Notes on the Therapeutic Role of the Alliance

The “therapeutic alliance” has been a functional therapeutic term for over half a century, and if we credit some of Freud's early adumbrations of the concept, nearly a century. Although the alliance is generally recognized as necessary for effective therapy, it is more often conceived as a precondition for therapeutic work than as an integral aspect of the therapeutic process (Allen & Lewis, 1996; Rangell, 1996). The concept evolved from Freud's (1937) early notion of the analytic pact, through Sterba's (1934) view of the therapeutic split in the ego, followed by the articulation of the alliance concept in Zetzel's (1970b) formulation, and further elaborated by Greenson (1978) as the “working alliance.” It represents that form of collaboration between analyst and analysand without which the analytic process cannot take place (Olinick, ). Along the same line, Busch (1994) observed, “It is one of those concepts that, while generally accepted as a necessary component of the process, is not fully integrated into our theory. Friedman (personal communication) calls it ‘an unscrutinized presupposition of the psychoanalytic procedure’” (p. 373). The fact that although its nature and function in the analytic setting continue to be debated there has been little effort to elaborate the concept itself beyond the level of understanding provided by Zetzel (1970b, 1970c) and Greenson (1978) led me to undertake an effort to clarify and extend the meaning of the alliance concept in the analytic framework (Meissner, 1992, 1996b).1 In an era of psychoanalytic conceptualization in which there is an almost paradigmatic shift from an intrapsychic to an intersubjective perspective (Mayer, 1996),2 the role of the therapeutic alliance takes on added significance as an essential and highly contributory