This article tracks the course of chronic loneliness from its roots in impoverished regulatory twinship selfobject experiences in infancy to its emergence as a serious health concern, and discusses clinical implications. Incorporating infant research, social psychology, neuropsychology, and cognitive and social neuroscience with contemporary psychoanalytic theory, the paper outlines the function of twinship selfobject experiences in the development of regulatory and other capacities linked to devastating experiences of alienation and isolation. The concept of chronic loneliness is illustrated with abbreviated clinical material.