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When Greenson1 elaborated his concept of the working alliance, he proposed that “the working alliance deserves to be considered a full and equal partner to the transference neurosis in the patient-therapist relationship” (p. 191). In this view, the working alliance, anchored to the real relationship between the patient and the analyst, secures the analytic effort. The patient complies with the basic rule that slowly permits derivatives of the infantile conflicts to appear as transferences to the analyst. The transference neurosis as it emerges opposes the rational ego because it is, by definition, regressive and seeks to repeat infantile object relations and gratifications. Working through, in Greenson's view, was contingent on recruiting the patient's working alliance to analyze the regressive transferences.
Over the last thirty years, the concept of the working alliance has had its critics and its advocates. Yet it has never achieved the status that Greenson had hoped for. Rather, most analysts acknowledge that episodically during a robust-enough analysis, the analyst and the patient struggle together against failed understandings and turbulent affects to work together to reveal the patient's unconscious conflicts.
Acknowledging and citing the vast American and German critiques of Greenson, Deserno believes that this extensive literature does not