An Analysis of Intrusive Morbid Imagery in Rorschach Responses: The Cases of Traumatized First Responders in Korea

First responders are generally a high-risk group, repeatedly exposed to traumatic and distressing scenes and events on their daily duties. Identification of detailed features and recurring patterns of intrusive visual imagery for first responders with posttraumatic stress disorder (PTSD) can uncover the psychological difficulties, defenses, and further adjustment issues of occupational groups exposed to repetitive trauma. To this end, 20 Rorschach protocols for Korean first responders with PTSD symptoms were collected and analyzed. The analysis of the Rorschach records was twofold. First, the structural features of the Rorschach responses, including R and the Trauma Content Index, were examined quantitatively. Second, the detailed features of the morbid content, such as thematic classification, trauma memory responses, and emotional reactions, were qualitatively reviewed. Both analyses identified a biphasic pattern between constricted and flooded responses, showing the participants' unsuccessful endeavors to defend against intrusive trauma-related imagery, which resulted in significant disorganization in thought and affect.