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In clinical work psychoanalysts have found the concept of unconscious fantasy to be a working tool of great value, if not indispensable. When we attempt to understand it theoretically, we are faced with difficult questions, some at present unanswerable. Paradoxically,
the state of consciousness or unconsciousness appears to be of secondary importance in the understanding of fantasy, its formation, and structure. Of greater significance are the cathectic shifts, the structure of mental content, the relation to verbalization and imagery, and the role of other ego functions—especially the synthetic or organizing function.