There is an old adage I first encountered as a graduate student that goes something like this: “Those who can, do. Those who can’t, teach.” According to this disparaging maxim, any incompetent can teach. By contrast, the three authors of this spare and thoughtful paper demonstrate that the transmission of clinical knowledge to aspiring mental health professionals is a complex undertaking that involves new and different applications of an instructor’s clinical skills. In essence, they manage to turn the adage on its head, so that it becomes, “Those who can, teach.” In particular, the authors emphasize the centrality of the relationship between teacher and student, which they term the “teaching alliance.” Modeled after the analytic concept of the therapeutic alliance (Zetzel, 1956), the teaching alliance acts as a nodal point around which the teacher–student enterprise succeeds or flounders. The crux of this elegant notion is the idea that a conscious, good–faith agreement to pursue mutually agreed–upon goals underlies both therapeutic and teaching efforts. However, the question needs to be asked. Does the analogy hold up? Starting with Freud’s idea of the analytic “pact” (Freud, 1940), much has been written about the nature of the therapeutic alliance. It has been termed the “working alliance,” the “rational transference” and the “mature transference.” (Greenson, 1965) These terms hint at the idea that the therapeutic alliance consists of more than a conscious good faith agreement. It includes murkier motivations that have their roots in long–forgotten childhood fantasies, joys and longings. This less–conscious aspect of the therapeutic alliance is highlighted by Greenson when he writes “...the working alliance may contain elements of the infantile neurosis which eventually will require analysis.” (1965, p. 158) Elements of the infantile neurosis include the common fantasy that the therapist, like the parents of early childhood, has magical powers to impart that will make the patient better, stronger, more beloved, if he only cooperates with the therapeutic effort. Many patients who start out with positive feelings for their therapist and a strong therapeutic alliance do so on this basis. They are willing to comply with the therapist’s agenda, because they believe that if they are “good patients,” they will be rewarded. Clearly, this belief in the value of compliance has to be addressed eventually if a patient is to achieve optimal benefit from her treatment. Psychiatry 70(3) Fall 2007 249