Preface
This preface starts with Vivek Murthy describing how, when he was beginning his role as Surgeon General of the United States, he started on a “listening tour” to find out from citizens of the U.S. citizens what kinds of health problems they were facing. What surprised him was the prevalence of people who told him they were lonely.
In these instances and in many others, I could see the vital role that social connections can play when individuals, families, and communities face difficult problems. While loneliness engenders despair, and ever more isolation, togetherness raises optimism and creativity. When people feel they belong to each other, their lives are stronger, richer, and more joyful.
p. 19
He talks about some of his own personal struggles with loneliness at different times in his life. He then spends some time introducing some of the people he met and some of the things they were facing, and how during the interview sessions the problem of loneliness came up often. This was true across all segments of our society: men and women, young and old, across all professions.
Many people described what they were feeling as a lack of belonging. They’d tried to do things about it. Many had joined social organizations and moved to new neighborhoods. They worked in open-office settings and went to happy hours. But the sense of being “at home” remained elusive. They missed the foundation of home that is genuine connection with other people.
To be at home is to be known. It is to be loved for who you are. It is to share a sense of common ground, common interests, pursuits, and values with others who truly care about you. In community after community, I met lonely people who felt homeless even thought they had roof over their heads.
p. 20
What surprised him was just how widespread this problem was. One thing he noted was that loneliness wasn’t just a problem on its own, it was also a problem that made other problems worse.
So many of the problems we face as a society – from addition and violence to disengagement among workers and students to political polarization – are worsened by loneliness and disconnection. Building a more connected world holds the key to solving these and many more of the personal and societal problems confronting us today.
p. 22
The irony is that the antidote to loneliness, human connection, is also a universal human condition. In fact, we are hardwired for connection – as we demonstrate every time we come together around a common purpose or crisis.
p. 23
He gives some examples of how as a society we have come together in times of crisis: after the Parkland high school shooting, after September 11, 2001.
He notes that his interest in the topic of loneliness continued after he finished as surgeon general. He wanted to solve some really important questions around the topic of loneliness including (from p. 24):
- What exactly has led to the fraying of relationships in communities and such high levels of loneliness?
- What other aspects of health and society are affected?
- How can we overcome the stigma of loneliness and accept that all of us are vulnerable?
- How can we create stronger, more enduring and more compassionate connections in our own lives and communities, and a more unifying common ground in our society?
- How do we shift the balance of our lives from being driven by fear to being fueled by love?
After discussing the key questions that he wants to answer in the book, he outlines the structure of the different sections:
The first section of the book is focused on the underpinnings of loneliness and social connection – the reasons why loneliness evolved in our highly social species and the ways in which our culture may help or hinder our efforts to bond with others and establish a communal sense of belonging. The section section addresses the process of connection that each of us individual must navigate in our own lives, beginning with our relationship with ourselves and moving outward through family and friends to ultimately build a more connected world for future generations.
p. 25
Chapter 1 : Making sense of loneliness
The whole conviction of my life now rests upon the belief that loneliness, far from being a rare and curious phenomenon particular to myself and to a few other solitary men, is the central and inevitable fact of human existence. ”
— Thomas Wolfe, God’s Lonely Men
In the beginning of this chapter Dr. Murthy describes his first day as a doctor. He describes how, as he began to get comfortable in his role as a doctor, he began to notice how the social lives of his patients played a role in their illnesses and in their healing. He noticed how many of those patients who didn’t have a sense of closeness and how they had a hunger for companionship.
He describes the example of a patient named James, who was dealing with diabetes and high blood pressure. As he discussed his story the patient said, “winning the lottery was the worst thing that ever happened to me.” After winning the lottery, he had quite his business and moved to a new, fancier gated community. Although he was rich, he had traded his social connections as part of his upward mobility. Dr. Murthy suggested that he improve his social life in addition to addressing his medical concerns. “If James could find a way to break out of his gilded cage, I suspected his health would improve dramatically.” (p. 31) The example of James and his struggles made him question how all the training he had received as a doctor had neglected this aspect of health:
My medical education did not prepare me to recognize the impact of social connection on health, and it certainly didn’t give me tools to help my patients who were struggling with loneliness. Instead, my training had been focused almost entirely on the physical body.
p. 32
He found that this kind of training wasn’t enough. It didn’t help him treat the whole patient.
One isn’t always the loneliest number
In the next section, Dr. Murthy goes into the definitions of loneliness and how it is more than just social isolation.
Many people think of loneliness as isolation, but the difference between these two terms is substantial. Loneliness is the subjective feeling that you’re lacking the social connections you need. It can feel like being stranded, abandoned, or cut off from the people with whom you belong — even if you’re surrounded by other people. What’s missing when you’re lonely is the feeling of closeness, trust, and the affection of genuine friends, loved ones, and community.
p. 33
He then defines three different types of loneliness that have been defined by researchers in earlier studies: intimate, relational, and collective.
Intimate, or emotional, loneliness is the longing for close confidante or intimate partner. Relational, or social, loneliness is the yearning for quality friendships and social companionship and support. Collective loneliness is the hunger for a network or community of people who share your sense of purpose and interests. These dimensions together reflect the full range of high-quality social connections that humans need in order to thrive. The lack of relationships in any of these three dimensions can make us lonely, which helps to explain why we may have a supportive marriage yet still feel lonely for friends and community.
p.33
Dr. Murthy then notes that the number of friends required for any one person is different, and that number can vary at different times in a person’s life. It also varies by a person’s personality: an extroverted person can need more social activity, where an introverted person will need less (but can still feel lonely if those needs are not met.)
