History

Michael Balint, History

The Balint group was developed 50 years ago by Michael Balint, a physician and psychoanalyst. He was born on December 3rd, 1896 in Budapest under the name of Mihály Moritz Bergmann which he later changed to Michael Balint.

He completed his medical studies in Budapest in 1920. Together with his wife Alice Balint (Székely-Kovács), he moved to Berlin where he worked in the biochemical laboratory of Otto Warburg who later won the Nobel Prize. At the same time, Alice worked in an ethnological museum.

In Berlin he worked on his doctorate while working part-time at the Berlin Institute of Psychoanalysis.

At the Charité Clinic in Berlin he undertook the Psychosomatic treatment of patients whom he was psychoanalysing. His training as a psychoanalyst commenced at the Hanns Sachs Psychoanalytic Institute in Berlin, where he performed his educational analysis too.

In 1924, when he completed his Doctoral Thesis in Biochemistry in Berlin, he returned with his wife to Budapest where he was trained in psychoanalysis by Sandor Ferenczi, a Hungarian psychoanalyst and important theorist of the faculty of psychoanalysis and Sigmund Freud’s close associate.

In 1926 he became a full member of the Psychoanalytic Institute of Budapest while in 1929 he published a work on psychoanalysis and clinical medicine, which rendered him into one of the pioneers of psychosomatic medicine. His first lectures would cover subjects such as “Analytical interpretation of gastric symptoms”, or “Cases from gastroenterology out-patient clinics”.

In 1935, he succeeded his director, Ferenczi, at the Psychoanalytic Institute of Budapest.

At the beginning of the Second World War,more specifically in 1939, due to the political condition in Hungary, Balint with his wife and son emigrated to Great Britain where he worked as a psychiatrist at Northern Royal Hospital in Manchester and as Director of two educational counseling centers. It is the same year that Alice, who in the meantime had contributed with significant publications to the field of Child Psychiatry, suddenly died at the age of 40.

In 1945, Balint was informed of his parents’ death, who committed suicide when arrested by the Nazis. That year he moved from Manchester to London where he continued his work in the Tavistock Clinic with practitioners in groups and worked as an assistant in the psychiatric service of the University College of London. There he met his future wife Enid Balint (Enid Flora Eichholz).

In 1948, Balint obtained the Master of Science degree in Psychology and his thesis was on “Individual Behavioral Differences in Early Childhood”.

In 1948, in collaboration with his second wife, Enid Balint (Enid Flora Eichholz), he created and worked with groups comprising of social workers and psychologists and organized the first seminars for social workers.

In 1949, he organized and commenced training groups of doctors, developing together with Enid the concept of the so-called “Balint Groups”.

In 1950, the seminars of medical practitioners followed. This progressively led to a continuous development of the “Balint method”.

Following seven years of research and training with groups, he published the results in his book “The Doctor, the patient and the disease”.

It is a supervision model based on the psychoanalytic approach and is addressed to physicians, nurses, physiotherapists, as well as social workers and psychologists, i.e. to anyone in the field of health care and interpersonal relations. The book was published in 1957 by the Tavistock Clinic in London and was widely accepted and in 1968, he was elected president of the British Psychoanalytic Society.

The Balint groups spread worldwide and formed the basis of a completely new but multiproductive research. Balint highlighted a new perspective on doctor-patient relationship with an approach that until then had not been taken into account by the field of medical science.

With the Balint method, he once again emphasized to general practitioners the importance of an overall approach of the patient, which was increasingly lost in the process. “According to Balint, the treatment is based, or at least is significantly affected, only by a special / particular relationship between the patient and his physician.

A therapeutic dialogue can take place only if the doctor is able to receive the messages sent by the patient and understand them gradually, in Balint’s words, ” as if he/she has a third ear”. “Maybe, thus, he/she can penetrate the true nature of the anxiety or the disorder expressed by physical symptoms and various difficulties. Therefore, for instance, insomnia, indigestion, bronchial asthma, migraines, etc., are exposed as a result of multiple factors.

In such a doctor-patient relationship, the conflicts can be comprehended and dealt with, as well as any difficulties that “suppress the heart” or “are breathtaking” or “weigh on the shoulders” or “are stuck in the throat”, “hit on the head”, etc. which are expressed, without necessarily the patient requiring to undergo Psychotherapy, but as Balint said, understand him/her, in the context of primary Psychosomatic Care.

In the reported patient cases, Balint recognized how well the doctor knew his patients. He emphatically underlined the undetected facts and details which were essential for the understanding of the patient and his/her illness, such the relationship with the spouses and children, the superiors, work etc. He always found gaps in the medical history that could be filled by an empathetic discourse.

This can not always take place within the limited session time, but usually in a more extended discourse. Nevertheless, however difficult such a discourse might be for the trainee whose office is overloaded with work on that day, it will ultimately turn out that the time invested on that discourse will significantly reduce the total treatment time.

Michael Balint died on December 31, 1970 in London at the age of 74 years.

The method, which is already being evaluated, is now applied to many other social professions, such as teachers, priests, social workers, clinical psychologists, nurses, educators, etc.,positively reinforcing their work. It is also compulsory for general Pathology internship and Gynecology in Germany, while its compulsory attendance by the other internships is currently under discussion, within the context of “Primary Psychosomatic Care”.