Structure and Reconstruction: A Critical Comparison of Michael Bálint and D. W. Winnicott

Michael Balint and D. W. Winnicott were both heuristically provocative, 'unorthodox' analysts. Their writings are a rich source of theoretical and clinical ideas. The purpose of this paper is to critically compare their respective contributions to structural theory, i.e. Balint's theory of the 'basic fault shell', and Winnicott's theory of the true self-false self split. My thesis is that despite their use of different terminology, both theorists have constructed essentially similar conceptual frameworks to explain the essentially similar data found in their analyses of borderline and deeply regressed patients. Finally, I shall very briefly offer an alternative theoretical model that seems more explanatory of their data and hypotheses.

Although it is presumed that most readers of the Journal are familiar with the theories of these men, I shall first present a rather brief summary of their structural schemes.1

In his work with deeply regressed and borderline patients, Balint became increasingly concerned with the more primitive, deeper level of two-person psychology. At this level, there is no conflict, and language is useless or misleading in describing events because words do not always have an agreed meaning. Balint calls this situation the 'basic fault' and describes it as an 'area of the mind'.

Balint says he calls this situation in two-person psychology a fault because that is how his patients describe it. It is a fault that must be fixed, not a complex. There is the feeling that the cause of this fault is that someone has failed the person or defaulted on him. The force originating from the basic fault is:

… a fault, something wrong with the mind, a kind of deficiency which must be put right. It is not something dammed up for which a better outlet must be found, but something missing … perhaps for the whole of the patient's life. An instinctual need can be satisfied, a conflict can be solved, a basic fault can perhaps be merely healed provided the defi