What Drives Loneliness to Dangerous Levels?

New research on what makes us lonely, and what we can do about it.

Posted Jun 28, 2019

       "We live in a society bloated with data yet starved for wisdom. We're connected 24/7, yet anxiety, fear, depression and loneliness is at an all-time high. We must course-correct." —Elizabeth Kapu'uwailani Lindsey

Written By Grant H. Brenner, MD, FAPA

Elliott Chau, StockSnapIO, Creative Commons CC0
Source: Elliott Chau, StockSnapIO, Creative Commons CC0

Research on loneliness has picked up steam in recent years, given the loneliness epidemic we are facing. We now understand that loneliness is a risk factor for physical and emotional unwellness, associated with a statistically shorter life span due to cardiovascular illness and increased suicidal thinking—independent of other factors. As reported by the Campaign to End Loneliness:

  • Loneliness, living alone, and poor social connections are as bad for your health as smoking 15 cigarettes a day.
  • Loneliness is worse for you than obesity.
  • Lonely people are more likely to suffer from dementia, heart disease, and depression. 
  • Loneliness is likely to increase your risk of death by 29 percent.

...and that's just the tip of the iceberg.

Suppression of Emotion and Self-Monitoring

Two important factors are attracting the interest of loneliness researchers seeking to understand what causes loneliness and identify areas for potential intervention. As reviewed in their recent paper, cleverly entitled "Purposely Stoic, Accidentally Alone?" Smith, Lair, and O’Brien (2019) note that emotion suppression and, importantly, self-monitoring are factors which influence loneliness. Stoicism, while appealing to many as a way to bear the slings and arrows of outrageous fortune, comes at a high cost.

Smith and colleagues note that emotion suppression is the “conscious inhibition of one’s own emotional expressive behavior while emotionally aroused.” Do you recall a time when you felt strong emotions and pushed them down? This can happen consciously or unconsciously, the result of a deliberate choice—for instance, tamping down anger in the workplace and choosing a more diplomatic path—or it may be reflexive, as when someone who grew up in a household where they weren’t allowed to cry or show their feelings learns to automatically swallow their feelings without noticing they are doing it... let alone realizing it is often problematic. 

The authors report on research showing that emotional suppression leads to reduced well-being—for example, it is associated with “feelings of depression and decreased self-esteem, optimism, life satisfaction, and purpose in life.” While suppressing emotions—or more specifically, managing how emotions are displayed—plays an important role in social relationships, we can’t go around spewing unedited emotion all the time. We must learn to express emotions effectively depending on the context. Simply suppressing them is ill-advised.

Furthermore, suppressing emotions can backfire when we are unable to use our feelings effectively, or when we don't even know what we are feeling when we are feeling it. We need to know what we are feeling in order to make considered decisions; feelings are critical self-referential data we need in order to know ourselves. On the other hand, feelings are not the be-all-end-all, though sometimes they seem to be the only thing that matters, an unhelpful thinking approach known in cognitive behavioral therapy as "emotional reasoning."

Suppressing feelings can, moreover, backfire. The study authors reference prior research showing that sometimes when we suppress emotions and think we aren’t showing them, we actually end up showing them in ways we don’t intend. Participants in this experiment were instructed to try to suppress strong negative emotions—and ended up expressing them strongly instead.

       Emotions have a way of coming out whether we want them to or not. Try to stuff them down, and they return with a vengeance, often when we least want them to in ways we can't predict or control.

Smith and colleagues note that in addition to emotion suppression, another likely player in the loneliness story is self-monitoring. Self-monitoring theory, they write, “concerns differences in the extent to which people value, create, cultivate and project social image and public appearance.” Self-monitoring is roughly divided into high self-monitoring and low self-monitoring for research purposes, though of course, the way we self-monitor is also crucial. Self-monitoring can be more rational, a process of self-appraisal designed to notice areas of success and need for improvement, with feedback to oneself more on the encouraging, positive side.

On the other hand, self-monitoring can be associated with crushing, self-conscious, distorted, negative, or shameful feelings about ourselves and assumptions about others which may cause us to withdraw and avoid social situations, and assume others feel bad about themselves, as well. These are not useful or accurate beliefs to hold—but they can be powerful nonetheless.

The study authors note that, on balance, people high in self-monitoring tend to talk more and initiate conversation, but also tend to see themselves and others as more self-conscious as well. Self-monitoring can assist in greater emotional expressiveness and adaptive awareness if used effectively, but it can also lead to greater emotion suppression if it leans more toward a shameful sense of self.

They go on to note that when people keep too much to themselves, they naturally share less about themselves in social interactions. This, in turn, leads to less self-disclosure, impairs the development of intimacy through mutually getting to know one another, and could, therefore, tend to lead to greater loneliness—but only under the right circumstances. When people open up to one another, we tend to grow closer.

Results: Loneliness, Emotion Suppression, and Self-Monitoring

Given the relatively small amount of research looking at loneliness and emotion suppression, specifically, as a function of self-monitoring, Smith, Lair, and O’Brien designed a study to further define these factors. They recruited 142 undergraduate students with an average age of 21.2 years and conducted a 60-minute, in-person assessment. Participants completed the Loneliness Scale (LS), relevant subscales of the Emotional Regulation Questionnaire (ERQ), and the Self-Monitoring Scale (SMS)

As anticipated, they found that there was a significant correlation between loneliness and emotion suppression. Self-monitoring was not directly correlated with either emotion suppression or loneliness, which makes sense given that self-monitoring can both support or interfere with social function.

More interestingly, they did find a significant interaction effect when they looked at whether self-monitoring modified the relationship between loneliness and emotion suppression. They learned that for high self-monitoring participants only, emotion suppression was associated with more severe loneliness. This effect was not seen at lower levels of self-monitoring.

In fact, though the effect was too small to be statistically significant in this study, low self-monitoring was associated with a little bit less loneliness in participants who suppressed emotions less. Perhaps being a bit free-wheeling with the expression of emotions and not worrying too much about how it comes across may lead to greater authenticity and connection. As Smith and colleagues report, people who suppress their emotions have been shown not only to be less likely to share both positive and negative experiences with others, they are also less likely to feel authentic—and if we don't feel authentic, we don't feel good about ourselves, according to recent research.

Understanding how self-monitoring affects communication and the development of intimacy is a key area for future research. While this research is an important first step, highlighting how high self-monitoring may lead to emotion suppression and hence increased loneliness, it does not prove cause-and-effect and only shows enticing correlations. It may be that other factors, such as an overall tendency to be negative, underlie the observations.

However, the observed effect of self-monitoring as a moderator—in which high self-monitoring is connected with a stronger relationship between suppression of emotions and loneliness—may provide useful insights and action points for people suffering from loneliness. 

Effective Self-Monitoring

While future research looking for causal relationships will answer questions about causality and underlying factors, lonelier people can pay attention to their own individual habits. Am I someone who suppresses my emotions? Do I pay painstaking attention to how I come across, what I am thinking and feeling, how others see me? Do I feel more authentic when I show my emotions? Is there a role for greater self-compassion in how I relate with myself? Would it behoove me to more actively, candidly govern myself?

If I’ve developed the habit of suppressing my emotions, how can I learn to be more expressive in ways which facilitate, rather than impede, social interaction? If I open up more to people, without oversharing or sharing too fast, too soon, will I, over time, develop more fulfilling relationships? How can I monitor myself at an intermediary level, balancing the costs and benefits of how much and in what ways I reflect on my own thoughts, feelings, and behaviors to enjoy greater self-esteem, authenticity, sense of purpose, and significant relationships?

These, and other questions, are important ones to ask—and begin to answer—in order to forge paths out from deadly and destructive isolation.