Aggression in the service of the ego and the self.

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. Missing for Jay were the contributions that an adequate rapprochement subphase furnishes the organizing function of the ego. Not only did the rapprochement subphase fail to correct the inadequacies of the earlier subphases, the failures of rapprochement represented the last and final blow to the development of even a semblance of self- and object constancy, so that borderline pathology was the result. We can follow the progress made by the analysand by his own statements: Early: "I don't have a reserve of self-love to carry me through." Later, "I'm at a stage when I feel I can organize things without great anxiety. Plan things. Going ahead and slipping back sometimes too, but feeling confident." It has been the aim of this paper to show how the most malignant narcissistic rage has been converted into constructive aggression. Despite the greatest intrinsic and environmental odds, this patient, because of his good endowment, and aided by psychoanalysis, succeeded in gradually converting destructive aggression into constructive aggression by amalgamating it with more and more libido. Along with this, he also developed a sound secondary narcissism, so that his prognosis at eighteen years of age is optimistic.