descriptive terms will suffice, such as succorant, hostile, exploiting or exploitable, friendly, dangerous, ete. Identification: 1t is important to note with whom the child identifies in the family, namely, which sibling, which parent, etc. It will also be most important to ob- serve the role which each parent takes with regard to adequacy, and appropriateness, as an identification fig- ure. For instance, whether a male child after the age of five identifies with the father, or an older brother, uncle, etc., rather than with say, the mother or a younger sister’ While, of course, the process of identification will ‘not have been completed until the end of puberty, the carly history may be of great importance. 5. FIGURES ARE SEEN AS Here we are interested in the way the child sees the figures around him and how he reacts to them. We know something about the quality of object relationships — symbiotic, anaclitic, oral-dependent, ambivalent, etc., at different stages of development and in different person- alities. However, in a broader scheme we may de- scriptively speak of supportive, competitive and other relationships. 6. SIGNIFICANT CONFLICTS When we study the significant conflicts we not only want to know the nature of the conflicts, but also the defenses which the child uses against anxiety engendered by these conflicts. Here we have an excellent opportun- ity to study the early character formation and we may be able to derive ideas concerning prognosis. ‘There are those conflicts which all children experience as they grow from one phase to the next: Thus, beginning, at about age 3, we ought not to be alarmed to find evi dence of the oedipal struggle and defenses against the fantasied relationship. Some conflicts are part of 0, 45 well as L. Bellak, The T.4-T. and C.A.T, in Clinical Use, Grune & Stratton, Ine., N-Y., 1971 and, also Schizophrenia: A ‘ogos Press, N'Y. 1955; and 1. Bellak, ahd L.Smail, Emergency Psychotherapy and ee, and L- Bellsk, and 1 Loch eds, The Schizophrenic Syndrome, Grune & Stratton, (10)normal growing up; others may have pathological significance, 7. NATURE OF ANXIETIES ‘The importance of determining the main anxieties of ‘a child hardly needs emphasizing. Those related to phys- ical harm, punishment, and the fear of lacking or losing ove (disapproval) and of being deserted (loneliness, lack of support), are probably the most important. It will be valuable to note in the context the child’s defenses, against the fears which beset him. We will want to know. the form which the defense takes: whether it is flight, passivity, aggression, orality, acquisitiveness, renuncia- tion, regression, ete. 8. MAIN DEFENSES Stories should not be studied exclusively for drive content, but should, in addition, be examined for the defenses against these drives. Not infrequently such a study of defenses will actually offer more information in that the drives themselves may appear less clearly than the defenses against them; on the other hand, the defensive structure may be more closely related to mani fest behavior of the child. By means of studying drives and defenses the C.A.T. often permits an appraisal of the character structure of the subject. Aside from a search for the main defense mecha- nisms, it is also valuable to study the molar aspects of the stories. For instance, some subjects choose obses- sive defenses against a picture of disturbing content. They ‘may produce four or five themes, each very short and descriptive, manifestly different but dynamically simi- Jar. Sometimes a succession of themes to one and the same picture shows the subject's attempts to deal with @ disturbing conflict; successive stories may become ‘more and more innocuous, showing an increase in de- fensive operation. The concept of defense has to be understood in an increasingly broader sense, best discussed recently by Lois Murphy — with her associates — in connection with coping. ie., the person’s general ability and mode of meeting external and internal stimuli. With the advance in ceo-psychology, and a focus on the problems of adap- tation a study of these functions is likely to play an in- creasing role in the exploration of projective methods We not only want to know the nature of the defensive maneuvers but also the success with which they are ‘employed and/or rather the sacrifice such maneuvers demand from the functioning personality The concept of perceptual vigilance may be thought of in connection with projective methods. Various stud- ies have suggested that not only the defensive projective function of the ego is increased in stress but also its oy ‘cognitive acuity may be improved at the same time. In the study of children’s stories, it must be remem- bered that we view the nature and pathogenicity of defenses and other structural concepts in terms of age appropriateness. What may be quite normal at one age may be pathological at another age. In the absence of reliable data, not only in the projective literature but any literature at all, some very rough, fallible guide- lines have to be adhered to. 9. ADEQUACY OF SUPEREGO AS MANIFESTED BY “PUNISHMENT” FOR “CRIME” The relationship of the chosen punishment to the nature of the offense gives us an insight into the severity of the superego; a psychopath's hero who murders may receive no punishment other than a slight suggestion that he may have learned a lesson for later life, while ‘a neurotic may have stories in which the hero is acci- dentally or intentionally killed or mangled or dies of an illness following the slightest infraction or expres- sion of aggression. On the other hand, a non-integrated superego, sometimes to0 severe and sometimes too len- ient, is also frequently met in neurotics. A formulation as to the circumstances under which a person's super- ‘ego can be expected to be too severe, and under what ‘ther conditions itis likely to be too lenient is, of course, related to the difficult problem of acting out. In addition, however, itis a generally valuable piece of information. 10. INTEGRATION OF THE EGO This is, of course, an important variable to learn about for in its many aspects it reveals the general level of functioning. To what extent is the child able to com- promise between drives and the demands of reality on the ‘one hand, and the commands of his superego on the other? The adequacy of the hero in dealing. with the problems the story-teller has confronted him with in the CAT. is an important aspect in this variable, Here, we are interested also in formal characteristics: is the subject able to tell appropriate stories which con- stitute a certain amount of cognizance of the stimuli, or does he leave the stimulus completely and tell a story with no manifest relation to the picture because he is not well enough, therefore, and too preoccupied with his own problems, to perceive reality? Does he find com- fort and salvation from anxiety stimulated by the test by siving very stereotyped responses; or is he well enough and intelligent enough to be creative and give more or less original stories? Having produced a plot, can he attain a solution of the conflicts in the story and within himself which is adequate, complete and realistic; or do his thought processes become unstructured or even bizarre under the impact of the problem? Does he havethe ability to go from a past background of the story to a future resolution? This will depend on the age of the child as well as on his unique personality. ‘These observations, together with the dynamic diag~ nosis which the content variables supply — thus facilitat- ing possible classifications of the patient in one of the nosological categories — are the main contributions of the CAT From a formal standpoint, it is useful to consider that telling stories to the pictures is a task which the subject must perform. We may judge his adequacy and cego-strength and other variables from the standpoint of his ability and way of meeting the task. Of course, the adequacy of the ego and its various functions has to be ‘considered in relation to the specific age again. Consid- ‘eration should be given to a variety of ego-functions such as drive control (related to the story sequence and out- ‘come) frustration-tolerance (related to adequacy of hero) anxiety-tolerance, perceptual and motor adequacy and others. USE OF SHORT FORM** ‘Completely unfolded this three-page booklet permits ‘easy recording of variables in appropriate boxes for all, ten stories; these can be summarized consecutively, un- der the same heading, at the extreme right. The final report can be written with the summary sheet opened out, in full view. ‘The Analysis Sheet permits a safe transition from ‘concrete primary data to summary of inferences, with ‘a minimal danger of personal interpretive contamination. Serutinize each story, with the help of the ten major ‘categories given and record the essential data in the relevant box. These categories and listed details should bbe used as a frame of reference — a reminder of certain factors. When a certain aspect does not appear in the story, leave the box blank. Occasionally, facets not men- tioned in the Blank will occur and need recording. ‘When the stories have been analyzed, the main data should be noted on page 4. Once the summary page is studied, a repetitive pattern in the subject’s responses ordinarily becomes clear. The final report should fol- low the category's sequence on the summary page. In its new revised version, the Short Form (1974) shows a shift to more interest in ¢go psychology in that the revised form lists 12 ego functions. These are to be gauged—as many of them, and as well as possible—as a further indi- cation of adaptive capacity. A detailed account of these ‘ego functions can be found in Bellak and Loeb’s The Schizophrenic Syndrome {9.] and most extensively in: Bellak, Hurvich & Gediman, EGO FUNCTIONS IN SCHIZOPHRENICS NEUROTICS, AND NOR- MALS, Wiley Interscience, 1973. (See graph P. 7) EGO FUNCTION ASSESSMENT Reality testing. The major factors are (a) the distine- tion between inner and outer stimuli; (b) accuracy of perception (includes orientation to time and place and. intepretation of external events); (c) accuracy of inner reality testing (psychological mindedness and awareness of inner states) Judgment. (a) Awareness of likely consequences of intended behavior (anticipating probable dangers, legal culpabilities, social censure, disapproval, or inappropri- ateness); (b) extent to which manifest behavior reflects the awareness of these likely consequences. ‘Sense of reality of the world and of the self. The com- ponent factors are (a) the extent to which external events fre experienced as real and as being embedded in a familiar context (degree of derealization, déja vu, trance- like states); (b) the extent to which the body (oF parts of it) and its functioning and one’s behavior are experi- enced as familiar, unobtrusive, and as belonging to (or tmanating from) the individual; () the degree to which the person has developed individuality, uniqueness, and 4 sense of self and self-esteem; (d) the degree to which the person’s self-representations are separated from his object representation. Regulation and control of drives, ales, and impulses. (a) The directness of impulse expression (ranging from primitive acting out through neurotic acting out to rela- {ively indirect forms of behavioral expression); (b) the effectiveness of delay and control, the degree of frustra~ tion tolerance, and the extent to which drive derivatives are channeled through ideation, affective expression, and manifest behavior ‘Object (or interpersonal) relations. ‘The components are (a) the degree and kind of relatedness to others and investment in them (taking account of withdrawal trends, nareissistic self-concerm, narcissistic object choice or mu- tuality); (b) the extent to which present relationships are adaptively or maladaptively influenced by or pat- termed upon older ones and serve present, mature aims rather than past, immature aims; (c) the degree to which the person perceives others as’ separate entities rather than as extensions of himself; (d) the extent to which he can maintain object constancy (ic., sustain relation- ships over long periods of time and tolerate both the physical absence of the object and frustration, anxiety, and hostility related to the object) “The Bellak TAT, Blank and Analysis Sheet and accompanying manval continues to be published by the Paychological Corpora: tion, 187 Third Aves New York, N'Y. TOOI7. Its particularly wetul for learning Purposes and research and may altogether be preferred by some. See also Haworth’s Schedule of Adaptive Mechanisms in C.A.T, Responses and The Psychodiagnostic Test Report Blank, published by OP Sine See Page 8 02]_ icc ei. ‘Thought processes. The components are (a) the ade- quacy of processes which adaptively guide and sustain thought (attention, concentration, anticipation, concept formation, memory, language); (b) the relative primary- secondary process influences on thought (extent to which thinking is unrealistic, illogical, and or loose). Adaptive regression in the service of the ego. (a) First phase of an oscillating process: relaxation of perceptual and conceptual acuity (and other ego controls) with a concomitant increase in awareness of previously pre- conscious and unconscious contents; (b) second phase of the oscillating process: the induction of new configur- ations which increase adaptive potentials as a result of creative integrations Defensive functioning. (a) Degree to which defensive ‘components adaptively or maladaptively affect ideation and behavior: (b) extent to which these defenses have succeeded or failed (degree of emergence of anxiety, de pression, and /or other dysphoricaffects, indicating weak- ness of defensive operations). Stimulus barrier. The component factors are (a) threshold for, sensitivity to, or awareness of stimuli im= pinging upon various sensory modalities (primarily ex- ternal, but including pain): (b) nature of response to various levels of sensory stimulation in terms of the ex- tent of disorganization, avoidance, withdrawal, or active coping mechanisms employed to deal with them, Autonomous functioning. The components are (a) de- zee of freedom from impairment of apparatuses of prim- ary autonomy (functional disturbances of sight, hear ing, intention, language, memory, learning, or motor funetion): (b) degree of or freedom from impairment of secondary autonomy (disturbances in habit patterns, learned complex skills, work routines, hobbies, and in terests) ‘Synthetic-integrative functioning. (a) Degree of re- conciliation or integration of discrepant or potentially contradictory attitudes, values, affects, behavior, and self-representations; (b) degree of active relating to- ‘ether and integrating of physic and behavioral events, whether contradictory or not. Mastery-competence. (a) Competence, the person's performance in relation to his existing capacity to inter- act with and master his environment; (b) sense of com- petence, the person's expectation of success, oF the sub- Jective side of actual performance (how well he believes he can do). Fgo Function Assessment (EFA) has been accom- plished with statistical reliability and validity, ona seven ‘or 13 point scale, as reported in Bellak, Hurvich & Gediman, EGO FUNCTIONS IN SCHIZOPHREN- ICS, NEUROTICS, AND NORMALS. (8) This book also provides a guide for assessment and a manual for scaling ego functions. Since this volume was published, a large number of applications have been found for EFA. (See: (1975) Bellak, Meyers, “Ego Function ‘Assessment and analyzability,” International Review of Psycho-analysis, Vol. 2, Part 4, pp 413-427, 1975. (10) (1976) Bellak, Sheehy. “Broad Scope of Ego Function Assessment,” American Journal of Psychiatry. 133:11, pp 1259-64, November 1976; (11) (1978) Sharp, Bellak, “Ego Function Assessment of the Psychoanalytic Pro- cess, Psychoanalytic Quarterly, Vol. XLVII, 52-72, 1978. (43) SAMPLES Below, we present a number of parts of sample rec~ ords to illustrate a variety of responses to the C.A.T They are not selected for particular successfulness, but rather in order to show difficulties and subtleties of interpretation, Case I. 8. Q. Aged 3:11 Male, Black, Poor Socioeconomic Situation. Subject was easily approached in nursery with an offer t0 help him dress for out-of-doors period. Later brought cut cheek to be cared for and accepted offer to play game (C.A.T.). Seemed a little indecisive about go- ing out or coming with examiner. Short period observed in outdoor playground showed him to feel ill-at-ease, although not shy. Three stories of his record will be pre sented. Picture 2: “Bear, kitty cat and rope man... A (3) big, big bear... and he gets so big. (What is he do- ing?) He came to visit the people.” Picture 4:°A pipe man that lives in the house. He's taking his clothes off. (Why?) Because he has no clothes. He threw all his clothes away. He don't want ‘no clothes. (singsong) No pants, no socks, no shoes, (What does he wani?) He wants to have a lot of hait ‘around him. (Whar's he doing?) He's sitting in a dirty chair with no clothes on.” Picwure 9: “Bunny rabbit. You see this bunny? He's in his bed. And the other bunny rabbit is way upstairs. He took the stuff and come home and said he may Put another bunny up the house. He ran upstairs and come right back down (singsong) and the father bear come out from basement (dark left corner) and saw a rabbit — run upstairs — go upstairs to. your bed!”Story #2 is certainly a very meager one. All that at- tracts attention is “the big bear who got so big” — which by itself — surely barely deserves any speculation. Story #3 however, demonstrates repeatedly that the subject rejects the clothing, wants to “sit in a dirty chair with no clothes on.” This would indicate a wish to regress to ‘an earlier stage. Still, we have no idea why. Then, in picture #9, the most manifest clue is contained in the fact that the bunny “may put another bunny up the house.” This definitely sounds as though the subject is preoccupied with another baby coming into the house. ‘Those psychoanalytically trained will be able to see a symbolic restatement of this thought in the running up- stairs and the father bear coming out from the base- ment coupled with an apparent memory of being told to go to bed perhaps in connection with some sexual activity. Our assumption now may find some corrobora~ tion in the brief reference in story #2, “the big bear who got so big,” which may refer to the mother's preg nancy. Then we can understand his regressive pattern in story #3 in relation to the arrival of the rival. These were the conclusions we arrived at on blind analysis of these stories. A check with data from the social worker showed that it was not actually a sibling, but a little cousin, that had arrived in the home. Since the aunt and the rival (her son) lived in the same household with the subject, the psychological significance was the same. The kindergarten teacher was replete with confirmation, Of the subject’s behavioral problems. We had occasion to consider further the subject's statement that the hero “wants to have a lot of hair around him.” The inference fone could make is that he has compared himself to the father and wants to have hair on the chest and in the Pubic area also, Outstanding among the behavioral problems as reported by the teacher, was the fact that the subject explored his litle girl playmates with a great deal of interest. This record can serve as an example of relatively poor returns in a small child wherein each story by itself is quite disappointing unless and until one can bring each story in meaningful relation to the others Nevertheless, the usefulness of the C.A-T., in this case, becomes quite clear. The teacher and social worker know that he was a behavioral problem with excessive sexual interest in little girls. Our test relates his. be~ havioral diffcultios to rivalry with a sibling-like figure, and a preoccupation with procreation. Having estab- lished these relationships, it should be relatively simple to discuss this with the child apropos of his stories: that hhe must be angry about the new arrival; must wonder where babies come from, ete. At the same time, the social worker might attempt to decrease his sexual stim: U4) ulation by whatever means the circumstances might per- ‘it, and instruct the mother about handling him. Case 2. K. S., Aged 64, Female, White, Upper Middle Class Sociveco- ‘nomic Situation. We are presenting only the response to picture #3. In this, the lion becomes the father figure for this very bright girl, and the oedipal situation is clearly revealed. Picture 3: “This will be a good one. King Lion, that’s what TM call it. Now, I guess I'll make a name for these, O.K.? There was a lion and he said to the king: “I have heard your stories and I hear you are very tired and you are looking for another lion to put in your place.” This I don’t want you to write — T just want to tell you (10 examiner). You see, the other lion was the king of all the lions and was getting tired, so she said to the other lion, “If you will do all these hard tasks, if you ean do them all, you will become king. The first task is that you must go and find a princess — a queen — no, a princess, to marry. If you don’t find one who will be right for you — off with your head.” Ah! thought this lion, if T could only find my dear, dear daughter. Because he was a king of the lions also, but he never mentioned it, see? "Now, I can go and look for my daughter.” This 1 just want to tell you, but don’t write it.” (The story was then considered finished but ex- aminer took it up again, later.) “Now I don’t want you to write this one, I just want to tell you about it. The king wanted to find his daugh- ter. He had sent her out to seek the world and so he called her up at the first place she was supposed to be and they told him she had left, Then he called at the second place she was supposed to be and she wasn’t there either. So he called her at the third hotel and they got her on the phone and she said she would be right there — in four minutes and they were mar- ried and then they played a joke on the other king. You know, this king was really the king of the lions but hadn't told anyone. So they went before the other king and he said, ‘What are you doing here? Get ‘out of here!” But they said they were married and that this king was the real king; so the other king had to go away.” Unabashed by cultural taboos as yet, the king (father) marries his daughter though some of the story becomes ‘quite confused. There is clear evidence of identifica tion switching, as well. There is some subliminal aware- ness of the forbiddenness of it all in the fact that thelitte girl asks the examiner not to write the story down.* Aside from the dynamic aspects, the concreteness and specificity of the childish thought processes deserve note: “in four minutes they were married.” Case 3. M.1., Aged 104, White, Male, Poor Socioeconomic Situation. We are presenting the following story to picture #3 to demonstrate how extensive and rife with material a response may be. Picture 3: Once upon a time there was a lion who lived in the forest. He was very mad and he dida’t like anybody but himself and he was very proud of himself and he didn’t like no one but himself and everyone was afraid of him because he was very strong and he could break anything like trees that were 60 oF 70 feet high and 3 feet thick and he just pushed them like rope and they were nothing. One day, he thought that he was going to hypnotize all the people and animals so that he could rule over them. First, he went to one of the homes of the fox and he looked at them and looked at them until they were hypnotized and the whole family came running to him. Then he went to the chipmunks’ place: he hypnotized their whole family and all the chipmunks that were around. He lived in a great big home and he had everything he wanted. After he hypnotized everybody and he had a great big chair and a nice pipe and he had a storage room full of tobacco and hhe had a dungeon and he had another one full of ‘canes; but there was one thing he didn’t have — he didn’t autiful body. He wanted to have yel: low hair — yellow and brown together, blue eyes and his hair combed out nice sind straight, He wanted all of his things shiny and he didn’t have enoush people 10 polish his canes and things. The next day hhe went into the forest again and he didn’t see any fone so he kept walking until he came to a big city and he did not see anyone there because it was dark. rot even a light was shining so he kept on walking until he came to a big big castle. He was very jealous of it because it had a great big steeple and on the top was a great big diamond that he wanted and there was also a great big courtyard: on the other end was another part of the eastle that had 3 steeples: a great h the middle and a smaller one on each side sind they all had diamonds on them: and fon the door there was a big ruby and the other door fon the other side had one. too — 2 blue ruby and he way s0 jealous that he was running around in circles, And he roared very loud and it reflected on all the building around and it hit him in his ears and he got {quiet because it hurt him. He had never known how Strong his voice was. Then he was sneaking up into the castle, then he got near the door and he saw a bell and he didn’t know what it was so he pressed it and it made so much noise it scared him; then a little while no one answered it, so he saw the door knob and he opened it and saw that it was pitch black So he was walking around in circles and finally he hit something — so he fell down, and found it was a door so he opened it and found there was a bed with a ful princess on the bed and he saw it and he didn’t like to see her having a good time when he wasa’t so he went over and gulped her down in one mouthful and after that he was walking and when he got back to his castle he felt very funny. So he sat down and was thinking and got very mad at himself cause it was the girl — she was a very good srl and she loved everybody and he went over to his place where he had lots and lots of food; so he got Chickens, pigs (animals that were already killed) all food that the animals liked and then he went to another room and got wood. Then he was getting all the wood and food and everybody was watching him teven the mouse in the house, Then he went in another storage and he got tons and tons of cheese and made a big hole and the mouse made his home in the cheese. He was very hungry cause he was very thin and by the time he finished he couldn't get back in his hole, Then the lion went outside and gave everyone everything and he was very happy. The next day everyone liked him but he still didn't like himself because he forgot to unhypnotize beavers so hhe went over and unhypnotized the beavers and every- body liked him.” M. I. identifies himself with the lion in a story that is apparently to a large extent a wish-fuliling fantasy. Frequently, criticism and awareness of self-deficieney stand side by side, with over-compensa- tion. “He didn't like anybody but himself and he was very proud of himself and everybody was afraid of him and he could break anything like . ..” Then, after equip- ing himself with a beautiful home and a nice pipe, he suddenly shows us that he feels his body is inadequate, This is followed by a symbolic story of jealousy of “great, big steeple”... “with two smaller ones on each side”: probably @ symbolic representation of Dig genital. Subsequently, he finds a beautiful princess in bed, He then gives us a perfectly primitive oral fan- tasy of acquisition (probably of the mother): “he gulps the princess down in one mouthful.” Having committed this crime, he shows us his conscience (superego) as * tavestigation revealed heyonk! « dowht that this Hite girl was in marked conflict snd Fvaley with her mother. Us}1 form of reaction-formation to his drives. He procures tons of food for all the animals including the mouse and. “gave everyone everything . . . then he was very happy.” In the course of this story, he makes certain, in a paren- thetical remark, that all the chickens and pigs which he is now feeding to the other animals, were already dead. That is, he lets us know that he did not commit, any further killing. Later, he finds the reward for re- rnuneiation of his acquisitive and aggressive drives in being liked by everyone: that is, we clearly find a pic~ ture of socialization. He stil disapproves of himself until he recalls and undoes his earlier act and unhypno- tizes the beavers ‘This is the story of an apparently fairly disturbed child who feels that his body is inadequate; who has strong acquisitive and ageressive drives which he con- siders very evil, and who is developing an excessive superego to deal with these drives. The severity of the disorder, and the full extent of it became clearer in a number of other stories which we do not need to re produce here. Examination of the reality situation re- vealed that this child lived in a very disturbed home, the father having deserted, and the mother being sus- pected of gross promiscuity. The boy actually was physi- cally undersized, and frequently did not have enough to eat. This latter information highlights his (the lion's) dissatisfaction with his body and his great need for ac- quisition and oral incorporation, This story and several others of this subject show an excellent vocabulary, and an organizing ability consist- ent with intelligence considerably higher than average. The C.A.T. proves most helpful in this respect since formal intelligence testing has resulted in an LQ. of only 103, The C.A.T, shows us that his truc intellectual level must be considerably higher and that probably the emotional disturbance of this child is responsible for his poor functioning. Case 4.C. C., Aged 10;6, White, Female Good Socioeconomic Situation. The following case is presented for the purpose of providing users of the C.A.T. with a demonstration of a so-called normal record. It will be confined to three Stories from a series of relatively innocuous ones.* We again present the response to picture #3 for its contrast value as compared with the response to this picture by the child in Case 3 Picture 3: “Oh, this reminds me of the fable of the lion and the mouse; can it be that kind of story? Once upon a time there was a lion who was king of all the beasts, He worked very hard day and night Some stories uid show considerable oral wishes. We are somewhat 6) and got very litle rest, He would roam up and down his whole kingdom to see what everybody was doing. He never had time to have any fun because he thought he had to watch everyone to make sure everything was well. One day, he sat down to relax for a few ‘minutes with his pipe and he thought, ‘Gosh, I don't have time for any fun; here I am getting old and wrinkled and pretty soon I'll be old enough to die and I haven't done any of the things I wanted to.” ‘The king did not know that he was talking out loud, and much to his surprise he heard a voice say, ‘Oh king, you are right, and if you don't start doing some of the things you would like, you never will.” The kking jumped up in amazement and looked around and there — out of a little hole in the wall — stood a mouse. The king at frst was very angry; then he started to laugh at the idea of a little mouse telling him what to do. So the king said, ‘what would you sug- gest, you bold little mouse” The mouse said, ‘What do you want to do first” The king thought for a min- ute, and then said, ‘I would like to take an airplane trip to a foreign country.” The mouse said, “Who is the next smartest animal in your kingdom?” The king said, "Now let me think; I know who is the boldest you are. Oh, yes, my cousin Leo, the Lion, he got almost as good marks as I did in school.” ‘Fine,’ said the mouse, ‘you appoint him Vice-president and then £0 on your trip.’ So the lion did and he had a won- erful time, and when he came back he was all rested up and he decided that he would reward the little mouse for his wonderful suggestion.” This child identifies herself with the mouse, but with fa very bold and intelligent and resourceful mouse. She sees the lion, apparently, as a father who works very hard and watches over everyone benignly. The father- lion is willing to accept a suggestion from the mouse- child who shows such friendly concern for him. The entire story is carried off with a fine sense of humor and 1 subtle awareness of the role of child by our subject. She willingly identifies herself with the welfare of the father in order to derive indirect benefit for herself. Picture 1: This is a rooster and hen family and three little chicks. They are all at the breakfast table and the mother hen is spooning out the cereal. Father rooster says, ‘Oatmeal, I hate oatmeal!” The middle chick says, “Oatmeal,” T hate oatmeal!” The oldest chick says, ‘Oatmeal, hate oatmeal!” Mother hen says, “That is too bad; guess what you are all going to eat for breakfast this morning: Oatmeal!’ ” This story does not illustrate a great deal except that we find a domestic scene in which the chicks identify ly of oversimplification in the presentation of this casewith the father, while the mother presents in a simple way a consistent authority figure within her domain. The implication of the facts that the story is not further claborated and that the mother's dictum constitutes the tend of it, permits us to think of it as reflecting essentially good adjustment. To be sure, this impression is sup- ported by the content of the other stories, and again, the humorous tone it takes. Picture 4: “One day mother kangaroo said to big sister, "You do not hop fast enough or high enough. This afternoon, after lunch, I will take you out and give you lessons." So in the afternoon, mother kan- garoo and big sister kangaroo left the house for the nearby hill. It was a lovely, clear, cool day; just right for jumping lessons. So off they started, mother show= ing big sister just what to do. After about half an hour, sister caught on and was hopping just as fast and high as mother, so mother said, ‘Let's go back and get baby and then we will hop down to the office to show daddy how well you can hop.’ ” In this story, the child is seen as capable, the mother as helpful and interested in exhibiting the child’s achieve- ment 1 a father whom it seems permissible to visit at the office, The baby is willingly included in the family bliss that pervades the entire tone of the story of this apparently very bright child. Investigation of the reality situation corroborated the fact that we are dealing with an emotionally well developed child in a psychologically sophisticated and nontraumatic home, who however was not entirely without some behavior problems around a demand for a good deal of affection. RESEARCH ASPECT The statements made about the C.A.T. are thus far based on approximately 200 records of children be- tween the ages of three and ten inclusive.* We are releasing the test on the basis of such a relatively small sample since we believe that a projective test does not need validation and the establishment of norms in the sense in which such operations are necessary for intel- ligence tests. In an intelligence test, any datum has mean- ing only in relation to the frame of reference of its sam- ple population. In projective techniques, provided one accepts the basic hypothesis of projective — or apper= ceptive — phenomena, the individual ease can stand by itself. In projective techniques the data of manifest be- havior are compared with those of unconscious tenden- cies of the same individual, Normative factors enter in helpfully, of course, if one wishes to appraise the rela jostic purposes, oF, as in our case, when h to establish age norms for certain phases of dynamic development.* For the majority of records we were provided back- ground material by the clinical worker, this material pictures brought out problems which the clinical worker had pointed out and that the responses further illum inated the dynamic background of these problems. Nevertheless, it will be useful to accumulate further quantitative material on the responses which are ob- tained by each picture, at various age ranges. In the long run, we would like to have a thousand responses tabu- lated for each picture at age 3,4, etc, including an anal- ysis of the dynamic problems represented, for various Socioeconomic, intellectual, and ethnic groups. Since it is well-nigh impossible for us to organize such a large- scale investigation, we arc releasing the pictures in the hope that the work and publications of the other inves- tigators will contribute additional data. At the same time, ‘we will continue our own work and will, from time to time, attempt to organize all available findings and make them available to users of the C.A.T., upon request. If it should appear necessary to substitute pictures in the future, we shall be happy to forward them upon request at nominal cost. We will furthermore be happy to co- foperate with those users of the C.A.T. who may wish to apprise us of their findings, suggestions, etc., acting being used for purposes of verification of our blind — to an extent ~ as an informal clearing house. analyses’ findings. We were able to ascertain that the The AT sfrequently ysed in vitally all countries in Europe und also in Australia, South Africa, India. Japan and South America: this fact be ofintcvestto sual scentines concerned svth cultural comparisons of personal Teisaso published {wth marual in foreign language) n Belgium, France, Germany, Italy, Argentina and Brazil, Japan Seq also the CAT. H, HAWORTH'S, SC INCLUSIVE PSYCHODIAGNOSTIC TEST REPORT BLANK. tn india (uich an apd set of pictures). ULE OF ADAPTIVE MECHANISMS IN CAT. RESPONSES, AND THE a7BIBLIOGRAPHY () Ainsworth, M.D..& Boston, M,Psychodiagnostic Assessments of (28) Harris. AJ. & Roswell FG. Cinical Diagnosis of Reading Disabil ‘Child after Prolonged Separation in Eanly Childhood. Brit J. Med fig. J, Popcho. 1953, 3, 323-340, Psychol, 1552, 28, 169-20 (29) Holden, RH. The CAT with Cerebral Pahied and Normal Cild- (2) Bella, L. Onthe Concept of Projection, Psychiatry, Vol VIl,No. tn, Child Development, 1956, 27.38 November, 1946, 383.370. (G0) Kase, N-H. The Relationship between Ineligence Level and (9) Beliak, 1. 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Techniques for and Evaluation ofthe Responses of Sehizophenic and Cerebral Pabied Chien t0 the ‘Childrens Apperception Test(C-AT) Quart. 1. Chld Beha 951 Shas, ‘Seminar onthe Children's Appescepion Test held in Washington, (20) Vislpern, F, Projective Tests in the Personality Investigation of Dic. and reported in The Souraal of Projeive Techeiques & (Children J. Pediatrics, 1981, 38, 70-795, Personality Assessment, Vol 32, No.5, 1968 FOR THE MOST RECENT REVIEW SEE: BELLAK. L. THE T.AT. CA AND S.AT IN CLINICAL USE, GRUNE & STRATTON, INC. THIRD EDITION, 1975, go Function Assessment (EFA) hasbeen accomplished with statistical reliability and validity, on aseven oF 13 pont scale as eportedin Blak, Hurvich °Gesiman, FGO FUNCTIONS IN SCHIZOPHRENICS, NEUROTICS, AND NORMALS. This ook alo provides a guide for assessment and a ‘manual for scaling ego functions, Since tht volume was published. large mimber of appeatons have heen fund for EFA. See relerenes 10 11,4, (8)