Living with Loneliness
Loneliness, a normal part of the human condition, has reached epidemic proportions in recent years. Amplified by the social isolation that the COVID pandemic imposed (and continues to demand of the elderly and the immune-compromised), loneliness as a social issue was already on the rise. As I wrote in a 2017 post on social support (1), a national survey revealed that 25% of Americans said they had no one in whom they could confide or share a personal problem. (A similar survey in 1985 had reported that most people had at least 2 – 3 trusted confidants.)
The highest reported rates of loneliness are among seniors, who are more likely to be living alone, retired from the workforce, and needing to protect themselves from the risks of catching not only COVID but all of the other viruses circulating out there. One of the most unfortunate consequences of our modern society, particularly in this country, is the sidelining of elders, who in earlier generations were considered a necessary part of a family, whether as caregivers for grandchildren and keepers of the home fire, or as sources of wisdom and familial history and traditions. Now, many elders are left feeling superflous, invisible, not belonging anywhere.
Right behind seniors in reported rates of loneliness are teens, who are developmentally still learning social interaction rules and skills, and who were hit hard by the closing of schools during the lockdown. Some still have not returned, or have dropped out. Teens lack the perspective that “this too shall pass,” giving more urgency to current distressing circumstances. And they are more reliant on their smart phones and social media, which create a false sense of being connected while not requiring any direct social interaction at all.
And in between are the rest of us, who may be experiencing loneliness for a variety of reasons, and to a greater degree than before. Everyone feels lonely sometimes, but as a recent article in The Atlantic says, “emerging evidence suggests that we are in the midst of a long-term crisis of habitual loneliness, in which relationships were severed and never reestablished.”(2)
According to Vivek Murthy, US Surgeon General, this is a public health issue.(3) Indeed, research has shown that loneliness is a risk factor for several kinds of health problems, including cardiovascular disease and dementia, as well as mental health, especially depression and suicide.(4)
While other nations (Japan,England) have created governmental agencies tasked with finding solutions to loneliness (5) the US has tended to regard it as an individual problem rather than a societal one, leaving Americans to cope with loneliness on their own. Ironic, but not surprising!
So if you are experiencing loneliness, you’re not alone! Know that this is a common condition in today’s world, caused by many factors over which we have little or no control (including the pandemic, political polarization, and over-reliance on smart phones and social media) so you are not to blame. I repeat, it is not your fault.
However, it is up to you to do something about it. The best remedy for loneliness is to reach out to other people – not to ask for help, but rather to offer it, either as a volunteer or a friend. There’s truth to the old adage, “get busy helping others and you’ll soon forget your own troubles.” As I have written previously,
It is easier to give than receive. Most people find it much easier to offer help, than to be the one asking for help. Research on the health benefits of social support shows that while giving support is correlated with health and living longer, receiving support conveys no longevity benefit. Perhaps this is because it’s stressful to ask for help, or because those who receive support are already suffering more ill-effects of stress. (6)
Find something you can do that will force you to get out and interact with other people. Make an effort to be kind and friendly to others. Look for opportunities to interact in person, from taking a walk with a friend to signing up for a class at a senior center or community college. Don’t be afraid to call someone you haven’t spoken to in a while – there’s a good chance that they may also be feeling lonely! And finally, if you’re not already seeing a therapist, consider contacting one. It can help just to talk about it.
NOTES
1. Here’s the blog post I wrote in 2017 on social support, that includes this startling statistic: Social Support – The Survey
2. “How We Learned to be Lonely,” by Arthur C. Brooks, The Atlantic, 1/5/23 (if you can’t access this online, let me know and I can send you a copy of the article from the print edition)
3. “The Pandemic of Loneliness,” article on the California Health Care Foundation website, published 8/2/21
4. “How Loneliness is Damaging Our Health,” by John Leland, New York Times online edition, 4/20/22
5. Vivek Murthy speaking at online international conference on loneliness, sponsored by the UK’s Campaign to End Loneliness (2/8/23)
6. Quote from my second blog post on social support in 2017
Learn MoreA Ladder and a Map: Tools for Emotion Regulation
I recently had the opportunity, due to the pandemic, to attend a virtual version of an annual conference for psychotherapists that is usually held in Washington D.C. One of the webinars I attended, by Deb Dana, LCSW, offered some simple and practical tools to use with clients, based on a not-so-simple to explain theory, the Polyvagal Theory. The first tool is a ladder; the second, a map, or a series of maps.
Polyvagal Theory was developed by Dr Stephen Porges, and even though I’ve read his book and listened to several talks he’s given, I still have trouble clearly explaining it. In a nutshell, it merges evolutionary neurobiology with attachment theory to describe the mechanisms behind a hierarchy of human responses to perceived threats. These responses include one most of us are familiar with, the “Fight or Flight mechanism,” as well as a “Freeze” response. Porges’ theory helps us understand how emotional regulation is a function of interpersonal connection, how trauma disrupts those connections, and most importantly, how people can regain emotional equilibrium after being dysregulated by a threat or trauma.
Before I get to the ladder and the map, a little background. If you studied human anatomy in school, you learned that our autonomic nervous system (ANS) has two branches, the sympathetic (SNS) and the parasympathetic (PNS). The SNS governs movement, doing, while the PNS governs resting, being. The “fight or flight” response is generated by the SNS, while the PNS leads us to “rest and digest.” In a healthy functioning ANS, the two branches work in harmony. The sympathetic branch acts like the accelerator on a car, while the parasympathetic branch acts like the brake. Simple, right?
Here’s where it gets more complicated. The term polyvagal comes from the vagus nerve, which is a large nerve that connects the brain with the major organs of the body – lungs, heart, stomach – as well as the face, eyes and ears. The vagus nerve is like “command central” for the PNS. A key discovery of Porges was that there are two pathways of parasympathetic response, one of which causes the “freeze” response, when a person becomes immobilized in the face of a threat or trauma. The other pathway has an opposite response, leading to social engagement and connection. The immobilization response is a more primitive protective mechanism that all mammals have. The social engagement response is a more evolutionarily advanced mechanism, which only some mammals (dogs, cats, horses, elephants) and all humans have.
These two pathways are called Dorsal Vagal and Ventral Vagal. In the Dorsal Vagal response, the organism moves to shut down, in an attempt to save itself (think of how a mouse might feign death to escape from a cat, who loses interest when it stops moving). A person in this state may feel numb, disconnected, lost, abandoned, invisible, hopeless, and despairing. The Ventral Vagal response, in contrast, moves the organism to connect to self and others. A person in this state may feel alive, energized, tuned in, resourceful, flexible, and hopeful. Can you recall experiencing either, or both of these states?
The ladder is a visual representation of the range of responses to a perceived threat, from immobilization (Dorsal Vagal) at the bottom, to social engagement (Ventral Vagal) at the top, with the sympathetic responses that mobilize us (Fight or Flight) in the middle. The ladder is a tool that allows you to locate where your own response lies, to identify how dysregulated you are, and to see that it’s possible to climb out of immobilization into mobilization, and from there into engagement and connection. Most likely, you will need help to do this.
Polyvagal Theory recognizes that all of these responses are adaptive survival mechanisms that often operate below the level of conscious awareness. We don’t choose to fight, flee, or freeze, so there’s no reason to get down on ourselves when we do. The good news is that once we can come to understand what’s happening, we can learn how to move out of that automatic reaction into a more regulated state.
Connectedness is actually a biological imperative. People are inherently social beings, and our nature is to interact and form relationships with others. And it is within those interpersonal relationships that we learn to regulate our emotions. Think about how a baby cries when it is hungry, tired, or has a soiled diaper, and how its mother-caregiver offers comfort through a soothing voice, facial expression, and physical touch. These are instinctive responses that bring mother and child into “co-regulation” of their physical and emotional states, an equilibrium. As adults, we still want and need to experience co-regulation with others. When we do, we feel safe, at ease, relaxed, content. We can face challenges and function effectively in the world.
Trauma and other threats to our safety and well-being disrupt this natural drive to connect, and interfere with an individual’s ability to seek and experience co-regulation. The fight or flight responses, and especially the Dorsal Vagal collapse, are coping mechanisms designed to keep us alive, but they aren’t intended to be long-term modes of functioning. And they block us from establishing the connections we need to co-regulate and regain emotional equilibrium. The dilemma is, how can we engage and connect with others when we don’t feel safe?
This is where the map comes in. In Deb Dana’s process, therapist and client co-create a map or series of maps to first name and describe where the person may be on the ladder, and then identify the steps that will move them toward connection and social engagement. For example, if they are immobilized in a Dorsal Vagal collapse, the first steps may include establishing a sense of safety by doing grounding exercises, and to offer themselves some kind words of comfort and soothing gestures. The maps include both things the person can do on their own, and things they can do that involve others, for example, text a friend, accept a hug, or go for a walk in a park where there are other people around.
If you would like to learn more about the Polyvagal Theory, there are many YouTube videos with Stephen Porges, and a TED talk by his son Seth Porges. To learn more about Deb Dana’s approach to restoring emotional equilibrium, I recommend her new book, and podcast, “Befriending Your Nervous System.” And if you would like to work directly with a therapist to learn how you can use the ladder and maps for yourself, please contact me!
Learn More