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There is, in ordinary usage as well as in psychoanalysis, a wonderful ambiguity about the word compliance. The term has been used to embrace a wide concept of accord. In John Trapp’s classic commentary on the New Testament, he writes, ‘He [Paul] tells them of his tears, and they answer him with tears: O happy compliance!’ (Trapp 1656).
Its more modern use involves the individual’s acting in accordance with, or yielding to, a ‘desire, request, condition, direction, etc.’ (Oxford English Dictionary (OED) 1989). However, the OED clearly recognizes the variety of motives and degrees of coercion involved. Thus compliance may be freely and gladly achieved or demanded by a powerful figure, under threat. Gilbert Burnet (1699) describes a situation in which ‘it was only a Compliance, and not a Submission to their opinions, that … [made them observe certain practices].’ Wendell Phillips (1872: 498) suggests that ‘all politics necessitates questionable compliances.’
These issues will be familiar in the analytic dialogue. The patient feels that a degree of compliance is required of him or her – both in relation to the analytic setting and in response to the ‘desire, request, condition, direction, etc.’ that the patient feels implicit in the analyst’s verbal interventions. The requirement or pressure for compliance is felt to be a potent force, which invokes infantile, childhood and adolescent struggles. It is never simple but usually involves some combination of willing agreement and conscious or unconscious submission – out of a desire to defer to powerful authority, out of fear, or for masochistic reasons.
An important, but difficult, aspect of analytic work is the analysis of the nature of the patient’s compliance, the motives involved, and
the functions that the compliance serves. In this chapter, I describe circumstances in which an ‘alliance’ is not therapeutic but, instead, serves mutual defensive needs. It may be easy to recognize pseudo-compliance or the patient who is