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The investigation of the psychodynamics of loneliness has long been neglected; this essay documents its importance. Fromm-Reichmann differentiates 'real' loneliness (schizophrenic or schizophrenogenic loneliness) from culturally-determined loneliness, from the 'constructive loneliness' of the creative individual, and from
that of the mourner who has suffered an object loss. Real loneliness is overwhelmingly painful, disintegrative, and paralyzing. It represents a blocking of the fundamental need for personal intimacy, and it originates in pathological object relations in infancy and early childhood. Psychotherapeutically it is difficult to discern real loneliness because the patient cannot communicate it verbally and is frequently unaware of it, and because the more prominent symptoms of hostility and anxiety mask it. These views are related to the work of Spitz on anaclitic depression, Lilly and others on experimental sensory deprivation, the existentialists, and several creative writers. The psychoanalyst will find much of this stimulating and provocative, some of it equivocal and ambiguous.