The concept of a reasonable autonomous ego functioning independently of the primitive, unchanging drives and of the rest of the personality partakes of Freud's earlier idea of an ego patterned after the conception of self-preservative instincts. This by-passes later views in which he saw the id and ego as a unit in the healthy personality. Although it denies doing so, in practice ego psychology elaborates the concept of structure that is typical of the obsessive personality rather than the normal. The consequence of reliance on organ analogy to supply the causal principle behind ego control has meant neglect of the internal object relationship between ego and superego, and of the relationship between patient and analyst. The views have led to a depersonalized approach to treatment, to neglect of unconscious fantasy, and to ego bolstering and symptom relief rather than true personality change. An extensive bibliography accompanies the detailed discussion.