Psychotherapists may depend on it, but all psychiatrists use it in forming and maintaining healthy relationships with patients. To some degree the alliance relies on ‘adult’ qualities in the patient such as willingness to cooperate and ability to tolerate treatment. It is also partly contingent on the patient's transference patterns manifest as a need for love or attention. But we have a part to play too: jointly formulating and agreeing the goals and the tasks of treatment, and maintaining an appropriate bond which will support this work. Occasionally this bond may just hinge on our ability to acknowledge our mistakes.