ABSTRACT
The first step across the threshold into therapy is so often a painful one. Patients enter therapy with a volatile mix of hope and dread. When therapy is sought only after many other attempts at solving life's challenges have led to naught, patients view therapy as their last recourse. A sense of urgency pervades the description of their problems. If therapy does not work, they do not know where they will turn. They must reveal their “failures” to a total stranger. They do not know whether this stranger will scorn them, be kind to them, like them, or perhaps be indifferent to them and their sufferings. The patient is often awash in dread and shame and usually unable to speak of it because the relationship is so new and frightening.
