Chapter 4 The Basic Fault (1968)

We now come to Balint’s last book, which gathers together much of his thinking on theoretical and technical concepts as they have been described previously. In addition, however, he is still extending his thoughts and adding further concepts, even suggesting at the end of the book future pathways by which the work could be extended. It is important to note that the subtitle of the book is ‘Therapeutic Aspects of Regression’, since it is in this area that the greatest advances are described.

In the first part of the book he introduces the concept of the three areas of the mind: the area of the Oedipal level, the area of the basic fault and the area of creation. He starts by wondering why some patients who have been judged suitable for analytic treatment are more difficult to treat than others, and why some analyses are less rewarding to analyst and patient than others. He suggests that we do not have a great deal of knowledge of the therapeutic processes and of the changes that may occur in the id, ego and superego in these processes. He also suggests that we have even less knowledge of the relationship between these processes and changes and the different techniques that are used by analysts of different schools, and that possibly the different schools succeed or fail with different sorts of patients. He notes how any research into this topic seems to arouse great anxiety and resistance among analysts.

He then discusses one aspect of interpretation, in that an interpretation consists of sentences made up of words which have an agreed meaning to both analyst and patient. If the ego is sufficiently strong, the interpretation is ‘taken in’ by the patient and followed by ‘working-through’ as described by Freud. Problems will arise when interpretations are not taken in as such, and normal working-through cannot then occur.

From this, Balint conceptualized two levels of analytic work occurring in two areas of the mind, which he described as the Oedipal level and the level of