Dr.LauraTrevisanMauriello
Loneliness

Loneliness is defined as a distressing feeling that accompanies the perception that one's social needs are not being met by the quantity or especially the quality of one's social relationships. (“Loneliness: Symptoms, Causes, Types, Effects ... - mind.help”)
At certain moments in life almost everyone feels the pain of loneliness.
In these difficult times with Covid, social distancing and lockdown, many people find themselves in isolation and the feeling of loneliness is at times described by people with words like anxiety, fear, helplessness.
Loneliness is not itself considered a mental health issue. However, mental health problems, in particular depression and social anxiety can increase or cause loneliness. Similarly, loneliness can cause and coexist with other mental health issues.
Humans are inherently social beings. We need others and mainly in the old times, people needed others to survive.
Society was intrinsically based on community. Historically and even today in some countries, survival instincts drove us to be with others and form tribes of some sorts. The need for protection, shelter, hunting and obtaining food was done in community and the needs for one another were crucial for survival as a species.
In today’s world, we don’t face the same challenges as our ancestors did. However, socialization and the need of having social connections with others is very important for human beings and for our mental health. Feeling isolated and lonely can be a contributing factor to mental and physical health problems.
Transient loneliness is normal and we consider it and accept it as part of life. Everyone feels lonely at times, especially when we are unhappy with our social life, family, or colleagues. The problem can become painful and bigger because of the inability to solve it. Often, this leads to isolation.
On the other hand, chronic loneliness is torturous, as it persists for a long time. Surrounding yourself with people alone cannot cure loneliness. You could be at home with your family, in a relationship, working in a office crowded with bright people, but feel the subjective experience known as loneliness.
Loneliness is not the same as solitude. Desired solitude yields peace and tranquillity. We need solitude at times, for meditation, for writing and other peaceful activities. Being alone, in solitude, energizes the mind and can help you think clearly. On the contrary, loneliness is draining, painful, upsetting and distracting.
To understand how important social life is for human beings, consider that when people are asked what the main factor is that gives them happiness, the majority rate love, intimacy, social affiliation above fame, wealth and even physical health.
Our most evocative events in life have been weddings, births and funerals. All of them are bonds that hold life together.
The acceptance that these bonds and events provide and the pain of rejection when these are denied makes us vulnerable to social evaluation.
We give too much importance to what others think of us and this is the reason why out of ten people who seek counselling, three are related to social anxiety. In particular, fear of public speaking, fear of crowds and fear of meeting new people.

Loneliness and depression
To understand the exact dimension of loneliness is challenging, also because it rarely appears alone. Several studies conducted in clinical settings show that the loneliness and depression often coexist. Also,in some psychometric tests for depression the question ‘do you feel lonely?’ is present.
However, the analysis of the characteristics of the two issues show that they are different and they trigger different responses.
Loneliness prompts a desire to affiliate and triggers feelings of threat and fear and in the long run prompts a tendency of being critical of others.
Loneliness reflects how you feel about your relationships, whereas depression reflects how you feel, period.
Like other emotions and feelings, these are prompts to change or signal that we need something different. Loneliness is a warning to do something to alter an uncomfortable or painful condition.
Depression makes as apathetic. Loneliness urges us to move forwards, depression holds us back. However, they converge in the ability of personal control, which leads to passive coping. This passivity is one of the reasons why, although loneliness is painful and needs urgent remedy, it does not always lead to effective action.
Loneliness can be both a trigger and a symptom of depression. As a stressor, it affects your mental processes. When you to isolate yourself, it becomes more difficult to change a situation, leaving you to your thoughts and perceptions. When you ruminate over things on your own, it is more probable that you have negative thoughts and your perspective could be different and probably darker then the real situation on the ground.
Negative thinking and helplessness lead to depression. Dealing with the problem by ourselves may become overwhelming. Loneliness reduces cognitive thinking, interferes with your sleep cycle, and impairs your rational reasoning.
To self-regulate, loneliness and depression are closely linked push and pull forces.
Loneliness is an alarm signal that serves a survival function, but it can exist as an adaptive social role also for a mild depression.
Consider for example a situation in which a person just moved to a new town and motivated by loneliness and feeling of social isolation, tries to join a party, court a person or join random groups. For various reasons, he felt rejected. In this situation a mild depressed mood can be helpful to back off and analyse his behaviour in a constructive self-critique. Maybe the approach to the party and to the courted person was too strong. May be it is better to try a more soft and kind approach.
In this case, the mild depression has the social survival function, not only to step back and think again, but also to signal submissiveness. A person crying, a dog showing his vulnerable belly are signalling to others that they are not a threat and minimize the risks of social interaction.
Towards getting it right

Counselling
For some individuals troubled by loneliness, it can be useful and at time necessary to see a counsellor who can address the accompanying psychological issues that can reinforce their sense of isolation.
When life is depriving the individual of the needed connections,creating a sense of fear and threat that generate negative effects such as anxiety an hostility, it can turn their sense of isolation into a painful and persistent reality.
Although our emotions can be painful and irritating, our thoughts are something that we can learn to control.
By reframing our cognitive perceptions, we can begin to change our lives.
It is never a bad idea to go for depression counselling. A problem shared, mainly with someone who can understand you, is a problem half solved. A counsellor will walk with you and help you develop a healthy and positive attitude through social experiences.
Counsellors have the resources and expertise to help you overcome loneliness. With their guidance and support, you can walk together until you are empowered mentally. It is not easy to walk alone. Having someone passionate, non-judgemental and an expert in dealing with depression and loneliness makes the experience bearable and increases the chances of improving your mental health.
A counsellor can help you feel connected with someone and supported. Talking to a professional counsellor, you can realize that it’s normal to feel lonely, you can experience validation, and understand that it’s not your fault and that support is available.
In counselling sessions, you can be able to overcome the feelings of isolation that may be dominating your life. It’s an opportunity to look at the reasons of your loneliness and identify situations that make this painful feeling deeper and stronger.
If you’re seeking therapy for loneliness and associated issues, a counsellor will give you a secure, caring environment in which you can open up.
In counselling for loneliness, the counsellor will help you to explore how to make a connection with others or reconnecting with people. The aim is to help the individual to find out what it is that they seek in others and their real needs so that you are making meaningful connections with others.
Loneliness is a painful condition that can diminish our self-esteem, confidence and self-worth and cause us to feel anxious and depressed about who we are and where we fit into society.
A counsellor will explore what feeling ‘connected’ means to you how you can foster that in others and in yourself to re connect.
Cognitive Behaviour therapy is an evidence based method to redirect emotions by modifying thoughts and behaviours.
With CBT a counsellor can help the lonely client to analyse and discover how irrational beliefs,for instance in case of loneliness, the belief that we are and will be socially unwanted or rejected are not supported by reality and can be challenged as a negative thought.
Behaviour and actions that help fighting loneliness
The perception of being threatened or judged motivates the withdrawal and passivity associated with loneliness.
There are some simple steps the individual can do to help ease the loneliness and give a maximum positive reinforcement while challenging the negative cognition.
As Cacioppo, J.T. and Patrick W. in their book “Loneliness” explain, we can summarize the steps with the acronym EASE, where:
E for Extend Yourself
A for Action plan
S for selection
E for expect the best
E for Extend yourself
Starting with small steps and testing some behaviours that can produce positive reinforcement without the feeling of danger can be relatively easy and useful to start.
Without focusing on big targets, such as finding the love of your life or reinventing yourself completely, you can try to receive positive sensations from small positive social interactions.
It can be useful to begin with simple exchanges in a grocery store. It is important not to place any expectations on the other person, Just exchanging a few word like “Enjoying the sunny day today?” can bring a friendly response. To send a signal and receive a signal back.
If it happens that the person is having a bad day and the response is not so friendly for some reason, it is important to realize that it does not depend on you and you can move on and try again.
It is important not to make assumptions and limit the goals and expectations when practicing new behaviours.
To feel positive sensations and increase your desire to change, it can be useful to confine the experiment outreach in some safe confines such as charity and volunteering.
Volunteering for people in need will not necessarily result in you receiving gratitude, but very rarely will you receive socially punishing or negative criticism for your efforts.
Volunteering can be a positive way of feeling involved with the local community. Volunteering often comes with the opportunity to meet others and to feel a part of something.

A for Action Plan
To realize that you are not a passive victim, through your actions you can gain some control and change the situation by challenging your thoughts, expectations and changing your behaviour, which combined, can have a powerful effect on your self-esteem as well.
Volunteering and charitable activities enable the individual to be in a social picture without the fear of rejection. However, it is worth considering which activity is more suitable for you.
For example,If you love theatre but maybe you are not talented in acting or singing, you can offer your help to the theatre group by helping backstage .
For a person who has difficulties in interacting with people, is shy or suffering social anxiety, but loves animals it can be useful to volunteer in an animal shelter. You will feel welcomed by the animals and feel their gratitude for feeding and taking care of them.
When you feel more confident to reach out to humans, it is safe to assume that the other volunteers at the shelter share the same love and interest for animals which can give you a base for starting a conversation and finding connections.
When developing an action plan it is also important to remember that doing things for others does not mean allowing them to exploit you. You choose carefully and avoid those who can manipulate your fear. Willing reciprocity is an important aspect of a healthy relationship. Feeling lonely can make us fall victim for our eagerness to please. To slowly develop a plan that combines the openness to engage with realistic expectations, accurate perceptions of social cues, including the ones that suggest caution, can be a simple but important step towards your change of feelings.
S for selection
To feel less lonely we need to focus on the quality of relationships and social interaction more than quantity.
Loneliness makes us particularly sensitive and attentive to social signals . It is important to be calm and rational to interpret the signs properly.
Knowing ourselves, our personality and needs is also useful to select the right relationships for us.
Compatibility often depends on common beliefs and similar personal traits and interests.
For an introvert who is more quiet than talkative, it can be easier to feel more comfortable with more silent companionship rather than an extrovert who talks a lot. Even though it can happen that the attraction of opposites brings the two together and they can reach a balanced middle point of communication and understanding.
For a person who loves to read and might be shy, it can a good idea to select places like the library or a bookshop or engage in reading groups to share common interests and ideas,instead of going to a dance club.

E for Expect the best
Social contentment can make us more optimistic, generous and resilient. This, with the power of reciprocity can attract warmth and goodwill from others.
Focusing on the small rewards we receive when reaching out will increase our resilience and help us to change and not fall into the fear and frustration that leads to the self-protective isolating behaviour.
In the process of change, the risk of going back to the well-known defence mechanism can be there, mainly at the beginning of the outreaching social interaction activity.
The temporary protection that the defensiveness and isolation provide comes with very high costs in the long run.
Patience and focus on the positive are useful for continuing towards the changes on ourselves, our relationships and social interactions.
Giving positive comments or gestures to others and offering cooperative behaviour, elicit further cooperation and positivity from others.
Loneliness heightens our threat surveillance and our fears and impairs our cognitive abilities. Therefore, to act as individuals and as a society to manage our needs of human connections is rewarding and important. Connection can nourish our human potential and the warmth of genuine connection frees our minds to focus on the challenges that lie in front of us.
If you feel lonely, remember that you are not alone and try to walk through the process of overcoming the negative feelings. Also, talking to another lonely person can be useful to see things from another perspective. Being with people, sharing the same problems as you, helps with socialization, communication, problem-sharing, and self-awareness. While interacting with others with the same pain, you see how it is practically possible of overcoming your issues.
Sharing your loneliness with others can give you the opportunity not only find support, but also becomes a shoulder for someone else.
