This chapter describes all aspects of ego functions, namely: apparatuses, object relations, and defenses. It also describes the universal structural ego organization of all these functions in near psychosis. Near psychosis, like psychosis, is a mental state in which reality experience is used for purposes of expressing emotional experience. The chapter discusses the autonomous ego problems common to all near psychotic states before discussing the characteristic near psychotic condensation. In near psychotic states, the relationship of reality experience to emotional experience is a condensation capture of part of reality experience by part of emotional experience in the preconscious. The unique feature of near psychotic defenses is their capture of preconscious reality experience. Projective identifications involving projections to the experience of the real self are very important in near psychotic depressions, manias, and psychosomatic illness. Symbolic alterations of reality are condensations that capture and use aspects of reality experience to symbolically represent an emotional experience.