Clinical observations and metapsychological interpretations are almost inextricably mixed together in the concept of the pensée opératoire. The authors regard lack of imagination as the chief criterion of the pensée opératoire. They explain it on the basis of the psychoanalytic theory of fantasy and characterize it as a Rorschach fantasy syndrome. Comparing forty psychosomatic and forty psychoneurotic patients, they find that the former showed a lesser capacity for fantasy.