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This enormously scholarly volume is impossible to summarize, but not because there is no central theme. Strikingly, the theme is discussed
in encyclopedic fashion, dealing with every conceivable connection to the therapeutic alliance. It is like a working through in analysis, in the best sense, with all related data covered in depth. It is a handsome volume, written clearly, with wonderful organization and exhaustive references and notes. Many will find it useful as a reference book, rather than just reading it through from beginning to end. To presume that it will stand as the definitive work on the therapeutic alliance is not an overestimation.
Meissner begins with a history of the term and helpfully explicates the various confusing definitions of the concept, beginning with Freud's describing the “unobjectionable transference.” In his presentation of the material, the author puts forth various conflicting views and then offers his own. Although adhering largely to his position as an analyst working in a classical mode, it is most impressive to note the careful and thoughtful flexibility that he demonstrates. The emphasis in most of his positions is to work to maintain the therapeutic alliance while carrying on the other necessary aspects of analytic work. Meissner very clearly distinguishes the therapeutic alliance from transference, countertransference, and the real relationship, presenting both the genesis of the different concepts, as well as developmental aspects of the alliance.
Although Meissner's volume is not rich in clinical vignettes, it abounds in discussion of clinical situations. The therapeutic alliance is always kept in the picture, but many other technical considerations are discussed along the way, adding considerably to the value of this book. For example, transference is discussed in terms of the ways that it can distort the alliance. The manner in which transference is at the root of most therapeutic misalliances and the best way t