This is a scholarly and closely reasoned book that goes beyond the limits of its title, and provides a broad overview of the author's concepts of the process and technique of psychoanalysis. It is divided into four separate parts, with nineteen chapters plus an appendix of guidelines related to the management of treatment boundaries, and a section of chapter notes. The list of references covers forty-nine pages.

In the first chapter, Meissner develops a history of the concept of therapeutic alliance and stresses the importance of distinguishing the therapeutic alliance from both transference and countertransference, and from the real relationship between patient and analyst.

The fact that they intersect in complex patterns and are in continual interaction and mutual modification makes it difficult to preserve their distinct intelligibility, but I propose that the effort to keep them at least conceptually separate furthers our understanding better than prevailing approaches that tend to blur