Loneliness – what it means for our health
The #1 Public Health Issue Doctors Aren’t Talking About
This talk amazed me, but that’s not surprising because Lissa Rankin is an amazing person. The first half of the talk is interesting from the scientific viewpoint (Lissa is an M.D.) where she explains how loneliness is clearly linked with health. That was really interesting to hear, but the second half of the talk is what really got me excited. Here, Lissa “talks to our hearts” and this becomes very interesting at a spiritual level. Even though Lissa is an M.D., she’s also very clearly a spiritual person and a very loving person.
I leave you to listen to her talk here (there’s a full transcript of the talk just below the video). Enjoy.
Full Transcript – Loneliness – what it means for our health
A few years back, I was on a book tour for my book “Mind Over Medicine“, and I was talking to big audiences like you all and I, as a physician, I had done research on some of the conventional things that affect our health but also some unconventional things and the question I would get asked over and over again is “what is the greatest risk factor for your health?”. And I would say loneliness. And there would be dead silence in the room just like there is here. And it took me a while to figure out that this was a really uncomfortable answer for a lot of people. People wanted me to say diet, or exercise, or maybe yoga, or meditation, or something that they felt like they could do and be proactive about. And people felt helpless in the face of their loneliness. And this helped me to realize that we need to start to pay attention to this.
So I want to start by telling you a story and then I’m going to give you some data to speak to your mind in case you don’t believe me and you’re feeling a little skeptical that loneliness could be this important. That it could actually be the number one public health issue that we’re facing right now. And then I want to speak to your heart, cause that’s really what this is all about.
So let’s go back to 1961 to Roseto Pennsylvania. And Roseto Pennsylvania in 1961 was a very special place that was filled with Italian immigrants who had come from the old world in Italy and had settled in this small town. And Dr. Stewart Wolf was the cardiologist from the University of Oklahoma, and he showed up in Roseto one day because he had a vacation home in the Poconos, and he was having a drink at the local bar with one of the doctors there and the doctor there said “you know it’s so strange, the people of Roseto, they never seem to get heart attacks”. Well he’s a cardiologist so this caught his attention. So he went and he checked out the death records and sure enough these people were not dying of heart disease. The people of Roseto had half the rate of heart attacks of the national average, there were no heart attacks in men under 65, and the death rate from all causes was 30 to 35% lower than average. So this was unusual. So Dr. Wolf called in a whole team of researchers and they started researching these people to figure out what’s going on here. And John Bruhn was one of these researchers and he said there was no suicide, no alcoholism, no drug addiction, and very little crime. They didn’t have anyone on welfare. Then we looked at peptic ulcers – they didn’t have any of those either. These people were dying of old age. That’s it. So they thought well it must be something in their diet. Maybe it’s the olive oil, but they found out that the people in Roseto we’re eating meatballs fried in lard, they were eating pizza and pasta with egg and sausage, a whopping 41% of their calories came from fat. Many of them were morbidly obese, they didn’t exercise and they smoked. So you can imagine this cardiologist was going “wait a minute” with this. So they thought well maybe it’s something in their DNA. They went back and they checked the their ancestors who came from Roseto Valfortore in Italy and they found those that had settled elsewhere in the US but, no, it wasn’t that – they had the same rate of heart disease everybody else in the US. And it wasn’t their healthcare, and it wasn’t their water, they ruled out everything that they could and they finally concluded that the people of Roseto had half the rate of heart disease and significantly lower rates of all other causes of death because the people in Roseto were never lonely.
Let that sit for a minute.
This doesn’t have such a happy ending, because like many people in our culture you know that the children of Roseto grew up and they wanted the American Dream, they wanted to be modernized like everybody else, they didn’t like living in this small community village where everybody lived in multi-generational homes, Grandma and the kids all lived together, they all go to work, they’d come home, they’d have celebrations, they’d go to church together. The Roseto in 1961 was evidence of the power of the tribe. But by 1971 everybody had moved to the suburbs, they gone into their own little boxes, they had started separating from one another, they weren’t living in multi-generational homes anymore. In 1971 the first heart attack death in somebody less than 45 happened. High blood pressure tripled, strokes increased, and by the end of the 1970’s Roseto had the same risk of heart disease as everybody else in the country. So Roseto, we learned from them that human beings nourish each other, and the health of the body reflects this. Now researchers have studied a lot of blue zones and Roseto was one of those blue zones. Blue zones are places on the globe where there’s an unusual number of people who lived to be greater than a hundred. And these are places like Okinawa Japan, Sardinia Italy. Loma Linda California, Ikaria in Greece, and in every single one of these blue zones, they lived like the people of Roseto did. They live in community, they live in tribe, they know they belong, they grow up from the time they’re little knowing that they’re part of this tribe. And this has a physical health protection on the body. So how does this happen?
Let’s talk a little bit about the physiology of loneliness. We are tribal beings. We are supposed to be together. We come from love and when we die we go back to love. And the whole point of being human is that we’re here to love each other, we’re here to be together, and our nervous systems are wired that way. So when we feel socially isolated then the nervous system goes into threat and the limbic brain, the survival part of the brain, the really primordial brain starts to freak out. It goes into the sympathetic nervous system or what Walter Cannon at Harvard called the stress response, you may know it as the fight-or-flight response. And when the nervous system is in fight-or-flight response, the body fills with cortisol and epinephrine. These hormones put us at risk of heart disease and every other kind of illness. And we know that the body is beautifully equipped with natural self healing mechanisms, we make cancer cells every day, we fight our own heart disease every day, we have natural longevity enhancements built into our bodies. But here’s the kicker. Those natural self healing mechanisms only work when the nervous system is in what Herbert Benson at Harvard called the relaxation response. This is the parasympathetic nervous system. When we know that we belong, when we can feel ourselves in love, in community, in tribe, then the nervous system relaxes. But you think about the single mom who’s by herself, trying to raise three kids, and get to her job, and the kids are sick and she doesn’t have any help, and what about her social life and what about her self-care? Her nervous system is in stress response all the time. And this puts her at risk of disease and decreases her longevity. And we Americans, you know we’re only supposed to be in stress response when we’re getting chased by a tiger, but evidence shows that were in stress response more than 50 times per day. And lonely people are in stress response even more than that.
So this is the part where I’m going to talk to your mind in case you don’t believe loneliness and health are related. Air pollution increases your mortality by 6%, obesity by 23%, alcohol abuse by 37%, loneliness by 45%. Loneliness is as dangerous for your health as smoking 15 cigarettes per day. There was a study in Alameda County that showed that people with the fewest social ties were three times more likely to have died over a nine-year period. There was another study in UCSF of 3,000 women with breast cancer that showed that people who go through their cancer journey alone are four times more likely to die from their disease than those who have 10 or more friends. Lonely people have higher rates of heart disease, cancer, dementia, high blood pressure, diabetes, infection, anxiety, depression, insomnia, suicide and alcoholism, addictions. There was one great study done by Harvard where they followed 700 men over 75 years to look at wellness and well-being in general and Robert Waldinger, one of the researchers, said over and over, over these 75 years, our study has shown that the people who fared the best for the people who leaned in to relationships with family, with friends, with community. But one in five Americans is lonely, this is 60 million people, this is a massive public health epidemic. But when was the last time your doctor prescribed healing your loneliness as part of your wellness plan, or as part of a healing journey.
So what do we do about this, what is the cure for loneliness? Is it to get as many people in our social circles as possible, and if so what about the introverts among us (I’m super introverted). Right, is it about quantity? Well no, we know that. We know that you can feel lonelier in a crowd of others than when you’re alone. So is it about having a significant something, a spouse, a child? But we know that nothing feels lonelier than feeling separate from the people that you love the most. So many of us have had those feelings of deep connection in nature, is it about that? And many of us have had intense spiritual experiences, mystical experiences, experiences in prayer, in meditation, is about connection with the divine? Charles Eisenstein says that it comes, it stems, from what he calls the story of separation. This I think is that primal wound, that wound that says I’m separate from you. I’m separate from you, I’m separate from the trees and the stars and the oceans and the mountains. I’m separate from the people in Syria, from all of the people that are doing horrible things to our country right now. Those are other, those are not connected to me. But it’s also I’m separate from that force of love that flows through us, that animates us, that’s our are very life force, that force of love that you might call the divine. Lisette Schuitemaker from Findhorn calls it “othering”, when I make you other. And she also talks about enemy making. Right, when I separate myself and I say “oh well, I’m separate from the terrorists, they’re not part of me, we don’t were not part of the same human family, I need to separate myself from them”. This creates a deep existential loneliness inside of us. Brené Brown says the number one barrier to belong is fitting in. You know, if I’m feeling like I have to pretend to be something that I’m not in order to belong with you all, I’m gonna feel lonely even if I’ve got 1,800 people here in the room with me. But there’s another way to do this. So what is the loneliness prescription? And I want to start by saying we don’t know. We don’t know. But here’s some ideas that maybe we can play with and see if it resonates.
And I want to give you a hint, because really it’s a paradox. Healing loneliness is an inside job, but you can’t do it alone. We need each other, and sometimes we need therapists and spiritual counsellors and clergy. It starts with befriending yourself. As long as you’re out war with yourself with those inner voices that are telling you that you don’t belong, that you’re not lovable, that you’re not enough, that you don’t deserve to be part of a community, you’re gonna have a hard time magnetizing towards you the people that are right here to love you. We have to heal shame and perfectionism, not just in our selves but in how we relate to others. Because if I’m in shame and I’m hiding myself from you, or if I think I have to be perfect and I’m not allowed to reveal my vulnerabilities to you, I’m going to separate myself. And again, even if I’m surrounded by people, my nervous system is going to go into threat. It’s going to put me at risk of disease, and as long as I expect you to be perfect, and I’m going to judge you or criticise you, if you do something that I don’t like, then I’m not going to be able to show up for you and know that you’re part of my human family. We’ve got to own our stuff. That means we’ve got to get out of our victims stories. Right, I’ve gotta quit saying it’s your fault, you did me wrong you, you know, criticise me in some way. I’m separate from you. But instead, if I’m able to say well I’m participating in the creation of my life, I know that I have childhood wounding and patterns and limiting beliefs, we all do. We all got programmed by our parents no matter how well-intentioned. And I’m a parent myself so I know that no matter how much we try, it’s impossible for us not to end up as adults with some of those patterns, and we need to own those patterns. We need to start to see them and it helps if we engage in spiritual practice. If we meditate, if we pray, if we spend time alone listening, then we start to get insights and epiphanies. We start to be able to see the patterns that we recreate in our lives. We’re all so afraid of abandonment and rejection, of being judged and criticised. But a lot of that comes from childhood and we actually can change that. We’ve been so traumatised. All of us. Every human in this room, every human on this planet, has had their own trauma. And trauma puts us into the story of separation and makes us forget that we belong to each other, that we’re here to love each other. And when we’re able to take time to engage in spiritual practice, that helps us remember the love that is available to us at all times even when were alone. We have to be vulnerable. I have to be willing to show you the parts of myself my friend Amy Eilers calls my big ugly tail. You know we all have it, and we’re always stuck trying to hide it, we’re trying to stuff back, to make sure you don’t see my big ugly tail. But if I’m brave enough to take risks and to show you my big ugly tail, and to see if you love me anyway, then we start to build trust and then I can maybe reveal something a little more vulnerable and I can see whether that’s safe. This helps us develop resilience because sometimes I’m going to show somebody my big ugly tail and they’re gonna judge me, and they’re going to be mean to me, and they might reject me and then I might be tempted to close my heart, to withdraw, to go back into the story of separation. But when we develop resilience we actually get brave and we start being willing to give other people permission to break our hearts, permission to betray our trust, because everybody’s doing the best we can. But then the more I reveal, and the more you trust me, and the more I trust you, the more intimate we become the more we develop resilience so that we can handle the occasional person who isn’t conscious enough to meet us in that heart space.
We also have to bench press are receiving muscles. Many of us are walking around surrounded by people who love us and we can’t even tell because we’ve put up this wall, we’ve got this armour. And when we take the armour down, we start to be able to open our heart and reconnect to that force of love that’s flowing through me right now and pouring onto you, and flowing through you and pouring onto me. This allows us to hold space for others. Instead of judging and criticising, holding space means we can be present. We can withhold judgment, we can trust that we’re doing the best we can. All of us. It’s hard to be human. We can listen generously without fixing. We can be with what’s true for one another, and this lets us be willing to bear someone else’s burden. When we have enough to give, when we’re so full of love that we have enough to give, then we can start to be generous with our love, we can start to be somebody else’s tribe instead of just thinking about what do I want, what do I need. We have to remember that we’re all connected in “interbeing”, that we belong with one another. Charles Eisenstein says “the science is beginning to confirm what we have intuitively known all along: we are greater than what we have been told. We are not just a skin-encapsulated ego. A soul encased in flesh. We are each other and we are the world”.
So now I want to invite you to reach out and call in those friends of your soul. We are dehydrated fish swimming in a massive lake. There is love all around. It’s right here. Loneliness is the siren of the soul, calling us back home to one another. But we’re in the space between stories, so this is our chance. I wanted all of you to stand up right now, and hold hands with the person next to you. Take a risk to get close. Be brave. Look, you’ve got tribe. Your community is right here. Right here. This is how far away love is. It’s this far. It’s right here. So I want to invite you all to hold hands as long as you want, and come back here anytime you want and create your own soul tribes and find what you need.
This is medicine people.