If it’s difficult to respond to people in this state, it is harder still to reach out from it.  Loneliness feels like such a shameful experience, so counter to the lives we are supposed to lead, that it becomes increasingly inadmissible, a taboo state whose confession seems destined to cause others to turn and flee.  In her essay, Fromm-Reichmann returns repeatedly to the issue of incommunicability, noting how reluctantly even the loneliest of patiences approach the subject.  One of her case studies concerns a schizophrenic woman who asked to see her psychiatrist specifically in order to discuss her experience of deep and hopeless loneliness.  After several futile attempts, she finally burst out: ‘I don’t know why people think of hell as a place where there is heat and where warm fires are burning.  That is not hell.  Hell is if you are frozen in isolation into a block of ice.  That is where I have been.’

I first read this essay sitting on my bed, the blinds half-drawn.  On my printout, I’d drawn a wavering Biro line under the words a block of ice.  I was often feeling then like I was encased in ice, or walled up in glass, that I could see out all too clearly but lacked the ability to free myself or to make the kind of contact I desired.

The Lonely City: Adventures in the Art of Being Alone