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When the author of this paper states that his aim is “to create conceptual tools for listening psychoanalytically,” we sit up and take note because we are always in need of new ways of looking at what goes on in the analytic setting. Dr Sapisochin introduces the term “psychic gesture” and even though this may not be an entirely new concept, since it seems to be what we think of as a jointly created enactment, he gives it a new emphasis and shows us how to use it to explore the transference. Psychic gestures are not limited to actions such as those we might call acting out, but include verbal interchanges and interpretations so that we are able to observe psychic gestures in the totality of the interaction between patient and analyst. Like Sandler (1976) and Joseph (1981, 1989), Dr Sapisochin recognises that through these enactments the analyst is drawn into playing a role in the patient’s phantasy world and he shows us how examining psychic gestures can provide information about these roles as they are actualised in the relationship with the analyst.
The value of such an approach is shown in the clinical example where the study of a psychic gesture alerted the analyst to a specific type of object relationship in the transference. His 24-year-old patient, David, gave an account of an unstable career, broken-off therapies, and failed relationships, and the impression of unreliability was confirmed when he missed sessions because he overslept or forgot, and took unscheduled holidays. From the start of his analysis he complained about his intrusive mother who entered his bedroom without his permission, tidied up his things, and threw away some of his clothes because they smelled bad. He complained that she was mad and suggested that Dr Sapisochin should talk to her analyst, through whom he had been referred. The patient’s depiction of his mother was so convincing that Dr Sapisochin began his clinical account with the heading “David: A child abandoned to the flood of a de