“Structural change” has become an almost automatic phrase to differentiate psychoanalytic insight-producing therapy from supportive psychotherapies, which aim to strengthen an overburdened ego by the therapist supplying emotional support. Following psychotherapeutic support, the patient's ego returns to its premorbid state. If practical results accord with theoretical expectations, following the specific experience of the analytic treatment the ego advances to a new normal state. Clinical experiences and experimental research have been putting these theoretical formulations to the test for over half a century.

Structural change has become the accepted phrase, almost a symbol for analytic change. Curiously, it is used more widely than its meaning is known or established. And paradoxically, it has come into automatic usage even by psychotherapists who discard the theory of psychic structures or who operate without the concept of interstructural conflict. With such contradictions, the automatic use of the term has become an unexamined cliché.