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Disturbances in the subjective experience of the self—although having attracted, in the not so distant past, such psychoanalytic luminaries as Federn (1952) in his studies on 'ego feelings' in the psychoses, and Erikson (1956) describing identity diffusion during the turmoil of adolescence—has now become a central problem in the ever-growing group of patients suffering from narcissistic disorders, ranging from the more neurotic conditions (e.g. Kohut, 1971) to the clearly borderline (e.g. Grinker, et. al., 1968) ; (Kernberg, 1967) and psychotic. More and more today, patients who, for the most part, deal with the world and have personality organizations consistent with a diagnosis of neurosis, in addition, complain of some disturbance in self feelings or in the stability of their self-image. Likewise, this complaint regarding a deficit or instability in the self-experience, becomes a central and most agonizing experience for the more distinctly borderline personality, as well as a great number of psychotic disorders.
Furthermore, emptiness as a clinical experience, is considered by this author, to be a major expression of a severe disturbance of the sense of self in the severe borderline personality disturbances. A sense of incompleteness, vagueness, a search for 'one's being' or a shifting of subjective experiences of the self in response to vaccillations in self-esteem regulation are less severe experiences in the sense of self along a continuum leading to this inner desolation or emptiness of borderlines, which reaches its end-point in the psychotic's conviction of actual personal extinction or non-existence.
Only with the recent advances in psychoanalytic theorizing regarding defects in ego and narcissistic realms (e.g. Jacobson, 1964) ; (Mahler, 1971), (1972) ; (Kohut, 1971) ; (Kernberg, 1967), (1975), especially in regard to object relations, combined with the increasing number of borderline patients suffering from disturbances in the sense of self, could empt