Our contribution focuses on the first encounter with the patient and on the social and cultural context in which it takes place; we believe that psychotherapy begins with the very first encounter, whether or not it leads to a therapeutic relationship. Before the first encounter, the patient produces conscious and unconscious fantasies, sometimes even dreams, about the therapy, the therapist and the encounter itself; these fantasies constitute a sort of preformed, cultural transference. Besides the preformed transference, an actual transference relationship begins to develop, becoming activated in the patient by contact with the real person of the therapist, and in the therapist by contact with the real person of the patient, blending with the culturally preformed transference. This primitive transference can rapidly determine the outcome of the first encounter as well as of the actual project of entering therapy.