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• Last updated: September 7, 2020

Podcast #618: Finding Connection in a Lonely World

We’ve all been there: you’re sitting at home some evening and you don’t have plans, you haven’t heard from family or friends for awhile, and you’ve got things on your mind, but don’t feel like there’s anyone you can talk to about them. You feel down and adrift, and sense an almost physical ache in your heart. You’re experiencing loneliness, and my guest today says we ought to interpret this feeling the way we would hunger or thirst — as a signal that we have a need that we should take action to fulfill. 

His name is Dr. Vivek Murthy, he served as the 19th Surgeon General of the United States, and he’s the author of the book Together: The Healing Power of Human Connection in a Sometimes Lonely World. We begin our conversation discussing what loneliness is exactly and how we can feel interpersonally fulfilled in some areas of our lives, and yet lonely in others. Vivek then walks us through the very tangible harm loneliness can do to our mental health, before exploring why loneliness has been increasing in the western world. Vivek and I then discuss how loneliness affects men in particular. We end our conversation with things we can all do to battle the loneliness epidemic and feel more connected to those around us. 

If reading this in an email, click the title of the post to listen to the show.

Show Highlights

  • As a doctor, how did Vivek get cued into the loneliness as a health problem?
  • The far-reaching scale of loneliness in America
  • How is loneliness defined? How is it different from solitude?
  • The 3 types of loneliness
  • Why marriage alone doesn’t alleviate loneliness
  • The physiological repercussions of loneliness
  • Why are more people getting lonely in America?
  • How is our current media environment making us lonelier?
  • Why our expectations for friendship might be mismatched from reality 
  • How men and women experience loneliness differently
  • So what should you do if you’re lonely?

Resources/People/Articles Mentioned in Podcast

A book cover of "Together" by Vivek H. Murthy,MD.

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Read the Transcript

Brett McKay: Brett McKay here, and welcome to another edition of The Art of Manliness Podcast. We’ve all been there. You’re sitting at home some evening, don’t have any plans, you haven’t heard from family or friends in a while, you got things on your mind, but don’t feel like there’s anyone you can talk to about them, start feeling down and adrift, and sensing almost physical pain or ache in your heart. Well, that experience you’re feeling is loneliness. And my guest today says about interpret this feeling the way we would hunger or thirst as a signal that we have a need, that we should take action to fulfill. His name is Dr. Vivek Murthy, he served as the 19th Surgeon General of the United States, and he’s the author of the book, Together: The Healing Power of Human Connection in a Sometimes Lonely World.

We begin our conversation discussing what loneliness is, exactly, and how we can feel interpersonally fulfilled in some areas of our lives, and yet lonely in others. Vivek then walks us through the very tangible harm loneliness can do to our mental health before exploring why loneliness has been increasing in the Western world. Vivek and I then discuss how loneliness affects men in particular, and we end our conversation with things we can all do to battle the loneliness epidemic and feel more connected to those around us. After the show’s over check out our show notes at aom.is/loneliness. Vivek joins me now via clearcast.io.

Alright, Dr. Vivek Murthy, welcome to the show.

Vivek Murthy: Thanks so much Brett. It’s good to be with you.

Brett McKay: So you were the US Surgeon General of the United States from 2014 to 2017, but since then, you’ve written a book, it’s out now, called, Together: The Healing Power of Human Connection in a Sometimes Lonely World. And it’s where you take a deep dive into loneliness, which is an issue, a health issue, mental health issue that often gets overlooked. I’m curious as a doctor… And we typically don’t think of doctors thinking about loneliness, you’re the doctor, you’re cold, maybe you’re feeling depressed, but never… You’re the doctor ’cause I’m lonely. When did you as a healthcare practitioner start noticing loneliness being a health issue?

Vivek Murthy: Well, the truth is, I had seen loneliness long before I entered medicine, I had seen it in my own life. And as a child, I struggled a lot with being alone, I was very shy and had a difficult time going up to other kids and making friends, even though I really wanted to hang out with others. And I remember that loneliness so vividly. I remember pulling up to the front of the school each morning when my parents would drop me off and feeling this pit in my stomach, ’cause I was just dreading that feeling of being the one left out. And the toughest part of the school day for me was actually lunch time, when I would walk into the cafeteria not knowing if there would be somebody I could sit next to, and I carried that with me for a long time, even though I was able over time to build wonderful friendships and to feel a part of a community. I never forgot what it felt like to be lonely, and I was reminded of it when I began working in the hospital as a doctor, frankly even as a medical student, I started to see that so many patients would come in alone, and even at moments when we had to have very difficult conversations with them about a new diagnosis or had to make hard decisions about a treatment course, and I would ask them, is there somebody you want me to call so that we could have this conversation together, so you have some support?

And very often, the answer was, “I wish there was somebody, but there isn’t anyone.” Even Brett at the time of death, I remember sitting with patients at their bedside and knowing as painful as it was that we were the only ones, my fellow nurses and doctors in the hospitals, we were the only ones who were there with them in those final moments, and that there was no one else in their life to witness that final stage. It was painful to see then, but what was also painful, Brett, is I didn’t know what to do about it. I had never really trained in how to ask people about loneliness, talk about loneliness, much less address it. I responded to it as a human being and tried my best to listen with empathy and to be present for patients as they struggled with being alone, but I didn’t really know how to approach it or how to think about loneliness, and I certainly didn’t know that it had health consequences.

That, I only came to realize when I became surgeon general, and in the conversations I was having with people across the country, conversations about substance use disorders, about depression, about anxiety, about chronic disease, I came to see that there were these threads of loneliness that wove their way through so many people’s stories, whether they were college students, or moms and dads, or people living in remote fishing villages in Alaska, or even members of Congress in Washington DC. Person after person would say to me, I feel I have to carry all of these burdens in my life by myself, or I feel if I disappear tomorrow, no one would even know, or I feel invisible. And that’s where I started to delve into the research around loneliness and came to see that loneliness is extraordinarily common within the United States, more people struggling with loneliness were adults than adults who have diabetes or who smoke, and the consequences for our health are actually profound as well, far greater than I could have imagined.

Brett McKay: And we’ll talk about the health consequences of that. But before, let’s get the definitions. What is loneliness and how is it different from just being by yourself, solitude, ’cause I think everyone knows that you can be by yourself and not feel lonely, but then you can be in a crowd of people and feel incredibly lonely.

Vivek Murthy: That’s right. Loneliness is a subjective term, it describes a gap between the social connections I need and the social connections I have in my life. It is different from an objective descriptor, like isolation, which is more a description of the number of people you have around you, but we know that people can feel lonely even if they’re surrounded by many. This is a circumstance I’ve observed in so many college students who found themselves surrounded by thousands of other students on campus but still felt profoundly alone. And this is also different from solitude. Solitude is a state of being alone in objective terms but it’s not a painful state. In fact, it’s a peaceful and a welcomed state. And it turns out that solitude is a essential part of all of our lives, and cultivating solitude, being able to embrace those moments of solitude and make the most of them, are counter-intuitively, a key part of what we need to do to strengthen our connection with other people.

Brett McKay: And we’ll talk about that too, but what I love about in the book, you break down, you can experience different types of loneliness, it’s not just a single type of loneliness. You might have great strong connections with your family but you might feel lonely when you go to work, for example.

Vivek Murthy: That’s right. And I found that in writing this book, so important to understand the different types of loneliness, because if you don’t recognize that we have different needs in terms of our social connections, then you might assume that if you’re married and your partner is feeling lonely, that somehow that’s a reflection on your marriage or that if you got a best friend but they’re feeling lonely, that somehow you’re not a good enough friend to them. But what you have to understand there’s three types of loneliness that we can all experience. One is intimate loneliness, when we lack connection with people who know us really well, people with whom we can show up completely as ourselves, people with whom we can be real. And when we don’t have that, we experience intimate loneliness.

The second type of loneliness is relational loneliness, when we don’t have the kind of friendships with which we can seek out others to spend evenings or weekends with, the kind of friendships where we would go on a vacation or a trip with somebody or get our families together for special events. And there’s a third type of loneliness, collective loneliness, when we lack a sense of community, a sense of shared identity and purpose with a group of other people, whether that’s people that we volunteer with together or people that we attend church or synagogue, or the mosque with together, or people with whom we work and with whom we share the deep sense of mission. These three types of loneliness are important, and you can be fulfilled in one category, you can have great intimate connections, but still feel lonely if you don’t have a community, you can still not feel like you’re part of something. And so the more we understand this, the more we recognize that we all have different roles that we play in each other’s lives; but if we also want to live a truly connected life, we need those best friends and others who can serve as intimate connections. We need friends with whom we can engage in every day fulfilling activities with, and we need a community with whom we have a sense of shared purpose and identity.

Brett McKay: I’ve seen that play on my own life. Say for example, when I first got married… Maybe this happened to other newly weds. When I first got married, friends wasn’t really on the radar just like, “I’m married to my best friend. I got my wife and we just do everything together.” But I remember that we reached a certain… Both of us reached to a point it’s like, “But we need friends.” But because we were so invested in our just… The intimate relationship, we had let those friendships atrophied and it was like too late. So we were basically building starting from ground zero because we neglected that.

Vivek Murthy: Yeah, I’m so glad you brought that up, Brett, because this is a really common thing that happens to a lot of people, because what’s really interesting about society is society sends certain messages to us about what we need and what we should be fulfilled by. And it tells us, for example, that we can’t be happy if we’re not married and that once we’re married, then our spouse should be enough, but the reality is a lot more complicated than that. The realities are, number one, some people can have very fulfilled lives without being married per se, if they have intimate connections with close friends and if they have circles of friendships and community connections that keep them feeling like they’re living a deeply connected life. On the other hand, there are plenty of people who are in marriages and feel quite lonely, either because the relationship itself is not as open as they need or because their relationship has crowded out friendships and they have not prioritized building community as well.

I was actually an example of this in my own life. When I finished my tenure as surgeon general, I had to figure out how to put my life together again, because I realized that in the years that I served and I had focused on my connection with my wife, Alice, and with my connection with close family. But I had neglected so many friendships, I had lost the sense of community. And I had told myself in the job that this is an important job and that I had to do as much as I could for as long as I could, recognize that you never know how long you have the opportunity to serve, and I had a lot of public health campaigns that I wanted to launch during the time I had in office. But the truth is I did that to the point of neglecting my relationships, and I paid the price for that and I felt quite isolated and lonely at times during my tenure but even especially afterward. And I had to think, after I came out of office, “How do I rebuild a connected life, recognizing that even though I’m so grateful to have a fulfilling relationship with my wife, that both of us need more? We need other friendships, we need a sense of community.” And the years that followed in my time in government were a process of recognizing that need, of rebuilding that kind of connection in my life, and it’s a journey that continues ’til today.

Brett McKay: So what happens with our physiology whenever we feel lonely? ‘Cause I think everyone’s experienced that feeling and there’s almost like an ache, like it hurts. Why does it feel like that?

Vivek Murthy: Yeah, so loneliness we used to think of as just a bad feeling, but it turns out that loneliness affects our body in a profound way. On a biological level, loneliness puts us in a stress state, and in the short term, that stress can be good. It can motivate us to go and seek out other friends and family members, and to hopefully feel more connected and less lonely. But we run into problems when that loneliness is prolonged and when the stress state that it causes is prolonged as well, because we know that chronic stress is associated with higher levels of inflammation in the body, which in turn can lead to an increased incidence of heart disease and other chronic illnesses. So this is likely one of the key mechanisms through which loneliness has its impact on health.

And if you look at the data, the data I started to dig into once I recognized how common loneliness was in our country, you start to see that loneliness is associated with not only an increased risk in heart disease, but also an increased risk in dementia, in depression, anxiety, premature death, sleep disturbances. In fact, if you look at the mortality impact of loneliness, the amount by which our life is shortened in a sense when we’re lonely, that seems to be similar to the mortality impact associated with smoking 15 cigarettes a day, and even greater than the mortality impact that we see with obesity and sedentary living. I say this, Brett, as someone who served as surgeon general in an office that for decades worked on those three issues; smoking, obesity, sedentary living, yet I had not realized just how extraordinarily consequential this other issue was, the issue of loneliness. And the more I understood it, the more I came to realize that it was an important public health concern.

Brett McKay: Yeah, ’cause it seems like loneliness could underlie all those issues, ’cause usually if you have connections, family, friends, they can help you with those things; quitting smoking, obesity, etcetera, and if you don’t have that, it makes it a lot harder to overcome those issues.

Vivek Murthy: Yes. And so there, interestingly, I think, are these two components to how loneliness impacts our health. There’s a practical component of what you just said, which is, when you’ve got people in your life that you can lean on, they can encourage you to do the right thing, whether that’s eating right or quitting smoking. They can encourage you to go walking or go to the gym, they can actually practically help you get to the doctor’s office or remind you to take your medicines. So that’s sort of a practical way in which connections impact our health.

This stress-related pathway is a separate but also equally important one, and if you wanna understand why that is, that loneliness causes a stress state, it has to do with how we’ve evolved over thousands of years as people who were hunter-gatherers back in the day and who relied on each other for safety and protection. So back in those days, there truly was safety in numbers. When we were with others in trusted communities, we could watch out for predators, we could share food so that we had a stable food supply, we could help each other with childcare. And when we were separated from our tribe, that automatically reduced our risk of survival, and we knew that. And so our body went into a stress state, where it was prepared to either fight a predator, or to flee, or to quickly look for the tribe again. And in that stress state, what’s very interesting is because we felt that we were under threat, we developed a sense of hyper-vigilance, where even if something around us, the twig that cracked behind us had only a 1% chance of being a predator, we wanted to interpret it as something dangerous because our life may depend on it. Our focus also shifted inward, because we were worried about our safety.

Now, this all makes sense in an evolutionary context, but think about how it relates to the modern world, because even though our circumstances are dramatically different now, our nervous systems are remarkably similar, and so when we are lonely and we enter into this state of stress, the hyper-vigilance associated with loneliness and greater likelihood of assuming bad intent or threat behind what we see around us, that can actually make it harder for us to connect with people and interact with them. The increased focus we have on ourself can also make it harder for people to feel connected to us in conversation, not to mention the fact that when we’re chronically lonely, it can erode our self-esteem, as we come to believe that the reason we’re lonely is that we’re not likeable. And this is how, well, if you understand these mechanisms, you understand that loneliness begets loneliness, and it creates this downward spiral, and what we have to figure out when we address loneliness is how do we break that spiral and rebuild that pathway to connection?

Brett McKay: Let’s talk about why we have been seeing a spike in loneliness. ‘Cause I’ve seen those articles come out in the past 5-10 years that more and more people are lonely. In fact, I just saw an article the other day that more and more older Americans are dying alone. What’s going on here? What are the factors contributing to that?

Vivek Murthy: Yeah. So here’s what we know about loneliness in terms of the numbers. We know that loneliness is exceedingly common. If you look at a 2018 Kaiser Family Foundation study, it came up with the number 22% of adults in America who struggle with loneliness. Many would argue that’s actually on the lower end of the scale, if you look at other studies that have been done. More recently, the study done by the American health insurer, Cigna, a large population-based study using the UCLA Loneliness Scale, which is a validated, reliable scale. Found that the numbers were actually much higher and placed them actually closer to half the population, if not a bit more, that struggles with loneliness. Interestingly, they also found that unlike most people’s assumptions that loneliness is probably most concentrated among the elderly, it turned out that young people had some of the highest rates of loneliness, and this has also been seen in other data as well.

If you look at other countries, you see that the numbers are not dissimilar. The UK and Australia are struggling with around 25% of adults in their country who admit to being lonely. And many other countries around the world, in Asia, throughout Europe and in Latin America, are finding double digit percentages of loneliness. The question that is being asked is, “Is loneliness increasing or not? Have we always been this lonely?” And the truth is, we don’t 100% know the answer to that question, in part because we don’t have enough data. Some of the data that’s out there in the studies that are done are using different methodologies, so it’s hard to always compare apples to apples. But if you just look at the Cigna study that was run in 2018 and 2020, using very similar methodology, they did find a modest increase in loneliness. And John Cacioppo, who is widely regarded as the father of modern loneliness research, also believed that there was a modest increase in loneliness that was taking place in society. So I think that for multiple reasons, it merits paying attention to, and it’s important to prioritize loneliness, because we know it’s exceedingly common, we know it’s consequential, not only for our health, but also for how we perform in the workplace and in school, and there is a chance, given what we know in some of the limited data we’re seeing, that it may in fact be increasing as well.

Brett McKay: Do we have any idea the factors that have contributed to it?

Vivek Murthy: So I think there’s several factors in the modern world that are contributing to loneliness. There’s certainly the mobility factor, which has given us the opportunity to travel and to move many times in our lifetime for jobs, for opportunities, but has also uproots us from the communities that we have come to know. I saw this so clearly in my own parents who left India in the early 1970s to build a better life for themselves and for their kids, my sister and I, and they moved to England and to the United Kingdom, and then eventually to the United States. And while they were blessed to have many opportunities, what they missed and struggled with for years and years, was losing the community that they had in India of family and friends. And so, mobility is one factor.

The second factor is how we use technology. And notice I didn’t say technology, because technology at the end of the day is a tool. And the question is, can we use it to strengthen connection versus weaken connection. And when we use technology to stay in touch with friends who we otherwise may not be able to see, when we use it to video conference with a relative halfway around the world, or when we use it to post on social media that we’re coming into town and ask if any friends are free for dinner and then we meet up and catch up in person, these are all powerful ways that technology can help us stay connected to others.

But what I worry is that the way in which we’re predominantly using technology now may be in fact contributing to greater disconnection. And this happens when we do one of three things with technology, when we allow the amount of time that we’re spending in front of screens to edge out and crowd out the in-person time we have with others, that can diminish our relationships. When we also allow technology to creep into our conversations, such that we are catching up with friends while we’re also checking our social media feed or looking at our inbox or Googling a question that came into our head or looking at the score in the game, all thinking that we can multitask, and so we can fully pay attention to our friend. The truth is that our conversations suffer, because the science is very clear that we don’t multitask as human beings, we task switch. So when I’m looking at my inbox, I’m actually not able to fully pay attention and process what someone is saying.

But finally, the way in which technology can hurt is also by how it impacts our perception of ourself. And for many people who use social media in particular, they know that there’s this accelerated culture of comparison that technology has enabled. People have been comparing themselves to other people for thousands of years, and asking, “Do I have a car that’s as nice as my neighbor? Is my house as big as my friend’s?” But what happens on social media is that it is accelerated many, many fold. And so when you’re scrolling even through your Instagram feed or through your other social media feeds, you’re constantly comparing somebody’s curated pictures, really the best version of their life, to your average moments, and you often come up feeling short.

Social media also and media in general, has accelerated messaging to us that often tells us that we’re not enough, that we’re not thin enough, we’re not good looking enough, we’re not smart enough, we’re not rich enough, we’re not popular enough. And when you hear that time and time again, especially when you’re young and you’re developing your sense of identity, it can really impact your sense of self-worth and make you feel inadequate, and when you approach other people from a place of being inadequate and not feeling like you’re good enough, it actually impacts your ability to connect with them because you’re more focused often on validation, you’re more on edge, you’re more trying to be who you think they want you to be, then you are focused on just showing up as who you are, as just listening to them, as opposed to always thinking about what you’re gonna say.

So these are the ways in which I worry about technology, and the way in which we’re using it. But one last thing I’ll say, Brett, and this is perhaps the most insidious driver of loneliness, is a set of cultural constructs that I think we’ve come to live in in the modern world. They tell us that our self-worth is driven and defined by whether we’re successful, and that our success, in turn, is defined by whether we’re able to acquire wealth, power or fame. And if we’re able to do that, then we’re held up as successful. And that’s what we do. We glorify those who have become rich and famous and powerful, and while there’s nothing wrong with seeking out those things in and of themselves, where the problem is when we define our self-worth based on those external parameters.

And I worry that we have set our children up for failure in a sense, because we know that when people pursue wealth, power and fame and define their worth by that, that they rarely end up happy. The world is filled with rich, powerful, famous people who are a profoundly unhappy, and many of them are people I have talked to. Some of them are people who inspired some of the stories in this book. But unless we change that construct at a cultural level, and teach our children or remind ourselves that our worth is truly intrinsic, that it’s based on our character, our ability to be compassionate, to be kind, to be generous, and to operate from a place of love, then we will never have a secure place of worth. And that will affect how we approach our interaction with others and the relationships that we build with them.

Brett McKay: I mean, the other interesting thing about loneliness, because it is subjective, your calibration of what is an ideal social connection is different for everybody. That can get out of whack based on looking at social media. If you’re on social media and you’re seeing lots of people doing stuff with lots of people, you make that your expectation and because you don’t feel like you’re getting that, that you feel lonely. When maybe three close friends is what you need, or maybe there’s that weird distance that you can create a mental gap that can actually exacerbate the feeling of loneliness, that maybe you don’t need to create.

Vivek Murthy: Yeah, such an interesting point, Brett, ’cause you’re right. What we see shifts to our expectations, and when you’re constantly seeing people socializing and with friends and at parties, with the picture that paints us, and you see this on college campuses all the time, it paints a picture that to have a social life, we need to be going out all the time. We need to be at parties, we need to be invited to people’s houses all the time, we need to be with others constantly. And the truth is, and not everyone is built that way. If you’re an introvert and if you need more time alone or if you prefer interacting with people in smaller group settings or one-on-one, and you can quickly feel that you’re a loser if you’re not going out to parties every Friday or Saturday night. So I do think that those expectations get ratcheted in the wrong direction, and again, I should say distorted by what we see. In the book I talk about some research by a British gentleman by the name of Robin Dunbar, who’s done some fascinating research looking at social networks and primates, and extrapolating to how they may impact humans as well. And one of the things that he has suggested in looking at various types of social circles, is that our ability to hold close intimate relationships in our lives, the kind of friendships where people know us for who we are even when we forget. The kind of friendships, what we can really just show up as who we are and not try to be somebody else.

That our ability to maintain those is limited to around five people. Now that’s not to say, Oh, you can only have five, some people may have six or seven, but his point was, it’s a small number of people with whom we can enjoy that kind of intimate connection. And the reason it’s small is because cultivating and maintaining those kind of connections takes time. And so what he has also estimated, is that 40% of the social time that we spend is actually spent on our closest, on our inner circle, on those a small handful of relationships. And I think there’s an important lesson there because, in two forms. One is that we don’t need to have 20, 30, 40, 50 best friends in order to have a fulfilled life, we just need a few. And the second point is that friendships take time and investment and effort. We have to remember this because, what social media has made it easy to do, is to spend a little bit of time with a lot of people. So it is easier for me for example, to wish happy birthday to 100 friends on Facebook, just by typing HBD! And copying and pasting that on their walls, which many people do.

It’s easier to do that than to actually pick up the phone and have a half hour or 45-minute in-depth conversation with a friend on his or her birthday. And so we’ve lowered the barrier to having shorter, I would say less intimate interactions with people that we barely know, and as we’ve done that, that’s become the easier place to spend our time. But what Dunbar’s research reminds us of, is that it is with a few relationships that we need to spend a significant chunk of our social time, and that might be time just witnessing other people’s lives, by listening to them, by having conversations with them, not with a goal in mind to organize a trip or to solve a problem, but just to be there and ask how each other is doing. To understand what’s happening in someone’s lives. To spend time with them, to sit with them, and that art of friendship is something that has become lost in a world that feels increasingly oriented around goals and metrics, and around how many likes we can get and how many followers we can acquire on social media.

Brett McKay: How does loneliness affect men differently than women? Are men lonelier than women?

Vivek Murthy: It’s a quick question. The data seems to indicate that men and women have similar rates of loneliness, but it also suggests that men have a harder time admitting it, and I do think that men and women experience loneliness differently. For many men, growing up, what’s fascinating is that if you look at research that has been done by Niobe Way, from New York University, who has studied how young boys experience relationships. She finds that when you talk to young boys and young girls in elementary school about friendships, they talk about them in very similar ways. They use language like, “I love my friend, I can’t wait to hang out with my friend. I would go absolutely crazy if I couldn’t see my friend for a few days,” or “I really need my friend. We need to hang out with each other.”

But as they get older, as boys enter adolescence, as they start learning how to become “A real man,” the way they talk about friendships changes dramatically, and it diverges from how girls talk about relationships. So boys no longer use that language, but they more just say, “Yeah, it’s cool if I can hang out with my friend,” but they’re reluctant to show that they need their friend or that they’re dependent on them in any way. And what they’re doing is they’re hewing toward a model of masculinity that we teach boys at the youngest of ages, which tells them that real men don’t need anyone else, they’re self-reliant, they never get scared, they don’t experience fear, and they certainly don’t show their emotions, they’re stoic. And if you keep hearing that message as a young boy and you internalize that, that affects how you behave and the relationships you form.

The only place where it becomes acceptable for a real man to experience intimacy is in a romantic relationship, but not in the platonic friendships. And the only emotion that’s acceptable for a real man to express, is anger, which is why you see so many of our fellow men with challenges with anger, and with anger being the only pathway for them to express feelings of loneliness, and fear, and resentment and sadness. Once you understand that, you start to recognize how loneliness does in fact appear in unusual and in interesting ways in men. And I think of loneliness as a great masquerader. It doesn’t always look like someone sitting in a corner alone at a party, but loneliness often in men who are older, who experience one of the three great triggers of loneliness, retirement, illness or the loss of a spouse, they can actually manifest their loneliness in the form of irritability and anger. Other people will withdraw when they’re lonely, others will experience what looks like depression or anxiety. So loneliness can look like different things in different people, but in men, it is a real challenge because our model of masculinity tells us and demands that we operate in a way and that we shut off our emotions in a manner that is very counterintuitive and is frankly just not how we are built as human beings, and going against the grain like that can often make for a emotionally challenging and very lonely experience.

Brett McKay: So what do you think the first step is in overcoming loneliness? We’ve talked about what causes loneliness, what it feels like, the problem, but what can we do? What’s the first step in overcoming that?

Vivek Murthy: Well, the first step is to recognize that if you’re lonely, that you’re not alone, that all of us experience loneliness at some point in our lives, that we don’t often talk about it because we’re often ashamed of it, because we have come to believe that if we’re lonely, somehow we’re not likable, or that we’re broken in some way, but the truth is that all of us experience loneliness. So that’s the first and most important thing to understand, you are not alone. The second thing to understand is that if you’re lonely, you are not broken. Because loneliness is a natural signal that our body sends us when we lack something we need for survival, which is in this case, human connection, it sends us something that we should think about, just like hunger or thirst. If we’re hungry or thirsty, we don’t feel embarrassed that we’re hungry or thirsty. In a similar way, we should think about loneliness as something that is nothing to be ashamed of, but is a natural response.

The third thing to recognize is that rebuilding a life of connection does not necessarily have to entail wholesale transformation of your life. It doesn’t mean you’ve gotta quit your job and move halfway across the country to be closer to someone you love, although you may choose to do that, and that for many people is the right solution. But what I learned in the writing of this book is that small steps can make a big difference in how connected we feel, and the reason is because we are wired to connect with each other. And when given the opportunity to forge even a bit of connection, our body gravitates to it. Just like dry sand that sucks in any drop of water that it’s exposed to, we soak up human connection when it’s offered up to us in the right context. And so there are a few simple steps I think that we can all take to start building a more connected life. And the first thing we can do is we can make it a point each day to spend at least 15 minutes with someone we care about, that could be time that we spend video conferencing with a good friend, could be a call that we make to a family member, just to say, “I’m thinking of you and I just wanna know how you’re doing.” It could be an email that we write to an old friend just because we wanna see how they are.

The second thing we can do is we can make it a point to improve the quality of our interaction with other people by eliminating distraction when we’re in conversation. I say this as somebody who has been guilty of multitasking during many of the conversations I’ve had over the years when I was catching up with friends, and I don’t feel good about that. I know that they probably knew I wasn’t fully present. I know that I didn’t feel as fulfilled afterward in the conversation. But it’s so easy to do, to multitask. Our devices are right there in our pocket, the TV’s so easy to turn on, but what I have found is that even if we reduce the amount of time that we’re with other people, if we make sure that that time counts, then that can be profoundly fulfilling. If you’ve ever had the experience, Brett, of having somebody listen to you deeply and be fully present with you, you know that’s an extraordinarily powerful experience, it’s kind of experience where you feel seen and truly heard, and five minutes of conversation like that, with someone who is truly present, can often be more powerful than 30 minutes of distracted conversation.

The third thing that we can do is, we can look for opportunities to serve other people. The reason this is so powerful, and this was an unexpected discovery for me, is that service turns out to be one of the most powerful antidotes to loneliness that we have. When you understand the downward spiral that loneliness drives, a spiral which makes people turn more inward, feel more threatened and ultimately experience an erosion of self-esteem, then you can understand why service helps, because it short-circuits those mechanisms. It transfers our attention from ourselves to someone else, in the context of a positive interaction, and it also reminds us that we have great value to bring to the world. And so, in times like this, even if we’re not able to go to a soup kitchen or to volunteer at an organization in our neighborhood, calling a friend to check on them, looking in on a neighbor who might be struggling, delivering food to a colleague who might be having a hard time, and even offering to do something like virtually baby-sit for 10 minutes for a friend who might be struggling to telework and homeschool their kids at the same time, these are all small but powerful acts of service that can help us feel more connected to others, as well as to ourself.

And finally, Brett, I would offer one last thing, which is to recognize that moments of solitude are extremely important for us to embrace and protect, even as we seek to build stronger connection to other people. And the reason this is true, even though it seems counterintuitive like, “Why would we need more time with ourselves if we’re trying to connect with other people?” It has to do with the fact that the foundation for connecting with other people is our connection with ourself, which is marked by how comfortable we feel with who we are, how grounded and how centered we feel, how aware we are of our worth and our value. And moments of solitude are powerful because that is when we allow the noise around us to settle, it’s when we reground ourselves, it’s when we allow ourselves to process what’s happening in our world and make sense of the developments in our day.

And moments of solitude don’t have to look like a seven-day retreat that we take away from our family, they could be five minutes that we spend outside just feeling the breeze against our face. It could be a few minutes that we spend reading a book that inspires us, that we spend remembering three things we’re grateful for, taking a walk in nature, meditating or praying. There are many ways to experience the calming of solitude, but when we approach other people from that place of calmness and centeredness, and groundedness, we are often more able to be fully present with them when we’re able to listen, to show up as who we really are. And that is a foundation for creating stronger connection with others.

Brett McKay: I love that. And the other powerful tool that you had in your section about reconnecting, you can apply all these things you just talked about to this… I guess I’d call it a mental model of thinking of your relationships in circles. You have your close family, intimate friend circle, then you have a middle circle of associates, neighbors, then an outer circle of strangers, work associates. And thinking about your relationships, and that can be very helpful. You might think, “Well, I’m pretty good with my inner circle, maybe I can do better on that outer circle.”

Vivek Murthy: That’s right. Yeah, we have different layers of friendships in our life, and just as we talked about intimate loneliness and relational loneliness and collective loneliness, these correspond to three circles of friends, to intimate circles, to relational circles of friendships and then to collective circles, which are community circles. And if we recognize that these are all important, then we recognize that, “Yes, we’ve got to put a significant amount of time with our spouse and our closest friends.” That time matters, and you can’t substitute for it with gifts or with other forms of communication. You’ve got to sometimes just show up and be there in people’s lives. But the time we spend cultivating friendships, going out with good friends, having a friend over for a one-on-one conversation, these moments matter, and the community moments matter too. As human beings, I believe we all, across cultures, have a few core needs. We all wanna be seen for who we are, we all wanna know that we matter and we all want to be loved. That’s true of men and women, it’s true of people who are older or who are younger, it’s true of people in traditional cultures and people in the modern world.

And what’s extraordinary is that we can communicate this to someone else. We can meet all three of these needs simply by showing up, being fully present and listening deeply to another human being. We live in a world that’s a very action-oriented, so when we hear that somebody is struggling, so many times our thoughts, especially our thoughts as guys is, “Okay, how can I fix your problem? What can I do to solve it?” Well, sometimes that’s what’s needed in that situation, but sometimes what we forget, sometimes what I forget, and I have to remind myself of, especially in my conversations with my wife, but also with other friends, is that there is great power in simply showing up, in witnessing, in listening to someone deeply, because while it feels passive, you are telling somebody, when you are listening deeply to them, you’re saying to them, “I see you, you matter, you are loved.” There are few things that you could say that are more powerful than that.

Brett McKay: Well, Vivek, where can people go to learn more about the book and your work?

Vivek Murthy: Well, thanks, Brett. The best place to go is my personal website, which is vivekmurthy.com, my first and last name together, dot com, and there’s information there about the book. There is also an opportunity to sign up for our newsletter. We’ll be sending out some of the extraordinary stories that we’ve been getting from across the country, and really around the world, of people who are reading the book but also thinking about how they wanna build a more connected life. I’m finding many of the people who are reading the book are making it a point to identify one relationship that they wanna recommit to as a result of what they’ve learned in the book. Some cases it’s a family member, in other cases it’s a spouse. Sometimes it’s a close friend but I’m finding those stories to be particularly inspiring, and so we wanna share some of those. So you’re welcome to sign up, to join the community that we’re building to build a more connected life, and ultimately a more connected world.

Brett McKay: Well, Dr. Murthy, thanks for your time, it’s been a pleasure.

Vivek Murthy: So good to speak with you, Brett. I’m glad we did this.

Brett McKay: My guest here is Dr. Vivek Murthy. He is the author of the book, Together. It’s available on amazon.com and bookstores everywhere. You can find out more information about his work and his book at his website, vivekmurthy.com, that’s V-I-V-E-K-M-U-R-T-H-Y dot com, also check out our show notes, at aom.is/loneliness, where you can find links to resources, where you delve deeper into this topic.

Well, that wraps up another edition of the AoM Podcast. Check out our website at artofmanliness.com, where you can find our podcast archive as well as thousands of articles we’ve written over the years about pretty much anything you can think of. And if you’d like to enjoy ad-free episodes of the AoM Podcast, you can do so on Stitcher Premium. Head over to stitcherpremium.com, sign up, use code MANLINESS to check out for a free month trial. Once you’re signed up, download the Stitcher app on Android or iOS and you can start enjoying ad-free episodes of the AoM Podcast. If you haven’t done so already, I’d appreciate if you’d take one minute to give us a review on Apple Podcast or Stitcher. It helps out a lot. If you’ve done that already, thank you. Please consider sharing the show with a friend or family member who you think will get something out of it. As always, thank you for the continued support. Until next time, this is Brett McKay, reminding you to not only listen to the AoM Podcast but put what you’ve heard into action.

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