Psychoanalytic theory has always been pluralistic, but in the United States there was a prevalent institutional view called ego psychology. Ego psychology, including a focus on defensive operations working as unconscious controls of emotional dangers, prevailed in the last third of the 20th century. Technical advice focused on romantic drama-conflicts, as in Oedipal configurations. Neurotic patients were regarded as "most analyzable," that is, most likely to change unconscious structures of motivation and meaning. Such change was seen as enabled by insight and achieved with the help of the clinician's interpretations. By modification of unconscious defensive mechanisms, what was relatively unknown could be jointly examined.