With Jay, as with other patients in psychoanalysis, the pathological

has shed light on the normal. First, during symbiosis, physical illness markedly disrupted his sense of well-being. He did not develop sufficient reserves of narcissism and instead built up a superabundance of hostile aggression. In the differentiation subphase of separation-individuation, his aggression could not be used constructively in the service of differentiation. In the practicing subphase, still immobilized, he was unable to effect even physical separation, let alone psychic separation. These subphase inadequacies, of course, influenced the character of his rapprochement subphase. With functioning already impaired by earlier subphase experience, continuing emotional pain and frustration affected his ability to negotiate the rapprochement subphase.