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(1979). International Journal of Psycho-Analysis, 60:83-96

Aloneness and Borderline Psychopathology: The Possible Relevance of Child Development Issues

Gerald Adler and Dan H. Buie, Jr.

In our psychoanalytic and psychotherapeutic efforts at definitive characterologic work with borderline patients, we have observed a core experiential state of intensely painful aloneness. This feeling state often includes a sense of inner emptiness together with increasing panic and despair; over time these patients develop a concomitant desperate hopelessness that this feeling will ever be alleviated. When we view borderline patients on a spectrum extending from psychotic to more nearly neurotic experience, we find that those closer to psychosis experience this aloneness more frequently and more intensely. It appears as a major vicissitude in their attempts to form dyadic relationships, including those with their therapists or analysts. We find that this experience of aloneness is characteristic of borderline patients and is an intrinsic aspect of a fundamental personality defect which we feel is the consequence of a developmental failure. We believe this defect occupies a position of major importance when we consider the nature of the character changes which definitive treatment must involve.

A notable aspect of the borderline patient's experience with aloneness is his relative or total inability to maintain positive fantasies or images of sustaining people in his present or past life. At these times the patient often states that he has no fantasies at all; at other times he has fantasies, but they consist of unsustaining or disruptive negative memories and images o

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