The waning hours of daylight and the graying of our winter landscape made me curious about loneliness. Last year, loneliness was recognized as a public health problem. In his sweeping report, Surgeon General Vivek H. Murthy discussed the nature of loneliness and related concepts, its prevalence, causes, effects, and potential solutions to feelings of disconnection, isolation, insignificance, and invisibility.
- See Our Epidemic of Loneliness and Isolation. 2023 US Surgeon General’s Advisory on the Healing Effects of Social Connection and Community
It is helpful to take a closer look at the many faces of loneliness, its causes, and potential solutions. Let’s begin by clarifying related concepts before looking at the factors leading to increased loneliness and its toll on psychological and physical health.
Social Isolation, Loneliness, Aloneness, and Solitude (the Capacity to Be Alone)
My blog is not intended to oversimplify or capture a more complex phenomenon in a few sound bites. My words are also not intended as a substitute for reading the Surgeon General’s report, which is widely available and accessible.
The first chapter distinguishes loneliness-related phenomena, such as a sense of belonging, social connections, social isolation, and empathy. Let’s look at some of these.
At the center is the experience of Loneliness, understood as a painful subjective feeling resulting from isolation or lack of meaningful connections. Interestingly, people can feel lonely even when surrounded by others, which means that the quality, not simply quantity, of relationships is what matters.
Conversely, people do not necessarily feel lonely when by themselves. Here are some related terms and concepts.
- Social Isolation refers to an objective absence of social connections and group membership.
- A Sense of Belonging related to the fundamental human need to feel connected and understood.
- Though not addressed in the Surgeon General’s report, the concepts of solitude, aloneness, and the capacity to be alone are important to understand.
In his book, Loneliness, Robert Weiss wrote about the many faces of loneliness, noting that it is a natural experience.
Weiss distinguished between emotional loneliness and social loneliness––the former referring to the absence of an attachment figure and the latter, the absence of a social network that fosters a sense of belonging. Addressing these challenges depends on understanding the nature of the person’s loneliness.
In some regards, the difference between social and emotional loneliness reflects what is missing in one’s social versus intrapsychic world respectively. In other words, social loneliness can mean something vital is missing in one’s social connections, while emotional loneliness suggests an internal absence. The experience of “something missing” inside harkens back to attachment theory and its importance in human development.
Early in life, a secure, reliable attachment helps prevent the “something is missing inside me” experience that may be related to emotional loneliness. A secure attachment can help us develop a capacity to tolerate being alone.
The Capacity To Be Alone
Loneliness, social disconnection, and isolation are distinguished from two related concepts: solitude and the capacity to be alone. Solitude is defined as the state of being alone, which can be painful (i.e., lonely) or pleasurable.
Why do some people fear it and others seek it?
One answer comes from developmental psychology and psychoanalytic theory, which describe the conditions in early development that make separations and solitude intolerable or tolerable. Rooted in one’s secure and reliable experiences with a caretaker, who is, in D.W. Winnicott’s words, not perfect but “good enough,” the infant builds up an internal reservoir of supportive and reliable images and feelings that ultimately makes solitude not only tolerable but enjoyable.
The capacity to be alone with oneself is a developmental achievement associated with positive self-regard and being comfortable in one’s own skin.
Sadly, for many who do not have the “good mother/caretaker inside,” being alone can be excruciating, leading to an inner emptiness and frantic efforts to rid oneself of this painful feeling. Here is where the paradoxical experience of feeling alone when surrounded by others might make sense.
Even when surrounded by people, the individual who has not achieved the capacity to be alone may feel empty and, in some cases, desperate to find something external to fill the internal void.
Loneliness – A Public Health Epidemic
The Surgeon General’s report showed how loneliness, social isolation, and a sense of belonging and connection have steadily decreased over the last 20 years, with increasing risks to physical and mental health. Chronic loneliness can weaken the immune system, release stress hormones like cortisol, and increase inflammation and blood pressure.
The results are an increased susceptibility to infections, viruses, and cardiovascular disease (heart attacks and stroke). Persistent loneliness is also associated with depression, anxiety, substance abuse, dementia, and suicide. The increased mortality associated with loneliness is like the risks of cigarette smoking and obesity. The report also draws attention to the economic and educational impact of loneliness.
What Are the Causes and Contributing Factors of Loneliness?
Loneliness is caused by a range of psychosocial, sensory disabilities and medical problems, aging, societal, technological, and political factors.
- Psychological causes
- Sensory limitations and medical illnesses
- Societal factors
- Technological factors
- The Pandemic
- Political divisions and polarization
Psychological causes: A core factor is the lack of an internal capacity to be alone. Additionally, social anxiety, mistrust, and trauma can lead to avoidance and fear, leading people to withdraw. Unfortunately, withdrawing from others to decrease anxiety often increases disconnection and loneliness, leaving some too scared to get close but simultaneously, drowning in their loneliness.
Sensory limitations and medical illnesses may cut people off from the world around them. Consider the experiences of hearing-impaired individuals who cannot follow the flow of conversation around them. Though surrounded by others, they may feel a painful sense of loneliness. Those suffering from serious, life-threatening illnesses may feel their social connections diminishing, leading to increased loneliness and isolation.
Societal factors are multifaceted contributors to isolation, disconnection, and loneliness. Immigration, urbanization, and poverty may chip away at a sense of belonging. Some viewed recommendations in the Surgeon General’s report as a Band-Aid approach that ignored more societal fundamental ills.
For example, Newsweek writers Corbin and Waters spoke of a “social crash” and pointed out that the report did not adequately address the mix of socioeconomic factors that alienate, disconnect, and disempower workers and chip away at meaning in their lives.
Aging as a normal stage of life plays a huge role in social disconnections as increasing numbers of elderly experience losses of valued social support. Aging brings predictable losses of important other and of one’s health and occupational roles. Increased numbers of people living alone, a reduced sense of community, declining friendships, and membership in groups or organizations may also contribute to growing rates of loneliness.
Technological factors are a mixed bag, in terms of contributing to and ameliorating the experience of loneliness. Social media has become the connective social tissue for millions who would otherwise feel isolated and alone. For some who are more anxious about direct involvement, social media offers a safer way to feel connected and a part of an online community.
Paradoxically, the proliferation of social media has also contributed to social disconnection, sometimes substituting a greater quantity of superficial connections for those that are deeper and more meaningful.
We may ask ourselves, what was it like before we reached reflexively for our smartphones? Would we converse more with strangers in a public space? Would we engage and speak with each other more around the dinner table?
Ironically, social media offers the promise of more connectivity at the cost of reducing the number of meaningful connections. The Surgeon General’s report points out that our collective obsession with our phones monopolizes our attention and reduces the quality of our face-to-face interactions. The report notes that people who use social media for more than two hours perceived almost twice as much social isolation as those who used it for less than thirty minutes daily.
Additionally, cyberbullying is a toxic development that increases social alienation and loneliness and decreases self-esteem in young people, whose sense of self is not well formed.
The Pandemic exacerbated a trend of social disconnectedness that predated the onset of Covid-19. The pandemic made social distancing a reality for us all and increased the alienation and loneliness many had already faced. In her 2022 novel, When We Lost Touch, author Susan Krauss wrote about the corrosive impact of the pandemic on social connections.
Political divisions and polarization have grown due to the influence of social media and the social forces and events described above. Paradoxically, polarization brings like-minded people together while simultaneously driving many of us apart. The social cleavage and cut-offs lead to mistrust and alienation of those who espouse different beliefs.
In the wake of the polarization following the 2016 election, CNN Commentator Van Jones said words to the effect, “We can turn on each other or turn to each other.”
It seems that we have done both. In our current tribal environment, clear lines have been drawn, constricting our social communication and curtailing our connections.
Resources and Strategies For Combatting Loneliness
The Surgeon General’s report offers a national strategy to address the epidemic of loneliness at a macro level but also mentions actions individuals could take to combat loneliness, such as reaching out through phone calls and visits and becoming involved in service to others.
Interventions That Help
Besides structural changes in society, what can help individuals cope with loneliness? Effective intervention always requires an accurate “diagnosis” of the problem. If the primary problem is related to isolation and lack of social support, the strategies should seek to build the individuals’ social network by connecting them to others.
Group activities, social support groups, and volunteering to help others are recommended ways to build community and decrease social isolation or socially-based loneliness. The Campaign to End Loneliness is a clearing house offering information about support organizations for people of different ages.
Community and national resources are available to help the elderly cope with loneliness.
AARP offers local and national resources for seniors.
For those grappling with internal sources of loneliness related to attachment insecurity, social anxiety, mistrust, and a sense of internal emptiness, expanding one’s social network may help but not effectively address the core problem, which relates to a feeling that something is missing inside. For such individuals, psychotherapy is the most effective way of addressing internal or emotional loneliness.
Relationally based Individual therapy, whether psychodynamic or cognitive, with a trained mental health professional is the place to start. Adding group psychotherapy is another proven way of addressing both emotional and social loneliness.
Choosing Therapy is an internet site providing tools for coping with loneliness and links to finding a therapist in your community.
Loneliness in Literature
Loneliness is a prominent theme in fiction, with too many examples to note here. Authors have created characters who depict the social, emotional, and existential roots of loneliness.
Some prominent classics include Albert Camus’ The Stranger, which focuses on social alienation. The Count of Monte Cristo, by Alexandre Dumas, told of the restorative effects of social connections on loneliness. Themes of loneliness in childhood are reflected in the works of Charles Dickens. Mark Twain created the character Huck Finn, who, among other things, spoke of feeling so lonely he could die.
In my novels, central characters experience emotional and social loneliness. In The 11th Inkblot, protagonist Anton is alienated from his family and experiences a significant loss of his primary attachment figure. In my recent work, Tears Are Only Water, Carmine leads a lonely and isolated life, devoid of meaningful social connections. However, more importantly, we learn that his social isolation is a product of a deeper cut-off from himself, which continued into adulthood.
Both stories also tell of the healing relationships that helped the protagonists reconnect to themselves and the world around them.
Order his latest novel, Tears Are Only Water, here!
Purchase his book The 11th Inkblot here