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T HE present paper attempts to analyze some of the factors that go into the structuring of a counseling relationship. The analysis is based on the complete recording of a successful opening interview. Briefly, counseling involves three related processes: (i) the release of feelings; (2) the growth of insights about unsatisfying conduct-patterns and goals as the feelings become clarified; (3) gradually the selection of more satisfying patterns and goals. But before these three processes can occur, a "definitely structured permissive relationship" must be established in which the client is able to accept the aid of the counselor in clarifying his feelings. 1 The first step in counseling, therefore, is the structuring of this permissive relationship.A confused person is likely to approach the first interview feeling a minimum of responsibility for himself and a maximum of fear, insecurity, and defensiveness. Continued miscues on the part of the counselor in structuring the relationship seem to cause the client to begin to depend on the counselor, feel rejected and hostile if the counselor refuses to solve his problems, and finally in defensiveness and fear to flee the interviews and not keep subsequent appointments. The following excerpts from the case of "B" illustrate this sort of client reaction. At the beginning of the interview the counselor is not only defensively anxious not to answer any questions but he is wooden, cold, and unsympathetic, with little feeling for building up rapport. (T-Counselor C-Client) T: You feel it important to win friends. C: Why, definitely I think it so. You know, I can win friends, but after that it's hard to talk to them. I'd like to know what to say, just what to do when I'm in a conversation with someone >• You are a student of psychology and should know all the answers. T: You feel that earning a living is very important. C: I do. Particularly, if you want to have a family to keep and love. . . . (Pause) . . . If I could just carry on a good conversation with people, I'd get over a lot of my trouble. Right now I don't know what to say. You should know all about this; what do you think? T: You would like for me to tell you just what to do. C: Yes. . . . (Pause) . . . I'm waiting for your answer. T: You think that getting an answer would be enough. C: It might be. What do you think? T: Hmmmmm. C: If you know answers from several people, you can try them out. You only learn by experience. T: You think experience is best. C: That's true. The doctor may have several different types of medicine . . .(seeming again to watch T catching up in his notes . . . ). You're certainly filling up several pages of notes aren't you? What good does that really do? Do you ever really look back over them? T: Yes. (Completely missing the feeling expressed.) If you're interested, we might look over some of these interviews later.

That psychologic factors have been considered w > m the same dioroughness as diose of protein desensitisaetiologically significant in allergic diseases is evident *°a a l t h o u S h w o r k . i s bein S done on this aspect at the r I r r i • !• i i' moment, but preliminary work does not lead us to expect from the many references found in medical htera-a n y d r a m a t k c o n f i r m a t i ; n o f ^ v a l u e o f v a c c i n e s i n P t h e ture. Hyde Salter (12) emphasized the importance treatment of asthma.(2) There has also been further clear of the psychogenic factor in asthma over sixty years evidence of die importance of die psychological factor, this ago. The Asthma Research Council (3) in their d m e i n t h e e f f e c t s o £ beating "ses of rhinorrhoea with "Report of Progress" for the year ending October n o T r m a l s a l m e o n l y ' . , , r " ° > ° Last year we mentioned die 31, 1937, states:We are about to publish the results of inhalant protein treatment for bodi asthmatics and patients widi rhinorrhoea. In die latter group we find diat of diirty-five cases treated, fourteen showed eidier cure or considerable improvement, five showed some improvement and sixteen showed no improvement. The figures of improvement are not dramatic, but diey are encouraging when we take into consideration die intractability of diese cases and die fact diat they are probably less susceptible to spontaneous improvement than asthmatics. An interesting feature of die results is diat die recovery or improvement rate was in inverse proportion to die numbers of positive skin tests. The group considered is small although carefully selected but this finding requires furdier elucidation. It may be diat our mediod of doing skin tests is unsatisfactory and this point too is to be investigated during die coming year.Eyermann ( 5 ) stresses the emotional factors in We are now investigating a control series of patients with c e r t a i n c a s e s o f a s t h m a , but warns against too great rhinorrhoea treated with normal saline alone instead of in-, . °h alant proteins and diis group will serve as an interesting check on die figures previously quoted.And again:Dr. Strauss has continued his investigations of the psychogenic factor in asthma and has concluded that psychic factors contribute to die asthma syndrome in even greater measure than had been diought likely. Furdier work on this subject is being carried out in die Psychological, Department.year we mentioned the results obtained by the treatment of rhinorrhoea with solutions of inhalant proteins and we reported diat of 35 cases treated 14 showed eidier cure or considerable improvement, 5 showed some slight improvement and 16 showed no improvement.This year we treated a similar group widi normal saline solution only, instead of the solution of mixed inhalant proteins, and die results were somewhat starding, since of the 32, 13 were cured or much improved, 6 showed some improvement and 13 showed no improvement. In odier words, die results of treatment widi saline solution...

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