Rorschach Plate 1: A bat, a butterfly or a moth
When he's not patching up patients in the ER, Moose Jaw, Sask., doctor James Heilman can be found running ultra-marathons across desert and dune.
But recently, his endurance has been tested by a marathon of a different sort.
In mid-June, the physician and Wikipedia editor posted 10 Rorschach inkblots and the most common interpretations of them at the online encyclopedia, a move that has plunged him into an intense, and at times personal, debate with psychologists who want the 86-year-old evaluation method kept from the public eye.
"People take it very seriously," Dr. Heilman said during a lull in his shift at Moose Jaw Union Hospital. "They don't want their profession exposed. They want to stay as a secret society."
His single act of uploading may have taken down one of the oldest and most famous psychological tests around. It has also placed the Saskatchewan doctor at the centre of three long-standing debates involving secrecy of psychological testing, the effectiveness of the Rorschach test and the controversial editing process at the world's largest encyclopedia.
The discussions turned cruel yesterday after Dr. Heilman was quoted in the New York Times.
"You must be very proud of yourself ... from Moose Jaw to the NY Times," a commenter identified as Faustian wrote in a Wikipedia discussion forum. "All at the relatively small cost of just harming people who could benefit from the test."
That argument seems the most compelling rebuttal to Dr. Heilman and other Wikipedia users for whom online disclosure is a dearly held conviction. Conceivably, a patient could research the Rorschach test online before taking the evaluation and overplay or underplay a mental condition.
"If it were a good test for schizophrenia, which it's not, then anyone involved in criminal matter who knew how to appear schizophrenic on a given test might be able to get off using the insanity plea," said Scott Lilienfeld, professor of psychology at Emory University in Atlanta and co-author of What's Wrong with the Rorschach . "So you can see how, if this sort of disclosure became common practice for other psychological tests, it could set a very dangerous precedent."
Psychologists administer the test, among others, to give them insight into patients' personalities, moods, fears and coping strategies.
The most recent surveys on the issue show that as many as 80 per cent of clinical psychologists still use the test. Some experts worry that Mr. Heilman's decision to publish the Rorschach images and the most common responses could erode that.
"The test becomes meaningless," said Karen Cohen, executive director of the Canadian Psychological Association. "If someone has all the questions and the answers, you can't administer the test. That compromises its usefulness."
The association's policy states that tests constitute a "trade secret" and should be withheld from the public to prevent "significant negative impact on the health of Canadians."
The test might be a trade secret, but the copyright protection expired long ago. Even so, a German publishing company that sells licenses to the Rorschach images is considering legal action against Wikipedia.
While Dr. Lillienfeld worries about the precedent of publicizing all psychological tests, he has few qualms about outing the Rorschach.
"The test is so problematic it doesn't matter," he said. "It would be a bit like a baseball fan getting worked up when a .100 hitter sprains an ankle. There are still some holdouts, but the scientific consensus is that it's not a very good test."
As well, numerous other sites have already posted the inkblots accompanied by the most frequent responses.
"The cat's already out of the bag," said Dr. Heilman, who doesn't expect the marathon exchange to end any time soon.
"It's been going on for years," he said. "It's like the debate about abortion or the debate about showing images of Mohammad. We have two very polarized sides."
Patrick White