by Jacqueline Olds, M.D., and Richard S. Schwartz, M.D. Boston, Beacon Press, 2009, 240 pp., $24.95.
I read this book while traveling for a conference during a particularly busy time last fall. As travel goes, a thunderstorm occurred, and I got stranded at the airport overnight, along with many others. Airports are the perfect places for stranger encounters. People we sit next to hear our life stories, distilled and uninhibited, perhaps more easily than people we live next to. By the time we make it home, at the end of the day, those waiting for us get our last sparkle of energy before we turn off the computer—spent. How appropriate, I thought, to read about loneliness and drifting apart in the midst of a noisy airport.
The average American discusses “important matters” with only two people. The number of people who have no one to talk with about important topics tripled between 1985 and 2004, counting almost one-quarter of those surveyed through the General Social Survey (p. 2). According to the 2000 U.S. census, one out of every four households consists of one person only. These statistics, which the authors astutely bring to light, catch the reader’s eye from the first pages. But Drs. Olds and Schwartz, both Associate Clinical Professors of psychiatry at Harvard Medical School, do a lot more than just quote numbers. They look further into the social phenomena that these statistics draw attention to, rippling into individual lives or propagating outward, from personal stories to the greater society.
Many of us may have asked ourselves, “Will the tremendous communication technology advances of the last decades help us connect with others more easily or rob the depth of interpersonal dialogue?” How much are we bound to lose when e-mails with emoticons replace handwritten cards or when relationships get broken over text messaging? And are disorders manifested by social skills deficits, such as autism, more easily overlooked or almost adaptive in a society that rewards fast and facile communication? The authors carefully analyze advantages and challenges of Internet-mediated social experiences in the chapter entitled The Technology of Relationships. The jury is still out, it seems. While some studies cited have warned about shirking connections with friends and family, the Pew Internet and American Life Project found positive effects of large Internet-based social networks. Nevertheless, the authors advocate for the “old-fashioned bricks-and-mortar friendships, connections shaped by the proximity of two bodies in a physical world” (p. 113).
At the individual level, being busy has become a hallmark of success. Not committing to attend a party because at the last moment a more interesting social event might be on the horizon—although denoting higher social status—may trap some in their own cloak of success. Self-reliance is an admirable quality, celebrated through American history, from fearless pioneers who broke new ground to scientists who persevered in their experiments despite discouragement and a fight against accepted truths of their time. In the chapter entitled “Self-Reliance: Do Lonesome Cowboys Sing the Blues?” the authors bring to light the other facet of self-sufficiency: social isolation. Modern data from the neurobiology of attachment indicates that dopamine reward pathways are crucial to social attachment in animals and oxytocin is released during positive social interactions. Conversely, being socially ostracized is a painful experience (p. 70 [in the chapter entitled Left Out]). Drs. Olds and Schwartz support this evidence with examples from their own clinical experience, linking rejection with depressive states.
Without pathologizing loneliness, the authors draw a profound parallel between isolation and mental illness. While a life free from social obligations may have been ideal for some people, as the authors point out, today happiness is still not within reach of many. Shying away from relationships may be a sign of depression or anxiety as well as reinforcing these difficulties. The authors’ advice for the lonely includes engineering regular contact and shared projects with potentially interesting people. In their own words:
A web of relationships is like a hammock that holds a person safely above the ground of depression; a web of relationships is also like a snare that holds a person back from the freshness of new possibilities. It’s never easy to get the balance right, but when a person sheds too many obligations because they feel more like a snare than a hammock, he may shed the very connections that keep him from going to the ground. (p. 157)
Overall, the book is a wistful analysis of interpersonal connection and its avatars in times of amazing technological advances and economic affluence. The authors’ social message is not lost to us: together we may be better for the environment as well as for each other. As for my travel adventures, during the long night at the airport, I got to hear one young woman’s touching story. She needed someone to listen. And together we reflected on the number of people in our lives that we entrust with important matters; fortunately they are more than two.
The author reports no competing interests.
Book review accepted for publication December 2008 (doi: 10.1176/appi.ajp.2008.08121835).