The reverberations of physical trauma on the psyche. Reflections based on the Rorschach test

Doriana Dipaola, Simona Moschini, Gabriella Gandino


Backgrounds: PTSD occurs as a result of an extreme event in which the person perceived a threat of death or physical integrity or suffered a serious injury. The traumatic aspect of such events is the dimension of the unexpected and unpredictable, which triggers intense anxiety and feelings of helplessness with symptoms such as fear, depression, and hypochondriacal anxiety. Physical trauma causes a breakdown of the boundaries of the self and the connection between the body ego and the psychological ego is severely tested. Trauma abruptly breaks through para-excitatory barriers, confronts suffering and depressive experiences, and often brings narcissistic and loss wounds into contact. Sometimes the effects of physical trauma reactivate earlier psychological trauma, and the inability to make sense of what has happened represents a traumatic overlap.

Methods: This study uses Rorschach on 15 subjects who have suffered a severe physical accident with disabling but not permanent consequences. Protocols were administered scored and interpretated according to the method of the French school and compared with the Italian norm sample. The aims are to examine the effects of trauma on body image, self-image, and intrapsychic and interpersonal dynamics.

Results: Qualitative analysis of the response process in the protocols reveals a general sensitivity and reactivity to color, both in its chromatic and achromatic components, accompanied by a strong internal imbalance. The anxious-depressive dimension seems difficult to process and is accompanied by a thinking incapable of introspection. The representations of relationships are colored by elements of infantilism or drive neutralization. The centrality of the theme of the body and the presence of body anxiety seem to emerge in the protocols, as does the theme of self-boundary.

Conclusions: The study did not find a significant relationship between a specific personality function and the traumatic experience. However, recurrent personality traits were found. In addition to the trauma itself, the inability to make sense of what has happened and the inability to recognize their psychological wounds represent another traumatic overlap in these individuals. From this perspective, it can be hypothesized that the "crying" consequences of physical trauma serve multiple functions.


Post Traumatic Stress Disorder; Rorschach test; Physical trauma; Body image; Self image.

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