The Ego and the Id has served as an organizing model which has advanced psychoanalysis as a science and as a therapy. The paradigm offered by the structural formulations provided a framework for many developmental and clinical studies as well as an approach to a general psychology of human behavior. Therapeutic advances have been made, but the art of therapy has not kept pace with the scientific advances. Dissatisfaction with psychoanalysis and psychoanalytic theory is discussed. Theories have become too far removed from their clinical base; a changing sociologic climate that has reduced the impact of the rational attitude offered by psychoanalysis and the failure of psychoanalytic therapy to cure all ills have contributed to the dissatisfaction.