Loneliness is clearly bad for humans. There is a quickly-accumulating mountain of evidence showing its various pernicious effects. Loneliness, which psychologists define as the distress accompanying the perception of not having one’s social needs met, makes us more likely to have a lower quality of life, more likely to be sick, and more likely to die (Hawkley & Cacioppo, 2010; Shiovitz & Ayalon, 2010). It is implicated, with varying degrees of certainty, with suicide risk (Chang, Sanna, Hirsch & Jeglic, 2010), metabolic syndrome (Whisman, 2010), reduced physical activity and depression (Patterson & Veenstra, 2010; Cacioppo & Hawkley, 2010), increases and other disregulations of stress hormones (Doane & Adam, 2010), decreases in the benefits of sleep (Hawkley, Preacher, & Cacioppo, 2010), increased cardiovascular problems of many kinds (Hawkley, Thisted, Masi, & Cacioppo, 2010; Caspi, Harrington, Moffit, Milne, & Poulton, 2006), and sexual offending (Marshall, 2010).

The incidence of loneliness of any amount is roughly U-shaped by age, with about 80% of adolescents lonely, dropping during middle adulthood, and rising again to about 40% after age 65 (Hawkley & Cacioppo, 2010; Heylen, 2010; Stanley et al., 2010). The prevalence of chronic loneliness is lower, but still high, estimated at 15-30% of US population (Heinrich & Gullone, 2006; Theeke, 2009) and it may be greater for oppressed groups, such as those identifying as lesbian, gay, or bisexual (Heylen, 2010).

Psychologists sometimes distinguish between two kinds of loneliness—social loneliness, a lack of a sense of social integration, and emotional loneliness, the absence of an attachment figure (Heylen, 2010). This distinction may be useful for lonely clients, as they may be able to decrease their experience of loneliness by increasing both the connectedness and intimacy in their lives.

The Science of Meeting People

Many clinicians see single clients wishing to decrease their emotional loneliness by establishing an intimate relationship. There is a significant amount of research which may be useful, both for psychoeducation and for assessing clients’ constraints to meeting potential intimate partners. The following section is a very brief summary of that research presented in the book Close Relationships (Regan, 2011):

Awareness. To “get a date,” to establish an intimate relationship, first other people must be aware of you. Are your clients making others aware of them? Are they doing it in a way that will bring positive attention? The general rule here is to stand out from the crowd in some way that does not violate social norms, as standing out in a negative way will be counter-productive.

Attraction. Beginning a relationship that may become intimate also requires that another person is attracted to us. A client can have constraints to this process that may be ameliorated by psychoeducation and/or therapy. There are five major factors psychologists believe contribute to attraction:

Physical attractiveness. All else equal, the more you look like dominant culture’s idea of a beautiful man or woman, the easier it is to get a date. For some clients, this may suggest a conversation about grooming or hygiene, but it may just suggest focusing on other aspects of attraction.

Appropriateness. Violating social norms generally turns people off. This principle suggests assessing for attempted solutions which may violate social norms or somehow communicate lack of appropriateness to a client’s targets.

Familiarity. People like those who they know, and the better they know you, the more they are attracted to you, all else equal. Again, this effect disappears if there is an initial negative impression, but overall, becoming a regular will help.

Similarity. “Opposites attract” is incorrect. We like those who are like us, and the more similarity the better. This may be a good reason to encourage clients to attend special-interest events. (Bars, however, are an exception. Very few real relationships start in bars.)

Responsiveness. We are attracted to people who seem interested in us. Clients who have difficulty establishing intimate relationships may have an exaggerated sense of how much interest they are showing in others. Assess for eye contact, formulation of questions showing interest, and turning towards bids for attention.

Approach and affiliation. If you want someone to approach and choose you, you must be accessible and receptive. These principles are much like the awareness, familiarity, and responsiveness principles described above. And again, clients’ sense of their accessibility and receptiveness may be exaggerated.

The reality of social pain. Rejection hurts, seriously and physically (Eisenberger & Lieberman, 2004; Eisenberger, Lieberman, & Williams, 2003; MacDonald & Leary, 2005). This finding suggests that it may be helpful to normalize both the pain of rejection and the fear of the pain of rejection. It may also actually be helpful for clients to take a Tylenol before subjecting themselves to rejection.

References

Cacioppo, J. T., Hawkley, L. C., & Thisted, R. A. (2010). Perceived social isolation makes me sad: 5-year cross-lagged analyses of loneliness and depressive symptomatology in the Chicago Health, Aging, and Social Relations Study. Psychology and Aging, 25(2), 453-463. doi:10.1037/a0017216

Caspi, A., Harrington, H., Moffitt, T. E., Milne, B. J., & Poulton, R. (2006). Socially isolated children 20 years later: Risk of cardiovasculardisease. Archives of Pediatric & Adolescent Medicine, 160, 805–811.

Chang, E. C., Sanna, L. J., Hirsch, J. K., & Jeglic, E. L. (2010). Loneliness and negative life events as predictors of hopelessness and suicidal behaviors in Hispanics: Evidence for a Diathesis-Stress Model. Journal of Clinical Psychology, 66(12), 1242-1253. doi:10.1002/jclp.20721

Doane, L. D. & Adam, E. K. (2010). Loneliness and cortisol: Momentary, day-to-day, and trait associations. Psychoneuroendocrinology, 35(3). doi: 10.1016/j.psyneuen.2009.08.005

Eisenberger, N. I., & Lieberman, M. D. (2004). Why rejection hurts: A common neural alarm system for physical and social pain. Trends in Cognitive Sciences, 8(7), 294-300. doi:10.1016/j.tics.2004.05.010

Eisenberger, N. I., Lieberman, M. D., & Williams, K. D. (2003). Does Rejection Hurt? An fMRI Study of Social Exclusion. Science, 302(5643), 290-292. doi:10.1126/science.1089134

Hawkley, L. C., & Cacioppo, J. T. (2010). Loneliness matters: A theoretical and empirical review of consequences and mechanisms. Annals of Behavioral Medicine, 40(2), 218-227. doi:10.1007/s12160-010-9210-8

Hawkley, L. C., Preacher, K. J., & Cacioppo, J. T. (2010). Loneliness impairs daytime functioning but not sleep duration. Health Psychology, 29(2), 124-129. doi:10.1037/a0018646

Hawkley, L. C., Thisted, R. A., Masi, C. M., & Cacioppo, J. T. (2010). Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults. Psychology and Aging, 25(1), 132-141. doi:10.1037/a0017805

Heinrich, L. M. & Gullone E. (2006). The clinical significance of loneliness: A literature review. Clinical Psychology Review, 26, 695–718.

Heylen, L. (2010). The older, the lonelier? Risk factors for social loneliness in old age. Ageing & Society, 30(7), 1177-1196. doi:10.1017/S0144686X10000292

MacDonald, G., & Leary, M. R. (2005). Why Does Social Exclusion Hurt? The Relationship Between Social and Physical Pain. Psychological Bulletin, 131(2), 202-223. doi:10.1037/0033-2909.131.2.202

Marshall, W. L. (2010). The role of attachments, intimacy, and loneliness in the etiology and maintenance of sexual offending. Sexual and Relationship Therapy, 25(1), 73-85. doi:10.1080/14681990903550191

Patterson, A. C., & Veenstra, G. (2010). Loneliness and risk of mortality: A longitudinal investigation in Alameda County, California. Social Science & Medicine, 71(1), 181-186. doi:10.1016/j.socscimed.2010.03.024

Regan, P. (2011). Close relationships. Routledge: New York.

Shiovitz-Ezra, S., & Ayalon, L. (2010). Situational versus chronic loneliness as risk factors for all-cause mortality. International Psychogeriatrics, 22(3), 455-462. doi:10.1017/S1041610209991426

Stanley, M., Moyle, W., Ballantyne, A., Jaworski, K., Corlis, M., Oxlade, D., Young, B. (2010). ‘Nowadays you don t even see your neighbours’: Loneliness in the everyday lives of older Australians. Health & Social Care in the Community, 18(4), 407-414.

Theeke L. A. (2009). Predictors of loneliness in U.S. adults over age sixty-five. Archives of Psychiatric Nursing, 23, 387–396.

Whisman, M. A. (2010). Loneliness and the metabolic syndrome in a population-based sample of middle-aged and older adults. Health Psychology, 29(5), 550-554. doi:10.1037/a0020760

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