A group of 25 male patients with rheumatoid arthritis and a comparable group of 20 patients with low back pain were investigated.
Developmental data and social histories were obtained through clinical interviews. Unconscious fantasies and personality dynamics were estimated by use of the Rorschach Test, TAT, and Draw-a-Person Test. Two clinical psychologists reviewed the interview and projective test data and the principal characteristics of the two groups were identified. The unconscious fantasies of the arthritic group were so unique that three psychologists were able to differentiate with only one error the projective test records of 6 arthritic patients from those of 6 patients with low back pain.
In summary, the following personality description was found to be unique among the arthritic group: He is likely to be an overtly calm individual who rarely expresses or consciously feels anger. However, covertly he seems to be containing a large amount of hostile feelings. Aiding him in his defense against hostile expression is his unique body image. As expressed through his Rorschach fantasies, the arthritic thinks of his body as a kind of hollow container filled with uncontrolled, fluid material and surrounded by a hard, impenetrable surface. Inconsistent parents seem to have supplied the original model for this body image. Father is described by these patients as having been inconsistent in his expression of anger, being ordinarily a calm, easy-going person, but one who burst forth irrationally at times. Mother is remembered as an overtly moralistic and self-sacrificing person, but on the projective tests she is also revealed as having been a prohibiting and seductive figure. The arthritic patient attaches unusual significance to his body and is unconsciously desirous of exhibiting his physique. Overtly he denies his exhibitionistic desires and in fact complains of his shyness and inadequacy.