Today many medications act across diagnostic groups. Alliance effects also transcend specific psychotherapy methods. Both may be affecting profound psychopathological processes.
Of course they fought as lovers must do to find a liveable space.
Many patients cannot hear until they feel heard.
Above all, the clinician must not shake what little faith the patient has in himself.
An argument can be made that relationship building is the treatment.
The slow compromise, or even surrender, of our fondest hopes is a regular feature of normal human life.