Is Loneliness a Pathology?

The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham

“As the theory goes, we humans are social beings who have a fundamental need to belong. There is good evidence from a range of studies that when this need is not satisfied, there are negative consequences for our mental and physical wellbeing. This picture suggests that loneliness needs to be recognised, assessed, and alleviated.”  

Hide

A recent article in the Guardian warned against the long-term health costs of loneliness. According to a survey conducted by the Campaign to End Loneliness in 2013, one in ten GPs see between six and ten patients a day who have come in primarily because they are lonely. Only 13% of GPs feel well equipped to help their lonely patients. The effects of loneliness are reasons for concern. A study on the wellbeing of older people in the UK conducted by the Office for National Statistics found that loneliness is correlated with both low life satisfaction and poor health. 

One of the main problems in tackling loneliness is that it is elusive. We know that loneliness is distinct from solitude. Whereas solitude can be a pleasant state facilitating reflection and growth, a state we choose, loneliness has been defined as the aversive state we experience when a discrepancy exists between the relationships we wish to have, and those that we perceive to have. As the theory goes, we humans are social beings who have a fundamental need to belong. There is good evidence from a range of studies that when this need is not satisfied, there are negative consequences for our mental and physical wellbeing. This picture suggests that loneliness needs to be recognised, assessed, and alleviated. 

But if loneliness is a problem, how can we solve it? The existing literature on loneliness has focused on identifying its characteristics, utilising different approaches. The Horowitz prototype approach to loneliness, for example, provides a description of the typical lonely person. The lonely person experiences negative feelings, such as desperation and boredom, expresses negative attitudes, and may appear to be passive or socially awkward. Unfortunately, it is not clear whether these are consequences or causes of social isolation. 

There are, however, experiences of loneliness which require a different characterization, as those documented in the collection Loneliness and Longing. For instance, in contemporary adolescent culture, loneliness is not a state of passivity or social inertia, but can be masqueraded as connectedness via social media, as the work by Karen Lombardi shows. According to Michael O’Loughlin, feelings of loneliness and disconnection do not just manifest in boredom and desperation but can emerge as a result of trauma, for instance when collective acts of dissociation are caused by the failure to remember or recognise historical atrocities. Each of these manifestations of loneliness presents different features. When we focus on the variety of features we may feel like we are not making any progress towards an understanding and a treatment of loneliness in general. 

A different approach that we find promising consists in viewing loneliness as a construct which conveys cultural and personal meanings. Although many people report that they feel lonely when asked, their experiences are likely to be different, at the same time determined by bodily reactions to changes in their environment as any other emotion, and influenced by cultural context (“How many close relationships am I supposed to have?”) and personal circumstances (“Why do I feel lonely if I am in a loving relationship?”). In order to understand the cultural and personal meaning of the experience of loneliness we can use phenomenological analysis. The phenomenological approach provides a method for describing human experience and identifying implicit structures in that experience. Those structures make things appear to us in a particular way, instead of simply being ‘out there’ in the world. The lack of connectedness can appear to be a source of authenticity and creativity (solitude) or as a social deficit (loneliness).

There are three ways in which our research can help address the loneliness problem. Firstly, we create opportunities for a conversation among academics from different disciplinary backgrounds, mental health organisations, and campaigners (as in this forthcoming event funded by the Institute of Advanced Studies). Secondly, we ask when experiences become symptoms of a disorder. We find that there is no neat demarcation between the pathological and the non-pathological, and loneliness is a beautiful illustration of this continuity: an experience that we all have, and that is often part and parcel of life can also be so distressing that it is the main reason for people seeing their GPs. Thirdly, we question whether the experience that we categorise as ‘loneliness’ is always or entirely harmful. 

We are interested in the complex web of costs and benefits that many human experiences have. Even something that is obviously disruptive and misguided can have a positive role to play, at least temporarily. The case of loneliness induced by dissociation is a good example: the lack of social interactions is counteracted by the need to deny having witnessed an atrocity. Exploring the potential benefits of failed social connections will help us explain the loneliness epidemic and to give us a clearer idea of when and how we should intervene to end loneliness.