Basic Fault Theory was proposed by Michael Balint, and alludes to an individual's inability to form healthy relationships due to unresolved dependency issues from early childhood in relation to the formation of object reactions in an effort to deal with a lack of adjustment between their psychological needs and the lack or negative care provided by someone close to them.
Balint suggests that the doctor needs to perform “psychological mothering”, and act almost to re-establish a care relationship for the patient since that is what they most likely were lacking from childhood.
Balint was operating during the time of much growth and development in the 1950s for psychoanalysts – his peers were describing concepts such as ‘object relations’, Kleinian psychoanalysis and ‘attachment theory’.
Additionally, when Balint was still a young student, his interest in psychoanalysis was furthered by his introduction to Sigmund Freud's work by Alice Szekely-Kovacs.
He also argued that if health care professionals felt that only they, as doctors, were knowledgeable and superior enough than the public to help the sick, the relationship would not be as effective.
Balint stressed the importance of a healthy, unbiased, friendly relationship between doctor and patient, not unnecessarily applying barriers like status or occupation.
Analysts needed to be highly attuned to reading the subtleties and/or nonverbal cues of their patients in order to evolve their relationship, to uncover what is ‘hurting’ them, or causing a 'fault'.
Specifically, a negative event or trauma that occurs in one's childhood between them and an adult, causing a fixation on objects, intense and often overwhelming emotions and the incapacity to deal with stress.
Balint's views on what causes people to become profoundly disturbed differed from psychoanalysts of the time, as he proposed it was due to a deficit more so than a conflict during developmental stages.
Arguing that caregivers who provides care that is ‘insufficient, deficient, haphazard, over-anxious, over-protective, harsh, rigid, grossly inconsistent, incorrectly timed, over-stimulating or merely un-understanding or indifferent’[2] is not good for the infant's development.
Balint argued that some more ‘rigid’ techniques used by other psychoanalysts at the time were never going to be successful in helping all types of patients, as they relied too much on the interpretation of their life events.
[2] Balint found that these faults were created during early development stages, such as pre-Oedipal and pre-verbal, and were most successfully reached in regressed states.
[2] In order to get out of the ‘basic fault zone’, the patient needs to undergo a type of “psychological mothering”, with the help of the doctor.
The patient potentially possesses the ability to interpret the analyst's behaviour, which Balint describes can be perceived as telepathy or clairvoyance.
Resulting in patients potentially feeling that anything positive could exist, and that their frustrations are caused by anything other than evil intentions, malice or some form of criminal behaviour.