JOURNAL OF PERSONALITY ASSESSMENT, 1990, 55(3&4), 75(>-767Cop3mght 1990, Lawrence Erlbaum Associates, Inc.

Potential Space and the Rorschach: AnApplication of Object Relations Theory

Bruce L. SmithAlta Bates-Herrick Hospital

Berkeley, CA

This article examines the concept of potential space, developed by Winnicott(1971), and its relevance for Rorschach assessment. I propose that the responseprocess can be viewed as occurring in the potential space between reality andfantasy and that various forms of psychopathology can be conceptualized as formsof the collapse of potential space. I suggest that this model can be of utility ininterpreting the Rorschach protocols of a variety of difficult-to-diagnose patients.Examples from the Rorschach of a patient diagnosed with a dissociative disorderare presented to illustrate these points.

For the psychoanalytically oriented clinician who is also interested in theRorschach, these are the strangest of times. There has been an explosion of newideas and theories about development and psychopathology, especially aboutmore serious pathologies, that promises to add greatly to our understanding andability to treat a wide range of heretofore inexplicable conditions. At the sametime, there has been a reawakening of interest in the Rorschach, once thehallmark of psychoanalytic psychology, after several decades of relative neglect.Unfortunately, for the most part, these two areas of inquiry have had little, ifanything, to do with each other. This is largely a function of the atheoreticalempirical approach that has characterized much of the literature on projectivetechniques over the past 10 years. At the same time that Rorschachists seem tohave abandoned psychoanalytic theory as a framework within which to under-stand their observations, too many psychoanalytic psychologists have ignoredthe Rorschach as a means of learning about mental processes. The strength ofthe Rorschach lies not so much in the correlations between particular scores andformal diagnoses or behavioral ratings as in the opportunity that it offers to theclinician to view the mental processes of the subject. This requires a method ofinterpretation that pays attention to the response process itself as it unfolds in

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what Schachtel (1966) termed the individual's encounter with the blot and atheoretical framework within which to fit one's observations.

Recent advances in object relations theory have deepened the psychoanalyticunderstanding of numerous forms of psychopathology. These advances havenot, however, been matched by advances in psychological assessment. Al-though interest in the application of object relations theory to Rorschachassessment has grown considerably since Mayman's (1967) initial object-relational approach to content analysis, the view expressed by Blatt and H.Lerner (1983) is still valid: Research on the Rorschach test has not kept pacewith advances in psychoanalytic theory. Most of the more recent contributions(see Kissen, 1986; Kwawer, H. Lerner, P. Lerner, &. Sugarman, 1980; H. Lerner&. P. Lerner, 1988) have tended to focus on the assessment of self-representations or the representation of internal objects in Rorschach responses.It is my view that there are other areas of recent object relations theory that canbe applied fruitfully to the study of the Rorschach. In particular, the ideas ofWinnicott and his followers, in spite of wide application in the study ofpersonality and psychopathology, have yet to make an appearance in theRorschach literature. This contribution is an attempt to apply one suchconceptpotential spaceto Rorschach assessment, and I hope to demonstratethe utility of this concept both for furthering our understanding of theRorschach response process and for analyzing the protocols of a wide variety ofdifficult-to-diagnose patients.

POTENTIAL SPACE

The concept of potential space, initially articulated by Winnicott (1971) andfurther developed by others (e.g.. Green, 1975; Ogden, 1989; Pontalis, 1981),offers a fruitful approach to the understanding of both the Rorschach responseprocess and certain forms of psychopathology. Winnicott (1971) postulated thatthere was a potential space between the self and the object that both facilitatedand was a consequence of the process of separation:

I refer to the hypothetical area that exists (but cannot exist) between the baby andthe object (mother or part of mother) during the phase of the repudiation of theobject as not-me, that is, at the end of being merged in with the object, (p. 107)

This space can be conceived of as an intermediary area between reality andfantasy. Because creative living involves the constant interpretation of experi-encethat is, the reconciliation of the inner (fantasy) and outer (reality)worldsone can see why Winnicott (1971) also described this as the "placewhere we live" (p. 104). It is tbe location of symbolic thought, play, and cultural

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experiences. The crucial aspect of his area of experience' is the paradox of itslocus; it is perceived as on the border of the self and other, partaking of bo th -and neither-at the same time, much as the shore is land and sea simulta-neously.

The existence of potential space for the individual is synonymous with acapacity to tolerate illusion and develops out of process of separation from themother. Winnicott (1956/1975a) presumed that initially there is the illusion thatmother and infant are not separate; the mother exists only in the form of anonrepresented environment that meets the infant's needs in such a way thatthey are not experienced as needs. At this point, the task of development is fora gradual transition to a state in which there is a mother and an infant, separateand distinct. This can only occur through the gradual disillusionment of thefantasy of an undifferentiated dyad. As the mother gradually distances herselffrom the infant (by titrated absences and failures to meet his or her needs), aspace opens up between them that is filled by the infant's growing capacity tomanipulate symbols and thus create representations of the absent mother.During these absences, the infant learns to soothe himself or herself with the aidof a transitional object (Winnicott, 1951/1975b), a piece of the environmentthat is nevertheless experienced as under the infant's omnipotent control. Theoutcome of a successful process of separation is the development of a space thatis experienced as safe and ripe with potential. Where separation has been tooabrupt or traumatic or where the maternal care has been too inconstant, thespace between self and other is experienced as a frightening void, an emptinessthat cannot be filled or symbolized. Winnicott (1974) referred to this experienceas "primitive agony" (p. 104) and felt that such experiences must be avoided at allcosts.

Ogden (1989) suggested that there is a dialectical process between reality andfantasy in which each create and negate the other. Neither concept has meaningexcept in relationship with the other. This relationship occurs in the potentialspace. In this model, defenses can be thought of as disruptions in the dialecticalprocess between fantasy and reality in which each pole becomes dissociated fromthe other, resulting in the loss of meaning. Ogden referred to this process as thecollapse of potential space.

Many forms of psychopathology can be conceptualized as manifestations of acollapse of potential space. Ogden limns four ways in which this may occur:

1. The reality pole may be collapsed into the fantasy, such that fantasy isexperienced concretely as external reality as in the psychoses.

2. The fantasy pole may collapse into the reality, such that the capacity toimagine is impaired and experience is robbed of its color and vitality. This

'The terms area of experience or space do not, of course, refer to literal space in the Euclidean sense,but to a metaphoric zone of psychological experience.

POTENTIAL SPACE AND THE RORSCHACH 759

is observed in the severe obsessional states, psychosomatic illness, or thoseconditions described as "normotic" by BoUas (1989) or "normopathic" byMcDougall (1980).

3. A radical dissociation between reality and fantasy may occur, such thatthey are experienced as parallel and equal realities. Dissociative disorders,fetishes, and perversions manifest this form of collapse.

4. In extreme cases (i.e., autistic states), there may be a failure to create anyconnection between inner and outer experience; reality and fantasy are,thus, never created, and no meaning is generated in the first place.

Of particular interest are those cases in which reality is used as a defenseagainst fantasy and those in which there is a radical separation between the two.These patients can often look quite normal on the surface. Indeed, what one isstruck by is not what is there, but rather what is missingany sense of vitality orplayfulness. As discussed later, such patients can pose serious challenges for thepsychodiagnostician, because the absence of superficial signs of pathology onpsychological tests may belie the desperation and emptiness that these individ-uals feel.

POTENTIAL SPACE AND THE RORSCHACH RESPONSEPROCESS

How is it that subjects come to reveal their inner worlds through theirRorschach percepts? It must be remembered that Rorschach perceptsliketransitional objectsare simultaneously created and found: created in the sensethat the blot is an amorphous form that is given meaning by the subject's ovi^ nperceptual and cognitive processes, and found in that the resulting image mustbe reconciled with the attributes of the blot. This reconciliation of inner andouter occurs in the intermediate zonethe potential spacebetween reality andfantasy, and the resultant percept, like any creative product, contains elementsof both. In this process, the subject forms a relationship, albeit a transitory one,with the object represented in the percept. Most studies of object representationin the Rorschach tend to focus on the nature of the object represented. I suggestthat the nature of the subject's relationship to that object is a relevant dimensionas well. How was the object created? At what distance from the self is the objectexperienced? What are the subject's wishes toward the object? What are his orher fears of it? These, too, are relevant questions for the analysis of Rorschachprotocols and may be approached by a careful analysis of the nature of thesubject's response process.

These notions may best be illustrated by a consideration of what happens inthose cases in which there is a failure to maintain the potential space. For somepatients, the task of reconciling reality with fantasy is difficult, if not impossible.

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As a consequence, they lose the capacity to see the blot as if it were the percept.They either form relationships with their percepts isomorphic with real objectsor, alternatively, are unable to enliven them at all. One schizophrenic patient,for example, after responding to Card II, "It's having its period. . . ," dropped thecard abruptly on the table and began frantically wiping his hands on his trousersas if to remove the blood stains. For him, the card had ceased to be an inkblotthat reminded him of female genitalia or menstrual blood, it had become that,and he experienced all of the attraction, revulsion, and so on, that he felt towardwoman and their sexuality. One might say that he failed to reconcile reality withfantasy and instead superimposed the latter onto the former, in the processobliterating it. This is, of course, an example of the first type of collapse ofpotential space, in which the reality pole is collapsed into the fantasy. I suggestthat this inability to maintain awareness of the "as if aspect of the percept hasmore profound diagnostic and prognostic significance than the morbidity of thecontent or even many of the formal properties of the response. In this case, therelationship with the percept was quite intense, although predominantly aggres-sive. One might expect a proneness for developing powerful psychotic transfer-ences in which the therapist becomes the infantile object or at least a difficultymaintaining awareness of the nontransference relationship in psychotherapy.Indeed, this young man frequently developed delusional ideas about his thera-pist that were often quite difficult to manage. Less dramatic is the reaction of adepressed young woman who responded to Card III, "This card makes me feellike someone's been shot. . . ," at which point she needed to take a break fromthe testing. This patient experienced her reaction as if it had been produced bythe blot, almost as if the blot itself were animate. The inability to continue withthe testing reflects her failure to reestablish a potential space in which to createpercepts. In this case, what is particularly noteworthy is that this breakdownoccurred in the context of a protocol that was not formally disturbed (i.e., formlevel, experience balance, qualitive scores, etc. all suggested a nonpsychoticpicture). The patient herself was a highly accomplished academician whonevertheless tended to form primitive, intensely dependent relationships withher therapist, with transient psychotic transference manifestations. This lattertendency was reflected in her inability to maintain adequate distance from theblot.

By contrast, some patients fail to connect at all with their percepts. For them,the blot remains just tha t -an inkblot. When pressed, they might acknowledgethat the outline of the card roughly resembles the outline of a bat or a wolfs heador some other popular image, but they stress that it is only a vague resemblance.Their responses are lifeless, not because they are depressed or gloomy, butbecause they steadfastly refuse to inject any of themselves into them. Suchpatients are frequently highly attuned to nuances of denotative reality (reflectedon the Rorschach by good form level) but fail to animate their perceptions withany personal meaning. It is not that their fantasies are repressed; the effects of

POTENTIAL SPACE AND THE RORSCHACH 761

repression can be readily seen in Rorschach testing as has been carefullydemonstrated by Schafer (1954). Rather, fantasy has been foreclosed; it is notunconscious, it is missing from the psyche altogether. In the terms of thisdiscussion, potential space has been destroyed by the collapse ofthe fantasy poleof experience into the reality pole. This kind of restriction is often noted in theRorschach protocols of the broad spectrum of alexithymic patients,^ includingthose with psychosomatic illnesses, eating disorders, and sexual perversions, aswell as those of so-called "normopathic" patients. This latter group is character-ized by a lack of subjective distress (except, perhaps, for some vague sense of"something missing"), an improverishment of expression, and a profound lack ofcuriosity. For them, things just "are." Many of these individuals, especially thosewithout overt symptomatology, produce protocols that are superficiallyunremarkable. The number of responses is typically rather low and the Experi-ence Balance is usually coarctated, but otherwise the formal properties of theprotocol may be within normal limits. What sets these protocols apart isconstriction of the images represented, a lack of integration of other determi-nants with form, and, especially, the extreme difficulty the subjects have withthe task itself. As one young man expressed to me, "It's an inkblot, how could itbe anything else?" Another patient explained, when queried as to why he hadfailed to give more than one response per card, "If it looks like a bat, then it lookslike a bat. Bats don't look like anything else." Still a third could not understandthe task of the Rorschach at all, despite repeated instructions. Finally indesperation I likened it to the childhood game of staring at clouds and imaginingshapes in them. He looked at me in utter puzzlement and said, "People actuallydo that? I don't understand; clouds are clouds."

It is interesting to note that an unusually high number of space responses canfrequently be observed in the protocols of these patients. The concrete repre-sentation of emptiness or "the void" may stimulate primitive anxiety and a needto fill the space with something solid. This seems especially true for Cards II, III,and VII, which contain large central spaces that may symbolize either aseparation between the two main figures or, alternatively, an inner emptiness.Interestingly, these space responses are often the most elaborated and revealingof the entire protocol. For example, one young woman, who presented with amixture of psychosomatic symptoms and vague complaints of unease anddissatisfaction, gave no fewer than 12 space responses in a protocol of 38 totalresponses. Moreover, her form level was far better for these responses than fiDrresponses to the blots themselves. Indeed, a number of her space (S) responseswere scored as original percepts, in contrast to her other responses, which werealmost universally prosaic and of indifferent quality.

^Alexithymia is a term first coined by Slfheos (1967) to describe those patients who lack thecapacity to experience affect and can only express it through physical symptoms. Its literal meaningis "lacking words for feelings."

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The value of this approach to conceptualizing Rorschach responses is at leasttwofold. First, it offers a framework within which to understand the develop-ment of the response that is consistent with object relations theory. Thus, theresponses may be interpreted with the same language that one uses to discussaspects of the subject's relational world, including the psychotherapeutic rela-tionship. Inferences drawn in this way are likely to be of greater clinical utilitythan those that focus on general behavioral traits or nosological categories. Byconceiving of the response as an example of transitional functioning occurringin the potential space between reality and fantasy, the Rorschach response maybe seen as a reflection of the way in which the individual constructs his or herreality and copes with the trauma of separation and the awareness of connec-tion. Second, the model of psychopathology that is derived from the constructof potential spaceand its collapseprovides a framework for interpretingRorschach records that may appear superficially unremarkable but neverthelessreflect profound underlying pathology. This is especially true of the full spec-trum of alexithymic disorders firom the "normopath" to the pervert to thedissociative disorders. In the next section, I consider how this model can beapplied to one such disorder.

DISSOCIATIVE DISORDER: AN EXAMPLE OECOLLAPSED POTENTIAL SPACE

Dissociative disorders, including multiple personality disorder (MPD), are beingrecognized and diagnosed with increasing frequency (Putnam, 1989). A dissocia-tive disorder is one in which there are abrupt breaks in conscious experience suchthat the individual experiences amnesia for significant periods, fugue states, orevenin the case of MPDseveral parallel states of consciousness. Thepsychodiagnosis of these conditions can often be difficult because the nature oftest responses may depend in larger part on the state in which the subject tookthe exam (or in the case of MPD, which personality took the test). Thus, forexample, Wagner and Heise (1974) suggested a large number of diversifiedmovement (M) responses and labile conflicting color (C) responses as a commonpattern to MPD Rorschachs, whereas Lovitt and Lefkof (1985) found contradic-tory results. Using the Comprehensive System, they studied three MPD patientsand found relatively little communality among the cases with the exception ofambitent experience balances in all cases. Most interesting was the finding ofdifferent structural properties for protocols obtained from different personalitiesof the same individual. Although the patient as a whole may not evince aconsistent coping style, a particular personality is apt to. Thus, the nature of theRorschach protocol may depend on the ego state present when the test is given.

I believe it is fruitful to conceive of dissociative disorders as a form of collapsedpotential space, specifically one in which reality and fantasy are experienced as

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parallel-but disconnected-realities. In an earlier article (Smith, 1989), I arguedthat multiple personality can be understood in part as a failure to developtransitional objects at the phase-appropriate time. As a consequence fantasyobjects are experienced not as illusory, but as real. Unlike psychotic individuals,however, the experience of external reality is not thereby destroyed; rather aseries of separate, but equal, realities is experienced.

Given this conceptualization, one would expect Rorschach protocols fromsuch patients to manifest some of the features of collapsed potential space justoutlined. The evidence for a dissociative process may appear less in the struc-tural properties of the protocol as a whole than in the manner of approach to thetask, the relationships among the responses, and the experience of the whitespaces. Analysis of these features requires a careful, psychoanalytically informedscrutiny of the subject's verbatim verbalizations and affective demeanor. In thefollowing case example of a dissociative disorder, a number of these features arenoted.

The patient, Ms. A, was a 19-year-old college freshman who was hospitalizedfollowing a dramatic and extremely serious suicidal attempt; her survival ofwhich was nearly miraculous. Upon admission, she appeared calm, cheerful,and cooperative. She could give no reasons for the attempt on her life, except tosay that something had come over her and that she was sure that it would nothappen again. Hospital personnel were struck by the absence of any overtpsychopathology and were at a loss to explain her lethal behavior. She wasreferred for psychological testing in order to clarify this diagnostic puzzle.

Although Ms. A was administered a full standard psychological test battery,only the Rorschach is discussed here. The Rorschach was administered andscored according to the procedures recommended by Rapaport, Gill, andSchafer (1968) and Allison, Blatt, and Zimet (1968). These methods wereselected because they tend to produce somewhat longer protocols than theComprehensive System. In my experience, patients such as Ms. A frequentlyproduce protocols with too few responses for a valid structural summary to becomputed.

The formal scoring revealed few, if any, overt signs of psychopathology. Theprotocol was sparse, with only 17 responses, and the range of images was quiterestricted and stereotypic (47% animals and 30% populars). Form levels (F+%and extended F+ %) were high, suggesting intact reality testing, and the F% andextended F% were also in the expected range. An Experience Balance of 3:2.5suggests perhaps an inconsistent coping style, but only the presence of threeresponses using both blot and space {WS responses), a shading-form response{ChF) or achromatic color form response (CF), and one pure C are evidence ofmore serious pathology. In short, the general impression gleaned from theformal properties of the protocol is of a bland, constricted young woman in noacute distress.

Upon close inspection of the wording and sequence of responses, however, it

764 SMITH

is possible to see evidence for dissociative tendencies and the failure to maintainpotential space, as discussed in this article. In particular, the following featuresare highlighted: a focus on denotative reality; a preoccupation with the whitespace*,,ajack of connectedness between images; and, in particular, a dissociationbetween affect and cognition.

On the first card, following a response of a "dog's head" when asked if she sawanything else, she replied, "Else? It can be more than one thing?," and began totremble. She then responded with a "jack-o-lattern,' because the white spaceslooked as if a bright light were shining through them. Here we can see the shockand discomfort with the notion that the blot may represent more than oneimage as well as a preoccupation with the white space, in this case seen not as avoid, but as a strong light. This preoccupation with the white space continuedthroughout the protocol. On Card VII, for example, "two little girls" were seenas ignoring each other in part because there was "so much space in betweenthem."

A second striking feature was the severing of links or connections betweenimages. On Card II she initially saw "two clowns dancing . . . it also looks likethey could be fighting." After some time, she said, "It also looks like blood onpavement." Upon inquiry, she made it clear that these were two entirely separateresponses, and, furthermore, the association of "fighting" in no way related tothe "blood on the pavement." The latter response was determined solely by thecolors gray and red, whereas the former was determined by form alone. Here sheseemed to be saying that people may fight and there may be blood on theground, but the two events are in no way causally connected. Her only othermorbid response was similar in that it was disconnected from what preceded orfollowed it, and she had considerable difficulty justifying it. She saw half of CardVI turned sideways as "countryside that was either on fire or had been bombed."She was unable to explain what determined this response except to say that itlooked like smoke. Again, as with the response to Card II, there is an aftermath,but little indication of what might have caused it. Again, the introduction ofaffect, in this case in the form of shading or achromatic color, occurs in lieu ofcognition, as if it were a property of a different part of her and disconnected fromher thinking ego. Connectionor lack of connectionwas a preoccupationthroughout the protocol. Ms. A was visibly anxious whenever responding todetails rather than the whole blot, referring at such times to her images as "inpieces." On several occasions, she responded to one half of the blot, but neededto cover the other half with her hand in order to do so. In these instances, sherequired reassurance that she was permitted to respond in this manner.

What emerges from these observations is consistent with the con-ceptualization just put forth: a collapsed potential space and two parallel spheresof experience. Affectively laden percepts are disavowed and divorced from otherresponses, almost as if they were from a different person. There is an acuteawareness of and discomfort with representations of space and disconnect-

POTENTIAL SPACE AND THE RORSCHACH 765

edness. Finally, there is a preoccupation with the denotative aspects of externalreality and an attempt to deny inner reality (especially affect). Unlike that of thealexithymic, however, Ms. A's inner world is not entirely absent; rather it isexperienced as separate and distinct. It should be noted in passing that herThematic Apperception Test (TAT) stories were entirely consistent with theRorschach protocol: bland, unimaginative stories with occasional unexplainedreferences to death.

These observations neither constitute a thorough analysis of this case noroffer evidence for a particular hypothesis. Rather, selected observations werechosen solely to illustrate how a conceptualization of dissociation as a form ofcollapsed potential space can apply to the interpretation of a protocol with fewblatantly pathological formal properties.

Based on the results of the psychological assessment, Ms. A was diagnosed ashaving a dissociative disorder, possibly MPD. Based on the fact that thedissociated affective states typically appear in the form of the consequences ofaggression (blood on the pavement, smoke from a fire or bomb, the references todeath on the TAT), her suicidal potential was considered to be extremely high.Quoting from the original psychological report: ". . . the extremity of thedissociation and the lack of connectedness between her affects and her thoughtsall point to an ongoing significant risk of suicidal acting out. . . . Most alarming,of course, is the fact that she is unlikely, at least at present, to be able to giveclear-cut warning signals of her suicidal intentions (she is probably, for the mostpart, unaware of them herself)."

Following the psychological assessment, the hospital staff, who were alerted tothe nature of her psychopathology, began to see clinical signs of dissociationincluding sudden shifts in mood, frequent brief amnesias, and periods ofdepersonalization and derealization. Unfortunately, she insisted on being dis-charged from the hospital shortly after the testing was concluded, maintainingthat she was no longer suicidal nor depressed and that she fully intended tocontinued outpatient psychotherapy. Because there were not sufficient overtsigns of imminent suicidality, she could not be committed, and she left thehospital in cheerful spirits. Less than 12 hr later, she drove to a nearby bridgeand leapt to her death.

CONCLUSION

In this article, I attempted to discuss the implications of potential space, atheoretical construct derived from object relations theory, for Rorschach assess-ment. I proposed that the Rorschach response be considered as a transitionalphenomenon, a reconciliation of inner and outer reality that occurs in anintermediate zone of experience. It should be stressed that the analogy betweenthe Rorschach response and the transitional object is by no means perfect.

766 SMITH

Whereas the transitional object is chosen to soothe the child in the absence ofthe mother, the Rorschach percept is created in response to the demands of thetherapist. Likewise, the choice of object is not free. It is a crucial aspect of thetransitional object that the child choose it freely; it cannot be given to him. Withthe Rorschach, on the other hand, the objectthe blotbelongs to the exam-iner, and it is with this object that the subject must create the percept. Thisnecessarily brings into play the entire area of the transference relationshipbetween examinee and examiner, a topic well beyond the scope of this article.

I also suggested that several forms of psychopathology can be conceptualizedas the failure to maintain potential space, either in the form of one pole ofexperience collapsing into the other or of a dissociation between reality experi-ence and fantasy. This paradigm offers promise for the assessment of otherwisedifficult to diagnose conditions, such as alexithymia, dissociative disorders, and"normopathy." Again, no claim is being made for this as a comprehensive modelof psychopathology nor is it intended to replace other psychodynamicallyinformed modes of interpretation. In the Case of Ms. A, for example, acomprehensive Rorschach assessment included consideration of her self andobject representations, ego and superego functioning, and core dynamic con-flicts.

I suggest that Winnicott's (1971) concept of potential space offers promise fordeepening our understanding ofthe Rorschach response process and, thus, themeaning of Rorschach data. Basing our interpretations of Rorschach data onsound theoretical principles is necessary if we are to offer other than superficialobservations about patients. At the same time, operationalizing our theoreticalconstructs and applying them to actual clinical material is required if we are toadvance psychoanalytic theory. The reciprocal influence between theory andassessment can only be of benefit to both fields.

ACKNOWLEDGMENTS

Some of the ideas contained in this article were developed in discussions withLaura Doty, MA, whose stimulating collaboration is gratefully acknowledged.

An earlier version of this article was presented at the Society for PersonalityAssessment Annual Meeting in San Diego, March 22-24, 1990.

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Bruce L. SmithDepartment of PsychiatryAlta Bates-Herrick Hospital2001 Dwight WayBerkeley, CA 94704

Received March 1, 1990