By Randall C. Flanery, Ph.D

Loneliness and social isolation has become an urgent public health concern. The Surgeon General of the United States Vibek H. Murthy, in 2023, issued an advisory titled “Our Epidemic of Loneliness and Isolation.” In the advisory he noted that half of Americans today report feeling lonely, with teens and young adults experiencing the highest rates. The prevalence of loneliness has been growing steadily since the 1960’s, without any sign that it is abating. He summarizes the physical, psychological, and societal harm that disconnection has caused our citizens.

Loneliness and social isolation are inter-related but not synonymous. Loneliness is a subjective description that an individual’s fundamental need for belonging, authentic closeness, emotional intimacy, and support, both tangible and intangible, during adversity, are not being met.

That sense of belonging is derived from the broad range of relationships that humans have, from the casual encounters with the barista at your coffee shop to the highest form of friendship to be found within our families and those most virtuous of friends. Our engagement with others for a common purpose is a part of the constellation of interactions that buffer us from feeling all alone in the universe. It is wishing our neighbors well as we leave for work, engaging in worship together at Sunday mass, greeting our co-workers as we begin the workday. It is shared recreational activities like bowling in a league, playing an informal game of bocce, belonging to a book club, attending a sporting event, volunteering to address a social need of those less fortunate, participating in a service organization, social advocacy, public service, even political activity.

It is having a range of friendships ranging from the superficial to the highest order of the very best of friends. Aristotle’s categorization of the hierarchy of friendships remains useful to this day. Our human needs require relationships that range from the transactional, i.e. those based on utility, an exchange of goods for mutual benefit; to those based on mutual enjoyment, the happiness of being in each other’s company; and ultimately in those most valued and few friendships based on virtue. The antidote for loneliness is to have several friends for whom we want the very best, who are “our second self.” When confronted with adversity, these are the ones we go to share our woe, obtain guidance and encouragement, those with whom we can describe our misery without fear of the consequences.

Social isolation on the other hand is measured objectively by noting how many individuals a person confides in, who an individual talks to regularly or what social activities someone participates in. Americans are less engaged than ever before with members of their families and in the larger community. Public health scholars Viji Diane Kannan and Peter J. Veazie have documented the dramatic decline in social engagement from 2003 to 2020 (https://doi.org/10.1016/j.ssmph.2022.101331). Time spent with friends has decreased from an hour a day to 20 minutes, time alone has grown from 142 hours a month to 154 hours. For young people (15-24 years of age), time spent in person with others has decreased from 150 minutes a day to 40 minutes.

These results are highly consistent. Over 150 studies involving hundreds of thousands of individuals have found the same trends of isolation over the last 60 years. Many factors have been hypothesized to explain the reduction in social connection, and are much debated: more people living alone, social mobility, smaller families, urban sprawl, technology, changes in societal norms, public policies with the unintended consequence of promoting separation, the consequences of demographic trends, and the broad deterioration of morality.

Humans vary greatly in how many relationships they need for closeness, emotional intimacy and support; not having enough of them can have strikingly negative consequences for physical health, psychological functioning, resilience in the face of adversity, and spiritual well-being

Social isolation, loneliness, and poor support is associated with 30% or more increased risk of developing a host of medical conditions: cardiovascular disease, hypertension, diabetes, vulnerability to infectious diseases, and developing dementia compared to those who have substantial connections to others. Connection also reduces the severity of symptoms of these conditions and shortens the time for recovery. Taken together the likelihood of dying from all causes over a 10-year period are doubled among the lonely. In other words, public health investment in promoting social engagement, developing wider and more frequent personal relationships, may have as much health benefit as new biological interventions.

Social isolation also has broad negative effects on psychological functioning. Anxiety and depressive disorders, suicidality and self-harm are substantially higher among those lacking adequate social connection. Having an extended social network and several people to confide in promotes recovery from the effects of adversity such as trauma, the loss of loved one, or job loss. Having an extended social network reduces the severity of the physical and emotional consequences of adversity and shortens how long the negative effects last.

Antecedents of Loneliness

Significant life events can precipitate an acute sense of loneliness. Experiences of loss can come in a variety of ways: bereavement, disruption of relationships, marital separation or divorce, job loss, or personal injury or illness.

Life events that precipitate loneliness are also antecedents of depression. While loneliness and depression share many characteristics, they are not synonymous. Loneliness is an internal emotional state that can result in depression. Almost half of the US population is lonely; far fewer are depressed. It is possible to be depressed and have numerous satisfying relationships. The distinguishing element is that loneliness can itself increase stress, anxiety, and paradoxically anger towards others. In loneliness, persons turn predominantly inward, focused on their own woes and imagining that others are a threat to themselves. While craving the company of others, they also perceive the approach of others to be a danger to themselves. In other words, the very thing they most need is seen as a danger. Sadness, absence of pleasure, and a pessimistic world view are common; however, feeling personally threatened by others makes loneliness especially damaging.

The misery of loneliness can become so severe that any method of escape can be hard to resist. The world offers many temptations that promise to alleviate pain. These temptations provide immediate sensory pleasure, such as using substances of all sorts or engaging in behaviors whose pleasures are short-lived. One can abandon oneself to illicit sexuality, inordinate attachment to objects, or escaping the responsibilities of one’s station in life. At best they provide temporary relief, only to make life worse and lonelier afterwards. The pleasures are limited and the consequences may be irreversible.

Suicide is the Penultimate Form of Self-Destruction

The loneliness and inevitable failure of worldly methods of consolation can result in increasingly desperate self-destructive urges, especially violence towards oneself.. At such times, longer term consequences are of no concern; with death it will be gone anyway.

When in the midst of an episode of desolation, the sufferer is likely to have thoughts such as “no one cares, no one understands (including God),” life is without meaning, there is no purpose to what I do, and perhaps the most self-destructive thought of all, “what is wrong with me that I am like this?” These are profound existential questions for all humans and especially for Christians. It is an immediate antecedent to believing oneself to be rejected, and to reciprocate the slight by rejecting others, and the world itself, by causing one’s death. God is perceived as one of the rejectors. In such a state of desolation, any promise of surcease of misery is reasonable and welcome.

Loneliness Is Also a Community Concern

When contemplating loneliness, it is easy to assume it is essentially an individual problem; the personal consequences are obvious, as is the solution, namely, to go get some friends. In truth, it is just as much a community malady. A healthy society has dense social networks; families have relationships that extend across generations, and beyond just their family. Their social activities involve relationships that connect in multiple directions and whose friendships are virtuous. A healthy society has a dynamic balance of individual autonomy and an obligation to others who you do not know and, in justice, you must give them their due. If we as Christians are obliged to tend to the sick, visit the prisons, care for the poor, are we not also obliged to befriend the lonely?

Isolation and the Spiritual Life

I have had the opportunity to work professionally with people who were deeply committed to their faith and had incorporated into their lives daily prayer, spiritual reading, meditation on the mysteries of Christian faith, and fully participated in Sunday mass as well as other devotions. They were male and female, lay people and religious, members of religious orders and dioceses, even those of other faith traditions.

Unfortunately, a strong commitment to spiritual practices does not inoculate one from adversity, loss, human frailties, and our biological vulnerabilities which can result in depression, anxiety, OCD, and the consequences of PTSD. Many of these souls were lonely and spiritually desolate. The paths from spiritual vigor to desolation were varied and the interplay of natural and supernatural factors could be intricate, making it impossible to determine what caused what. The most consistent fact was that by the time they consented to getting professional help their spiritual lives were in disarray, no longer a consolation. They largely carried out their duties both practical and religious. The casual observer might not notice any slackening of conscientiousness. A noteworthy characteristic was how solitary their existence was, even when surrounded by people.

I am not attributing a decline in one’s spiritual life as a cause of loneliness or depression. Social isolation which fosters loneliness, I believe, is more of a reflection of a society that has strayed from our obligations to others, based on Christ’s example. An aggressive defense of personal rights and autonomy at the expense of an acknowledgment of the common good can result in estrangement and isolation. Loneliness and depression, however it develops, can damage one’s spiritual life. Ironically, returning to the fundamentals of our Faith can also be a remedy.

What Is To Be Done?

How might one go about combating the loneliness that can occur in modern life? Contemporary psychological science offers tools that can help. If the despair of loneliness has impaired the ability to fulfill one’s responsibilities in life, and especially if they are contemplating suicide, it is time to seek professional help.

For those who have not yet reached that point, the best help that I have found is The Catholic Guide to Loneliness by the late Kevin Vost, Psy. D, who was both a clinical psychologist and a scholar of Thomas Aquinas. He integrates the long tradition of Catholic teaching with the best that social science can offer and that will not contradict the catechism. In his book, he proposes five approaches that will help the lonely Catholic to understand what he is experiencing, learn to endure the isolation, and eventually with the help of God, overcome the desolation. I have summarized those approaches below. He outlines more detailed action plans after each chapter in his book.

1. The Catholic Church teaches us to discern the truth of the natural world as well as the supernatural Truths that we know by revelation. On the natural level, the most effective initial approach is to use the tools of psychological science to challenge the maladaptive social cognitions, false beliefs about oneself, others, and the world in general, that can evolve out of chronic loneliness. This includes erroneous beliefs about our relationship to God, what we are like in His eyes, and to discern what purpose he has assigned to us.
2. Cultivate Catholic virtues. Cultivating the moral virtues of temperance, of fortitude, justice, and prudence along with the theological virtues of faith, hope, and charity will prepare us to reach out to connect with God, and then to our neighbors, family, friends, even the down-trodden. It cannot but reduce our own loneliness, and theirs.
3. Embrace solitude. For all our human need for connection, we also need solitude. At times, we need to take ourselves away from the constant press of distractions and attractions, tasks, list of things yet to be done, reminders of our duties in life. Silence is an excellent way to be reacquainted with what it means to be human, to re-establish ourselves as a physical body that exists at a particular time and place, and to contemplate fundamental questions like the status of our relationship with God, to remember His love for us especially when we do not experience it with others, to hear what God is trying to tell us, which in the bustle of daily lives we have probably neglected.
4. Cultivate a spiritual friendship with Christ, the model of which we could generalize for our fellow human beings. Connecting to others is hard work. It takes seven minutes of talking before you can determine if the conversation is likely to be interesting. In other words, it takes intention, time, patience, and thought to launch an interesting conversation. Friendship with Christ incorporates all of the elements required for a friendship based on virtue. It becomes the template that we should have with others. One must deliberately put himself in the presence of the other, with humans to be physically in the same space, looking directly at the person, having put aside all distractions.
   
   Fortunately, we have several examples to work from. We can read deeply the writings of Sts. Aelred of Rievaulx and Thomas Aquinas on spiritual friendship with Christ. The Spiritual Exercises of St. Ignatius of Loyola are another source for guidance, not to mention an aid to embracing solitude.
5. Unite our suffering with Christ’s loneliness in the Garden of Gethsemane. Some theologians have argued that Christ’s greatest agony on the Cross was loneliness. The relevant passages from the Gospels and religious treatises such as the final writings of St. Thomas More when abandoned in the Tower of London can be an encouragement if we can unite our modest sufferings with those of Christ.

It is an ironic and exceedingly delightful discovery that an earnest pursuit of our faith can be an effective remedy for the modern malady of loneliness.

IMAGES: From Nighthawks (cropped), Edward Hopper (1882–1967).