Discussion of Enid Balint's Article, Training as an Impetus to Ego Development

There is considerable confusion about group psychotherapy and group dynamics, as compared to the kind of group work Mrs. Balint employs and the kind I came to foster in the New Orleans Program for Psychiatry and Medical Practice.

Much money is now available for general practitioners to procure “courses in psychiatry.” But, the most fruitful years of our program were those when the participants paid for it themselves. This was at a time when little interest was shown in general practitioners by medical schools or, for that matter, by most other organizations.

The program I worked out in New Orleans was adapted to such a setting. It was conducted outside the halls of learning. My groups met in the homes and offices of our participants, and one time on a Louisiana river bank. Yet, under these conditions, appetites and attitudes developed which enabled us to forge the tools which made our program a success.

It was nothing for us to drive 75-150 miles for our meetings. Though we did not have a conducive setting like The Tavistock Institute for Medical Psychology, we did have the sanction and encouragement of the Louisiana Academy

of General Practice. We tried many pedagogical procedures now in vogue, most of which were discarded after two or three years in favor of the more effective method of presentations made by the participating physicians.

The duration of one of our groups was ten years, the tenth year being devoted to studying each participant's achievement in terms of his professional work. Reevaluation studies point out that those who got through all of the phases set forth by Mrs. Balint remained until we terminated our program. Most evident was a reinforcement process that operated in the group, from which came an atmosphere quite tolerant and supportive during regressive phases. When a participant was forthright in reporting factual material about his patients and his relationships with them, the group seemed to reward him with approval, although at times there