Card Card
Main Theme: Main Theme:
Main hero: Main hero:
a) Age ______________ a) Age ______________
b)sex____________________ b)sex____________________
c) Vocation __________________ c) Vocation __________________
d) Abilities ___________________ d) Abilities ___________________
e) interests______________ e) interests______________
f) traits _________________ f) traits _________________
g) body image ________________ g) body image ________________
h) adequacy level _____________ h) adequacy level _____________
Needs: Needs:
Presses: Presses:
Figures seen as: Figures seen as:
Significant Conflicts: Significant Conflicts:
Nature of anxieties: (✓,✓✓, ✓✓✓) Nature of anxieties: (✓,✓✓, ✓✓✓)
a) physical harm/ punishment________ a) physical harm/ punishment________
b) disapproval__________ b) disapproval__________
c) lack or loss of love _________ c) lack or loss of love _________
d) illness or injury___________ d) illness or injury___________
e) being deserted ___________ e) being deserted ___________
f) deprivation _____________ f) deprivation _____________
g) being overpowered and helpless ________ g) being overpowered and helpless _________
h) lonely _______ h) lonely _______
i) being devoured __________ i) being devoured __________
j) other _________ j) other _________
Main defenses against conflicts and fears: Main defenses against conflicts and fears:
(✓) (✓)
a) repression ________ a) repression ________
b) reaction-formation __________ b) reaction-formation __________
c) splitting __________ d) regression _______ c) splitting __________ d) regression _______
e) denial _________ e) denial _________
f) introjection ________ g) isolation __________ f) introjection ________ g) isolation __________
h) undoing ________ i) rationalization________ h) undoing _______i)rationalization__________
j) other _______________ j) other ______________
Adequacy of superego as manifested by “ Adequacy of superego as manifested by “
punishment ” for “crime” being (✓) punishment ” for “crime” being (✓)
a) appropriate/ inappropriate _________ a) appropriate/ inappropriate _________
b) too severe ___________ b) too severe ___________
c) inconsistent _________ c) inconsistent _________
d) too lenient______________ e)delayed initial d) too lenient______________ e)delayed initial
response of pauses _________ response of pauses _________
f) stammer __________ f) stammer __________
g) other g) other
Integration of the ego, manifesting itself in Integration of the ego, manifesting itself in
(✓,✓✓,✓✓✓) (✓,✓✓,✓✓✓)
a) Hero: adequate/ Inadequate__________ a) Hero: adequate/ Inadequate__________
b) outcome: happy/ unhappy____ realistic/ b) outcome: happy/ unhappy____ realistic/
unrealistic______ unrealistic______
c) drive control c) drive control
d) thought processes as revealed by plot d) thought processes as revealed by plot
being : being :
stereotyped ________original _________ stereotyped ________original _________
appropriate ______ appropriate ______
complete ___________incomplete_________ complete ___________incomplete_________
inappropriate________ inappropriate________
syncretic________ concrete _________ syncretic________ concrete _________
contaminated_________ contaminated_________
Intelligence
Maturation Level
Organic Signs
