In my reply to Susi Federici-Nebbiosi, I emphasize and elaborate on the points of agreement between us, as well as the points where our thinking differs. My primary point of difference regards the suggestion that my accepting Yossi for short-term treatment was acquiescence to his request. This is only partially true. From his point of view, I offered him a treatment substantially longer than the one he wanted, thus I was agreeing and not agreeing to his request simultaneously.

The main idea that I put forth in my paper is that we always construct our setting together with our patients and that this is, in itself, a therapeutic factor. I share Federici-Nebbiosi's observation that the setting has undergone a great deal more change in practice than is reflected in the literature, and that there is unease discussing the issue of setting. I offer some thoughts on this and express the hope that the present exchange of ideas will lead to further discussion.