Regression and new beginnings: Michael, Alice and Enid Balint and the circulation of ideas

This article offers a new evaluation of Michael Balint's history. It starts with his growing up in Hungary and examines the central concepts of his writing: the analytic pair, regression and the basic fault and creativity, up to and including his renowned work on the eponymous Balint groups (which forged a unique link between psychoanalysis and medicine). While his name is, of course, well known, this article aims to bring his ideas to the attention of a modern analytic audience. Having trained in the 1920s with Ferenczi, Balint brought Ferenczi's literary inheritance to England where he lived until his death in 1970. His connections to Klein, Winnicott and Lacan, all of whom respected his analytic stance, are also examined. Furthermore, this article argues that his ideas were filtered through the theoretical lens of his first wife Alice Balint and later through Enid Balint, both of whom played a key - and rarely recognised - role in the development of his thought. It ends with a brief discussion of his ideas on analytic training and his quest, successful only after his death, to publish the complete Freud-Ferenczi correspondence, together with Ferenczi's diary.     

From the Balint method toward profession-related supervision

This paper focuses on Michael Balint's special application of psychoanalysis, originally conceived as a training of doctors. Then the attempt is made to discover indirectly, since Balint never described his method in context, what he thought mattered in terms of method. Besides Balint's own contributions, those of his own staff are also consulted as well as the cultural background of the Tavistock Clinic and the Tavistock Institute. Then the further developments of the Balint method in the German-speaking world are presented. At the center are the special features of the method: (a) the atmosphere, (b) the narrator's contribution, (c) listening and reactions of the members of the group, (d) the unconscious enactments in transference and countertransference and the mirror-phenomena, respectively. Furthermore, the respective central points of reference are discussed from the viewpoint of communication science: (a) case, (b) group, and (c) institution. In conclusion and based on these foundations, the characteristics of the application of the Balint method in the form of a particular profession-related supervision are presented.     

Winnicott: A research perspective

This paper describes research conducted over the past twenty years that was informed by Winnicott's thinking on the importance for child development of the early mother-infant relationship.     

Balint After Lacan ... and After

This paper examines Balint and Lacan's views about regression and symbolism, language, and transference. The author points out their similarities, their differences, and then proposes a synthesis through his approach of history, genealogy, trauma, and crisis. Freud's notions of masochism, of fixation (innate or phylogenetic) may thus be renewed, leading to the analyst's capacity to cope with deep regression and borderline (Balint) psychosis and perversion (Lacan) or to psychosomatics, including epilepsy.     

Transition and transience: Winnicott on leaving and dying

The author offers reminiscences and reflections on Donald Winnicott during the last phase of his life and considers the personal and theoretical importance for him of the topic of death. The author goes on to examine similarities and differences between Winnicott's concepts of coming into being and ceasing to be.     

Winnicott on Jung: destruction, creativity and the unrepressed unconscious

This paper considers Winnicott's critique of Jung, principally expressed in his review of Memories, Dreams, Reflections, which asserts that Jung's creative contribution to analysis was constrained by his failure to integrate his 'primitive destructive impulses', subsequent to inadequate early containment. It is argued that although Winnicott's diagnosis illuminates Jung's shadow, particularly his constraints vis-à-vis the repressed Freudian unconscious, it fails to appreciate the efficacy of the compensatory containment Jung found in the collective unconscious. This enigmatic relationship between destruction and creativity-so central to late Winnicott-is illuminated by Matte Blanco's bi-logic, and further explored in relation to William Blake. Winnicott's personal resolution through his Jung-inspired 'splitting headache' dream of destruction-previously considered in this Journal by Morey (2005) and Sedgwick (2008)-is given particular attention.     

Michael Balint: An Overview

Balint's important work extended over a period of 40 years in two directions; firstly the development of individual sexuality, and secondly, the development of object relationships, together with their relationship to psychoanalytical technique. He introduced the concept of primary love and was one of the pioneers in the thinking of the interdependence of mother and infant. He extended Ferenczi's work on therapeutic regression, introducing the concepts, among others, of benign and malignant regression, the basic fault, and the states of ocnophilia and philobatism. His applied psychoanalytic work is world famous, particularly the Balint groups for general practitioners and similar groups for marital therapists, social workers, and psychosexual counselors.     

The Balint movement worldwide: present state and future outlook: a brief history of Balint around the world

Michael and Enid Balint began running seminars for GPs (family physicians) in London in the late 1950s. Balint groups were soon started in other countries leading to the formation of the International Balint Federation. This paper describes the activities of the Federation and surveys the health and strength of the Balint movement in different parts of the world. While formal Balint training seems unlikely to become part of the official curriculum in more than a few countries, Balint's ideas will continue to be influential.     

D. W. Winnicott,transitional objects and the creation of the divine

Religious expressions and religious behaviours are often considered to be mainly mental or spiritual phenomena, to a large degree divorced from or threatened by physical or material forms that may accompany their expression. This paper asks whether the diminution of the material or the condemnation of idols, icons and religious art loses sight of possible benefits that involvement with these forms of material divinity has for believers. Using the concept of transitional objects and transitional phenomena developed by D. W. Winnicott, a mid-twentieth-century psychoanalyst, I argue that idols, icons and religious art often represent transitional objects that form psychological bridges, intermediaries or anticipated “transitions” from humans to unseen divinities who require materialisation in some form to be maintained actively in the believer’s mind. In the process of creating or designing these material forms, the forms themselves often come to be considered “divine”. Illustrations are provided.     

Thinking in the space between Winnicott and Lacan

The author, following André Green, maintains that the two most original psychoanalytic thinkers since Freud were Donald Winnicott and Jacques Lacan. Winnicott, it has been said, introduced the comic tradition into psychoanalysis, while Lacan sustained Freud's tragic/ironic vision. Years of mutual avoidance by their followers (especially of Lacan by Anglophone clinicians) has arguably diminished understanding of the full spectrum of psychoanalytic thought. The author outlines some basic constructs of Winnicott and of Lacan, including: their organizing tropes of selfhood versus subjectivity, their views of the "mirror stage", and their definitions of the aims of treatment. While the ideas of Winnicott and Lacan appear at some points complementary, the goal is not to integrate them into one master discourse, but rather to bring their radically different paradigms into provocative contact. A clinical vignette is offered to demonstrate concepts from Lacan and Winnicott, illustrating what it might mean to think and teach in the potential space between them.     

Jung,Winnicott and the divided psyche

In his review of Memories Dreams Reflections, Winnicott diagnosed Jung as suffering from a psychic split, and characterized the content and the structure of analytical psychology as primarily moulded and conditioned by Jung's own defensive quest for a ‘self that he could call his own’. This pathologizing analysis continues to be endorsed by contemporary Jungian writers. In this paper I attempt to show that Winnicott's critique is fundamentally misguided because it derives from a psychoanalytic model of the psyche, a model that regards all dissociation as necessarily pathological. I argue that Jung's understanding of the psyche differs radically from this model, and further, that it conforms by and large to the kind of dissociative model that we find in the writings of Frederic Myers, William James and Theodor Flournoy. I conclude that a fruitful relationship between psychoanalysis and analytical psychology must depend upon an awareness of these important differences between the two psychic models.     

Infantile sexuality: Its place in the conceptual developments of Anna Freud and Donald W. Winnicott

This essay explores the place of infantile sexuality in the theories of Anna Freud and Donald W Winnicott. Both Anna Freud and D.W. Winnicott incorporated and at the same time changed the classical psychoanalytic account of infantile sexuality and the instinctual drives. Whilst Anna Freud remained closer to her father's original conceptualization, she developed a multidimensional model of development which gave the drives a foundational status whist also maintaining their significance in giving meaning and texture to children's subjective experience. Winnicott also retained much of S. Freud's original theorizing except that in a fundamental way he turned it on its head when considering earliest development. For him the establishment of the self was paramount, and the drives and infantile sexuality merely served to give substance to that self.     

Breaking the Solid Ground of Common Sense: Undoing “Structure” with Michael Balint

Balint's great merit was to question what, in the classical perspective, was assumed as a prerequisite for analysis and thus located beyond analysis: the maturity of the ego. A fundamental premise of his work was Ferenczi's distrust for the structural model, which praised the maturity of the ego and its verbal, social, and adaptive abilities. Ferenczi's view of ego maturation as a trauma derivative was strikingly different from the theories of all other psychoanalytic schools and seems to be responsible for Balint's understanding of regression as a sort of inverted process that enables the undoing of the sheltering structures of the mature mind. Balint's understanding of the relation between mature ego and regression diverged not only from the ego psychologists, who emphasized the idea of therapeutic alliance, but also from most of the authors who embraced the object-relational view, like Klein (who considered regression a manifestation of the patient's craving for oral gratification), Fairbairn (who gave up the notion of regression), and Guntrip (who viewed regression as a schizoid phenomenon related to the ego weakness). According to Balint, the clinical appearance of a regression would depend also on the way the regression is recognized, is accepted, and is responded to by the analyst. In this respect, his position was close to Winnicott's reformulation of the therapeutic action. Yet, the work of Balint reflects the persuasion that the progressive fluidification of the solid structure could be enabled only by the analyst's capacity for becoming himself or herself [unsolid].     

Winnicott and Derrida: development of logic-of-play

In this essay I develop the logic of play from the writings of the British psychoanalyst Donald W. Winnicott and the French philosopher Jacques Derrida. The logic of play serves as both a conceptual framework for theoretical clinical thinking and a space of experiencing in which the therapeutic situation is located and to which it aspires. I argue that both Winnicott and Derrida proposed a playful turn in Western thinking by their attitude towards oppositions, viewing them not as complementary or contradictory, but as 'peacefully-coexisting'. Derrida criticizes the dichotomous structure of Western thought, proposing playful movement as an alternative that does not constitute itself as a mastering construction. I will show that Winnicott, too, proposes playful logic through which he thinks and acts in the therapeutic situation. The therapeutic encounter is understood as a playful space in which analyst and analysand continuously coexist, instead of facing each other as exclusionary oppositions. I therefore propose the logic of play as the basis for the therapeutic encounter. The playful turn, then, is crucial for the thought and praxis expressed by the concept of two-person psychology. I suggest the term playful psychoanalysis to characterize the present perspective of psychoanalysis in the light of the playful turn. I will first present Derrida's playful thought, go on to Winnicott's playful revolutionism, and conclude with an analysis of Winicott's clinical material in the light of the logic of play.     

Winnicott's dream: some reflections on D. W. Winnicott and C. G. Jung

The author discusses D. W. Winnicott's 1964 review of C. G. Jung's autobiography, Memories, Dreams, Reflections, emphasizing the psychological effect the reviewing process had on Winnicott himself. Writing the review constellated Winnicott's unconscious, and he reported having a healing dream 'for Jung and for some of my patients, as well as for myself'. Winnicott's 'countertransference' to Jung helped him personally, and the review was Winnicott's first written formulation of his theory on 'The use of an object'.     

Understanding the dynamics of the patient-physician relationship: balancing the fiduciary and stewardship roles of physicians

There has been growing concern about the effects on the patient–physician relationship of the increasing demands on physicians to balance their fiduciary and stewardship responsibilities, what has been called double agency. Various authors have proposed ways to restore patient centeredness to the patient–physician interaction. We have previously discussed the need to establish a patient–physician alliance to achieve this aim and to facilitate achieving this balance in mutual understanding. In this essay, we examine six concepts derived by Michael Balint from research seminars with primary care physicians. These six concepts are (a) the basic fault; (b) the physician's apostolic function; (c) the mutual investment company; (d) the drug doctor; (e) the deeper diagnosis; and (f) the conspiracy of anonymity. We believe these six concepts describe basic forces that shape the patient–physician relationship and allow for the development of an alliance between patients and physicians that can help preserve the essentials of the relationship.     

Winnicott,Kohut, and the Developmental Context of Well-Being

In this article, qualitative, case-based research findings from the works of D. W. Winnicott and Heinz Kohut, regarding the interpersonal world of the child, are used to show how quantitative data from positive psychology on well-being can be seen as emerging within a highly social developmental context. It was shown that observations concerning the optimal social context for healthy child development embedded within the works of both Winnicott and Kohut can be mutually employed in the service of a productive dialogue with the tradition of quantitative research on well-being within positive psychology. On a more general level, the analysis provides evidence in support of Friedman's (2008 Friedman , H. ( 2008 ). Humanistic and positive psychology: The methodological and epistemological divide . The Humanistic Psychologist , 36 , 113 – 126 .[Taylor & Francis Online] , [Google Scholar]) and Mruk's (2008 Mruk , C. J. ( 2008 ). The psychology of self-esteem: A potential common ground for humanistic positive psychology and positivistic positive psychology . The Humanistic Psychologist , 36 , 143 – 158 .[Taylor & Francis Online] , [Google Scholar]) calls for an enhanced dialogue between humanistic, qualitatively inclined psychologists and positive, quantitatively inclined psychologists.     

Searching for the enriching sense of otherness: The psychoanalytic psychotherapist as a meaning-bearing other

Abstract

This paper is a theoretical and clinical examination of the patient's search for the otherness of the therapist as a prerequisite for change and development in relational psychoanalytic psychotherapy. A basic assumption is that being in a relationship as well as being a personal self, is to be understood, as being with a “meaning-bearing other”; that is, someone who allows for the possibility of meaningful thoughts and feelings, either through an actual communicative presence or as a consciously, prereflective, or unconsciously imagined communication partner. The term “meaning-bearing other” is used to differentiate distinct, although often synchronic, modes of relatedness. The need for intersubjective “depth”—that is, to discover the otherness of the other, and for oneself to be recognized as an experiencing subject—is regarded as a main motivational force. Winnicott's, as well as Sullivan's developmental approaches, Mitchell and Aron's views on psychoanalytic interaction, and Heidegger and Gadamer's phenomenology and hermeneutics are used as theoretical points of reference for the present discourse. The theoretical points of view are examined and discussed through excerpts from twice-a-week psychotherapy with a six-year old girl.     

Shame,Ministry, and Theological Education: Leaves from the Notebook of a Defiant Seminarian

Many young adult Christians are highly influenced by relativism of all sorts, which can lead them to a state of doubt. If they voice their doubts too loudly, they are often shamed and abandoned by their elder Christians who do not have (or, perhaps better, do not voice) these doubts. I suggest that those of us involved in youth ministry must meet our youth where they are at, that is, meet them in their doubt, which is not, in my view, a bad place to be. This article focuses on a psychoanalytic understanding of shame and draws from the work of Donald Capps, Erik H. Erikson, Heinz Kohut, and D. W. Winnicott.     

Winnicott's children: The holding environment and therapeutic communication in brief and non-intensive work

This paper discusses brief and non-intensive work using a Winnicottian framework for understanding the processes involved. The importance of play, communication and interpretation are considered within the careful establishment of a unique holding environment for each patient. Parallels are drawn with ordinary development and care of the infant and young child. Two clinical examples are given to illustrate these concepts. The first describes the treatment of parents and children following the accidental death of the youngest child, and the second describes time-limited work with a sexually abused and abusing teenage boy. The value of providing a range of psychoanalytic treatments to meet the range of needs of patients is discussed. The importance of conceptualizing such treatments in ways that do not imply that they are ‘diluted’ psychoanalysis is also stressed, particularly with a view to the increasing pressure on therapists to offer help to as many children as possible within limited treatment time.