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 ————————————— 1 This paper, in draft form at the author's death, was completed by Mrs. Virginia Gunst and the staff of the journal. 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.

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Those whom teachers — nor parents, nor friends, nor spouses, nor lovers — cannot reach, those whose inner turbulence has metastasized into acute mental illness and shipwrecked them on the remotest edges of the mind, are left to psychotherapists.

But the most effective therapists are animated by the same unflinching conviction that within each patient lives an almost sacred person, and that no person, no matter how damaged and disturbed, is irredeemable or incapable of having a full life. This was the animating ethos of pioneering psychotherapist Frieda Fromm-Reichmann October 23, —April 28, , who had narrowly escaped from Nazi Germany, lived in exile in France and Palestine, and ended up in America to begin nothing short of a revolution in mental health care.

Adding another layer of rebellious complexity to her life was her decision to marry, while still in Germany, the great humanistic philosopher and psychologist Erich Fromm — her colleague and onetime patient, ten years her junior. In many ways, she was the Oliver Sacks of mental health, not merely applying her robust professional expertise to the healing of her patients but bathing them in largehearted perseverance of faith in the inextinguishable light of their humanity.

Fromm-Reichmann was introduced into the popular imagination by the improbable hit novel I Never Promised You a Rose Garden — the faintly fictionalized autobiographical account of Joanne Greenberg, one of her patients, who had made a seemingly miraculous recovery from what is considered the most hopeless of mental illnesses: schizophrenia.

She exited four years later as a fully functioning college student who went on to have a family and become a successful writer. Against the odds of what seemed like an unusual and ill-advised premise for a popular novel, I Never Promised You a Rose Garden became a sensation, amassing a cult following through the six million copies sold in decades since.

But its most enduring feat was to make its millions of readers fall in love with Frieda Fromm-Reichmann and her maverick insistence that even the most tortured minds have a shot at serenity given enough attentive patience and persistence on behalf of those qualified to help them. Later, working at a Prussian army hospital during World War I, she learned from brain-injured soldiers what it was like to have a shell explode in your face and still be alive.

Their muteness became her measure. When she took up treating schizophrenics in the s, they seemed so intact by comparison that she found the work a pleasure. But Frieda could wait cheerfully through years of infinitesimal gain; the knowledge that recovery was anatomically possible was enough to keep her going.

She could tolerate any behavior, no matter how disgusting or bizarre, so long as it seemed necessary to protect a vulnerable person. It was only when symptoms became ruses or habits that she started badgering patients to give them up and get better. Fromm-Reichmann held nothing back in helping her patients — nothing of herself, and nothing of the often arbitrary rules by which her profession operated.

Hornstein writes: She was willing to try practically anything that might help them, which was a great deal more than most other psychiatrists were willing to do. She took others on walks around hospital grounds, or to symphony concerts, or to country inns for lunch.

Those too distraught to leave at the end of an hour were permitted to stay for two. Hornstein captures its essence: For Frieda, treatment of mental illness was like physical therapy after stroke: a painstaking exercise in hope.

Improvement was unpredictable, and was often followed by relapse or deterioration. Recovery, to the extent it was present, proceeded at an agonizingly slow pace. A patient had to have at least one person who could imagine the possibility of his getting well. Hornstein writes: The loneliness of mental illness, Frieda emphasized, is nothing like the solitude people seek at the ocean or to do creative work.

It is a state of extraordinary anguish in which a person ceases to be able to imagine, much less experience, anyone else being able to enter his experience.

Rarely speaking directly about politics or history, analyzing loneliness was her way of coming to grips with the horrors she had witnessed: the men gassed in trenches who screamed in their sleep, the schizophrenics who set fire to their bodies, the refugees who stumbled across a ruined Europe, terror in their eyes. She spent many years writing and rewriting a trailblazing paper on loneliness that went on to shape the study of this commonest malady of spirit for decades to come.

Nor, unlike other non-communicable emotional experiences, can it be shared via empathy. Fromm-Reichmann knew that loneliness was neither symptom nor cause, not exactly, but more of a serpent with its tail in its mouth — the inescapable attendant malady of those suffering from mental illness, compounding their suffering often past the threshold of the bearable.

I think that the guilt feeling is an evasion of accepting the tragic facts of human loneliness. How Fromm-Reichmann devoted her life to alleviating that tragedy by tearing down the barrier of loneliness is what Hornstein goes on to explore in the revelatory and emboldening To Redeem One Person Is to Redeem the World. It takes me hundreds of hours a month to research and compose, and thousands of dollars to sustain. If you find any joy and solace in this labor of love, please consider becoming a Sustaining Patron with a recurring monthly donation of your choosing, between a cup of tea and a good lunch.

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Even Freud had only touched on it in passing. It might have been the young female catatonic patient who began to communicate only when Fromm-Reichmann asked her how lonely she was. Fromm-Reichmann cured Greenberg, who had been deemed incurable. Among analysts, Fromm-Reichmann, who had come to the United States from Germany to escape Hitler, was known for insisting that no patient was too sick to be healed through trust and intimacy. She figured that loneliness lay at the heart of nearly all mental illness and that the lonely person was just about the most terrifying spectacle in the world.



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