The experience of aloneness, object representation, and evocative memory in borderline and neurotic patients.

Psychoanalytically oriented theorists have repeatedly reported observing in patients diagnosed with borderline personality disorder severe pathology in the capacity to utilize internalized imagery as a source of self-soothing. Empirical support was provided for this observation: Borderline patients demonstrated a developmentally lower capacity for object representation and evocative memory of affective object relationships, fewer positively toned representations, and a more pervasive experience of aloneness than patients with neurotic character pathology. Moreover, the experience of aloneness was the strongest clinical predictor of diagnosis, supporting the contention that inner emptiness or aloneness may be central to these patients' subjective experience.