Being UnLonely

By Jeremy Nobel, MD, MPH

Connection to Self and Others: A Critical Aspect of Recovery

Why authentic and healthy relationships are essential to overcoming addiction.

By Jeremy Nobel, MD, MPH
As published on PsychologyToday.com 

This column will be a space for us to examine the broad range of scenarios and circumstances wherein loneliness and social isolation affect people. And although it’s become a social epidemic among Americans as a whole – nearly half of all Americans report feeling lonely or left out and one in four feel that they are rarely or never understood by others – certain populations, such as the elderly, the chronically ill and their caregivers, veterans, immigrants, and college students, are particularly susceptible. 

Going forward, join me and the UnLonely Project in exploring the effects of loneliness and social isolation on these communities and the individuals within them, and the variety of innovative approaches that can be used to foster a sense of connection to one’s self and to others. Together, we can forge new pathways to reduce loneliness and its burdens.

Recently, a friend of mine who is a primary care physician was trying to encourage their patient to quit smoking. “Doc, I can’t,” the patient admitted. “Every time I open a pack of cigarettes I have 20 friends.” This sentiment, that a person’s addiction offers a (false) semblance of companionship, is a common one. Note the well-worn phrase, “His only friend is the bottle.” Loneliness finds its way into many different kinds of addiction, and addiction can be both a source and a result of loneliness. Even things that aren’t typically considered “addictions,” like over-eating and excessive social media use, are often seen through the lens of loneliness. And, in the United States, loneliness and social isolation have become a significant part of our lives.

This May, Cigna released findings from their national survey that was meant to help us better understand loneliness in the United States. According to the survey, nearly half of all Americans report sometimes or always feeling alone (46%) or left out (47%), with one in four Americans (27%) rarely or never feeling as though there are people who really understand them. Loneliness impacts how we work, make friends, talk, eat, use technology, and even how we experience addiction. In 2016, the Substance Abuse and Mental Health Services Administration (SAMHSA) released a report stating that approximately 20.1 million people in the U.S. aged 12 or older struggle with a substance use disorder (SUD) related to their use of alcohol or illicit drugs. With loneliness and addiction on the rise, we are beginning to understand how the two interact  and what it could mean for the recovery of these millions of people. On the journey to recovery from addiction, loneliness can itself be a glaring risk factor for relapse and an overwhelming obstacle to achieving sobriety in the first place.

So how do we disrupt this growing sense of loneliness, especially for those on the path to recovery from addiction? According to the National Institute on Drug Abuse, addiction is a treatable disorder that can be managed, but not cured. Effective treatment often involves detoxification through medication, but this detoxification is “not the same as treatment and is not sufficient to help a person recover.” Treatment for substance abuse disorders and addiction can involve some mix of inpatient or residential treatment, intensive outpatient therapy, regular counseling, and 12-step fellowship. And the most powerful tool for eradicating loneliness is the tool of communication. Those who participate in 12-step programs and attend Alcoholics Anonymous (AA) meetings can check in with others, share their stories, and curb addiction. The group ethos of AA is widely recognized as a vital key to its success. And the power of community support applies not just to recovery from substance addiction, but to adherence to positive health behaviors in general. Even programs like Weight Watchers encourage participants to talk and share their eating behavior challenges, in addition to regularly stepping onto a scale and objectively sharing their dieting success and failures with others, both types of “sharing” allowing them to receive empathetic support from a dedicated community of peers.

The path to recovery often involves rebuilding healthy relationships that were dissolved by the earlier addiction-related behavior, with the help of a supportive community. According to Dolores Malaspina, professor of psychiatryneuroscience, and genetics at the Icahn School of Medicine at Mount Sinai in New York, humans have an innate biological drive to connect. Fortunately, we have at our disposal a wide range of ways to forge and foster authentic connection. For instance, we can create art, write books, make music, and find and make shared communities, all in an effort to connect with others. For those in recovery from addiction, drama therapyhas become a leading therapy choice. While 12-step programs are one example of providing those in recovery with a space to gather and share, drama therapy has shown significant impacts on the lives of those in recovery.

Through the experience of sharing your story, whether via performance or conversation, loneliness can begin to resolve as authentic connections are established and nurtured. Those with addictions who are working toward recovery need to be able to engage with others to spark a connection that improves a sense of self-esteem and better manage the urge to turn to substances as a toxic substitute. With the aid of different kinds of therapy and programs, they can turn from loneliness and toward true and sustainable positive relationships, first with themselves and then with family members, friend, co-workers, and neighbors that surround them.

Eli Harvey contributed to the research and writing of this blog.


Listen Now!

On the radio: Jeremy Nobel, MD, MPH, Founder and President of The Foundation for Art & Healing, joins host Janeane Bernstein on KUCI 88.9fm