Balint Groups

Timothy is an experienced and accredited Balint Group Leader with the Balint Society of Australia and New Zealand.

 

What is a Balint Group – some background information

A Balint group is an experiential, small group educational activity in which, traditionally, practicing GPs would meet regularly to discuss difficult or intriguing cases. The focus would be on the psychological aspects of general practice, and particularly the emotional content of the doctor-patient relationship. Balint groups for GP's continue to provide a supportive setting in which GPs can rediscover the human side of general practice, add a refreshing new dimension to their work and avoid burnout.

Today in the 21st Century the Balint group has evolved into a model of support, supervision and professional practice for professionals from a wide range of disciplines and walks of life, wherever there is an ongoing professional relationship, sometimes known as the 'i thou' relationship, between the giver/provider of a professional service and the consumer of such service.  Other than medical practitioners nowadays lawyers, social workers, ministers, Corrections and Probation staff are all able to develop their professional practice, competence, resilience and boost energy for their work by being part of a Balint group.

Back in the 1950’s a therapist, Michael Balint, introduced many interesting concepts in his now famous book "The Doctor, His Patient and the Illness", including the concept of "the drug, doctor". By this he meant that the patient responds, not just to a pharmacological substance, but to the person of the doctor: the atmosphere the doctor generates and what the interaction means to both of them. The doctor, too, responds to the patient as a person, and the doctor's response can be a source both of difficulty in their interaction and also of important information about the nature of the patient's problems. A Balint group explores such issues through detailed discussion of participants' accounts of their interactions with patients. Through participation, group members learn to understand and skillfully utilize the professional client/patient relationship.

Balint group participants always report increased ability to cope with difficult interactions, psychologically challenging situations in general work and with general practice, hospital and mental health issues; reduction in work-related stress; and increased professional satisfaction.

Michael Balint (1890-1970) was a psycho-analyst from Hungary who emigrated to Britain in the 1930s. After the war he practiced as a psychoanalyst at the famous Tavistock Clinic in London. However, to General Practitioners and family doctors, he will always be remembered for the work he did in the 1950s and 1960s in helping them to understand their psychology of the doctor-patient relationship. Enid Balint, also a psychoanalyst was Michael’s (third) wife. She was his colleague and partner in the work with family doctors.  You see below to your right a lovely pencil sketch of husband and wife Michael and Enid Balint.

How a Balint Group Works

Typically, up to twelve participants will sit on chairs in a circle, along with a trained leader or two co-leaders. A group member will present a case from his/her own practice. Other members listen to the presenters story, then discuss the case, with a focus on the presenter - client/patient relationship. Each presentation and discussion usually takes about 45 minutes, and groups usually meet for between 90 and 120 minutes either every 4 weeks or monthly.

The presenter tells the group about the case in an informal way, quite briefly, and without notes - because sometimes the way the story is told, including what is left out, can provide valuable clues to the nature of the presenter's interaction with the client/patient. The presenter tries to convey the essence of how they experience the interaction with the patient/client and the atmosphere in the consulting/meeting room, to describe anything they are finding difficult and to include their own feelings and reactions.

The presenter is free to choose any client/patient to present. Often the patient/client presented will have elicited strong feelings in the presenter, such as distress, frustration, surprise, difficulty, puzzlement or uncertainty.

In the group discussion, the group aims to explore the interaction between presenter and client/patient and to empathize with both of them. The group is encouraged to speculate, without any pressure to be "right". The aim is to understand the situation in a deeper way, not to judge, advise, or offer solutions. It is important for the presenter to be protected from interrogation or criticism and to have time to listen and reflect on the group's contributions. The atmosphere is mutually respectful and non-threatening. There is time to "sit" with uncertainty and complexity without the pressure to know the answer.

The doctor's response to the patient/client often provides valuable clues about  psychological difficulties. Because of the diversity of group members' varied personalities, life experiences and blind spots, there may be several ways of understanding the case. The group provides a place to express feelings - both pleasurable and painful. It provides camaraderie, intimacy and support. The presenter may find that in subsequent interactions with the patient, they are less defensive. They may find themselves increasing their repertoire of interventions and finding new approaches to recurring problems.

Participants always develop better listening skills, observation skills and empathy. They develop increased self-awareness and capacity to reflect about themselves and they learn how useful it can be to examine their own reactions to clients/patients. They experience the intimacy and power of working as a group which is more than the sum of its parts. They become more creative, divergent and integrative in their thinking. They become more sensitive and skilled in addressing psychological aspects of their patients'/clients' problems. They often develop increased professional satisfaction.

To read about one GP's experience of participating in a Balint Group please click here.

To read a recent article about Balint and supervision, written by Timothy and published, with appreciation and acknowledgement to the NZ Law Society,  in the New Zealand  Law Society journal 'The Advocate' please click here.

More information on Timothy as an Accredited Balint Group Leader

Timothy has been facilitating experiential groups for over 2 decades. He first participated in experiential groups in 1991 with the Jesmond Centre for Humanistic Psychotherapy. 

He is a former member of the Centre for the Study of the Person in La Jolla, California, established in the 1970’s by the legendary Carl Rodgers, where he also undertook intensive training in group processes. 

Throughout the 90’s and into the early part of this decade Timothy facilitated hundreds of experiential groups all around the UK. 

Today he is a member of the American Balint Society and an accredited Leader and member of the Balint Society of Australia and New Zealand.