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Grinker points out what he considers to be the current dilemma in therapy: for practical purposes, American psychotherapy has followed closely the psychoanalytic model, and, while this theoretical system furnishes the best psychodynamic
understanding, it interferes with psychotherapy as the therapist must see things and interpret them from this preconceived, theoretical bias and is therefore prevented from seeing and learning what is actually going on in the therapeutic situation. Grinker cites instances of young therapists trying to be analysts who are instead too passive, cold, interested only in content, and unaware of the patient's reaching out for help.
To correct this, the author proposes a form of treatment based on an operational theory of psychotherapy rather than on psychodynamics. What he offers is a model, derived from the behavioral sciences field theory, and role and communications theories. He calls the model transactional; the essence of it seems to be a higher or broader order in the relationship between two people, more than 'self-actional' or 'interactional'. And herein lies one of the weaknesses of his conceptualization. The assumption is that one cannot understand what goes on between a patient and a therapist by understanding the individual dynamics of each, but that the combination of patient-therapist is on a different hierarchal level, to which more has been added. Another questionable point is the implication that the young therapist cannot learn and improve through better analytic understanding, gained from personal analysis, training, and experience. Grinker maintains he can do a better job only within a different framework than analytic understanding and modifications of technique. His other major contention is the belief that theoretical bias or hypothesis is in itself bad.
The rest of the paper is concerned with a description, enhanced by case material, of good supportive therapy, utilizing interpretations upward, the avoidanc