Former Surgeon-General of the United States of America, Dr Vivek H Murthy, discusses his book ‘Together’, and the far-reaching consequences of leaving a ‘loneliness pandemic’ undetected
‘Picture yourself marooned on a deserted island; who would you like to be with?’ From school-crush conversations to magazine quizzes, the question runs through life. Somewhere we know that without social connection, we probably would not be able to survive. Even Tom Hanks’ Chuck Noland needed his Wilson to stay sane in Cast Away.
Often unacknowledged and easily dismissed as ‘a passing phase’, studies suggest that the impact of loneliness on the human psyche and well-being can be manifold. And for the majority of this year, COVID-19 has kept families apart and erased social connections.
Recognising the necessity of keeping hold of and developing our social bonds further, Dr Vivek H Murthy, the 19th Surgeon-General of the United States of America, penned his book Together: The Healing Power of Human Connection in a Sometimes Lonely World (Profile Books, distributed in India by Hachette India). Loneliness is the centrepiece of this quasi-memoir style compilation.
“COVID-19 has certainly exacerbated [loneliness] in our communities. When people struggle with loneliness, it can also lead to a greater risk of heart disease, depression, dementia, anxiety, and sleep disturbances. If we do nothing differently, we may see the physical distancing that is prescribed to combat the virus translate into social distancing. We will become lonelier,” says Dr Murthy, connecting over a Zoom call from his home in Miami, Florida. “But we can choose to use this moment to step back and take stock of our lives to recognise how important and powerful our relationships are. There is a chance we could come out of this pandemic stronger, more connected and fulfilled than before.”
Edited excerpts from the chat:
Separating stigma from mental health-related issues can be a task. Is it one reason why loneliness is less acknowledged?
There is an unfortunate stigma around loneliness. People think that if someone is lonely then something is wrong with them, or they are not likeable or loveable, or worse, that they are broken in some way. For these reasons, loneliness carries a sense of shame that makes it hard to talk about. We look around and it seems like we are the only one experiencing loneliness because nobody else is talking about what they are going through, and that further isolates us. So, loneliness begets loneliness.
Human connection is no different from hunger or thirst. We don’t feel ashamed when our body signals us that it is thirsty; we reach for a glass of water. So, one of the ways to de-stigmatise is by helping people understand that it is common and a natural signal that our body sends us.
Another powerful way to de-stigmatise any condition is by sharing our personal experiences with it. Every time someone stands up in a room to say they have been struggling with a problem, they may be met with silence. But that is not people judging you, it is them reflecting on their own lives.
I say that because I have and felt and seen it hundreds and thousands of times over many years. As I talked about this issue, I have noticed this visceral recognition in people’s eyes as they registered this is not something they need to be ashamed of, that it is nearly universal and hence they start to feel less judged… by themselves, most of all.
Convincing policy makers of this being a public health crisis can be a gargantuan task…
Around the world, there is a growing recognition that loneliness is a health and economic priority. Some of the data has been compelling for policy makers when they see it. That is an important caveat. In many countries, policy makers are not hearing about it, they are not seeing the data, and they don’t necessarily recognise how deeply connected issues like loneliness are to their front page issues we are reading about every day, whether it is addiction crisis or challenges with depression, anxiety and suicide, or even the deeper problems we face in workplaces and schools.
But when they are given the data, when they start to see what other governments are doing around the world, then it makes a compelling case for the policy makers to take action.
You quote research that suggests our ‘default social setting’, whether someone is an introvert or extrovert, is to socialise…
Our biology and study of human connections tell us that we are hardwired to connect with each other. So, the difference between introverts and extroverts is not in whether or not you need people, it is in how you prefer to interact with people and how much alone time you need. Introverts prefer to interact with people one-on-one and in small groups. They need more time in solitude. Extroverts gather energy from their interactions with other people and they often seek out and enjoy being a part of large groups.
Over the past two decades has there been less emphasis on developing quality human connections?
It is defensible to say that in modern society because it asks us to achieve more, go to the best schools, get the best jobs and earn the greatest awards.
When I think about the patients I care for in hospitals, especially those at the end of their lives… I think about those moments when we have no more medicines to offer them. All that we had was the opportunity to sit with them and be a witness to those final moments. What they didn’t talk about were the achievements and the awards or the positions they were given, the money they made and the number of followers on social media.
But what they did talk about were their relationships… the ones that brought them joy, the one they wished they had spent more time on and the ones that broke their heart. It is because in the final moments, everything else falls away and only the meaningful parts of our life remain. It is the relationships that rise to the top. That to me is a constant reminder that we don’t have to wait till the end of our lives to recognise that it is our relationships from where we derive our greatest joy and fulfillment.
And that is my hope in writing this book… that it would make the case for individuals, organisations and communities at large to ask how we can build people-centred lives and a people-centred society.
Can you elaborate?
In people-centred lives, we put people and relationships first when we are making decisions about where we need to put our time, effort and attention. In a people-centred society, we design our curricula in schools to give children the tools to build healthy relationships in the earliest of ages. We design our workplaces to support social connections and we examine public policy to understand what impact it will have on communities.
It is no coincidence that we see an extraordinary degree of political polarisation in countries around the world at a time when we are also experiencing a deterioration in relationships and an increase in loneliness.
What is the impact of social media on connection?
Like all technology, social media can strengthen or weaken our connections depending on how it is used. The challenge is the ways we are using it now contribute to a sense of isolation. I want to challenge the new generation of techpreneurs to think about how they can build products and services that can enhance human connections, recognising that it is the foundation on which we build everything else.
Is it possible for someone to live with loneliness their entire life and still feel fulfilled?
I don’t think so. Living a fulfilling life must involve fulfilling relationships. It doesn’t mean relationships are the only thing that contribute to fulfillment. The contributions you make in the world, the service you provide to others, the literature and art you consume, the music you create… all of these can all be incredibly rich sources of fulfillment.
But over thousands of years, we have evolved to need each other not just for the nuts and bolts of survival but for a sense of fulfillment and security. In the absence of those relationships, and in the presence of deep loneliness, I think it is very difficult to feel completely fulfilled.