The Initial Psychiatric Interview and the Principles of Psychotherapy; Some Recent Contributions1

The initial psychiatric interview as a problem in technique, a phase of therapy and an area of research opportunity has certainly been inadequately exploited by psychoanalysts. Freud (3) made very few comments on the subject of "history taking" as such. His most extended remarks appeared in his 1913 paper, "Further Recommendations in the Technique of Psychoanalysis." These suggestions appear to have influenced a great deal of past and current procedure in regard to this initial interview in psychoanalytic practice. In the beginning of "A Case of Obsessional Neurosis" (2) one notes a short, condensed initial interview which includes more than the chief complaint of the patient. It is reasonable to assume that this was conducted vis-à-vis since the next part of the report is entitled "The Beginning of Treatment." It is also apparent here that Freud felt it permissible to ask for certain direct information beyond what was freely volunteered. If one looked for injunctions rather than suggestions in his paper on technique, it might lead to the suspicion that there had been an interdiction of such previews. In this latter context he says in regard to diagnosis and the selection of suitable cases, "I have formed the practice of first undertaking it [the treatment] only provisionally for one or two weeks. If one breaks off within this period the patient is spared the distress of an unsuccessful attempt at