The Therapeutic Stance

  • Alvin Kahn
Part of the Critical Issues in Psychiatry book series (CIPS)


There are many modalities of person-to-person interaction. Human beings can fight, feed, or play with each other. It is significant that one of the earliest references to another fundamental quality of many object relations appears in Genesis, 2:18; indeed, it is the first definition of a human relationship that is mentioned in the Bible. God creates woman as a helpmate of Adam. More exactly, in the Hebrew, Eve is a help meet for Adam—a match for him, or someone to be at his side. It is a long way from the Creation to the busy workings of an emergency room, but the concept of one person helping another as equal partners in a mutually congruent relationship has been honored in all ages. The idea is captured in the modern theoretical construct of the therapeutic alliance, which we might appropriately rename the helping alliance. It is compounded of that part of the person in need that seeks, however awkwardly or even defiantly, some form of assisting contact with another; and that part of the therapist that is the matured distillation of his experience, his practical and theoretical knowledge, and those sublimations that have led him to his profession. This more or less rational aspect of the therapist’s share in the helping relationship can be usefully designated as the counteralliance, much as the term countertransference is applied to that counterpart transference of the therapist that is analogous to the mostly irrational transference of the patient.


Therapeutic Alliance Crisis Situation Soft Neurologic Sign Psychiatric Emergency Room Emergency Room Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    BassukEL,GersonS: Chronic crisis patients: A discrete clinical group. Am J Psychiatry 137: 12–16, 1980.Google Scholar
  2. 2.
    Jellinek M: Referrals from a psychiatric emergency room: Relationship of compliance to demographic and interview variables. Am J Psychiatry 135: 209–212, 1978.PubMedGoogle Scholar
  3. 3.
    Skodol A, Kass F, Charles E: Crisis in psychotherapy: Principles of emergency consultation and intervention. Am J Orthopsychiatry 49: 585–597, 1979.PubMedCrossRefGoogle Scholar

Copyright information

© Plenum Press, New York 1984

Authors and Affiliations

  • Alvin Kahn
    • 1
  1. 1.Harvard Medical SchoolBostonUSA

Personalised recommendations