The problem of alienation has exceedingly broad implications not only for modern psychiatry, but for society as a whole, particularly for the religious dimensions of modern life. The implications are especially relevant to individual religious conviction and belief and even more to the vitality of institutional religious affiliation. It was the existentialists who, in our own time, called attention to the growing sense of alienation. Kierkegaard pointed out man's sense of loss of meaningful relatedness to the world of his experience. In the existential context, then, alienation implies not merely a disturbance of significant relationships with other human beings, but a profound disturbance of man's relatedness with his environment and with the historical structures that provide the substance and continuity of his experience of himself. The problems of loneliness, estrangement, and isolation have increasingly been foci of psychiatric concern over the last several years. Psychoanalytic thinking has undergone a slow evolution that has shifted its emphasis from forms of psychopathology rooted in the disturbance of instinctual life to forms that have more to do with the impairment of object relations. Considerably more attention is paid these days to character defects of a narcissistic, depressive, or schizoid variety. There is a definite turning from the type of instinctual pathology Freud found in his "hysterical" patients to the characterological problems met with in analytic patients today. A significant proportion of the patients seen these days show certain schizoid features?detachment, poor capacity for object relations, isolated and withdrawn affect, intellectualizing defenses, etc. As a result of the emergence and development of analytic ego psychology in the last few years, the relation between man's intrapsychic life and the familial, social, and cultural contexts in which he develops and functions has undergone a profound reconsideration. In this more extended understanding of man's psychic development and structure, it has become possible to rethink neo-Freudian contributions and to integrate them meaningfully with
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