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