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This paper will attempt a preliminary characterization of what I have chosen to call the “therapeutic object relationship.” I use this term, in part, to emphasize points not included in concepts such as therapeutic alliance and real relationship. The need for an additional concept to define the analytic treatment relationship arises from three sources: (1) the nature of our work with the more regressed, but non-psychotic patient; (2) a continuing, excessive dichotomy in the literature between the transference and the actuality of the treatment relationship; and (3) the lack of systematization of the various approaches to the modified analytic relationship with the more regressed patient.
Within the category of more regressive pathology, the patient's structural impairment, combined with the depleted and archaic functioning of external and internal object relations, creates a relationship demand factor in treatment which cannot be met by interpretation alone. Regulation of the treatment relationship by the analyst thus becomes a more explicit concern than within the ordinary, analytic environment, which sustains interpretation in the more structurally intact patient.
The history of change in thinking about the nontransference relationship can be viewed as one version of the major changes in analytic theory and practice over the past four or five decades. A summary of the interplay between the “widening scope of psychoanalysis” and the expansion of interest in infant and early child development appears to be a useful way to present a brief history of the evolution of