Exploring the internal configuration of the cycloid personality : a Rorschach comprehensive system

Abstract

Exploring the cycloid temperament has been attempted throughout the ages by various pioneers in psychiatry, psychology and psychoanalysis. Contemporary psychiatric approaches have estimated that cycloid pathology, most evident as Bipolar Disorder, accounts for more than 1% of the population and is seen as the sixth leading cause of all illnesses. Despite the latter it is remains a desperately understudied area psychologically. Theoretically, BD is known for (1) its complex epidemiology, (2) costly treatment, (3) occupational impairment; (4) its negative interpersonal implications, (5) negative domestic effects, (6) forensic consequences, (7) death due to suicide and accidents, (8) cost in treatment, and finally, and most importantly from a humanistic perspective, (9) BD's diminished quality of life. Given the various realities faced by those suffering from Bipolar disorder the current study aimed at describing, through the use of the Rorschach Comprehensive system (CS), the self and object-representations, as well as the affect experiences of fifty, predominantly Bipolar I inpatients. The patients were selected through opportunity sampling at two provincial psychiatric hospitals in South Africa and included Caucasian, African and Colored respondents. All protocols were administered and scored by trained CS clinicians and re-scored by both the author and supervisor. Fifteen protocols were thereafter randomly assigned to three inter-raters and a high level of inter-rater reliability seemed evident. Given various inherent limitations of the study, that is, (a) a study of limited scope, (b) the heterogeneous nature of the sample and the reliance on opportunity sampling, (c) the small sample size, (d) lack of a control group, and (d) the focus of the study as exploratory-descriptive in nature, basic descriptive statistic were relied upon. Despite the various limitations, the results obtained seemed to hint at the possibility of a Neglected Self, characterised by difficulties in modulating affect in moderation, lack of self-esteem and positive self-regard, difficulties in introspection and self-inspecting behaviour, a general lack of interpersonal comfort and feelings of threat, as well as affectional and representational constriction. The presence of impaired self-regulation and reflection, possible perceptual differences in sensory-affective reactivity and processing, as well as difficulties in representational elaboration and differentiation needs further research and comparison to other psychiatric disorders. Basic therapeutic inferences were also discussed that may support those who treat cycloid patients.