Differences between Schizophrenics and Normal Controls

Using Chirological (Hand) Testing

Yael Haft Pomrock

Chirologist and Psychotherapist, Private Practice, Haifa, Israel

Yigal Ginath, MD

Associate Director, Be’er Sheva Mental Health Center;

And Senior Lecturer in Psychiatry, Faculty of Health Sciences,

Ben Gurion University of the Negev, Be’er Sheva, Israel

Published: Israel Journal Psychiatry and Related Sciences Vol 19 No 1 (1982) p 5 – 22

Abstract. Differences had been found and defined between schizophrenics and normal persons by making use of the chirological (hand) test. At a second stage a group of hospitalized schizophrenic patients were tested and compared to a group of normal controls. The examiner was blind to the diagnoses of patients at the time of the test. In four parameters (expression of the outer hand, expression and quality of the thumb, arrangement of the auxiliary lines and flow and quality of the three main lines), differences between the groups were found to be highly significant (P<0.0001 for most of these parameters). The technique and significance of the main components of the chirological test are described at length. An effort is made to discuss chirological findings within the framework of modern psychopathological theories of schizophrenia.

Introduction

Chirology (the science of hands) has been known from antiquity. Through the centuries it has been transformed from a diagnostic and prognostic instrument to a discredited pastime used for mantic purposes by gypsies and entertainers. In the 20^th century it has slowly reemerged as a meaningful personality test, and also as an important window into psyche-soma interrelatedness.

In his introduction to Julius Spier’s book ‘The hands of children, an introduction to psycho-chirology’, C.G. Jung writes that ‘The totality of conception of modern biology which is based on the evidence of a host of observations and research does not exclude the possibility that hands, whose shape and functioning are so intimately connected with the psyche, might provide revealing and therefore interpretable expressions of psychical peculiarity, that is, of the human character’ (1 p IX). Chirology as it is known today is based on the theories of Spier (1), Debrunner (2) and Wolf (3, 4), all of whom were influenced by Carus (5, 6).

From the earliest development of the infant we can discern that, together with his mouth, his hand is in motion, closing and opening (7 p 29). There appears to be a close connection between ego development and the use of the hand, as well as between hand manipulation and the infant’s construction of reality (7 p 48-50). Chirology is thus based on the assumption that the structure of the human hand and the interrelations and correspondences of its components: palm, fingers, lines, mounts, etc. are basically connected with the psychic structure.

Basics of the Chirological Test

The chirological test and its interpretation will be described as some length, as it is assumed that most readers are unfamiliar with the procedure. The test is started by producing a hand- print on paper using special black ink. This reveals the hand-lines and dermatoglyphics (papillary lines or ‘finger prints’). The outer aspect of the hand is then assessed as to its form and expression. The testee raises his hands while resting his elbows on a table, showing the outer side of his hands. The form and expression of the hand, and the relationships between the palm and fingers, are thus assessed; thus, the inner aspects of the hands are observed and checked, with special reference to the thumb, hand lines and mounts (3, 4, 8, 8a).

According to Spier (1) there are six basic forms of the hand. Many hands show combinations and variations of the basic forms. These are:

1. The conic hand which is more or less cone-shaped, wider in the lower part and narrower towards the tips of fingers. This is the receptive and impressionistic hand, the most influenced by outer and inner experiences; it is the hand of extremes, of sensitivity, and carries aspirations towards the synthesis of these extremes.

2. The square hand is quite the opposite of the conic hand. This is the hand of boundaries, of stability, of concreteness. It is by no means a coincidence that we designate a person with these characteristics as ‘square’.

3. The third form of hand is the spatulate which is very narrow at the base, spreading out like a spatula. Another variation is the inverted spatula, i.e. very wide at the base and narrowing towards the fingers. Like the spatula which raises a quantity of matter out of the mass of materia, so the person possessing this form distinguishes himself in his productions, be it either of an intellectual or technical nature. The owner of this hand requires acknowledgement for his deeds. It is a creative hand, par excellence.

4. The primitive hand is a heavy, crude-looking hand. It is earthy and

undeveloped.

5. The philosophical hand can best be illustrated by the famous painting of

Durer, showing hands in the prayer position. This hand has something of the conic and even spatulate, forming an oval-like shape. It has long fingers; the whole expression is one of search based on firm foundation.

6. The dysplastic hand is irregular, lacking specific form, and in this respect

cannot be defined as a type in itself. The fingers are of different shapes. This hand belongs to the person of diverse influences and contradicting inner forces. Only if there are other components (expressed in the inner hand) which can somewhat stabilize it, can its owner be fruitful.

Besides the form of the hand as a whole, each part has a specific importance in the chirological assessment. The outer side of the palm is examined for its expression and strength. On its inner side, the elevations of the inner palm (the ‘mounts’) are assessed, as are the lines, which are carefully examined for their quantity, quality placement, arrangement and form. Hand lines are divided into main lines, auxiliary lines and other lines, all of which should have definite directions.

Normal hands have neither too few nor too many lines. Deviations to either extreme signify disturbances in the flow of experiences and functioning. The quality of the lines, especially the main ones, is indicative of the mental function which they represent. Lines of good quality are curved and animated, i.e. lively.

There are three or four main lines. The first three are formed in the embryo (on the 55^th day, 65^th day and around the 80^th day). The fourth line is also formed in the pre-natal stage but may develop up to the age of 21 years or even later. The main lines are:

1. The thenar line, called the ‘life line’, surrounds the thumb and the thenar elevation. The name does not imply the length of life but rather the vitality of the personality.

2. The second traverse line, called the ‘head line’, usually begins in proximity with the thenar line, under the index finger, and ends towards the ulnar side of the hand. This line pertains to intellectual ability, the quality of thinking (scientific, practical, superficial or deep, etc.). Breaks in the flow of this line are indicative of disturbances of the mental process, related to personality organization and behavior. Scrupulous examination of the line may shed light on many dynamic aspects of the personality.

.Figure 1. A schema of the inner aspect of the hand, showing the divisions and main lines.

3. The first or upper traverse line, called the ‘heart line’ begins under the small finger and goes towards the radial side of the hand. This line pertains to the emotional sphere of the personality, the feelings, value judgements, affects, etc. The most serious psychological problems might lie in the interaction between feelings and thoughts.

4. The line of adaptation divides the palm into two vertical parts: the radial, including the thumb, index finger and one side of the middle finger and pertains to the conscious side of the personality and the attitude towards the outside world; the ulnar, including the other 2.5 fingers, pertains more to the unconscious aspect of the personality and to interpersonal relationships. This line indicates ‘the balance between the inner personality and the outside world’. It shows the attitude and reactions of a person to experiences, impressions and events; it is also the line of the ‘person’ and of ‘adaptation to the influence of the environment’ (1 p 74).

The thumb

The thumb is a human prerogative. No other species possesses a thumb except the chimpanzee, which has only an undeveloped thumb. It is only by means of the hand and especially the thumb that a man can hold, work, write, build and create. The thumb is the most flexible part of the hand and is set apart from the other fingers opposed to, and counter-acting, them. The thumb is the ‘chirological seat’ of the ‘I’, the ‘self’ that wants, thinks, executes. It is important to assess its quality, i.e. its potentiality, and its expression. By potentiality we mean its degree of ability to discriminate, to evaluate, to suffer frustrations and also to will and execute.

The term expression suggests how these aspects operate within the personality at the present moment (not at all, rigidly, weakly, strongly or in a lively way). In other words, the expression may change whereas the potentiality sets its limits. Combined, they indicate the current dynamics based on the inherent ability of the ego regarding volition, execution and thinking attached to it.

Relationships between various parts of the hand

It should be mentioned here that while every detail in the hand has a meaning, none stands alone. Each detail may have several implications depending upon the other components present. Interpretation, therefore, depends on the interaction and interrelations of each of the details with the whole. For example, the meaning and interpretation of a certain form or direction of a line will be different for a conic hand with short fingers than for a conic hand with long fingers.

The relation between the fingers and the palm is indicative of the harmony or disharmony between the ‘real’ world of practicability and adjustability to inner and outer stimuli and the ‘inner world’, the spiritual world, that of ideas, intellect and imagination. The outer aspect of the palm and fingers are regarded as the ‘archetypal layout’, or inherent structure of the personality, whereas the mounts and lines are their manifestations, or expressions of their dynamic activity within the personality.

The hand, being a representation of the mental apparatus and processes, is dynamic and changing. With time, new lines are formed, lines may disappear, change their course, their thickness, their ending and their expression. Such changes may occur within a very short period of time, in concordance with periods of emotional and personality change. However, the basic formation of the hand and fingers as well as the dermatoglyphics do not change.

The chirological test, therefore, discloses a wide spectrum of the personality including its structure, dynamics, capabilities and limitations, talents and possibilities for change. It should be stressed that the relationship between chirological findings and terms (e.g. ‘expression’) the psychological terms or personality traits (e.g. ‘ego strength’) is, at the current ‘state of the art’, strictly empirical.

With these considerations in mind, a research project was suggested with the purpose of investigating whether and how schizophrenia expresses itself in the hand. The assumption to be tested was that characteristics may be defined which will differentiate the hands of schizophrenics from those of non-schizophrenics. These characteristics would be comparable to differences which are found in the various psychological tests.

Methods

First stage

In order to define common denominators of the chirological expressions of schizophrenia we chose a group of 18 hospitalized patients diagnosed as schizophrenics. Both at the first and second stage, patients were considered schizophrenics only if the diagnosis was made clinically and agreed upon by two senior psychiatrists independently. No attempt was made to further differentiate the patients in this group (e.g. for type of schizophrenia).

After various stages of elimination, four characteristics were selected in which the hands of schizophrenics seemed to differ from most normal hands:

1. Expression of the outer hand.

2. Quality and expression of the thumb.

3. Quantity and arrangement of the hand lines.

4. Quality and flow of the three main lines.

Second stage

About 100 hospitalized psychiatric patients were examined by the senior author. This group included schizophrenics, as well as patients suffering from a large variety of other psychiatric disorders. The examiner was unaware of the diagnoses of patients at that time. After completion of the whole series, the code of diagnoses was broken, and all schizophrenics were included as a group.

A control group, comprised of a random sample of 50 ‘ non-patients’ comparable to the schizophrenic group in their sex distribution and age ranges (15 to 65), was used. These were people who sought chirological testing from the senior author for various reasons such as interest in self-experience and knowledge, job consultation, and help for neurotic and identity problems. None of them had a history of either psychiatric hospitalization or ambulatory treatment.

It is worth mentioning that many of the patients were receiving various psychotropic medications at the time of examination. Although the use of medications expressed itself in the hand- print (e.g. by some blurring of the dermatoglyphics) it by no means had an effect on the characteristics assessed.

Figure 2. Expression of the outer aspect of the hands of a normal testee, showing a lively expression.

Results

a. Expression of the outer hand

This showed the most consistent and impressive difference between the hands of schizophrenics and controls. Some elaboration on the term ‘expression’ is required here. Expression implies life, vivacity, content, substance, something flowing, a way of relating. It is difficult to measure expression, even more so to define what it is. However, it can be easily recognized when observed, in the same way that facial expression is.

Expression is, primarily, indicative of the current mental status. It varies and changes from ‘hand to hand’ with the psychological changes a person undergoes, but it also bears witness to the basic structure of the hand. To sum up, expression is a composite, expressing both the basic structure and the current mental state.

As is clearly seen from table 1, all the hands of the schizophrenics showed either total lack of expression, rigid or weak expression. In contrast, in the control group, only 1 in 50 showed weak expression (P<0.0001). All values of P were calculated using the Mann-Whitney test.

Figure 3. Expression of the outer aspect of a hand of a schizophrenic patient. Note the total lack of expression.

TABLE 1. Difference between schizophrenics and controls in

Expression of the outer hand

0 1 2 3 4 N

Schizophrenics 20 8 22 0 0 50

Controls 0 0 1 41 8 50

0 – Total lack of expression, lifelessness; 1 – Rigid expression; 2 – Weak expression; 3- Lively expression; 4 – Strong expression.

P<0.0001

b. Thumb

Two extremes were found here. In the one case, many schizophrenics had a thumb qualitatively lacking of vivacity, weak in form and expression, especially in the distal phalanx (chirologically considered the ‘set of will’), which was flat on the inside or pointed in form, or both. To the other extreme, in many cases the thumb was heavy in form and expression or too strong and rigid, with the upper phalanx full and strong but lacking flexibility (Table 2a).

None of the schizophrenics patients showed a lively thumb, whereas the majority of controls did. Of the 50 schizophrenics, 29 were rated as ‘expression-less’ or showing ‘rigid expression’, whereas none of the control group fell into these categories. None of the schizophrenics had the potentiality for a well-differentiated thumb, as compared to 31 of the 50 in the control group, while none of the control group had a poor or weak potentiality, as compared to 37 of the 50 schizophrenics (Table 2b). Again, values of P for both expression and quality are smaller than 0.0001.

TABLE 2. Differences between schizophrenics and controls in

Expression and quality of the thumb

a. Expression

0 1 2 3 4 N

Schizophrenics 17 12 11 2 8 50

Controls 0 0 10 29 11 50

0 – Total lack of expression, lifelines; 1- Rigid expression; 2- Weak

expression; 3 – Lively expression; 4- Strong expression.

P<0.0001

b. Quality (Potentiality)

0 1 2 3 4 N

Schizophrenics 10 27 9 4 0 50

Controls 0 0 1 18 31 50

0 – Poor potentiality, heavy, crude; 1- Weak potentiality; 2- Medium

potentiality; 3- Developed potentiality; 4 – Well-differentiate potentiality.

P<0.0001

c. Lines of the inner hand

Normally, the hand should have a few flowing lines, diagonally spread or directed towards the main lines. Even though statistically not significant, it can be seen in table 3a, that 20 out of 50 schizophrenics showed a multiple of lines. In some cases the concentration of the lines was more prominent at the proximal ulnar side of the hand or in the middle; in others there was a ‘flood’ or lines obliterating the main lines.

More schizophrenics (23) had a scarcity of lines, or no lines compared with controls (12), but again it did not reach statistical significance. However, the arrangement of the lines in the hands of schizophrenics was chaotic, and did not show the organization, parallel display, and connections with the main lines compared to the hands of controls (Table 3b).

TABLE 3. Differences between schizophrenics and controls in the

Quantity and arrangement of auxiliary lines

a. Quantity

0 1 2 3 4 N

Schizophrenics 5 18 4 3 20 50

Controls 2 10 29 9 0 50

0 – Total lack of lines; 1 – Too few lines; 2- Normal number of lines;

3 – Too many lines; 4 – Flooding of lines.

P=NS

b. Arrangement (Connections)

0 1 2 3 4 N

Schizophrenics 20 21 2 0 0 43*

Controls 0 9 27 12 0 48*

0 – Total lack of connections between lines; 1- Below average number of

connections; 2 – Average number of connections; 3 – Above average number of connections; 4- Great Number of connections.

* The smaller number of patients in both groups is due to subjects who either had no lines or only very few.

P<0.0001

d. Flow and quality of the three main lines

The quality and type of flow of the main lines gave weight to the other findings. The thenar line (Table 4A) of the schizophrenics was either indistinct and fragmented, or very thick and undifferentiated, and its quality was in most instances (33 out of 50) poor or weak. The same tendency is also demonstrated for the ‘head line’ and the ‘heart line’ (Table 4B & C). There were no schizophrenics with the highest score for quality of these lines and most were in the two lowest categories. The meaning of these findings will be discussed later.

Similar findings also characterized the flow of the other main lines. Even though the overlap of the groups tended to be somewhat greater, the value of P for all three lines is less then 0.0001, and the overlap of the extreme categories is quite small.

Figure 4. Hand print of the inner aspect of a right hand (in a left-handed normal testee). Note the above-average degree of arrangement and connectedness.

Figure 5. Hand print of the inner aspect of a left hand in a right-handed schizophrenic patient. Note the almost total lack of auxiliary lines.

TABLE 4. Differences between schizophrenics and controls in

Flow and quality of the three main lines

A. Thenar line (life line)

a. Flow

0 1 2 3 4 N

Schizophrenics 11 21 4 14 0 50

Controls 0 2 17 17 14 50

P<0.0001

b. Quality

0 1 2 3 4 N

Schizophrenics 16 17 5 12 0 50

Controls 1 0 15 19 15 50

P<0.0001

B. Upper traverse line (heart line)

a. Flow

0 1 2 3 4 N

Schizophrenics 23 21 3 3 0 50

Controls 8 5 26 11 0 50

P<0.0001

b. Quality

0 1 2 3 4 N

Schizophrenics 19 28 1 2 0 50

Controls 2 8 7 27 6 50

P<0.0001

C. lower traverse line (head line)

a. Flow

0 1 2 3 4 N

Schizophrenics 12 19 9 10 0 50

Controls 2 0 14 24 10 50

P<0.0001

b. Quality

0 1 2 3 4 N

Schizophrenics 9 31 8 2 0 50

Controls 3 0 5 28 14 50

P<0.0001

a. Flow: 0 – Totally fragmented; 1- Fragmented ; 2 – Slightly fragmented (medium) ; 3- Nicely curved; 4- Flawlessly curved.

b. Quality: 0 – Poor; 1 – Weak; 2 – Medium; 3 – Developed; 4 – Well-Differentiated.

Discussion

Upon examining the forms of the hands, it was found that in both groups the conic hand was by far the most frequent (48 out of 50 in the schizophrenic group and 31 out of 50 in the control group were identified as conic). As mentioned, this shape is characteristic of sensitive, labile, impressionable people, who often tend to extremes. This finding is also concordant with C. Wolf (4). Statistically, it is, of course, not significant, and could not be used to differentiate between schizophrenics and controls.

Expression of the outer aspect of the hand was found to be of decisive importance in differentiating schizophrenics from controls. As mentioned above, measuring expression presents a difficulty to the chirologist, as it cannot be measured quantitatively as most other characteristics are, and its monitoring calls for vast experience. We are used to read facial expressions but not expression of the hand. Yet both are used for communication, conveying meaningful messages to the keen and experienced observer.

Usually, people have less control over the expression of their hands than they do of their facial expression. We are familiar with the ‘poker face’ but ‘poker hands’ are much less often met. Expression is indicative of a current psychic state, but also shows the basic psychic structure. These two components of expression usually correspond with each other, but at times might be in contrast. A weak person might pose a facade of strength and vice versa. Thus, a rigid expression might be the result of using rigidity as a defence, covering a poverty of inner life. At other times we can diagnose a lack of vitality and a depressive expression in a well-structured hand. A weak expression might be indicative of a weak basic personality structure (‘low degree of ego strength’) or to schizophrenic activity.

As the chirological test proceeds expression usually becomes more ‘relaxed’, so that the ‘basic structure’ is more distinct towards the end of the hand test. Other components of the chirological test, and especially the examination of the thumb enables us to differentiate between these constellations.

It must be stressed that just as the various scales of a compound psychological test shed light on various psychological characteristics, and no test can give a complete picture of the structure and functioning of the personality, such is the case for various components of the hand test.

The thumb represents the ego forces, both inherent and actual. This was found to be a decisive factor differentiating normality from severe pathology. The two parameters examined were expression and quality. Expression signifies the dynamic and changing, the ‘present state of self’, whereas the quality or potentiality signifies the structural aspect of the personality (i.e., the ‘ego strength’). Both aspects relate to the volition or the ability to ‘will’ and execute. ‘Volition’, according to Arieti (9 p 303) is the process of choosing, initiating and executing an action. This section of the personality is one of the areas on which schizophrenia usually has a major effect, (9 p 305), resulting in the ‘bizarre’, ‘capricious’ or ‘ unpredictable’ behavior of many schizophrenics. It is considered a major indicator of this disorder.

Our results support these theoretical formulations very clearly (Table 2). The thumbs of schizophrenics were either expressionless, or exhibited a rigid or weak expression. In a few cases, the thumbs bore ‘strong’ expression, but all of these were of poor quality, which means that the person gives the impression of ‘pseudo-strength – an outer facade which masks weak willpower. No schizophrenic showed ‘lively’ expression, whereas most controls were in this category. The quality of the thumb shows an even greater dichotomy. This parameter pertains more to the basic structure of the personality and might have an important prognostic significance as it conveys the potential for the growth and change of the person, including the ability to benefit from psychotherapy.

The auxiliary lines relate very closely to the dynamic aspects of the personality. One of their most striking characteristics is the changes they undergo in relation to various psychological changes the person undergoes. A hand lacking in lines at a particular stage may show many of them later. This is most impressive during a process of psychotherapy or psychoanalysis. Lack of lines, in an otherwise mentally healthy person, indicates an excessive, but probably successful, use of repression, negation or intellectualization. A wealth of lines indicates openness to experiences and impressions, which means an inner flow of thinking and feeling, free use of sensations, intuitions and imaginative process.

The other parameter that we used for assessment of the auxiliary lines was the degree of ‘connections’ they had to the main lines or to fingers, and their degree of ‘arrangement’, i.e. being parallel or arranged in the same direction, versus being disorganized and pointing in all directions (Table 3). Both parameters pertain to the degree of harmony between the various drives, feelings, emotions, tendencies, aspirations, etc. The more directed and connected the auxiliary lines are, the more harmonious are the inner mental processes. Disarrangement points to an inner ‘chaos’ or ‘schizm’, i.e. disharmony between the various aspects of the personality.

Many schizophrenics had an unusual excess of lines, all of which were also totally disorganized and disconnected. This probably expresses the ‘flooding’ of the mental apparatus by conflicting drives, affects, etc., phenomena that had been designated clinically as ‘ambivalence’, ‘inner chaos’, ‘flooding of the ego’ or ‘incongruity of thought and affect’, etc. The excess of these forces, combined with the failure of the ego to organize and direct them, resulting in disintegration and psychosis, thus finds a parallel in hand-print.

The main lines represent three of the main aspects of mental functioning – thought, affect and vitality. The ‘flow’ of these lines is indicative of the process of their execution or functioning of the processes they represent, i.e. fragmentation signifies a break, a disharmony in the way the function is executed, respective to the line which is affected. This is the dynamic aspect expressed by behavior in the real world. Even though the results show some overlap (Table 4) of the schizophrenic and the control groups, it is clear that most schizophrenics demonstrate a high degree of fragmentation, while most controls are included in the groups with flawless curves. Whereas normal persons react to inner and outer stimuli and conflicts and ‘solve’ their problems successfully, schizophrenics tend to fail at the task and are, relatively, more ‘inadequate’ in adapting to reality or ‘functioning’.

The quality of the three main lines signifies the basic ‘quality’ of the respective processes they represent. The artificial categories which we created serve as landmarks n the health – sickness continuum. There, again, in spite of some overlap, the large majority of schizophrenics fall in the two lower categories, while most controls are included in the highest two. Concurrent with clinical observations, it was seen that in some schizophrenics a greater tendency toward abnormality is expressed in the heart line than in the head line, i.e. in the affective rather than in the cognitive field.

Another interesting phenomenon was that the degree of pathology of the ‘life line’ in the schizophrenic group was relatively smaller than that expressed in the other two main lines. This might be explained by the nature of the population of schizophrenics from which we drew our sample, which was comprised mainly of ‘active’ rather than chronic, withdrawn patients.

Following Spier (1), the left hand of right-handed testees was considered to be ‘their’ hand, and the right hand was taken to express the prenatal characteristics as they are introjected within the person. The opposite applies to left-handed people. A large portion (19 out of 50) of the schizophrenic patients showed a major pathologic condition in the ‘parental’ hand also, sometimes even to a higher degree than in ‘their’ hand. This finding reminds one of Arieti’s (9) and Laing’s (10) contention that a sick person is often the carrier of the illness of another family member, mother or father, who ‘schizophreno-genic’, or, that he represents a sick family.

A related explanation may be that, as the interaction with the ‘pathogenic’ parental figure occurs at a very young age, the same process may be at the base of both the pathological development (11,12) and the development of the hand lines. This finding, however, calls for further investigation.

Conclusion

This paper presents the results of preliminary research. We feel that we have demonstrated that the chirological test can differentiate schizophrenics from non-schizophrenics using a number of parameters and, therefor, it might be considered as an additional and powerful instrument in the assessment of schizophrenia. At this stage only patients with clear-cut diagnoses were included. The next step should be to examine other categories of mental patients, e.g. depressives, borderline personalities, acute psychotics, various personality disorders, etc. We believe that the difference between the mentally ill and the mentally healthy is ‘only by degree and not in kind’ (13 p 61), so that the distinction may not be terribly clear. Also, the predictive power of the test has to be examined using a blind examiner.

In summarizing these preliminary results it may be stated that the parameters by which schizophrenics could be best differentiated from controls are the expression of the outer hand, expression and quality of the thumb, arrangement of the auxiliary lines and flow and quality of the three main lines. In all three aspects of the mental processes, namely cognition, affect and volition differences between schizophrenics and controls were demonstrated by using the chirological test. The hands of schizophrenics demonstrated the pathologic condition both in regard to the current functioning, ‘expression’, according to chirological terminology, as well as in regard to the structure or basic personality organization, which we called ‘quality’ or ‘potentiality’.

We may conclude with Arieti’s words that schizophrenia appears to be both ‘an entity and process’ (9 p 437); where the genetic-structural factors, as well as the early family influences and multitude of life events, impinge on the personality and interact in endless combinations. The chirological test might provide an important tool for assessment of these components and their interrelationships.

Acknowledgement. The authors wish to express their thanks to the staff and patients of Talbieh Mental Hospital whose help and cooperation enabled the performance of the study. Special thanks are due to Hai Halevi, PhD, who performed the statistical supervision and calculations.

References

1. Spier J. the hands of children . an introduction to psychochirology. London: Kegan Paul, 1994.

2. Debrunner H. Zur Morphologie der menschilchen Daumenfurche. Z. Menschl Vererb Konstitutions 1955; 33: 131-50.

3. Wolf C. The human hand. London: Methuen, 1942.

4. Wolf C. the hand in psychoogical diagnosis. New York: Philosophical Library, 1952.

5. Carus CG. Uber Grund and Bedeutung der verschiedenen Formen der Hand, in verschiedenen Personen. Stuttgart, 1848.

6. Carus CG. Psyche: part I. On the development of the soul. Zurich and New York: Spring Publications, 1971.

7. Cameron N. Personality development and psychopathology. Boston: Houghton Mifflin, 1963.

8. Haft-Pomrock Y. Psyche and soma in chirology: personality changes in analysis as reflected in the hand. Annual of Archetypal Psychology and Jungian Thought. Zurich-New York: Spring Publications, 1974.

8a. Haft-Pomrock Y. Chirology as self-creating mirror. Confin Psychiatr 1978; 21:

51-7.

9. ariei S. Interpretation of schizophrenia. 2^nd ed. New York: Basic Books, 1974.

10. Laing RD. The self and others, further studies in sanity and madness. London: Tavistock publications, 1961.

11. Winnicot DW. Collected papers: through pediatrics to psychoanalysis. London: Tavistock Publications, 1958.

12. Khan MMR. The privacy of the self. London: Hogarth Press, 1974.

13. Fromm-Reichman F. Psychoanalysis and psychotherapy. Chicago: University of Chicago Press, 1959.