The Concept Of Therapeutic Alliance: Implications For The "widening Scope"

OVER THE PAST 25 YEARS there has been an increasing tendency in psychoanalysis to extend our sphere of interest beyond the patient's intrapsychic life to embrace all aspects of the therapeutic relationship, including the analyst's self-observations. Numerous trends of variable importance have contributed to this expansion, including ego psychology; developmental psychology; psychoanalytically oriented psychotherapy — especially of borderline and psychotic patients; studies of empathy and countertransference, the "analyzing instrument," the "corrective emotional experience," object relations theory, etc. A significant contribution to this trend has been the study of the collaborative aspects of the analytic relationship, as exemplified in the concepts of the "therapeutic alliance" (Zetzel, 1956a) and the "working alliance" (Greenson, 1965). In examining the theoretical and clinical implications of these latter concepts on can more clearly delineate some of the gains and insights as well as the problems and confusions typical of the general trend itself. Certainly, this extension has made more explicit many elements of the analytic process which had been treated pragmatically as "givens" to be taken for granted. At the same time, an overemphasis on one aspect of the total process