In "The Primacy of Structure" Althea Horner argues that effective psychotherapeutic intervention depends on the understanding of clinical symptoms in terms of the patient's underlying character structure. For example, obsessive behavior that functions to hold together a fragile, inadequately integrated self must be distinguished from obsessive behavior that defends against awareness of guilt and anxiety. Mental health professionals will find this a useful guide to psychotherapy of the character problems that lie behind their patients' presenting symptoms.