You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
Ever since Greenson introduced and elaborated his concept of the working alliance, analysts have debated its validity and usefulness. Some have found his groundbreaking idea that “the working alliance deserves to be considered a full and equal partner to the transference neurosis in the patient-therapist relationship” (1967, p. 101) to be a highly important and useful contribution. Others have regarded it as a
threat to the integrity of the transference concept, insofar as the patient's “rational, non-neurotic rapport” with the analyst is necessarily infused with transference elements. Deserno clearly stands with the latter group in contending that the working alliance can be the Trojan horse in which the analyst conceals and subtly conveys his expectation that the patient comply and cooperate. In fact, Deserno makes a significant contribution to the debate by asserting that the working alliance may become a vehicle for the analyst to unconsciously and unwittingly demand that the patient follow certain social conventions in the analytic situation rather than adhere to the basic rule of free association. Despite the analyst's conscious wish to establish and ambience in which polite conventional expression is set aside in favor of uncovering the patient's neurotic conflicts, the analyst's anxieties, shame, and revulsion might lead to the desire to stifle such freedom. And, claims Deserno, the analyst's use of the working alliance concept can be the chief culprit in enabling the enactment of such unproductive countertransference-based demands.
The author's main thesis is that analysts should assiduously refrain from insisting that the patient comply with the basic rule. Rather, analysts should be constantly alert to the trap of becoming irritated when the patient stubbornly withholds or is uncooperative. His view is that the analyst must work toward interpreting the patient's transference resistance. To think in terms of a weak or ruptured alliance only leads to effor