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Published Online:https://doi.org/10.1176/ajp.116.1.16

The effect that our informants' experiences during the past 15 years have had upon their mental health has become a focus of our concern. Their performance upon the projective tests was such that, were they people drawn from an American middle-class background, one would have expected that a great many of them would be very seriously ill, and that some would have to be placed in mental hospitals. On the other hand, on clinical examination their overt symptoms of psychological illness were, in general, of no great severity, not disabling, and not greatly out of keeping with their present situations. Judged by their history of past performance, and by their ability to survive and not break down in situations of extreme adversity–loss of fortune, loss of social status, loss of family members, rape, torture, imprisonment, concentration camps, and prolonged insecurity and frustration–they were people of outstanding adaptive capacity; for a great many other people, in similar situations, died or disintegrated. The body of our evidence suggests that unconscious processes may be notably influenced by intense and prolonged adult experiences. It likewise suggests that the interpretation of performance on projective tests must be carefully evaluated in terms of the cultural and social background, and the recent, as well as remote, life experiences of the person tested.

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