'The world is suffering from an epidemic of loneliness': Former US Surgeon General Dr Vivek H. Murthy

A room full of people is the last place where one could be lonely. Or so you think. Recently, in a searing essay in Harvard Business Review, the former surgeon-general of the United States Dr Vivek H Murthy drew attention to the increasing social isolation at workplaces and its impact on businesses. The essay has also triggered the conversation on loneliness as a growing health epidemic. Can loneliness - in professional as well as personal spaces - shorten life spans? How can modern societies and institutions contain this 'epidemic'? In a conversation with WKND, Murthy points out what is at stake.
What are the roots of the loneliness epidemic?
There are a number of reasons why rates of loneliness are growing in many parts of the world. First, geographical mobility has increased, leading more people to move away from home and live separately from family and friends. Second, while I am a firm believer in the power of technology to improve connection when applied in the right manner, social media has led far too many people to substitute offline connections for online connections. But they are not interchangeable. Our cities are filled with people with thousands of friends on Facebook and LinkedIn who feel profoundly alone. Additionally, the more we shift from speaking on the phone to texting and from having an in-person conversation to emailing someone down the hall, the more layers we place between ourselves and others. While there are times when it's easier and more efficient to text or email, we have to ask ourselves if the pendulum has swung to the point where we are paying too high a price in terms of isolation. Also, the nature of work is evolving in a way that crowds out our sustaining relationships. In our constantly connected culture, work is increasingly spilling into evenings, weekends and vacation time, constraining time that was previously reserved for family and friends. And more time working doesn't necessarily mean stronger connections with your work colleagues. As beneficial as telecommuting can be, it increases the risk of disconnection as opportunities to have face-to-face interactions are diminished. Even in the office, people sit in open-plan workspaces, but everyone is staring at a computer or attending task-oriented meetings where opportunities to connect on a human level are scarce. We evolved to be social beings. That doesn't mean we all have to be extroverts. It does mean that we all need some level of authentic, fulfilling social connection in our life. Without such connection, our health, our happiness and our productivity suffer.
'Epidemic' is a very strong word to describe a condition. What compelled you to qualify loneliness as one?
When you look at the data, you see that loneliness is not only prevalent but has also increased over the past few decades. Loneliness is affecting the elderly, the middle-aged and our youth. It is impacting people in urban and rural areas. This is happening despite the fact that we live in the most technologically connected time in the history of civilisation. We tend to think about epidemics as having health impacts. That is absolutely the case with loneliness. Loneliness and weak social connections are associated with a reduction in lifespan similar to that caused by smoking 15 cigarettes a day and even greater than that associated with obesity. Loneliness is also associated with a greater risk of cardiovascular disease, dementia, depression and anxiety. At work, loneliness decreases performance, limits creativity and impairs other aspects of executive function, such as reasoning and decision-making. The greatest pathology I saw as a doctor was not heart disease or diabetes, it was loneliness. Sadly, the stigma associated with many health conditions such as mental illness and addiction also contribute to a sense of loneliness. Far too many people feel ashamed and judged as a result of their illness. Ironically, it is when we are experiencing stressors such as illness that social connection becomes so important.

Dr Vivek H. Murthy
In the HBR article, you address the issue of loneliness at work. Its impact, however, can be felt as gravely in life outside of work. What can help individuals deal with loneliness in personal life?
First, help others. While it may seem counterintuitive, extending help to others creates a mutually reaffirming experience that can reduce feelings of loneliness in both the giver and the receiver. Second, protect your time with family and friends. Drawing clear boundaries around work time can ensure you have quality time with the people who sustain you. Third, put away your phone when you are spending time with family and friends. Our phones too often distract us from being fully present in conversation. Without being present, we cannot listen well. Without listening, we cannot build and sustain strong relationships. We may think that we can fully engage with someone while still checking our phones, but that is rarely the case. Scrolling through our inbox, checking updates on social media, and wondering who is trying to reach you every time your phone lights up - doing this during a conversation or social engagement amounts to multitasking. Studies have shown that we significantly overestimate our ability to focus while multitasking. Especially for people whose personal time is at risk of being crowded out by work, it is all the more important to make your personal time count. Putting away your phone is one way to do that.
How do you think cosmopolitan cities like Dubai, which consist of a considerable expat population, can address the issue of loneliness?
Firstly, measure the prevalence of loneliness in your community. As the saying goes, if you don't measure it, it doesn't matter. It is important for communities to understand how common loneliness is, including which groups are most affected. Setting clear goals for improvement and tracking progress in addressing loneliness is essential as well. Secondly, create a culture of volunteerism. Helping others is one of the most powerful ways to combat loneliness. There aren't always easy ways for people to engage in volunteering their time in the service of others. Creating a culture of volunteerism is most effective when major sectors of society - businesses, schools, government and social organisations - integrate service opportunities into how they operate. Thirdly, create opportunities at work and school for people to understand each other. The likelihood that authentic social connections will develop is greater when people feel understood and appreciated as individuals with full lives - as mothers and fathers, sons and daughters, individuals with passions outside of work, concerned citizens and community members. By creating opportunities for employees and students to learn about each other beyond their specific skill sets, an organisation can create stronger, deeper connections. It is important to note, however, that strengthening connections between colleagues and classmates requires more than just time spent together. The quality of that time matters too. In happy hours and other post-work gatherings, people tend to talk about what they have most in common - their work - instead of learning about other dimensions of their colleagues. Additionally, when such gatherings require a substantial investment of one's leisure time, they can take away from nurturing connections with family and friends, which can, in turn, create a greater risk of loneliness. The key is to create opportunities for people to learn about each other that are respectful, convenient and don't infringe too much on work or leisure time. During my tenure as the Surgeon General of the United States, we implemented one such approach in a five-minute activity called "Inside Scoop". During our weekly staff meetings, one member of our team would present a few select pictures with the group that captured a part of their life experience that was important to them. It could be about family, prior work, hobbies or aspirations. It was a simple exercise, but its impact was powerful and immediate. People felt more valued by the team after seeing their colleagues' genuine reactions to their stories. Team members who had traditionally been quiet during discussions began speaking up and taking on tasks outside their traditional roles. They appeared less stressed at work. And most of them told me how much more connected they felt to their colleagues and the mission they served. Lastly, protect time with family and friends. Such relationships are nourishing and they help reduce stress.
Among a lot of young people, there's a taboo associated with talking about loneliness since it is considered to be at odds with being 'independent'. How can this issue be addressed? Also, is the quest for independent space leading to the loneliness epidemic?
Thousands of years ago, our ability to have a stable food supply and be protected from predators was enhanced by having a trusted social network. Over time, that need for connection has become baked into our nervous system, which is why the experience of loneliness causes a physiological stress response in the body. The bottom line is: we need each other. It's not a question of philosophy, it's a matter of biology. And it is surely not a sign of weakness. There is another reason why admitting to loneliness is taboo, one that I experienced myself. As a child, I was very shy and had a tough time making friends. As a result, I spent much of my early school years feeling lonely. But I was too ashamed to confess my loneliness to my family, even though I knew they loved me unconditionally. There is a stigma associated with loneliness. To admit you are lonely feels like admitting you are not worthy of being loved. I want people to know that if you are lonely, you are not the only one. And if you aren't lonely, there is a strong chance that someone you know is lonely - it could be your own child or spouse or friend. The reality is this: the world is suffering from an epidemic of loneliness. It is up to each of us to do what we can in our families, workplaces, schools and organisations to rebuild the strong social connections that are the foundation of a healthy, strong society. When we are connected to each other, we are more likely to trust each other, look out for each other, and come together during difficult times. When we are disconnected from each other, we tend to doubt each other's intentions, we splinter in the face of adversity instead of unifying. You don't need a medical degree to address loneliness. You only need the ability to be present, the willingness to listen, and a heart full of compassion.
anamika@khaleejtimes.com