Certain conceptual aspects of the therapeutic alliance are considered. Although therapeutic alliance, transference, and the real relation are intermingled and intertwined in the actuality of the analytic relationship, they remain distinguishable and open to differentiating analysis. The distinctions between the therapeutic alliance and transference, and between alliance and the real relation, are explored and their differences clarified, including the difference between therapeutic misalliances and transferences. Some of the component dimensions of the therapeutic alliance are explored, including empathy, the therapeutic framework, responsibility, authority, freedom, trust, autonomy, initiative, and ethical considerations including values and confidentiality. Further exploration of these and other dimensions of the therapeutic alliance is called for, especially the extension of these dimensions to their practical clinical application.
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References
1.
BeresD. (1968). The role of empathy in psychotherapy and psychoanalysis. J. Hillside Hosp., 17:362–369
2.
BeresD. (1971). Ego autonomy and ego pathology. Psychoanal. Study Child, 26:3–24
3.
BeresD.ArlowJ. A. (1974). Fantasy and identification in empathy. Psychoanal. Q., 43:26–50
4.
BrennerC. (1980). Working alliance, therapeutic alliance, and transference. In Psychoanalytic Explorations of Technique: Discourse on the Theory of Therapy, ed. BlumH. P.. New York: Int. Univ. Press, pp. 137–157
5.
BuieD. H. (1981). Empathy: its nature and limitations. J. Amer. Psychoanal. Assn., 29:281–307
6.
CurtisH. C. (1979). The concept of therapeutic alliance: implications for the “widening scope.”J. Amer. Psychoanal. Assn., 27 (Suppl.):159–192
7.
DickesR. (1975). Technical considerations of the therapeutic and working alliances. Int. J. Psychoanal. Psychother., 4:1–24
8.
EriksonE. H. (1959). Identity and the Life Cycle. Psychol. Issues, Monogr. 1. New York: Int. Univ. Press
9.
EriksonE. H. (1963). Childhood and Society.New York: Norton
10.
FreudS. (1912). The dynamics of transference. S. E., 12
11.
GillM. M. (1979). The analysis of the transference. J. Amer. Psychoanal. Assn., 27 (Suppl.):263–288
12.
GillM. M. (1982). Analysis of Transference, Vol. 1: Theory and Technique. Psychol. Issues, Monogr. 53. New York: Int. Univ. Press
13.
GiovacchiniP. L. (1979). Treatment of Primitive Mental States.New York: Aronson
14.
GrayP. (1990). The nature of therapeutic action in psychoanalysis. J. Amer. Psychoanal. Assn., 38:1083–1097
15.
GreenacreP. (1968). The psychoanalytic process, transference, and acting out. In Emotional Growth, Vol. 2. New York: Int. Univ. Press, pp. 762–775
16.
GreensonR. R. (1960). Empathy and its vicissitudes. Int. J. Psychoanal., 41:418–424
17.
GreensonR. R. (1965). The working alliance and the transference neurosis. In Explorations in Psychoanalysis.New York: Int. Univ. Press, 1978, pp. 199–224
18.
GutheilT. G.GutheilT. G. (1979). The therapeutic alliance: contemporary meanings and confusions. Int. Rev. Psychoanal., 6:467–481
19.
HartmannE. (1966). The psychophysiology of free will: an example of vertical research. In Psychoanalysis—A General Psychology, ed. LoewensteinR. M.SchurL. M.LoewensteinR. M.SchurL. M.. New York: Int. Univ. Press, pp. 521–536
20.
HartmannH. (1960). Psychoanalysis and Moral Values.New York: Int. Univ. Press
21.
HoltR. R. (1965). Ego autonomy re-evaluated. Int. J. Psychoanal., 46:151–167
22.
KnightR. P. (1946). Determinism, “freedom” and psychotherapy. In Psychoanalytic Psychiatry and Psychology.New York: Int. Univ. Press, pp. 365–381
23.
KohutH. (1959). Introspection, empathy, and psychoanalysis: an examination of the relationship between mode of observation and theory. J. Amer. Psychoanal. Assn., 7:459–483
24.
KohutH. (1971). The Analysis of the Self.New York: Int. Univ. Press
25.
KohutH. (1977). The Restoration of the Self.New York: Int. Univ. Press
26.
LangsR. (1975a). Therapeutic misalliances. Int. J. Psychoanal. Psychother., 4:77–105
27.
LangsR. (1975b). The therapeutic relationship and deviations in technique. Int. J. Psychoanal. Psychother., 4:106–141
28.
LangsR. (1976). The Therapeutic Interaction, 2 vols.New York: Aronson
29.
LesterE. P. (1990). Gender and identity issues in the analytic process. Int. J. Psychoanal., 71:435–444
30.
LewyE. (1961). Responsibility, free will, and ego psychology. Int. J. Psychoanal., 42:260–270
