From Swallowing to Savoring Emotions : A Therapeutic Assessment Case Study Using the Thurston Cradock Test of Shame as an Assessment Intervention

Abstract. This article presents a Therapeutic Assessment case study of a 48-year-old Catholic nun who was evaluated for concerns related to recurrent depression, difficulty relating to others, trouble following through on tasks, and lack of self-care. Maria was given the Rorschach, MMPI-2-RF, Wartegg Drawing Completion Test, and Thurston Cradock Test of Shame (TCTS). Testing results suggested depression, problems regulating emotion, incongruence between external presentation and internal state, and impaired functional intelligence when negative emotions are triggered. Maria’s TCTS protocol indicated a tendency to deflate in the presence of shame or criticism. She used tentative language around emotion, did not access support, and struggled to resolve emotionally charged situations. The TCTS results appeared to access and explain Maria’s core difficulties. TCTS Cards 6 and 8 were selected for an assessment intervention session (AIS) designed to help Maria understand what she does with negative feelings. Maria was asked to tell a story focusing on the main character. Through half-steps and affective scaffolding, Maria identified how she “swallows” her negative feelings and “isolates” when emotions are strong. The authors discuss how the AIS helped Maria access her split-off affect, and understand its relation to her symptoms, poor self-care, impaired follow-through, and relational difficulties.