Walter Trinca **




1. NATURE OF THE DRAWING-AND-STORY PROCEDURES


The Drawing-and-Story Procedure (abbreviated D-E) has been introduced by Trinca (1972) as a tool for clinical exploration of the personality. It is not a psychological test, but an auxiliary instrument to expand the investigation. In the psychological diagnosis, it occupies an intermediary position between the thematic and graphic projective tests and the non-structured interviews. In effect, it consists of a set of motorial-expressive(in which free drawing is included) and dynamic-nonperceptive processes (thematic verbalizations); besides that, it includes directed inquiry associations. From such a conjunction, a new and individualized tool has arisen, with its own characteristics. It is a "large bandwidth" process, i.e., it offers a wider variety of information with lesser safety, which distinguishes it from objective tests.

In this process, the subject must fulfil a series of five free drawings (chromatic or achromatic), each of them representing a stimulus for him to tell a story in a free association basis immediately after each drawing is completed. Having concluded each story-drawing, the examined provides explanations (the inquiry step) and the story's title.

The Procedure's administration is individual, and it must be applied by properly qualified professionals. A black pencil, A-4 size blank paper sheets, and colored pencils are used. The subject is invited to sit and work on a table, and the examiner sits in front of him. The task is presented following achievement of a satisfactory rapport between examinee and examiner. The pencils are spread over the table, being the black pencil (graphite tip) placed at random among the others.

A sheet of paper is placed horizontally, the larger side next to the subject. The possibility of shifting this position is not mentioned, nor its importance is emphasized. The examinee is asked to do a free drawing. "You have this blank sheet and may draw whatever you wish, as you wish". One waits for the first drawing to be concluded. When it is finished, it is not taken away from the subject. The examiner then asks him/her to tell a story associated with the drawing: "Now you, looking at the drawing, can make up a story, telling me what happens". In case the examinee shows difficulties to associating and making up the story, additional resources may be introduced, e.g., one may say: "You can start talking about the drawing you have made".

When the story-telling step is finished in the first drawing, the inquiry comes next. In this step, it is possible to ask any explanations needed in order to understand and interpret the material, both from the drawing and the story. The inquiry also aims to obtain new associations. With the drawing still in front of the subject, the story's title is asked. At this point, the drawing is taken away from the subject's sight. Thus, the first production unit is concluded, consisting of free drawing, story, inquiry, title and other elements reported.

The examiner will take detailed notes of the story, verbalizations of the subject while drawing, fulfillment order, auxiliary resources employed, questions and answers in the inquiry step, title, as well as all expressive reactions, parallel verbalizations and other kinds of behaviour noticed during the process application. The intention is to obtain a series of five production units. Thus, when the first unit is finished, the same procedures are applied for the others. If it is not possible to get five units in one single 60-minute session, it is advisable to set the subject's return for another application session. If, in spite of having used the time of two sessions, the number of five units is not achieved, the material thus produced by the examinee shall be considered and evaluated. If the verbal associations are poor, it is recommended the process to be applied again, from the story-telling step. For further explanation as to the application, see Trinca (1987 e 1997a).

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2. FUNDAMENTALS

The Drawing-and-Story Procedure is based on the following assumptions:
  • The subject may reveal his conflicts, dispositions, etc. upon structuring a situation not previously defined.

  • Free associations tend to converge to areas where the individual is emotionally more sensitive.

  • In any projective approaches, the less structured and stimulus-oriented, the higher the probability for emotionally meaningful material to emerge.

  • In the initial contact, the client is bound to communicate his/her main unconscious conflicts and fantasies about disease and cure.

  • The child and the teenager would preffer to communicate themselves by means of nonperceptive drawings and fantasies, rather than express themselves through direct verbal communication.

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3. POSITION IN THE PSYCHOLOGICAL DIAGNOSIS

The Drawing-and-Story Procedure puts itself into the comprehensive process, which characterizes "a series of situations including various aspects, as: to find a meaning for the set of available information, to take what is relevant and meaningful in personality, to empathically get in touch with the emotions and, also, to know the deep motifs of one's emotional life" (Trinca, 1984, p. 15). The structural components of the comprehensive process include: a) elucidation of the meaning of disturbances; b) focus on the unconscious emotional dynamics; c) considerations about the whole to the clinical material; d) search for the client's globalized psychological understanding; e) selection of critical and nodal aspects; f) predominance of clinical judgment; g) diagnosis process subordinated to clinical thought; h) prevalence of the use of examination methods and approaches based on free association.

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4. AGE GROUP

By the time it was introduced, the Drawing-and-Story Procedure was primarily aimed at children and teenagers in the 5 to 15 year old age group, because "the forms of interview should adapt to the particular way of children communication, which are close to the ones prescribed by the graphic and thematic processes in the projective approaches" (Trinca, 1972, p. 49), thus giving to these examined subjects an opportunity to talk indirectly about themselves. As time went by, however, this approach has been extended not only to adults but also to children under 5. Mestriner (1982), Al'Osta (1984), Fernandes (1988), Giannotti-Hallage (1988), Barbosa (1989) and Castro (1990), among others, have conducted studies with adults. Paiva (1992) demonstrated that 4 to 5 year-old children showed good responsiveness to D-E application. Currently, its use is established for different age groups from all intellectual, economic, social and cultural levels.

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5. EVALUATION

Drawings, stories, inquiry answers and titles constitute a communication unit, and as such, represent multiple components and varied forms of expression wich enable to convey messages irreductible in themselves. Therefore, they should be evaluated as a whole, being focused as a unitary communication process.

Usually, the evaluation is made through a simple inspection of the material, depending on what the examiner intends to investigate. The evaluation can be made according to a psychoanalytic perspective; we have seen, however, the use of other perspectives, as well as multiple ones. Usually, the perspective used by the professional in his/her own work is the one to be adopted.

Taking free association as the fundamental, the D-E promotes such a proximity concerning the emotional life, through a "dive" in a dream atmosphere, in which unconscious fantasies prevail. The task reinforcement by means of five production units paves the way toward deep psychical constellations. In this case, the D-E may be evaluated using similar methods to dream assessment. Migliavacca (1987), taking the Freudian dream interpretation as point of departure, has confirmed the existence of the following aspects in the D-E: a) unconscious contents; b) desire-fulfillment contents; c) anguish contents; d) condensation; e) displacement; f) dramatization; g) secondary elaboration; h) reverse representation; i) dispersion; j) personification; k) symbolisms. One may conclude that the contents revealed in the D-E resemble the material appearing in dreams.

Conversely, the Drawing-and-Story Procedure may be evaluated as a form of interview. In the hands of skillful professionals, there is a high probability to succeed in discriminating the basics of the disturbances (if the evaluation is made according to the principles of the clinical method). Mestriner (1982) discusses the role of the D-E as a mode of diagnostic interview and as a means of communication which are emphasized, on which the professional focus his/her attention.

In order to make the examination of the material easier, references for analyses have been built (see Trinca, 1987, p. 36). These references express the prevalence of certain aspects in the population in general. Tardivo (1985), partly reformulating a previous reference, found validity for the following psychodynamic factors, in a 5 to 8-year-old child drawing sample:

I. Basic attitude

  • Acceptance

  • Opposition

  • Insecurity

  • Positive identification
  • Negative identification
II. Meaningful figures
  • Positive mother figure

  • Negative mother figure

  • Positive father figure

  • Negative father figure

  • Positive fraternal and other figures

  • Negative fraternal and other figures
III. Expressed feelings
  • Feelings derived from Instinct of Life

  • Feelings derived from Instinct of Death

  • Ambivalent feelings
IV. Tendencies and desires
  • Necessity for suppressing basic needs

  • Destructive tendencies

  • Constructive tendencies
V. Impulses
  • Loving

  • Destructive
VI. Anxieties
  • Paranoid

  • Depressive
VII. Defense mechanisms
  • Splitting, projection, repression, denial, regression (and fixation), rationalization, isolation, displacement, idealization, sublimation, reactive formation, maniac or omnipotent denial.

During evaluation it is possible to regard specific problems to be investigated as they emerge from personal and group dynamics. For example, in the school representation studied by Cruz (1987), student-school relationship was the central purpose. Through that assessment, conflicts and anxieties appear generally connected with punishment fantasies, exigencies, attacks and injustices perpetrated by teachers and classmates against the student. Deep conflicts on the specific school life situation are re-inscribed.

Moreover, particular evaluation of certain aspects such as the cognitive ones cannot be discarded. Elements for distinguishing highly cognitive themes were indicated by Tardivo (1985), while the involvement of cognition and affectivity with school performance was associated by Paiva (1992), and D-E application was extended to the comprehension of slight mental retardation by Moreno (1985).

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6. SPECIFIC GROUPS

Another really interesting aspect in the use of the Drawing-and-Story Procedures is to detect behaviours of particular groups having common features. These features are generally defined in terms of situations or configurations such as school failure, pre-surgery period, bronchial asthma etc. When submitted to specific anxious situations, individuals tend to react by means of peculiar characteristics which can be studied in groups. Thus, D-E application for the assessment of certain anxious moments as well as of some problems of certain groups and populations has been possible. Excellent results achieved by some of such studies will be reported as follows.

D-E was applied by Giannotti-Hallage (1988) as an ancillary aid resource for psychological knowledge of patients with congenital cardiopathy. Sterile women with endometriosis were analyzed by Castro (1990), combining D-E with interviews, TAT and Rorschach, and considering the possibility that psychological factors may affect sterility. The researcher concluded that, as a group, the sterile women showed a peculiar profile. Primiparas' unconscious fantasies were interpreted by Fernandes (1988), following D-E procedure, and results confirmed the presence of not only life forces in pregnancy but also destructive ones in which the baby is seen as a threatener.

In another study, psychodynamic factors in male adolescents' personality who had committed homicide were investigated by Mázzaro (1984). Through D-E, he found out that those teen-agers present a generalized claim for satisfaction of affection primary needs, related to the introjection of good and loving objects. Later on, D-E was once more applied by Mestriner (1989) to determine asthmatic children's psychodynamism differentiating them from normal ones. So, through qualitatively and statistically assessing, she was able to identify characteristics peculiar to asthmatic children. D-E was also used by Gimenez (1983) to systematize the most frequent anxiety types in clinical frames of school phobia. It was, then, verified that school phobia is different in terms of prevailing anxiety: depressive, paranoid, Oedipal and primary.

Children with peptic diseases were examined by Hames (1992) through interviews and D-E, achieving a dimension for internal dynamic of conflicts as well as for potentially chronically conflictive family environment, which required excessive responsibilities gently and serviceably accepted. In turn, intercurrence of problematic factors for the identification of the male sexual role in boys ranging from 7 to 13 years of age was approached by Brito (1986). In addition to typical aspects common to the examinees' personality conflicts, she also found disturbing factors in the scope of family dynamic. Moreno (1985) used D-E to assess the personality of slightly mentally retarded teen-agers, comparing them with normal adolescents and with normally intelligent children, ranging from 7 to 8 years of age. Thus, D-E value for making differential diagnosis of slightly mentally retarded adolescents was confirmed by results which showed the specific group characteristics.

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7. THEMATIC D-E

Less common, yet still frequent, has been the use of Thematic Drawing-and-Story Procedure. Theme was introduced into school representation by Cruz (1987) with children from working class. Instead of saying "You can draw anything related to school, the way you wish", the instructions were "You can draw anything related to school, the way you wish". Theme introduction makes the task easier for it enables the researcher to point out the issue, whenever he wants it to be directly treated. In such cases, there is generally no setting which by itself could offer a framework to the examinee's task, so it must be stated by the examiner. This subject was discussed by Aiello-Tsu (1990) during the "III Encuentro Latino-Americano de Psicologia Marxista y Psicoanalysis" in Havana (Cuba), where her study on mental disease representation was carried out. While examining school children, she requested drawings from a mentally ill individual (Aiello-Tsu, 1991), and later on she carried out an investigation upon social representation of problem-child with the help of public school teachers, whose answers stressed aggressivity problems mainly related to family environment (Aiello-Tofolo et al., 1991).

Though studies on thematic D-E have conducted, we believe that the client's conflictive situation by itself allied with the helping relationship developed into the D-E setting easily lead to and facilitate naturally spontaneous movements for communicating his/her anxieties, unconscious fantasies and defenses. Mostly, they make him/her stress the central aspects of his/her disturbance, albeit unconscious. Children ranging from 7 to 11 years of age undergoing pre-surgery situation had their communication specially focused by Trinca, A.M.T. (1987), through using "standard" D-E. By working at a children's hospital for in the city of São Paulo, she succeeded in having children, who were awaiting a medium-sized surgery, express their anxieties concerning the operation. It was shown that facing a special situation which provokes conflict also causes the emergence of "situational anxieties", representing re-inscriptions of former anxieties. It has been verified that similar manifestations occur in other contexts as well. As for thematic D-E, it is necessary to remember that excessive task guiding may lead to either resistances to or an impasse in the communication process.

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8. THE FAMILY THEME

Since 1978, Trinca (1989) has been publicizing a technique for clinical investigation of personality which aims at assessing conscious and unconscious dynamisms related to family situation. It is the Drawing-of-Family-with-Story Procedure (DF-E) that, after a previous version whose instructions were slightly modified, is currently structured as follows.

The subject makes a series of chromatic or achromatic family drawings, and each of them provides a stimulus for his telling a freely associated story following each drawing. After finishing the story, the examinee goes on giving explanations (inquiry step) followed by the story title. Each family drawing has a definite instruction as well as an application order, strictly set as follows:

a) "Draw any family".
b) "Draw the family you would like to have".
c) "Draw a family in which there is somebody that is not well".
d) "Draw your family."

The subject is requested to make the drawing according to the first instruction. The drawing once completed is not taken away from the subject's sight. Then the examiner asks him/her to tell a story connected with the drawing: "Now, while looking at your drawing, think of a story and tell me everything that is happening". After the story-telling step, it is time for the inquiry. During inquiry the examiner can freely request any explanation necessary for the comprehension and interpretation of the produced material, that is, both the drawing and the story. The acquisition of new associations similar to the free ones demanded for dream reports is another purpose of the inquiry. In certain cases, however, when that is not possible or advisable, inquiry should be conducted as a non-structured clinical interview. Then the story title is asked. At this point the drawing is taken away from the subject each time instructions are repeated to the subject. If it is not possible to complete all four drawings in one session, the testing may continue later on. In case it is impossible to carry out the four units during one session, the subject's coming back to a new one is recommended. The material is limited to some sheets of blank legal-size paper bearing no lines, a nº 2 black pencil and a 12-unit color pencil box, scattered on the desk. The examiner should neither tell the subject he/she may not use the color pencils nor encourage him/her to make use of them (Trinca, 1989).

DF-E contains the Drawing-and-Story Procedure for direct reference maintaining, mutatis mutandis, similar foundation. Its application has been extended to adults, for individual and couple diagnosis as well as crossed-use with child and his/her parents in order to assess the family dynamic (Trinca et al., 1990). In this respect, family pychodynamic which is interwoven with ineffective school adaptation of children of both sexes was investigated by Lima (1991), through the study of boys and girls ranging from 5 to 10 years of age and lodging school complaints. So DF-E was applied to those children and their parents, and a meaning for the symptoms was found in the context of personal and family story. The conscious or unconscious problems tackled by the family affect the child's school performance. An unconscious family object becomes a model for the quality of interpersonal interactions inside the family. Previously, DF-E had already been used by Brasil (1989) in order to study school failure putting emphasis on the child's symbolic universe, following basic postulates of jungian theory.

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9. D-E WIDER COVERAGE

Emphasis has been put on the therapeutic value of Drawing-and-Story Procedure (Mestriner, 1982; Trinca, A.M.T., 1987). Additionally, it is deemed adequate for evaluation of psychotics, and its value for schizophrenic in-patients was also tested by Mestriner (1982). Through using the simultaneous validity method, she concluded that D-E most probably makes it possible to discriminate a schizophrenic group from one of normal subjects: since in relation to drawings as well as verbalization the schizophrenic group shows typical characteristics. Having D-E as reference, Al'Osta (1984) was able to compare a group of chronic manic-depressive psychotics with one of normal subjects by using similar methods. The subjects for that research were female adults who were clearly discriminated by the examiners.

D-E has also been of great value for follow-ups to psychic processes. It was used by Gorodscy (1991) for the follow-up to the therapeutic evolution of 7 to 12-year-old superactive children. Through using the instrument at the beginning of the therapeutic process and again 6 months later, she observed that the psychotherapeutically-influenced changes occurred in the personality during that period were reflected in D-E production. Such results allowed her to arrive at the conclusion that D-E can be considered an excellent assessing instrument for therapeutic evolution of children. Likewise, Cruz (1987) made consecutive uses of D-E, maintaining approximately 6-month intervals, with the purpose of following up the transformations occurred to school representation of working class children. D-E, along with other techniques, allowed the follow-up to those transformations (since before the child's first contact with school) as well as to the determination of the main steps for evolution of adaptation to school.

Flores (1984), on the other hand, contributed to the extension of D-E application to terminal children. He aimed at apprehending and understanding emotional contents present in 3 to 10-year-old children during hospitalization period and, therefore, becoming of great help to the care and orientation of those children. In addition to aggressive impulses, defense mechanisms and search for protective objects, he also observed fantasies and anxieties before death as well symbolisms and personification of death. In a psychological study of women who had undergone mastectomy because of cancer, Barbosa (1989 e 1991) used the D-E allied with other psychological techniques for the evaluation of personality. Choosing the female physical identity as a starting point, she tried to understand psychical pain experienced by women who had had a fundamental organ for their female identity amputated. D-E was used by Perina (1992) for collection of information and therapeutic interventions in the care of children with cancer during the disease regression periods: relapse, closed and terminal prognosis. It was possible to follow up the psychodynamic processes present in the interpersonal relationships of the child as well as the experiences before death and process of dying.

In another pioneering study, D-E was adapted by Amiralian (1992) so that blind subjects could follow their own graphic expression. A drawing board coated with window-screen and used as a holder for typing paper was set up, enabling the blind to draw with a common pencil. Thus, she studied the organization of blind subjects' personality. Her purpose was to understand the meaning of blindness based on the blind's anxieties, choices of their affective objects, definition of defense mechanisms and the paths for their ego elaboration.

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10. CONCLUSION

As we have seen, several studies carried out for both statistical and clinical validation of the "Drawing-and-Story Procedure" - as well as the derivative "Drawing-of-Family-with-Story Procedure" (also foll. Porto, 1985) - have corroborated the hypothesis that such instruments are suitable for the evaluation of basic anxieties, nodal conflicts and disturbance which are present at some time or another in everyone's life. They are, therefore, of great assistance to the professional, aiming at directly reaching major disturbances, which makes them important assessing tools in terms of evaluation of learning difficulties, their follow-ups and therapies.

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* Published in the British Journal of Projective Psychology, vol. 40, nº 2, Dec. 1995, pp.32-43.
** Full Professor at the University of São Paulo's Institute of Psychology and Member of the Brazilian Society of Psychoanalysis of São Paulo and of the International Psychoanalytical Association.

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