Balint’s Basic Fault Theory, General Medicine and Salutogenesis

Abstract

This essay aims to scientifically justify the incorporation of Michael Balint’s basic failure theory (BFT) into medical education. This theory postulates that human beings suffer a fault between their needs and what the environment provides during critical periods of development in childhood and possibly from intrauterine life. The fault can be biological, physical, psychological or social. The sooner the basic failure is compensated, the better the person’s subsequent health will be. Clinical illness, in this interpretation, is a symptom of an uncompensated basic failure. Balint proposed BFT in opposition to the theory of external agents penetrating the defenses of a basically healthy organism, which is usually taught in medical schools. BFT facilitates direct access to the person-centered clinical method, facilitates the approach through narrative-based medicine; and notably, admits compassion as a therapeutic element in the doctor-patient relationship. Conceptually, it clearly fits with salutogenic approaches such as “The natural history of health” that are emerging in medical education. The scientific foundations supporting TFB come from fields such as social genomics, sociology, and historical-cultural learning theory.