The ego refuses to be distressed by the provocations of reality, to let itself be compelled to suffer. It insists that it cannot be affected by the traumas of the external world; it shows, in fact, that such traumas are no more than occasions for it to gain pleasure.

Psychoanalysis remains influential within psychiatry and across the humanities. His analysis of his own and his patients dreams as wish-fulfilments provided him with models for the clinical analysis of symptom formation and the mechanisms of repression as well as for further elaboration of his theory of the unconscious as an agency disruptive of conscious states of mind. Auden wrote in a poem dedicated to him: "to us he is no more a person / now but a whole climate of opinion / under whom we conduct our different lives".