The Clinical Interaction: With Special Reference to the Rorschach

Sarason argues that the Rorschach cannot be understood in isolation as a psychometric instrument but only in terms of the interpersonal interactions of the clinical situation [citation:2]. The book stems from the belief that 'practically all clinical problems are concerned with data obtained from an interpersonal interaction' and that certain variables are always operative regardless of how interactions differ . This means the crucial part of the clinician's task is not merely deriving scores but ascertaining what goes on between examiner and subject—how the subject formulates the task, and how the clinical interaction determines the results . The Rorschach is treated as a special case of social interaction, subject to the same situational variables that shape any face-to-face encounter.

Sarason's survey found that many traditional interpretive assumptions lacked empirical support. He stressed that clinicians have an obligation to avoid using assumptions that, although stated with frequency and authority in textbooks, have little or no basis in the research literature . One reviewer noted that this critical survey suggested a 'minimal number of statements which may usefully and validly be made about the Rorschach,' and that these were 'much more down to earth and realistic' than the material clinicians were accustomed to . Another reviewer observed that clinical psychologists using the Rorschach had been criticized for ignoring research, and that Sarason's effort would help bring the instrument closer to contemporary empirical psychology [citation:4]. However, reviewers also noted Sarason's pro-Rorschach bias occasionally led him to conclusions others might find unacceptable, particularly regarding Rorschach indices of performance under stress [citation:4].

Sarason emphasizes that the examiner is not a neutral conduit but an active participant whose characteristics shape the data obtained. A reviewer summarizing the book's argument noted that Sarason reports investigations showing that the personality of the examiner, as well as the setting, the social class of the subject, and many other variables, affect the outcome of the test . This recognition of the examiner's influence was part of Sarason's broader insistence that clinical assessment is a social situation, not a controlled measurement procedure. It also explains why he devoted the book's third section to making explicit 'what the clinician thinks and does in the process of interpretation' . The implication is that clinical training must address the examiner's own role in the interaction, not just the instrument's administration.

Reviews were generally positive about the book's critical stance but divided on its scientific status. One reviewer called it 'clear, well written, knowledgeable, critical, and altogether superior to the great majority of books in this field' as a contribution to Rorschach literature . Leonard Goodstein in Psychological Bulletin noted it would help answer criticisms that Rorschach users ignore research and would bring the instrument closer to empirical psychology, while acknowledging Sarason's pro-Rorschach bias [citation:4]. A reviewer in the Journal of Consulting Psychology described it as 'a unique volume and a most stimulating one' that 'leaves its author conflicted—a feeling that will be shared by many readers' [citation:2]. The same reviewer observed that the book was intended as a text for Rorschach instruction but was 'much more than a Rorschach book' [citation:2].

The third part of the book presents six detailed cases designed to illustrate 'the processes of inference by which the psychologist draws his conclusions' [citation:2]. Sarason concentrates on 'what the clinician thinks and does in the process of interpretation, the major assumptions about the dynamics of behavior which seem necessary in such a process, and the deductive nature of the clinician's thinking' . This section makes explicit the inferential chain that usually remains implicit in clinical reports—the assumptions, hunches, and logical steps that connect a protocol to a diagnostic conclusion. A reviewer noted that this case material was 'designed to illustrate the processes of inference' and was a distinctive feature of the volume [citation:2]. The approach anticipates later work on clinical judgment and decision-making, treating the clinician's reasoning as itself an object of study.

The Clinical Interaction is Sarason's earliest major statement of a theme that would define his career: that psychological phenomena are inseparable from the interpersonal and social contexts in which they occur. The book's argument that clinical assessment is a form of social interaction anticipates his later insistence, in The Psychological Sense of Community (1974), that the sense of being part of a supportive network is the foundation of psychological well-being. The examiner-subject relationship is a microcosm of the larger social relationships Sarason would later analyze at the community level. His critique of clinicians who ignore research also anticipates his later critiques of educational reformers who ignore the culture of schools. The book establishes the analytic stance—attentive to context, critical of professional complacency, insistent on empirical grounding—that runs through all his work.