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In the last chapter, I reviewed the healing forces that provide a foundation for any individual psychotherapy. In this chapter, I discuss the mechanism through which those forces are brought to bear. A fish in the water does not feel wet: although the water provides buoyancy, oxygen, support, and shelter, it is simply the medium in which the fish moves. In the same way, the psychotherapy participants may be unaware of the therapeutic milieu in which they operate, the interpersonal and environmental factors that support the healing process. Yet these factors are crucial to psychotherapeutic success. They are subsumed under the general heading of the psychotherapy relationship, but it is useful to examine its component elements. To be successful, you must pay as much attention to the milieu as you do to your specific therapeutic modality.
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