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A revered teacher of mine once made the audacious claim that all of clinical technique—its theorization and its practice—boils down to tact. The OED defines tact as “a ready and delicate sense of what is fitting and proper in dealing with others, so as to avoid giving offence, or win good will; skill or judgement in dealing with men or negotiating difficult or delicate situations; the faculty of saying or doing the right thing at the right time.”
I invite you to join me in treating Sidney Phillips's remarkable clinical work here as a systematically sustained effort at finding his way toward tactfulness, toward “saying or doing the right thing at the right time.”
A closer look at the word tact leads us to its sensuous companion, tactile. This places the word nearer the body and expands its meaning to include “a keen faculty of perception or discrimination likened to the sense of touch.”
“Likened to the sense of touch,” tact, psychoanalytic or otherwise, can be seen not only as a way of directly relating to a person, but also as an indirect way of relating to that person's body, to that person's skin—it becomes a “fitting and proper” manner of speech and behavior whose aim is to deftly, and multidimensionally, touch another person indirectly.
So, perhaps what we are looking for in proper clinical technique, and what Phillips has so adroitly found here, is a way of delicately touching our patients, finding a sensuously sound way to make contact—psychic skin to psychic skin—with our words and therapeutic approach. This way of positioning “tact,” and clinical technique, carries us back to Freud's prescient theorization of the ego as “first and foremost a bodily ego” (1923, p. 26). Touch the ego, then, and indirectly you are touching the body. The ego's sensitivity to verbal touch corresponds to the body's sensitivity to physical touch.