LONELINESS



 CHAPTER 2

LONELINESS

Relationship Muscle Weakness


Our world is shrinking. Social media platforms allow us to stay in touch with dozens if not hundreds of friends at once, dating websites offer us lavish smorgasbords of potential mates we can peruse from the comfort of our homes, and a simple click of a computer key allows us to forge new connections with strangers from across the globe who share our interests and passions. Yet, despite this era of unprecedented global human connection, more people than ever are suffering from severe loneliness.


The 2010 U.S. Census found that 27 percent of households in America are single-person households, now outnumbering all other groups (such as one-or two-parent households with children). Of course, not everyone who lives alone is lonely and not everyone who is lonely lives alone. Many of us suffer from loneliness despite living with a spouse or being in a committed relationship. In fact, cohabitating with someone with whom we share a physical proximity but little else often highlights the immense emotional distance and profound disconnection we feel, leading to powerful feelings of isolation.


What determines our loneliness is not the quantity of our relationships but rather their subjective quality, the extent to which we perceive ourselves to be socially or emotionally isolated. Indeed, many of us have address books full of casual acquaintances yet still ache from a lack of deep friendships. Some of us have a tight network of supportive friends yet feel the acute absence of a romantic partner. We might spend our days surrounded by work colleagues yet feel removed and isolated from all of them. We might be blessed with strong familial relationships but find ourselves geographically distant from those who care for us most. Those of us who are fortunate enough to grow into old age with our health and faculties intact might experience a rising tide of loneliness as we witness friends and partners succumb to illness and die one after the other.

What Loneliness and Cigarette Smoking Have in Common

Having meaningful relationships is essential for leading a happy and self-fulfilled life, but chronic loneliness can damage us in ways that go far beyond limiting our basic happiness. In addition to the emotional pain and longing loneliness causes, it is also associated with clinical depression, suicidal thoughts and behaviors, hostility, and sleep disturbances.


More important, loneliness has an alarming effect on our general health. It alters the functioning of our cardiovascular systems (leading to high blood pressure, increased body mass index, and higher cholesterol), our endocrine systems (increasing stress hormones), and even our immune systems. As an illustration of how directly loneliness impacts our physical health, one study found that in otherwise healthy college students, lonely students had a significantly poorer response to flu shots than nonlonely students did. Loneliness also causes a decline in our mental abilities, including poor decision making, decreased attention and concentration, impaired judgment, and a more rapid progression of Alzheimer’s disease.


Shocking as it may seem, loneliness poses just as large a risk factor for our long-term physical health as cigarette smoking does, as it literally shaves years off our life expectancy. While cigarette packs come with health advisories, few of us are aware of the dangers of inhaling two packs a day of social isolation. As a result, feeling lonely rarely triggers a sense of urgency and we rarely prioritize the need to break free of its clutches and treat our psychological wounds.

Loneliness Is Contagious

Another factor that adds urgency to our need to treat the psychological wounds loneliness inflicts is that recent studies have demonstrated something rather stunning—loneliness is contagious! One study tracked the spread of loneliness within social networks over time and found that loneliness spreads through a clear contagion process: individuals who had contact with lonely people at the start of the study were more likely to become lonely themselves by the end of it. Further, the virulence of the contagion depended on the degree of closeness between the lonely and nonlonely person. The closer nonlonely individuals were to a lonely person the more virulent the effect of the contagion and the lonelier they became later on.


Specifically, scientists found that lonely individuals were continually pushed toward the periphery of their social networks and into positions that were increasingly more isolated. Once people were in close contact with lonely people they became affected and were pushed toward the periphery as well. Alarmingly, this contagion was “transmitted” from one person to another even beyond the immediate circle of the lonely person, such that it spread throughout the entire social network. Such studies help demonstrate both why and how loneliness is at epidemic proportions in today’s society.


Unfortunately, despite its contagiousness and despite the severity of the health risks it poses, loneliness remains one of the most neglected psychological injuries we sustain in daily life. Few of us realize how crucial it is to treat the psychological wounds loneliness inflicts and fewer still know how to do so effectively.

The Psychological Wounds Loneliness Inflicts

Given the severity of the risk loneliness poses to our physical and mental health, we should make every effort to escape its impact as soon as possible. However, two factors are likely to make it challenging for us to do so. First, loneliness causes us to become overly critical about ourselves and those around us, and it makes us judge our existing relationships too negatively, all of which impact our interactions with others. Second, one of the more insidious effects of loneliness is that it leads us to behave in self-defeating ways that diminish the quality and quantity of our social connections even further. As a result, the very fibers that comprise our “relationship muscles”—our social and communication skills, our ability to see things from another person’s perspective, and our ability to empathize and understand how others feel—become weak and are likely to function poorly when we need them most.


To be clear, it is not our fault that we are lonely, nor is it usually a reflection on our social desirability. But regardless of the circumstances that cause it, once loneliness sets in, it triggers a set of psychological reactions that can lead us to inadvertently perpetuate our situation and even to make it worse. Because such dynamics usually operate outside our awareness, the most important tool we can carry with us going forward is an open mind. We might strongly believe we’ve done everything in our power to change our situation and that we’re certainly doing nothing to make matters worse. But by being open to the possibility that our behaviors might be contributing to our predicament, we can be open to discovering ways to change them. Difficult as it is to open our hearts and minds, to challenge our established perspectives, and to take emotional risks, we must be brave enough to do so if we wish to treat our loneliness.

1. Painful Misperceptions: Why We Feel Invisible but Our Loneliness Isn’t

People confide many negative things about themselves to their therapists, but one of the things people rarely have the courage to admit is how lonely they feel. Loneliness carries a stigma of shame and self-blame that operates in all our minds to some extent. Over 40 percent of adults will suffer from loneliness in their lifetime and virtually all of them will think poorly of themselves because of it. Indeed, one of the more significant emotional wounds loneliness creates is that it leads us to develop inaccurate perceptions of ourselves as well as of others and to take too harsh a view of our existing relationships and social interactions.


Lionel, a former World War II officer who received numerous medals for valor, was referred to me for psychotherapy some years ago by his daughter, a social worker who lived out of town and was concerned about her father’s increasing social isolation. Lionel lived alone (his wife had died some years before), and although his daughter called him every day, their conversations were usually quite brief as Lionel believed that “phones are for making appointments, not for idle chitchat!” I quickly learned that Lionel was not a fan of any kind of chitchat, idle or otherwise, something that made our sessions somewhat challenging at first. For example, my efforts to assess the extent of Lionel’s social isolation went something like this.


“Who else do you speak with regularly other than your daughter?”

“Housekeeper. Comes twice a week. Cooks and cleans.”

“Tell me about the conversations you have with her.”

“She tells me what she made. I leave her money on the counter.”

“What about other family members?”

“No relatives other than my daughter.”

“What about friends from the service or even former colleagues, are you in touch with any of them?”

“No.”

“Why do you think that is?”

“Because they’re dead.”


I resisted the urge to sigh and gave Lionel a sympathetic nod. I kept probing and eventually discovered that Lionel did engage in one regular social activity—he belonged to a chess club. Every Tuesday Lionel would put on a jacket and tie and go down to the seniors’ center to play a couple of games. Unfortunately, as far as games go, chess is about as conducive to social interaction as solitaire is, if not less so. True, chess does require two people to play, but any talking during the game is strictly discouraged as it can interfere with the concentration of the other player.


“Do you play with the same people?” I inquired. I was curious about whether any of the regulars tended to meet outside of chess club hours.

“Mostly.”

“Have you ever socialized with any of them?”

“They’re not interested.”

“How do you know?”

“Why would they want to socialize with me? I’m eighty!” I doubted that age was the real issue. The club was for seniors, after all; how much younger could the other players be?

“You’re eighty and they are...?”

“Not interested.”

“Do they socialize with one another?”

“Sometimes.”

“And they’ve never invited you to join them?”

“They’re not interested!”


Lionel was convinced the other, “younger” members of the chess club would rebuff any attempt he made to forge friendships with them, despite the fact that he had no evidence whatsoever that his age or anything about him would cause them to snub him. But he was determined to avoid disappointment and rejection at all costs. He arrived right before game time and left immediately following the last round. He approached no one and spent coffee breaks sitting in a corner reading a book. In other words, he gave the other chess club members no opportunity whatsoever to get to know him.


Lionel had already been suffering from loneliness for some years when we first met and his self-defeating strategies were already well entrenched. However, the damage loneliness inflicts on our perceptions of social situations can happen extremely quickly. For example, scientists found that simply asking college students to recall a time in their life when they felt lonely or socially isolated was sufficient to elicit from them a more negative assessment of their current social support systems as well as to boost their shyness, increase their social anxiety, cause a drop in their mood and self-esteem, and impair their optimism.


Loneliness also causes us to evaluate others more harshly and to perceive our interactions with friends and loved ones more negatively than we would if we were not lonely. Another study videotaped students as they interacted with a friend and then asked them to rate the quality of the interaction and that of the friendship. Lonely individuals rated both their interactions and their friendships far more negatively than nonlonely people did. The participants were then shown the videotapes again one week later. While there was no change in the assessments of nonlonely people, lonely people rated their friendships even more negatively the second time around.


Lionel believed the members of the chess club ignored him and marginalized him because he was essentially invisible to them. However, the tragic irony of loneliness is that while we often feel invisible to others, our loneliness is usually very visible to them indeed. Numerous studies have found that lonely people are easily recognizable to others and that once we’re judged as being lonely we’re likely to be viewed negatively as a result. Lonely people are often seen as less attractive and even less intelligent than nonlonely people (physical attractiveness provides no immunity from loneliness whatsoever; attractive individuals might draw a greater quantity of people initially but the quality of their relationships are no different and they are just as likely to experience loneliness).


The bottom line is that loneliness affects perceptions in numerous ways. It impacts how we perceive ourselves and others, as well as how we perceive the quality of our interactions and our relationships. Loneliness also impacts how others perceive us, making us appear less interesting and less appealing as social prospects. The combination of these factors makes it extremely difficult to shed our cloaks of invisibility and engage in successful efforts to forge new social connections or deepen existing ones.

2. Self-Defeating Prophecies: Why Trying Harder Leads to Failure

Many journeys into loneliness begin during periods of transition and change. College freshmen often feel extremely lonely when they first arrive at college, surrounded by unfamiliar faces, far from home, and removed from the comfort of their friendships. Divorce, separation, and bereavement, especially when they befall us unexpectedly, can leave us entirely unprepared for the palpable loneliness that accompanies such losses. When work and colleagues provide our primary source of social interaction and engagement, losing our job can mean losing our entire social support system when we most need it. Relocations and emigrations are often characterized by extended periods of loneliness as we labor to build new social and support networks from scratch.


In each of these cases, we typically emerge from loneliness once we adjust to our new realities and rebuild our social infrastructures. Most college freshmen eventually make new friends, divorced people typically begin to date within a year following their separation (although it takes longer in cases of bereavement), looking for a new job often requires us to network and to contact people with whom we lost touch, and most of us eventually forge social and intimate connections in our new towns and communities.


Yet, at times, the cold grip of loneliness extends far beyond the normative adjustment period. We become trapped in it, paralyzed by waves of emotional pain, defeated by feelings of worthlessness and hopelessness, and overcome by the devastating emptiness of our profound social and emotional isolation.


Why does this happen? What is it that prevents some of us from breaking free of the bonds of loneliness and getting our lives back on track?


The answer is that in addition to painful misperceptions, loneliness also drives us into cycles of self-protection and avoidance that cause us to create self-fulfilling prophecies and to inadvertently push away the very people we hope to engage.


Serena, a high school teacher I worked with recently, found herself in exactly such a vicious cycle and she too was entirely unaware of it. What brought her to psychotherapy was her “nonexistent dating life.” At first I was at a loss to understand why she had never been in a serious relationship. She was in her midthirties and, furthermore, she was simply stunning. I had no doubt that she received plenty of attention from men. I soon learned that Serena’s appearance had gone through a radical transformation four years earlier, when she lost eighty pounds.


“I was heavy my whole life. Men would look right past me as if I wasn’t even in the room. And trust me,” Serena added with a wistful smile, “I was hard to miss. Now they stare, they smile, they wink, and somehow it still feels the same. Like they’re responding to my appearance, but when it comes to who I am as a person, they’re still looking right past me.”


Serena was desperate to find a husband, but she was equally desperate to avoid getting hurt. While her hesitancy and mistrust were certainly justified after the years of rejection and loneliness she’d experienced, her fears caused her to come across as withdrawn, defensive, and suspicious. As a result, her dates with men were often tense and awkward, and few of the men expressed an interest in seeing her again. Their failure to follow up only confirmed Serena’s suspicions that they were never interested in the “real her” to begin with. The fact that the “real Serena” spent every moment of her dates hiding behind a psychological wall and was never truly present in the first place was something she never considered.


The reason we get trapped in such cycles is that loneliness tips the balance of our social motivations. Once we feel vulnerable and socially disconnected we become intensely self-protective and we seek to minimize any potential negative responses or rejection from others. As a result we approach people with distrust, suspicion, cynicism, and anxiety or we make efforts to avoid them altogether. Because we don’t expect our social interactions to be positive, we make fewer efforts to seek them out and we are less responsive to them when they occur.


Unfortunately, the longer our loneliness lasts, the harder it can become to change our perceptions and behaviors and to break the cycle of self-defeating thoughts and behaviors that perpetuate it. We end up behaving in ways that push away the very people who could alleviate our loneliness and we then view their distance as further evidence of our basic undesirability. As a result we feel like passive victims in a harsh world and fail to realize the extent to which we are active contributors to our own predicament.

3. Atrophied Relationship Muscles: We Use Them or We Lose Them

Alban, a successful sales executive, came to couples therapy with his wife, Blanca, after months of urging on her part. “Blanca accuses me of being married to my job and I guess I am. It’s not that I want to be, but my job demands it. Blanca gets frustrated that I have to work even when I’m home and I totally understand how she feels.” Alban put his arm around his wife and gave her a wink. “I keep telling her it’s natural for the ‘other woman’ to feel jealous.”


Blanca quickly pulled away. “You know I don’t think that’s funny!” Blanca turned to me and said, “He keeps telling people that joke and I hate it.” She turned back to Alban and her eyes welled with tears. “It’s not that you’re away so much that bothers me, it’s that there’s a real disconnect between us when you are home. There’s no affection, no romance, no intimacy. I’m lonely and miserable ... and you don’t care.”


Alban’s eyes also welled up. “Of course I care! And I feel lonely too. But it’s hard to connect when you’re angry all the time. Last week I brought you flowers and a card for Valentine’s Day and all you did was yell at me.”


“Because you never even gave them to me! You were in such a rush to check e-mails from work you just left them on the kitchen counter. I only discovered them two hours later and by then you were already asleep!”


“But I got them for you! You keep telling me it’s the thought that counts, except it doesn’t!”


“You got them for me but you didn’t think to give them to me. Your thought was to leave them on the kitchen counter in the same spot you leave money for the cleaning lady!”


As their discussion progressed it became evident that leaving the flowers on the kitchen counter was not the only instance of Alban’s good intentions going awry. He clearly cared about Blanca, but something went consistently wrong when it came to translating his feelings into actions. Given how angry Blanca felt and the level of disconnection between them, it had clearly been going wrong for some time.


When we lack meaningful and deep connections with others or when we fail to invest in the relationships we have, we stop exercising the skill sets required to maintain such relationships. Our “relationship muscles” function in much the same way regular muscles do. When we fail to use relationship muscles regularly (such as our ability to empathize or see things from the other person’s perspective) or when we use them incorrectly, they atrophy and become less functional.


The problem is we’re often unaware of just how weak our relationship muscles have already become. Alban believed his relationship muscles were functioning properly, but they were not. True, he’d invested thought and effort in getting Blanca flowers and a card, but leaving his gifts on the kitchen counter and forgetting about them undid any positive impact his efforts might have had.


When we try to walk after spending a week in bed with the flu we are often surprised by how our legs buckle under us and leave us in a heap on the floor. While we are quick to realize our muscles have weakened in such situations, we rarely have the same insight when it comes to poorly functioning relationship muscles, no matter how many times we find ourselves in a metaphorical “heap on the floor.” Indeed, rather than concluding that his relationship muscles were faulty, Alban was convinced Blanca was simply being unappreciative.


As another example, when we falter in our first dating efforts after a long dry spell of being alone, we rarely attribute the result to our having rusty dating skills and weak relationship muscles. Instead we take the rejection extremely personally and assume it is merely a reflection of our fundamental undesirability.


Even once we’re aware of the need to strengthen our relationship muscles, we often fail to anticipate how uneven our efforts are likely to be. For example, once I made Serena aware that she might be contributing to her lackluster dating experiences, she was determined to change how she was coming across to her dates. However, her first few efforts were just as unsuccessful, this time because she was trying too hard and appearing too desperate.


While improving our social skills is certainly doable, many who experience loneliness face the far more daunting task of developing relationship muscles we’ve never used before. Serena had no experience with serious dating and Lionel had little to no experience and a very limited tolerance for casual socializing and small talk. Alban, on the other hand, lacked the ability to empathize, to understand Blanca’s needs and feelings well enough to make his efforts meaningful to her. In all of these cases, they needed to learn new skills and find the courage to practice them, despite the emotional risks involved.


Lionel was a good example of someone who regularly overlooked vital information of this sort. I was eventually able to persuade him to approach Stanley, the chess club member whom he enjoyed playing against most, and suggest they grab coffee. We discussed how important it was to precede the actual request with a comment or two about the game, so as not to come across as too abrupt. Lionel came into our next session and immediately informed me that he had taken the plunge and asked Stanley to have coffee with him.


“Great!” I responded. “So he said yes?”

“He declined.”

I tried to hide my disappointment. “I’m sorry to hear that. Did he say why?”


“He didn’t have to. It’s because he’s a sore loser.” Lionel went on to explain that Stanley used to be the best player in the club until Lionel joined and that he’d lost to Lionel regularly ever since. I was dismayed that Lionel had not thought this information important enough to mention earlier. Had he considered things from Stanley’s perspective, he might have realized that winning all his games, refusing to interact with the other members, and reading in the corner during breaks made Lionel appear aloof if not actually disdainful of the others, Stanley most of all.


Understanding a person’s needs and feelings from his or her perspective is vital for creating and sustaining close friendships and emotional intimacy. When these relationship muscles are weak, we overlook crucial information about how the other person thinks and feels and our efforts often fail.

How to Treat the Psychological Wounds Loneliness Inflicts

Many of the circumstances that lead to being lonely are temporary and allow us to recover in a relatively short amount of time. For example, kids usually forge new friendships within hours or days of starting summer camp, and people whose relationships make them feel lonely might actually feel relieved after a separation if they take steps to reconnect with friends and loved ones with whom they had lost touch. Treating the wounds of loneliness becomes much more urgent when we’ve been in its grips for extended durations and when we feel discouraged about being able to change our social and emotional isolation. Let’s open our psychological medicine cabinet and review our treatment options.

General Treatment Guidelines

In addition to the pain and suffering loneliness causes, three other psychological wounds require emotional first aid. First, we must identify and change the misperceptions that lead to self-defeating behaviors. Although we might struggle to see such patterns, if we’ve been lonely for some time, they are definitely there. Second, we need to strengthen and enhance our relationship muscles so that our efforts to forge new connections and deepen existing relationships will be more successful, meaningful, and satisfying. Third, we need to minimize the ongoing emotional distress loneliness causes, especially in cases in which the options for improving existing social connections and creating new ones are limited.


The treatments that follow are listed in the order in which they should be administered. Treatments A (challenging negative perceptions) and B (identifying self-defeating behaviors) are effective primarily for correcting the misperceptions loneliness causes and the self-defeating behaviors that result. Treatments C (taking the other person’s perspective) and D (deepening emotional bonds) will help strengthen relationship muscles crucial for forming new connections or deepening existing ones. Treatment E (creating opportunities for social connection) will help identify new avenues for social engagement; and Treatment F (adopting animals) discusses ways to reduce the emotional suffering loneliness inflicts and is especially suited for people with limited options to expand or improve the quality of their social connections (because of geographic isolation, health or mobility limitations, or other special circumstances).


As with all emotional injuries, it is best to treat the wounds loneliness inflicts as soon as possible. The longer we go without exercising the full range of our relationship muscles, the more they will atrophy and the longer it will take for us to regain their full functionality. Further, rehabilitating muscles of any kind requires repetition, practice, and patience. If we try to rush our recovery we are likely to reinjure ourselves and encounter setbacks and disappointment. And remember, not all forms of loneliness can be remedied by first aid techniques alone. At the end of the chapter, I discuss when it is recommended to consult a mental health professional.

Treatment A: Remove Your Negatively Tinted Glasses

Loneliness makes us constantly on guard, prepared for the disappointment and rejection we are sure will come. As a result, we miss opportunities to make social connections and we behave in ways that push others away. In order to challenge these distorted perceptions and avoid acting in self-defeating ways we need to do three things.

1. Fight the Pessimism!

Loneliness makes our minds generate instant negative thoughts as soon as we contemplate engaging in social interaction. We get invited to a party and vivid scenes of awkwardness, rejection, and disappointment pop into our heads entirely unbidden. We become convinced we won’t know anyone there. We envision ourselves standing alone by the hummus and vegetable dip, feeling conspicuous and embarrassed. The thought of approaching a stranger or, worse, a group of strangers, and initiating a conversation is enough to cause a sense of panic, and we anticipate any such efforts ending disastrously.


Although we are unlikely to prevent pessimistic scenarios from elbowing their way into our thoughts, the best way to fight our fears and pessimism is to purposefully visualize scenarios of success that are both reasonable and realistic. By picturing successful outcomes in our minds we are more likely to recognize such opportunities when they arise and to take advantage of them. For example, we could acknowledge that it is just as likely for people at the party to be friendly, welcoming, and happy to meet and chat with us. Even if we don’t meet new people, it’s just as possible we’d have a perfectly nice time catching up with the one or two folks we do know. We might even end the night by making plans to see them again in the near future.


Lionel had to overcome the belief that none of the other players in the chess club were interested in socializing with him (“Why would they want to socialize with me? I’m eighty!”). Once Stanley turned him down he was extremely reluctant to approach anyone else. The first order of business was to help Lionel see his part in creating the situation.


“You’ve been seeing things too negatively, Lionel,” I explained. “True, they haven’t asked you to hang out but you also haven’t given them any reason to do so. They know nothing about you, nothing about your life, and nothing about your thoughts or feelings.”


“So you also think it’s pointless.” Lionel nodded.


“No, I’m saying the opposite. I’m saying it’s not as bleak as it seems and that you can do something about it. Let them get to know you. Chat a little, exchange pleasantries, kvetch about the weather, or ask about their weekend. Make the effort for a couple of weeks and I assure you they will be far more open to hanging out, even Stanley.”


Lionel was extremely hesitant to initiate conversation with the chess club members, but when I appealed to his military experience and presented the challenge as a mission he had yet to accomplish, he finally agreed. After a few weeks of occasional chatting, he mustered the courage to ask another member to coffee. They met at a diner several weeks later. I told Lionel how impressed I was with his efforts. “I know it was difficult to open up and start chatting but I’m so glad you did. I’m sure it made a difference with other club members as well. Who knows,” I added, “maybe you and Stanley will have coffee one day after all.”


“That’ll never happen,” Lionel said immediately.

“Here’s that negativity again,” I cautioned him.

“It just won’t happen,” Lionel insisted.

“Really?” I demanded. “Why not?”

“Because Stanley’s dead.”


Lionel told me Stanley had died two weeks earlier. His death led to the other members talking more among themselves and getting closer. They decided to attend Stanley’s memorial service later in the month and when they did, Lionel went with them.

2. Give the Benefit of the Doubt!

Another misperception loneliness burdens us with is that we tend to assume the worst about how others feel about us. Toby, a young man who had recently lost his job, was devastated when the holiday season approached and he failed to receive an invitation to his good friend’s annual Christmas party (the friend still worked for the same company). Toby was convinced his friend no longer wanted to be associated with him because he had been fired. Since I knew Toby’s e-mail had recently changed (he had used his work e-mail for personal communications) I suggested he check his spam folder. Lo and behold, there was the invitation, where it had been all along. Toby had spent the better part of two weeks feeling betrayed and mourning the loss of a friendship that was still perfectly intact (although, if he had missed his friend’s party with no explanation, it might not have been intact for long).


Loneliness might make us question how our friends feel about us, but we should always balance our doubts with reminders of our mutual history and the shared experiences that created and sustained the friendship over time. Doing so will help reassure us that our friendships are probably a lot more stable than our loneliness-fueled fears might lead us to believe.


Serena, the high school teacher who had gone from heavy to bombshell, was also quick to judge others and their intentions toward her. She was certain any man who expressed an interest in her did so solely because of her appearance and had no intention of getting to know the “real” her. Although men were unquestionably drawn to her appearance, they definitely cared about her personality. Indeed, it was her closed and guarded behavior that made most of them reluctant to ask her out again.


A couple of years later, at a social event, Serena bumped into one of the men she thought had rejected her. She was extremely surprised when he introduced her to his friends as “Serena, the beauty who dumped me after one date.” Clearly, he had mistaken her guardedness for disinterest. Had Serena given him the benefit of the doubt and expressed interest he would have happily initiated a second date.


Understandable as our fears are when we already feel lonely and leery of rejection, indulging them will only bring about the very thing we seek to avoid. Instead, we must battle the internal tide of skepticism we feel and give the new people in our lives and the ones with whom we have existing relationships the benefit of the doubt.

3. Take Action!

Chronic loneliness causes us to perceive ourselves as passive victims of our harsh circumstances and we feel helpless to change our social, emotional, or intimate isolation. Such feelings, powerful as they might be, are nonetheless founded on perceptions that are too negative and pessimistic. There are always steps we can take to improve our situation. It is important to do so because taking action of any kind will make us feel better about ourselves as well as about our prospects. Lionel had a room full of chess players from which to choose when it came to making new friends, Serena had numerous men clamoring for her attention, and Toby had plenty of people from his former job who were interested in continuing a friendship with him. Yet loneliness made all of them perceive their situation as one in which their options were severely limited.

EXERCISE FOR IDENTIFYING AVENUES FOR SOCIAL CONNECTION

The following writing exercise will help identify potential actions you can take to expand and deepen your social connections and, by doing so, counter feelings of helplessness.

  1. Go through your phone numbers, e-mail addresses, and social media contacts and make a list of people you consider friends or good acquaintances.
  2. For each person, note when you last saw or communicated with him or her and create a master list of people you haven’t been in touch with for a while.
  3. Prioritize your list by ranking all the people on it according to who in the past has made you feel best about being you. Your final ranking represents the order in which you should contact the people on your list. Reach out to at least one or two people a week and, when possible, initiate plans to meet.
  4. Go to websites that list meetings or activities and scroll through their categories. For example, Meetup (meetup.com) is a website that lists meetings for people with mutual interests, hobbies, passions, or careers. Even if you don’t find a specific meet-up that fits your interests, such sites are good places to get ideas for activities or hobbies that might intrigue you.
  5. Identify at least three activities or topics you might want to pursue (e.g., book clubs, adult education classes, hiking or biking groups). Search online for meetings in your area.

Use your lists to recharge your old friendships and to explore venues for creating new ones.

TREATMENT SUMMARY: REMOVE YOUR NEGATIVELY TINTED GLASSES
Dosage: Administer full treatment and repeat as necessary until you’ve revitalized your social or dating life.

Effective for: Correcting painful misperceptions and avoiding self-fulfilling prophecies.

Secondary benefits: Reduces emotional suffering.

Treatment B: Identify Your Self-Defeating Behaviors

Loneliness makes us approach people with caution and suspicion, and our hesitancy usually comes across loud and clear to others, prompting them to retreat from our bad vibe. We then feel crushed and conclude we were right to be suspicious and cautious in the first place. The fact that our own actions created a self-fulfilling prophecy often eludes us entirely. As is often true in life, when we act out of fear we risk inviting the very thing we hope to avoid.


But if our self-defeating judgments and behaviors seem completely justified in our own minds, how are we to identify those that are self-sabotaging?


The truth is that while we’re often blind to our self-defeating behaviors in the moment, we’re much better at identifying them in hindsight. For example, we might feel justified in keeping to ourselves at a social event if the few people we know are already engaged in other conversations. But once our social anxiety has diminished the next day, we would probably recognize that we could have simply joined their conversations or introduced ourselves to at least one or two people we didn’t know.


More important, we tend to repeat the same self-defeating behaviors in a variety of situations, which should make identifying them easier once we’re alerted to their existence. Once we recognize what these tendencies are we can become more mindful of them and catch them in action going forward.


So consider yourself alerted.


While the notion of analyzing our own behavior accurately might seem daunting at first, when I ask patients to reflect on their social encounters and identify their errors, they typically do so quite successfully. Once we accept the basic premise that at least some of our actions are not serving us well, we should be able to start identifying things we’ve said and done that might have had unintended consequences. For example, Serena was quick to recognize that she asked her dates very few questions about themselves and that such omissions probably led her dates to conclude she had little interest in them. In addition, her anxiety was such that she rarely smiled when she was on a date and she was certainly too tense to laugh. Once she realized this, she thought back on her dates with dismay but with insight.


“They must have thought I really wasn’t enjoying their company. Geez, I’m one heck of a lousy date!”


“Lousy!” I agreed, which made Serena laugh. “But whether you continue to be is up to you.”


Serena’s self-sabotaging behaviors are by no means unusual. Other common forms of self-defeating behaviors are finding poor excuses to turn down invitations to social events, skipping spontaneous get-togethers because you’re “unprepared” either emotionally or otherwise, neglecting to convey birthday wishes or other celebratory messages to friends and colleagues, taking friendly ribbings too personally, using defensive body language (e.g., folding your arms over your chest, standing with your hands in your pockets, exaggerated rummaging through your purse, or faking intense interest in nonexistent text messages), responding with curt or monosyllabic sentences or overtalking and hogging the conversation, neglecting to ask others about their lives and opinions, and confessing your faults and insecurities to people you’ve just met.

EXERCISE TO IDENTIFY SELF-DEFEATING BEHAVIORS

Take time to reflect on how you might come across to your friends, colleagues, and loved ones or when you are on a date or any other type of social engagement. Try to identify at least three behaviors (including omissions, such as not conveying interest), even if they seem entirely justified and even if they seem relatively minor, that might be pushing other people away.

  1. My self-defeating behaviors are:
  2. Once you’ve identified what you might be doing incorrectly, be extremely mindful of avoiding such behaviors in the future. Keep your list handy and read it before you attend social engagements. Self-defeating mechanisms can be changed once you’ve identified them correctly but don’t expect to eliminate them all at once. As we will see in the next section, all social skills require practice.
TREATMENT SUMMARY: IDENTIFY BEHAVIORS THAT WORK AGAINST YOU
Dosage: Administer full treatment as soon as possible after unsuccessful social interactions. Make sure to go over your list before attending any forthcoming social interactions so you can be as mindful as possible to minimize self-defeating behaviors.

Effective for: Improving social and romantic interactions, avoiding self-defeating behaviors, and correcting painful misperceptions.

Secondary benefits: Reduces emotional suffering.

Treatment C: Take the Other Person’s Perspective

Relationships of any kind are always about give-and-take. But to “give” successfully we have to be able to “take” the other person’s point of view. Known as perspective-taking, accurately reading another person’s point of view is a vital relationship muscle. It allows us to understand their priorities and their motivations, to anticipate their behavior, and even to predict their reactions. It enhances our ability to negotiate and cooperate successfully, to strategize and problem-solve, to communicate effectively, and to access our compassion, altruism, and empathy.


Loneliness and social isolation weaken our perspective-taking muscles and make us far more likely to commit social gaffes or to come across as inappropriate, too eager, or too detached. The fastest way to rehabilitate this relationship muscle is to identify our perspective-taking blunders and to correct them. The following three errors are the most important to keep in mind, as they represent our most frequent oversights.

1. Failing to Engage Our Perspective-taking Muscles When We Should

As simplistic as it may sound, the reason we usually don’t understand the other person’s perspective is we never tried to in the first place. Perspective taking is a mental exercise, not a mind-reading trick. If we don’t make the effort to think through how other people might see things, how they might react, or how their agenda might be different from our own, we are unlikely to take such considerations into account when interacting with them. One common manifestation of this omission involves our use of humor. When we’re considering whether to tell a joke, we typically give almost exclusive priority to whether we find the joke funny and fail to consider whether it will be funny to others. Alban thought referring to his wife as “the other woman” (relative to his job) was hilarious, while Blanca obviously did not. Had Alban given even a moment’s thought to how she reacted to the joke in the past, her feelings about it would have been immediately obvious to him.

2. We Favor Our Own Point of View

Our own perspective is so apparent to us that we often fail to give the other person’s point of view sufficient weight. For example, scientists studied how people interpret sincere versus sarcastic phone messages (where tone of voice is helpful in detecting sarcasm) and those communicated by e-mail. We are all aware that written messages lack tonal cues that help the recipient understand our intended meaning. Yet time and again we anticipate readers will be able to distinguish between our sincere and sarcastic e-mail messages with the same accuracy as they would a phone message. And time and again we are surprised to discover that our messages are taken the wrong way.


The reason this happens is that although we’re aware electronic communications can easily be misinterpreted, we tend to assume such errors are the reader’s fault; but research clearly demonstrates it is the person who sends the message whose assumptions are faulty. To correct this specific error we must give sufficient weight to how the other person might interpret our electronic communications (and, no—emoticons are not the answer).

3. We Consider the Wrong Information

We often fail to consider accurate information that could potentially provide insight into another person’s point of view (such as his or her facial expressions) but happily consider inaccurate information (such as broad stereotypes or gossip). For example, when evaluating the preferences of people we perceive as similar to us, we tend to use ourselves as reference points. But when we perceive others as being less similar, we are more likely to resort to stereotypes to assess their preferences. Once we consider how this dynamic might play out in gift-giving scenarios, it becomes clear why Grandpa ended up with twenty-three pairs of woolen socks for Christmas but without the Kindle he’d been hinting at since Thanksgiving.

Perspective-Taking Errors in Intimate Relationships

The more familiar we are with another person, the more accurate our efforts to understand their point of view should be. As such, we might assume that the longer a couple has been together, the fewer perspective-taking errors they make with one another. But, as most couple therapists can attest, couples who’ve been together longest are often those who exhibit the most perspective-taking flubs.


Why does this happen?


Unfortunately, it is the couple’s very familiarity with one another that trips them up. The more time we’ve spent with our partner the more confident we feel in our ability to assess his or her point of view without giving it much thought (perspective-taking error #1 in action). However, since familiarity with a person rarely bestows the ability to read the person’s mind, such confidence is likely to land us in the doghouse more often than not.


This blind spot can be extremely troublesome for intimate relationships. For example, partners often dread birthdays and Valentine’s Day for this exact reason. One thinks, “Why can’t my spouse ever get it right?” and the other, “No matter how much trouble I go to, nothing is ever good enough.” In reality, neither person is taking the time to examine things from the partner’s point of view. If they did they would communicate with one another and clarify their expectations ahead of time, rather than just playing out the same gift-giving debacle year after year.


Of course, having such “relationship discussions” is not always easy. One of the reasons Blanca initiated couples therapy with Alban was that he tended to clam up whenever she tried discussing relationship issues with him. Indeed, women are often more proficient than their husbands at discussing their feelings and expectations, which can make men feel they’re fighting a losing battle. Rather than saying the wrong thing, they prefer to say nothing and get their “inevitable defeat” over with as soon as possible. The best way for women to fight this tendency is to avoid outtalking their partners. Women should give men the space and leeway to express their thoughts and even to restate them (without incurring a “penalty”) if their words do not reflect their true intent. When men are more proficient at emotional expression than their partners, they should take similar precautions.


In short, we should always ask ourselves how the other person’s point of view might differ from our own. We should give weight to what we know about their priorities and preferences, to the history of the relationship between us, and to the context of the current situation. Taking a few minutes to answer such questions can save hours of relationship talks to smooth over a situation that could have been prevented had we made the effort to think through the other person’s perspective ahead of time.

TREATMENT SUMMARY: TAKE THE OTHER PERSON’S PERSPECTIVE
Dosage: Administer full treatment and practice frequently. Do not get discouraged by initial failures, as building and improving these skills takes both time and practice.

Effective for: Rebuilding and strengthening weak relationship muscles, improving social interactions, and enhancing relationships.

Secondary benefits: Reduces emotional suffering.

Treatment D: Deepen Your Emotional Bonds

Empathy involves stepping into another person’s shoes in order to gain an understanding of their emotional experience and then conveying our insights to them convincingly. Rather than merely acquiring their point of view as we do when perspective-taking, we seek a deeper understanding so we can glimpse how they actually feel. Much as we do with perspective taking, we regularly overestimate our capacity to employ empathy successfully. One of the reasons this happens is that empathy is not necessarily an easy skill. It requires a Jedi mind trick of sorts, albeit one we do to our own minds. Specifically, we have to direct our awareness to a place it does not automatically go—to what it actually feels like to be another person—linger there for a moment until we register the other person’s emotional landscape, and then return to our own reality.


Surveys of college students have found that their empathy skills have decreased significantly over the past thirty years, which probably reflects a larger societal trend. Most of us could use a tune-up when it comes to both our empathy and perspective-taking skills. For example, Alban had trouble understanding why his wife, Blanca, was so angry with him for leaving the flowers and card he got her for Valentine’s Day on the kitchen counter. After all, he’d not only remembered Valentine’s Day (as opposed to previous years in which he had forgotten it entirely), but despite the huge amount of work waiting for him when he got home he’d taken the time to stop and get his wife tokens of his affection. When I asked Alban to consider things from Blanca’s point of view, he quickly conceded he’d screwed up, but he just didn’t understand why his good intentions counted for so little.

How to Access Our Empathy

The only way to gain insight as to how other people feel is to imagine ourselves in their situation, not just for a second or two, but until we can use our own emotional compass to point to how they might be feeling. To do so accurately, we need a good sense of their emotional landscape—the context leading up to the situation in question. For example, I asked Alban to consider Blanca’s expectations, how she might have experienced the two hours between the time he arrived home and when she discovered the card and flowers on the kitchen counter.


“She saw me working in the study,” Alban said, thinking aloud, “but she didn’t see the flowers because they were in the kitchen.” Alban’s eyebrows shot up and he turned to Blanca. “You thought I’d forgotten Valentine’s Day again! That’s why you didn’t respond when I said good night.”


Blanca nodded. I asked Alban to continue the exercise. “Now, taking that into consideration, how did Blanca react when she saw you in the study?”


“She didn’t,” Alban said. “She must have been upset, but she didn’t say anything because I was working.”


“So she was being considerate,” I said. Alban nodded. “So how was she feeling right before she discovered the flowers in the kitchen?”


“She was upset and disappointed; but she decided to be considerate and not discuss it with me until I finished working.”


“For two whole hours,” I pointed out. “She sat on her feelings for two hours. You go to bed and only then does she pass by the kitchen.”


“And sees the flowers and cards on the counter,” Alban continued. “And ... damn!” He turned to Blanca. “You must have thought I don’t even care enough to hand them to you in person.” Blanca nodded. “You made efforts to contain your disappointment all evening and I couldn’t even take a moment to hand you the flowers in person.” Blanca nodded, exhaling deeply. Alban put his arms around her. Slowly, she softened into his embrace. “I’m such an ass,” Alban whispered. “How do you stand me?”


“You do make it difficult,” Blanca responded with a brief smile. Alban quickly promised to take Blanca out for a belated Valentine’s dinner to make it up to her.


I continued to work with Blanca and Alban for several months. Alban had done a good job exercising his empathy muscles in the session, but it takes more than a single empathy workout to build up relationship muscles to their full strength. Alban continued to practice using empathy, and the more he persisted, the happier he and Blanca became. Over time, and with lots of work, their strained and distant marriage changed to one in which they both felt trusted, supported, and cared for by the other.


Improving our empathy skills will do wonders for our most important relationships. The caring and consideration that empathy conveys can spark a cycle of goodwill, affection, and generosity of spirit that radically deepens bonds of marriage, family, or friendship. Obviously this works best when both people are strengthening their empathy muscles with one another at the same time, but even unilateral efforts can bear significant fruit.


Because of the practice this skill requires, we should endeavor to practice our empathy muscles in a variety of situations and with numerous people. In doing so, we should seek opportunities to anticipate how people might feel about future situations as well as past ones. Keep the following in mind:


Visualize yourself in their situation. The best way to assess another person’s emotional experience is to visualize yourself in his or her situation in as immersive a manner as possible. Take notice of the surrounding environment, of who else is there, the time of day, the person’s mood, and any physical pains or ills the person may be suffering from. Imagine how you come across to him or her, not how you actually feel but what you actually convey to the other person. Keep in mind that in many situations we experience feelings that are contradictory. For example, when Blanca found the flowers on the kitchen counter she probably felt pleased that Alban had made the effort even though she also felt hurt, disappointed, and angry that he’d executed it so poorly.


Context is key. Understanding someone’s feelings involves having at least a rough sense of his or her frame of mind at the time. The following questions are ones you might want to consider: What are the person’s previous experiences with similar situations? What fears, doubts, hopes, or expectations might he or she have about the situation? What else is happening in his or her life at the time? What has his or her day been like up to this point? How might other relationships be impacting his or her responses?


Convey your insights thoughtfully. Having insight into another person’s feelings only matters if we can convey our understanding convincingly and compassionately. Knowing how someone feels but communicating it poorly is akin to buying him or her flowers and then leaving them on the kitchen counter. Be as descriptive as possible. The more the other person realizes you’ve put thought and effort into appreciating his or her point of view, the more impact your empathy-informed communications will have.

TREATMENT SUMMARY: DEEPEN YOUR EMOTIONAL BONDS
Dosage: Administer full treatment and practice frequently. Do not get discouraged by initial failures, as building and improving these skills takes both time and practice.

Effective for: Rebuilding and strengthening weak relationship muscles, improving social interactions, and enhancing relationships.

Secondary benefits: Reduces emotional suffering.

Treatment E: Create Opportunities for Social Connection

Loneliness makes us extremely hesitant to create new opportunities for social engagement or to take advantage of existing ones. We feel uncomfortable attending social events (especially those with too many unfamiliar faces), we hate traveling by ourselves, and we are reluctant to sign up for new activities or social groups because we dread showing up alone. We might see options for social activities around us, but we fear coming across as “losers” or “loners” and inviting the very stigma of loneliness we are desperate to escape.


The best way to overcome feelings of vulnerability, reduce our hesitancy, and avoid being labeled as lonely is to approach situations with a larger goal in mind. For example, participating in a speed-dating event would feel far less uncomfortable if we were doing so as research for an article on our blog or college newspaper. We would be far less apprehensive about signing up for a tour with other singles if we were amateur photographers or artists and planned to paint, sketch, or photograph the sites we visited for our portfolios. And we would find it easier to join a swimming, biking, or running group if we were training for a triathlon.


By having an additional agenda, we come across not as someone who is lonely, but as someone who is passionate about our hobby, devoted to our goals, or serious about our creative endeavors. Having a larger goal also helps reduce insecurity and self-consciousness because our attention is focused on the task at hand; documenting our speed dates, creating art for our portfolios, or making it through the triathlon.

Go Online

The Internet allows us to connect to people with whom we might share common interests and experiences without leaving our homes. It also allows us to adopt identities through which we can interact with others and express ourselves in ways that might not be possible in our regular lives. For example, Second Life (secondlife.com) is a three-dimensional virtual world where users interact with one another using a digital representation of their own choosing. Users can switch genders, make themselves older or younger, choose how attractive they would like to be, and give themselves various other characteristics and abilities. The interactions in Second Life cover the gamut from chatting to virtual mating, from conducting business to constructing homes, and participants report having meaningful friendships and relationships with one another.


Relationships and friendships that start online can be substantial and they often translate into in-person interactions. For example, a recent study found that online dating is now the second most common way couples meet (being introduced by mutual friends is the most common), surpassing previous romantic venues, such as bars, clubs, and the vegetable aisle in the local supermarket on Sunday afternoons.

Volunteer to Help Others

Another option for creating new social bonds is to volunteer. Helping others reduces feelings of loneliness, increases feelings of self-worth, and makes us feel more socially desirable to others. Helping others contributes to more happiness and greater life satisfaction, and it can also reduce our fear and hesitancy about engaging with new people (or indeed with people in general). By setting out to give rather than get, we can focus on the person in need instead of on ourselves, which in turn makes us feel less self-conscious, less insecure, and less vulnerable.

TREATMENT SUMMARY: CREATE OPPORTUNITIES FOR SOCIAL CONNECTION
Dosage: Administer full treatment as needed and repeat as necessary.

Effective for: Reducing emotional suffering and increasing opportunities for social interaction.

Secondary benefits: Strengthens weak relationship muscles.

Treatment F: Adopt a Best Friend

In some cases, circumstances may prevent us from creating new social bonds or enhancing existing ones. People with limited mobility, who are isolated geographically, or who cannot reach out to others for various reasons frequently adopt pets to soothe feelings of loneliness. Dogs are great at soothing feelings of loneliness in people who are isolated, elderly, or dealing with a significant illness or psychological injury such as post-traumatic stress disorder. Dogs are also great people magnets, and many friendships and relationships have started with the sentence, “Oh, your dog is so cute! What’s its name?”


Attesting to the singular therapeutic powers of our canine friends, one study had lonely people spend time alone with a dog or with another person and a dog together. Those who spent time alone with a dog reported feeling significantly less lonely than those who shared the company of the dog with another person. Whether the “other persons” in the study were informed they came in second to animals that drink out of the toilet and lick themselves is unknown.


Despite the many advantages of dog therapy, adopting any pet, especially a dog, is a huge responsibility and one that some of us cannot undertake for practical reasons. Cats have been studied less frequently than dogs, but they too can provide significant companionship and they are easier to care for than dogs, especially by people who are homebound.

TREATMENT SUMMARY: ADOPT A BEST FRIEND
Dosage: Administer as needed and to the extent circumstances allow.

Effective for: Reducing emotional suffering.

When to Consult a Mental Health Professional

Treating loneliness with the emotional first aid techniques discussed in this chapter should help soothe the emotional suffering loneliness creates, correct the perceptions and behaviors that sabotage our efforts to deepen and expand our emotional and social connections, and provide new opportunities for social interaction.


However, if your emotional pain is so great you have thoughts of harming yourself or others, or if you find yourself thinking about what it would be like if you were no longer around, you should seek the immediate help of a mental health professional or go to your nearest emergency room. If you have not had self-injurious thoughts but nonetheless feel too hopeless or discouraged to apply these first aid treatments, or if you’ve tried to do so but were unsuccessful, a mental health professional could help you assess factors that might be holding you back and provide the emotional support necessary for you to move forward.







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