And her husband and also about her struggles after

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and her husband and also about her struggles after the death of several family members). Gail bought Dr. R a paperback copy of a book Gail had loved as a child, one she also thought Dr. R would enjoy. Gail gave Dr. R the book at the beginning of a session about halfway through the course of her 2-year therapy and acknowledged that she had mixed feelings as she did so (she felt shy and vulnerable because “you never know if the receiver will like the gift” but also felt excited and safe). Gail noted that she gave the gift to communicate her appreciation for all that Dr. R had done for her: The gift was an appropriate, small, inexpensive, and not overbearing expression of appreciation and thanks to Dr. R for being not just a therapist but also a kind, caring human being, for “giving of herself” to help Gail and others, and for showing genuine, unwavering concern for Gail’s well -being. The gift also marked an important life event for Gail (it was the anniversary of her recovery from significant medical concerns). Gail and Dr. R talked briefly about the book but did not probe its potential deeper meaning (Dr. R said, “Thank you, that’s very nice,” and they chatted briefly about the book). Gail felt that the event positively affected both her (it was one of many examples of Dr. R accepting rather than rejecting Gail) and Dr. R (Dr. R appreciated the gift, read the book, and stated that she enjoyed it). Gail noted, as well, that Dr. R seemed surprised by the gift (Dr. R said “Oh, what is it… ohhh!”).
NOT THE PUBLISHED VERSION; this is the author’s final, peer -reviewed manuscript. The published version may be accessed by following the link in the citation at the bottom of the page. [Citation: Journal/Monograph Title , Vol. XX, No. X (yyyy): pg. XX-XX. DOI . This article is © [Publisher’s Name] and permission has been granted for this version to appear in [email protected] . [Publisher] does not grant permission for this article to be further copied/distributed or hosted elsewhere without the express permission from [Publisher].] 15 Many-gift example Emma (pseudonym) had given Dr. E (pseudonym) more than 100 gifts across their 5-year course of daily therapy, collectively totaling thousands of dollars. Some of these gifts included sizable donations, in Dr. E’s name, to local charity groups, as well as books, concert tickets, movies, music, flowers, stuffed animals, food, jewelry, and crafts. In addition, some gifts were items originally loaned by Emma to Dr. E, who did not return them. These gifts were given sometimes weekly, and at least monthly, to express feelings that Emma was uncomfortable verbalizing, such as her love and affection for Dr. E or her “need to repair something in [her]self” through Dr. E’s accep tance of her gifts. Dr. E always welcomed and accepted Emma’s gifts (welcomed them “in an overtly warm and often verbally and affectively effusive” way in praise of the gift and in appreciation of the thoughtfulness), regardless of their value, which Emma said reinforced her gift-giving behavior.

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