Psychotherapy & Loneliness: A Psychoanalytic View

Loneliness is often spoken of as an epidemic in contemporary life. Yet in psychoanalysis, loneliness is not simply the absence of others. It is also an expression of our inner world — the ways we carry past relationships within us, and the ways we imagine what connection with another might mean.

Loneliness, Aloneness, and the Early Environment

Donald Winnicott, one of the most influential psychoanalysts of the 20th century, argued that true aloneness becomes possible only when one has first experienced the presence of another:

“It is a joy to be hidden, and disaster not to be found.”
— Winnicott, Playing and Reality (1971)

For Winnicott, the ability to be alone depends on an internalized sense of a reliable caregiver. Without that foundation, solitude can feel like abandonment rather than peace.

Loneliness as a Repetition of Early Loss

Psychoanalyst Heinz Kohut described how disruptions in empathic attunement — when caregivers are unavailable, unresponsive, or intrusive — can leave behind a vulnerability to loneliness later in life. He wrote:

“The human being is not only governed by the pleasure principle… he is also in need of an empathic milieu.”
— Kohut, The Restoration of the Self (1977)

From this view, loneliness in adulthood often revives the early wounds of not feeling mirrored or emotionally held.

The Unthought Known

Christopher Bollas offered another perspective on how loneliness is tied to unconscious life. He described experiences and relational patterns that shape us but cannot easily be put into words — what he called the unthought known:

“The individual is the outcome of unremembered but formative experiences… known but unthought.”
— Bollas, The Shadow of the Object (1987)

When we feel lonely, we may be encountering something of this unformulated history — a familiar absence, a pattern of disconnection that is both known and mysterious.

Loneliness in the Therapeutic Encounter

In psychoanalytic psychotherapy, loneliness often shows up in the room itself. Patients may feel that the therapist is too quiet, too distant, or not fully attuned — experiences that echo earlier disappointments. Rather than dismissing these feelings, the therapeutic work involves exploring them.

Through the process of transference, the patient’s past ways of relating re-emerge with the therapist, providing a chance to examine and work through them in real time. Over time, this can lead to a different internal experience: a sense that another person can be present, responsive, and trustworthy.

From Isolation to Connection

Loneliness cannot be eliminated; it is part of being human. But psychoanalysis can make loneliness more understandable, less overwhelming, and more connected to the story of one’s life. With time, patients may discover not only greater capacity for intimacy with others, but also a more compassionate relationship with themselves.

If loneliness is something you are struggling with — whether as a persistent background feeling or as an acute experience — psychotherapy can provide a space to explore its roots and possibilities for change.

— Dr. Max Malitzky, PsyD

Further Reading on Loneliness in Psychoanalysis

If you are interested in exploring some of the writings that inform psychoanalytic perspectives on loneliness, here are a few starting points:

• Donald Winnicott (1971). Playing and Reality.
  A classic text where Winnicott explores creativity, play, and the importance of being alone in the presence of another. His work helps us understand how the capacity for solitude is built from early relationships.

• Heinz Kohut (1977). The Restoration of the Self.
  Kohut emphasizes the role of empathy in development. His concept of an “empathic milieu” shows why disruptions in early attunement can reverberate into adult feelings of isolation and loneliness.

• Christopher Bollas (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known.
  Bollas develops the idea of the “unthought known,” referring to formative experiences that shape us but often remain inaccessible to conscious thought. His work provides a way to think about the mysterious, familiar quality of loneliness.

• Melanie Klein (1940). Mourning and Its Relation to Manic-Depressive States.
  Klein connects loneliness with the inner work of mourning and loss. She highlights how the capacity to face painful feelings is tied to growth and richer internal life.

• Julia Kristeva (1989). Black Sun: Depression and Melancholia.
  Though not strictly psychoanalysis in the Freudian sense, Kristeva explores the inner experience of emptiness and melancholy, offering a poetic and clinical reflection on loneliness and psychic pain.