An Initial Interview

The initial interview contains possibilities for benefit to patient and therapist that have not always been fully appreciated. For the patient this may be the first contact with therapy and therapist, the first serious attempt at revealing and discussing personality problems. To this interview he brings his conscious and unconscious doubts, reservations, fears and oppositions, as well as a greater or lesser degree of lack of knowledge concerning psychoanalytic treatment. At the same time, he may also bring to this interview his conscious or unconscious hope that he may find here the help which can enable him to free himself from the neurotic web in which he is entangled. For the patient, then, the initial interview, and all that goes on during it, may have a very great significance.

For the therapist, the initial interview has many important functions. In this initial meeting, which may consist of several interviews, the therapist makes a tentative psychiatric and psychoanalytic diagnosis. He obtains a picture of the general outlines of the patient's neurotic structure and the main difficulties stemming therefrom. This picture contains the longitudinal view of the person's development and the horizontal view of his present state of being. At the same time the analyst seeks for evidence, in the past and present picture, of constructive forces in the individual, evidences of aliveness, relatedness, energy, a genuine interest in growth and self-realization. These observations enable the analyst to prognosticate concerning the possibilities and probable duration of therapy. They permit him to determine whether the individual is ready for analytic work. If it is felt that he is, the initial interview includes the important function of helping to prepare the patient for analytic therapy. If such treatment is not indicated, the analyst must consider in what other ways he can help the patient to deal with his problems.

In addition to these diagnostic, prognostic, and preparat