Suffering brings the patient to us...the patient needs to feel heard and seen-that is, met, by another person.
Of course they fought as lovers must do to find a liveable space.
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.
Many patients cannot hear until they feel heard.
Above all, the clinician must not shake what little faith the patient has in himself.
Today many medications act across diagnostic groups. Alliance effects also transcend specific psychotherapy methods. Both may be affecting profound psychopathological processes.