Chapter 1
Loneliness: is it a problem?
This book is about loneliness, and why it is a social problem, that is, why it is not merely an individual, psychological, or medical problem. Before answering those questions, we must be clear about what loneliness is, so that we know exactly what we mean when we use the word, and more importantly, we will not confuse it with other words. This remains necessary and useful particularly because loneliness is a word used in the daily language and it is an emotion that most people are familiar with â our ânaturalâ language is rich and vivid but not always accurate. Everyone with proper vision knows what the word âsunlightâ means, but not so many know how sunlight differs from other lights and what it does to our body. People who have felt lonely many times might not take their feelings seriously; if they see loneliness as a ânormalâ part of their life, they would not pay much attention to the medical implications that loneliness has for their physical and mental health. But if we accept loneliness as a normal feature of life, there would be no need for scientific research on loneliness. Something that happens to us constantly and regularly should not mean that we should accept it as normal. The rapidly growing academic publications have demonstrated serious consequences that loneliness could bring to us, and I shall present a selection of key scientific findings as a way to show how it poses serious threats to our health. In addition, I shall also present some statistics about loneliness so that we can have a good idea of how serious the problem is in terms of its prevalence. All this evidence, however, may still be insufficient to a small number of people for treating loneliness as a problem. In fact, some religious scholars, philosophers, and psychiatrists see loneliness as an opportunity to grow spiritually because, as they argue, it urges us to examine our inner self and reveals our relationship with the external world and the divine entity. The meaning of such âspiritualâ or âexistentialâ loneliness is different from that used in daily life and in the scientific literature. Like many other concepts in life and social science research, loneliness has not one but multiple meanings.
What is loneliness?
It should be safe to assume that loneliness, like many other emotions such as joy or sadness, is universal among human beings. In other words, the percentage of people who have never felt lonely should be very low, although it is expected to vary greatly across different groups of people and from one time point to another. We shall learn more about these later in this chapter and the rest of the book. In this section, our aim is to explore and define the meaning and nature of loneliness: if it is so commonly experienced, then people should know what they mean when they say âI am lonelyâ even though they may not be able to provide a clear definition. Here are some of the âcommon elementsâ of the meaning of loneliness in daily languages: it is unpleasant to feel lonely, you are alone when you do not want to be, you cannot be with the person you love or want to be with anymore, you feel something separating yourself and others apart, or others around you do not accept you as one of them. The Oxford English Dictionary (hereafter OED) defines loneliness, when used for describing a human being rather than a place, as âWant of society or company; the condition of being alone or solitaryâ and âThe feeling of being alone; the sense of solitude; dejection arising from want of companionship or society.â According to this definition, you are lonely when you are socially alone; it does not matter whether you are physically alone; you are lonely when you feel sad about not being part of companionship or society. When we are lonely, we are clearly aware that we are alone, but we do not like such aloneness because the society or company we want is missing; therefore, a sad emotion of dejection arises in us, which we call âloneliness.â In academic circles, the most widely cited definition of loneliness was produced by Daniel Perlman and Letitia Anne Peplau in 1981: âloneliness is the unpleasant experience that occurs when a personâs network of social relations is deficient in some important way, either quantitatively or qualitativelyâ.1 For convenience, we shall refer to this as the PP definition of loneliness.
There are two important, albeit subtle, differences between these two definitions (OED and PP). The first relates to the difference between aloneness and loneliness: by defining loneliness as âthe conditionâ or âthe feelingâ of being alone, the OED definition runs the risk of confusing loneliness with aloneness. Researchers of loneliness have long urged people not to confuse loneliness with aloneness â the former is an emotion and therefore subjective, while the latter is a physical situation and therefore objective. More importantly, although it may have become common sense now, it is still worth pointing out that aloneness may or may not cause loneliness. People can be alone but not lonely, particularly when they choose to be alone. Conversely, people may feel lonely while they are not alone, such as being surrounded by a large crowd that they cannot relate to or feel close to. What remains not much common sense is the following question: if aloneness and loneliness do not have any certain corresponding relationship, when will aloneness lead to loneliness? Put differently, if aloneness by itself does not necessarily make people lonely, what other factors must there be so that the feeling of loneliness will arise? We shall examine these complex situations in the following chapters.
Furthermore, although aloneness and solitude have been used interchangeably in many situations, as in the OED definition, to be conceptually clear, in this book I shall define âsolitudeâ as chosen, voluntary, or preferred aloneness. But if solitude is the desirable state of aloneness while loneliness is the painful state, then what does it take to achieve solitude or transform loneliness to solitude? Throughout human history, a number of philosophers and religious scholars have reflected on this practically important question, and in the later chapters we shall learn their advice in connection with the recommendations that researchers of medicine and health have offered.
The second subtle difference between the two definitions is that while they share the same idea of tracing the source of loneliness to the absence of desired social relations (companions or communities), the PP definition covers a relatively broader set of situations (deficient social relations), which include not merely the absence of desired social relations but also the presence of undesired (deficient) ones. In this sense, besides describing what loneliness is, both the OED and the PP definitions are actually theories of loneliness as well; that is, they explain why loneliness occurs. However, the explanation is implicit, and it implies a key cognitive mechanism: deficient social relations do not directly lead to loneliness; the perception and the interpretation of such deficiency are the intermediary mechanisms that connect deficient social relations and loneliness. Therefore, this explanation is consisted of three steps in a logical sequence: certain social relations (objective state) Ă perception and evaluation of these social relations as being deficient or unsatisfactory (cognitive state) Ă loneliness as emotional reaction to the perceived deficiency of social relations (emotional state). In reality, few would pay much attention to these mental processes, let alone reflecting on them carefully, because these processes usually occur at a very high speed in peopleâs minds. One reason that loneliness is a serious social problem is because these mental states and processes involve social relations and interpretations of social relations; obviously, social relations and their interpretations are social phenomena beyond individual control, even though it is down to the individual to interpret and evaluate their social relations. The reader will find further elaborations on this point in the next chapter.
Breaking the loneliness experience into the above three steps helps us to better understand why loneliness is both universal and specific. Loneliness is universal because social relations are everywhere and always changing in human life. Loneliness is specific because there are a large number of types of social relations, and the interpretations of social relations will change from one person to another and from one time point to the next. For loneliness as a negative emotion to arise, it requires both the objective existence of social relations and the subjective interpretations and evaluations. The large number of sources and representations of loneliness make it a complicated phenomenon to study despite the fact that most people have encountered it at some point in their life. As human life starts and ends with social relations, and as these social relations are bound to change, the probability of finding a desired social relation missing or being involved in an undesirable social relation must be very high, which is why loneliness is a universal emotion â parents cannot stay with their babies all the time, children leave their families for schools, young people start new jobs, adults marry and divorce, older people retire and die, people move from one place to another for a variety of reasons, new members join or leave a family, an organization, or an informal group, for a variety of reasons. As long as human beings live in social relations and social relations sooner or later terminate, there is no way to escape from loneliness.
While social relations keep coming and going, the minds of those involved are busy responding to these changes, consciously or otherwise. It is reasonable to expect at least some of them to become lonely because, as Cacioppo and Patrick claimed, âOur brains and bodies are designed to function in aggregates, not in isolation. That is the essence of an obligatorily gregarious species.â2 It is thus safe to assume that human evolution has programmed our minds so that they would react negatively when we perceive social relations that we value missing or disappearing. The study of loneliness therefore leads us to some fundamental issues about human nature and social life in general: What do we mean when we say human beings are âsocial animalsâ? How do social relations affect who we are? How do social relations change across time points, places, groups and societies? Are members of a society all obliged to help those who feel lonely? These are difficult sociological and philosophical questions.
The case for loneliness as a problem
By definition, loneliness must be a problem â it is an unpleasant emotion, and it usually comes with other unpleasant emotions, such as sadness, emptiness, desperation, grief, anxiety, hopelessness, and depression. It is thus difficult to imagine that the emotional reaction to the perceived lack of desirable social relations could be positive, although we shall see in the next section some people do think so. In this section we focus on the reasons why loneliness is a problem, that is, an undesirable experience.
So the first reason for loneliness as a problem is obvious: by itself it is a painful psychological experience. Few have expressed the pain of loneliness more powerfully than Bertrand Russell in âTo Edithâ (his fourth wife, Edith Finch), the opening poem of his Autobiography:3
Through the long years
I sought peace,
I found ecstasy, I found anguish,
I found madness,
I found loneliness,
I found the solitary pain
that gnaws the heart,
But peace I did not find.
Now, old & near my end,
I have known you,
And, knowing you,
I have found both ecstasy & peace,
I know rest,
After so many lonely years,
I know what life & love may be.
Now, if I sleep,
I shall sleep fulfilled.
Not only he suffered from loneliness, but also in his eyes the whole world is full of âloneliness, poverty, and painâ which âmake a mockery of what human life should beâ.4 What loneliness does to the mind is what hunger and cancer do to the body. The most effective, if not the only, antidote to loneliness, as many have believed, is love. But as Russell lamented, love is so rare and elusive, which is why love is so precious and loneliness so persistent. If love is the most powerful antidote to loneliness, the elusiveness, the rarity, and the temporality of love are the sources of loneliness.
A less obvious reason for loneliness as a problem is that it is much more than a psychological pain â as demonstrated below, loneliness could lead to a variety of harms to our mind and body. The causal chain between loneliness and these harms remains long and uncertain, however, which is why these harms usually escape ordinary peopleâs attention. Although the effects of loneliness, isolation, or deprivation of intimate social relations on physical as well as mental health did not escape the attention of medical scholars, it was mostly since the end of the Second World War that medical researchers could have the peace and the resources for studying such effects rigorously. To make a case as strong as he could, Dr James Lynch compiled a large amount of evidence for âThe Medical Consequences of Lonelinessâ in two volumes, published in 1977 and 2000, respectively.5 In Russellâs poem, he was simply employing a metaphor when he was describing how âthe solitary painâ of loneliness gnawed his heart. According to Lynch, it was much more serious than that: loneliness âcan break the human heartâ, literally, because âthere is a biological basis for our need to form loving human relationshipsâ.6
For the sake of clarity, I must point out that Dr Lynch used the word âlonelinessâ in a rather relaxed manner. He did not draw on any direct and reliable measures of loneliness; rather, he used other indicators that he believed to be associated with loneliness, such as divorce, loss of loved ones, rejection, and so on, assuming that these experiences necessarily bring about loneliness. As I shall show in a subsequent section, carefully designed and rigorously tested measures of loneliness were not produced until the end of the 1970s, so it is understandable that Lynch did not make use of these scales in his first book, which is published in 1977. It is however puzzling that he did not use these scales and some of the large-scale sample surveys that included questions on loneliness in his second...