Loneliness
The Geography of Loneliness
Part I: Our human need for relationships with others—some definitions.
Posted March 22, 2020
THE BASICS

“So this is hell … all we were told about the torture-chambers, the fire and brimstone … there’s no need for red-hot pokers. Hell is—other people!” So says journalist and man of letters, Garcin, a deserter, one of the three “absentees” together confined forever in Jean-Paul Sartre’s 1940s play No Exit. (Vintage International Edition, 1989) “Each of us will act as torturer of the two others.” “Each must try to forget the others are here.” “How utterly absurd,” says another. “I feel you in every pore.”
The paradoxical capacity to be alone in the presence of another person is one of the most important signs of emotional maturity. (Winnicott, International Journal of Psychoanalysis, 1958) Sartre's version of "familiarity breeds contempt," though, is at least as old as 16th-century Dutch philosopher and Christian scholar Erasmus, (Oxford English Dictionary.) What kind of hell is there when no one else is there?
Poignantly depicted in Rod Serling’s "The Lonely" (Twilight Zone, Season 1, Episode 7, 1959), we find Corey, a man who killed in self-defense, condemned to total social isolation on an asteroid millions of miles from earth. Four times a year a spaceship arrives to bring him supplies—and stays 15 minutes, not even enough time for a game of checkers or cards. He tells the captain he is “dying of loneliness, in agony.”

The captain, appreciating this “unnecessary cruel punishment” takes pity on him and brings him an enormous crate with Alicia, physiologically and psychologically a “human being” with feelings and speech. “I don’t need a machine—you mock me—you are a hunk of metal,” says Corey. When he admits he is about to lose his mind out of loneliness, Alicia starts crying and says, “I can feel loneliness too, Corey.” Over the next 11 months, they develop a “strange and bizarre relationship” and Corey, no longer lonely, comes to love Alicia.
When the supply ship arrives with news he has been pardoned and they have to leave immediately, Corey insists he is not leaving without Alicia. The captain tells him he has no choice—and shoots Alicia in the face—at which point Corey sees Alicia’s head was all metal and wires. Says the captain, “All you are leaving behind is loneliness.”

Many people across the world are recently experiencing either mandatory or self-quarantine, precipitated by attempts to contain the COVID 19 pandemic, but loneliness and social isolation are neither new nor uncommon phenomena within the global population. What are the differences between social isolation and loneliness?
Loneliness is actually a ‘modern emotion’ (p. viii) whose meaning has evolved over time. (p. 18) (Alberti, A Biography of Loneliness, 2019) Prior to the 18th century, it was not part of the medical literature: (p. 21) there was no mention of loneliness in Robert Burton’s Anatomy of Melancholy, 1621. (p. 26) Originally, there was the concept of oneliness, a sense of solitude, as depicted in DeFoe’s Robinson Crusoe (1719), a story of a man who spent 28 years alone on a remote island. (p. 20) It was after 1800 that its contemporary meaning emerged, (p. 10) and only recently have we come to appreciate the pathological mental and physical consequences of loneliness. (p. 18)
THE BASICS

Loneliness is a subjective negative feeling associated with a perceived lack of a wider social network (social loneliness) or the absence of a specific companion (emotional loneliness) (Fakoya et al, BMC Public Health, 2020) “In loneliness, we are inarticulate. There are no words. That is the agony…and the intense shame…it is not at all acceptable to say ‘I am lonely.’ And since it is subjective, strictly speaking we can only say, ‘I am lonely,’ and not ‘He is lonely.’” (Hobson, Journal of Analytic Psychology, 1974)

"Part of the reason that loneliness is so hard to see in others," explains Alberti (2019) "is that it is not a single emotional state...and is not signified by a distinct set of socially understood gestures...." Lonely people can be sad, but also "angry, resentful, ashamed, resigned, or even at peace." (p. 200) Further, because loneliness is a "totally subjective state," and not necessarily about being alone, someone can be lonely in a crowd. (p. 139)
Loneliness Essential Reads
Loneliness has been described as a “painful sense” of disconnection (Alberti, 2019, p. viii); a “complex set of feelings that occur when intimate and social needs are not adequately met;” (Cacioppo et al, Journal of Research in Personality, 2006); “feelings of distress that stems from a person’s individual perceptions of inadequacy in his or her social relationships,” (Brown et al, Psychophysiology, 2018); “an experienced absence of social contact, belongingness, or sense of isolation—a perceived discrepancy between social needs and their availability in the environment.” (Beutel et al, BMC Psychiatry, 2017) Further, loneliness can have structural aspects (i.e., the extent to which relationships are present); functional aspects (i.e., extent to which others can be relied upon); or quality aspects (i.e., extent to which others can satisfy) (Holt-Lunstad, Public Policy & Aging Report, 2017)

Social isolation is a multidimensional concept involving an objective lack or paucity of social interactions with friends, family, and the community, and there is "much less consensus on the definition of social isolation." (Fakoya et al, 2020) Both loneliness and social isolation, though, have significant physical and psychological consequences for people and are "serious yet under-appreciated public health risks," particularly in the older U.S population. (Social Isolation and Loneliness in Older Adults, National Academy of Sciences, 2020, which has an extensive bibliography.) This is Part 1 of a two-part post. In Part 2, I will discuss some of the physical and emotional consequences of loneliness and isolation. Special thanks to Judy Salerno, M.D., M.S., president of the New York Academy of Medicine, for suggesting this timely and relevant subject.
This is part 1 of a series. Please see part 2 here.