MY TASK IS TO PRESENT some alternative approaches to the clinical material described by Dr. Balint. My views emerge from the perspective of a family and marital therapist.

The very honesty and completeness of Dr. Balint's report makes one feel apologetic for picking up the many transparent clues he provided which lead to alternative interpretations of the data. My own view is that Balint was so locked into his formulation by his short-term goals that he could not attend to the loss themes which were cropping up in his patient's material. Only after two futile attempts to terminate did Balint come to see significance in Baker's sense of loss and move beyond the initial formulation, namely the patient's inability to enjoy victory over adversaries. The work was then successfully concluded and a follow-up almost seven years later indicated that the improvement had been sustained.

I suggest Baker's lack of trust in his wife's fidelity was related to his belief that, as a boy, he was treated as a means to his parent's