We make good care better

"At the center of medicine there is always a human relationship between a patient and a doctor."
Michael Balint

Paul Scott
Emeritus Councilor
2013 - present

My involvement in the Balint Method came as a result of a fortuitous intersection between my personal and professional interests, and a coincidence. I found myself in Pittsburgh after Michael Balint’s United States travels had brought him to that city several years earlier. Beginning in 1956, Dr Rex Pittenger, chief of the Staunton Clinic, sponsored Michael and Enid Balint’s visits to Pittsburgh, eight times over a 12-year period. Balint met each time with a group of local psychoanalysts, leading groups and instructing them in his method. A study group was formed at Staunton Clinic, and Rex extended the work and ideas of Balint through teaching, consulting, writing, and presenting at regional, national, and international meetings. In 1970, he and a member of the study group, Dr Ralph Coppola, began conducting Balint seminars for the faculty at St. Margaret Memorial Hospital’s nascent Family Practice Residency. The following year they initiated the first class of residents in a weekly Balint group. Their immeasurable advantage was having a program faculty now Balint devotees, based on their own yearlong Seminar.

I came to this opportunity prepared by several intersecting educational and personal influences. I attended medical school from 1964 to 1968, at Case Western Reserve University, in Cleveland, Ohio, a forward-looking institution with an experimental curriculum and a deep psychoanalytic leadership. The Dean, Dr Douglas Bond, was himself a psychoanalyst and one-quarter of my classmates became psychiatrists. I had intended to become an internist or neurologist, and to that end pursued a residency in Internal Medicine, followed by two years of research at the National Institutes of Health. During that time I worked in psychiatric settings when I could, fascinated by the chance to understand the deeper layers of human emotion and motivation. Eventually, I realized that helping people with talk therapy was my true calling, and sought out a psychiatric program with a strong psychoanalytic bent, choosing Western Psychiatric Institute and Clinic in Pittsburgh, Pennsylvania.

This change deprived me of the scientific discipline and close personal care of patients with medical illness. However, when introduced to the Balint groups at St. Margaret by Ralph, I discovered a tailor-made laboratory to meld my psychiatric, medical, psychoanalytic, and group process interests. It was a perfect fit.

I was honored to be chosen as a member of the first ABS Council, and was subsequently elected to Council for 23 consecutive years, until term limits caught up to me in 2013. Following that retirement, I was most honored to be named an Emeritus Councilor. In those years I served in a number of executive and committee positions, culminating in that of President of the Society from 2005 to 2007.

With experience in other organizations, I knew that the natural evolution of a society like ours might become overly hide-bound by our own necessary policies, and more erosively, by an ethos of this is the right and only way to be a Balint leader. I believed that our strength and our future lay in our very diversity of membership and openness to inquiry and uncertainty. As anyone who practices Balint knows, we never come to a final certain answer to the kinds of questions we entertain. Reviewing this essay I feel embarrassed by the focus on me, especially because I am self-consciously aware that nothing above could have been accomplished or even dreamt of without the unwavering support, dare I say love, of a group of unparalleled colleagues and friends in the Balint movement. I thank you.

For a narrative of Dr. Scott's work with the ABS, consult his Emeritus Nomination.