TAT, CAT, and SAT: Clinical Use - Bellak System of Scoring - PDF

# TAT, CAT, and SAT: Clinical Use ## Chapter 6: The Bellak System of Scoring It is obvious that TAT responses have been studied in many ways. The simplest procedure is the **inspection technique**. Often it is useful to read the stories through, consider them as significant psychological communica...

# TAT, CAT, and SAT: Clinical Use ## Chapter 6: The Bellak System of Scoring It is obvious that TAT responses have been studied in many ways. The simplest procedure is the **inspection technique**. Often it is useful to read the stories through, consider them as significant psychological communications, and underline everything that seems significant, specific, or unique. When an experienced examiner rereads the stories a second time, he often finds a repetitive pattern in all of them, or he may be able to discover facets of different stories that seem to come together to form a significant whole. This method becomes easier with increased experience in using the TAT and in the process of psychotherapy. In psychotherapy, it can be particularly helpful for patients to have a carbon copy of their TAT stories while the therapist has another. The patients can then be asked to make free associations to the stories in general and to make their own attempts at interpretation. Because the **strength of the TAT** lies in its ability to elicit content and the dynamics of interpersonal relationships and psychodynamic patterns, the Bellak System of Scoring focuses on these dimensions and only to a lesser extent on formal characteristics. The first point to remember in the **interpretation of the TAT** is this: in psychological terms, the TAT cards represent a series of social situations and interpersonal relationships. Instead of responding to real people in real situations, the examinee responds to people in the pictures, whom he imagines in certain social situations. When one is operating under less restriction from the conventions of reality, it is more likely that the responses will represent inner feelings. This means that it is possible to arrive at the current social behavioral patterns of the person examined and, with frequency, to infer the genesis of these patterns. Interpretation, then, is the process of finding a common denominator between the current and genetic conduct patterns of the person (Bellak, 1993a). Among other things, this definition of interpretation implies something that is never emphasized enough, particularly with the beginner: the difficulty of making a diagnostic statement based on data revealed in only one story. Impressions derived from one example should be considered only as a tentative inference for which one should search for corroboration in other stories or through some source of information external to the TAT. A **repetitive pattern is the best guarantee** that one is not dealing with an invention. ## Diagnostic Observation - Close and Distant Sometimes, psychoanalytic psychotherapy has been hampered by the fact that one therapist might make one kind of interpretation, whereas another therapist makes another. Both might be correct because they are each attending to different aspects of the patient's statement. Therefore, it is necessary to specify the level of abstraction to which one is attending. "The patient is angry" would be a **close observation diagnosis**. To say that certain **representations of object are in conflict** with certain **internalized self-representations** (for example, those of fathers whose images interact in a conflicting manner with internalized images of the self), which then may result in anger, would be a **distant observation inference**, implying the involvement of structural concepts and internalizations. The probabilities of error and misinterpretations are far higher for distant observation conclusions. Similar problems occur with TAT interpretations. Perhaps it is true that, the less experienced a clinician is, the more "far out" the interpretation will be. One of the primary attempts to avoid "far out" interpretations is the **TAT Record Protocol**. This is especially true as the scoring is broken down into the **descriptive, interpretive, and diagnostic levels**. The **descriptive level** is the closest to observation, whereas the diagnostic and symbolic levels are quite distant to this. Keeping these concepts in mind should help to further prevent unfounded interpretations. The following story of a 15-year-old child might serve as an example: ### History 1 It is obvious that he doesn't want to play the violin because his mother told him to. He is a little mad because she told him to play the violin, right? But he can't play that note. So he is a little mad and frustrated. He wants to give up. But I think he is going to keep trying. What will the outcome be? He will keep on trying (He hums "trying" to himself). * **Descriptive Level:** The boy doesn't want to play the violin because his mother told him to, but he is frustrated because he can't do it. He wants to give up, but he also wants to keep trying and he will keep trying. * **Interpretive Level:** If a mother figure tells one to do something, one gets mad and frustrated because one can't do it. In the long run, one will keep trying. * **Diagnostic Level:** He reacts with anger towards mother figures. There is a conflict between disobedience and the desire to get it right, and eventually the boy conforms and succeeds. This story reveals that the adolescent telling the story has a conflict with mother figures, but he resolves the conflict by succeeding in his efforts. The story tells us that this 15-year-old is rebellious toward his mother, but his own striving for achievement makes him succeed in his endeavors (in a broad sense, he is growing up). ### History 2 There are three things that are different here. They don't look very good. Three people who probably don't know each other. The girl is going to school and she is thinking about what she might have forgotten at home. That guy is too preoccupied to worry about anything because he is trying to hit the horse. The lady is somewhere else. She doesn't know what she is doing either. She is just staring off into space. It seems like everyone is doing their own thing. * **Descriptive Level:** In general, this card is considered to be a reflection of family relationships. The descriptive level is that three people are doing different things and they don't even know each other. The girl might have forgotten something at home. The man is busy and is preoccupied. He is hitting the horse. The woman is "nowhere" and she doesn't know what she is doing. * **Interpretive Level:** If a family of three people is together, they are totally alienated from one another, although not without conflict. The girl thinks she might have forgotten something at home. The man is using excessive activity to deny it and he is directing his anger toward the horse. The mother is in the "nowhere" as well. * **Diagnostic Level.** A family in which there is no contact between the family members and where the narrator complains that "the girl might have forgotten something at home." The mother is described as being "nowhere." This is obviously an adolescent who feels a sense of great isolation within his family (which angers him) and who wishes that weren't true. He directs his anger towards other things, such as hitting a horse. This example demonstrates the ease with which considerable information can be gleaned by careful progression from close observation data to distant data. In addition to this diagnostic description, it is important to see that these two stories by themselves - and in the rest of the stories not described here, and further discriminations - are valuable guides for the planning of psychotherapy. The first card suggests a strong connection between the individual's feelings of frustration and the need for therapy. The second card highlights a need for family therapy. ## The Bellak Scoring Protocol Chapter 1 describes how the Bellak System of Scoring began. It originated as a collaboration between Bellak and his professor, Murray, in 1941. Bellak added to Murray’s categories of "hero needs" and “environmental pressures” a number of scoring categories based on Freud’s latest theory (1923) regarding the psychology of the ego. These include the analysis of defense mechanisms, anxiety, conflicts, and superego functioning. The Psychological Corporation published Bellak’s system of scoring (1947) and his scoring protocols as the *TAT Record and Scoring Protocol of Bellak* (Figure 6-1). The system is simple enough to master and, besides serving as a guide and a frame of reference, allows for the acquisition of the most important data from a 10-card TAT in approximately half an hour. ## How To Use the Bellak Scoring Protocol The Bellak Scoring Protocol consists of a six-page folder, with separate pages for recording and analysis, one of which is reproduced within the folder. The folder's front page provides space for the client's personal information and, once the analysis is complete, a final report. As mentioned previously, some therapists prefer that subjects write their own stories. Because these subjects should not have access to the scoring sheet, they should write their stories on regular 8.5 x 11-inch paper. If these stories are short, they should be cut and pasted onto the scoring sheets or stapled to the back of the scoring sheet so that the resulting format is the same as if the examiner had written the information on the back of the scoring sheets. On the scoring sheet, one should note the appropriate information gleaned from the story. This information should be brief or use key words useful to the analytical process. One could use a check mark (✔) to indicate the mere presence of an attitude, conflict, or situation. Two (✓✓) or three (✓✓✓) check marks could be used to indicate the increased significance of a given item when the story is summarized. This system of quantification will encourage research into interpretational reliability between examiners. Spaces are provided to add categories or ideas that are not listed in the protocol. Despite an increase in the use of the Short Form of the Protocol, which is more popular, the Long Form continues to be very useful, especially for training and research. ## Scoring Categories The following suggestions for the use and interpretation of the individual scoring categories in the Bellak Scoring Protocol can be useful. **1. The Main Theme** The main theme can be best understood as an attempt to restate the essence of the story. (Remember, a TAT story may actually have more than one basic theme.) Because beginners tend to get off track when interpreting the main theme, it is recommended that this be broken down into five levels. This breakdown of the main theme is a vital teaching tool. It steps the student through the process of generating sound inferences, moving automatically from primary data to more ambitious, but also riskier, conclusions. This procedure helps to prevent unfounded interpretations. The five levels are: * **The Descriptive Level:** This should be a simple restatement of the essence as summarized from the story. It should present the overarching tendency and express it briefly and in simple language. * **The Interpretive Level:** Express the general meaning of the story. * **The Diagnostic Level:** State the possible psychological problems expressed. * **The Symbolic Level:** State possible symbols with psychological meanings. * **The Elaborative Level:** Express any free associations with the elements of the story. The example of the following story may be helpful: (6VH) This is a young, successful engineer. He is an only child. His father is deceased and his mother is very close to him. He works in the oil industry and was offered a contract to go overseas to the East Indies. He signed the contract and is about to leave. He says farewell to his mother, and they separate in a heart-rending moment. After a while, she feels very lonely and decides to follow her son to the East Indies. There is a war going on, and she manages to get passage on a ship to the island where he is stationed. An enemy submarine sinks the ship, and the woman dies. Her son is unaware, but he had already planned a surprise visit for her. He decides to come home unexpectedly. The ship he boards is on the same route his mother took. At precisely the spot where his mother died, the ship is attacked by another enemy submarine, and he too dies. For the beginner it is useful to force oneself to follow all five levels. However, you need not write out all five. The descriptive level may be just a mental checklist, or perhaps it is enough just to express the theme at this level. The interpretive level may be recorded on each scoring sheet and the diagnostic level, or one above it, can serve as the basis for the statement that is made in the summary. These levels serve primarily as a learning tool. Once you have some experience, the interpretive and diagnostic levels should be enough, and the blank spaces should be used for the summary. **2. The Main Hero** The main hero is the character about whom most is said, whose feelings and ideas are most often discussed, and generally the character with whom the narrator seems to identify. In case of doubt, it should be assumed that the “main hero” is the person who most resembles the patient in terms of age, sex, and other characteristics. Occasionally, a man will identify with a “main heroine.” If this happens often, it could be considered a possible sign of latent homosexuality (depending on the overall image). While most young men identify with the young woman in the foreground of card 2, only a few (there is disagreement as to the percentage) regard the figure in card 3VH as female. The hero’s vocation, interests, traits, abilities, and fitness, as well as their body image, often represent the patient’s real or desired traits. The concept of "**fitness of the hero**" refers to the hero's ability to accomplish tasks, in the face of external and internal difficulties, in a social, moral, intellectual, and emotionally acceptable manner. Often, the hero's fitness fits a pattern over the course of the stories, and it is frequently related to the strength of the ego of the patient. It must be mentioned that sometimes there is more than one hero in a story. The patient might use a second character with whom he identifies, aside from the clearly recognizable main hero. This happens very rarely. It generally involves a figure: Introduced, but not present in the card itself, and relates to drives and feelings that are even more critical to the person than those associated with the main hero. Other mechanisms for trying to distance oneself emphatically from a story include placing it far away in a geographical, temporal, or both senses. For example, the story might be set in medieval Russia. Schilder (1925) was the originator of the concept of “body image,” and he stated: “The body image signifies our mental representation of our own body. It denotes the way our body appears to us.” This concept is particularly clear in the violin card (card 1) but also in 3VH and the string card (17VH). In card 1, one can obtain information about the person's concept of his or her own body, both in the analysis of the child and, frequently, in the way the violin is treated. It seems as if the instrument is identified with the hero and he could be described as broken or empty, dead, and in pieces. This is particularly true in the latter case, where the reference goes beyond the body image and actually becomes a matter of self-image — including the emotional tone and the idea of the individual’s role in the world. (Sometimes, the violin is identified with the female body, and the bow represents the male body.) Similarly, cards 3VH and 17VH lend themselves to a characterization of one’s concept of the body, self, and social role. **3. The Main Hero’s Needs and Drives* Experience in teaching the TAT shows that the inquiry about the needs of the main hero yields three types of data that are often confused, which detracts from the accuracy of observations. * **Behavioral Needs:** These needs of the main hero constitute the initial data. It is worth recording whether the hero is extremely aggressive in the story, attacks and harms several other people as the plot unfolds. Of course, it’s useful to remember that the behavioral needs of the hero may be the behavioral needs of the person, but they are apparently only the fantasy needs of the person. * **The problem** of the relationship of **latent needs** in the TAT to **real behavior** should be explicitly stated. Frequently, the interpreter of TAT stories must decide whether a need expressed relates to the level of fantasy or the level of reality. For example, the need for aggression or achievement. The psychologist must have a maximum of clinical and biographical data about the patient. The problem of the TAT's validity is addressed in experiments and should be decided there. If one has sufficient information about the patient, then the TAT stories should be viewed as complementary data and considered along with the behavioral data obtained. For instance, the implications are obvious if the individual is shy and withdrawn and the stories are full of aggression and feelings of guilt about figures. However, there are certain indications within the TAT that allow one to make assumptions about manifest or latent needs expressed in the TAT. For example, in stories about achievement, it is vital to distinguish between the stories that follow the deus ex machina mechanism (simple fulfillment of the wish) or, in reality, where success is achieved step by step, suggesting much more than a need for achievement. Sanford (1943) stated that there are some important rules regarding the relationship between fantasy needs and behavioral needs. He suggested that there are certain needs that tend to be intense at the fantasy level and rare at the behavioral level — that is, those needs that are generally prohibited and inhibited by cultural pressure against their explicit manifestation. These are primarily the needs for acquisition, aggression, autonomy, sexual activity, the desire to be cared for, and the need to avoid being hurt. However, some needs might be poorly expressed in fantasy, but they might have many expressions of **manifest behavior** because of the demands of reality. For example, the need for order, to avoid societal censure, to learn. Again, there is a class of needs that are very intense in both. ## Further Explanation The concept of **dynamic inference.** If the main hero in a story often takes care of and supports several other figures, there is reason to suspect that these figures are the hero’s secondary or tertiary identifications, and that the care shown indicates an attitude of profound need and craving for support on the hero’s part, an attitude from which he protects himself by means of this care. Or perhaps the hero is avoiding any reference to aggression because this represents a very large amount of aggression, which he has kept under control by completely denying it (a valid inference only if there is evidence to support it). **The introduction of characters, objects, or circumstances.** If the person introduces weapons of one kind or another into several stories (even without using them in the context) or includes food as an integral part (even without eating it), one could tentatively consider that such evidence suggests a need for aggression or oral gratification. Similarly, one might interpret the introduction of certain figures, such as those who punish, chase, benefit, etc., or of circumstances, such as injustice, deprivation, etc., with due consideration to the rest of the protocol. **The omission of characters, objects, or circumstances.** If the person does not mention the pistol in card 3VH or the rifle in 8VH or does not perceive that one of the women in card 18NM is strangling the other or that a woman in card 13HM is almost completely exposed, one may infer a need to repress aggression - or a need to repress sexual urges if the person ignores the near nudity in the background of card 4 or considers card 13HM to be totally devoid of sexual references. The inference can only be tentative until one has sufficient data to develop a base line about which objects are introduced or omitted so that one has a reasonable degree of certainty about when a person deviates from the norm. **4. The Concept of the Environment (World)** This concept is a complex mixture of unconscious self-perceptions and distorted apperception of stimuli due to images from the past that are locked in memory. The more consistent a particular image of the environment seems to be in TAT stories, the stronger the reason to consider it as part of the individual’s personality and as a useful clue about the individual's reactions in everyday life. General descriptive terms, such as needing protection, hostile, exploitative, friendly, dangerous, etc., will be sufficient. **5. Figures Viewed As** The TAT is primarily an instrument that allows for the study of the distortions in the apperception of social relationships and of the dynamic factors that are its basis. Therefore, a detailed study of the hero’s attitudes toward his parents, contemporaries, and people who are younger or less significant is an integral part of our scoring system. This method permits us to record such apperceptions and the individual’s reactions to these perceptions. That is, each card allows the person to create a situation that can be viewed as a problem (“tell me what is going on”). Then the person has to resolve the situation (“and tell me what the outcome will be”), which reveals his or her ability to make adjustments to personal needs. In other words, it reveals his or her ability to create coping mechanisms for personal needs. For example, if a person tends to perceive female figures in the TAT as aggressive, then it is worthwhile to determine how the person reacts to these fantasy creations: by withdrawing, reciprocating the aggression, intellectualizing, or with other forms of behavior. **6. Significant Conflicts** When studying the significant conflicts of an individual, it is not enough to know the nature of the conflict, but one also should know the defenses that the person uses to overcome conflict. Once one determines which drive or force is in conflict with the superego, it is important to specify, in 1 or 2 words, the resulting behavior. For instance, if the conflict is between the superego and aggression, the person may be timid. In this case, a good opportunity exists to study the character structure and prognosis for the person. Sometimes the conflict is not between the superego and drives such as aggression, acquisition, or sexual desires, but rather between two drives, such as achievement and pleasure or autonomy and submission. **7. Nature of Anxieties** It scarcely needs repetition to emphasize the importance of determining the main anxiety. Again, it will be valuable to point out the defenses in this context, which will be expressed in the form of passivity, flight, aggression, orality, or those mentioned below. **8. Principal Defenses Against Conflicts and Fears** The TAT should examine not only the content of needs. It should also, and indeed, must examine the defenses against these needs. Often, such study provides more information about the needs, because the needs themselves may be less evident than the defenses against them. On the other hand, the defense structure can be more closely linked to manifest behavior. Frequently, through a study of drives and defenses, the TAT allows for a clear evaluation of the person’s character structure. It is also helpful to study the macro aspects of the stories. For instance, some people might choose obsessive defenses against the disturbing content of a card; they might produce four or five themes, each very short and descriptive, that are different in terms of manifest content but identical at the dynamic level. Sometimes a succession of themes to the same card shows that the person is trying to deal with a disturbing conflict; successive stories become less and less threatening, which shows an increase in defenses. On the other hand, each successive theme might allow for more expression of the disallowed desire or need. **9. Fitness of the Superego as Manifested by “Punishment” for “Delinquency”** The relationship between the severity of the offense and the severity of the punishment provided by the hero’s superego in a story is a key factor in judging the severity of that superego. A psychopathic character might go unpunished in a story about murder, and at most there might be a slight suggestion that he has learned a lesson for future behavior. A neurotic character might invent stories in which the hero is killed accidentally or intentionally, or he dies from illness after having committed a minor transgression or expression of aggression. On the other hand, an unintegrated superego is sometimes overly severe, and at other times too lenient, which can be seen commonly in neurotic individuals. **10. Integration of the Ego** Of course, this is an important variable to investigate. It reveals how well the ego functions. It expresses at what level the ego is capable of making a successful adjustment between its needs and the demands of reality on the one hand, and the dictates of the superego on the other. The hero’s ability to handle the problems that he encounters in the cards and his own perception of these problems reveals what the therapist seeks to ascertain. In this case, interest centers on certain formal characteristics: Is the person able to tell stories that are appropriate to the given stimuli and to make a certain amount of sense concerning the adaptive aspects of these stimuli, or does the person abandon the stimuli completely and tell a story that has no clear relationship to the image or the situation because the individual lacks a sufficient grasp of reality, or is the individual too concerned with personal problems to handle them? Is the individual overly preoccupied with his or her anxieties and related problems, and do these preoccupations seem relevant or not? Does the individual escape from anxiety by providing stereotypical responses to the stimuli, or is the individual in good condition and sufficiently intelligent to be creative, providing more or less original stories, or are his or her conflict-resolving abilities within the story - and within himself - adequate, complete, and realistic, or are his or her thought processes unstructured or even bizarre under the impact of the problem? These observations allow for a more comprehensive understanding of the ego strength of the patient, which contributes significantly in facilitating the possible classification of the patient into one of the nosological categories, in addition to the dynamic diagnosis provided by the content variables. There are also considerations in this situation, such as the **individual’s distance from his story**. For example, if the setting of the story is in a place that is very far away or if the events took place a long time ago, or if the hero is only a spectator, or if events are narrated as if they were a scene from a movie, or if emotions are expressed in a sarcastic tone or hushed tones, in general, all of these factors imply an attempt to distance oneself from the emotional content of the story as a defense mechanism. On the other hand, if an individual immediately takes a personal approach to the story, saying: "That is just what happened to me," it may mean a loss of distance. This indicates a very narcissistic concern for oneself. From a formal viewpoint, it is helpful to consider that **storytelling is a task** that the person should accomplish. The person's ability to carry out the task, his or her ability to handle the task, and the strength of his or her ego, and other variables can be judged from the perspective of his or her ability and manner of accomplishing the task. Clinical interest in **ego functions** has steadily increased. Therefore, page 6 of the Bellak Scoring Protocol provides a specific scale for assessing ego functioning. This scale is based on detailed definitions and on extensive research presented in another text (Bellak, 1993a). When ego functions were studied through interviews, psychological tests, and laboratory methods, it was found that the scores obtained from TATs by various scorers were correlated to a greater degree with Rorschach scores, WAIS scores, drawings of figures, and Bender Gestalt test scores (Arnold, 1951, p. 331). Ego functions can be evaluated from the TAT stories themselves and recorded on the scoring scale. If desired, the scores can be linked using lines (Figure 6-2). Ego functions can be assessed from the person’s behavior during testing. It is recommended that this behavior be recorded and reported separately on the space provided below the scale on page 6. The **12 ego functions** can be briefly defined as follows: ## The 12 Ego Functions 1. **Reality Testing.** The ability to differentiate between internal and external stimuli implies a search for ongoing confirmation and selective matching of current perceptions with past perceptions. In evaluating reality testing, always consider the contexts and social norms of the time. This scale also includes **internal reality testing**. It is reflected here in the degree to which the person is in touch with him or herself at the internal level. In other words, it means an "introspective mentality" or a "reflective consciousness" (for example, awareness of the implications of TAT stories). 2.** Judgment.** Judgments are based on data that indicate the understanding and evaluation of hypothetical and real situations, and the person's assessments of the consequences of such situations, as well as of all actions and other behaviors that relate to the situations, as the person creates them. 3. **Sense of Reality of the World and of the Self.** This scale evaluates disturbances in the individual's sense of self, in terms of the relationship with the external world. For instance, the patient's stories might include supernatural beings or make-believe worlds. For example, certain TAT stories include phantoms, sprites, or imaginary worlds! 4. **Regulation and Control of Drives, Affects, and Impulses** This function refers to the degree to which the mechanisms of delay and control allow the derivatives of drives to be expressed in a moderate and adaptive manner, which is characterized, optimally, by a degree of control that is not too excessive or too limited. 5. **Object Relations.** Optimal object relations are relatively free of maladaptive elements that suggest interaction patterns that were more appropriate for childhood situations than for actual situations. The most extreme example of this would be, in essence, an absence of relationships with any person; this exists in situations in which a person's relationships are based on early fixations, unresolved conflicts, and hostile and sadomasochistic relationships. The most mature relationships would be the most mature, relatively free of distortions, and gratifying to adult libidinal, aggressive, and egoic needs. For instance, in card 1 of the TAT a story in which a violinist plays with pleasure before a totally empty Carnegie Hall would suggest a large amount of narcissism. 6. **Thought Processes**. It is necessary to rate any disturbances in the formal characteristics of logical thinking, as well as the interference of the thought process of primary material. 7. **Regressive Adaptation in the Service of the Ego (RASE).** This refers to the ego's ability to initiate a partial, temporary, and controlled reduction of its functions (in this case, one should keep in mind all 11 ego functions) for the sake of its own interests (i.e., to promote adaptation). Such regressions result in relatively free, but controlled, participation of primary process material. This ego function can be observed clearly in the way a person is able to handle the TAT as a creative task. 8. **Defensive Functioning**. Defenses protect unconscious and conscious organizations from the intrusion of derivatives of the id, the unconscious ego, and the superego's tendencies. They help in adaptation by controlling the emergence of content that increases anxiety or that is psychologically distressing in some other way, such as instinctual and ego-dystonic drives (including depression) that are in conflict with the demands of reality. Of course, excessive defense mechanisms are also maladaptive. It is always a good idea to monitor the presence of defense mechanisms, whether excessive or insufficient. 9. **Stimulus Barrier**. Both the thresholds and the responses to stimuli contribute to adaptation through the organism's potential to respond to sensory input. The input will often be high, average, or low, so as to maintain homeostasis and optimal flexibility (just as the adaptation). The threshold to stimuli determines, in part, what the degree of flexibility is in a given person or how he or she readapts after stress and the impact of stimuli are no longer present. For example, the story of a mother who is unable to tolerate her son’s screaming and how this affects her, would provide considerable information in this regard. 10. **Autonomous Functioning**. The intrusion of conflict, ideas, affects, or drives, or all of these, into the functioning is one of the main criteria for determining whether the alteration is in primary or secondary autonomy. The basic apparatus and functions of primary autonomy are: * Perception * Intentionality * Concentration * Attention * Memory * Audition * Vision * Discourse * Language * Productivity * Motor Development * Expression 11. **Synthetic-Integrative Functioning.** This function of the ego fulfills one of the major tasks of the ego, as defined by Freud, in terms of reconciling the often conflicting demands of the id, superego, and the external world, as well as incongruities within the ego itself. It emphasizes the reconciliation of conflicting areas and also the degree to which areas that are not in contrast are related. 12. **Domination-Competence** Scores for **competence** and **sense of competence** should be rated independently, because several relationships are possible between these two aspects: * **Congruence:** Competence and sense of competence may be in agreement. * **Outperformance:** Actual performance might exceed the sense of competence. * **Overconfidence:** The sense of competence may exceed actual performance. ## Summary and Final Report After all the cards have been analyzed, the main data should be noted in the space provided on page 4. When examining the summary page, a consistent pattern frequently becomes clear in the responses of the person. * The final report can be written directly from the summary page. Here are some suggestions on the format of the final report: 1. The final report should follow the sequence of the 10 categories on the scoring sheet. 2. The main themes, including variables #2 and #3, allow for a description of the person's structure and unconscious needs, while the fourth and fifth categories offer insights into the person's concept of the world and of significant figures, as well as attitudes and other behaviors. Categories 6, 7, 8, 9, and 10 can be used, in effect, as headings for statements concerning the respective dimensions of the personality. 3. Of course, the format of the final report will depend on the specific individual to whom it is addressed. However, the goal is to move away from vague statements and erroneous inferences by following the protocol. The first half of the report might consist of general abstract statements concerning the person, following the outline outlined above. The second half of the report should then include specific and concrete documentation using excerpts from the stories or specific references to the stories themselves, which are the basis for the main abstract statements. *This layout is especially helpful in cases where the psychologist is part of a team and is writing the report for psychiatrists and counselors who may not have enough time or experience to read all the stories themselves. A purely abstract report may have little meaning for them. *If a diagnosis must be made, or if one wants to, then use this formula: "The data set forth in the TAT are consistent with a diagnosis of..." This makes it clear that the TAT is not primarily a diagnostic test (in the sense of labeling a patient at a nosological level - but it is certainly diagnostic of dynamic and structural variables) and also that one should never make a diagnosis based solely on a single test, or, at the very least, never make such a diagnosis without supplemental information obtained through a clinical interview. ## The Short Form of the Bellak Scoring Protocol* The **Short Form** of the original protocol was mainly published for clinical convenience. Although it uses almost the same variables as the earlier protocol, it consists only of a three-page format, which folds into a single sheet of letter size paper, with the summaries in front. When the protocol is not folded, one can record each variable in the appropriate sections for the 10 complete stories and they can be summarized consecutively beneath the same headings placed to the right. It is possible to simplify the writing of the final report by keeping open the summary page. It should be noted that the 10 main variables or categories are used essentially as a framework; not every aspect will be relevant to each story, and sometimes details not included in the scoring protocol will emerge, which should be noted. The main function of the protocol is to further ease the transition from concrete primary data to inferential summary and final diagnoses by having three pages open in front of the scorer. The Short Form is also less burdensome. In its revised version, it reflects a shift toward a greater interest in the psychology of the ego. The revised version lists 12 ego functions. As many of these functions as possible should be evaluated as an additional indication of the person’s adaptive capacity. A detailed explanation of these ego functions can be found in Bellak and Loeb’s *The Schizophrenic Syndrome* (1969) and in *Ego Functions in Schizophrenics, Neurotics and Normals*, besides an article entitled "A Systematic Study of Ego Functions" (Bellak, Hurvich, and Gediman, 1973). * Those who have experience with the TAT and who have become familiar with our methods might want to use only the *TAT Record Protocol*, using the middle page as a guide for recording related information in the summary sheet, rather than actually placing information in the 10 scoring sheets. <br> &#x20; *Published by C.P.S. Inc., P. O. Box 83, Larchmont, New York. Examples of using the Short Form are given in Case 3, the analysis of Somerset Maugham’s short stories (Chapter 10), and Chapter 16.