One of the more painful dimensions of the human experience is feeling lonely in a crowd, surrounded by people but unable to make a connection. It is naturally more difficult to tolerate your own separation from others when they seem just within reach.
“Eleanor Rigby,” by the Beatles, describes this kind of isolation. Rigby “picks up the rice in the church where a wedding has been.” Wilco describes something similar in “How to Fight Loneliness.” The song’s protagonist advises, “You laugh at every joke,” and “Fill your heart with smoke,” to essentially hide how lonely you feel.
It’s a variety of loneliness that may have especially devastating consequences. Cornell University psychology researcher Anthony Ong and a team of colleagues recently decided to look more closely at the health impacts of something they call “social asymmetry”—the mismatch between how lonely you feel versus how socially connected you actually are by objective measures.
They followed nearly 8,000 older adults in England for about 13 years and tracked who developed heart disease, chronic obstructive pulmonary disease, and dementia as well as those who died. They split people into a few groups. Those who were both objectively isolated and also felt lonely; those who weren’t isolated but felt lonely; and those who were socially isolated but felt fine. The first group, they found, had higher risk across every health outcome. The second group—lonely but not isolated—had significantly higher risk of heart disease and death. The final group were fine on all health measures except dementia risk.
Feeling lonely, then, may be generally more dangerous than being alone.
I spoke with Ong about whether we’re in an epidemic of loneliness, whether there’s a magic number when it comes to age and loneliness, what chosen solitude has to do with happiness, and how the findings might affect evolutionary theories about cooperation and social connection. Ong expressed surprise at the dementia risk result. “It suggests that when it comes to these neurobiological phenomena, it’s more than a feeling. It’s your actual social world that may be protective,” he explains.
What was the inspiration for this study?
There’s been a lot of public attention around this so-called “epidemic” of loneliness and a lot of effort to understand the health consequences of loneliness and social isolation. We were motivated to map how these two phenomena come together. How do people who are around other people all the time, but lonely, compare to people who are relatively socially isolated, but aren’t lonely? These so-called asymmetries in social experience haven’t been captured in prior work.
What’s the consensus at this point on whether there is an epidemic of loneliness? I know there have recently been some challenges to the earlier work that asserted extraordinary population levels of loneliness, which had inspired the Surgeon General to announce that we were facing an epidemic. Do these challenges stand?
It depends on whom you ask. Certain segments of the population are more vulnerable to social isolation and loneliness: Younger populations, such as adolescents, as well as older populations, who have issues with mobility, tend to be more at risk for loneliness. But I wouldn’t use the word epidemic.
In this study you chose to work with people over the age of 50. Is that a magic number when it comes to loneliness and isolation?
No, I wouldn’t say so. This is an existing dataset, so we were using what was available to us. This sample was middle-aged to older adults. But while loneliness does tend to spike during these later years, the relationship between age and loneliness is a challenging question. Once you account for things that travel with age, such as disability and cognitive impairment, you don’t see this age-related trend. For people who are socially active and physically mobile, their loneliness profiles look like those of younger adults. To some extent, it’s a story about aging, but if you look underneath, it’s really a story about lifestyle and behavior changes. If you don’t act your age, you don’t see this increase in loneliness that you see at the population level.
Many philosophers have written about the distinction between solitude and loneliness, stretching back to Marcus Aurelius and Seneca, who argued that chosen solitude doesn’t have to mean suffering. When being alone isn’t associated with loneliness is it because it has been chosen or because of something else?
The data that we have are silent on whether the experience of solitude that we’re measuring is chosen, because we didn’t look at this directly. But we’re making that inference. We use the term social resilience to describe people who report less loneliness despite being relatively isolated. One might presume that’s because they’re choosing to be isolated and there’s a positive valence to that. Some people find solitude energizing in some way. It’s that unchosen aspect of social isolation that makes loneliness so detrimental.
Read more: “Loneliness Is a Warning Sign to Be Social”
On the other hand, psychoanalyst Erich Fromm argued that people who can’t tolerate solitude often have shallow social connections. I wonder if that idea shows up in any of the loneliness research, or aligns with what you’re thinking. If he’s right, it’s a kind of catch-22. You won’t choose loneliness if you can’t tolerate solitude, and yet, if you can’t tolerate solitude, you’re likely to have less satisfying connections, and therefore to feel more lonely.
In this particular study, we weren’t able to measure the qualitative aspects of people’s social isolation experiences, which is what you’re getting at. It’s whether people report contact with other people in the last month or so. But we do need to capture these experiences in a much more nuanced way.
Another thing that these data don’t pick up is the discussion around technology, and whether people’s online social experiences should be accounted for as instances of social connection in the same way that in-person social experiences are. I don’t think there’s a settled answer on that yet. It’s probably more relevant for younger populations, who probably get a lot of their social experience online. These big datasets predate social media, so it’s a measurement issue that we’re slowly trying to correct.
What do we know about how being connected online influences a person’s feelings of social isolation or loneliness?
Of course, there are many people who are isolated in terms of having actual physical contact, but spend a lot of their time on social media or online engaging with other people. But my guess is that we need actual physical contact. Some communities of people who are actually physically isolated from other people geographically are also stigmatized in some way. They may get social connection from online experiences that they just couldn’t get in their near-term environments. That’s where technology can be a social good. But even in those contexts, if you stay completely online, there’s going to be a point where that could be detrimental. So there may be a Goldilocks zone to online experiences beyond which you’re really not going to get the benefit, whatever that may be.
Yes, also, so many people turn now to chatbots to appease loneliness and disconnection. Those who are most socially isolated are both most likely to turn to chatbots and most vulnerable to harms from those interactions.
Absolutely. That’s a whole other frontier that we’re still thinking about. The danger of that is the possibility of hallucinations, where the interactions go sideways, because the chatbot might be suggesting things that might be harmful. But even assuming that there are guardrails against that, if one stays online completely and that’s their main form of interaction, I’d imagine that that won’t be very healthy.
Many years ago, John Cacioppo, who did a lot of research in this area—he is known as Dr. Loneliness—had this intuition. I don’t think there’s much data on this, but he speculated that lonely people don’t spend any more time online relative to non-lonely people. Where they differed was how they used that experience. Lonely people basically use their online interactions to stay online. Not-lonely people used online interactions to make more offline connections. So it wasn’t the technology that was the problem. It was the way in which people used technology.
I think that’s really relevant here. If there were a way of using chatbots to make more real connections, that would be great. Similarly, if we used our online experiences in a way that was complimentary and not as a replacement for our offline experiences, that too would be great.
How would your findings influence some of the evolutionary theories around social isolation and loneliness? The cooperative survival hypothesis says that because we need other people to survive, natural selection favors people who find exclusion agonizing. If it’s not so much about the people as the feelings, do those theories need to be revised?
I think it’s still about the people. It’s a combination of having people in your life, but not necessarily depending on a large social network. The findings speak to the need for social connections that are meaningful. It’s not about the quantity, it’s about the quality. We need to focus on those relationships that help us manage our loneliness. We know from the loneliness research that you only need one person in your life who really gets you, who really understands you.
What remedies for feeling lonely do your findings suggest? Are there evidence-based ways of helping people improve the quality of their connections?
These particular findings don’t directly speak to this, but there is work suggesting that one effective way of reducing loneliness among older adults is to engage with others. Volunteer programs like Experience Corps, where older adults act as mentors to younger adults, gives the older adults a sense of mattering to someone else’s life. It’s ironic in the sense that in order to feel like you matter, you have to focus on other people. Those kinds of programs have been effective for reducing loneliness among older adults.
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What do we know about these individuals who are relatively isolated, and yet don’t feel lonely? Do they have different psychological profiles?
This idea of social asymmetry is a new line of work. For the most part, we try to focus on identifying the health consequences of these different profiles. But the question of what predicts these profiles, whether it’s personality, age, or other demographic characteristics, we haven’t fully explored. That’s the next phase of this: to understand what accounts for this social resilience in people who are isolated but not lonely.
Have researchers found any differences along racial or socioeconomic lines in terms of feelings of loneliness and isolation?
There’s a neighboring literature that comes under the umbrella of social experience that has to do with things like social rejection and social exclusion, which certainly can be related to loneliness, but I’d say that literature is much more well researched in terms of demographic differences. So we know that there are racial differences in people’s experiences of social exclusion and obviously discrimination. To the extent that there are differences in loneliness, they’re reflected in these rejection experiences that people report. I don’t know if there’s a robust literature on socioeconomic differences in loneliness, actually.
What about cultural differences?
We looked at this idea of social asymmetry between the United States and Japan, and we found that the effects on health are much stronger in the U.S. Being more lonely than one would expect given one’s social circumstances is more detrimental to health in the U.S. than in Japan. It’s still detrimental in Japan. But in Japan, we find that there’s more acceptance and less stigma associated with being alone, in part because people are around other people all the time.
That’s wild. I would have expected the opposite—that more stigma would be associated with being alone in Japan, given that the culture is so communal, so much less individualistic, at least as far as I understand it.
I think part of it is that in Japan, people don’t talk about their loneliness. There’s less of a need to be expressive about your social experience. In the U.S., because of the focus on independence, there’s this expectation that you’re responsible for any shortcomings.
Do you have any hypotheses about what makes some people more or less resilient against loneliness? Are there any structural, societal factors that you plan to look at?
At the level of structural factors, it would be plausible to assume that the sense of mattering that I mentioned earlier could be a kind of placeholder for people who might feel lonely in a crowd, right? These people who might feel invisible. I’d imagine that various kinds of stigmatizing might play a role, certainly one’s position in society writ large and socioeconomic status probably would play a role. There’s also a phenomenon in psychology called rejection sensitivity or stigma consciousness. These are all factors that might put people on higher alert to these kinds of experiences of invisibility.
On the resilience side, that’s also a very interesting question. What accounts for people who are doing okay despite not having a lot of social contact? I don’t know structurally per se, but the stereotype of the lone farmer comes to mind. I can’t imagine this person being a rich tech bro, but rather someone who has a sense of purpose in their lives. Maybe there’s an element of faith or religion. Maybe you don’t have a lot of people in your life, but you have a strong connection to spirituality.
These are all guesses and speculations, but that’s the next thing we want to excavate. 
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