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Balint discusses the question of therapeutic failures in analysis, especially those referable to difficulties inherent in the illness or the personality of the patient, and those attendant on a failure to adapt adequately therapeutic skill to the qualities of the case. He discusses the parts of the patient's mental apparatus 'influenced' by the therapeutic process. In some patients the superego should be 'changed', but Balint asks how one rids the patient of old introjections, identifications, and idealizations. How does one make the ego stronger? How are the drives influenced? How does fusion of aggression occur through object relations? What kind of object relation promotes such fusion? These questions are not as yet answered, and therefore do not help in accounting for therapeutic failure. Especially in patients fixated at the 'pregenital' level serious problems of communication occur, because in these patients an interpretation may not be experienced as such. Balint contrasts the nature of the relationship of a patient fixated at the Oedipal level, and its attendant conflicts, with the kind of relationship, dynamic forces, and essentially preverbal level that pregenitally fixated patients manifest. It follows that such patients experience interpretations and communications in an entirely different way from those patients whose conflicts and fixations are predominantly at the phallic level.