Why we need to stop medicalising loneliness
What does loneliness sound like? I asked this question on Twitter recently. You might expect that people would say “silence”, but they didn’t. Their answers included:
The wind whistling in my chimney, because I only ever hear it when I’m alone.
The hubbub of a pub heard when the door opens to the street.
The sound of a clicking radiator as it comes on or off.
The terrible din of early morning birds in suburban trees.
I suspect everyone has a sound associated with loneliness and personal alienation. Mine is the honk of Canadian geese, which takes me back to life as a 20-year-old student, living in halls after a break-up.
These sounds highlight that the experience of loneliness varies from person to person – something that is not often recognised in our modern panic. We are in an “epidemic”; a mental health “crisis”. In 2018 the British government was so concerned that it created a “Minister for Loneliness”. Countries like Germany and Switzerland may follow suit. This language imagines that loneliness is a single, universal state – it is not. Loneliness is an emotion cluster – it can be made up of a number of feelings, such as anger, shame, sadness, jealousy and grief.
The loneliness of a single mother on the breadline, for example, is very different to that of an elderly man whose peers have died or a teenager who is connected online but lacks offline friendships. And rural loneliness is different to urban loneliness.
By talking about loneliness as a virus or an epidemic, we medicalise it and seek simple, even pharmacological treatments. This year researchers announced that a “loneliness pill” is in the works. This move is part of a broader treatment of emotions as mental health problems, with interventions focusing on symptoms not causes.
But loneliness is physical as well as psychological. Its language and experience also changes over time.
Lonely as a cloud
Before 1800, the word loneliness was not particularly emotional: it simply connoted the state of being alone. The lexicographer Thomas Blount’s Glossographia (1656) defined loneliness as “one; an oneliness, or loneliness, a single or singleness”. Loneliness usually denoted places rather than people: a lonely castle, a lonely tree, or wandering “lonely as a cloud” in Wordsworth’s poem of 1802.
In this period, “oneliness” was seldom negative. It allowed communion with God, as when Jesus “withdrew to lonely places and prayed” (Luke 5:16). For many of the Romantics, nature served the same, quasi-religious or deistic function. Even without the presence of God, nature provided inspiration and health, themes that continue in some 21st-century environmentalism.
Critically, this interconnectedness between self and world (or God-in-world) was also found in medicine. There was no division of the mind and body, as exists today. Between the 2nd and the 18th centuries, medicine defined health depending on four humours: blood, phlegm, black bile and yellow bile. Emotions depended on the balance of those humours, which were influenced by age, gender and environment, including diet, exercise, sleep and the quality of the air. Too much solitude, like too much hare meat, could be damaging. But that was a physical as well as a mental problem.
This holism between mental and physical health – by which one could target the body to treat the mind – was lost with the rise of 19th-century scientific medicine. The body and mind were separated into different systems and specialisms: psychology and psychiatry for the mind, cardiology for the heart.
This is why we view our emotions as situated in the brain. But in doing so, we often ignore the physical and lived experiences of emotion. This includes not only sound, but also touch, smell and taste.
Warm hearts
Studies of care homes suggest that lonely people get attached to material objects, even when they live with dementia and can’t verbally express loneliness. Lonely people also benefit from physical interactions with pets. The heartbeats of dogs have even been found to synchronise with human owners; anxious hearts are calmed and “happy hormones” produced.
Providing spaces for people to eat socially has, as well as music, dance and massage therapies, been found to reduce loneliness, even among people with PTSD. Working through the senses gives physical connectedness and belonging to people starved of social contact and companionable touch.
Terms like “warm-hearted” describe these social interactions. They come from historic ideas that connected a person’s emotions and sociability to their physical organs. These heat-based metaphors are still used to describe emotions. And lonely people seem to crave hot baths and drinks, as though this physical warmth stands in for social warmth. Being conscious of language and material culture use, then, might help us assess if others – or we – are lonely.
Until we tend to the physical as well as the psychological causes and signs of loneliness, we are unlikely to find a “cure” for a modern epidemic. Because this separation between mind and body reflects a broader division that has emerged between the individual and society, self and world.
The limits of the individual
Many of the processes of modernity are predicated on individualism; on the conviction that we are distinct, entirely separate beings. At the same time as medical science parcelled up the body into different specialisms and divisions, the social and economic changes brought by modernity – industrialisation, urbanisation, individualism – transformed patterns of work, life and leisure, creating secular alternatives to the God-in-world idea.
These transformations were justified by secularism. Physical and earthly bodies were redefined as material rather than spiritual: as resources that could be consumed. Narratives of evolution were adapted by social Darwinists who claimed that competitive individualism was not only justifiable, but inevitable. Classifications and divisions were the order of the day: between mind and body, nature and culture, self and others. Gone was the 18th-century sense of sociability in which, as Alexander Pope put it, “self love and social be the same”.
Little wonder then, that the language of loneliness has increased in the 21st century. Privatisation, deregulation and austerity have continued the forces of liberalisation. And languages of loneliness thrive in the gaps created by the meaninglessness and powerlessness identified by Karl Marx and sociologist Emile Durkheim as synonymous with the post-industrial age.
Of course loneliness is not only about material want. Billionaires are lonely too. Poverty might increase loneliness linked to social isolation, but wealth is no buffer against the absence of meaning in the modern age. Nor is it useful in navigating the proliferation of 21st-century “communities” that exist (online and off) that lack the mutual obligation assured by earlier definitions of community as a source of “common good”.
I am not suggesting a return to the humours, or some fictitious, pre-industrial Arcadia. But I do think that more attention needs to be paid to loneliness’s complex history. In the context of this history, knee-jerk claims of an “epidemic” are revealed to be unhelpful. Instead, we must address what “community” means in the present, and acknowledge the myriad kinds of loneliness (positive and negative) that exist under modern individualism.
To do this we must tend to the body, for that is how we connect to the world, and each other, as sensory, physical beings.
Written by Fay Bound Alberti, Reader in History and UKRI Future Leaders Fellow, University of York. Republished with permission of The Conversation.