A comparison of cardiac and cancer inpatients on the MARI® Card Test

The MARI® Card Test is a projective preference test developed by art therapist, Joan Kellogg, based on her extensive study of mandalas (circle drawings). As used in this study, the test involved selecting the most and least preferred mandalas from a set of archetypal designs, called the Great Round. The test was administered to 195 patients, 132 hospitalized for cardiac disease and 63 hospitalized for cancer. The purpose was to identify similarities and differences in the design and color choices of the two groups, and to interpret the choices. Based on mandala theory, the projective evidence indicated that both cardiac and cancer patients are trying to preserve what they have achieved in life, and both are fearful of falling apart. Along with a strong will to survive, there is a preoccupation with death, feelings of depression, dependence, and anger, and a general avoidance of deep existential or spiritual issues. The will to survive is accompanied by a strong tendency to find creative ways of dealing with the illness and its treatment. With this comes a need to understand things—their lives, their own identities, their illnesses, and their best treatment options. Differences between the groups were found in specific fears (death, falling apart, spread of cancer); however, these differences may be due to age and length of illness as well as diagnosis. The caveats of projective tests are examined, and implications are drawn for arts therapists.