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Psychoanalysis On and Off the Couch

Jun 9, 2019

“Most primary care family physicians you talk to will say that about half of their patient visits, in any given week, are emotional, situational, and relational problems.”


Description: Harvey Schwartz welcomes Dr. Randall Paulsen who is a psychiatrist, a training and supervising psychoanalyst and past president of the Boston Psychoanalytic Society Institute. He is an Assistant Professor of Psychiatry at Harvard Medical School and currently supervises and consults at Brigham Women’s Hospital. Dr. Paulsen’s career has been focused on applied psychoanalysis, he directed inpatient and day hospitals at Tufts Medical Center, he developed Primary Care psychiatry as a component of Healthcare Associates and facilitated a long term Balint group for physicians which is the subject of today’s interview. He was the Consulting Psychiatrist at Osher Institute, Harvard Medical School, where he also lead mindfulness-based stress reduction courses. He views psychoanalysis as a subjective science in healthcare, human development and relationships, both individual, group and institutional. Currently, he has a private practice of psychoanalysis in Lexington, Massachusetts.


Key takeaways:

[4:15] The history of Balint groups.

[9:31] A new model for physicians. 

[9:58] Three crisis in the history of psychoanalysis.

[11.45] Balint groups in the past and nowadays.

[17:27] How Balint groups work.

[18:35] Sample case of a Balint group.

[23:05] Mindfulness with physicians and patients.

[27:15] Psychoanalysts’ skills applied to the work in Balint groups.

[28:59] The Hungarian model.


Mentioned in this episode:

IPA Off the Couch


Recommended Readings:

Balint, M. (1966). Psycho-Analysis and Medical Practice. Int. J. Psycho-Anal., 47:54-62. PEP


Balint, M.  The doctor, his Patient, and the Illness 1st ed of the book (Int. Univ. Press, 1957).

The 2nd addition, with an intro by John A. Balint, was published by Churchill Livingstone in 2000.


Laurel Milberg, PhD. "The Evolution of Balint Leader Training and Credentialing in the American Balint Society"