nonverbal behaviors in the analytic situation the search for meaning in nonverbal cues

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487 James T. McLaughlin

American Imago , Vol. 67, No. 4, 487–514. © 2011 by The Johns Hopkins University Press

487

JAMES T. MCLAUGHLIN

Nonverbal Behaviors in the Analytic Situation:

The Search for Meaning in Nonverbal Cues

“He that has eyes to see and ears to hear may convincehimself that no mortal can keep a secret. If his lips aresilent, he chatters with his fingertips; betrayal oozes outof him at every pore.”

—Freud, Fragment of an Analysis of a Case of Hysteria

Two extended clinical examples are offered to show the value ofattending to nonverbal behaviors in the analytic situation. Such kine-

sics may be highly charged transference actualizations that lead to the

recovery of early memories. The material is viewed primarily from thetheoretical standpoint of separation-individuation dynamics. The au-

thor argues that nonverbal phenomena should not be viewed as inferior

to verbal communications or as less central to analytic work. (PLR)

Eloquent Hands

Mr. E. enters my office in his usual fashion, as he has donefour times a week since he began to lie on my couch two yearsago. A slim, somber man, tight and constrained in body and

manner, he strides past me without comment, quick-wiping hisnose and mouth with the back of his right hand as he passesme. While his eyes never meet mine, I can see from theiroblique set in my direction that he keeps me in his peripheral vision as long as he can. I have had many thoughts about hisbehavior, each time he has passed. When I saw it for the veryfirst time it made me think of the eyes-right/pass-in-reviewparades I sweated through in my army days, and his a rather

strange salute.

This paper was first published in Selma Kramer and Salman Akhtar, eds., When theBody Speaks: Psychological Meanings in Kinetic Clues (Northvale, NJ: Aronson, 1992), pp.131-62, and is reprinted here by the kind permission of the editors and the publisher.


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488 Nonverbal Behaviors in the Analytic Situation

He stretches out on the couch in a relaxed fashion, handslaced behind his head, right leg bent horizontally and resting on

his outstretched left leg. Immediately he launches into tellingme about his many successful enterprises, soon gesticulating vigorously in the air with his right hand and arm. His speech isdeclamatory and at times loud, his voice conveying intensitiesthat I hear as pleasure and pride mixed with some anxiety andpleading. The contrast between off- and on-couch behaviorsis striking, even though I have seen it played out like this forthe last three months.

There are other contrasts, equally striking, when I thinkback to his first year on the couch. Then Mr. E. lay stretchedout motionlessly, legs side by side, hands clasped tightly on hisupper abdomen. His voice was small, and often I had to strainto hear his brief phrases, remarkable in their cautious gener-alities, constant revisions and disclaimers. His most frequentexpressions were “but, I don’t know” as a coda to his own com-mentary, and “it could be” as a response to mine. My initialappraisal of him was that he was a bright, even intellectuallygifted man, inhibited in assertiveness and lacking in self-esteem,held back in his full unfolding by obsessional defenses againststrong affectivity.

Back then, he lay very still on the couch. His main mo-tor activity, one that went on almost incessantly from the firstcouch hour, was his hand play. I cannot recall another patient whose constantly touching hands held so rich a repertory ofhand-to-hand combat, play, and lovemaking. His fingertips

and nails were tattered survivors of years of picking and tear-ing that went on in bursts, in a manner I presumed to be ahabitual cuticle picking and nibbling habit. At lesser intensity,his fingers scratched, squeezed, tapped and banged, on theirothers, or at times gently smoothed and massaged their ownor their counterparts. His thumbs had their own place in theaction, tapping on or twirling around each other, concealedin the curled fingers of own or opposite hand, and often the

target of attack or caress from the other hand. While we worked together in the first year or so, in an

analytic mode wherein I maintained a rather quiet style, I hadample opportunity to observe these hand-behaviors as they


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played out in the context of the verbal component of ourdialogue. Mr. E. was one of those patients whom I attempted

to track with a style of observing and notetaking that I havedescribed elsewhere (1987). Its essence lay in my trying, withprocess notes and scrawled gestural notations, to capture innear simultaniety the words and the actions of my patient.

The stimulus for this attempt came from experiences thatI kept having while watching, largely with left peripheral vision,the kinesic behaviors of my patients as they lay diagonally tomy left, and spoke or were silent. What kept happening, with-out my consciously intending, was that often, as I looked andlistened, I experienced a dawning sense of pattern or contextrelating to the verbal, actional, and affective components ofthe patient’s communication. I did not know what it was thatI had registered; but, repeated variously over analytic time,the patterns had become recognizable, even though not yetidentifiable. Hence the search for learning what I could aboutthese simultaneities.

Those of you who know this story will remember that thesheer burden it placed on my efforts to analyze forced me toput the project aside except for spot sampling and followingchange over time. I did find that it was descriptively possible,and clinically useful, to distinguish between behaviors that wereoccasional, conspicuous, and idiosyncratic and those gesturalpatterns that were repetitious, unobtrusive, and likely to go un-noticed until repeated over time in synchrony with verbalizedcontent (1987, 573–77).

In Mr. E.’s instance I had, from the outset, no chance tobe rigorous, for the rapidity of his finger—hand activities wasbeyond my capacities to record but a fraction. Yet I did reg-ister much, in the multilevel ways of seeing and hearing that we all habitually use, often without our conscious knowing. Itis from this sum of what I came to know in this manner aboutthis patient, how he behaved as he spoke of himself and thosearound him, that I draw in scanning Mr. E.’s behaviors and

analytic progress in his first year of analytic work.I learned that Mr. E. had grown up as the middle child of

three, with a sister three years older, and a brother who camealong just two years later. Both parents struggled to survive in


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separate professional careers that took them early and oftenaway from the home, once brother was born. My patient carried

a blur of memories from his early years, of cleaning women andsitters looking in on him and the other two. He had sharperrecall in his memories, some of these his earliest, of his turn-ing, as did his brother, to his sister for attention.

He still felt grateful to her for what she provided, althoughit came in ways imitative of his mother’s unreliable bursts ofcaring. In our work he tended to merge mother and sister inhis sortings of his past. He described both as being at timessolicitous and doing for him, in ways that could be comfort-ing; yet more often taking him over and doing to him, whiledemanding his grateful compliance. Both were capricious andtotally unpredictable in responding or ignoring; either couldturn on him with fury, slaps, and stomping off, if what he didoffended them. He remembered being bewildered and upset,lost and helpless, growing quiet and cautious.

A parallel but very different confluence showed in his per-ceptions of brother and father. Mr. E. lumped them together with tolerant dismissal. Brother was more bother than he was worth, someone to team up with in warding off, baiting, orcompeting with big sister; an uncertain ally in a show of strengthin standing up to mother’s absolute power; and another loserin their conviction that mother vastly preferred their sister. Mr.E. had vague guilt over having distanced himself early fromhis brother’s littleness and haplessness, and watching with dis-dain his brother’s floundering even in adulthood. Father was

portrayed from a position of distance and uncertainty. Mr. E. was his most indecisive and noncommittal in letting me knowabout his father, the latter coming across as absorbed in hisown struggles unsuccessfully to cope with life in general, and wife in particular; as a nonpresence in relation to any of hischildren. When he did get involved with the two boys he didso through perfunctory disciplining demanded by mother. Thetwo lads shared the conviction that father, too, preferred their

self-assured and colorful sister.I will only sample in summary fashion some of the rich

concurrence that I often saw, and occasionally recorded,between Mr. E.’s hand/finger play and his verbal/affective as-


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sociations around these central figures of his primary family.Much of these kinesic patternings became active when he was

caught up in thinking about his wife and others of importanceto his current life, and, in time, about me. I shall refer to thesecollateral happenings mainly to instance their transferenceimplications. I could see no indication that any of these smallbehaviors were in the patient’s awareness.

Soon into the analysis Mr. E. altered his basic claspedhands in different ways and in different contexts. When hespoke of needing comforting or reassurance from his wife,then associatively his sister, the fingers of his left hand mightfree themselves to cover, and gently rub, the back of his righthand. Then his thumb, usually the right, could slowly be en-folded in the clasp of the other hand. He did not make thiskinesic linkage when speaking of his mother. Toward her hedescribed more his wariness of never knowing whether she would remain calm or overwhelm him in unprovoked verbaland physical assault. Here one thumb would rapidly disappearinto the clasp of the other hand or of its fellow fingers; in afrequent variant, both thumbs could tuck out of sight beneaththe still-interlocked fingers. From his words I began to heara richer context for his troubles with mother as these smallrituals played on. His mother had pressed him to be a big boyin complying quickly with her rules about obedience, sphinc-ter control, and eating what was put before him. At the sametime, she could not tolerate his efforts to do things his way andbecame angry, often physically punitive, at his wilfulness, his

straying away, and his curiosity about her body and that of the woman caretakers who came and went. He had been brieflyprovocative, but crumpled into overt submission out of fear ofbanishment. As he grew, he became stubborn and subversive,never capitulating completely.

As he slowly became freer to reveal himself to me, in whatI sensed to be a form of idealizing transference, he drummedon the back of one hand with the stiffened fingers of the other,

back and forth, with great vigor and audible force. Mainly hespoke at such times of his controlled anger at his mother forthe constraints she had placed upon him, his rage toward herthat he felt helpless to express lest she retaliate tenfold. His


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heightened body tension amplified the anxiety engendered inhim as he spoke of how it was to this day when in any way he

was stirred to anger by anyone important to him. The finger-drumming began also to occur during silences between us. Wecould gradually explore these silences, and he could acknowl-edge that he perceived my silences as failing to meet his silentneeding that I help him to deal better with his emerging ragetoward mother.

It was around this time, toward the end of his first year,that his thumb-picking stepped up in tempo and prominence. Able to speak more fully of his needs and frustrations felt inrelation to both parents, and now towards me, he began openlyto pick at the periungal skin of both thumbs with thumb andindex finger of the other hand. These attacks were at timesliterally bloody. This prompted me, for the first time, to calldirect attention to these kinesics, partly out of mild concernfor this self-mutilating, partly because I knew from my analyticexplorations of my own adolescent cuticle-picking what richdynamics of pent-up anger and sexual conflict could lie in thisbehavior. Lastly, I assumed that the pain he was experiencingmust surely be in his awareness.

I was wrong in my assumption. Mr. E. showed shock, anxi-ety, and speechlessness. Later he described his silence as firsta fear of saying anything at all, then a state of confusion andfear. At that moment of his confusion I intervened actively toreflect upon his apparent state and how what I had done hadupset him so. Gradually he regrouped and spoke of being en-

tirely unaware of his skin-picking; he felt caught and about tobe given a beating, or told he was unanalyzable and we werethrough. He acknowledged that his cuticle-picking was a habitfrom his early school years, but had nothing more to say at thatpoint. Following our enactment, this kinesic pattern left theanalytic scene for several months, although his thumbs, andfingers as well, bore mute witness to ongoing combat elsewhere.Only some months later, as he worked over his experiencing

me as having let him down, turned on him, and changed in-explicibly from the comforting helper that he thought he had,did more history about these kinesics emerge. Notably, his usualdisclaimers and qualifiers had dropped in frequency as this


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piece of work was accomplished, and he was more forthrightin his speaking. He could not remember when his nail-biting

and picking had begun. It had driven his mother to enragedscreaming and face-slapping in her helplessness that she couldnot break him of the habit. He could recall gloves tied on hishands, foul-tasting stuff smeared on his fingers, and beatingsgiven him by both parents. These memories were entangledin other recallings of even earlier battles and chemical warfarearound thumbsucking, which struggles mother apparently had won. This later one she could not win.

I reflected to him, and he acknowledged, his pride in hisnearly lifelong angry, stubborn holding onto what he could that was his own, often at the cost of mutuality and intimacy. Havingthis struggle played out between us opened the way for us to work on what we both had come to see: the battle scars fromboth campaigns that left him wary of his wife’s often generousgiving and my efforts to reach him; chronically striving to con-trol his temper and his need to overeat; and nagged by guiltover whether he really loved anyone. Then we could address,in conflict terms, the enduring pain of his unmet hopes forsteady caring and anxious fury over the uncertainties of caregiven or denied.

This samples the manner of our working, up to the stateand place where I introduced Mr. E. to you. By that time hehad shown considerable loosening of his behavioral constrictionon the analytic couch, as well as gaining a broader range of af-fective freedom and access to aspects of his troubled past that

earlier he had repressed or disavowed. His limited behavioraldisplay had gradually given way to freer kinesics that I inferred,and he corroborated, to be a reflection of his greater comfortand collaborative involvement in the analytic search.

At no time, excepting for the confrontation I made aboutthe bloody skin-tearing, was it necessary to address the handkinesics directly. The nonverbal components served mainly asguide and affirmation for my enhanced understanding of Mr.

E.’s dynamics. These cues often alerted me to his underlyingaffective states and conflicts at a time when he could not, and would not, put words to them. The metaphor they providedhelped me find good words.


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He and I had later to do considerable further work oncastration-level conflicts centered in his avoidance of intel-

lectual aspiration and professional achievement, consideredby the patient to be destructively competitive toward bothparents and me. Fresh reflection of what turned out to be cas-tration anxiety over exhibiting emerged in a new mannerismof clutching his necktie as he spoke of his desires to excel asan intellect. This conspicuous behavior was one that I couldmore freely address, in contrast to the quieter backgroundkinesics. After some time I asked him to notice his tight grasp-ing, as something to explore. We learned first that there wasan ongoing battle between wife and patient around who wasto select the ties that he wore. When he wore those that hehad chosen, he felt conspicuous and vulnerable to criticism. And well he might, for his were wildly polychromatic, herssubdued and sincere. This led him to his choice of a spouse:he had defended against his richly incestuous desires by hislesser marital choice of a sister-figure. With her he could gainthe comfort of a subtle devaluation of both wife and himselfthat sidestepped the tensions of his reaching for full revengeand fulfillment. As these old dynamic issues became revivedin the analytic work, Mr. E.’s grabbing of his flamboyant ties,at the height of uncertainty over the outcome of his dilemmaover wish and fear of accomplishment, made these tensionsmanifest. Here was something simultaneously real and sym-bolic that we both could see, grasp, and soon chuckle about,an insight gained between us with a graphic power that words

alone could never reach. At this point we must remain uncertain as to whether these

clinical data have demonstrated their relevance for the issuesof separation, individuation, and rapprochement that Marga-ret Mahler (Mahler, Pine, and Bergman 1975) helped us seethrough her infant research. I think that the circumstantial evi-dence is rather compelling, given its fairly clear linkage to veryearly dynamic concerns. I shall return to this challenge later.

Meanwhile, I want to stress that a particular reason forproviding this overview has been to describe the changesthat can be discerned in the background kinesics of a not-extraordinary analytic patient as the work progressed. These


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changes that patients generally experience as they improveover analytic time are much like those described for Mr. E.: a

gradual relinquishing of initial constraint and prevailing im-mobility, and the achievement of evident relaxation and morefreely displayed expressive motility. The initial backgroundkinesics tend to drop away in frequency, as the accompany-ing dynamic concerns are reduced through the analytic work,resurfacing occasionally as these concerns return for further working through. I have found these changes particularly inthose patients with a preponderance of inhibitory neuroticsymptoms and obsessional characteral disposition.

Stuck in the Stirrups

My second vignette is more immediate in its clinical detail,and more graphic in its depiction of uncertain object constancy.It may be more compelling in its portrayal of linkage between verified experiences of specific traumata occurring in first two years of life and separation-individuation dynamics played outin the patient’s behaviors as an adult.

Mrs. T. presents a quite different picture and clinical chal-lenge from Mr. E., at a time when she is well into the third year of an increasingly turbulent analysis.1 Thanks to repeatedsmall enactments of our shared shaping, we are—certainly Iam—having growing difficulty in working without encounteringanother troublesome break in our communication.

Mrs. T. enters grim-faced and flashing a brief blank starein passing.

Pt. “I thought what you had to say on Friday was crap, way off target; left me nowhere all weekend. Made methink of other stuff like it you’ve said that was just asoff the wall. Can’t remember what it was.” (Right handclutches strands of gold chain necklace on upper chest.)

“Can you?” A. “Maybe you can get to it. We can see—”Pt. “Not much help, as usual—something about how Idon’t pay attention to what you say, can’t let you help me.


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Which is a crock. I ask your help and you don’t even hear. And that stuff last week about how my mother conned

me into dumping my bottle in the trash can, said be abig girl; and I wasn’t ready to give her it—I mean, up. You acting like that meant something, and I don’t thinkit meant much!” (Right hand flings chain with motionthat bounces chain off her nose and lips as patient ges-ticulates to right, towards me. Pause. Near crying.) “Whydon’t you help me?” (Right hand clutching and twistingchain on her throat.) “I could choke you!” A. “How do you see my helping you?”Pt. “See! You don’t even know! You’re not paying atten-tion. You should know, and why should I have to tell you, come to you? Why aren’t you there?” (Hands clutcheach other on chest.) “It’s no use. I’m always on my own,floundering. Trying to learn how to feel good feelings,to relax and feel my sexual feelings; instead, just tightenup, get anxious; then feel nothing but anxiety and angereverywhere. I leave here like this and go out there andget into real trouble, lose my job, my home, my chance tohave a baby, have my feelings! Say something!” (Voice inhigh-pitched anxious rage; right hand clutches necklace,left fingers to mouth.) A. “Perhaps we can look at your getting afraid here when you try to feel good. Something happens in youthat you have to stop the good feelings, become emptyand frustrated.”

Pt. (After long silence, then in cold contempt and fury,hands pounding the couch.) “That does it! That ruinsthis hour! I ask your help in letting me feel good, relaxedand right. And you tell me to go be afraid of you, tightenup; rub my nose in it and there’s nothing there! I couldclaw you, rip off your genitals, break up this room!” (Sitsup to glare at me and kick at the coffee table. Longsilent glaring.)

A. “Are you thinking of something?”Pt. (Still furious.) “I am but I won’t! Talking about what you want talked about will just push me down deeperinto the muck. I could just walk out of here and nevercome back—or come back with my gun!”


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A. “You see me as making you do what I want, go lookin the garbage can for what isn’t there?”

(Pause)Pt. “You bastard, you’re doing just what you were doingon Friday, rubbing my nose in how much I need you andcan’t do without you or with you.” (Quieting a bit, stillglaring, right hand clutching necklace almost to breakingpoint). “You keep doing this to me; just when I’m goingto risk letting you see me being me, you’re off somewhereor telling me I ought to be looking at something else,or go lie on the couch all by myself!”(Silence of several minutes of near-unblinking staringat me, as I look wide-eyed back, leaning forward in mychair a little. She breaks gaze and swings round so asto be half-sprawled away from me, face muffled in thecouch; mumbles inaudibly.) A. (Leaning farther forward in chair) “I’m sorry. I justcan’t hear what you’re saying; but it sounds like you’recrying.”Pt. “If I’m crying it’s not for you, it’s for me. I feel lostand stuck; afraid to get up and get out of here, or whatto do if I do. But I’m so goddamned attached to you!”(Hand again clutching necklace and blouse at throat.)“Why don’t you do something!” (Said with less heat.) A. “Maybe you’re saying, “Help me help myself, and stopgetting in my way?”(Long silence—perhaps four to five minutes—patient

sinking back onto the couch in semi-reclining position,right foot on floor, left hand on forehead, right holdingnecklace and bodice in relaxed way.)Pt. “I’m remembering what you said a long time ago. It wasn’t the way I thought you said it was; it had to do with with me telling you about that time in the departmentstore, and I wanted to look around and she stood there;let me run off and be lost, and they brought me back

crying and wet myself. You said then that I wasn’t lettingmyself feel anything as I was telling you, and I wouldn’t. And you said it was important and I didn’t think so. You took it away from me; saw more in it than I did. I


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couldn’t work with it anymore, it wasn’t mine. But there was more to it: she told the clerk she had kept an eye

on me all the time; that she wanted me to feel what it was like not to heed and run off and get lost. Years latertold me the same thing and I asked her if it was true.She let me do what I was doing by myself and made ithers, made it bad, to teach me a lesson! Well, she taughtme, and I’m all fucked up for it!” (Jerking and twistingthe pendant, grabbing it and throwing it away in rapidalternation.) “Just like she talked me into how good it was to throw away my bottle, and I did, and I didn’t feelgood at all—I felt lost. And I did go looking all over forit, in the garbage can next day, but it was gone, and I feltgone.” (Hands down to sides in opened fashion.) “I’mstill tied to her and now I’m stuck to you.” (Both hands white-knuckled clasp necklace.) “I want to be on top andinstead I’m in the pits.” (Pause) “You’re awfully quiet. Are you there? THERE?” (Looks back briefly). “Yeah,guess you are. You usually are. Now, what do I do withthat! Maybe you don’t always crowd me, or leave me likeI think. But, it’s hard to know you’re mine or I’m yours,to count on where I can feel you with me, okay?”

I think these combined data tell much about the dynamicconflicts, and their developmental-phase origins, of this patient,about whom I have told you practically nothing, as well as myown, often ill-advised, efforts to make contact with her. I have

presented them in their stark and painful actuality in order toask, as well as to challenge, the reader to resonate to the nonverbal pantomime that complements the verbal communication. At this point, in the clinical narrative, I would wonder what you feel can legitimately be inferred, from this single interviewalone, about separation, individuation, rapprochement, andtransitional phenomena.

Meanwhile, here are some salient aspects about Mrs. T.’s

background, and a sketch of the course of the analysis up tothe time of the interview just described.

Mrs. T. had entered analysis frantic for help with her wor-ried absorption in her job, her near-disabling anxiety over how


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she was perceived and treated in her work, her frigidity in hermarriage, and a pervasive inability to sustain pleasurable feel-

ings connected with idleness, recreation, or sexuality. An attractive woman in her late twenties, Mrs. T. struggledto maintain her place in a professional field long known tobe dominated by men. She held to firm convictions that anyrevealing of inadequacy on her part to her male associates would lead to her downfall; and she saw being casually friendlyor flirtatious as a bow to their chauvinism that left her shamedand guilty. In actuality, she continually encountered what shefeared, both with her bosses and her husband. Her accountsof repeated and painful accounts of being “put down” by allthose in power portrayed her as behaving habitually in a muted,self-depreciative way until goaded to petulant complainingthat provoked further rejection. Her manner of relating to megradually portrayed this pattern. At the beginning she was eagerto please and anxiously bent on avoiding my criticism. I oftenhad to strain to hear her small voice or decipher her quick,slurred words. My asking her to repeat or clarify brought herto flushed confusion and stammering, and she acknowledgedthat she felt criticised and “uptight.”

Initially compliant, and clinging to my words as gospel,Mrs. T. spun out her story of sturdily trying to ward off disas-ters that still kept happening. She gradually showed flashesof tense playfulness, at times being provocatively flirtatious. When I kept failing to respond, except to inquire further, shebecame abashed, ashamed, and angrily withdrawn. She initially

rebounded to a stance of insistent independence and “Whoneeds you, anyhow?” After awhile, she began to subside intoa “help me—I don’t know what’s wrong; what’s happening tome?” mode whose evident suffering I experienced poignantlyas a pleading to be rescued. I reflected this to her in an ex-ploring and tentative fashion. It was then that I gradually firstheard about a chronic illness, during the patient’s secondfive years, that kept her closely dependent upon her mother,

whom Mrs. T. described as being then a hovering and solicitoushomemaker until the patient’s kindergarten years. At that pointmother ceased to be housebound and went off to work as asecretary, where she described herself as forever overworked


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and underappreciated, and more burdened than ever at home,but obviously pleased with her career.

Once, as she dwelt wistfully upon those early years of hermother’s caring, I could hear Mrs. T.’s gut-rumblings, mostlysoft gurglings, as she lay quietly, her hands intertwined on herepigastrium. I was first surprised, and a bit abashed, when Iheard my gut-sounds, piping a kind of counterpoint, or obligato,to hers. Mrs. T. also heard, and she reacted alertly. “Are youmaking that sound to tease me, like at times the tapes youplay in the sun porch seem like you chose them on purpose?” While I was pondering an answer, my gut obligingly rumbledagain. This time, Mrs. T. laughed in what seemed to me relief(hers, or mine?), and said: “Well, guess I finally got a responseout of you!” Later, as she reminisced upon instances of hermother’s solicitude whenever the patient was hurting, and herstomach would speak, she seemed also to be listening for meto repeat my contribution to the duet. When on occasion thisdid happen, and I silently resigned, she spoke with pleasureabout how this “seemed to bring us close, like we were joined.”I may have been acting analytically, but I do know that I alsofelt some anxious press to reclaim the right to speak for my-self when I acknowledged that we both seemed to find somespecial meaning in the images of a caring mother being closeto her hurting child.

Shortly afterward she began, for the first time, to cry in mypresence, as she began to relate aspects of her early years thatcast her mother in a different light from the rosy idealizing of

her initial account of her childhood.Haltingly, Mrs. T. sketched a picture of arriving as the third

child of overworked, bluecollar parents absorbed in jobs andhome renovations, and eager to speed the maturing of theirtrio. Only the firstborn, a son, was allowed freedom, bikes, andthe privilege of being with father in his bulding projects. Thetwo little girls, just eleven months apart, were kept on shorttether and pressed into housekeeping chores that the brother

escaped.Both from her own retrieval of early memories and ac-

cording to family accounts, Mrs. T. had been rushed through weaning from breast and bottle and toilet-trained very early.


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She had been twinned to her sister by mother, who dressed andtreated them alike for the first six years, pressing both to strict

rules of controlled behavior. Her earliest memories included wrangles with sister, who would scorn her for her shamefulbaby weaknesses, then tell on her; as well as her house-frazzledmother reproving her for bothering everyone with her helplessscreaming about unfair treatment.

Mrs. T. had matured early into a good and conscientiouslittle girl who developed in preadolescence a severe religiousscrupulosity that caricatured the strict upbringing of homeand religious education. In both places she was castigated forher sneaky stubborness and punished for her rare outflares of verbal rebellion; she became guilty and anxious thereafter ifshe deviated from compliance.

Inwardly chafing over the preferential treatment accordedher brother in furthering his access to sports and education,she experienced rebuff and censure from the parents when shebegged for equal opportunity. So, she found her own fundingfor advanced schooling and pushed herself far beyond thelevels achieved by parents or siblings. The higher she went, thegreater became her anxiety and guilt. She felt estranged andlost in her college years. While there she quickly entered intomarriage to an undemonstrative man, educationally beneathher and given to controlling her with unremitting criticisms andneedling her weaknesses. She was painfully dependent upon hisapproval, unable to defend herself, and only rarely orgasmic.

To go back again to the beginning of the analysis: Mrs.

T. showed from the start an anxious vigilance, gazing intentlyinto my eyes while entering and leaving my office, at times with warm friendliness, at times with baleful glare. On leaving,she invariably said goodbye to me twice, breaking gaze, thenquickly looking back to make eye-contact again and repeat herfarewell. I had a strong sense of being checked on in her wayof being sure that I was still watching. She was visibly uneasyon the couch, finding it hard to lie still, and soon established

a behavior of quickly glancing over her right shoulder to makesure I was there. She acknowledged that she needed to checkout my facial expressions to see if I was still kindly inclined.She was particularly apt to do so while telling of her sexualand hostile feelings.


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Often her anxiety in this regard was such that she wouldswing suddenly to a sitting posture on the couch, speaking of

her need “to feel the floor under my feet.” I found that myencouraging her to lie down when she could, for the usualgood analytic reasons, evoked only dull submission and affect-less rumination, then mute rage and anxiety that we could not work on. Similarly, when I met her sitting gaze with exploringquestions and requests for analytic work, her agitation andmotility increased. She could not sit, but would leap up andrush to the windows at the far end of my office and drum onthe panes; or head for the door and stand irresolutely in thedoorway, peering intently at my face. If I asked anything of herthen or tried to interpret what I thought to be the basis for herturmoil, she was given to quitting the hour entirely. Then laterI would hear of more work anxiety, wrangles with husband,hurting her body by stumbling and other kinetic clumsiness,and increased drinking.

Gradually, at these times of her fight or flight, I saw thatI did best if I just sat still and returned her gaze with widenedeyes and smiling—inquiring look. Then she would settle downand return to the couch to resume work in her own fashion.

In the context of these anxious activities a most unusualact of postural kinesthetics came to the fore. While still lyingdown, Mrs. T. would speak in mounting tension of “feeling up-tight,” helpless and stuck. Suddenly she would draw her kneesupwards and flex them so that both feet were flat on the couch.She reached down so as to bring her hands to her shoes, then

hooked both forefingers around the heels. As she did this, shespoke anxiously of her fears that she might seduce me or thatI was about to attack her genitals, penetrate her sexually. Thenshe would be irreparably damaged; mother would discover andbanish patient forever from her sight. An alternative outcome,exciting but sure to leave her deserted and guilty, was that I would claim her and force her to yield to sex and elopement.I was struck at such times that Mrs. T. did not seem to own

either her body or her sexuality; she appeared helplessly readyto allow them to be at the whim of any forceful man.

I watched this combination of kinesics and content for afew months, while exploring the latter, but not addressing the


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odd kinesic display. The yield was meager. So I called atten-tion to her hold on her heels and asked her what it felt like

or made her think of. She obviously felt caught, released herheels and brought her legs down to stretch; and said she was very uptight. I agreed that I could hear her distress, and said Ireally wasn’t expecting any answer unless she found somethingin it that she would want to work on. This she eventually did,in her way. First, she casually informed me that she had suf-fered from a chronic urinary tract problem, from age six tofourteen. The details gradually emerged. She had been madeto lie still for many urological exams and procedures, oftenprolonged and painful, on her back and in stirrups. She triedto heed the demands of the male urologists that she be a goodgirl, lie still and quiet. She did her best, with held-in rebellionand fear. As she reworked this recall with tears and muted an-ger, she retrieved memories of frequent genital stirrings anderotic interest in some of the doctors. She recalled both feelingashamed and frightened that her excitement might show, as wellas defiant protest that it was not her fault the doctors wantedto do these things to her. For awhile, working over this stretchof traumatic history allowed the patient to settle in upon thecouch more comfortably.

During this time of relative comfort I watched Mrs. T.bring into play this stirrup posture in synchrony with a verydifferent verbal content. She reached for her heels often whenspeaking of her conflicted wishes to assert her independence ofher mother. She saw mother as binding her by somehow filling

Mrs. T. with guilt over any emotional distancing from mother,or being different from mother over the right ways for theirrelating to each other. She “wanted so much to be my own self,free to fly!,” and held her heels. Her pain over differences hadspread to include patient’s feeling disloyal for any enjoyment ofthe pleasures of living, including sex, that she felt her motherdid not enjoy or endorse. Mrs. T. could allow herself very littlesense of her own competence in work or play, constricting her

intellectual and professional capacities to the point of jeopardy.She did so out of a conscious conviction that to do otherwise was to inflict crushing shame upon her mother and invite thelatter’s complete rejection and abandonment. Thinking, during


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an analytic hour, of such a breach between them could bringthe patient to what seemed like near-fragmentation, clutching

her heels and quivering. She had long ago learned to restoreherself by getting in telephone contact with her mother todetail her sufferings of the moment, to emphasize to motherher helplessness and need for warm reassurance. She had longnoticed, but now began to reflect upon, her mother’s reliableinterest in and consoling response to expressed suffering; yether notable turning off when the patient spoke of achievements,travel plans, or free spending.

By the time of the clinical sampling presented above, Mrs.T. was well into her version of a transference neurosis, playingout many of these mother-centered wishes and fears increas-ingly in her relationship to me. These she phrased mainly interms of complaints about not getting the relief from anxietyshe demanded that I provide for her. She was by now oscillat-ing between rage and rebellion, then compliant beseeching;between tender and timid little-girl amorous overtures, andnear-belligerent sexual provocativeness. She spoke of fear ofsexual attack and genital mutilation by me as real and immi-nent, but also as irrational fantasy. She was not in touch withher huge envy and strivings to preempt that were aimed towardme as someone combining the life-and-death powers over herthat she attributed both to her mother and to powerful malefigures, exemplified by doctors.

While Mrs. T. was able usually to recover her poise andadult perspective on these in-hour preoccupations, I heard

increasing complaint of her falling into anxiety states and de-pression outside the hours, and her resorting to wine in theevenings to soothe herself. It took much focusing upon theseepisodes to learn that they tended to happen when she left anhour in a state of angry distancing from me over some breakof comfortable rapport between us. Then she found herself“feeling alone, adrift, not able to think of anything you hadsaid or done, and no pictures of you or the sound of your

voice,” unlike her comforting recall of me experienced when we were early in the work.

These breakdowns between us often were triggered bycertain behaviors of mine as I tried to meet and understand


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her quicksilver challenges and pleas for rescue or guidance. IfI responded in a fashion that carried even a hint of steering

or persuading, Mrs. T. could sit up or leap from the couch toconfront me in blazing-eyed rage, screaming that I had wipedher out, taken her over, and threatening to kill me with someobject snatched from the coffee table. If I remained silent, shepersisted in her pleadings, then collapse in a heap, sobbinginconsolably. I found that I could best restore something be-tween us, at such times, by facing her fury with as much showof relaxed calm as I could muster and talking through her withdrawn sobbing, using slow, quiet words to acknowledgeher misery.

This is how things were, at the time of the analytic hour with which I prefaced this vignette. We accomplished a lot, upto and beyond that hour, the work extending over many years;but we could not go as far as either of us would have liked.Mrs. T. survived family deaths and disasters in solid fashion.Her affect storms largely left the scene, along with her stirrupritual, but never entirely. Her sexual inhibitions released, andshe went on to have two children whose rearing imposed furtherburdens and seriously curtailed her professional advancement.These combined constraints eventually forced us to drop back to weekly psychotherapy, within whose limitations further workingout of her ambivalent dependency and shaky object constancybecame protracted indeed.

Discussion

The place and importance of the nonverbal components ofthe psychoanalytic dialogue have been variably and uncertainlyregarded in mainstream psychoanalysis. Our analytic fathersfrom the beginning addressed, out of clinical necessity and intheir fascination with hysterical symptoms, the complexities ofthe behavioral dance and somatic music that accompany the

poetry of human communication. Some became enthralled with the vast significance they found (Groddeck 1923). Oth-ers, such as Ferenczi (1919), wrestled with the muscular andgut power of what caught them up and went off in directions


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of their own in their struggles to acknowledge the role of thenonverbal aspects of their analytic experience.

But what carried the greater weight of persuasion, from thebeginnings of analysis to this day, was Freud’s overriding com-mitment to the saving power of rationality, and to the secondaryprocesses that language provided to insure the dominance ofreason in human endeavors. This conviction led him, both inhis theoretical and clinical pronouncements (Freud 1911; 1912;1913; 1914) to relegate to infantile beginnings and psychicprimitivism such matters as body language and organ music.These were to be regarded as the primary stuff, the basic bodyego (Freud 1923), out of which rational man, now epitomizedby the generic analyst and the well-analysed patient, was toshape and assert his higher reality view.

Many enduring perspectives were reached from this van-tage point. We still accept as valid the proposition that adultthinking is blended from three essential ingredients: a senso-rimotor-visceral-affective mix that is the infant’s earliest modeof responding; his later, or perhaps simultaneous, imaging inall sensory modes; and gradually, as childhood is traversed, a verbal-lexical capability that achieves a relative dominance overhuman behavior (Horowitz 1978). Much that ego psychologyhas laid out about the emergence of the sense of self, pari passu with the acquisition of operational competence to survive inthe world of one’s culture, has built upon this heirarchicalsequence over which language is king.

We analysts still ascribe central importance to the spoken

word as a prime carrier of our therapeutic endeavors, eventhough we may no longer agree with the rigors of Kurt Eissler’s(1953) technical distinctions regarding what is, or what is not,truly psychoanalysis.

A major liability, however, in this emphasis upon theprimacy of the spoken word has lain in a pervasive tendencyamong us to look upon the nonverbal components generallyas an inferior and lower order capability, a marker of the in-

fantile and regressed, in keeping with other aspects of primaryprocess. Thus, William Needles (1959) reflected the prevailing view in stating that “gesticulation as an accompaniment of,or substitute for, speech bears all the earmarks of regressive


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behavior . . . [and] represents a return to an infantile levelof functioning” (292–93). It was from within this context that

Felix Deutsch (1947; 1952) carried out his pioneering work ofrelating the verbal themes of his patient’s utterances to theirpreferred postures on the couch, devising for this purpose stickfigure “posturegrams” by which quickly to capture their majoralignments. The beauty and authenticity of these observations was overshadowed, however, by the author’s efforts to elaboratea theoretical psychosomatic formulation to account for thesebehaviors in terms of repression and regressive deployment oflibidinal energy.

In a similar vein, during a 1969 panel exploration ofnonverbal communication (Panel 1969), some of the power ofthis old constraint can still be seen, as well as the struggle totranscend it. Dorothy Zeligs is noted as referring to posturingand gesturing as more primitive forms of nonverbal commu-nication (960). Leo Rangell and Carl Adatto, both with earliercontributions made upon the significance of hand-snout kine-sics in relation to poise and social-sexual anxiety (Adatto 1970;Rangell 1954), found it necessary to affirm the analytic needthat such behaviors be pursued to full verbal articulation. Jacob Arlow (Panel 1969, 961) provided a four-part generalizationabout nonverbal behaviors cast exclusively in the metaphorof the written word: nonverbal acts are a punctuation thatemphasises or modifies the verbal, are a glossary that explainsor elaborates the text, or are footnoting commentary upon what is verbalized. Lastly, they are automatisms resulting from

the irruption of dissociated, highly organized mental activity.Three of these describe the nonverbal in strictly literate, verbalmetaphor, and as subordinated to the latter. The fourth as-signs the nonverbal to the realm of the dynamic unconsciousand repressed, yet still to be compared to a palimpset, a usedparchment previously written upon.

What is striking is that Arlow went on to provide a clinicallysensitive scanning of the rich significance of the nonverbal in

the analysis of a never silent and gesturally busy patient whohad been raised by deaf-mute parents and habitually signedas he spoke. This patient feared dumbness, even as from thebeginning he had learned to communicate in the family sign


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language they had devised. It became necessary for the patientto translate this other language for the sake of the analyst’s

understanding. The latter saw this signing as motor commu-nication alluding to parental transference (Panel 1969, 962).Recognition of the full potentiality of gestural expressive-

ness for our psychoanalytic work has been nearly as slow incoming as has been the acknowledgment of the unique powersof natural sign language for the congenitally deaf. For their fieldit would take many years of practical experience and research,documented eloquently by Oliver Sacks (1989), to override theprevailing bias that the deaf should learn oral speech, and todemonstrate the natural signing of the deaf to be a completeand supple language in its own right, superior to mere wordsin its power of portrayal in a four-dimensional fashion.

In our field we have had our equivalent struggle to realizea comparable affirmation of the power and depth of nonverbalexpression in those of us who also speak. The older emphasison the regressive and primitive significance of the nonverbalcomponents of human communication, traditionally viewed assynonymous with primary process, has only slowly been chal-lenged by a developmental viewpoint that would ascribe to pri-mary process modes a continuing importance for all aspects ofhuman behavior throughout life (McLaughlin 1978; Noy 1969).

From this developmental perspective, the nonverbalcontributions of both parties to the analytic work originatein capacities we acquired during those formative years whennonverbal interactions were the primary carriers of the infant’s

communicating with his mother. Action and gesture were therefrom the beginnings of our internal psychic life, central to itsunfolding and affective enrichment. We learned to trust thislevel of speaking and knowing more deeply than the wordsthat came later, and few have put aside our awareness of whatgestures and body language have to tell us. In the repetitionand familiarity that mark the analytic work, these nonverbalcontributions become recognizable, deepening the experiential

and affective dimensions of the analytic exchange for both, not just as a remnant of the developmental past but as an essential,continuing enrichment of the full range of subtlety and nuanceof our words that carry the analytic dialogue.


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I know that I am pleading a personal bias in claimingsuch importance for observational data that can carry little

relevance for those analysts, and there are many, who do notneed kinesic cues to inform their work. I do need and utilizethis visual, multisensorial input. This is linked to my perceptualstyle of analytic listening. Not blessed with a strong capabilityfor visual imagery, I make much use of my kinesthetic-affectiveresponses in tracking and resonating to my patients. I need tolook while I listen. As Cecil Mushatt put it during yet anotherpanel years later (Panel 1977), analysts are also subject to sen-sory deprivation in the analytic situation, particularly when theydo not attend to the patient’s nonverbal behavior (704). It isnoteworthy that by then some of the contributors seemed toaccept that valid meaning could be gleaned from attending tothe nonverbal, and now were more concerned with technicalissues of how and when to deal with these communications.

By now there has grown to be a substantial literature onthe matter (Anthi 1983; Jacobs 1973; Shapiro 1979; McLaughlin1987). Theodore Jacobs (1991) particularly has described wellhow the the analyst’s own kinesic and inner bodily experiencesprovide valuable data alluding to the dynamic processes cur-rent in both.

My particular focus in this presentation has been on thepossibility of amassing clinical data that might collectively attestto relevant linkage between persistent kinesic phenomena seenin adult patients and the developmental vicissitudes of their very early years. I put it thusly because, in matters such as these,

there is no way to make clear and linear connections. Perhapsthe best that can be done is to identify similarities of themeand mode, gathered from as many aspects of the particularanalytic experience as can be noted. Then one can allow thesecollectively to converge in their own fashion, to shape or mimea pattern or mosaic that might show fit or match with the past.

The two clinical instances I have offered involve dynamicissues that overlap and provide a complementarity to each

other, both in terms of their adult behaviors in analysis as wellas in terms of how these two patients experienced their earlymothering and maturational struggles.

Mr. E., a solid obsessional with only moderate problems atthe oedipal level, saw himself as caught up in larger conflicts


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centered in his relationship to mother, with whom he seemedfrom his early days to have been in trouble, as was his younger

brother. Matters of freedom, autonomy, reliable nurturance,and rapid propulsion through the times of feeding, weaning,and achieving sphincter control all were suffused with theturmoil of casual and erratic mothering, worsened by punitivedemands for compliance and obligatory attachment.

Here the similarities with Mrs. T. are evident. Although thequalities of mothering were different, insofar as her motherseemed much more available and reliably responsive to herchild’s physical discomforts, there is good evidence to supportMrs. T.’s perceptions of her mother as expecting a similarlydocile alacrity in getting through the early acquisition of controland autonomy of body functions. Similarly, mother put muchconstraint upon her daughter’s freedoms and autonomy at alllevels of expression, using not physical coercion but induc-tion of guilt felt in relation to a suffering mother, and then apunitive god.

Both patients showed as adults much shame aroundadequacy of performance and uncertainty of the reality andownership of their bodies and capacities. Both felt themselvesperpetually in a dangerous struggle over claiming their accom-plishments in their adult work and personal life, and earlierfrom a mother who seemed to need to own and control all.

Both clung to regressive ways of soothing their oral hun-ger and rage: Mr. E. with his “I’ll get it for myself” snacking,as well as his intractable nail biting; Mrs. T. with her mouthing

her baubles and fingers, and resort to solitary wine-drinkingat night.

For both, it is possible to trace rather clear connectionsbetween these contemporary manifestations of oral depen-dency and their historical antecedents receding into earlydevelopmental time. Mr. E.’s accounts of battles with motherover his nail biting, and earlier his thumbsucking, emergedin the analysis in accompaniment to his actual nail-picking

and thumb-picking, plus mute evidence of renewed nailbitingoutside the analytic hours. Mrs. T.’s behaviors with her neck-lace—mouthing, clutching, hurling away—occurred as shebrought out her rage and fear over concerns about me having


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to do with her need for nurturance and her fear of depriva-tion and abandonment. And she went on from these to make

affectively rich recounting of her forced weaning and hurriedtoilet training, accomplished in a context of parental censurefor any oral protest.

Both patients played out kinesically their oscillating be-tween a reach for autonomy and separateness and their needfor protected closeness. Mr. E. did so very quietly, in his overallstillness on the couch, with only his hands in action, his fingersand thumbs pantomiming in affirmation, at times contradiction,of his verbally expressed wishes and concerns. Mrs. T. couldalso be quiet in playing out these themes, as in her trinket play.She more often was dramatic in her whole-body behaviors, asin looking back to make eye-contact; turning to me in abjectpleading or coming at me in roaring fury, weapon in hand;running to the glass boundary between my space and theoutside world; or hovering on the threshold, either to returnto the couch as a submissive heap or to bolt through the doorand be gone. Her stirrup ritual, though from a later time, alsoportrayed this conflict in graphic tensional poignancy, as sheliterally immobilized herself in a position of vulnerability bypreventing her feet from flying.

Winnicott’s (1953) concept of transitional phenomena andobjects comes into focus, as a construct overlapping those ofseparation and rapprochement. I think that some of Mr. E.’sgentler finger and thumb kinesics can be viewed as a carryoverof transitional usages. The justification lies in the clear-enough

temporal linkage between these behaviors and the verbal con-tent speaking his needs for soothing and sheltering from wifeor from me, along with his recalling how he did turn to andreceive some affection and caring from his sister in his toddler years. I think of an attenuation, a kind of wistful reminiscence,in such small kinesics, that alludes to once-important, earlydynamic issues now revived in the multiple layering of theanalytic transference. In Mr. E’s case, the allusion would be to

those times when a very small boy found in his thumbsuckingsuch transitional aid and solace by which to handle his needfor more nurturance and comfort.

In Mrs. T.’s instance, I had strongly the impression thather ways of using her necklace and bodice, to grasp and fon-


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dle, then violently throw aside, put into action her uncertaingrasp of the comfort of a transitional object. These behaviors,

repeated over and over, seemed in consonance with, and partof her shaky grasp on, object constancy, so very prominent inher relationship to me.

I find another level of confirmatory evidence in the rela-tionship vicissitudes of enactment and tension that my patientsand I fell into, tested, and found helpful or hindering as westruggled to make headway in the work. I feel that the data Ihave provided point to high intensities of anxiety and regres-sion in both patients in response to my behaviors that struckthem as threatening their autonomy and boundaries, even asthey simultaneously hungered for my solace and rescue. Bothneeded, and responded quite positively yet differently to,behaviors of mine that acknowledged their right to own whatthey clung to as their own, and allowed them gradually to beboth close to and apart from me with less turmoil. At suchtimes either patient could allow me a freer field in which tocontribute my own reflective metaphor, cued by the metaphorof their nonverbal behaviors. Together we often came uponlevels of highly charged transference actualization, leading toaffectively rich recollection of the troubled past.

As I conclude, I know that all I have been able to gathertogether about separation-attachment issues from my clinicaldata from adult analyses must be acknowledged to be a collageof circumstantial evidence. I would hope these are sufficientto support my general view of the effective psychoanalytic ex-

perience as a prolonged enactment or actualization, in whichnonverbal behaviors have an essential role. I have tried tofashion a dramatic unity out of the words of patient and ana-lyst, along with their large and small actions, that portray thethemes of past and present which through transference comealive in the mind of the patient and analyst, and get enactedbetween the pair in the analytic moment; and then to blendin the music of the affective experiences of both parties that

authenticate the whole.Sacks (1989) has described how readily even the hear-

ing inhabitants of Martha’s Vineyard tended to resort to thenatural signing of their community. “They would slip into it,


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involuntarily, sometimes in the middle of a sentence, becauseSign is ‘natural’ to all who learn it (as a primary language),

and has an intrinsic beauty and excellence sometimes superiorto speech” (35).I would like to extend Sacks’s observation to include all

of us, even though we are certainly not sign-fluent, so as toremind us of what we know: that we constantly provide stampand signature for what we are, and for what we feel, throughour posture, gestures, facial expressions, voice qualities, andthe rest. That to a varying extent we are forever signers, as wellas speakers, because we spent so many years in rapt mimeticabsorption of our world, before we had words to supplementthese alternative ways of knowing and telling. And we do notlose or relinquish these ways just because there are times when words are better.

Notes

1. She, like Mr. E., was one of those with whom I attempted to capture the simultaneity

of verbal and kinesthetic content. These clinical data were presented on October5, 1982 as part of panel presentation of the Workshop Series of the AmericanPsychoanalytic Association titled “The Relevance of Infant Observational Researchfor Clinical Work with Adults.” I refer to Mrs. T. also in McLaughlin (1987).

References

Adatto, Carl. 1970. Snout-Hand Behavior in an Adult Patient. Journal of the AmericanPsychoanalytic Association , 18:823–30.

Anthi, P. 1983. Reconstruction of Preverbal Experiences. Journal of the American Psy- choanalytic Association , 31:33–59.

Deutsch, Felix. 1947. Analysis of Postural Behaviors. Psychoanalytic Quarterly , 16:195–213.

———. 1952. Analytic Posturology. Psychoanalytic Quarterly , 21:196–214.Eissler, Kurt. 1953. The Effect of the Structure of the Ego on Psychoanalytic Technique.

Journal of the American Psychoanalytic Association , 1:104–43.Ferenczi, Sandor. 1919. Thinking and Muscle Innervation. In Further Contributions to

the Theory and Technique of Psychoanalysis . New York: Basic Books, 1952, pp. 230–32.Freud, Sigmund. 1911. The Dynamics of Transference. S.E., 12:97–108.———. 1912. Recommendations to Physicians Practising Psychoanalysis. S.E., 12:109–20.———. 1913. On Beginning the Treatment (Further Recommendations on the Tech-

nique of Psychoanalysis I). S.E., 12:.121–44.———. 1914. Remembering, Repeating and Working-Through (Further Recommenda-

tions on the Technique of Psychoanalysis II). S.E., 12:145–56.———. 1923. The Ego and the Id . S.E., 19:1–66.Groddeck, Georg. 1923. The Book of the It: Psychoanalytic Letters to a Friend . New York:

Nervous and Mental Disease Publishing Co., 1928.Horowitz, Mardi Jon. 1978. Image Formation and Cognition . New York: Appleton-Century-

Crofts.


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Jacobs, Theodore J. 1973. Posture, Gesture and Movement in the Analyst: Cues toInterpretation and Countertransference. Journal of the American PsychoanalyticAssociation , 21:77–92.

———. 1991. The Use of the Self: Countertransference and Communication in the AnalyticSituation . Madison, CT.: International Universities Press.

Mahler, Margaret, Fred Pine, and Anni Bergman. 1975. The Psychological Birth of theHuman Infant . New York: Basic Books.

McLaughlin, James T. 1978. Primary and Secondary Process in the Context of CerebralHemispheric Specialization. Psychoanalytic Quarterly , 47:237–66.

———. 1987. The Play of Transference: Some Reflections on Enactment in the Psy-choanalytic Situation. Journal of the American Psychoanalytic Association , 35:557–82.

Needles, William. 1959. Gesticulation and Speech. International Journal of Psychoanalysis ,40:291–94.

Noy, Pinchas. 1969. A Revision of the Psychoanalytic Theory of the Primary Process.International Journal of Psychoanalysis , 50:155–78.

Panel. 1969. Nonverbal Communication in the Analysis of Adults. Reported by AlvinSuslick. Journal of the American Psychoanalytic Association ,17:955–67.Panel. 1977. Nonverbal Aspects of Child and Adult Psychoanalysis. Reported by Roy

Lilleskov. Journal of the American Psychoanalytic Association , 25:679–92.Rangell, Leo. 1954. The Psychology of Poise—With a Special Elaboration on the

Psychic Significance of the Snout or Perioral Region. International Journal ofPsychoanalysis , 35:313–32.

Sacks, Oliver. 1989. Seeing Voices: A Journey into the World of the Deaf . Berkeley: Universityof California Press.

Shapiro, Theodore. 1979. Clinical Psycholinguistics (Cognition and Language). New York:Plenum.

Winnicott, D. W. 1953. Transitional Objects and Transitional Phenomena. International

Journal of Psychoanalysis , 34:89–97.

nonverbal behaviors in the analytic situation the search for meaning in nonverbal cues

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