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The author rejects Hartmann's proposition of an 'autonomous sphere of the ego', which he finds to remain unsubstantiated. In his opinion Loewenstein's illustrations of such a sphere can as well be interpreted according to Freud's early view on the development of the ego as sequelae of the interaction of id-drives with the environment.
In the new-born certain automatisms have been observed which disappear immediately after birth but reappear again in the course of progressing ego-development. The energic source of all ego functions has to be looked for in the id-drives. The author agrees with Hartmann and Hoffer that the physiological approach cannot be dispensed with. Modern physiological studies have reinforced the argument that the link between neurovegetative, endocrine, and other functions and mental functioning is a very close one. Attention is drawn to Selye's work. The interdependence of both systems can be substantiated by direct child observation as it has been carried out by Anna Freud and Spitz.
Most important in the study of the id-ego relationship is the degree of integration of aggression and the problems arising from it. Since fear acting as 'aggressor' (Selye) may produce excitation of the hypophysis and hypothalamus, it thus acts on the drives by determining an increase or decrease in a quantitative sense. Fear (the response to insecurity) 'represents perhaps the most tangible instance of transition from the psychic to the somatic level that we are able to discern'. The stabilization of ego functions modifies the person's total, physiological make-up.