Psychological Tests: The Uninvited Guest

On the Thematic Apperception Test (TAT) Tina's stories were logical and coherent, contraindicating an overt psychotic thought disorder. While she tended to utilize fantasy and daydreaming as major defenses, she was able to organize the themes of the pictures without resorting to gross reality distortion. However, her object relationships were some what disturbed. She tended to characterize relationships as over-idealized and viewed women as unfulfilling, untrustworthy, and guilt provoking. There was the suggestion that she avoided angry feelings because of their perceived destructive potential. Men were also over-idealized. Moreover, Tina equated the physical expenditure of energy and high activity level with maleness and identified with both aspects. There was, however, no evidence of her preoccupation with sexual surgery and there was a conspicuous lack of attention to gender related themes (both of which are of interest).

While Tina's Rorschach test elicited only fifteen responses (below the norm of twenty), the number of movement responses (a measure , of tension, anxiety, and conflict) and the use of multiple determinants suggested that she was experiencing a considerable amount of inner turmoil and anguish. Indeed, she seemed to be attempting to control and defend against unacceptable sexual and aggressive impulses which were seeking self expression beyond her control. Her defensive struggle was not entirely successful. At times her massive use of denial and projection could interfere with her judgment and reality sense. While she evidenced the capacity for realistic perceptions, and was not overtly psychotic, her thinking was, however, subject to intrusion and distortion from her affectively laden impulses. Indeed, at times her thinking could appear confusing and perplexing. She appeared to have a subtle, but generally non intrusive, thought disorder. None of this was evident on clinical interview (unless one viewed the symptoms of transsexualism as manifestly "crazy").

As a woman Tina felt vulnerable, weak, strange, odd, unconventional, and overwhelmed by her dependency needs and her yearnings to surrender to another woman in a passive way. Her feelings of discomfort as a woman also stemmed from her fear of being penetrated, intruded upon, or becoming the object of aggression. Indeed, as a woman she perceived herself as small, hopeless, ineffectual, and overwhelmed. Her "male" personality element, while acting as a kind of talisman (via the symbolic power she associated with the penis), was also formless and at times ego alien. The split between her male and female elements was experienced as ego dystonic. She seemed to believe that only as a man could her dependency needs be met. In effect, she was enmeshed in a profound personality conflict from which there seemed no escape. In an attempt to resolve this conflict she had conceptualized a solution that was at best primitive to become a man and thereby omnipotently resolve all her conflicts.

Tina also seemed to be struggling with an underlying depression which was defended against by her homosexual excitement. Indeed, she was preoccupied with homosexual imagery which she found both exciting and frightening. At times she seemed to defend against these impulses by resorting to phallic images which had a magical soothing quality. Her response to card 9 of the Rorschach ("looks like a real strong flower," combined with a sexual theme) suggested that she was still trying to integrate the phallic elements into her personality without resorting to the drastic measure of sex change. It was also suggested that she could be quite guarded and at times paranoid. This paranoid style and the use of primitive psychological defenses -- denial, splitting, omnipotence, projection, projective identification helped to defend against her inner feelings of fragmentation of self which threatened to overwhelm her ego. (see PROPOSITION 1: THE SO CALLED "STABLE" COURSE OF FEMALE TRANSSEXUALISM PART VII)