A Method of Personality Diagnosis and Evaluation With Provision for Social Service Propaganda
- Author:
Guy G. Fernald, A.M., M.D.
Massachusetts Reformatory, Concord, U.S.A.
In the comparatively rapid advancement made in recent years in that branch of Social Psychiatry known as the study of the Feeble-minded and its subsidiary, the study of the Defective Delinquent, a most significant development has been the increased attention directed to the observation of the quality of the mentality which we call character in contrast with the degree of mentality which we call intelligence. The various investigators in this field have used each his own laboratory methods and avenues of approach and the nomenclature is by no means uniform: but that the trend of the more progressive investigators is in the direction of a more nearly adequate observation of character traits is shown by their employment of terms which discriminate between “Mentality” on the one hand and “Intelligence” and other mentality components on the other and by the appearance in recent literature of such terms as “Behavior Disorders,” “Conduct Anomalies,” “Personality Studies,” “Personality Ratings,” “Characterial Deviations,” etc.
The mental organisation or system which eventuates in action is quite as significant as an index of personality efficiency as is the mental organisation which eventuates in thought and its expression. A clear recognition of this fact shifts the investigator’s viewpoint to one whence the potentiality of characterial mental factors is seen.
In actual daily usage, as well as in juridical procedure, each personality is held accountable for behavior or action, the product of character essentially; but is not held responsible for thought, the produce of intelligence chiefly, which does not eventuate in action. ‘ ‘A man may think whatever he pleases so long as his actions do not contravene established legal or social forms.”* Any basis of fact then, on which to assess a valuation of personality can not consistently ignore the ascertainable facts to be connoted under characterial deviations or rectitude.
That 110 method has been advanced of directly testing and numerically scoring the quality and quantity of the characterial deviations and rectitude determining behavior need not discourage effort to discover such or to devise other methods of case presentation which serve the various administrative or scientific purposes demanding them. Psychiatrical studies of personality have depended upon scientific observation and description rather than upon numerical scoring for clarity in such presentations quite successfully and have been greatly aided by the various categories devised.
It may be helpful in the present state of our knowledge of this developing speciality of personality evaluation to consider in turn the findings in these three fields of investigation: (1) Mental disease, (2) Intelligence, (3) Character. Few personalities present symptoms of mental disease, but all personalities present observable variations in kinds and degrees of mental activity in both the field of intelligence and in that of character. Moreover efficiency is determined by the kinds and degrees of these activities.
It may be suggested that temperament is a mental organisation influencing conduct and efficiency and it may well be that temperament and the instincts and possibly other mental organisations should be investigated in a given case; but until it is shown that in personality studies these or other organisations should be regarded as separate fields of investigation, they may be given appropriate attention under character without being regarded as major headings.
We submit the following tentative scheme of case groups noting that the list of possible diagnoses is susceptible of expansion and of statistical and crossreference treatment and that any given case, categorized as an entity may still present symptoms or indications tending to modify classification which no complete investigation may ignore. For instance, it is conceivable that an imbecile may be found to present the symptoms of a dementing psychosis or a congenital syphilitic may be an epileptic also, or a sex psychopath may be of adult mentality or a moron or an imbecile.
Character vs. Intelligence in Personality Studies,” by the author. Journal of Abnormal Psychology, Vol. XV., No. 1, April, 1920.
TENTATIVE CLASSIFICATION OF BEHAVIOUR DISORDERS PSYCHOPATHIC LABORATORY MASS. REFORMATORY CONCORD, MASS.
Imbecile Moron Subnormal Behavior Limited < Psychoneuroses Disorders J ? Con’1 Psychopathies ^Aberrations Neuro’l Disorders Endocrenopathies v Entire Habits of Action Characterial Deviations or rectitude GRADES OF EFFICIENCY. DIAGNOSES SuperNormal Normal or adult Subnormal Institutional Psychoses Recoverable Recurrent Ch. without deterioration Ch. with deterioration Traumatic Alcoholic Syphilitic Senile Arteriosclerotic. Brain Tumors Myxedematous, etc. Epilepsies Grand Mai Petit Mai Jacksonian Masked, etc. Intelligence Defects Idiot Imbecile Moron Subnormal Psychoneuroses Hysteria Psychasthenia Neurasthenia Paranoid Personality Con’s’l. Psychopathies Co-ordination Psychopath Sex Psychopath Neurological Disorders Neurosyphilitic Tremors, tics, chorea Endocrenopathies Characterial Deviations*
Specified in case notes and there associated, contrasted and illustrated. Certain observed deviations of frequent occurrence are the following, viz.: Too egocentric, lacks self respect, sex conflict, lacks definite ambition, acquisitiveness uncontrolled, lacks foresight, sordid tastes unchecked, too labile emotionally, too suggestible, misanthropy uncontrolled, too tenacious, unamenable to reason or authority, etc. ad lib.
No form of case presentation is complete which does not recognise the limitations of categorization. Our classification deals with the functional content of mental organisations or complexes and is an aid to analysis. It can not alter the fact that many elements enter into every problem of personality evaluation; but should aid in making all the facts clear without confusing the issues by conducing to an increased breadth of view which discovers factors in the problem not disclosed by a narrower outlook. No categorical scheme can replace a scientific presentation of all the findings; but the former may supplement the latter and aid in the process of preparation thereof.
Cross-reference treatment of such a syllabus as that suggested, introducing three or more grades of mental efficiency would tend to meet the objection that a category can not state all the facts, but does not eliminate the objection; since use of the cross-reference device still leaves us under the necessity of recourse to scientific description for an approach to completeness. This emphasises the observation that any scheme of categorization is only an aid, a means to the end of adequate presentation and is not to be regarded as compassing the end. Its chief value when rightly used is in its capacity to extend the investigator’s vision and as a statistical device. Its place is in summarising and preparing for case and statistical presentation and not in the search for material facts at the time of the examination. Obviously use of the category should not narrow the investigator’s search for facts, only facilitate his collection and presentation thereof. The employment of any scheme which limits or prejudices the search for truth is a misuse. To the extent our outline of a method of evaluating the whole personality conduces to correct evaluation it is of value; but it is valueless to the extent it is an attempt to justify a method.
The importance of ascertaining the intelligence age level is not to be minimised, but the fact remains that in determining intelligence age level the investigator is canvassing only one portion of the area to be investigated in personality evaluation. Factors of personality quite as significant in the determination of efficicncy or inefficiency are to be found in the field of character.
It is in the character of the individual that search is made for the strength of will needed for the overcoming of tendencies to sloth which may defeat success in those of high as well as those of low intelligence age level. The ability to plan a judicious course of self-training for efficiency resides pre-eminently with those of a superior intelligence; but the ability to continue to deny oneself pleasure in order to succeed is less an attribute of intelligence and more one of character; since one may know full well that continued self-denial is necessary and still be unwilling to compass the sacrifice involved. Failure, sociologically and economically is at least as often due to mediocrity of ability to continue to pursue a well selected purpose as to paucity of academic knowledge of the course to pursue. We know a young man of superior intelligence who has spent about five years in prison for repeated thefts. He knows the disaster consequent upon stealing; but he is weak in his ability to resist the temptation to steal, the temptation consisting of his wish.for money to spend with expensive associates. We know two imbeciles incapable of self-determination. The one lives happily on a farm and drives cows, milks, etc., always under supervision, but trusted within limits. The other, of no lower order of intelligence will not work, but will beg. He is a tramp in pleasant weather and does not hesitate to pilfer or falsify to gain his little ends. The actions of the one measure up well with his intelligence rating; while the actions of the other do not correspond with his roughly equal academic knowledge. The one does as well as he knows how to do; but the other does not do as well as he could. The essential differences in the two personalities are in the field of character.
The hope for the sociologic improvement of those of defective mentality and for the raising of the standard of community efficiency lies along the lines of conserving and developing character values where possible, as well as in educating technically. To conserve and upbuild character values in defectives, these values or the want thereof must be recognised early and advantage be taken of the possibilities of habit formation.
Therefore we would point out that the personality investigator who seeks to make a complete presentation should approach his problem in the spirit of the scientist determined to thoroughly know his material. One method is to first determine whether mental disease is to be excluded. If it is excluded then the mental capacities and incapacities of the reactant may be investigated by deter* mining the intelligence age level and by determining the characterial deviations and rectitude. All the facts may then be considered and the reactant’s place be found in some scheme providing for statistical treatment, filing convenience or what not; but no scheme of tabulating or filing for group treatment should be substituted for a full case summary which will present all the essential facts some of which cannot appear in a tabulation or a bare diagnosis.
The following abstract of that portion of a psychopathic note from our files which deals with the characterial reactions related to habitual lying is rewritten only to eliminate the abbreviations and elisions incident to the actual running account of occurrences as they are noted during the interview which in this case lasted more than two hours, in two sessions. The length of this partial quotation, though not unusual precludes the submission of others. This case is selected as it illustrates the method of search for characterial deviation data and also the attempt to constructively aid the reactant, obviously our social service opportunity. Besides the notes the cases on file contain the field investigator’s calendar of information which is very full and informing, and the physical information sheet. On the basis of the latter this reactant was instructed again in sex hygiene, this time on the deleterious effects, intellectual and moral especially, of masturbation, and proved a very appreciative listener. The questions he asked were well chosen and such as to create the suspicion that the information was appropriately given. He was not asked to commit himself, however. Sex hygiene information on the very best way to avoid the contraction of venereal diseases, it should be explained, is given at the time of the physical examination, i.e., on arrival. With selected cases the following points are frequently made, viz.: that solitary sex indulgence must be stopped by one who is to reform himself, that on cessation of indulgence one’s returning self-respect is a great aid in the struggle for self-mastery in other ways, that this is a form of temptation to be met before leaving the reformatory and that one may test himself and his capacity for resisting temptation from day to day, that every man can stop the habit and that one who does not do so, should hardly expect to succeed in other really worthy undertakings. These points were made late in the interview with the reactant whose case abstract is given, viz.:
SPECIMEN ABSTRACT FROM A PSYCHIATRICAL NOTE.
No (Name) 20 (age). Date Ethical Discrimination Test :* .56. (A judgment and observation test, standardised with nine others, this one employing 10 offences as units to be arranged in a series from least to greatest in the order of their gravity from top to bottom. Stimulus given by reactant’s reading it aloud).
Stimulus repeated as a question beginning, “If you arrange these offences, ctc.; where will you place the least offence when you find it ? ” ‘ ‘At the bottom.’’ No. Question repeated. “In the middle.” Manner almost insolent. Attitude toward test rebellious. “Why do you give that answer ? … Such an unexpected answer as that has sonic reason back of it. What is it?” “It is foolish. Why do you ask me such foolish questions?” Is told tliat so far from being foolish it serves its purpose well and its value has been favourably reported upon by experts, that it helps to show how one’s mind works, whether ill or well, that to find whether a man can control himself or not we must know how his mind works, that the Parole Board can not tell whether a man is worthy of parole or not till they know something about the kind of a mind he has. Is then asked whether the test or his reply to my question is foolish. He sulkily replies, “The test” and pushes the apparatus away. Asked again the reason in his mind when he replied that the least offence should go in the middle, he hesitates, then says, “The Parole Board hasn’t got anything on me but smoking in the morning” (out of hours). Is told that that docs not answer my question and he hazards, “Then they want to know about an abscess I had in my ear when I was 1.3 or 14years old.” Is told sharply that docs not answer the question put, that no evasion will be acceptcd, that his manner is offensive, almost insolent, that if he allows himself to be insolent the interview will be terminated and the report made on that basis. He smiled in some embarrassment and thenceforward his manner was inoffensive and he exerted his best effort to meet the requirements. Requested to arrange the offences as directed he set about doing so with the above indicated score. Asked why he replied that the least offence should be placed in the middle, he replied, “I didn’t stop to think.” He again attempted to justify or exculpate when asked whether his life had been more one of failure or success; but finally admitted to his discredit.
‘ ‘Are you a sane man and responsible for all you do and say or not ? ” “I am sane.” “Did you ever tell a lie ?” … “Yes.” “Now look back into your life of the past few years and see whether or not you find you have gradually got into the habit of giving the answer j^ou thought you could get by on whether true or not.” …”Yes, I have.” “Those are disagreeable questions to ariswer. You have stopped trying to impose on me and have made yourself stop and think before answering and you have met the disagreeable issues presented. What is the reason I put these disagreeable questions and raise these unpleasant issues and stimulate you to answer truthfully ?” ‘ ‘Because you have a good reason to.” ‘ ‘What good reason would I have ? ” … “You want to help me ?Monograph review by Prof. L. Jacobsohn-Lask, “Uber die Fernald’ehe Methode zur Prufung des Sittlichen Fuhlens und iiber ihre weiters Ausgestaltung.” Beihefte zur Zeitschrift fur angewandte Psychologie Herausgegeben von William Stern und Otto Lipmann. 24. Leipzig, 1920. Verlag von Johann Ambrosius Barth, Dorrienstr. 16.
Also “The Defective Delinquent Class: Differentiating Tests,” by the author. Am. Journ. Insanity, Vol. XLVIII., No. 4, April, 1912. Second Edition, 1917. ‘A0Nai3i^aMi ivxmhk ni saianxs 31 along … and to make a better man of myself.” It is explained that while I might wish him to be always at his best, no one but himself could really do that, that my reason for asking the disagreeable questions and stimulating him to answer truthfully was to discover especially to him a certain weakness in his character, i.e., that of being willing to let a wrong impression obtain when it seemed to him expedient. He reluctantly admitted the weakness- In making this point, however, the expression was used as an illustration?”The bluffing of parents or teachers or a policemen” He at once volunteered “I never lied before I came here,” then recalling his admission above, apparently, “I never lied to a policeman.” Asked if his statements are not good illustrations of the point just made and do not show clearly how thoroughly fixed his habit is of conveying a wrong impression when tempted, he smiled sheepishly and averted his eyes.
“Has your self management experiment, since you broke away from home and school restraint and training been good or bad? … Now there is another disagreeable issue to face.” “It has been good.” “You ought not to “fall down on” that after the lesson I’ve given you on the wisdom of telling the truth.” … “It’s been bad, I guess … I’ve done nothing worse than smoking in the morning here.’’ Epilepsy eliminated, also insanity. No evidence of neurological disorder nor of psychoneurosis. The tests for intelligence age level are given at this point. The age level by the Terman tests falls at 10-2 years. Blood Wassermann is negative.
‘ ‘3/8 plus 5/16 ? ” ‘ ‘8/24.” “17ft. 8in. equal how many inches ?’’ Asks if he shall multiply by 12. Makes a mistake in multiplying and is shown that his incorrect answer is due to that error. Had studied “Interest” in school. Headaches denied. “Only sick headaches when young … too much sweet stuff.” Did your parents favour your eating as much sweet stuff as you did, or did they advise your eating less ? “They didn’t say nothing.” “Sothey let you eat all you wanted to ? ” ‘ ‘No, they told me not to.” ‘ ‘Your answers are not very consistent. Why didn’t you do as they told you ? ” ‘ ‘Too young 7 or 8.” “Then you weren’t taught to mind and were disobedient and are now paying the price.’’
‘ ‘Look back over your actions and see what they show you wanted most in life. The merchant wants success in his business and his actions show it. The teacher wants to do his best as a teacher as shown by his actions. He works hard for small pay. A brick-layer working on his own house works hard and long and does thorough work; but the hired brick-layer might work slowly or carelessly; if he were a timeserver. Now, what do your actions show you wanted most in life ? ” ‘ ‘Success.” ‘ ‘But you haven’t succeeded … why not ?” “I was all right till I got in with the crowd.” “Don’t try to shift the responsibility. You lived your own life. That doesn’t answer my question.” …. ‘ ‘Because I didn’t get enough school in the first place.” ‘ ‘Are you sure you wanted to succeed most of anything ? ” “Yes.” ‘ ‘What kind of success did you have in mind ? ” ‘ ‘In a factory?(rubber)?rising, to be foreman.” ‘ ‘But you are not a foreman. Why not?” … Question repeated. … Is still sure he worked for success. Admits he did not study evenings and that he left after a year and a half without notice to take a vacation in summer and that on his return he was told another had his place. ‘ ‘Do not your actions show that you really wanted a good time more than you wanted success ?’’ “Yes.’’ (With conviction, apparently). “I’ve been reformed since I’ve been here.” “Oh, no! You are not yet reformed, … not in this short time. You need to change yourself over in your habits of thinking and acting, to really make a man of yourself. It is a long, hard job to restrain oneself, knock off all the old habits and become a real hustler. You have all that to do for yourself, now that you have cut loose from home and school and have been idle and disorderly so long. Instead of being reformed you are only sorry you are here. Now if you were going to really undertake a job like that how would you go about it ? Your being sorry you are here is only the first step. That is good as far as it goes.” “And sorry for what I’ve done.” ‘ ‘That is one of the best things you ‘ve said yet. I’ve no doubt you are.
Now when one is sorry what is the next step toward better acting and living?” “Have a good ambition.” “Yes, that is good too, or have good intentions. The ambitions come a little later. Is anyone reformed who has good intentions ?’’ ‘ ‘No, the task is to be done.” “I suppose everyone in this reformatory is sorry and intends to do better when he is at his best … and don’t you think so ?” ‘ ‘I don’t know. Some are not, I guess.” ‘ ‘Oh, I think when they are alone and think it all over, when they are at their best, they intend to do better; but they forget their good intentions. You are now at your best, trying your best to think and understand and plan. At the first of the talk you were not at your best. You didn’t try to do the best you could.” At one point he volunteerd he must plan to stop stealing as well as lying.
‘’Now what next… after good intentions, for the man who really wants to reform himself ? ” ‘ ‘Go ahead and do it.” “No not yet. Suppose I have the good intention to build a house. What next ? ” ‘ ‘Do it.” ‘ ‘No, not without a plan, would I ? ” ‘ ‘No.” ‘ ‘Well, then the man who is to reform himself, make himself over in habits and manner of work and study must plan carefully and well or he will fail.” Here follow directions for writing out his plan for at least five years of work by day and study in classes in the evenings, involving the learning of a trade and the judicious use of time and money, the rewriting of the plan many times, scores of times with the view that he will plan for success without counting the sacrifice. The point is made that he can’t reform in the reformatory, the time is too short (he hopes for release in less than five years, his sentence) and we can’t bring the temptations he will meet outside in here for him to practise with. He must wait till he goes out to meet them there. This is a very good place in which to prepare for the reformation which lie is to try outside, as the High School is a good place in which to prepare for the college course. His plan is part of his preparation. A good one will be the best protection against yielding to temptation when he goes out that he can provide himself.
‘ ‘After the plan is so nearly done that you begin to feel some pride in it and begin to see that if you live up to it, your life will be a worthy one; what next, if you are really to reform yourself ? ” ‘ ‘Do it, right off, before I could forget it.” (earnestly.) “No, you overlook a short but very important step. Before I build my house, after the plans and specifications are all ready, what must I do before building ? ” “I don’t know of anything else.” ‘ ‘Why, I must decide whether I can pay the costs, mustn’t I? And I must determine I will pay them. I must decide to draw my money from the bank and must determine I will have the house; even though it costs so much.” ‘ ‘Yes.” ‘ ‘Well, I’ve told you something about how much it will cost you to reform yourself at this late day. You are almost at the end of the formative period of life. No one learns a trade or reforms after 25. Habits are fixed by that time.
Now your work is outlined and you know something of the difficulties ahead of you; but you also know something about how to go to work on your own rebuilding. No matter how hard you work on your plan you will be no more than ready to leave this place when the time comes. You can’t be too well prepared for the five years struggle that is to begin when you leave. Better not really take the fourth step, the deciding and determining one, till the day you leave this place.’’ He is given a brochure on ‘ ‘Reformation as an Undertaking’’ and another on “Reformation and Masturbation.”
With a handgrasp and a spontaneous, if somewhat mumbled word of appreciation and thanks, he departs, glancing back furtively, with an expression we obviously could not interpret; but doubtless an expression of his mixed feelings. It is frequently suggested to reactants whose educational advantages have been improved by them that they write out for themselves i.e., not to be vised, their notes on what they regard as the good points brought out in the interview as a basis for their effort to commit their plan to writing.
Too much space would be required to present our search in other directions for characterial data in this case; but his slothfulness, self indulgence, the poverty and perverseness of his filial reactions, failure to use his will power, and to exert a correct influence on others, his unchecked yielding to selfish impulses, his ignoring the rights of others and his too great tenacity of his own opinions were all admitted by him. He was credited with sufficient will power, if it were only rightly directed, and with feeling keenly his disgrace and with the intent to achieve success and he was taught how to utilize these and other good qualities in his strife for success.
Following is a copy of an abstract of his case from our case files, viz.:
MASSACHUSETTS REFORMATORY PSYCHOPATHIC LABORATORY Case Abstract Summary No 19 (age) Date Intelligence Age Level: 10-2 years I.Q. .65 Category: Middle Grade Moron
Characterial Deviations: These are wide. He cast loose from home and school restraints too early and has been a pleasure seeker since, often in vicious surroundings. Falsifies easily and habitually. Has been damaged especially in self respect by vicious sex indulgence. Is too easily grouchy and offensive. Unpractised in self control.
Sociologic Maladjustment: Thief and unreliable. Physical Health: Free from disease, well nourished. Sexual excesses have damaged him somewhat.
Laboratory Classification: Characterial Deviate. Mental Disease: None.
The card for the index file contains in addition to identification data, notation of the intelligence age level and I. Q., and the symptoms; if a neuropathic, neurosyphilitic or psychiatric case, or one of the like kind presents, the characterial deviations, the laboratory classification and a private code sign indicating the grade of efficiency. Findings of social maladjustment, sanity, physical handicaps and our recommendations are not included in the card index. They are included in abstracts, however, as these are of administrative importance and of special interest to the Board of Parole,
The plan of laboratory procedure outlined and partly illustrated which serves fairly well the scientific and practical needs of our clientele would almost certainly require adaptation on transplantation. Any procedure, however, which proves on use to be other than scientifically exacting, inclusive and constructive, will also be found to be inadequate.
In conclusion, success in personality diagnosis and evaluation is less a matter of method than of manner. The method must be adapted to the personnel in any event. Binet tests are adapted to childhood ages; but not to the adult minded. Given a good working method then, whenever it is applied scientifically and the investigation adequately covers the whole area presented by mentality, a step forward will have been taken toward the further development and standardization of this advancing psychiatrical and sociologic speciality.
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