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In this closely argued paper on the interrelationship of anxiety and narcissism, the author criticizes Freud's discussion in Inhibitions, Symptoms and Anxiety because the question of primary narcissism of the neonate is not well worked out. It is difficult to see how the fetus moves from an absolutely narcissistic position, in which it does not know the mother at all, to the ego of the oedipal phase. Green suggests that Freud was correct to reject Rank's hypothesis of birth trauma, for, as Winnicott showed with his concept of holding, there occurs after birth a reconstitution of conditions as close as possible to intrauterine life, amounting to the external nesting of the infant. A second birth, the loss of the breast, is really the first or psychological birth of the ego, assuring its distinctness from the object. Green argues against phenomenological concepts of the ego, which neglect the purely metapsychological character of the ego. He maintains a certain reserve with respect to such terms as "consciousness of the self" or "identity," which are phenomenological in their inspiration. There can be no ego representation, for the ego is a theoretical concept, not a phenomenological description. The ego deals with representations, but is not itself represented. When one speaks of narcissistic relations, what Winnicott termed ego-relatedness, we must realize that this is used loosely. Ego representations are in fact representations of the object which are then changed into representations of the ego by narcissistic cathexes. Only thus can one begin to talk intelligibly about narcissistic anxiety. Phenomenologically, it is appropriate to describe such manifestations, but, theoretically, narcissistic anxiety is anxiety about objects transformed into narcissistic objects. Thus the ego functions as a reservoir of operations without any representation of itself. One of these operations is identification, which suppresses the distance separating object and ego.