The subtitle of the book, "Harmonising the Environment With the Patient," seems to suggest that the book and the therapy focus on some sort of environmental manipulation. On the contrary, the book is about careful listening to a person who seems to be ill, to helping him or her find an environment in which to live more comfortably. It is thus very much in a European tradition that involves listening to the life stories of very unusual people, such as hermits or marooned shipwreck survivors, and suspending all judgment of how they lived their lives. The candidates for such therapy might be persons such as J. Alfred Prufrock from T.S. Eliot's poem, who seems to have restricted his own environment because of diffidence. Tyrer points out that Darwin proposed that survival comes from being able to adapt to an environment, a concept that Herbert Spencer somehow mutated when he convinced Darwin to rephrase it as survival of the fittest.