Kernberg begins with a review of the criticisms of the Kleinian school by more 'mainstream' ego-psychological analysts; for example, Waelder, Bibring, Jacobson, and Zetzel. These criticisms are directed at: 1, the concept of an inborn death instinct; 2, the concept of innate knowledge of genitals and sexual intercourse; 3, the neglect of epigenetic development and of environmental factors; 4, the 'pushing back' of psychic development into the first few months of life; 5, the ambiguity of much Kleinian terminology; 6, the application of Kleinian analysis to all patients regardless of severity of pathology; 7, the neglect of the defensive organization of the patient in theories of technique; 8, the lack of 'deepening' of the analytic relationship as a result of interpreting the same pattern of primitive conflicts repeatedly; and 9, the lack of humility of Kleinian analysts as to their therapeutic results.