In the author's view, closeness between patient and analyst enables the patient to gain insight into the pain of separation and thus to tolerate it, but at the same time brings up, paradoxically, a sense of separateness difficult to deal with. A distinction is made between separation and separateness.

Through clinical material, the author tries to show that while analysis can help patients to come to grips with the pain of separation, it has limited effect on the profound core of affects which have to do with fear of death and emptiness — the affects pertaining to separation.

Ognuno sta solo sul cuor della terra trafitto da un raggio di sole: ed subito sera.

—S. Quasimodo