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After a rather long article Isaacs adds a concise summary. In essence she states that what Freud calls 'psychic representations' of instinctual drives should be called unconscious phantasy (not fantasy—the latter spelling refers to daydreams). This unconscious phantasy must be understood as something primarily without word symbols. Since every structure is derived from the id, and the id is composed of instinctual drives, and instinctual drive is experienced as phantasy, every life or ego manifestation can be reduced to its origin in an unconscious phantasy. The oral zone as the first phantasy-cathected zone gives its imprint to all phantasy connected with other bodily or mental activity. Ultimately the unconscious phantasy—without words—is: I want to take it in, or I want to destroy it orally—libido-destrudo.
In general one gets the impression that the author is very much attracted by the continuous undercurrent of deepest unconscious instinctual life ever present in associative material. Less attention is paid to the mainstream in which the rich variety of ego elaboration moves.