The misalliance dimension in Freud's case histories: i. The case of Dora

This paper presents an effort to identify sectors of therapeutic misalliance between Freud and his patient Dora based on modifications in the framework of the analytic relationship and situation. Use is made of a template based on the current ground rules and boundaries of the patient-analyst relationship, and three deviations from this template are identified in Freud's analytic work with Dora. The intrapsychia and interactional sequelae of these deviations in technique for Dora and for the course of her analysis are traced out. The consequent sectors of misalliance are identified and the participation of both Dora and Freud is described, as are their respective, largely unconscious efforts to modify these areas of unconscious collusion. Stress is placed on Dora'a unconscious preceptions of the actual implications of Freud's modifications in the frame. The role of Freud's failure to rectify these deviations and to analyze their implications for Dora are considered, including their influence on the patient's premature termination of her analysis.