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W. W. Meissner has undertaken the much-needed task of clarifying and elaborating the concept of therapeutic alliance, particularly its interrelationship with the transference and the real relationship. He correctly recognizes that despite the term's general acceptance by psychoanalytic writers, it remains inadequately defined and badly in need of being more clearly conceptualized.
His general views stand out in bold relief. The therapeutic relationship consists of three components—the therapeutic alliance, the transference (and countertransference), and the real relationship. Although they are interdependent and interact in complex ways, Meissner believes that these three variables should be regarded as separate and distinct. His objective in the book is to demonstrate that keeping these facets clearly differentiated—particularly the alliance and the transference—permits more effective therapeutic interventions with a wide variety of patients.
He first sets out to distinguish his views from those of the pioneers in this area, Elizabeth Zetzel (a former supervisor and mentor) and Ralph Greenson. His quarrel with Zetzel is that she confounded the transference and the alliance, particularly in her view that the patient's earliest experiences with the mother were the bedrock on which the alliance is built. While positive early nurturance indeed contributes to the growth and consolidation of the patient's basic trust as a necessary