I've posted before about the proto ego ideal and compulsions.
Freud mentions the dictatorial thou shalts of the ego ideal and there are many different forms of compulsive character in egoists. Compulsive workaholics, compulsive 'my way of doing things is the best' types, compulsive schedulers who must maximize all their time, compulsive obsessives who think about old relationships or certain subjects, people who are compulsively self-reliant and learn to live as if they will be surviving on their own, compulsive cleaners, compulsive hoarders, etc.
When the person brings up the compulsion as ego alien they can talk about the dictatorial part and call it oppressive, tyrannical, an asshole, annoying, etc. and you-statements can be formed that will link it to parental-substitutes. The discharge of aggression towards them will result in some relief from the symptom.
With altruists who are unable to say no to others the ego ideal inhibition on saying it is analyzed through the other person. "If you said no to your sister [who asked to borrow money, which you gave although you didn't want to] what do you think she would think about you?"
"She would think I don't care about her, that I'm selfish, etc."
If you say "you don't care about me, you are selfish, etc., who comes to mind?"
"My boyfriend" "My mom"
The ego ideal inhibition to say no shows up as an introjection from a parental-substitute who treated one badly.