Draw a Person Test in Sex Therapy

Draw a PersonTest in SexTherapy
-
Dr K Esther Sapire
Dr I(E Sapire
Summaryt
MBChB
Heac.l:Dcpt Family Plirnning
Groote Schuur Hospital
Mcclicla School, Anzio Roacl,
Obsen'atorv, 7925
The Drau a Person (DAP) Testbas
proued tc,tbe a useful toolfor tbe
therapist in the assessmento.f'patients
u,bo comefor counselling.fbr sexual
rl.ysfunction. It also giues infonnation
about chanSqe
during therapy. And it
bas been a use.lul tool.fbrpatients
wbo baue dilficultlt in uerbalising
their problem. Tbreepatient studies
illustrate this.
Curriculum Vitae
Dr Sapirewas born in Rhodcsia (norv
Zimbabvvc) ancltrainec'las a medical
doctor at the Universiry of Cape Town
(L952). Sl.reis marricd and the.v l'rave
three childrer.rand six grandchildrcn. Shc
'rl<rrkcdin Rl-roclesia
until 1976, rvherc
shc r,vasinvolveclin fhrnilv planning ancl
as Medical l)irector of the F'amily
Planning Associationr,vasresponsiblcfor
the nredicrrlasl)ccts,and trrining
programnrcsfbr rlicllvives, rtursesancl
other health n'orkers. In 1969 shc r.vas
approintcd lecturer in fhrnily plrrnr-ringir-r
the Dcpartn-rer-rt
of Otrstetricsar-rd
Gynaccologv at the lJniversitv of
Rhodesiir.Sir.rce1976 Esther has becn
senior lecturer ir-rfarrily planning at
U(iT, ancl l.reaci
of the family planning
antl scx thcrapy clinics at Groote Schuur
Hospital. SI.reis responsiblcfor thc
training of rrndcrgracluateand
postgraduatcstudents,and has
conclucteclmanv familv plannir-rgand sex
education programmes fbr prof-essionals
anclthe generalpr,rblicin South Africa.
Sincc 1990 she has bcen national
Parcnthood
presidentof tl're Planr-rccl
Associationof South Afiicr. She is the
author ()f "Contraception urcl Sexr.rality
in Health and L)iseasc"(McGrau'-Hill)
rvl-ricl-r
has beer-rapproved xs n ref'ercnce
book br, thc FarnilvPlarrrrirrg
Associatiorr,United I(ngdorn. Shc has
bccn iuvolvedin rcsctu'ch
irr
contraccptivetcchnology and
sociologicrl studies,and has published
53 papcrsin n.rcdicaljournals. Shc has
also prescntcd papersrt many
international conftrences.
S Afr Fam Pract 1994;15:64-6
I(EYWORDS:
Physicians,
Family;
Illustrations,
Medical;
Counselling;
Sexual
Dysfur-rctions;
CaseReports.
The "Drar,va Person" test (DAP) has
proved r.rseftilin the asscssmentof
patients for counselling fbr sexual
dysfur-rction,and irlso as a source of
infbrmation about changc during the
course ofthcrapy. I havc used this
tcst on nlrmcrous occasions,and
t i > u n di t h e l p f u li n m a n y i n s t l r r c c s ,
Three incidents \,vcreparticularly
striking, and illustrate thc valuc of
using this mcthod to dernonstrate
psychopathology,ie problems with
b o d y i m a g ca n d b c h a v i o r r r .
The first was a couple who wcre
refbrred for "sexual problems". Thc
fbmale partner was clearly distr.rrbed,
wcepy and not able to give a clear
history. I suggestedthat she "draw a
picture" of herself,as this could oflbr
an easiermealls of expression. I was
64
SA Famih'Practicc Fcbruan, I994
astonishedlvhen she procir.rced
two
separatesheetsofpapcr on which she
drew a "dismembered" body (Figure
l). I showcd tl'risto a psychiatrist
lvl-roconfirmed that it was evidence
of psychopathology. Fortunately the
pxtieut agreedto entcr int()
psychotherapv. This lastedtrvo years,
at thc end ofthis she produced a
pictr.rrcof herselfand her husband
(Figures2 & 3)which showedthe
enormolls transformation that had
takcn place during therapy.
The secondpatient was refbrred to
me fi'om thc PsychiatricUnit where
she had been an in-patientfor 3
months. In the assessment
sessionI
fblt that she was having difficulty
expressingherselfin regardto her
scxuality,and so I askedhcr to draw
a picture of herselfand l-rcrl.rr-rsband
(Figures4 & 5). When I askedher
why sl'reclrew hersclf as a pig, she
said that was horv she felt about
herscl{l I sharedthis picture with thc
psychiatristr.vhohad been treatir-rg
l r c r ,i l s i r w n sc v i d e n tt h r t i t w a s
Be circumspectabout
interpreting their pictures
neccssaryfor her to Llndergomore
therap,vregarding her self worth, and
that sex therapy would be
inappropriate at that time.
The third couple were refbrred bv
their generalpractitioncr because
"sex was a problem in their
m a r r i a g e " .T h e s e x u e h
l istory
shor,vedthat neither was in fact
sexuallydysfunctional,but that sex
SA Huisartsprlkn'k Fcbruarie 1994
,
... Draw a Person:Test in SexTherapy
Figure 6.
proved helpful to illustrate patients'
body image- the anorecticwoman
who draws enormolls bulges on
thighs, abdomen, breastsand arms;
the "not so beautiful" ladYwho
draws a featurelessface; and the
woman who drew a reallY nice
oicture of herself, but with her hands
tehind her back - who explained that
she was embarrassedbecauseshe
bites her nails!
the psychosexualhistory and clinical
of
observationin the assessment
where
particularly
sexual dysfunction,
be
a
to
appears
body image
Problem.
Bibliography
Sapire I(E. Contraception and Sexuality in Health
and Disease.UK: McGra*Hill, 1990.
It is necessaryto be circumsPect
about interpretation and allow
patients to expresstheir feelings
about what they have drawn and how
they seeit. The partner's comments
may also be helpful.
In conclusion: I have found the
DA? test useful in many ways,
particularly when people have
difficulty verbalisingtheir problems.
The DAP test is a useful adiunct to
66
SA Family Practice February 1994
SA Huisartspraktvk Februarie 1994