Some depressive illnesses are considered as consequent to defects in ego development resulting from early object loss or defective relationship. Such defects are manifested by lack of ego individuation with splitting of the ego, persistence of primitive introjection-projection mechanisms with failure to develop real identifications, distortions of the self-image, lack of instinctual fusion, inability to achieve real object relationships, and pathological, affective reactions to loss or disappointment. Treatment in such cases is directed primarily to repair of the ego defect in order to achieve some measure of increased self-esteem. Those depressive illnesses based on a predominant superego conflict have already achieved some considerable development of psychic structure, and therapy in such cases is directed toward modification of the superego pathology.