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Safran and Muran's book on the therapeutic alliance is a true tour de force. It bridges the chasm between theory and practice in psychotherapy by showing in detail how to heal ruptures in the relationship between patient and therapist. In describing the literature on the therapeutic alliance, the authors review psychotherapy research that is often unfamiliar to psychoanalysts. Their examination is scholarly and thorough, citing evidence that the therapeutic alliance is the most robust predictor of treatment success. The book is an excellent one for conveying much of contemporary interpersonal-relational theory without employing the mystifying jargon or questionable intervening variables used by some psychoanalysts.
Safran and Muran see the goal of treatment as “learning to constructively negotiate the need for agency vs. the need for relatedness” (p. 34). In this volume, the authors also attempt to systematize some of the central principles of relational thinking. Their ideas are influenced by experiential psychotherapy (Gestalt and client-centered), by cognitive psychotherapy, and most importantly, by relational psychoanalysis. In this respect, they provide an excellent synthesis of some important aspects of these orientations.
Consistent with their wide intellectual scope, Safran and Muran place current psychoanalytic thinking within a broad philosophical context. They hold a constructivist point of view consistent with Hoffman's (1998) “dialectical constructivism.” This position argues that one's perception of reality is always constrained by one's preconceptions, but that reality is more than simply a reflection of the perceiver's mind. Citing the Buddhist