Consider this familiar scenario. One of the interns in your practicum has completed an outpatient testing on a 25-year-old male, J. D. You have supervised the Rorschach and agreed that J. D. had a high number of minus-form-level responses and gave three Level 2 Special Scores, or Cognitive Codes as they are now described in the Rorschach Performance Assessment System (R-PAS; Meyer et al., 2011). The severity of these scores indicates a disturbance in reality testing, along with both a severe lapse in J. D.’s logic and disorganization in how he verbalized his responses. Although there were no accompanying clinical signs of psychosis and no one on the team has raised questions about this possibility, your intern is certain that we have evidence that J. D. must be psychotic. Do you agree? Before you answer, it might be useful to review the relationship between reality testing, thought disorder, and psychosis.