Having listened to people for a long time, I believe many of us should be thankful not to be shot.
Above all, the clinician must not shake what little faith the patient has in himself.
Many patients cannot hear until they feel heard.
The first goal is for the clinician to find the patient, and the patient to find the clinician, as both are required for a real alliance.
Of course they fought as lovers must do to find a liveable space.
Today many medications act across diagnostic groups. Alliance effects also transcend specific psychotherapy methods. Both may be affecting profound psychopathological processes.