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The initial sessions with a psychoanalytic patient make evident the rationale for the particular style each analyst has of entering a relationship with a patient. For my part, when I begin an analysis, I pay attention to the simplest concerns. For example, the room should be pleasant, neither too warm nor too cool, neither too well-lit nor too dim. My style of dress is usually not extreme, nor does it attract too much of the patient's attention. I want to enter the session relaxed, that is, free enough of distractions so that I can be interested in what the patient wants to talk about. However, I don't want to be overly interested—I don't want to lean forward in my seat or hang on the person's every word. In the first session my primary interest is in why the patient is consulting me. To find out more about the problem I ask some variation on the question, “What brings you here?” It is not my intention to say much more in the early part of this session unless the patient addresses me directly with questions, or a question is necessary to make sense out of what my visitor is saying.
I find that when I act like this in the first session my visitor responds in his own style to my question “Why are you here?” He may or may not ask questions. They may be questions about how to proceed, such as: “Do you mean who suggested I come?” or, “Do you want to know what made me think analysis would be a good idea?” or, “Are you asking me what's bothering me?” If, on the other hand, the potential patient understands my question, he may tell me