Understanding Loneliness

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“All the lonely people, where do they all come from?” —The Beatles, “Eleanor Rigby,” 1966

Loneliness has been a problem throughout human history. In recent times, population growth, migration into cities and away from smaller communities, the loss of traditional family and social structures, and the rise of social media and virtual relationships, as well as related generational changes, have ostensibly accelerated the loneliness epidemic to global health proportions.

The consequences are not abstract. Loneliness increases the risk of premature death more than obesity, physical inactivity, or smoking up to 15 cigarettes a day (Holt-Lunstad et al., 2015), a finding sobering enough that, for this and other generational and post-pandemic related reasons, the U.S. Surgeon General declared loneliness a public health crisis in 2023.

When Being Alone Feels Safer Than Being Together

Many of us will find that moment of choice and vulnerability familiar—when we both want to give voice to and self-silence a heartfelt, meaningful experience, whether expressing affection or a desire for more closeness when we are unsure whether this will be reciprocated. Many don't take the risk, fearing rejection or humiliation often more than merited based on prior disappointments, and regretting our decision in hindsight.

For many people, this goes deeper than a single hesitant moment. When we both want and may in fact need intimacy yet are also scared of intimacy because of experiences we have had—scared of failing or getting hurt again—it places us in a very difficult, but importantly not impossible, double bind. If we are more aware, we may experience this as overt inner conflict. If we are less so, we may experience distress, dissonance, confusion, and ambivalence—feeling closeness but then blowing it up for unclear reasons, or thinking things were going well and then getting blindsided.

Early experiences shape which version we inhabit. Those with avoidant attachment carry a painful longing in the background while maintaining distance. Those with preoccupied attachment reach urgently for closeness in ways that can paradoxically push it away. For some with more severe early adversity and possibly chaotic disorganized attachment, longing and terror become so fused that neither safe connection nor safe distance feels available.

Too often, we encounter a tragically familiar story: A person who seemed to have a perfect life, happy, contented, with a great family and job. It's all picture-perfect, and when they die from suicide, we are surprised, shocked, and frightened because there is no clear explanation. On some level, this fear may speak to our own hidden existential struggles, or even unacknowledged and masked clinical depression, trauma, shame, or related problems. Suicidal crises are precipitated by a feeling of "entrapment" and intolerable psychological and emotional pain (Galynker et al., 2024). Loneliness and isolation are risk factors, and it is worth noting that social exclusion activates the brain in ways similar to physical pain (Eisenberger, 2012), increasing the subjective sense of psychic pain further.

Research on people who survived near-lethal suicide attempts found that most reported those closest to them had no idea—concealment was characteristic, the private self hidden even from the person carrying it. Many people who function well, and who would not recognize themselves in the above, nonetheless carry what might be called a lonely core—one they are dimly aware of but have learned, without quite deciding to, to look away from before it fully arrives. What tends to surface it is another person—a therapist, a close friend, a spiritual guide—who notices what isn’t being said. Once the loneliness is partly named in the presence of another, it begins to gain traction: frightening, and also potentially the beginning of something.

Understanding Loneliness

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Solitude ≠ Loneliness

Solitude and loneliness are not the same thing—though the psyche, for its own protective purposes, may experience confusion between them.

Genuine solitude can be deeply nourishing. The relationship with oneself, when it is real, is enriching, a state of relative wholeness that doesn’t require the suppression of anything. For many people, the capacity for genuine solitude is also a precondition for intimacy: the secure internal base from which the approach/avoidance seesaw can finally be examined rather than simply enacted again.

But there is another kind of aloneness, one that has solitude’s shape without its substance, what might be called performative solitude, in which the person is not really alone with themselves but managing themselves. What keeps the loneliness in place is something like a complicated psychological and emotional (psychodynamic) swaddling—layers of self-relation that keep intimacy safely enfolded, protecting against recognition of what is actually present. The defenses exist because they once were necessary, but they persist beyond their use, leading to the repetition of problematic patterns along with a desire to "break" or abruptly "let go of" those same patterns, rather than perhaps bending away from and resculpting our attachment patterns. The faster changes often take place against the backdrop of longer-term efforts.

For some, the choice is not between healthy connection and unhealthy isolation, but between forms of distress and deprivation. Performative solitude is the available position, a compromise that deserves understanding rather than prescription.

Loneliness Desensitization

The idealization of solitude is spending time with oneself, perhaps engaged in something deeply meaningful, or perhaps more ostensibly frivolous—whether writing a novel, enjoying a cup of tea and a book, or working on a hobby. The flipside is whether that time becomes hollow, imitating solitude, with the hours becoming excruciatingly boring and tense. It is at times when it becomes more tormenting that loneliness cannot be tuned out without turning to extreme measures, often at the expense of health and well-being.

The rationalization of emptiness resonates with existential nihilism, making it seem factual. The painful longing in the background is held largely at bay, coming through in occasional pangs that can be suppressed, numbed away, or sometimes self-medicated with a range of more or less healthy options. Ways of connecting with others are often scarce, though sometimes they are more available than one admits, and while solutions are being developed by loneliness public health advocates (e.g., the "social prescription"), the work is young.

Unfortunately, as is often generally true with problems, many people do not seek help until the consequences are dire, serious, and harmful to one's health. We know that loneliness does terrible damage, worse than many vices, but when we are prone to loneliness due to problems with intimacy, recognizing when one is in need, seeking help, and having people there to help can seem out of reach.

Change in these patterns rarely happens all at once. It's more like a phase transition than a tipping point, a gradual shift in which something long fixed begins, slowly, to move. A conversation becomes slightly more compassionate and candid. A moment of recognition isn't immediately brushed aside. But with recognition, the loneliness becomes more acute, elevating anxiety, potentially leading to further distraction...and sometimes, with time and building safety, and with support and a plan, insight and positive change.

The song "Eleanor Rigby" ends without resolution. Father McKenzie walks away from the grave, wiping dirt from his hands. As the song goes, "No one was saved." It does not have to end that way. Where do all the lonely people come from? Perhaps from the same place as everyone else—learning, early and often, that love is not always safe. The question worth sitting with is not how to stop being lonely, but what might make it slightly more possible to be known.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the 988 Suicide & Crisis Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory.

Loneliness resources are available through the U.S. Surgeon General’s Advisory on Loneliness and Isolation.

Eisenberger NI. The neural bases of social pain: evidence for shared representations with physical pain. Psychosom Med. 2012 Feb-Mar;74(2):126-35. doi: 10.1097/PSY.0b013e3182464dd1. Epub 2012 Jan 27. PMID: 22286852; PMCID: PMC3273616.

Galynker, I., Bloch-Elkouby, S., and Cohen, L.J. (2024). Suicide crisis syndrome: a specific diagnosis to aid suicide prevention. World Psychiatry, 23: 362-363. https://doi.org/10.1002/wps.21229

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: A meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352

Office of the Surgeon General. (2023). Our epidemic of loneliness and isolation: The U.S. Surgeon General's advisory on the healing effects of social connection and community. U.S. Department of Health and Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf

Tillman, J. G., Stevens, J. L., & Lewis, K. C. (2021). States of mind preceding a near-lethal suicide attempt: A mixed methods study. Psychoanalytic Psychology. https://doi.org/10.1037/pap0000378

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