Would you knowingly engage in behaviors that you know would lead to a cascade of negative health events? After her husband died, Shirley regularly declined invitations to go places with friends by saying, “Oh, my husband really wouldn’t want me to be going out at night,” or “I really need to watch golf on TV this afternoon, because my husband enjoyed it so much.”
Before long she had a regular catalog of excuses (nearly all of which were tied to an explanation which included her husband) for avoiding social calls. Not surprisingly, people stopped inviting her to socialize with them. These well-meaning people thought they were giving Shirley “space” to grieve and sent her cards and pictures rather than making phone calls and sending invitations.
Situational Loneliness Can Become Chronic Loneliness
Shirley continued to talk about her friends as if she were seeing them regularly, and while pointing to their pictures displayed on the refrigerator, she made excuses on their behalf about how busy they were with work and family responsibilities. She left the television on day and night and fell asleep on the sofa only to awaken in the middle of the night never having made it to bed. Shirley clearly understood and valued the importance of being deeply socially connected, but when her own children invited her to visit for holidays or family events, her excuses soon expanded to include many things she said she would never do again– fly, take the train, or drive beyond her own town. If they really wanted to see her, Shirley said, the children and their families could come to her house. After all, she reminded them—that is what their father would have wanted—the whole family together.
Breaking Down the Scaffold that Supports YouFeeling known and valued by others is so important to our well-being that without it we languish. A grief counselor would instantly recognize Shirley’s overwhelming loneliness. She had effectively disassociated herself from her social network. To put this into context, Shirley had lived in countries all around the world and was seen as very outgoing by others she knew at church and at her volunteering job. Perhaps her husband, when living, had been her bridge to the social world. Perhaps she missed him so much that no other social connection seemed to matter.
Underneath the more obvious behaviors that shrunk Shirley’s social opportunities was a more insidious decline—the loss of health benefits, what social psychologists Louise Hawkley and John Cacioppo (University of Chicago) call the “scaffold for the self.” Loneliness is not just unfortunate. It also predicts a plethora of undesirable health problems, including inattention, declining cognition, negative emotion, and poorly self-regulated behavior, that lead to illness and mortality.
The Impact of Chronic LonelinessChronic loneliness is bad medicine for the self. When adults move from being situationally lonely (as in early-stage grieving, such as from a death, divorce, moving, or job change) to chronically lonely, this deep social disconnection predicts all-cause mortality, even when controlling for age, gender, chronic diseases, alcohol use, smoking, self-rated general health, and pre-existing health limitations.
Among women, the toll of chronic loneliness is also associated with coronary heart disease and depression and a significantly higher risk for cardiovascular mortality. It increases not only the risk of Alzheimer’s disease but also faster cognitive decline among those with dementia. In fact, the list of negative health factors correlated with loneliness is too big to list in this article.
The loneliness model from Cacioppo and his colleagues connects social isolation to underlying feelings of peril. In the presence of social threat, peoples’ confirmation bias shifts to the negative, and they both expect more and remember more negative social information. This loneliness loop, with its hypervigilant feelings of strong negative emotion, then activates neurochemical and psychological mechanisms that lead to the undesirable health outcomes mentioned above.
Consider that the lonely person who now has an impaired ability to self-regulate, unwittingly engages in what feels like self-protection. Unfortunately, like Shirley above, these behaviors result in cutting off the very nutrients that could help them feel whole again. Sleep regulation is also affected, and its disruption fuels a whole new downward spiral of social and health events.
Relieving Social Disconnection
What can help relieve and even prevent social disconnection?
- Recognize the slow slide from situational to chronic isolation. If you have a family member or friend who declines your invitations, keep the lines of communication open. Offer to drive. Even show up unexpectedly. Keep on inviting and including, even if you are turned down. Get a group of family or friends in on this, too.
- Professional help might be needed. Positive effects for relieving loneliness have been achieved with social cognitive therapy, using training to identify the automatic negative thoughts and confirmation biases that can then be discounted by alternative evidence, thus reframing one’s sense of personal control. (This is what we use in resilience training, too.)
- Connections to other people matter and they bring great joy and meaning (albeit with some frustration thrown in now and then). Keep connections alive to prevent loneliness. Warm social relationships predict so very many positive outcomes that they, too, are beyond the scope of this article.
Cacioppo, J.T. & Patrick, W. (2008). Loneliness: Human Nature and the Need for Social Connection. New York: W.W. Norton.
Hawkley, L.C. & Cacioppo, J.T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine 40:218-227.
Vaillant, G. (2003). Aging Well: Surprising Guideposts to a Happier Life from the Landmark Harvard Study of Adult Development. New York: Little Brown. Social connectedness is one of the factors that George notes contributes to aging well.
Missing Him is an illustration drawn by Kevin Gillespie from Sherri’s chapter in the Resilience book. Shirley’s husband was the Timothy in that chapter – both names changed.
Bamboo Scaffolding courtesy of Ioan Sameli
Loneliness courtesy of Cia de Foto
Grandmother and granddaughter courtesy of Jenny818
Love is Being Stupid Together courtesy of Nattu