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Murray emphasizes the importance of analyzing the narcissistic as well as the libidinal components of the ego if structural change is to be achieved. The ego ideal is transformed from primordial pregenital origins by change of aim and object relationships. It may lose its intactness and regression to the level of its earlier narcissistic antecedents may ensue.
Various types of symptomatology can be explained on the basis of regression from the desexualized and deaggressivized components of the ego ideal into more primitive pregenital components. Such disorders as schizophrenia, depression, homosexuality, and criminality are dealt with by clinical examples. An individual with severe narcissistic fixations may be unable to relinquish the primitive satisfactions once enjoyed and to liberate himself from his sick attachment to the primary mother. Failure to achieve the ego ideal may lead to regressive processes with release of homosexual libido and concomitant guilt (social anxiety).
The criminal is depicted as an individual with the persistence of the old infantile, pregenital narcissistic attitudes. In the criminal these elements have not been transformed into the socially useful elements of the sound ego ideal.