The very first moments of contact with a patient may provide a vital clue to the core dynamic of the therapeutic process.

Some analysts have stressed the importance of the first dream of an analysis. Others have focused on the first session as being seminal. In this paper I want to raise a few questions about what goes on in the very first moments of meeting a patient and its potential implications for the subsequent work. I shall try to differentiate the nature of what occurs and suggest that such differentiations might contribute to assessment, particularly where the initial interview is also the first session with the same therapist.