Can You Relate? Social Connectedness Is the Key to Health
While the mechanisms by which social life impacts health are not fully understood, the data are clear about this general equation: Connection = Health.
Posted May 13, 2020
While holding classes remotely during the final weeks of the recently ended spring semester, I asked my quarantined students what they missed most about their pre-corona lives. The consensus answer was: time with friends. This is not surprising, given that young people tend to spend the majority of their time with peers.
Yet my guess is that other demographics might offer a similar answer. Even the other things we may be missing these days, like freedom of movement, in actuality amount to missing people. When you’re free to move around, where do you go? Mostly to places where you get to meet, hang with, and interact with others. Among the many costs we have incurred due to the coronavirus shutdown, the psychological costs related to disrupted social connectedness may prove to be some of the most significant and long-lasting.
Human beings are, first and foremost, social creatures. Psychological theorizing has long converged on the notion that social connectedness is a core feature of our internal architecture. Freud, for one, theorized that the dynamics of early family relations are crucial for the formation personality and the development of the neuroses. Following Freud, Object Relations theory placed an even greater emphasis on the role of interpersonal relationships in personality formation (the ‘object’ in ‘object relations’ is most often another person).
Freud’s contemporary, Alfred Adler, argued that "social interest"—defined as “a feeling of community, an orientation to live cooperatively with others, and a lifestyle that values the common good above one’s own interests and desires”—was a necessary precondition for psychological health.
In fact, the enterprise of psychotherapy itself from Freud onward rests on the premise that relationships can heal. Indeed, research has shown that therapist-client rapport is the most important ingredient in successful therapy
Developmental theorists have also noted the primacy of relationship. For example, Attachment Theory, proposed in the mid-20th century by British psychoanalyst John Bowlby, rests on the notion that the quality of early attachment between parent and child predicts the child’s future social adaptation. Arriving from behind the Iron Curtain in the 1970s and 80s, the writings of Russian theorist Lev Vygotsky postulated that children are socialized into healthy functioning through guided interactions with supportive, competent adults. The human mind itself, according to Vygotsky, is formed socially, as cultural tools (such as language) become internalized.
In the mid-1990s, the psychologists Roy Baumeister (Case Western Reserve University) and Mark Leary (Wake Forest University) marshaled substantial evidence from research in motivational, social, developmental, and cognitive psychology to support their theory that the need to belong is a fundamental human motivation. According to Baumeister, “The motivation to form and sustain at least a minimum amount of social connections is one of the most powerful, universal, and influential human drives. It shapes emotion, cognition, and behavior. “
In the decades since, empirical literatures from various branches within and outside psychology have continued to converge decisively on the notion that relationships are at the heart of humanity. For example, studies in the relatively new field of positive psychology, focusing on human thriving and flourishing, have shown repeatedly that, bang for the buck, social connectivity is the most powerful predictor of well-being and life satisfaction, and that the relationship is not merely correlational but causal.
In 2010, Julianne Holt-Lunstad, Timothy Smith (Brigham Young University), and J. Bradley Layton (University of North Carolina) published a meta-analysis of the social relationships literature, compiling results from 148 studies involving 308,849 participants. They found a “50% increased likelihood of survival for participants with stronger social relationships. This finding remained consistent across age, sex, initial health status, cause of death, and follow-up period.” The authors concluded: “The influence of social relationships on risk for mortality is comparable with well-established risk factors for mortality.” More recent data have backed up this assertion, as Claire Pomeroy, blogging for Scientific American, noted: “Loneliness has been estimated to shorten a person’s life by 15 years, equivalent in impact to being obese or smoking 15 cigarettes per day.“
Again here, empirical developmental studies have reached a similar conclusion. For example, Summarizing the results of the Grant Study, an 80-year longitudinal study of adult development, Robert Waldinger, the director of the study, and a professor of psychiatry at Harvard Medical School, said, “The surprising finding is that our relationships and how happy we are in our relationships has a powerful influence on our health…Taking care of your body is important, but tending to your relationships is a form of self-care too. That, I think, is the revelation.”
In 2017, Holt-Lunstad, Theodore Robles (University of California, Los Angeles), and David Sbarra (University of Arizona), writing in the flagship journal American Psychologist, summarized the literature on the effects of social connectedness to conclude that, “A robust body of scientific evidence has indicated that being embedded in high-quality close relationships and feeling socially connected to the people in one’s life is associated with decreased risk for all-cause mortality as well as a range of disease morbidities.”
The authors proposed that in light of these data, social connectedness should be advanced as a public health priority. Indeed, this idea has become increasingly integrated into our health consciousness. To wit: The World Health Organization has begun listing “social support networks” as an official health determinant. The UK government has marked loneliness as a health priority and created a minister of loneliness position to address the issue.
Former U.S. Surgeon General Vivek Murthy has been vocal on the importance of social connectedness (and the risks of loneliness), brought into stark relief by the coronavirus pandemic. In interviews, Murthy has traced our need to belong to our evolutionary heritage: “When we were hunters and gatherers roaming the tundra… we depended on each other... for protection from predators… for a stable food supply. Now over thousands of years, that became baked into our nervous system, such that if we were separated from our tribe, it placed us in an automatic stress state... We were at greater risk of either starving or being caught by a predator.” Our biology, he continues, has not changed much since: "When we are separated from people, when we feel separated… we enter into a similar stress state.”
Murthy further notes that this stress reaction to separation serves a useful function. "In the short term, if I feel loneliness, it's like any other biological signals. It's like hunger or thirst. It's alerting me that something that's critical for my survival is missing. And in that case, I either go find food or water because I'm hungry, thirsty, or in the case of loneliness, I seek out greater social connection.”
The problem, he warns, emerges when loneliness is chronic, and when separation from others persists. "Then we enter into a chronic stress state. And that is what has dramatically consequential impacts on our health. Because in chronic stress, we also increase our levels of inflammation in the body, which damage tissues and blood vessels and increase our risk of heart disease and other chronic illnesses.”
It is important to note that while social connectedness indeed appears to affect health in part by reducing physiological stress, such stress reduction is not the only mechanism responsible for the link. Connectedness may also influence health through behavioral and psychosocial paths by, for example, promoting health behaviors, enhancing people's sense of personal control, and creating meaning and purpose. In fact, our understanding of the mechanisms of effect regarding the connectedness-health link is still incomplete. Both social connectedness and health are complex constructs, and the relationship between them is embedded in a difficult-to-disentangle ecology of influences.
Still, while the mechanisms by which social connectedness impacts health are yet to be fully understood, the general equation revealed by the accumulated data is fairly clear: Connection = Health. Or, as the late psychologist Christopher Peterson said when asked to define positive psychology, “Other people matter. Period,”
It is a lesson we’re re-learning now, and it’s one worth taking with us into the post-coronavirus world.