[Importance of Understanding Loneliness by Richard Booth, Ph.D.] Dr. Booth is a Professor of Psychology, Department of Social & Behavioral Studies, Black Hawk College, Quad-Cities Campus, Moline, IL, USA [______________________________] Phenomenological Observations and Naive Beginnings I first became formally interested in the topic of loneliness -- naively -- in the early 1980s. I had recently accepted a full-time teaching position, altering my professional life from full-time practice with part-time teaching to full-time teaching with part-time practice. At that time, I brought to the classroom ten years of experience in treating psychological disorders of all types, on both an inpatient and outpatient basis. Surrounded by undergraduate students of all ages every day, I began to notice in some of them what appeared to me to be an "affective state" that was not depression but which approximated it in some significant ways. This emotional state was accompanied by diminished affect, self-preoccupation, dissatisfaction with social relationships, negativism, self- and other-critical statements, and being (from what I could tell by observing) alone. Often bright, many of these students seemed, nonetheless, unmotivated academically, somehow disengaged from campus activities, and lethargic. Often, they would tell me they were in no hurry to go anywhere since they had nowhere to go. There was a certain sadness in their faces and a lack of direction in their lives. At that time, I did not identify what I was seeing as loneliness. At the same time that I changed jobs, I was doing doctoral work and my dissertation advisor introduced me to the formal study of loneliness. It was then that I knew what I was seeing in my students. I was intrigued by the implications of the loneliness literature. Right before my eyes, it seemed, a prototype of the lonely person began to take shape. If my students were, in fact, lonely, what impact was this having on their lives in general and their academic lives in particular? Was the unmotivated behavior I thought I was observing only a facet of a much larger construct? And, what had I missed in all the clients I had treated for the past ten years? Had I misunderstood their loneliness and called it depression -- or, at the very least, missed the part of their depression that was loneliness? And, if loneliness was pervasive in the culture, why did empirical research in this area begin, in earnest, just a short time ago? All these questions were on my mind. Through the years, I have become more interested in loneliness than I was at the start of my search. I am now persuaded that mental health professionals encounter lonely people all the time -- people who are presenting with a mix of symptoms that are amenable to a formal diagnosis but whose loneliness is all too often overlooked. I am also convinced that any number of mental health professionals are themselves experiencing loneliness and, because it is not foremost in their minds as a diagnostic possibility, are all too often missing the importance of its implications in their own personal and professional lives. Loneliness can be a very painful place to be. We all experience it from time to time, but some people live it day after day for years on end. It is emotionally depleting, interpersonally inhibiting, and psychologically regressing. When we are lonely, we feel empty and very much alone. Intimacy needs are not met and, if they are, they somehow remain fundamentally unsatisfying. When we are lonely, our thinking can become distorted so that we may over-react to life events that we might otherwise take in stride. For these reasons, it is important that mental health professionals become acquainted with the condition of loneliness. If we can learn to identify loneliness in ourselves, our students, and our clients, we may be able to increase the potential for greater life satisfaction and potentiation. Significant Emotional Characteristics of Lonely People In some relatively extensive work on loneliness, Jones, Freemon, and Goswick (1981) found that lonely people self-describe as feeling worthless, helpless, powerless, unacceptable, self-absorbed, and separated from other people. Jong-Gierveld and Raadschelders (1982) found that, embedded in the lonely person, are feelings of boredom, self-pity, sadness, and sometimes depression. In addition, lonely people say they feel nervous, empty, and disoriented (Jong-Gierveld & Raadschelders, 1982). Their self-esteem is low and they often feel that there is no one with whom they can communicate openly, honestly, and intimately. They miss having an intimate other in their lives and, at times, crave the fulfillment of this need in a desperate way. Feeling alone in the world, lonely people often begin to think about themselves with a form of distorted logic. It is as if they say to themselves: "I am alone; therefore, no one wants to be with me. If no one wants to be with me, they are not willing to help me escape from my loneliness. If they are not willing to help me, I will reject them, too." In fact, the authors cited above found that, in general, lonely people are more rejecting of others than others are of them (Jones et al., 1981). Lonely people tend to chase away, therefore, the resource they need the most to move beyond their loneliness, namely, other people. Given the feelings discussed above, lonely people are dissatisfied with what other people provide. Being generally rejecting of others and negatively critical of them, lonely people tend to remain lonely without understanding why they feel so miserable. But, feeling "bad" is only one dimension of loneliness. Loneliness and Social Skills It is important for everyone to be able to survive in a very challenging world. This survival occurs on multiple levels: economic, personal-psychological, academic, occupational, and social, to name just a few. Part of the success of this survival is measured in terms of personal happiness (Booth, Bartlett, & Bohnsack, 1992). In other words, all things considered, do we feel generally satisfied with the quality of our lives? Lonely people do not. And, part of the reason for this is their social skills deficits. Jones (1982) found that loneliness is inversely related to such factors as social risk-taking, sociability, and affiliative tendencies. He also found that such characteristics as introversion, self-consciousness, and having difficulty approaching people for the initiation of relationships are positively related to being lonely. It appears that lonely people possess certain clusters of inhibitory responses to social contexts which keep them at a distance from others. Several researchers have also found that lonely people tend to be more shy than nonlonely people (Booth et al., 1992; Cutrona, 1982; Rook & Peplau, 1982). Excessive fear of being interpersonally rejected, negative expectations about others, and social inhibitions and deficits all contribute to the maintenance of loneliness, as does the persistent fear of having to survive alone in a dangerous and unfriendly world without knowing how to establish relationships that anchor us (Weiss, 1987). How Lonely People Function Cognitively I have already discussed lonely people's tendency to perceive others as threatening and unwilling to provide the resources necessary for friendship, intimacy, and social support. In addition, however, lonely people possess unrealistic expectations about relationships and social reality (Booth, 1983). Gordon (1976) found that lonely people entertain certain unrealistic expectancies that predispose them to powerful interpersonal disappointments, such as thinking they should always have dates or be popular, beautiful, or successful. Often, they expect that their friends should meet a criterion that is abnormally high, namely, they should always be available. They want their friendship group to be perfect -- an expectation that cannot, of course, be attained. Anderson (1990) argues that these expectancy sets, because they are unrealistic, may create major disappointments and lead to prolonged negative emotional states. Lonely people, while they may be extremely competent in non-interpersonal problem-solving situations, tend to solve their interpersonal problems in unsatisfactory ways. Horowitz, French, and Anderson (1982) gave a series of hypothetical social problem situations, together with a test that measured loneliness, to a group of research participants. They found that, unlike those participants who were not lonely, the lonely people were unable to generate a sufficient number of alternative problem-solving strategies and the quality of the strategies they did generate was less satisfactory than solutions offered by their nonlonely counterparts. Thus, if one can extrapolate from a research setting to "real world" problem-solving, one would expect that lonely people, when faced with interpersonal conflicts or other difficulties, would generate neither a sufficient number of workable solutions nor solutions of sufficient quality to solve the problems. Maintenance of loneliness would be the likely outcome. In one of my own studies (Booth, 1985), I measured a number of my undergraduate psychology students on both loneliness and abstract-concrete thinking. I wanted to find out if lonely students were thinking in the same way that nonlonely students were thinking. I found that the lonely students functioned significantly more concretely than the nonlonely students. In short, the lonely students were less able to move alternatives around in their heads and were more likely to think in the single-track ways that Farnam-Diggory (1972) has described. So, whereas Horowitz et al. (1982) found a deficiency in solving interpersonal problems, my results suggested that the inability of lonely people to generate alternatives might go beyond relationship issues. The intensity of lonely feelings and the importance of accompanying cognitive distortions should not be underestimated. Loneliness is a psychological state which can be so powerful that it brings about a deep and persistent feeling of futility. The futility may be accompanied by behaviors that are non-specifically motivated or impulsive, that is, lonely people may, at times, reach out before they think and "grab" what appears to be satisfying. At times, this behavior can lead to counter-productive results and relationships which find the lonely person feeling even more lonely, desperate, and worthless. There are many definitions of loneliness but none that all scientists agree upon (see, for example, McWhirter, 1990). The research seems to make clear the assertion that there are emotional, cognitive, and social or interpersonal factors involved in loneliness. There is some evidence for several kinds of loneliness, some of which are more severe than others and some of which include elements of depression (Jong-Gierveld & Raadschelders, 1982). However, loneliness is not the same as depression; they are similar in some ways and different in others. And, since depression is formally recognized in the Diagnostic and Statistical Manual of Mental Disorders IV (1994) and loneliness is not, mental health professionals, if they are unaware of the dynamics of loneliness and its similarity to depression, may prioritize the treatment of depression for some clients who are primarily lonely. The Relationship Between Loneliness and Depression: A Synopsis Because loneliness and depression share a number of important features, differential diagnosis may, at times, be challenging. Many lonely people say they are depressed and many depressed people say they are lonely, but, while the two constructs overlap, they are not identical (Russell, 1982). What are the primary similarities and differences? Weiss (1973), in an early work, argued that "in loneliness there is a drive to rid oneself of one's distress...in depression there is instead a surrender to it" (p. 15). In other words, while lonely people feel desperately anxious about their loneliness and strive, sometimes inappropriately, to dispel it, depressed people have a greater tendency to acquiesce to their condition. Jong-Gierveld and Raadschelders (1982) disagree, in part, with Weiss (1973), arguing that some types of lonely people surrender to their loneliness, just as depressed people appear to submit to their depression, while other types of lonely people do not. Friedman (1973) asserts that the "biggest factor bringing on depression" is guilt (p. 1700), while this has not been shown to be the case with lonely people. Diamont and Windholz (1981) found that both lonely and depressed people felt equally hopeless and that both groups had equal potential for suicide and aggressive behavior. They also found that shame and guilt were more often associated with depression than with loneliness. Bragg (1979) measured 333 people on both depression and loneliness inventories. He discovered that, while the two were correlated at .49, each was also correlated with different factors -- and herein lies a key to understanding the difference: in general, depression was correlated with anger and dissatisfaction with non-social aspects of a person's life while loneliness was not. Moreover, loneliness was correlated with low frequency of initiating contact with friends while depression was not. People who were both depressed and lonely suffered from the cumulative effects of both factors. Cutrona (1982) distinguishes between chronically lonely people and situationally lonely people; the former are very likely to be depressed as well as lonely while the latter are more likely to be merely lonely. A number of important factors for differential diagnosis have emerged from the above data; I would like to draw the reader's attention to three of them: (1) the client's focus of dissatisfaction; (2) the duration of complaints/symptoms of loneliness; and (3) the presence of guilt as a presenting symptom. Specifically, clinicians should probe the degree to which dissatisfaction in the client is primarily within the interpersonal sphere of his or her life or with life in general -- the former being more typical of loneliness and the latter more typical of depression. The clinician should also be concerned with how long the person has felt lonely. If the loneliness is determined to be of the situational type, the clinician, while not dismissing all possibility of depressive symptoms, should explore the possibility of loneliness; if the loneliness is determined to be chronic, depressive symptoms should be explored together with possible symptoms of loneliness. Finally, the clinician should keep in mind that guilt appears to be more typical of depression than of loneliness. The real difficulty arises, of course, when the clinician sees a multiplicity of symptoms and attempts to sort them out and "weigh" the importance of each for diagnostic and treatment purposes. For those clients who present with both depressive and loneliness symptoms, a dual course of treatment may be indicated. Vegetative symptoms (e.g., dyssomnias, eating too much or too little) have been shown to be more typical of depressed people than lonely people (Horowitz et al., 1982). Thus, while one is likely to find some vegetative symptomatology in the chronically lonely -- because they may also be depressed -- the situationally lonely person may not manifest any vegetative involvement. These researchers also found that depressed people are more likely to drink alcohol as an escape than are lonely people (Horowitz et al., 1982). Finally, I am not aware of a seasonal effect in loneliness. However, this does not mean that, when a person presents with what appears to be Season Affective Disorder, he or she is not also lonely. The winter months may increase the isolation (or perceived isolation) of people who are already lonely or a winter loneliness may be misconstrued by a client as a depression. Moreover, there may be some people who are given to seasonal loneliness but about whom we have little, if any, research. Since SAD is a depressive situation, the cues from the data discussed can serve as a guideline for diagnosis in this situation, too. Possible Treatment Strategies for Loneliness What strategies might be considered in treating lonely clients? I would suggest the following brief list of ten interventions, which certainly does not exhaust the possibilities: 1. Help lonely clients focus on their expectancy sets. Do they expect too much -- or even the impossible -- from friends and family? Setting realistic expectations about what can be reasonably derived from relationships is necessary in order to avoid continued frustration and disappointment. 2. Help lonely clients identify their emotions accurately. Many lonely people misidentify their feelings. A good example is that some lonely people call their loneliness depression. If they do that, they may then begin to behave in "depressed" ways, aggravating their situation. 3. Help lonely clients understand that aloneness is not synonymous with loneliness. Being alone can be very healthy. All of us need alone time for reflection, reading, and other activities that are best done by ourselves. 4. Help lonely clients understand that they can handle their own loneliness. In other words, the loneliness and its concomitant anxiety need not rule their lives. Once they have begun to understand what they are dealing with, efficacy can be increased. 5. Help lonely clients re-frame their lives. One example is to explore alternatives to having an intimate in their lives right now. Help them decrease their internal sense of urgency and desperation about having that special confidante or life partner immediately. They can become comfortable with the idea of taking the time to carefully choose the people they let into their lives. 6. Help lonely clients understand the importance of learning appropriate and effective interactive skills. Many lonely people do not realize, in any clear way, why or how they are ineffective in relationship-building. Social skills training may be in order. 7. Help lonely clients learn more effective strategies for solving interpersonal problems and conflicts. Often, they feel as if a conflict in a relationship means that another "failed relationship" has occurred. They may not realize that conflict can make relationships stronger. 8. Help lonely clients understand their tendency to self-deprecate and to blame both themselves and others for their unhappiness. They may need to learn that, at times, relationships just "go their own way" and no one is to blame. 9. Help lonely clients learn empathy. Lonely people tend to be self-absorbed and narcissistic. They can become easily injured and easily inflated. They may need to learn to view themselves in a more realistic way. 10. Help lonely clients understand the importance of practicing the tasks that are likely to decrease their loneliness. For example, an assignment to meet one new person during the next week, following appropriate discussion about the best ways to do that, might be an important method of engaging them in the process of their own recovery. Feedback about how the attempt went is a salient aspect of the practice element. In closing, it is important to know that millions of people are lonely every day. With their loneliness comes wasted opportunities, lost possibilities for friendship, and a deep inner pain that sometimes feels unbearable. If we all understand some fundamental characteristics of loneliness, we will be in a better position to identify it in ourselves as well as in others. Once identified, we can begin to ameliorate it. Lonely people are not happy people. Alleviating the intensity of loneliness may well lead to a quality of life that many lonely people have not even dreamed was possible. --------------------------------- References 1. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author. 2. Anderson, J. R. (1990). Cognitive psychology and its implications. San Francisco: Freeman. 3. Booth, R. (1983). Toward an understanding of loneliness. Social Work, 28, 116-119. 4. Booth, R. (1985). Loneliness and abstraction level of college students. Journal of College Student Development, 26, 204-209. 5. Booth, R., Bartlett, D., & Bohnsack, J. (1992). An examination of the relationship between happiness, loneliness, and shyness in college students. Journal of College Student Development, 33, 157-162. 6. Bragg, M. E. (1979). A comparative study of loneliness and depression (Doctoral dissertation, University of California, Los Angeles). Dissertation Abstracts International, 39, 79-13710. 7. Cutrona, C. E. (1982). Transition to college: Loneliness and the process of social adjustment. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 291-309). New York: John Wiley & Sons. 8. Diamant, L., & Windholz, G. (1981). Loneliness in college students: Some theoretical, empirical, and therapeutic considerations. Journal of College Student Development, 22, 515-522. 9. Farnam-Diggory, S. (1972). Cognitive processes in education: A psychological preparation for teaching and curriculum development. New York: Harper & Row. 10. Friedmann, J. J. (1973, June 15). Depression, failure, and guilt. New York State Journal of Medicine, pp. 1700-1704. 11. Gordon, S. (1976). Lonely in America. New York: Simon & Schuster. 12. Jones, W. H. (1982). Loneliness and social behavior. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 238-252). New York: John Wiley & Sons. 13. Horowitz, L. M., French, R. de S., & Anderson, C. (1982). The prototype of a lonely person. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 183-205). New York: John Wiley & Sons. 14. Jones, W. H., Freemon, J. E., & Goswick, R. (1981). The persistence of loneliness: Self and other determinants. Journal of Personality, 49, 27-48. 15. Jong-Gierveld, J., & Raadschelders, J. (1982). Types of loneliness. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 105-119). New York: John Wiley & Sons. 16. McWhirter, B. T. (1990). Loneliness: A review of current literature with implications for counseling and research. Journal of Counseling and Development, 68, 417-422. 17. Rook, K. S., & Peplau, L. A. (1982). Perspectives on helping the lonely. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 351-378). New York: John Wiley & Sons. 18. Russell, D. (1982). The measurement of loneliness. In L. A. Peplau & D. Perlman (Eds.), Loneliness: A sourcebook of current theory, research, and therapy (pp. 81-104). New York: John Wiley & Sons. 19. Weiss, R. S. (1973). Loneliness: The experience of emotional and social isolation. Cambridge, MA: MIT. 20. Weiss, R. S. (1987). Reflections on the present state of loneliness research. In M. Hojat & R. Crandall (Eds.), Loneliness: Theory, research, and applications [Special issue]. Journal of Social Behavior and Personality, 2 (2, pt. 2), 1-16. ----------------------------------------------------------------- [ << ] Back to Perspectives Table of Contents [MHN Navigation Bar]