Rorschach Method (Paris School) in Primiparous Women During Pregnancy and the Postpartum PeriodAbstract
This study describes and compares psychodynamic indicators among women during pregnancy and the postpartum period. Fifteen pregnant women (mean age 29 ± 2.6 years) with singleton, spontaneous pregnancies, favorable educational and socioeconomic conditions, and a stable relationship with the child’s father were individually assessed using a sociodemographic and clinical questionnaire and the Rorschach Method (Paris School) during the third trimester and the postpartum period. Nonparametric analyses compared logical functioning and affective experiences. The results revealed emotional and identity-related changes, including a high number of responses, increased use of blank spaces, elevated Anxiety Formula (FA), and frequent anatomy, blood, and sex responses at both assessment points. These indicators suggest self-preservation during pregnancy and mourning over the end of the symbiotic bond in the postpartum period. The findings highlight the value of psychological assessment using the Rorschach Method during pregnancy and the postpartum period.
Keywords:
psychological assessment; pregnancy; postpartum period
Resumo
Este trabalho procura descrever e comparar indicadores psicodinâmicos de mulheres na gravidez e no puerpério. A amostra envolveu 15 gestantes com idade média de 29(±2,6) anos, com gestação única e espontânea, bom nível educacional-econômico, vínculo estável com o pai da criança, que foram individualmente avaliadas por meio de Questionário Sociodemográfico e Clínico e Método de Rorschach (Escola de Paris) no terceiro trimestre de gestação e no pós-parto (puerpério). Análises estatísticas não paramétricas compararam variáveis do funcionamento lógico e vivências afetivas. Os achados evidenciaram particularidades emocionais e identitárias nas mulheres incluindo elevado número de respostas, redução de globais, maior uso do branco, elevada fórmula da angústia (FA), maior frequência de anatomia, sangue e sexo nos dois momentos avaliativos. Os indicadores apontam para autopreservação na gravidez e luto pelo fim da ligação simbiótica com o bebê no pós-parto. Os resultados confirmam a riqueza da avaliação psicológica pelo Método de Rorschach na gravidez e pós-parto.
Palavras-chave:
avaliação psicológica; gravidez; período pós-parto
Resumen
Este estudio analiza indicadores psicodinámicos en mujeres durante el embarazo y el puerperio. Se evaluaron 15 gestantes (edad promedio 29 ±2,6 años) con gestación única y espontánea, buen nivel socioeconómico y vínculo estable con el padre. Mediante un Cuestionario Sociodemográfico y clínico y el Método de Rorschach (Escuela de París), se compararon variables del funcionamiento lógico y experiencias afectivas en el tercer trimestre y el posparto, utilizando análisis no paramétricos. Los resultados revelaron cambios emocionales e identitarios, como alto número de respuestas, mayor uso del blanco, elevada Formula de la Angustia (FA) y frecuentes referências a anatomía, sangre y sexo. Los indicadores sugieren autopreservación en el embarazo y duelo por el fin del vínculo simbiótico con el bebé en el posparto, destacando la riqueza del Rorschach en la evaluación psicológica durante el embarazo y el puerperio.
Palabras clave:
evaluación psicológica; embarazo; postparto
Pregnancy is a period of significant, multidimensional changes in a woman’s life, involving biological, psychological, and social transformations that reconfigure female subjectivity (Raphael-Leff, 2017). More than a biological event, it constitutes a stage of physical and psychological preparation for parenthood (Chauhan & Potdar, 2022; Coutinho et al., 2014), profoundly affecting a woman’s emotional and psychological experience. In this context, the baby’s development is inseparable from the intersubjective environment, permeated by maternal fantasies, anxieties, and aspirations (Raphael-Leff, 2017). These processes involve identity and relational restructuring that, by encompassing sexuality and social roles, trigger ambivalence and mood swings typical of the period (Bjelica et al., 2018; Catalá et al., 2025; Cisneros Hilario et al., 2022). Such changes can become long-lasting, reshaping a mother’s sense of self and patterns of action (Belot et al., 2021; Pointurier et al., 2023).
With the onset of the postpartum period, the need for adaptation intensifies as the mother faces the newborn’s complete dependence, requiring maternal flexibility to build a bond that, although initially undefined, is emotionally intense (Coutinho et al., 2014; Sarmento & Setúbal, 2003). From a psychoanalytic perspective, this connection is made possible by “primary maternal preoccupation” (Ogden, 2024; Winnicott, 2000), a state of heightened sensitivity that facilitates conscious and unconscious identification with the baby’s needs (Belot et al., 2021; Winnicott, 2000). Paradoxically, this state is frequently removed from conscious memory by the mechanism of repression (Winnicott, 2000; Xie et al., 2023), a psychic process that regulates affects and organizes object relations by removing anxiety-provoking content (Riefolo, 2025).
In this context, the literature also describes baby blues, or postpartum blues, as a transient depressive state characterized by emotional hyperreactivity between the third and tenth days postpartum (Campos & Féres-Carneiro, 2021; Sarmento & Setúbal, 2003). Given the evidence of a direct association between mental health indicators and attachment quality (McNamara et al., 2019), the present study investigated these elements through psychological assessment at the end of pregnancy-a phase in which feelings about the imminent birth predominate (Ekelöf et al., 2025)-and during the postpartum period, employing projective methods to access the nuances of this subjective experience.
Psychological assessment using projective methods during pregnancy and postpartum
Components of human identity and psychodynamics can be examined through a systematic process of psychological assessment, particularly when it involves projective methods that provide insight into the way individuals think and act (Meneses & Amparo, 2025). These instruments are characterized by the presentation of relatively unstructured stimuli, which require the participant to produce interpretive and personal responses based on their own perceptions and lived experiences.
Considering pregnancy as a period that brings experiences to the surface and involves a regressive movement through which a woman identifies with the baby, the informative value of projective psychological assessment methods can be highlighted, as these methods provide access to representations, elaborations, and personal defenses during this time (Minjollet & Valente, 2015). In this context, the Rorschach Method stands out because its stimuli favor the emergence of content related to body image, self-representation, and perceptions of early object relations, understood as the initial bonds established with significant figures, which are fundamental to the constitution of psychic life and highly mobilized during pregnancy and the postpartum period (Belot et al., 2021). In this sense, projective methods can contribute to a dynamic understanding of personality during transitional moments and experiences of motherhood (Palaux & Cognet-Kayem, 2023), enabling a nuanced understanding of the mechanisms involved in the process of meaning-making brought about by the birth of a baby.
In a literature review on the use of projective methods during the perinatal period, Minjollet and Valente (2015) highlighted key findings from 28 examined articles. The women showed a borderline psychic organization, understood as a mode of functioning marked by emotional instability, fragility in identity integration, and difficulty in object relations (Fisher-Kern et al., 2010), as well as difficulties in dealing with internal conflicts during pregnancy. Bodily fragility also emerged as a relevant aspect of women’s experience, with observed attempts to reinforce bodily boundaries and efforts to cope with feelings of strangeness in relation to their own bodies. Furthermore, anxiety was a persistent feeling during the perinatal period, especially toward the end of pregnancy (Minjollet & Valente, 2015).
Several important components of mental functioning during pregnancy, understood as the set of psychic processes through which an individual perceives, elaborates, and responds to internal and external experiences, were documented through the analysis of the Rorschach Method in Bellion’s (2001) study. Signs of thought inhibition were identified, as evidenced by protocols with a reduced number of responses, suggesting restricted associative production. Despite the presence of impulsive content, low affective expression and limited elaboration or diversity in representations were observed.
The overall results of this study indicated the organization of rigid thinking, as observed in the Rorschach Method by the increased frequency of responses with formal determinants: F% (percentage of responses based exclusively on form, indicating cognitive control), F+% (percentage of formally adjusted responses, associated with perceptual accuracy), and F+ext% (percentage of responses with extended positive formal quality, related to the overall level of perceptual adaptation). These findings suggest that, during pregnancy, there may be attempts to rationally organize experiences through thought processes, to the detriment of affective and imaginative expression.
Another component identified in the scientific literature on psychic experiences during pregnancy and the postpartum period (Bellion, 2001; Belot et al., 2021; Clesse et al., 2023) is a marked investment in the boundary between the internal and external worlds. This is evidenced by responses that refer to elements such as clothing, shells, costumes, and masks, suggesting a concern with psychic protection and the maintenance of boundaries. In addition, responses in the Rorschach Method indicate a feeling of estrangement from one’s own body, which is often represented through postural discomfort or as something attacked or destroyed, permeated by content related to decomposition and fragmentation in some stimuli of this projective psychological assessment method.
To examine psychological movements associated with motherhood and adaptation to the many demands of the postpartum period, Belot (2014) used the Rorschach Method (Paris School) to assess 26 French primiparous women with babies aged zero to six months. The Paris School is a psychoanalytically inspired branch of the Rorschach Method, developed in several countries, that enables the investigation of subjective processes involved in the experience of pregnancy. The women assessed showed results that diverged from the instrument’s normative patterns in the following indicators: a decrease in responses (possibility of affective inhibition); an increase in F+% (percentage of responses with good form quality = quality in the perception of reality); a decrease in D% (percentage of responses located in large details of the stimuli = sign of less attention to the immediate and practical components of reality); an increase in Dbl% (percentage of responses located in the white part of the card = related to sensitivity to emptiness, linked to insufficiently elaborated initial phases of maternal development); a decrease in A% (percentage of animal-content responses = decreased socialization, linked to primary maternal preoccupation); a decrease in kan, kp, and kob (minor kinesthesia = lower intensity of psychic work and imagination); and a decrease in determinants associated with E (responses with shading effects = sensitivity and psychic distress). The results revealed singularities in the Rorschach protocols of primiparous mothers, suggesting intense psychic mobilization accompanied by regressive movements and difficulty in processing postpartum experiences (Belot, 2014).
To expand empirical findings on these experiences, Belot et al. (2021) evaluated 30 women in the postpartum period, 18 of whom were primiparous mothers. The Rorschach Method (Paris School) was used, and the data were compared with normative parameters for the French population. Signs of difficulty in processing emotional experiences were evident, accompanied by regressive tendencies, understood as movements of return to more primitive or less adaptive modes of functioning in the face of internal or external demands. This was indicated by a decrease in the number of interpretations in the Rorschach Method, with a reduction in minor kinesthesia responses and an increase in the use of the white area of the cards (elevation of Dbl%). Indicators of decreased socialization and regressive tendencies, without necessarily indicating psychic disorganization, also reappeared, as shown by an increase in chromatic responses and a decrease in A% and D%. The increase in expressed levels of distress may be related to the higher incidence of anatomical content, replicating results from other studies (Belot et al., 2021).
The internal experiences of women facing pregnancy for the first time, compared with mothers who already had children, were examined and discussed by Clesse et al. (2023). The authors described indicators from the Rorschach Method in 54 first-time pregnant French women, highlighting their particularities in relation to what would be expected in the normative population and interpreting them as representations elicited by the transition to motherhood. Signs of social inhibition and associative difficulties were identified, with increased latency time. The presence of a coarctative Intimate Resonance Type (TRI) was also observed, characterized by restricted affective expression and a predominance of more controlled and formal responses, indicating a tendency toward emotional containment and superficiality (G%), understood as the avoidance of mobilizing psychic content. In addition, first-time pregnant women showed difficulty engaging in the projective situation (Dd% and Dbl%), which may reflect limitations in psychic availability to access more regressive or emotionally significant internal content. These findings were analyzed in relation to the investigated axes: the logical-rational axis, related to cognitive control and the organization of thought; the narcissistic axis, associated with the preservation of self-cohesion; and the axis of sensitivity to emptiness, which concerns the capacity to come into contact with experiences of lack, absence, and psychic helplessness (Clesse et al., 2023). Finally, the authors argue that further research on the psychological experiences of pregnancy and the postpartum period is necessary, given their impact on maternal and infant health and on the quality of future interpersonal bonds. This type of research could help identify relevant variables to support the healthy development of the mother-child dyad, with substantial potential for practical application in maternal and child care policies.
Against this background, this study seeks to describe and compare psychodynamic indicators in women during pregnancy and the postpartum period. The Rorschach Method (Paris School) was used to examine variables related to logical and rational functioning (F%, F+%, and F+ext%), the narcissistic axis (response content, assessing the predominance of animal or human content, as well as anatomical and sexual content), and sensitivity to emptiness (Dbl%), comparing findings obtained at two assessment points: the end of pregnancy and the postpartum period.
Method
Participants
This study included 15 primiparous and primigravid women aged 25 to 45 years, with singleton, spontaneous pregnancies (without the aid of medication or procedures), and who were in a stable relationship with the child’s father. Pregnant women with a previous psychiatric diagnosis, a history of depression, self-reported gestational conditions during the initial interview (such as gestational diabetes, eclampsia, or preeclampsia), obesity [Body Mass Index (BMI) > 30], or same-sex parenting arrangements were excluded from the study. The participants lived in the interior of the state of São Paulo, Brazil, and had a mean age of 29 (±2.6) years. They had favorable socioeconomic conditions (higher levels according to the Brazilian Economic Classification Criteria) and a high level of education: ten had completed higher education, and the others had completed high school.
The volunteers were evaluated at two time points: during the third trimester of pregnancy, from the 26th week of gestation onward, and after the baby’s birth, when the infants were two to three months old. The first evaluation occurred, on average, at the 30th week of gestation (30.5±3.3 weeks), corresponding to the last trimester. The second data collection point, or re-evaluation, was conducted during the postpartum period, when the babies had a mean age of 2.3±0.4 months.
Regarding childbirth experiences and infant health, nine of the 15 women underwent cesarean section, two of whom had mild complications: high blood pressure and intrauterine growth restriction. The remaining women delivered vaginally (n = 6), and two had postpartum complications: lacerations and hemorrhage. All babies were born at term and had no health complications requiring hospitalization or intervention.
Instruments
Sociodemographic and clinical questionnaire: adapted from the model developed by Pedreira and Leal (2015), focusing on mental representations of attachment in pregnant women. Items for socioeconomic classification were included and measured using the Brazilian Economic Classification Criteria (Brazilian Association of Research Companies [ABEP], 2021).
Rorschach Method (Paris School): a projective method aimed at exploring the organization of mental functioning through responses to ambiguous cards, addressing aspects such as perception, associative activity, interpersonal interactions, and affective experiences. The theoretical framework used was the Paris School assessment system, which is based on psychoanalytic and psychodynamic principles (Chabert et al., 2020; Pasian, 2000; Rausch de Traubenberg, 1998). In the present study, protocol analysis sought to encompass psychodynamic dimensions particularly mobilized in the context of primiparity, operationalized through classic Rorschach indicators from the Paris School. The axis of narcissism and self-image refers to modes of investment in one’s own body and self-representation, which are especially relevant in view of the intense bodily transformations of pregnancy. The indicators considered included double responses (two people, two animals), mirrored responses, human content (H), and global apprehensions, which may reflect processes of identification, body image integration, and self-cohesion. The dimension of boundaries and identity concerns self-other differentiation and the integrity of psychic boundaries, which are frequently strained during the pregnancy-postpartum period. To this end, protocol coherence was analyzed, understood as the maintenance of internal logic in the responses (clarity, associative continuity, and absence of marked contradictions), as well as the quality of the relationships between figures, considering whether the characters are perceived in an integrated, differentiated way and in plausible interactions or, conversely, in a fragmented, confused, or undifferentiated manner. In addition, banal responses (Ban) were considered expressions of defensive organization and identity stability. The management of impulses and affectivity was investigated through responses involving color, shading, and affective formulas, as well as lifestyle (extratensive/introversive), allowing for the understanding of modes of emotional regulation, tolerance of internal excitations, and the capacity to symbolize affects, central aspects in a period marked by emotional intensification. Finally, the axis of object relations was explored based on the presence of human content (H and H%), relational themes, and the quality of interactions between characters in the responses, making it possible to access internalized representations of attachment, relational expectations, and modes of investment in the other, which are particularly relevant in the transition to motherhood. The choice of these axes is justified by their sensitivity in capturing transformations in identity processes, psychic boundaries, affective economy, and bonds-dimensions widely mobilized in the pregnancy-postpartum cycle.
Procedures
Data collection. This is an empirical, mixed-methods study, with quantitative and qualitative approaches, a descriptive-interpretive design, and a longitudinal comparison of data from a single group (Creswell & Creswell, 2021). This methodological strategy aims to encompass the analysis of the phenomenon under study, namely psychodynamic aspects during pregnancy and the postpartum period, which is complex and permeated by multiple factors.
This study was submitted to and approved by the Research Ethics Committee (CAAE No. 46099921.7.0000.5407) of the institution with which the first author is affiliated, following the guidelines of Resolution No. 466/2012, which addresses research involving human participants. The sample was recruited by convenience, using the “snowball” strategy to identify participants (Parker et al., 2019). The pregnant women who participated in the study referred other potential participants until the desired number of 15 to 20 volunteers was reached across the two assessment stages.
The volunteers were examined at two time points: during the third trimester of pregnancy and two to three months after the baby’s birth, with the same technical steps replicated in both assessments. The timing of the first assessment was chosen because of the predominance of feelings toward the baby that pregnant women tend to experience as birth approaches (Ekelöf et al., 2025). The second time point took into account the minimum period needed for the woman to organize her daily routine during the postpartum period.
Data collection was conducted in person and individually, in a protected environment with minimal external interference. It began with a sociodemographic and clinical questionnaire, administered as an interview, followed by the Rorschach Method, according to the guidelines of the Paris School (Chabert et al., 2020; Pasian, 2000; Rausch de Traubenberg, 1998). Data collection primarily took place in a private room in the participant’s own home. The average data collection time ranged from 90 to 120 minutes, respecting the participants’ associative pace.
Data analysis. The data were initially systematized descriptively by identifying frequencies in the evaluative categories of the Rorschach Method according to the Paris School (Chabert et al., 2020; Rausch de Traubenberg, 1998). Two psychologists with professional experience using the instrument independently coded each protocol, and consistency between their classifications was examined. In cases of disagreement, the responses were analyzed by a third experienced examiner, leading to the final coding of the responses. The agreement index between independent evaluators across the set of classifications, expressed by Kappa (Fonseca et al., 2007), exceeded 0.80, which is considered a positive indicator of reliability in the analysis of the volunteers’ Rorschach productions.
After this stage, the data were systematized and tabulated in Microsoft Excel for subsequent statistical analysis, comparing the Rorschach findings at the two assessment points. For the numerical variables of this projective method, the Wilcoxon signed-rank test for paired samples was used, considering the small sample size and the dependent nature of the measurements, pre- and postpartum, which makes this procedure appropriate for comparing the two time points. It is important to note that the results should be interpreted with caution, considering the lower statistical power of nonparametric analyses and the risk of not detecting potential differences between the assessment points. In the analysis of the Experience formulas, Type of Intimate Resonance = TRI, Secondary Experience Balance or Latent Tendencies = TL, and Chromatic Reactivity = RC, findings from pregnancy and postpartum, expressed as case frequencies, were compared using the chi-square test. Statistical analyses were conducted using JASP, version 0.16.4 (JASP Team, 2022), with a significance level of 5% (p < .05).
Results
Given that the main objective of this study was to describe and compare psychodynamic characteristics of primiparous women during pregnancy and the postpartum period, assessed using the Rorschach Method (Paris School), the empirical findings focus on the variables of this projective psychological assessment method. The comparison of the main variables in the Rorschach Method psychogram between the two assessment points is presented in Table 1. The analyses of these variables followed the guidelines described in the section on the Rorschach Method. In summary, they involve: (a) the axis of narcissism and self-image: double responses (two people, two animals), mirrored responses, human content (H), and G%; (b) the dimension of boundaries and identity: protocol coherence, quality of relationships between figures, and Ban%; (c) impulse and affective management: color responses, shading, experience formulas, and lifestyle (extratensive/introversive/ambitendent); and d) the axis of object relations: human content (H and H%).
In terms of Rorschach productivity, the results indicate that the mean number of responses was high at both assessment points compared with the norm (pregnancy = 17.5 ± 5.9 responses; postpartum = 20.1 ± 6.4 responses; norm = 12 to 15 responses). There was a decrease in additional responses (RA) in the postpartum period (pregnancy = 0.6 ± 0.6 responses; postpartum = 0.2 ± 0.6 responses; z = 1.8; p = .04).
A reduction in global responses (G%) was also observed (pregnancy = 39.3 ± 22.3%; postpartum= 34.0 ± 22.0%; z = 1.9; p = .03) with values below the norm at both assessment points. A higher incidence of responses focused on small details (Dd) was noted during pregnancy compared with the norm (Dd = 20.9%; norm = 11-18%). There was also a higher frequency of blank-space responses (Dbl%) during both pregnancy and the postpartum period compared with the normative standard (Dbl during pregnancy = 1.6; Dbl during the postpartum period = 1.9; norm = 0).
Regarding logical functioning, the Rorschach variables F% (rational investment), F+% (quality of logical analyses), and F+ext% (overall accuracy of interpretations of reality) showed values close to those expected according to the normative standard during pregnancy and the postpartum period. Despite the large individual variability in these variables, the current empirical findings point to adequate rational functioning among the women assessed, with no relevant alterations during pregnancy or the postpartum period.
Another indicator to be highlighted is the Rorschach Anxiety Formula (Paris School), which was above average both during pregnancy and in the postpartum period. The Anxiety Formula (FA) was calculated as the sum of contents associated with specific bodily and affective experiences-Hd (human details), (Hd) (unreal human details), Anat (anatomical content), Elem (fire), Sg (blood), and Sex (sexual content)-divided by the total number of responses. In the literature on the method, these contents are traditionally associated with concerns about the body, integrity, and drive-related excitation, so that higher FA values are interpreted as indicative of greater intensity of anxiety or psychic tension. This result reinforces the findings of higher anxiety in both periods (FA during pregnancy = 25.5%; FA during the postpartum period = 20.7%; norm < 15%). It is worth noting that animal-content responses (A%) decreased in the postpartum period compared with pregnancy and with the expected norm (A% during pregnancy = 48.3%; A% during the postpartum period = 45.1%; norm = 49-57%).
Next, we sought to systematically analyze response content in detail, as a relevant indicator of the participants’ identity characteristics. Table 2 presents these findings from the Rorschach Method (Paris School).
The results show that responses with object content (Obj) increased in the postpartum period compared with pregnancy (pregnancy = 1.2; postpartum = 2.3; z = -2.4; p = .01). During pregnancy, there was a higher incidence of content related to animals (A; pregnancy = 7.0; norm = 6.1), anatomy (Anat; pregnancy = 2.3; norm = 1.1), blood (Sg; pregnancy = 0.1; norm = 0.04), sex (Sex; pregnancy = 0.8; norm=0.3), and abstraction (Abst; pregnancy = 0.7; norm = 0.1) compared with the normative reference for adults. Conversely, during pregnancy, there was a lower occurrence of content referring to animal detail (Ad; pregnancy = 0.9; norm = 1.3), botany (Bot; pregnancy = 0.5; norm = 0.7), and fragments (Frag; pregnancy = 0.1; norm = 0.5) compared with the expected norm.
In the postpartum period, responses related to objects (Obj; postpartum = 2.3; norm = 1.2), animals (A; postpartum = 7.1; norm = 6.1), anatomy (Anat; postpartum = 2.7; norm = 1.1), blood (Sg; postpartum = 0.1; norm = 0.04), sex (Sex; postpartum = 0.6; norm = 0.3), and geography (Geo; postpartum = 0.7; norm = 0.3) were more frequent. It is worth noting that responses related to human body parts were less frequent in the postpartum period (Hd; postpartum = 0.8; norm = 1.3), showing a decrease compared with the norm and the pregnancy phase. The remaining variables showed a distribution very close to normative expectations, without significant interpretive relevance.
Finally, we sought to systematize the participants’ production in terms of their emotional experiences, as represented in the Rorschach Experience Formulas. Table 3 illustrates the distribution of cases according to the Type of Intimate Resonance (TRI), Secondary Experience Balance or Latent Tendencies (TL), and Chromatic Reactivity (RC), following the guidelines of the Paris School. The Type of Intimate Resonance (TRI, first experience formula) expresses the predominant mode of experience formula (introversive, extratensive, coarctative/coarctated, ambitendent); Latent Tendencies (TL, second experience formula) relate to dispositions and internal resources that are not fully developed; and Chromatic Reactivity (RC, third experience formula) indicates sensitivity and responsiveness to affective stimuli mediated by color. These indicators allow for an integrated understanding of the participants’ predominant style of emotional experience.
The comparative analysis of the distribution of affective experience styles among the participants showed no statistically significant differences between the first and second assessments, that is, between the end of pregnancy and the postpartum period. This finding suggests stability in women’s patterns of affective experience throughout this important period of their lives, based on the longitudinal observation conducted in this study.
The extratensive style predominated as the participants’ Type of Intimate Resonance (TRI), followed by the ambitendent style and a few cases of introversive experiences as the habitual mode of affective interaction with the world. In terms of personal resources (second experience formula, Latent Tendencies = TL), potentials of an extratensive and introversive nature were observed, that is, internal complements available for affective experiences, not necessarily in full use, signaling emotional reserves and psychic richness. In terms of Chromatic Reactivity (RC), the ambitendent and introversive styles predominated in both assessments, which may indicate lower affective expression in the protocol, recognized as a sign of defensive effort toward emotional containment.
Discussion
By describing and comparing women’s psychic functioning at two points in the perinatal period, pregnancy and postpartum, using the Rorschach Method (Paris School), this study identified relevant particularities. It is worth noting that the interpretation of this method prioritizes deviations from normative parameters as indicators of psychic dynamics, even when they are not highly expressive numerically.
In both time periods, a lower occurrence of global responses (G%) and a higher mean number of responses (R) were observed, in addition to a higher frequency of interpretations in the white area of the card (Dbl%) and an increase in the Anxiety Formula (FA). An increase in animal (A), anatomical (Anat), blood (Sg), and sexual (Sex) content was also observed compared with the adult norm. During pregnancy, a higher incidence of small-detail responses (Dd%) and abstract content (Abst) stood out, associated with a lower frequency of animal detail (Ad), botanical (Bot), and fragment (Frag) content. In the postpartum period, fewer additional responses (RA) and less use of human parts (Hd) were identified, with a higher occurrence of animal (A%) and object (Obj) content compared with pregnancy, as well as an increase in geographic content (Geo) compared with the norm.
Regarding productivity, the high mean number of responses at both time points suggests breadth of interpretive processes and availability of associative resources in the primiparous women assessed. This result differs from Belot (2014) and Belot et al. (2021), who observed a reduction in responses among French primiparous women. The higher productivity may reflect sociocultural particularities, which should be explored in cross-cultural studies.
Regarding working style, a reduction in additional responses (RA) was observed in the postpartum period. This pattern may stem from greater familiarity with the task and the bond established with the researcher, which may have favored more direct engagement with the interpretive process and, consequently, reduced the emission of additional responses. The absence of this variable in previous studies limits comparison with the literature.
In the approach to the stimuli, the lower incidence of global responses (G%)-more pronounced in the postpartum period-suggests less attention to the overall context and greater focus on specific elements. This finding contrasts with Clesse et al. (2023), who identified an increase in G% during pregnancy, interpreted as a possible defensive strategy of focusing on broad stimuli. Belot (2014) indicates that elevations in G% and Dbl% tend to reflect difficulties in thought functioning.
According to Chabert et al. (2020), the reduction in G responses identified in this study may indicate a narrower range of contact with the environment, with a focus on more specific elements of reality. During pregnancy, this process may be associated with the reorganization of identity and with the way women interact with their context in response to the internal demands characteristic of this period (Raphael-Leff, 2017). This reduced perceptual amplitude partly reflects transformations in the experience of bodily integrity, with emphasis on delimited and more specific parts of the body itself and on a more focused perception of the environment. Responses that use the entire blot indicate a global apprehension of the stimulus, associated with the ability to integrate different perceptual elements into a unified representation. Thus, responses located in the total area of the card represent the search for unity and cohesion, in a process of integrating percepts and constituting an object whole representative of body image. In the postpartum period, the continued reduced use of global location in Rorschach interpretations suggests that the identity process has not yet been fully reorganized, with attention remaining less directed toward global aspects of the environment.
In terms of response location in the Rorschach Method, greater use of small details was observed during pregnancy, with an increase in Dd% compared with the norm, which once again differs from the findings of Clesse et al. (2023). According to Chabert et al. (2020), the presence of Dd% may signal symbolized and displaced concerns projected onto specific parts of the cards. One interpretive hypothesis for the increase in this variable is that pregnant women may focus on personal and meticulous details of the stimuli in this projective method, signaling greater attention to details related to the anxieties and doubts aroused at this time in their lives.
Regarding the mode of reality perception, the higher incidence of responses in the blank spaces (increased Dbl%) was identified both during pregnancy and in the postpartum period among the primiparous women assessed, possibly related to sensitivity to emptiness, connected to early and unelaborated phases of maternal development (Belot, 2014; Belot et al., 2021). According to Rausch de Traubenberg (1998), the Dbl response reflects an inhibited or repressed aggressive charge, whereas Chabert et al. (2020) interpret this location as an attraction to emptiness-the absent part of the blot-that seeks to preserve bodily integrity. The white area in Dbl refers to the reactivation of an affective deficiency and threats to narcissistic integrity (Chabert et al., 2020), which may be associated with the psychological and physical losses inherent in motherhood. In the postpartum period, the increased use of the Dbl response may express sensitivity to the concrete absence of the baby inside the mother, symbolizing the void left by birth and separation (Belot, 2014). During this period, bodily integrity faces a double threat: the physical absence of the baby and the transformations caused by pregnancy and childbirth.
The analysis of the variables representing logical functioning (F%, F+%, and F+ext%) showed that the participants examined in this study maintained rational production adapted to the environment. In other words, despite the overload of experiences during pregnancy and the immediate postpartum period, they maintained logical adjustment and connection with reality, as would be expected in adults without previous psychological complications, which was one of the participant selection criteria.
In turn, the content of Rorschach responses represents intrinsic motivations and the constitution of self-image (Rausch de Traubenberg, 1998). The current data pointed to a lower incidence of animal content (A%) in the postpartum period, confirming findings by Belot (2014) and Belot et al. (2021). This indicator may be related to decreased socialization, influenced by primary maternal preoccupation (Winnicott, 2000). A% reflects the capacity for adaptive and socializing integration. Thus, its reduction suggests a return to the internal world characteristic of the postpartum period, when energy is directed toward the process of meaning-making that characterizes this stage. In the studies mentioned, this phenomenon was interpreted as a displacement of the animal figure in favor of the space occupied by the human figure, highlighting the importance of the initial bond. Furthermore, primary maternal preoccupation can weaken the aspects of socialization normally associated with animal content (Belot, 2014; Belot et al., 2021).
The higher occurrence of anatomical and sexual responses resulted in elevated scores on the Rorschach Anxiety Formula (FA), above the normative mean at both assessment points, corroborating findings by Belot et al. (2021). The intense bodily transformations of pregnancy, combined with the physical experiences of childbirth and the postpartum period, make this empirical finding of emotional channeling into anatomical and sexual content compatible with experiences characteristic of this period. In the postpartum period, the increase in object-type responses suggests signs of devitalization, which can be interpreted as a component related to mourning for the body and the absence of the symbiotic bond with the baby (Belot et al., 2021).
Finally, it is important to focus on the participants’ habitual style of emotional experience, especially as represented by the Rorschach TRI variable. The predominance of extratensive functioning in the TRI identified here contrasts with the findings of Clesse et al. (2023), who reported indicators of social inhibition and associative difficulties in French primiparous women, evidenced by increased latency time and coarctative TRI. Once again, this difference can be interpreted as part of the identity reorganization associated with pregnancy and childbirth, reflecting movements of integration between the psychic dimension, involving the re-experiencing of primary figures, and the somatic dimension, involving the internal presence and birth of the baby (Raphael-Leff, 2017). This process may have important sociocultural markers, which should be examined in further studies, as they fall beyond the objectives of the present study.
This study aimed to describe and compare psychodynamic aspects of primiparous women during the third trimester of pregnancy and the postpartum period, using the Rorschach Method (Paris School). The results indicated that these periods are associated with projective Rorschach indicators suggestive of important and mobilizing emotional experiences related to self-image, reflected in the participants’ particular responses, which were examined through various identity axes, following Chabert et al. (2020). At both assessment points, signs of greater use of content associated with anatomy, blood, and sexuality were observed, in addition to a higher frequency of responses in the blank spaces (Dbl%), suggesting sensitivity to emptiness and emotional meaning-making. During pregnancy, a greater number of small-detail responses (Dd%) stood out, pointing to the mother’s need to turn toward her inner world, restricting her perceptual field. In the postpartum period, it is important to note the higher incidence of content related to objects and signs of devitalization, interpreted as possible mourning for the symbolic separation from the baby and for bodily transformation, in addition to decreased socialization (lower A%), a characteristic of primary maternal preoccupation.
Although the findings reinforce the importance of the Rorschach Method for accessing psychic dynamics during pregnancy and the postpartum period, this study has important limitations, namely its small sample size (N = 15) and specific socioeconomic context, which restrict the scope of the results. The scientific literature consistently points out that language use, especially vocabulary, syntactic complexity, and pragmatic competence, is strongly associated with the level of education and literacy opportunities throughout development (Pereira & Ortiz, 2022). In this sense, although the sample in the present study is relatively homogeneous in socioeconomic terms, differences between participants with and without higher education may imply variations in the linguistic repertoire available for elaborating Rorschach responses. Considering that the method relies on verbal expression to access aspects of psychic functioning, it is possible that participants with higher levels of education may produce more elaborate responses from a descriptive and associative point of view, without this necessarily corresponding to structural differences in mental functioning, but rather to distinct symbolic and narrative resources. In the context of primiparity, a period marked by intense psychic transformations in the pre- and postnatal periods, such differences may influence how content related to motherhood, the body, and affects is communicated. Furthermore, although the age range of the sample is not broad, age-related variations may also affect the experiential and discursive repertoire, contributing to different ways of organizing responses. These aspects suggest the importance of considering language as a mediating variable in the interpretation of the protocols, avoiding readings that may confuse discursive sophistication with greater socio-affective elaboration and psychic complexity. The follow-up period after the babies’ birth, although sufficient to capture significant differences among women, could be extended to better understand the psychological processes throughout the transition to motherhood.
It is also worth pointing out a limitation regarding the Rorschach data analysis process in relation to the normative standards available for adults. This process was based on a visual inspection of possible particularities in the women assessed, without a systematic empirical comparison, which may reduce precision. However, this technical decision aligns with broader practices in the clinical field of personality assessment (Chabert et al., 2020), which may be improved in the future.
Nevertheless, the study offers relevant contributions to the understanding of maternal mental health, highlighting the need for psychosocial interventions that consider the specific emotional demands of pregnancy and the postpartum period. It also points to avenues for future research, suggesting the expansion of the participant pool and the inclusion of broader sociocultural backgrounds, as well as the use of additional technical and scientific resources to examine women’s psychological experiences associated with motherhood, deepen the analysis, and seek cross-validation.
References
-
Associação Brasileira de Empresas de Pesquisa. (2021). Critério de Classificação Econômica Brasil (CCEB). https://abep.org/wp-content/uploads/2026/03/CCEB_2026.pdf
» https://abep.org/wp-content/uploads/2026/03/CCEB_2026.pdf -
Bellion, E. (2001). Agressivité et grossesse: Pour un cheminement nécessaire vers la naissance de la relation mère/bebe. Le fonctionnement psychique chez la femme enceinte à la lumière du Rorschach et du TAT [Aggression and Pregnancy: A Necessary Journey Toward the Development of the Mother-Infant Bond. Psychological Functioning in Pregnant Women as Revealed by the Rorschach and TAT Test]. Devenir, 13(1), 67-83. https://doi.org/10.3917/dev.011.0067
» https://doi.org/10.3917/dev.011.0067 -
Belot, R.-A. (2014). La singularité des protocoles Rorschach chez une population de femmes en période postnatale [The uniqueness of Rorschach protocols in a population of women in the postpartum period]. Devenir, 26(3), 165-204. https://doi.org/10.3917/dev.143.0165
» https://doi.org/10.3917/dev.143.0165 -
Belot, R-A., Pheulpin, M-C., Roman, P., Bouteloup, M., Pointurier, M., Paez, D., Mottet, N., & Mellier, D. (2021). Motherhood specificities with the Rorschach Method. Rorschachiana, 42(1), 72-92. https://doi.org/10.1027/1192-5604/a000137
» https://doi.org/10.1027/1192-5604/a000137 -
Bjelica, A., Cetkovic, N., Trninic-Pjevic, A., & Mladenovic-Segedi, L. (2018). The phenomenon of pregnancy: A psychological view. Ginekologia Polska, 89(2), 102-106. https://doi.org/10.5603/GP.a2018.0017
» https://doi.org/10.5603/GP.a2018.0017 -
Campos, P. A., & Féres-Carneiro, T. (2021). Sou mãe: E agora? Vivências do puerpério [I am a mother: Now what? Experiences of the postpartum period]. Psicologia USP, 32, e200211. https://doi.org/10.1590/0103-6564e200211
» https://doi.org/10.1590/0103-6564e200211 -
Catalá, P., Peñacoba, C., Écija, C., Gutiérrez, L., & Meireles, L. G. V. (2025). Psychological needs in Spanish pregnant women during the transition to motherhood: A qualitative study. Societies, 15(3), 50. https://doi.org/10.3390/soc15030050
» https://doi.org/10.3390/soc15030050 - Chabert, C., Louët, E., Azoulay, C., & Verdon, B. (2020). Manuel du Rorschach et du TAT Dunod.
-
Chauhan, A., & Potdar, J. (2022). Maternal mental health during pregnancy: A critical review. Cureus, 14(10), e30656. https://doi.org/10.7759/cureus.30656
» https://doi.org/10.7759/cureus.30656 -
Cisneros Hilario, C. B., Bedoya Castillo, M. P., Lázaro Huamán, B. A., Mendoza Chávez, K. E., & Cisneros Hilario, E. J. (2022). Pregnancy in times of pandemic: A look at mental health before and during the pandemic. Revista de la Facultad de Medicina Humana, 22(2), 402-408. https://doi.org/10.25176/rfmh.v22i2.4802
» https://doi.org/10.25176/rfmh.v22i2.4802 -
Clesse, C., Rivat, M., Simon, A., Belot, R.-A., & Lighezzolo-Alnot, J. (2023). Période périnatale et Rorschach: Normes, indicateurs, mentalisation et perspectives théorico-cliniques. Psychologie Française, 68(2), 209-225. https://doi.org/10.1016/j.psfr.2021.10.002
» https://doi.org/10.1016/j.psfr.2021.10.002 -
Coutinho, E. C., Silva, C. B., Chaves, C. M. B., Nelas, P. A. B., Parreira, V. B. C., Amaral, M. O., & Duarte, J. C. (2014). Pregnancy and childbirth: What changes in the lifestyle of women who become mothers? Revista da Escola de Enfermagem da USP, 48(spe2), 17-23. https://doi.org/10.1590/S0080-623420140000800004
» https://doi.org/10.1590/S0080-623420140000800004 - Creswell, J. W., & Creswell, J. D. (2021). Projeto de pesquisa: Métodos qualitativo, quantitativo e misto [Research project: Qualitative, quantitative, and mixed-methods approaches] (5a ed.). Penso.
-
Ekelöf, K., Tangen, G. A., Nyström, C. D., Löf, M., & Thomas, K. (2025). Mental wellbeing during pregnancy and the transition to motherhood: An explorative study through the lens of healthcare professionals. BMC Pregnancy and Childbirth, 25, 803. https://doi.org/10.1186/s12884-025-07894-5
» https://doi.org/10.1186/s12884-025-07894-5 -
Fonseca, R., Silva, P., & Silva, R. (2007). Acordo inter-juízes: O caso do coeficiente kappa [Inter-judge agreement: The case of the kappa coefficient]. Laboratório de Psicologia, 5(1), 81-90. https://doi.org/10.14417/lp.759
» https://doi.org/10.14417/lp.759 -
McNamara, J., Townsend, M. L., & Herbert, J. S. (2019). A systematic review of maternal wellbeing and its relationship with maternal fetal attachment and early postpartum bonding. PLoS ONE, 14(7), e0220032. https://doi.org/10.1371/journal.pone.0220032
» https://doi.org/10.1371/journal.pone.0220032 -
Meneses, N. P., & Amparo, D. M. (2025). Psicodiagnóstico interventivo psicanalítico: Construindo um dispositivo para a clínica dos extremos [Psychoanalytic interventional psychodiagnosis: Building a device for the clinic of extremes]. Psicologia: Ciência e Profissão, 45, e281516. https://doi.org/10.1590/1982-3703003281516
» https://doi.org/10.1590/1982-3703003281516 -
Minjollet, P., & Valente, M. (2015). Période périnatale et épreuves projectives: Une revue de la littérature [The Perinatal Period and Projective Tests: A Literature Review]. Psychologie Clinique et Projective, 21(1), 137-170. https://doi.org/10.3917/pcp.021.0137
» https://doi.org/10.3917/pcp.021.0137 -
Ogden, T. H. (2024). Giving back what the patient brings: On Winnicott’s “mirror-role of mother and family in child development”. The Psychoanalytic Quarterly, 93(3), 413-430. https://doi.org/10.1080/00332828.2024.2369507
» https://doi.org/10.1080/00332828.2024.2369507 -
Palaux, O., & Cognet-Kayem, A. (2023). Trouble de la gestation psychique et expérience d’attachement mère-enfant à la suite d’un déni partiel de grossesse. La Psychiatrie de l’Enfant, 66(2), 303-321. https://doi.org/10.3917/psye.662.0303
» https://doi.org/10.3917/psye.662.0303 -
Parker, C., Scott, S., & Geddes, A. (2019). Snowball sampling. In P. Atkinson, S. Delamont, A. Cernat, J. W. Sakshaug, & R. A. Williams (Eds.), SAGE research methods foundations Sage. https://doi.org/10.4135/9781526421036831710
» https://doi.org/10.4135/9781526421036831710 - Pasian, S. R. (2000). O psicodiagnóstico de Rorschach: Atlas, normas e reflexões [The Rorschach Psychodiagnostic Test: Atlas, norms and reflections]. Casa do Psicólogo.
-
Pedreira, M., & Leal, I. (2015). Terceiro trimestre de gravidez: Expectativas de emoções sobre o parto [Third trimester of pregnancy: Anticipation and emotions surrounding childbirth]. Psicologia, Saúde e Doenças, 16(2), 260-273. https://www.redalyc.org/articulo.oa?id=36242128010
» https://www.redalyc.org/articulo.oa?id=36242128010 -
Pereira, A., & Ortiz, K. Z. (2022). Language skills differences between adults without formal education and low formal education. Psicologia, Reflexão e Crítica, 35, 4. https://doi.org/10.1186/s41155-021-00205-9
» https://doi.org/10.1186/s41155-021-00205-9 -
Pointurier, M., Belot, R.-A., Roman, P., Mottet, N., & Mellier, D. (2023). Modalités d’attachement et maternité: Étude des remaniements psychiques à partir d’un cas [Attachment Styles and Maternity: A Study of Psychological Changes Based on a Case Study]. Annales Médico-Psychologiques, 181(1), 46-51. https://doi.org/10.1016/j.amp.2021.05.007
» https://doi.org/10.1016/j.amp.2021.05.007 - Raphael-Leff, J. (2017). Gravidez: A história interior [Pregnancy: The inside story]. Blucher.
- Rausch de Traubenberg, N. (1998). A prática do Rorschach [The practice of Rorschach]. Vetor.
-
Riefolo, G. (2025). Dissociation, repression, and return. The thirty-year arc of the concept of defence in Freud and towards contemporary psychoanalysis. The International Journal of Psychoanalysis, 106(5), 938-957. https://doi.org/10.1080/00207578.2025.2466464
» https://doi.org/10.1080/00207578.2025.2466464 -
Sarmento, R., & Setúbal, M. S. V. (2003). Abordagem psicológica em Obstetrícia: Aspectos emocionais da gravidez, parto e puerpério [Psychological approach to Obstetrics: Emotional aspects of pregnancy, childbirth, and the postpartum period]. Revista de Ciências Médicas, 12(3), 261-268. https://seer.sis.puc-campinas.edu.br/seer/index.php/cienciasmedicas/article/view/1260/1235
» https://seer.sis.puc-campinas.edu.br/seer/index.php/cienciasmedicas/article/view/1260/1235 - Winnicott, D. W. (2000). A preocupação materna primária [A mother’s primary concern]. In D. W. Winnicott, Textos selecionados: Da pediatria à psicanálise Imago.
-
Xie, Z., Yan, Y., & Peng, K. (2023). Pragmatism or idealism: A systematic review and visual analysis of Winnicott’s psychoanalytical treatment views. Frontiers in Psychiatry, 14 https://doi.org/10.3389/fpsyt.2023.1237005
» https://doi.org/10.3389/fpsyt.2023.1237005
