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The outcome of therapy is always to some extent determined by the first session, its nature and success. Freud himself attached considerable importance to the start of the treatment. Lesley Murdin's Setting Out comprehensively considers issues and debates around the subject addressing both experienced clinicians and students of psychotherapy and counselling.
Chapter one, ‘In the Beginning Was the Word’ makes the book's position clear. Beginnings in therapy are vital; after all, some prospective patients will attend for only one session, leaving the issue of what they will take away with them as a most pertinent question. In the early sessions, for those who stay, most would agree that the main role of the therapist is to listen attentively and actively. The patient may need to see current relationships in terms of her/his originary myth; and an appropriate question at the assessment stage may be, ‘How do you think your parents felt about your birth?’ (Later the authors advise the therapist also to attend to her own myth of origin.)
One way of beginning is with phenomenology; each model has some kind of developmental theory from Freudian fixation points, through Jung's archetypes, to twenty-first century writers' updating of the archetype through knowledge of genetics. The patient comes to therapy with some patterning, with certain responses to a new situation inbuilt. The writers enjoin the competent contemporary therapist to be informed about current developments in information theory, genetics and neuroscience. The clinician should not, it is stressed, be alone in her endeavours but should have a supervisor or consultant and make her work visible to another.
Chapter two addresses ‘The Birth of a Narrative Self, the coming, in Lacanian terms, into 'full speech’. Apart from Lacan, however, there is a dearth of literature on language development. This is linked possibly with the Kleinian emphasis on projective identification. As a culture we seem fascinated in this cent