Ladies
and Gentlemen,
dear collegues, dear friends,
Welcome
to the 12th International
Balint Congress.
It is a great
pleasure for me to see collegues from all
over the world here in Portoroz.
In spite
of the world’s situation, in spite of
terror, fear and conflicts we come
together to share our experiences.
Whatever happens, we are going on to treat
patients, to take care of ill or injured
people and we take care of ourselves as
well when we come together in Balint
groups.
Analyzing the doctor-patient-relationship
means both: seeing the patients conflicts,
needs, suffers, illness and getting to the
own problems, feelings, resistance;
being aware of ourselves.
I
am very glad that you invited
medical students to this Congress
to get to know the psychosomatic point of
view early and to pay attention to the
doctor-patient-relationship right from the
beginning.
Enid Balint, who played an important role
in the development of Balint-groups was a
social worker. I am happy to say, that
social workers are here too and will work
together with us in the groups.
“Balint
after Balint” – what happened during
the last 50 Years since Michael Balint
invited GP’s in London for a seminar
“to study psychological problems in the
medical work”?
His
thought was, that “the most used
drug is the doctor himself” and
that for this very important medicine
"there is no knowledge about
its pharmacology”.
“There
is no textbook in which you find something
about the dosage in which the doctor
should prescribe himself ... or where you
find a description of the side effects...”
So he as a psychoanalyst decided to do
research on this question together with
GPs.
Balint
considers, that somatic diseases very
often are the expression of affective
tensions or conflicts.
The patient goes to his doctor and offers
him bodily symptoms. Balint’s
hypotheses: “If the patient would
be able to talk about his conflict he
would not need the illness.”
The
patient offers different symptoms until
doctor and patient agree and find them
reasonable. The patient then will stick to
the illness and organize himself with it.
Balint
discussed with the GPs what alternative
they have to discover the problems and
conflicts together with the patient before
(s)he converts it and develops a
psychosomatic disease.
In
his workshops together with the GPs –
the “training
cum research groups”,
as he called them
- he
points out that the doctor-patient-relationship
is most important for diagnosis and
therapy.
The doctor has to listen to what the
patient tells him in words, gestures, body
language. He has to understand the
symbolic character of symptoms, in which
the patient acts his inner conflict.
Especially the GP can use his knowledge of
the patient and their close relation to
understand the message.
The
results of this first training cum
research group were summarized in the book
“The doctor,
his patient and the illness”
This
book was well recognized.
Many doctors all over Europe and the
United States read it and came to London
to discuss with Balint and participate in
his seminars.
And
Balint was invited to come to other
countries like France, Belgium, Germany
and Switzerland.
When he held his first seminar in Sils
Maria
as a guest of the “Swiss
Psychosomatic Society” many GPs came to
participate and watch his work. That was
when he created the “fish bowl group”.
He worked as usual with 12 doctors in an
inner circle, and all the others sat
around and listened.
Wherever Balint presented his work colleagues
were impressed to be able to understand
what was going on between doctor and
patient and to learn how important the
doctor-patient-relationship is for
diagnosis and therapy.
After years of working in a Balint group
the GPs develop a more analytic thinking
and it leads them to a “slight but
important change in their personality”,
as Balint stated.
Around
1970 the first national Balint societies
were founded.
In 1972 the International
Balint Federation was
established in Paris by representatives of
Great Britain, France, Belgium and Italy.
The
goals of the IBF are:
1.
To contact and to keep in contact with the
member-countries and doctors,
2.
to encourage collegues to do Balint-work
and to establish national societies,
3.
to advise group-leaders and discuss the
standard of leader’s training,
4.
to organize an International Balint
congress every 2nd
or 3rd year,
5.
to integrate Balint-work in the education
of all medical students and specialists.
As
we can see here today, Balint’s idea
spread all over the world.
Nowadays
Balint-work has an important place in the
education of medical students and doctors
– GPs and other specialists - in many
countries.
What
is so fascinating about Balint work?
Last
weekend I was at a workshop in South
Germany to train Balint-group-leaders.
Some of the trainees said: “We thought
it would be an exhausting weekend. But we
learned that Balint-work is relaxing and
fun, too. To “think fresh”, deal with
imagination and fantasies,
to be free to express ones feelings
was a relief.
It is exciting
to analyze what is going on in the
group, to find out what influence the
leader has, to brighten blind spots of the
presenter, to recognize the mirroring of
the doctor-patient-interaction in the
group...”
I
myself am always impressed by the
tolerance in
Balint groups, the way to listen to
each other, to respect the thoughts, the
feelings, the different
perspectives.
And I am eager to learn about peoples
thoughts from other countries, different
religions and social back ground in the
groups.
That is what we will be able to experience
in the next few days.
May we learn from each other and have a
good time together.
Last
but not least I would like to thank all
who made it possible that we can meet here
in this wonderful place Portoroz.
Especially
many thanks to Zlata
Kraijl, who offered two years
ago to
host this 12th
International Balint Congress in Slovenia.
Thank you, Zlata, you had a hard time with
us putting up questions again and again.
Thanks for being tough and carrying it
through. Thanks to you and to your colleagues
for all the work you did.
I wish you all a pleasant time.
