Threatened loss of integrity of the ego is the stress that, acting on 'the world of inner reality', produces the clinical reactions that make up the nightmare. Borrowing from Stern's work, the author divides these reactions into two categories. One is the akinetic, which is passive and is a shock reaction to the danger of death (or loss of ego). The second is kinetic; it is active and represents a defense against the threat of extinction of the ego. The ultimate basis for these phenomena is the wish for reincorporation within the bad object. The terminology (largely adopted from Fairbairn) is confusing and the overconcretization of various concepts of the ego appears to be both unwarranted and misleading.