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Are You Feeling Lonely? If So, You Are Not Alone

Loneliness is common, but it’s not benign.

Are you feeling lonely? If so, you are not alone. Data suggest that chronic loneliness may afflict 15-30% of the general population. A recent report from The Health Resources and Services Administration, an agency of the U.S. Department of Health and Human Services, states: “Two in five Americans report that they sometimes or always feel their social relationships are not meaningful, and one in five say they feel lonely or socially isolated.” In a recent US national survey of 20,000 adults, approximately half reported that they “sometimes or always feel alone (46 percent) or left out (47 percent).” One in four (27 percent) reported that they “rarely or never feel as though there are people who really understand them.”

Loneliness, which may be defined as, “a negative and distressing emotional state that arises from a discrepancy between one’s desired and achieved levels of social connectedness," has attracted psychologists’ attention in part because it’s so common and in part because it’s so consequential. High levels of loneliness predict a diverse host of negative health outcomes both physical and mental, including depression, Alzheimer’s disease, and early death. As a health risk factor, loneliness is "comparable in size to obesity, sedentary lifestyles, and possibly even smoking.” A recent review of the literature involving 128 articles from 15 countries found that all but two of the studies reported “a detrimental effect of isolation or loneliness on health.”

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Loneliness is difficult to study well. Unlike the related concept of ‘social isolation,' which can be measured directly and objectively by considering parameters such as living situation and social network, loneliness is a subjective experience. With loneliness, the objective circumstances matter less than one’s perception. One can feel lonely in a crowded room, and fully connected on a remote mountaintop. Being subjective, loneliness is difficult to measure independently of individual self-report. Self-report measures are problematic, as people may not know or wish to share how they truly feel.

How and why does loneliness come about? Evolutionary scientists have argued that, like hunger or thirst, loneliness has evolved as an adaptive cue to drive individuals toward making social and intimate connections—both of which help our survival and reproductive chances. According to this view: “Early in our history as a species, humans survived and prospered only by banding together—in couples, in families, in tribes—to provide mutual protection and assistance. In this context, disconnection from others was a life-threatening circumstance, and loneliness evolved as a signal to change behavior—very much like hunger, thirst, or physical pain—that serves to help one avoid damage and promote the transmission of genes to the gene pool. In the case of loneliness, the signal is a prompt to renew the connections we need to survive and prosper.”

Psychodynamic theories tend to locate the roots of loneliness in the early parent-child dynamic. The prominent 20th-century psychologist Harry Stack Sullivan saw loneliness as, “connected with inadequate discharge of the need for human intimacy.” The great psychoanalyst Frieda Fromm Reichmann, perhaps the keenest observer of loneliness, regarded it as “an extremely uncanny experience,” akin to the experience of panic and often too terrifying to talk about. “A person who is lonely in his present environment," she's written, "has anachronistically held on to early narcissistic need fulfillments or fantasized substitutive satisfactions.” The psychoanalyst Gregory Zilboorg, in an early (1938) classic work, likewise argued that loneliness represents narcissistic hostility, born of the unfulfilled need for audience and a realization of one’s dependence on others; it may thus manifest in aggression. Research has provided some support for this idea.

Sociologist Robert Weiss, working within the framework of attachment theory, developed an influential model of loneliness in the 1970s. According to Weiss, two types of loneliness exist: emotional loneliness, related to the loss of attachment figure or intimate partner, and social loneliness, related to the loss or absence of sufficient social contentedness. Weiss argued that different relationships afford different "social provisions" with which we meet our myriad social needs. A person’s experience of loneliness depends on what kind of provisions were lost, or are missing. Weiss identified six social provisions:

“(a) attachment, provided by relationships in which the person receives a sense of safety and security; (b) social integration, provided by a network of relationships in which individuals share interests and concerns; (c) opportunity for nurturance, derived from relationships in which the person feels responsible for the well-being of another; (d) reassurance of worth, provided by relationships in which the person's skills and abilities are acknowledged; (e) reliable alliance, derived from relationships in which the person can count on assistance under any circumstances; and (f) guidance, provided by relationships with trustworthy and authoritative individuals who can provide advice and assistance.”

According to Weiss, different types of losses require different types of solutions. If you feel lonely because you lost or have insufficient reliable alliances, then adding a friend who offers reassurance of worth will not fix the problem, etc.

The humanist psychologist Carl Rogers had a different take, proposing his own distinct types of loneliness. The first relates to “the estrangement of man from himself, from his experiencing organism.” In other words, some people, having succumbed to social pressures and lost contact with their internal true selves, present a façade to the world in order to please and placate others. However, the cost of such pretense is emptiness, experienced as loneliness. This, by way of analogy, is the loneliness of a fake orgasm. The other form of loneliness is, “the lack of any relationship in which we communicate our real experiencing – and hence our real self – to another." This happens when an individual who finally allows his defenses to recede is met with hostile judgment. This, by way of analogy, is the loneliness of masturbation.

Cognitive psychologists have argued that loneliness may emerge from faulty attributions or dysfunctional cognitive evaluations. For example, some people may appraise social and intimate situations through negatively distorted lenses, judging the odds of failure as high and the consequences as catastrophic. These appraisals may lead to avoidance, which in turn leads to deteriorated social skills, resulting in unsatisfactory personal relationships, and hence loneliness.

Accumulating data have shown that multiple factors converge and interact to shape the experience of loneliness. Evolution indeed plays a large role. Twin studies suggest that about 50% of variations in loneliness are explained by genetics. Personal attributes matter. For example, research has found a link between the personality trait of neuroticism and loneliness. Age appears to be a factor. Research suggests that loneliness tends to decrease in adulthood until around the age of 75 years old, after which it increases markedly. Older adults are more susceptible to loneliness in part because of decreased mobility and independence and the deaths and loss of friends and family members.

Technology may also play a role. For example, early studies have noted the ‘internet paradox’ by which Internet use, ostensibly facilitating communication, nonetheless predicts lower communication levels with family and friends as well as increased loneliness. Research since has painted a more nuanced, contextual picture, whereby Internet use may predict more or less loneliness, depending on how it interacts with other environmental or individual variables. For example, people with high social skills may use online connections to augment and expand their offline contacts, thus decreasing loneliness, while people with low social skills and high anxiety may use the Internet as an avoidance strategy, thus eroding their social skills and social ties to negative effect.

In sum, many paths lead to the place of loneliness. We still have ways to go in deciphering this profound psychic phenomenon and the mechanisms of its formation and impact. And while loneliness is currently considered a symptom, not a formally diagnosed disorder, a change may be warranted given the accumulating evidence of its complexity, prevalence, and adverse health consequences. For now, clinicians and physicians may do well to include an assessment of the client’s loneliness as part of their initial evaluation checklists. And all of us are wise to take note of our feelings of loneliness, should they arise, and take action to address them. The consequences of not doing so may be far from benign.