In this paper the developmental hypothesis is presented that verbalization is a crucial element in integration and differentiation of the self. Material from four patients is used to illustrate paraverbal manifestations of psychophysiological distress in the transference-counter-transference relationship at moments of separation. These led to the reconstruction of a line of pathological development which was initiated in these patients by experiences of helplessness and rage at a time when affects and sensations were not clearly differentiated and no words were attached to them to integrate the body ego into the ego and self. Retrieval and gathering-in of these experiences to the ego took place initially through the analyst's perception of signal states of tension and confusion, which became part of the construction of the image of the patient as a toddler, and then led to verbalization of the affects and sensations involved.