What is loneliness? Mental Health Awareness Week 2022

This week for Mental Health Awareness Week we’re exploring loneliness and its impact on our wellbeing. But what exactly is loneliness and why does it matter?

Rozmin Mukhi, Grenfell Specialist Psychotherapist explains in full, in this paper that she wrote and presented at a conference.  

Definition of Loneliness

Loneliness is defined as the distressing experience that occurs when one’s social relationships are perceived to be less in quantity, and especially in quality, than desired. Being alone and experiencing loneliness are not the same thing. People can be alone without feeling lonely and can feel lonely even when with other people. Loneliness is associated with depressive symptoms, poor social support, neuroticism, and introversion, but loneliness is not synonymous with these psychological characteristics. Loneliness is typically thought of as a stable trait, with individual differences in the set-point for feelings of loneliness about which people fluctuate depending on the specific circumstances in which they find themselves. Loneliness changes very little during adulthood until 75 to 80 years of age when it increases somewhat. Loneliness puts people at risk for mental and physical disease and may contribute to a shortened life span.

Though our need to connect is innate, many of us frequently feel alone. Loneliness is the state of distress or discomfort that results when one perceives a gap between one’s desires for social connection and actual experiences of it. Even some people who are surrounded by others throughout the day—or are in a long-lasting marriage—still experience a deep and pervasive loneliness. Research suggests that loneliness poses serious threats to well-being as well as long-term physical health.

Although loneliness has always been part of human existence, it has a relatively short psychological history. John Bowlby’s attachment theory emphasized the importance of a good attachment bond between the infant and caregiver, and this theory was a forerunner to theories of loneliness. From this perspective, loneliness is the result of insecure attachment patterns that lead children to behave in ways that result in being rejected by their peers. Experiences of rejection hinder the development of social skills and increase distrust of other people, thereby fostering ongoing loneliness.

Attachment theory formed a foundation for an influential psychological theory of loneliness developed by Robert Weiss; who identified six functions or needs of social relationships that, if in short supply, contribute to feelings of loneliness. These needs are attachment, social integration, nurturance, reassurance of worth, sense of reliable alliance, and guidance in stressful situations. Weiss went on to distinguish loneliness from social isolation e.g. a lack of social integration; and loneliness from emotional isolation e.g. the absence of a reliable attachment figure. As would be predicted by attachment theory, Weiss maintained that friendships complement but do not substitute for a close, intimate relationship with a partner in staving off loneliness.

The negative, self-protective lens through which lonely individuals view their social world also influences how they interpret and cope with stressful circumstances. Lonely individuals are more likely to disengage or withdraw from stressors, whereas non-lonely individuals are more likely to actively cope e.g. problem solve and seek tangible and emotional support from others. Passively coping or withdrawing from stressful circumstances is reasonable in certain instances, but when applied generally to everyday hassles, it can lead to an accumulation of stress that becomes increasingly taxing and oppressive. Increased stress may be at least partially responsible for the risk of mental and physical disease in lonely individuals. For instance, loneliness has been associated with elevated levels of stress hormones, poorer immune functioning, and health-jeopardizing changes in cardiovascular functioning.

Loneliness, Health, and Well-Being

Technology provides instant access in an ‘always-on’ society. But there’s also growing awareness and concern about loneliness in UK society. Described by some as an ‘epidemic’, loneliness is the mismatch between the quantity and quality of social relationships that we have, and those that we want.

Of course, loneliness isn’t an illness, but it can be closely linked to life events that impact on wellbeing and mental health. Retirement, bereavement, ‘empty-nest’ and onset of chronic illness all contribute, but do not in themselves explain, loneliness in later life.

A number of unfavourable outcomes have been linked to loneliness. In addition to its association with depressive symptoms and other forms of mental illness, loneliness is a risk factor for heart disease, Type 2 diabetes, and arthritis, among other diseases. Lonely people are also twice as likely to develop Alzheimer’s disease, research suggests. The state of chronic loneliness may trigger adverse physiological responses such as the increased production of stress hormones, hinder sleep, and result in weakened immunity.

Social prescribing by GPs and other primary care professionals helps people to local, non-clinical services and activities. Accessing support services and social activities has been demonstrated to improve health and wellbeing. The challenge, however, is to engage people whose untreated anxiety and depression prevents them from taking the first step to accessing services and activities.

We’ve never been so connected to friends, family, organisations, services and market-places.

In a report ‘Learning Not Lonely U3A’ acknowledges that it can be difficult for people to come along to an activity and that a level of confidence is needed to become involved in learning for the first time. Anxiety undoubtedly prevents may people from taking the first step.

GP practices and employment assistance programmes, recognises the difficulties some older people face in taking steps to becoming involved in community activities for the first time. For an already anxious person, the thought of joining a group will fill them with dread – but arguably these are the people that need us the most.

Group activities such as friendship circles and socialising with group members in activities such as walking groups tailored for different abilities, languages and wine-tasting have shown benefits to the well-being of people who experience loneliness. Other activities such as sewing a quilt in a group, cooking together for the circle or even book reading and gardening have also shown to have positive impact on lonely people.

References:

Cacioppo, J. T., Hawkley, L. C., & Berntson, G. G. (2003). The anatomy of loneliness. Current Directions in Psychological Science, 12, 71-74.

Ernst, J. M., & Cacioppo, J. T. (1999). Lonely hearts: Psychological perspective on loneliness. Applied and Preventive Psychology, 8, 1-22.