Little has been written about psychotherapy with the seriously physically ill and this book seeks to remedy that. The title "Dual Realities" refers to the inner reality of the individuals internal world and the outer reality of their illness and the interaction between the two. Out of this arena came an understanding that what is important for the client/patient is the meaning, for them, of their illness. "Dual Realities" aims to show how therapists can work effectively with ill or disabled people, by facing their fears, adjusting their technique and by learning from their patients. To the general reader it offers an insight into this important area of psychotherapeutic work. To us all it gives the opportunity to discover the courage of those who were willing to pursue the path of psychotherapy in the search for wholeness and meaning in their illness and who have allowed their explorations to be published. This book will be of value to both qualified and trainee counsellors and psychotherapists who find themselves working with clients/patients who are seriously physically ill or disabled. It will also be of interest to other professionals who care for ill people at home or in hospital and to anyone who wants to understand the emotional impact of a serious illness or disability on the individual and their families.