Beating the Loneliness Epidemic- straight from the US Surgeon General
Updated: Jun 7
Together: Why Social Connection Holds the Key to Better Health, Higher Performance, and Greater Happiness
Vivek Murthy, 2020
Loneliness isn't exactly the first thing that comes to mind when you think of global health issues, but this silent epidemic has exploded during the socially distant Covid-19 era, and thrown a huge monkey wrench into human mental and physical health issues. In the United States, which prides itself as an individualistic culture, loneliness has become the disease people don't want to talk about because it makes them seem weak.
What is loneliness? In a world with billions of human beings running around, is it even possible to feel alone? Absolutely. Loneliness isn't the lack of people to hang around with. It's the lack of meaningful social connection with those who are all around you. It's not being comfortable looking at someone in the eye, smiling, waving, or asking for their name. It's feeling the weight of the world on your shoulders and not being able to reach out for help. It's being cut off from friendship, conversation, and sharing interests with others that make the social emotional side of our beings alive and whole.
In the movie, Cast Away, Tom Hanks masterfully plays a man going through madness as he's left on an island all alone. His only relationship is with a volleyball that he calls Wilson talking to it daily, and finally deciding to embark on a suicidal ocean voyage rather than fae another day of loneliness. Imagine for just a minute how you would feel if stranded far away from all other human beings- unable to communicate in any way- and how lonely and painful that might feel. For many of us, the opportunities to reach out are everywhere, but we don't take advantage of them. Many of us prefer to stay safe and alone, making our pet dog or cat the closest relationship in our lives.
Vivek Murthy was the US Surgeon General under Barack Obama, and has recently been appointed to the same post by Joe Biden. This is his first book and I find it curious that of all the health-related topics he could have chosen, he chose loneliness. I have previously written here about Johann Hari's book, Lost Connections, and Robert Putnam's book, Bowling Alone, both of which cover the same territory. Many of our health problems- anxiety, depression, drug abuse, heart disease and even cancer- can be traced to the lack of meaningful connections in people's lives.
Humans are a social animal, able to build the most complex community structures, and our unique abilities to communicate, share emotions, and create meaning have been our secret sauce in building giant economies and nation-states. We are wired to connect to each other, and when we're separated from that connection, we feel real, physical pain.
The saddest reality is that loneliness is a vicious cycle. When we are rejected by others, we feel real, intense pain. This pain causes us to look at others not as potential friends, lovers, or colleagues, but as potential threats and sources of even more pain. People coming off of a toxic relationship take a long time to be able to trust others again, if they ever can. In the meantime they question their own likeability, and whether they deserved receiving the pain in some twisted way. Being rejected causes a stress response, making one hyper-vigilant against future possible rejections. It's a trap that can be hard to escape from.
The book tries to answer the question of why things seem to be so bad now. What changed in the past generation to make us so disconnected? Murthy points a finger at the usual suspects- the internet, less interaction on the job, and a much faster pace of change that keeps us from staying with the same people too long. He added one other cause that I hadn't thought of before- the fact that many of our connections today are front-loaded with information from dating sites, the internet, and the flood of information out there. The very act of learning about people slowly, while you're interacting with them, is what creates real connection. Front-loaded data makes you think you know that person more than you actually do, and robs you of the chance to learn deeply what makes that person tick.
Murthy describes a theory of three bowls of human interactions. In the first bowl, the widest, everybody needs plenty of space and attempts to operate as rugged individuals who need little to no help from anyone else. The second bowl is a collectivist culture that is very, very narrow, where the well-being of the group is paramount and everything is interconnected. The third bowl of culture, which Murthy prefers, is in the middle of the wide and narrow ones- enough space for people to feel unique, but enough connectivity so that no one feels ashamed or embarrassed about reaching out for help. This is the happy medium that seems so elusive in so many parts of life.
The book looks at the works of Robin Dunbar, who divided our circles of connection into three groups. Our intimate connections are the ones we spend the most time with, and sometimes they're rewarding but often they aren't. Then there's the relational circle, which includes about 150 people of co-workers, extended family, and neighbors- people who you would say hello to on the street and spend small amounts of time with. Then there's the collective circle, that includes anybody else you might know by sight, but not much else, including people like your mailman, folks at church, very extended family members, and people we interact with on a very limited basis. I would add a fourth circle- celebrities and virtual people who we interact with online only, but never meet in reality and get next to no connection value from.
Probably the best and most inspirational part of this book is its stories. Murthy tells stories about people who've gone out of their way to create connection for themselves and their communities. For instance-
- A Jewish young man who kept inviting a KKK member to dinner and gradually won him over with simple gestures.
- A young woman who had a large table set up in her back yard and invited hundreds of random neighbors from the Nextdoor App to come and share meals there. Many accepted the offer, and the gatherings grew.
- A family of a bullied, disabled, young girl who died, that set up a non-profit, Beyond Differences, that has grown into a national organization with the mission to Inspire students at all middle schools nationwide to end social isolation and create a culture of belonging for everyone.
- The amazing men's shed project, a non-profit that has spread worldwide with the goal of connecting lonely, retired men with building projects to make them feel connected and useful again.
- The community gardening movement that gives lonely people a plot of land and fellow gardeners to socialize with while growing healthy food and beautiful flowers.
- A lonely college student who started up conversation groups called Space Gatherings, where no cell phones were allowed and honest conversation was encouraged.
- A delicatessen called Zingerman's that purposely created an employee oriented workplace where communication is key.
Together looks in depth into schools, the workplace, and families to examine why these structures that should offer connection often make things worse. Co-workers and classmates used to be the main source of connection for many, and now they are seen as potential threats to be neutralized. The book looks at political polarization, where the different camps ascribe evil motives to their opposition, and not just good-faith disagreements.
This is the third book I've read and reviewed on the loneliness epidemic this year and it's clear that there are very real repercussions for not taking it seriously. Loneliness and lack of meaningful connections cause serious health and mental health problems, but few political or thought leaders seem to want to address it. The Covid epidemic has made the problem even worse by shutting down so many venues where people were able to gather, and making us afraid of even being in the same room with each other. It will take a concerted effort to counter this disconnection, and the stories from Together provide some welcome examples.
Murthy closes the book with this letter from a parent to a child.
"The greatest gifts you'll ever receive will come through relationships. The most meaningful connections may last for a few moments or for a lifetime, but each will be a reminder that we were meant to be a part of one another's lives, to lit one and another up, to reach heights together greater than any of us could reach on our own.
"Our hope is that you will always have friends in your lives who love and remind you of your innate beauty, strength, and compassion. Equally as important, we hope you will do the same for others.
"You are precious precisely because you have the ability to give and receive love. That is your magic. And it is our mission as parents to make sure you know that no one can ever take that away from you."
To combat the pain of rejection, we need to fool our brains into getting back out into the world again. We need to find causes to work with others on, so that the focus isn't totally on us, but instead on the shared project. It's in those micro-moments, working on shared causes, we can get to know people with their guard let down, and make some real connections. We can't just go out on Facebook and ask everybody to be our friend. We need to create intentional events and projects that allow connections to return organically, so that we can all thrive and feel loved and appreciated again.