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The interactional perspective in psychoanalysis has gained increasing prominence and acceptance as integral to the therapeutic and theoretical consensus in the field. The problem on both levels centers around the difficulties in bringing the disparate perspectives together in a coherent form that allows the intrapsychic and interactional frameworks to be utilized in complementary and mutually reinforcing ways in clinical analytic work. One aspect of the problem relates to a clearer conceptualization of the interactional dimensions that contribute to the psychoanalytic interpersonal interaction and, thus, come into play in the psychoanalytic dialogue.
I have argued (Meissner, 1992) that the therapeutic relationship in psychoanalysis involves multiple components; at a minimum these would include transference (and its correlative countertransference), the real relationship, and the therapeutic alliance. These components are constantly present and mutually interactive dimensions of the therapeutic relationship, but for clarity of thinking and effectiveness of our theoretical assessment of the therapeutic process, they demand distinction and separate articulation (distinguir pour unir). The conclusion of this line of argument is that the therapeutic alliance is to be distinguished from both transference and the real relation; it involves a separate line of expression and development in the analytic process and brings into focus different aspects of the analytic interaction than do either transference or real relation.
As a recent survey of the understanding of therapeutic alliance suggests (Gutheil and Havens, 1979), the concept of therapeutic alliance