MMHC Swimming Pool and Basketball Courts (Symbol)
In 1973, van der Kolk became the first chief resident in psychopharmacology at the Massachusetts Mental Health Center (MMHC). When pharmacology revolutionized psychiatry, the pharmaceutical industry sponsored laboratories and prestigious hospital departments. In the early 1990s, the swimming pool and indoor basketball court at the MMHC were respectively transformed into a laboratory and clinic (Chapter 2). This symbolizes the disappearance of places where patients could engage in embodied and joyful activities in community settings. Van der Kolk came to see this as harmful.
Projective Tests (Motif)
The Rorschach Test is a projective test where individuals describe what they see in a series of inkblots, and their responses are analyzed to assess personality characteristics and emotional functioning. Although research has since challenged its validity, van der Kolk used the Rorschach Test as part of a study he conducted while working at the VA (Chapter 1). Whereas most people see ordinary and sometimes whimsical images, traumatized individuals tend to superimpose their trauma onto the image. This showed van der Kolk and his colleagues that trauma becomes the lens through which people see the world, affecting their imagination and presence in their lives.
Later in Chapter 7, van der Kolk describes how Dr. Elizabeth Koby and Dr. Nina Fish-Murray expanded on the Thematic Apperception Test (designed by Henry Murray), which asked individuals to interpret cards depicting realistic, ambiguous, and somewhat troubling scenes. Koby and Fish-Murray designed their own set of test cards geared to the population of children they were working with. They used ordinary images of everyday life. Children with histories of abuse responded with "intense feelings of danger, aggression, sexual arousal, and terror" (Chapter 7). Like the veterans that van der Kolk worked with who suffered from PTSD, these children experienced reality filtered through their traumatic experiences.
