This paper explores the dilemmas that arise when treatment is offered in circumstances when spiritual and ethical survival comes into conflict with physical survival and material well-being. Through an exploration of the author's experience in South Africa's war of liberation, this conflict is explicated. Although these experiences are now historical, it is argued that they are pertinent at the current time as the West, following 9/11, finds itself encouraged to think in terms of war, as notions of both a war against the West and a war against terrorism have become part of many public discourses. Questions that may arise for us as relational analysts and as individuals as a result of this are flagged, and although no easy answers are proposed, the importance of this exploration is highlighted.