The Three Faces of Loneliness by Jeremy Nobel, MD, MPH Excerpted from his new book Project UnLonely

In 2019, I gave an early morning talk on loneliness at a senior center in Manhattan. Every seat in the hall was filled, though I suspect that the offer of a free hot breakfast might have been a bigger draw than I was. During the Q&A session that followed my talk, an older woman named Mary raised her hand. “You know,” she said, “I come to these lecture events because people tell me it’s a way to get out and meet people. But you just gave this whole talk about loneliness, and it did no good. I’m still lonely.”

Mary choked up on the word lonely and then started crying. The people seated nearby rushed to comfort her. Some wrote out their phone numbers and asked her to call them. It was a touching moment that illustrates the power of vulnerability. Mary had divulged something personal and painful about herself and the total strangers around her responded with empathy and concern. A simple, sincere statement of need, uncomfortable as it may have been for Mary, allowed her to “show up” more clearly for the others in the room, who immediately connected with her.

My response to Mary that morning was to first acknowledge how rarely we even name the problem for what it is: loneliness; the absence of what we are thirsty for. It’s as if in even speaking the word out loud, we confirm our own worst fears of our deep and shameful inadequacy.

Instead, we sidle up to the topic, saying, “I wish I had more friends,” or even “It would be nice to go out more.” When we do muster up the courage to mutter to others, “I’m lonely,” in response we often hear very simplistic prescriptions for curing loneliness: get a pet, join a book club, volunteer at a senior center. These are all conceivably good things to do, but they don’t necessarily address the underlying causes of chronic loneliness. The activities themselves are not an answer. How we engage in them makes all the difference.

If our engagement with others amounts to fleeting moments with people who remain strangers, that won’t address our core loneliness issues. If we seek out the company of others simply to avoid being alone, we can come away from such experiences feeling even lonelier than before. The shame of loneliness can lead you to feeling very lonely in a crowd. 

At the same time, being alone is not the same as loneliness. We even have a high-​class word for it: solitude. You can live alone, with very limited engagement with others, and not be lonely at all. You can be very satisfied by your few connections, however sparse. Religious hermits, for example, are comforted by the presence of God. And when Henry David Thoreau was asked if he was lonesome living at Walden Pond, his reply was, “I am no more lonely than the loon in the pond that laughs so loud, or than Walden Pond itself. What company has that lonely lake, I pray?”

The common confusion between loneliness and spending time alone often hinders our ability to communicate our experiences of loneliness or do something about it. Loneliness is broadly defined as the uncomfortable feeling of a perceived gap between the connections we want with others and the connections we feel we have. The definition leaves a lot to be desired because the perception of such a gap can be manifested in different ways.

The typology of loneliness that I’ve come to rely on divides the experience into three distinct categories: psychological loneliness, societal loneliness, and existential loneliness. Each one feels very different, although they are often confused with one another. Each one manifests differently, and although people frequently experience more than one type of loneliness at a time, each requires a distinct approach when we attempt to address and alleviate it.

Psychological Loneliness
“I don’t feel very much like Pooh today,” said Pooh.
“There, there,” said Piglet. “I’ll bring you tea and honey until you do.”
 —A. A. MILNE

Psychological loneliness is what most people describe when asked if they are lonely. It is the experience of wishing someone else was there, a specific someone, a warm and fuzzy flesh and blood person they can feel reliably and authentically connected to. It is marked by a longing for an authentic connection to another person, someone to trust and tell your troubles to, someone who has your back in anxious times, someone to care about. Not to be confused with “alone time,” “me time,” or solitude — all experiences that can be sources of calm, inspiration, focus, or rejuvenation — psychological loneliness is an uncomfortable state of being, tinged with negative emotions, perhaps sadness, fear, shame, regret, anger, guilt, or self-​doubt.

Often, people suffering from psychological loneliness are fearful of developing these kinds of intimate relationships. Their attachments to others are somehow inadequate, insecure, or unstable. Many who suffer from psychological loneliness are around other people all day. Their problem is that there is no one among all those people whom they truly trust or can confide in. Someone who is very popular and has many friends may still feel desperately lonely if they have a psychological fear of opening up emotionally to any one of those friends.

Research in psychology on what’s known as attachment theory also illuminates this aspect of loneliness. We are born dependent on others, particularly our mother, for survival, and learn and develop through attachment, with various long-lasting effects on our psyche, personality, and nervous system. The unhealed trauma of a dysfunctional upbringing, followed by subsequent traumas and negative experiences in adult life, can damage a person’s ability to create and sustain healthy human connections. Eventually, the dull pain of chronic psychological loneliness can seem preferable to the acute pain of bad relationship experiences. 

Societal Loneliness
“I’m not antisocial. The society is anti-me.”
—ANONYMOUS

The second kind of loneliness, societal loneliness, is the overwhelming sense of not fitting in or belonging, of being systemically excluded. It’s the experience of being uninvited or rejected by either a peer group, work colleagues, neighbors, or society at large. Societal loneliness can be envisioned through the questions often on the minds of those who experience it. As I imagine entering a room full of people, am I welcome? Is my arrival anticipated? Do I fit in? Will I be safe? With psychological loneliness we might ask, “Where are my people?” With societal loneliness we ask, “Where is my seat at the table?”

This form of loneliness burdens the individual with a different and harder-to-relate-to stigma. Psychological loneliness, the longing for another, more readily engenders sympathy or empathy on the part of a confidant. Talking about societal loneliness can amount to tattling or, on a deeper level, a less congenial soul-baring. For individuals lacking a confidant, to say nothing of a social network, such conversations are less likely to occur, exacerbating the associated negative health consequences. 

Many people experience this kind of societal loneliness when they may most want and need to foster connection, such as in a new school, workplace, or community. On a societal level, all forms of discrimination and bias inflict feelings of loneliness on those who are different due to race, gender, religion, sexual orientation, nationality, or disability, or merely because they don’t conform to social norms for attractiveness or personal behavior. Societal loneliness is prevalent in the psychologies of many of the socially awkward loners who perpetrate mass shootings. Taken to scale, this type of loneliness is the hallmark of institutionalized racism or any other systemic and prevailing prejudicial or exclusionary bias.

Existential Loneliness
“He who has a why to live for can bear almost any how.”
—FRIEDRICH NIETZSCHE

Existential loneliness, the third kind, might also be called spiritual loneliness. This loneliness is part of the human condition. It arises from the fundamental mystery of life and its meaning on a planet Carl Sagan once called “a lonely speck in the great enveloping cosmic dark.” You may feel connected intimately to others, but something is still missing. We aren’t born with the answers to questions such as, Where did I come from? Why are we here? Do we connect to what was here before us, to what will be here after we depart? Do we have a mission and purpose that connects us to the universal? Do we matter? Do our lives have consequence? Where do I fit in? Psychological loneliness can overlap with and feed existential loneliness. If you lack connection with people, you are at elevated risk of losing connection with yourself and with meaning in your life.

Studies suggest it is worth our while — when confronted by middle-of-the-night mental wrestling matches — to address our existential angst. Individuals who believe their lives are meaningful are reportedly happier. Happier individuals are more resilient, less vulnerable to or more tolerant of the other kinds of loneliness, and coincidentally, healthier. Their satisfaction with their lives and their security about their place in the universe may effectively reduce any discomfort caused by a relative lack of intimate connections with other humans. They experience less or no pain when they are alone or in unfamiliar social settings. In other words, they are less lonely.

Relieving Loneliness
What all these types of loneliness share is the gap in our perceptions between the way we want things to be and the way we experience them to be. On a practical level, it’s important to differentiate between the lonely feelings that arise when we tell ourselves, “I don’t know who I am anymore, or what matters to me,” versus “I don’t have a friend in the world,” versus “I feel excluded at work.” Only when we can identify the type of loneliness we are feeling can we begin to explore what is behind that feeling, and how best to respond.

Three things matter most in relieving loneliness, regardless of the particulars. 

First is to accept that the relationship you have with yourself is fundamental to addressing any type of loneliness you may be feeling. 

Second, you must reexamine the personal biases you use to interpret your experience of loneliness. When you begin to question the reasoning behind why you say “This is the way it is” about your loneliness, you will open doors to new possibilities for yourself. You can change your reality by changing your interpretation of reality. 

Third, and perhaps most difficult, is to tolerate the discomfort of moving forward. You must resist the natural urge to avoid the risks involved with both discovering and revealing who you are. This struggle is a universal experience, and the more you learn about it, the easier it is to accept that your loneliness is there to help you make meaning in your life. The French author La Fontaine observed that people often meet their destiny on the road they took to avoid it. He could have added that the road is often a lonely one, but it doesn’t have to be.

Jeremy Nobel, MD, MPH, is a primary-care physician, public health practitioner, and award-winning poet with faculty appointments at the Harvard T.H. Chan School of Public Health and the Harvard Medical School. He is the founder and president of the Foundation for Art & Healing (www.ArtandHealing.org), whose signature initiative, Project UnLonely, addressing the personal and public health challenges of loneliness and social isolation, has gained national visibility.

Excerpted from PROJECT UNLONELY by arrangement with Avery Books, a member of Penguin Group (USA) LLC, A Penguin Random House Company. Copyright © 2023, Jeremy Nobel