Discussion

WE NOTE IN THE REPORT OF Balint's case a variety of interventions—interpretative, empathic, manipulative, individual, familial, and various mixtures of these. Perhaps in keeping with sectarian biases, we assign importance to these interventions. For example, Malan, in his discussion of the material, emphasizes the interpretation, particularly, I think, of the oedipal material (Malan, 1963). Others emphasize the sharing of pain and aloneness, in keeping with Myerson's formulation, that "the patient was suffering from hurt and lonely feelings" (Myerson, 1977). Gustafson, in a recent, remarkable account of the material, emphasizes Balint's manipulation of the transference, his disconfirming the transference, or, to use the language Gustafson perfers, Balint's passing the patient's tests (Gustafson, 1981).

There are still other possibilities. Balint himself mentions the patient's "newly won identification with the therapist" (p. 69) and the patient's having "introjected my ideas and words" (p. 115). He does not discuss how this was achieved. One could also emphasize the building up of the patient's confidence against father's reiterative denigrations, what I call counterprojection and, in some instances, counterintrojection. Or, still another possibility, perhaps both the patient and his mother suffered from endogenous