6. The Initial Interview and the Latent Presence of Third Parties

Patient and analyst usually meet for the first time in the waiting room, but each has already formed some kind of image of the other. Consider a patient who has arranged his appointment on the telephone or in writing. He has outlined his problems in brief or has written a detailed account of his life and current situation to emphasize the urgent need for a consultation. He may also have expressed his doubts and his hopes that this analyst, whom he has heard of through the grapevine, will take him on as a patient and that his long-postponed decision to undergo analysis will now lead swiftly to successful treatment of his chronic symptoms. For his part, the analyst has already learned or inferred much about the patient's life and current situation from the way in which the patient has come or been referred to him and from the content and form of the letter or telephone call. Thus even before the first encounter, processes of transference, countertransference, and resistance have been set in motion. In anticipation of the first meeting our imaginary patient may even have dreamed of a house whose similarity to the building where the analyst's office is located was obvious to him on waking. For his part, the analyst may have noticed in himself signs of positive countertransference in the more comprehensive sense of this term. Since the patient has described his work situation in a way which permits the analyst to assume that he has considerable flexibility with regard to appointments, the analyst has checked his appointments schedule to see what he can offer.

Two things can be gathered from this brief account of an imaginary typical case. First, transference, countertransference, and resistance begin before the first encounter between patient and analyst. Second, the patient's hopes also start to affect his dream thinking before the initial interview. It is for these reasons that this chapter comes after the chapters dealing with those aspects. With regard to t