Discussion

My remarks are perforce very brief.

I appreciated the gracious character of Dr. Abend's presentation of a point of view with which I am really not in agreement but with which nevertheless I have strong sympathy intellectually. At least he didn't verbally persecute those of us who disagree. He accepted the fact that there were other points of view. To me, there is a certain making much of words, not necessarily by Dr. Abend, but in the controversy at large. The terms working alliance or therapeutic alliance are to me descriptive of a fact, a phenomenon. The whole idea that acceptance of this concept may lead to a great deal of activity in cultivating the positive transference, and so on—I think this is rare nowadays. But I don't believe that this is the issue. For people to work together successfully in analysis, let's say from the phenomenological point of view, there must be a working alliance or a therapeutic alliance. The two people can't be at odds with one another in a basic sense if they're engaged in a mutually cooperative, highly technical, and difficult procedure. The “alliance” exists whether people like to use the term or not.

This controversy leads me to remember a quotation from Goethe which an ex-German professor friend of mine at Dartmouth spent hours looking up, to the effect that: when an idea is missing, there stands a word. Here the basic idea is simple and real, that people must work together in an important undertaking, if it is to succeed. What are the absolute essentials of the therapeutic alliance? One is the adult participation and attention of the patient. Because the patient, in entering treatment with an analyst—assuming the patient is not crazy or not a phony or whatnot—must know that he is undertaking an important project in which his participation must be at least equal in interest and perseverence to that of the analyst. So just