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This book consists of a collection of papers written between 1954 and 1991 covering the three areas of the English psychoanalyst Enid Balint's professional development: as psychoanalyst in the “consulting room”; as consultant and group leader to general medical practitioners; and as supervisor to marital therapists. She is associated with the independent tradition of British psychoanalysis and frequently quotes Freud, Ferenczi, Bion and Winnicott, as well as her husband Michael Balint. “Afterthoughts,” an interview with Juliet Mitchell, is offered as a dialogue between the two psychoanalysts.
Balint demonstrates how a clinician operates when she listens to the patient, developing technique and theory only after an understanding develops. Her struggle to hear the preoedipal patient is evident even though her training had emphasized the oedipal nature of neuroses. She describes, in detailed clinical case presentations, how she tried increasignly to behave as as a nonintrusive presence for patients with preverbal disorders. She learned to follow the patient's lead and developed her theoretical concepts only after a detailed examination of the case.
The articles also reveal a shift in her assumptions about the patient's alleged awareness of a distinct object. Her later articles on treatment accept a quite distinct underlying assumption. “It is only relatively recently that I stopped assuming there was more than one person in the room, and that there was a relationship even if the patient did not think so” (p. 232).
Balint is able to work with this disconcerting state through the “mirror image.” “I see him as relating to himself in the mirror, and finding someone else; and then not being able to, and then being able to again. I think, but I am not sure about this, that gradually I am being seen in the mirror when he looks at himslef. There is the looker, and there is what is in the mirror” (p. 233). Balint believes that the ability to create the perception of another is an