Therapeutic alliance and collaborative interactions

Since its original formulation the concept of therapeutic alliance has remained basically bound to the ego-psychology model. After a first phase of heated debate about its clinical utility and its theoretical foundation, interest in this concept has waned. Even though it refers to a relational dimension it plays a minor role in the contemporary relational trend in psychoanalysis. Starting from the premise that the concept of therapeutic alliance has made a distinctive contribution to the psychoanalytic theory of technique, the author addresses the issue of the interactive dimension involved in the regulation of the collaborative relationship, focusing on some aspects of patient-analyst interactions aimed at fostering the collaborative process. These, illustrated with clinical material, concern: (1) the use of analytic method, considered as an object shared by the patient and the analyst, (2) the existence of different levels in the collaborative relationship, (3) the analysis of the pragmatic meaning of verbal communication as a tool for constructing collaborative interactions. By shifting her attention from the symbolic content of words to the pragmatic meaning of discourse--the author highlights the continuity between fostering the collaborative relationship in the course of proper interpretive activity and dealing with it directly by non-interpretive interventions.