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Viewing therapy as a conversation among participants, rather than as an interview concluding with an intervention selected by an expert, allows one to consider the contributions of each member of the conversation in comparable terms. I propose a distinction between intimate interaction, in which meaning is co-created or shared, and non-intimate interaction, in which meaning is rejected, provided, or misunderstood. I suggest that intimate interaction between therapists and clients is therapeutic and that non-intimate interaction rarely is. However, it is in the acknowledgment and repair of the inevitable lapses of intimate interaction that occur between therapists and clients that there is an opportunity for a profoundly meaningful collaboration.