American Balint Society Essay Contest Rules
ACGME (2007). Competencies & Balint Training: Competencies Taught by Balint Work.
This article from the American Balint Society website, lists the competencies as specified by the ACGME which are taught by Balint training. The Accreditation Council for Graduate Medical Education is responsible for the accreditation of postgraduate medical training programs within the U.S.A.
Addison, R. (1994). Balint Leadership and Hermeneutic Research, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Addison, R., Miller, W., and WIlliamson, P. (1994). Outline for Closing Plenary, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Balint, Enid (1969) The Possibilities of Patient-Centred Medicine. Royal College of General Practitioners, 17:269. Historically fascinating and still relevant today, this article explores the tensions in the GP’s varying roles as explored in early Balint seminars.
Balint, E., (1980). The Doctor Patient-Relationship in the 1980’s. Talk delivered in South Africa. Extracts relating to Balint group leadership
Balint, E., (1985). The history of training and research in Balint-groups. Psychoanalytic Psychotherapy,1(2), 1-9
Benoit, Reverzy and Suied (2002). Three testimonies about meeting Michael Balint and his ideals. The American Journal of Psychoanalysis, Vol. 62, No. 4. These short memoirs include an account of a paediatricianís experience of being a Balint group member ñ “a training that no reading and no teaching could replace.”
Benson, J. and Magraith, K. (2005). “Compassion fatigue and burnout: the role of Balint groups”. Australian Family Physician. 34-6, 497-498. Describes how Balint groups can help prevent compassion fatigue and burnout.
Brock, C., Johnson, A., (1999). Balint Group Observations: The White Knight and Other Heroic Physician Roles. Family Medicine, 31(6):404-8.
Cataldo, K., Peeden, K., Geesey, M. and Dickerson, L. (2005). Association Between Balint Training and Physician Empathy and Work Satisfaction. Family Medicine 37(5):328-31.
Council of the British Balint Society, (1994). ‘Essential’ and ‘Desirable’ Characteristics of a Balint Group, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Courtenay, M., (1984). The place of Balint work in medicine – looking back – looking forward, Journal of the Balint Society, 12, 8-11.
Courtenay, M., (1977). The leaders, the doctors, and their patients. Journal of the Balint Society.
De Lambert, Louise (2010). Postscript to Balint Work Increases the Ability to Think One’s Own Thoughts. Group analysis, 43:86.
Devens, M. and Dornfest, F. (2007) Balint co-leadership: Suggested checklist for general preparation of new coleaders prior to leading a group together at Intensives (unpublished).
Dornfest, Frank. How-To Manual. This manual includes a description of Balint groups for future participants, an overview of groups for practicing GPs, trainees, or students, a description of the Balint group leader roles and functions, ground rules for a Balint group, and a comparison of Balint groups with personal and professional development groups. Included is a 44-reference bibliography.
Dufey, J. (1994). A New World Address, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Ghetti, C., Chang, J., Gossman, G. (2009). Burnout, Psychological Skills, and Empathy: Balint Training in Obstetrics and Gynecology Residents. Journal of Graduate Medical Education
Gill, C., (1985). Tensions in General Practice, Journal of the Balint Society, 13, 10-16.
Haslam, Nick, (2007). Humanising medical practice: the role of empathy. Medical Journal of Australia. 187: 381-2. An excellent overview and brief literature review of the importance of empathy in medical practice.
Jablonski, Henry (2003). Defining Balint Work – Is there a heartland? and which are the neighbouring countries?. In Salinsky, J. and Otten, H. ( eds. ) (2003). The doctor, the patient and their well-being ? world wide. Proceedings of the Thirteenth International Balint Congress Berlin 2003. The International Balint Federation.
Johnson, A., Nease, D., Jr, Milberg, L. Addison, R., (2004). Essential Characteristics of Effective Balint Group Leadership. Family Medicine,36(4):253-9.
Johnson, A., Brock, C., Hamadeh, G., and Stock, R, (2001). The Current Status of Balint Groups in US Family Practice Residencies: A 10-year Follow-up Study, 1990-2000. Family Medicine, 33(9):672-7.
Johnson, A. (2001). The Balint Movement in America. Family Medicine, 33(3), 174-7.
Katz-Bearnot, Sherry (2007). The Medical Education of Generation RX. The Future of Psychoanalytic Education Conference, New York, 2007. About the author’s work educating medical students and young doctors about patients and their relationships with their patients, using psychoanalytic ideas and with a nod to Michael Balint.
Kjeldmand, Dorte. (2006). The Doctor, the Task and the Group: Balint Groups as a Means of Developing New Understanding in the Physician-Patient Relationship. A PhD thesis on Balint groups in Sweden.
Kjeldmand, D. et al (2004). Balint training makes GPs thrive better in their job. Patient Education and Counselling, 55:230-235. (Swedish research on Balint groups demonstrating some of their benefits).
Klee, Thomas (2008) The function of Balint’s levels of mind in Balint groups. Journal of the Balint Society.
Lachowsky, M. (1994). The Effect of Balint Work on Our Patients, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Leggett, Andrew (2009). Establishing a Balint group for mental health workers: the Inala community mental health experience. Proceedings of the 16th International Balint Congress, Polana Brasov, Romania.
Levenstein, S. (1994). Balint Group Leadership, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Lichtenstein, Albert and Lustig, Marion (2006). Integrating intuition and reasoning: how Balint groups can help medical decision making. Australian Family Physician. 35(12), 987-989. Includes case vignettes.
Lustig, M. (2004). Generating a reflective space for GPs; working with Balint groups. Australasian Journal of Psychotherapy, 23:66-85. Includes case vignettes.
Lustig, M. (2006). Balint groups: an Australian perspective. Australian Family Physician Vol. 35 (8): 639-652 . Introductory article including case vignettes. (Some of the information on this website first appeared in this article).
Lustig, M. (2007). From psychoanalytic psychotherapy to Balint groups- what do leaders need to know? Australasian Journal of Psychotherapy, 26(1), 40-46. Aimed at psychotherapists interested in leading Balint groups.
Lustig, Marion (2008). Humanising medical practice: the role of empathy. 188 (4): 263-264.This letter is a reply to Haslam, Nick (2007) and highlights the role of Balint groups in developing empathy.
Lustig, Marion (2016) Balint Groups: An Australasian perspective for psychiatrists
Scan down and read pages 2-5
Australasian Psychiatry 2016, Vol 24(1) 30–33
Milberg, Laurel. Some Random Thoughts about Balint Group Pitfalls, Pratfalls, and Pot Holes . This article raises common and deadly problems that can derail Balint Groups, either in how they are organized or how they are run.
Milberg, Laurel (2002). Balint Groups From the Perspective of a Teacher. Presented as keynote address at Balint Weekend Meeting at Exeter College, Oxford, U.K. An experienced American Balint group leader presents feedback from GP trainees on their Balint group experiences during training
Donald Nease (2007). Mutiny on the Balint? A reflection on the relevance of Balint, 50 years hence. Family Medicine 39(7):510-11. This article, written in response to an article by Smith and Anandaraja (see below) is a thoughtful overview of Balint work. In particular, Nease defines what is unique about Balint groups and considers issues of orthodoxy, boundaries, flexibility and group safety.
Norell, J. (1991). The International Balint Federation: past, present and future. Family Practice. 8 (4): 378-381. Historical article.
O’Neill S, Foster K, Gilbert-Obrart A (2015): The Balint group experience for medical students a pilot project, Psychoanalytic Psychotherapy Online Journal http://dx.doi.org/10.1080/02668734.2015.1107124
Orman, Jan (2005). Balint Groups – A Participant’s Experience at the RACGP Conference in Darwin 2005.
Pinder R, McKee A, Sackin P, Salinsky J, Samuel O, Suckling H. ‘Occasional Paper 87 – Talking about my patient: the Balint approach in education’ RACGP publication – A new publication exploring the influence of Balint groups in general practice, has been published by the Royal College of General Practitioners (RCGP). This publication is the report of a research project into Balint group work in vocational training in the London area. The report explores what happens when a Balint group takes place in vocational training, how it is variously read and understood by practitioners and with what likely benefits and consequences. The case studies illustrate both the potential of the small group and also of the method used to investigate the subject.
Platt, F. (1994). Findings from Miles Workshops on Physician-Patient Communication, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Royal College of General Practitioners (2007). Curriculum Statement 2: The general practice consultation. This document outlines the U.K. general practice training curriculum with respect to the consultation. It recommends Balint groups for doctors in training and explains why.
Salinsky, J. (2002). The Balint movement worldwide: present state and future outlook: a brief history of Balint around the world. The American Journal of Psychoanalysis 62:4. Historical article.
Salinsky (2003, revised 2005). Balint Groups and the Balint Method An excellent overview, including history, Balint groups for GPs and GP trainees, a description of how a trainee group operates, Balint in the UK, benefits of Balint groups, research.
Salinsky (2009). ‘Writing prescriptions is easy’ Franz Kafka and his country doctor. Presented at the International Balint Federation Congress, Rumania. A delightful reflection about a Kafka short story about a night call from hell and what a Balint group might have made of the case.
Samuel, O.W. (1989). How doctors learn in a Balint group. Fam. Pract. 6, 108-113. A lucid introduction.
Sanders, D. (1994). The Use of Individualized Balint Training in One-On-One Teaching, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Schoenberg, P. and Suckling, H. (2004). A Balint group for medical students at Royal Free and UCH School of Medicine. Journal of the Balint Society, 32:20-23.
Smith, Marcia and Anandaraja, Gowri (2007). Mutiny on the Balint: balancing resident developmental needs with the Balint process. Family Medicine 39:7, 495-7. This article describes a Balint group in an American family medicine training program in which the residents initially expressed strong dissatisfaction with the group. Some modifications were made to allow the group to address professional development topics and the group spontaneously returned to a process more consistent with traditional Balint.
Storas, B. (1994). Psychiatric Group Supervision in Family Practice and Concomitant Focus Group Evaluation, Proceedings of the International Balint Federation Congress, Charlston Carolina.
Stone, Louise. (2014) Blame, Shame and Hopelessness: Medically Unexplained Symptoms and the “Heartsink” Experience , Australian Family Physician Vol. 43 No. 4 April 2014 Pp 191-195
Suckling, H. (2005). What do Medical Students discuss in Balint Groups?, Journal of the Romanian Balint Society. Themes of the cases discussed in Balint Groups for medical students.
Suckling, H. (2006). Balint in a nutshell (unpublished). A handout for medical students which is an excellent introduction for anyone.
Suckling, H and Shoenberg, P (2005). What effect does a Balint group have on medical students? The International Balint Federation and The Swedish Association of Medical Psychology. Proceedings of the 14th International Balint Congress Stockholm 2005. 55-60.
Turner, A. and Malm, R. (2004). A preliminary investigation of Balint and Non-Balint behavioural medicine training. Family Medicine, 36(2): 114-7 (research on Balint groups in GP training).
Rüth, U. (2009). Classic Balint Group Work and the Thinking of W.R. Bion: How Balint Work Increases the Ability to Think One’s Own Thoughts: Group Analysis 2009; 42; 380
The native form of this personal name is Bálint Mihály. This article uses Western name order when mentioning individuals.
Michael Balint (Hungarian: Bálint Mihály, pronounced [ˈbaːlint ˈmihaːj]; 3 December 1896 in Budapest – 31 December 1970 in London) was a Hungarianpsychoanalyst who spent most of his adult life in England. He was a proponent of the Object Relations school.
Balint was born Mihály Maurice Bergsmann, the son of a practising physician in Budapest. It was against his father's will that he changed his name to Bálint Mihály. He also changed religion, from Judaism to Unitarian Christianity. During World War I Bálint served at the front, first in Russia, then in the Dolomites. He completed his medical studies in Budapest in 1918. On the recommendation of his future wife, Alice Székely-Kovács, Bálint read Sigmund Freud's "Drei Abhandlungen zur Sexualtheorie" (1905) and "Totem und Tabu". He also began attending the lectures of Sándor Ferenczi, who in 1919 became the world's first university professor of psychoanalysis.
Bálint married Alice Székely-Kovács and about 1920 the couple moved to Berlin, where Bálint worked in the biochemical laboratory of Otto Heinrich Warburg (1883–1970), who won the Nobel Prize in 1931. His wife worked in a folklore museum. Bálint now worked on his doctorate in biochemistry, while also working half time at the Berlin Institute of psychoanalysis. Both he and his wife Alice in this period were educated in psychoanalysis.
In 1924 the Bálints returned to Budapest, where he soon assumed a leading role in Hungarian psychoanalysis. During the 1930s the political conditions in Hungary made the teaching of psychotherapy practically impossible, and they emigrated to London in 1938, settling in Manchester, England, in early 1939, where Bálint became Clinical Director of the Child Guidance Clinic. Here Alice died, leaving Bálint with their son John. In 1944 Bálint remarried, but the relationship soon ended, although they were not divorced until 1952. In 1944 his parents, about to be arrested by the Nazis in Hungary, committed suicide. That year Bálint moved from Manchester to London, where he was attached to the Tavistock Clinic and began learning about group work from W.R. Bion; he also obtained the Master of Science degree in psychology.
In 1949 Bálint met Enid Flora Eichholz, who worked in the Tavistock Institute of Human Relations with a group of social workers and psychologists on the idea of investigating marital problems. Michael Balint became the leader of this group and together they developed what is now known as the "Balint group": a group of physicians sharing the problems of general practice, focussing on the responses of the doctors to their patients; the first group of practising physicians was established in 1950. Michael and Enid married in 1958. In 1968 Balint became president of the British Psychoanalytical Society.
The Michael-Balint-Institut für Psychoanalyse, Psychotherapie und analytische Kinder- und Jugendlichen- Psychotherapie in Hamburg is named for him.
The three stages
Balint 'took an early interest in the mother-infant relationship...a key paper on "Primary Object-Love" dates from 1937'. Thereafter, developing an idea of John Rickman, he argued that 'mental function is quite different, and needs to be described differently, in three-person and two-person relationships, and different in creative activity alone'.Lacan wrote (almost approvingly) that 'Michael Balint has analysed in a thoroughly penetrating way the intricate interaction of theory and technique in the genesis of a new conception of analysis...[using] the catchphrase, borrowed from Rickman, of a "two-body psychology"'. On that basis, Balint thereafter explored the idea of what he called '"the basic fault": this was that there was often the experience in the early two-person relationship that something was wrong or missing, and this carried over into the Oedipal period (age 2–5)'.
By 1968, then, Balint had 'distinguished three levels of experience, each with its particular ways of relating, its own ways of thinking, and its own appropriate therapeutic procedures'.
'Psychoanalysis begins at level 3 – the level at which a person is capable of a three-sided experience...primarily the Oedipal problems between self, mother, and father'. By contrast, 'the area of the Basic Fault is characterised by a very peculiar exclusively two-person relationship'; while a 'third area is characterised by the fact that there are no external objects in it' – level number 1.
'Therapeutic failure is attributed by Balint to the analyst's inability to "click in" to the mute needs of the patient who has descended to the level of the basic fault'; and he maintained that 'the basic fault can only be overcome if the patient is allowed to regress to a state of oral dependence on the analyst...and experience a new beginning'.
Along with his wife, Enid Balint, and Paul H. Ornstein, Balint developed a process of brief psychotherapy he termed "focal psychotherapy", in which 'one specific problem presented by the patient is chosen as the focus of interpretation'. The therapy was carefully targeted around that key area to avoid (in part) the risk that 'the focal therapy would have degenerated into long-term psychotherapy or psychoanalysis'. Here as a rule interpretation remained 'entirely on the whole-person adult level...it was the intention to reduce the intensity of the feelings in the therapeutic relationship'.
In accordance with the thinking of other members of 'what is known as the British independent perspective...such as W. R. D. Fairbairn and D. W. Winnicott', great stress was laid upon the creative role of the patient in focal therapy: 'To our minds, an "independent discovery" by the patient has the greatest dynamic power'.
It has been suggested that it was in fact this 'work of Michael Balint and his colleagues which led to time-limited therapies being rediscovered'.
'Michael Balint [as] part of the independent tradition in British psychoanalysis, [was] influential in setting up groups (now known as "Balint groups") for medical doctors to discuss psychodynamic factors in relation to patients'. " Instead of repeating futile investigations of increasing complexity and cost, and then telling these people there was nothing wrong with them, Balint taught active search for causes of anxiety and unhappiness, and treatment by remedial education aiming at insight, rather than tablets aiming at suppression of symptoms." Such seminars provided opportunities for GPs 'to discuss with each other and with him aspects of their work with patients for which they had previously felt ill equipped. Since his death the continuance of this work has been assured by the formation of the Balint Society'.
- Individual Differences of Behaviour in Early Infancy. Dissertation for Master of Science in Psychology. London, 1945.
- Primary Love and Psycho-Analytic Technique. 1956.
- The Doctor, His Patient and the Illness. London: Churchill Livingstone, 1957.
- German translation: Der Arzt, sein Patient und die Krankheit. Stuttgart, Klett, 1966.
- Thrills and Regressions. 1959.
- German translation: Angstlust und Regression. Stuttgart: Klett-Cotta, 1991.
- Basic Fault. 1967.
- The Clinical Diary of Sándor Ferenczi. Edited by Judith Dupont. Translated by Michael Balint and Nicola Zarday Jackson. First cloth edition, 1988.
- Franz Sedlak und Gisela Gerber: Beziehung als Therapie Therapie als Beziehung. Michael Balints Beitrag zur heilenden Begegnung. München: Ernst Reinhardt Verlag, 1992, ISBN 3-497-01257-2.
- Harold Stewart et al.: Michael Balint: Object Relations Pure and Applied. London: Routledge, 1996.
- Osborne, Thomas, 'Mobilizing Psychoanalysis: Michael Balint and the General Practitioners' Social Studies of Science 23(1) (1993): 175–200
- Columbia University Psychoanalytic Movement Project: oral history, 1963–1982; interview of Dr Michael Balint by Dr. Bluma Swerdloff, August 1965, London
- ^Philip Hopkins, ‘Balint, Michael Maurice (1896–1970)’, Oxford Dictionary of National Biography, Oxford University Press, 2004 accessed 6 Dec 2015
- ^John Hunter Padel, "Freudianism: Later Developments" in Richard Gregory ed., The Oxford Companion to the Mind (Oxford 1987) p. 272
- ^ abPadel, Mind p. 272
- ^Jacques Lacan, Ecrits: A Selection (London 1997) p. 90
- ^Padel, Mind p, 272
- ^Josephine Klein, Our Need for Others and its Roots in Infancy (London 1994) p. 112
- ^Klein, Need p. 112
- ^Balint, in Klein Need p. 385
- ^Balint, in Klein, Need p. 385-6
- ^Janet Malcolm, Psychoanalysis: The Impossible Profession (London 1988) p. 135
- ^Charles Rycroft, A Critical Dictionary of Psychoanalysis (London 1995) p. 13
- ^Rycroft, Critical p. 58
- ^Michael Balint, Paul H. Ornstein & Enid Balint, Focal Psychotherapy (London 1972) p. 76
- ^Balint et al, Focal p. 76
- ^Glen O. Gabbard, Long-Term Psychodynamic Psychotherapy (London 2010) p. 12
- ^Balint et al, Focal p. 68
- ^Alex Coren, Short-term Psychotherapies: A Psychodynamic Approach (2001) p. 22
- ^Ian Parker, Japan in Analysis (Basingstoke 2008) p. 121-2n
- ^Julian Tudor Hart (1988). "New Ideas in Old Structures". A New Kind of Doctor. Socialist Health Association. Retrieved 17 May 2014.