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The author proposes that the role of early trauma be re-examined with regard to regressive ego states in schizoid personalities. The wish to return to the womb may represent primitive regressive strivings rather than being an Oedipal incestuous derivative. Fantasies of a return to the womb imply abandonment of object relations while breast and incest fantasies do not.
Using the clinical and theoretical concepts of Melanie Klein, Winnicott, Fairbairn, Balint, and his own, Guntrip develops the theme that a regressive shift of part of the infantile ego to fantasies of the security of the womb engenders the ego split characteristic of the schizoid personality. The clinical material emphasizes the turtle-like probing for and withdrawing from object relationships, the see-saw battle between the ego elements for the safety of the womb, and the struggle to escape the 'annihilation' of withdrawal from all objects. Therapeutic difficulties arise when the patient is required to expose the regressed, infantile ego so that interaction can occur. Patient and therapist may have to concede that permanent ego restrictions will remain.