One of the noted object relations practitioners, Michael Balint, actually applied this perspective to his work with physicians and other professionals. When engaged, the Balint Group Method (Otten, 2017) typically involves the identification of various internal voices that are operating when a specific physician encounters a particularly difficult and elusive clinical issue. These diverse, often contradictory and at times “shadowy” voices are presented to other members of a Balint Group and members of this group then are assigned specific roles, with each member taking on one of the voices. An enactment of the internal conversation among the voices then takes place with each member of the group verbalizing the voice they have been assigned and interacting with the other voices in a rich and often insightful dialogue regarding the presenting clinical issue.
The person presenting this issue listens to the dialogue and when it is finished reflects on what has been learned. The external enactment of the internal dialogue can be a rich source of learning for the physician (as well as other members of the Balint Group). Critical (often collective) discernment can take place in a supportive, public setting. Personal sources of expertise are now explicit. No longer held in a tacit manner, personal expertise can now be viewed in a new way by the physician with the assistance of their Balint Group colleagues. We would suggest that this Balint process can be of value when engaged in many other settings. We have found this to be the case in our own work with the Balint Method. The Balint Group can be of particular value when engaged to enhance the benefits derived from personal expertise.
Outside the psychoanalytic world, we find a similar theme conveyed by many authors who (like Balint) are portraying a noisy dialogue that is operating within the head (and heart) of their protagonist. For example, we find this description in the novels of Pulitzer-prize winning Marilynne Robinson (particularly Jack) and graphically portrayed in the theatrical productions of Pulitzer-prize winning Arthur Miller (particularly The Death of a Salesman). We find that Truman Capote (1994) offers an especially insightful portrayal of dialogue-filled unconscious life. He writes about Voices from other rooms that are often pushed aside or silenced during our youth but demand attention during our mature years.
While Capote is concentrating on the voices that are silenced or muffled, we can also point to those voices that operate at the other end of the vocal spectrum. We often only hear the loudest, most powerful of the voices—especially when we are faced with time-pressures and/or stress. In responding to these loud voices that often come from the media (especially cable channels and internet sites), we move to fast thinking and attend that source of expertise that is most readily available. This certainly is not one of the voices from our back home (unconscious)—voices that speak of deferred past dreams or ambitious dreams that have been abandoned in favor of expedience (Bergquist, 2012).
Sadly, these voices of lower amplitude often yield the most important advice and the kind of personal expertise that requires a quiet place for reflection and a slowing of the thought processes. Their source is often the printed media (especially long, scholarly essays) and public media (television and radio). Policy documents (“white papers”), commission reports, and findings reported by nonprofit and nonpartisan organizations are likely to remain unread. The “experts” who report on (and interpret) these findings are likely to provide only partial (and selective) reviews.
