Together: Why Social Connection Holds the Key to Better Health, Higher Performance, and Greater Happiness

by Vivek H. Murthy

Researchers1 2 3 have identified three “dimensions” of loneliness to reflect the particular type of relationships that are missing. Intimate, or emotional, loneliness is the longing for a close confidante or intimate partner—someone with whom you share a deep mutual bond of affection and trust. 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 three 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 dimensions can make us lonely, which helps to explain why we may have a supportive marriage yet still feel lonely for friends and community.

The space where we confront our demons is not always a space we enter willingly. But it’s in the grappling that we work through issues, gain clarity about our feelings, and build comfort with ourselves. Developing comfort with solitude, then, is an essential part of strengthening our connection to ourselves and by extension enabling our connection with others. Solitude, paradoxically, protects against loneliness.

Even in the absence of others, stories make individuals feel connected and promote a sense of belonging. This helps to explain the enormous role that storytelling plays in securing human values, purpose, and identity, and in bonding us emotionally. Ever since the first cave drawing, we’ve been encoding our experiences in stories through words, pictures, music, and rituals to be passed down generation to generation. These tales help us understand who we are. They give meaning to our struggles, and comfort us when we are suffering or afraid. They bring us together. All this means that our social evolution is deeply intertwined with our physical evolution. And this whole process is still baked into our collective psyche today, Bill told me. “If I’m not sharing knowledge and emotions, then I feel lonely.”

“What’s disturbing about this,” Steve Cole observed, “is that we have created a culture of living which is different from our historical default state. I think we are relaxed and at ease by default and are bonding oriented in our resting state. But few of us feel this way. It’s less common for us to be sitting around our fire talking with neighbors. Instead, we are racing around trying to get work done all the time. So, I think our current state is different from what our physiology is engineered to support.”

When I began my rotations in the hospital as a third-year medical student, I was struck by the distinctions we typically made between emotional pain and physical pain. When we encountered physical pain in our patients, we would rush to determine the origin of the pain, asking questions, performing exams, and obtaining laboratory and imaging studies. And we would be aggressive about monitoring and treating the pain. When we discovered someone was experiencing emotional pain, we reacted with concern and compassion, but there was an underlying assumption that this was less of a concern and less consequential than physical pain. What few of us understood at the time was that, within the brain, there’s less difference between the two than we think. The sensory fibers that register emotional and physical pain overlap in the brain. This proximity means that loneliness, loss, or disappointment can produce symptoms similar to those caused by physical blows or wounds.24 If you feel shunned, researchers have found, you’re likely to flinch the same way you would if slapped. If the shunning and slapping occur during an fMRI, the same region of the brain (the dorsal anterior cingulate cortex) will light up in both events.

While we recognize loneliness and other sources of emotional pain as risk factors for misuse and addiction, we don’t make the connection often enough. I have found the opposite also to be true: social connection is an essential part of the addiction recovery process. In caring for patients over the years and during my time as surgeon general, I met thousands of people who struggled with addiction to opioids, alcohol, and other substances, and when I reflect on those who made it through that dark tunnel and emerged in recovery, nearly all of them described a trusted relationship or a trusted group of close family or friends who had made their recovery possible. While loneliness has the potential to kill, connection has even more potential to heal.

“People are hard to hate close up.”

One might ask, Isn’t it the responsibility of the user to exercise willpower and moderate their use? In theory, yes. But in practice, to do so we must overcome deeply ingrained behavioral instincts that have been honed over millennia.

When we’re on the digital tether, she says, we’re not fully present in either our virtual or our physical life. Also, we’re not fooling anyone. Others can tell when we’re not paying attention, and it makes them less likely to share as much or as deeply. No wonder the constant presence of our phones and other communication technology has been shown to reduce the emotional quality of our conversations. As Andrew Przybylski and Netta Weinstein found in their experiments, the mere sight of phones during conversation negatively impacted “the extent to which individuals felt empathy and understanding from their partners.”15

The irony is that our capacity for solitude also is diminished by technology. Social media’s constant presence creates the illusion that we never need to be alone—and that something must be wrong with us if we feel alone. Yet we still need solitude, as well as the time and space to cultivate its benefits. We need regularly to free our minds to wander and explore without being directed by network algorithms and autoplay ads. Solitude allows us to get comfortable being with ourselves, which makes it easier to be ourselves in interactions with others. That authenticity helps build strong connections.

The way to get people to find common ground on reproductive rights, climate change, and criminal justice is not necessarily to talk first and hear everyone’s arguments. Instead, it’s to establish relationships between those who disagree—relationships where people meet first as fellow human beings, not as political positions. Derek’s right: once we find points of shared value and concern, our minds and hearts open to each other. And that’s when we, too, can “move together against gravity.”

“Almost without exception,” Wilson wrote, “alcoholics are tortured by loneliness.12 Even before our drinking got bad and people began to cut us off, nearly all of us suffered the feeling that we didn’t quite belong. Either we were shy, and dared not draw near others, or we were apt to be noisy good fellows craving attention and companionship, but never getting it—at least to our way of thinking. There was always that mysterious barrier we could neither surmount nor understand.”

2016. Friendship, he said, is “not about what someone can do for you, it’s who and what the two of you become in each other’s presence.” He added, “The notion of doing nothing but spending time in each other’s company has, in a way, become a lost art.”

According to Waldinger, the Harvard data showed that inner-circle relationships were better predictors of health and happiness throughout life than IQ, wealth, or social class. Having someone you can call for help at three a.m. can be a buffer against mental and physical decline. “The people who were the most satisfied in their relationships at age fifty,” Waldinger said in his TED talk about the study, “were the healthiest at age eighty.”5 These close relationships also are our primary defense against intimate loneliness.