The patient in a state of primary identification is absolutely dependent. Like the infant, he may emerge in two ways: a 'good environmental adaptation' leads to healthy ego development and adequate transference relationship, or inadequate 'environmental adaptation' leads to a poorly developed ego and a pseudo self. The stage of emergence from primary identification is therefore a crucial one. In treatment of a patient with a pseudo self (a damaged ego incapable of real transference) the analyst must make those adaptations described by Sechehaye as 'symbolic realization'. Under those conditions a true self can emerge, a more mature ego can develop.