The Psychological Journey To and From Loneliness: Development, Causes, and Effects of Social and Emotional Isolation

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Prologue: Getting loneliness out of the closet

Loneliness and the feeling of being unwanted is the most terrible poverty.

Mother Teresa

Ours is the age of relationships. We, in the Western world, believe in the uniqueness, importance, and availability of relating to others, thinking that we know how to conquer the barriers against closeness that we erect. To the post Second World War generation, work was seen as the valued solution to self-fulfillment, today it is relationships which appear to be the main, if not the only means by which self-esteem can be affirmed. That results in a paradox, whereas on one hand, we yearn and long for close intimate relationships, but on the other hand, our social conditions are not conducive to the development of the close relationships which we so want. Our Western lifestyle, in the second decade of the 21st century, appears to enhance interpersonal alienation as well as make it more difficult to cope with. Everyone is seeking companionship and many seem to be having trouble finding it.

Although the human race is made up of many different people, and despite the many dividers among us (such as language, culture, religious beliefs, and socioeconomic levels) we share some fundamental similarities. One of those similarities is our yearning for love, acceptance, and understanding. Since we have only a limited ability to control life and the people around us, we go through life experiencing frustration, restlessness, and loneliness. We live knowing that others do not fully understand us, and may not know us. We are reminded that the world around us, as accommodating as it may be, is out there, while we are in here. We are part of, yet distinctly separate from, all which is around us. That very separation is the core of our loneliness and alienation. And although we all share this fate, most people tend to hide their pain, deny their loneliness, and assume that others do not experience such a phenomenon. The following three accounts will demonstrate how our concerns and yearnings are, basically, quite similar.

Rebeca is a 32-year-old woman who is married and a mother of two children. We met in her office, and as I asked her to talk about her loneliness experience, she was observing her 10-year-old daughter who played with her dog in the backyard. Rebeca’s eyes became misty and seemed to indicate that she was only partly attending to our meeting. A few minutes later, she explained that seeing her daughter sitting alone in the backyard revived her memories of her own loneliness in childhood.

Rebeca started speaking about her loneliness as a child and recollected the pain and alienation that she felt since about the age of 4. She was not accepted by her peers, and those she did manage to relate to, were outcasts themselves. Her family seemed distanced and she did not fit in with them. Consequently, at the age of 9, she was sent to live with her grandparents and helped them on their farm. Getting to know the other workers on the farm was a slow and painful process for her, though once she felt somewhat more comfortable amongst them, she was sent back home to her parents, being accused of taking and relating too much to the other farm workers and thus lowering their productivity. She continued to experience bouts of loneliness throughout her adult years.

Debbi is a 19-year-old female. When asked to reflect on her loneliest experience, she wrote: I had not been very happy at home for many years as a teenager. My older sister had already left home 5 years before at the age of 15. My brother was only seven years old so he couldn’t leave. I was 17, the legal age to leave one’s parents without being dragged back by the court. I always told my mother ‘when I’m 17, I’m leaving’. So, on October 6, on my 17th birthday, I told my parents I was going. I went to work that morning and after work at 5 o’clock my boyfriend and I went in his car to pick up my belongings from my parents’ house. When we arrived, I saw all of my clothes, etc. on the grass in front of my house. My dad had gone to my room upstairs, opened the windows and threw everything out for me to pick up off the grass. The final separation had come. I was leaving. What a way to go. No goodbyes, no good lucks, nothing. Picking up my clothes was the hardest thing I have ever done in my life. We drove off. I felt totally alone. I wanted it but I really didn’t want it that way at all. I wanted my folks to beg me to stay. They didn’t. I was walking, but couldn’t feel it, I was looking but couldn’t see, I was eating and couldn’t taste, I couldn’t feel anything, except totally and absolutely alone.

Fred is a 69-year-old retired teacher who writes: Upon returning home after a two month stay in hospital (following my retirement) I was all alone in our apartment, heavily medicated, depressed, and longing for my wife who had to return to work. At my age, being sick, I found that I was also not doing all that well socially. My children (all three of them) got married and left the house, several of my friends died of old age, others were put in old folks homes which were too far for me to visit, and still others moved away. My wife is my only comfort, though I am fearful of the day she dies. I am lonely and accepting that which I cannot change.

These three letters, which were amongst more than 750 that I have received over the past four decades, as part of the research that I am conducting on loneliness, were written by people who were very different from one another in age, marital status, educational background, occupation, and race. Nevertheless, there are some common themes that run through them, which also appeared in almost all the other letters that I have received:

• Loneliness is a universal phenomenon which is fundamental to being human. Everyone, regardless of ethnic origin, religious beliefs, socioeconomics, or social status and age or sex can identify the pangs of loneliness at some point in their lives.

• Although common to all of us, the nature of loneliness as a subjective experience is varied across different people, under many conditions, with a multitude of causes and enumerable results and consequences.

• Although, loneliness is a complex and multifaceted experience, it is always very painful, severely distressing and individualistic.

Loneliness has been around since man first walked on earth. The Bible, philosophical writings, art, and literature are all a testament to the presence of loneliness in our lives. The stigma that loneliness evokes makes addressing it, or admitting that one is experiencing it, quite difficult and threatening. I saw my mission as a researcher and a writer to get loneliness out of the proverbial closet. Help the public realize that it is as natural an experience as sadness, joy, pain, longing, and love. A painful experience, but a natural consequence of some life and/or personal events. Lately, the British Prime Minister May has created the ministry of loneliness—a blessed acknowledgment that loneliness is a national issue and deserves recognition and specific resources to be directed into addressing it.

Loneliness is a prevalent, common and disconcerting social phenomenon. It is suggested that up to 32% of adults experience loneliness, and up to 7% report feeling intense loneliness. We have polluted our social environments and actively rely on materialistic and individualistic criterion to gage well-being. Hence, to do well economically is a cherished state of being. Competition is encouraged and rewarded. The ethical salvation of our families and society at large is the commitment of people to each other, for all else will breed alienation.

Most people are reluctant to admit, even to themselves, that they are lonely. We tend to deny the very same loneliness that is probably responsible for many of our thoughts, feelings, and behaviors. Loneliness is socially stigmatized and is vied as a weakness in the Western culture. That denial, although an expected reaction to our fear of social repercussions should we admit to being lonely, does not eliminate loneliness. We still hurt, live with pain and feel alienated at times. The drawback in our self-deception is that we cannot work through our loneliness since we refuse to recognize and accept it. And despite our denial, loneliness is present, and is now becoming a recognized epidemic. All one needs to do to evidence the presence of loneliness, is see the increased use of drugs and alcohol, the sale of pornographic material, and the thousands of calls to distress hot lines, which are a clear indication of that alienation.

Loneliness, which can involve both excruciating physical and mental suffering, is an ancient nemesis. It is implicated in numerous somatic, psychosomatic, and psychiatric diseases. No one is completely self-sufficient (despite our Western culture’s attempts to encourage us to be so) and we could not exist without the society in which we live. Being a uniquely subjective experience, loneliness is caused by the individual’s personality, environmental and social changes, and his history.

This book was written with the purpose of reviewing and describing loneliness from various angels, at various life points, and as is it influenced by one’s history, personality, and stage in life. We endeavored to summarize the available theoretical basis for more research to take place, and bring about progress not only in the academic sense, but one that will be available to the public who needs to be encouraged to utilize whatever assistance can be provided by the state.

1

Belonging—the essence of a community

Abstract

Being such a central feature of our humanity, belonging is reviewed, its importance, definition, and beneficial effects are listed. It clearly indicates that belonging is essential to our survival, as individuals, communities, and nations. Psychological theories about social connection, and familial support are presented, and cultural influences on social inclusion and belonging are discussed.

Keywords

Belonging; social connectedness; relationships; culture; psychological theories

Humans are obligatorily gregarious… The average person spends nearly 80% of waking hours in the company of others… and their survival depends on their collective abilities, rather than on their individual might.

Distel et al. (2010, p. 480/481).

Belonging, being part of the larger community, and having a special someone who cares deeply about us, is an essential need for humans who have been referred to as social animals (Rokach, 2017). We only need to watch National Geographic films to realize what happens to the deer who lags behind and is not part of the group. It becomes dinner for the waiting lion. Movies about the Wild West, which many of us, baby boomers, may remember, demonstrated the importance of belonging. At night, the travelers would form a circle with their wives and children in the middle, and protect them against prying man and animals. Devoldre, David, Verhofstadt, and Buysse (2017) highlighted the importance of the social support that belonging fosters, and the stresses and negative effects on mental and physical health that lack of such support may bring about (see also Rook & Charles, 2017).

Mellor, Stokes, Firth, Hayashi, and Cummins (2008) poignantly asserted that as social beings, most humans live in a matrix of relationships that, to a large extent, define their identity (I am a daughter, wife, mother, student, etc.), and our personality (I am extraverted, friendly, and kind). Moreover, the importance of such connections transcend cultural differences… Given such dependency on relationships with others, it is not surprising that factors such as belongingness and loneliness are important predictors of psychological health (p. 213).

Baumeister and Leary (1995), in their seminal article on belonging and its importance to well-being, suggested that humans have a pervasive (and I would add an inborn) drive to form and keep lasting significant and positive relationships. However, they added, failure to have those belongingness needs met, would quite certainly lead to feelings of social isolation and loneliness. One of the points which is frequently highlighted in the literature about belongingness, is that the quality of those relationships which we have, rather than their quantity, is the defining feature and the significant variable in creating a positive relational context and which will satisfy the need to belong (see Rokach, 2014). Just like with food, once satiated, people are less focused on searching and securing nourishment sources, those who enjoy good social relationships, are less driven to look for more of them, and thus, noted Kelly (2001), some people with a few good and reliable connections, may be satisfied and display a lower need to belong, while others will look to increase their circle of friends who cannot offer them the quality and intimacy that they yearn for, not unlike the constant searching for new friends on Facebook.

Belonging and being part of an intimate relationship may foster higher general life satisfaction than reported by those who do not get that caring and nurturance (Baumeister, Wotman, & Stillwell, 1993). Interestingly, and as with other basic needs, such as food, for example, once people feel that they belong, say in a romantic union, they are less likely to search for another partner (DeWall, Baumeister, & Vohs, 2008). In fact, contend Baumeister and Leary (1995) intimate relationships are so important to humans, that there may be an internal gauge which they termed the socio-meter and which helps us constantly monitor the environment for clues to changes in our inclusionary status. For it is so important to us, that as we become aware of it, we may endeavor to improve it. Both, loneliness and belonging, share the subjective perception of connectedness to others. Psychologists’ research has long established that relationships have the power to influence physical and mental health, for better or worse…. The evidence is leading psychologists to say that strengthening those bonds should be a public priority…. Strong social relations increase the likelihood of survival by 50 pecent regardless of age, sex, or health status, according to a meta-analysis of 148 studies on mortality risk (Weir, 2018, p. 48).

Cacioppo, Reis, and Zautra (2011), the leading researcher on loneliness, observed that human evolutionary heritage has endowed us with the capacity to feel the pain of social isolation and the rewards of social connection. Importantly, it has also endowed us with the capacity to feel others’ pain and the compassion to care for the sick and the elderly far beyond their reproductive or instrumental utility (p. 43). Weil (1997), a holistic physician, observed that the human species is comprised of highly social, communal animals that are meant to live in families, tribes, and communities, and when they lack those connections, for whatever reason, they suffer. It is ironic that our Western industrialized society glorifies individualism and fosters a spirit of Every Man for Himself. Weil pointed out, as I have observed as well (Rokach & Sha’ked, 2013) that many people pride themselves on their independence and seem to clearly and actively distance themselves from others. Some, offered Weil, may indulge in isolation using it as a defensive strategy against emotional pain, while others may never have learned how to meaningfully connect to anyone beyond themselves. Hagerty, Williams, Coyne, and Early (1996) asserted that establishing and maintaining relatedness to others is a pervasive human concern, believing that through interpersonal interactions people survive, develop and grow (p. 235). A testament, to how important connectedness and belonging are, can serve the practice of ex-communication that was the Church’s most severe social reprimand and the solitary confinement used in jail to punish unruly criminals. Social alienation may be so painful and damaging that people may use the same terms to describe rejection as they do to describe physical injury. We have all heard of feeling hurt or crushed, just as two examples (Leary & Springer, 2001). DeWall and Baumeister (2006) provided scientific evidence to that claim. Their participants responded similarly to physical and social pain-producing events. When, for instance, they were interpersonally rejected, they reported a sort of numbness (similar to the physical analgesia that is usually the initial response to trauma) and that helped to protect them from distressing emotional reactions. Eventually, this analgesic effect fades away and the social (or in the other case, physical) effects will be experienced (Pond, Brey, & Dewall, 2011).

Many of us may still remember our parents’ or grand parents’ Great Depression generation, where one’s work was seen as the valued means of self-fulfillment; for that generation, it was about breadwinning through a career or a job for men, while for women, it was about the creation of a home and family. The 21st century, is however, the age of relationships. We believe in the importance, uniqueness, and availability of methods of relating to others. At present, relationships appear to be the main avenue, and perhaps the only means, by which self-esteem can truly be affirmed. As Gordon (1976) so poignantly observed, To be alone is to be different, to be different is to be alone, and to be in the interior of this fatal circle is to be lonely. To be lonely is to have failed (p. 15). We seem to be living in a Noah’s Ark society where everything goes two-by-two, and if you are lonely, you are out of place.

What is social connectedness?

I do know for sure that connectedness is necessary to well-being. You can eat as much salmon and broccoli as you can, take anti-oxidants for the rest of your life, breath terrifically, and walk all over the earth, but if you are disconnected [from others], you will not achieve optimum health

Weil (1997, p. 153).

Kohut (1977) saw it as a fundamental human concern to establish and maintain connection and relatedness to others. That belief has led to the exploration of many concepts that are put forth in order to assist us in understanding relatedness through social behavior, psychological drives, attachment systems, and cultural environments. Since there is no one acceptable definition of belonging, various terms will be used interchangeably, including such terms as social support, relatedness, affiliation, community, and belonging. Hagerty, Lynch-Sauer, Patusky, Bouwsema, and Collier (1992) conceptualized belonging as the experience of personal involvement in a system or environment so that person feels themselves to be an integral part of that system or environment…. Two dimensions, or defining attributes of sense of belonging are delineated: (1) Valued involvement: The experience of feeling valued, needed, accepted with respect to other people, groups, objects, organizations, or spiritual dimensions, and (2) fit: the person’s perception that his or her characteristics articulate with or complement the system or environment (p. 173). Sense of belonging could be viewed from various dimensions. It could be, for instance, considered from a psychological, sociological, physical, and spiritual perspectives. From a psychological perspective, belonging is an internal affective evaluative feeling or perception (Hagerty & Patusky, 1995). This is, commonly, referred to as the sense of belonging, as it highlights the individual’s experience of being important and valued by some external referent (Friedman, 2007). While we assume that a sense of belonging may be related to one’s connection to one’s family, Pilisuk and Hillier Parks (1986) indicated that one’s sense of belonging cannot be met by one’s family alone. Josselson (1996) defined belonging as linking of the self to a larger social environment (p. 181).

Hagerty et al. (1992) observed that the sense of belonging is the experience of personal involvement in a system or environment so that persons feel themselves to be an integral part of the system or environment (p. 173). When asked (Distel et al., 2010) which of their social activities was most enjoyable, the participants pointed to their intimate relationships and activities that promote bonding and high-quality relationships; commuting and working were seen as the less enjoyable. Cohen (2004) describes it as a social network’s provision of psychological and material resources intended to benefit an individual’s ability to cope with stress (p. 676). Brisette, Cohen, and Seeman (2000) grouped together the various kinds of possible support into three categories: instrumental support, which involves the provision of material and practical help; informational support, giving information that could aid the receiver in coping with difficulties or current problems; and emotional support, involving the expression of empathy, caring, trust, and reassurance that could be an invaluable assistance at times of need or crisis. Social integration is the construct that includes the behaviors that one engages in, in order to be integrated into and feel part of the community.

What is a community then? A community has been associated with physical space and a social network that existed in that space over time. Another approach suggested that the definition of community is closely related with that of a sense of belonging. Blow and Timm (2002) viewed community as a network of significant relationships that are characterized by caring, understanding, mutual valuing, and commitment. It is, thus, composed of a network of people who are committed to each other and interact on an ongoing basis. In addition, participants have a feeling of fitting in, of belonging, of being valuable to others. Community includes belonging plus a sense of genuineness and love (Friedman, 2007). Today’s society is not as cohesive, close-knitted, and involved in its members’ lives as it was in yesteryears but the longing to belong and be part of a community still exists because it is an integral part of being human, and until it is fulfilled, will drive us to achieve it. Commenting on the importance of community to our well-being, Lewis, Amini, and Lannon (2000) observed that with results like these backing the medical efficacy of mammalian congregation, you might think that treatments like group therapy… would now be standard. Guess again. Affiliation is not a drug or an operation, and that makes it nearly invisible to Western medicine (p. 80).

Weir (2018) reviewed various studies and opined that social connection (or disconnection) can affect health through biological pathways such as immune function or the regulation of stress hormones. Relationship quality can affect health by influencing psycho-social factors such as mood, motivation and coping skills. Friends and family members can also influence a person’s health related behaviors such as eating and exercise habits. Together, those pathways can have long term outcomes for physical and psychological health (p. 48). Research has extolled the power of social integration and support by suggesting that they rival, in their positive influence, cigarette smoking, obesity, elevated blood pressure, and physical inactivity, which are all well-established biomedical risk factors (House, Landis, & Umberson, 1988; see also Cacioppo, Cacioppo, Capitanio, & Cole, 2015). Berkman (1995) in his large-scale longitudinal study concluded that those who were able to develop and maintain a supportive social network were less likely to die in the following 9 years through which the study was conducted. Moreover, social support does not only affect our capacity to ward-off loneliness, but it may also affect the rate of recovery from a variety of illnesses (Cassell as cited in Cacioppo et al., 2002; Pilisuk & Hillier Parks, 1986).

Maté (2003) examined our infancy exploring humans’ inability to survive on their own and their limited capacity for self-regulation, pointing out that our internal biological states such as heart rates, hormone levels, and nervous system activity, depend completely on the infant’s relationship with her caregivers. Highlighting the essential role that belonging has in our lives, Maté stated that human beings did not evolve as solitary creatures but are actually social animals whose survival was contingent on emotional connections with family and tribe. He further stated that social and emotional connections are an essential component of our neurological and chemical makeup. Maté pointed out that social support helps to reduce physiological stress, and people who are more isolated are more prone to illness.

The 1998 movie Patch Adams (about a noted physician by that name) centers on the community that this physician has created where he hospitalizes, treats, and heals the sick. He does so not in a detached, efficient, and modern hospital, but in a house that he bought, and later in his Gesundheit Institute, which he created, where the sick are tended to by physicians free of charge, and in turn contribute to the maintenance of the institution by tending (socially and emotionally) to other patients, helping wherever they can and creating a society that takes care of its members: in the operating rooms, the nursing, the garden, and the kitchen. He continues to live among us and preaches that the healing that the ill patients need, involving caring for their physical, mental, and emotional needs, is best done in a caring community.

The beneficial effects of belonging

Ornish (1998) interviewed James Billings, who studied clinical psychology and epidemiology, for his book, Love & Survival. Billings commented on psychology and human nature and how we miss the mark. It moved me deeply and seemed to validate what I felt for a long time and would like to share his words with the reader:

Western psychology, which is a little more than a hundred years old, really redefined man by developing a new paradigm of what is normal and what is abnormal. The focus shifted almost completely to the individual. The very idea that someone was dependent on another person was diagnostic of any number of pathologies. In my dissertation I followed a group of people for five years after they were hospitalized for attempting suicide. I was surprised to find that people in therapy were killing themselves at a substantially higher rate than the others! [What I then understood after further investigation] was that [the] people killing themselves in treatment were seeing an analyst therapist who maintained a detached distance from them—they would lie on a couch, not able to see the therapist, who would say very little to the patient during the session. The patient was having an enormous need to make contact with the therapist and to have him or her respond in a nurturing, caring way, when the therapist didn’t, the patient often ended up attempting suicide or actually killing himself or herself.

These people were usually the ones who were often depressed, who were feeling isolated, abandoned, and they were having a hard time getting someone to respond to their condition… so we have a world full of people who have a genetic predisposition to affiliation, the need to belong, and we still have a psychological development theory that defines what is normal as making sure that people are not dependent in their relationships. It says that affiliation is pathological, that what you really need to be healthy is not to need anyone. These psychological constructs define what is normal in ways that are at odds with our biology, that thwart affiliation and add to the demise of the family… We need a place where we belong, where we are seen, we are visible, we feel welcome, a place where we can talk easily, and we can listen easily (pp. 225–6).

It is universally recognized, claimed Begen & Turner-Cobb (2015) that the social environment influences health and well-being. And so are the evolutionary and practical benefits of inclusion in the naturalistic environment (Leary, 2010). Research evidence suggests that inclusion and belonging increase trust (Hillebrant, Sebastian, & Blakemore, 2011) and reduce the impact of prior exclusion, if there was one (DeWall et al., 2010) with consequent health benefits. Inclusion was found to relate to reduced heart rate. Research Weir (2018) indicated that the quality of close family relationship can affect endocrine function and nervous system activity, both of which are linked to leading causes of illness and death, including cardiovascular and infectious diseases, and cancer. On the other hand, research indicated that close family relationships are linked to favorable levels of the stress hormone cortisol, which plays a role in important functions such as glucose metabolism and immune function. Oxytocin, which was shown to be released during social bonding has a protective role and helps reduce blood pressure and lowers cortisol levels (Weir, 2018). Segrin, Burke, and Badger (2016) noted that from the moment of birth the welfare of any human being is dependent upon the protection and care provided by other human beings. Examining it from an evolutionary perspective, the ability to survive is largely dependent upon successful affiliation with other people. And so, when people are socially isolated or marginalized, loneliness motivates a reestablishment of social contacts that are necessary to the welfare and survival of the once lonely individual.

Children’s relationships are of utmost important. Weir (2018) suggested that supportive relationships can protect children against future physical health problems. When the children’s relationship with their parents and family members are comforting and emotionally significant, they tend to have better health profiles throughout their lives. In later life, the elderly at times struggle to keep or acquire friends, due to death or illness of those they have. The elderly are satisfied with their relationships and lives, when they have supportive connections, but when those are lacking they report social isolation and loneliness. In their recent review of belonging, social ties, and health, Rook and Charles (2017) noted that being socially integrated and having access to social support throughout adulthood, have been found to be related to better physical health, including reduced risks for infectious illness, overall cognitive and physical decline, cardiovascular disease, and both cancer-specific and overall mortality. However, being socially isolated and feeling lonely were shown to be related to worse physical and cognitive functioning and earlier mortality. Pietromonaco and Collins (2017) reviewed recent psychological literature highlighting not only belonging, but more specifically close social ties. They concluded that recent theoretical models and experimental reports indicated that supportive close relationships contribute to good health both by helping people cope with stress and by enabling them to fulfill basic needs such as love, intimacy, companionship, and security. Relationships were shown to benefit health through such processes as exploration, personal growth, and goal strivings, all of which are essential for health and well-being. They further point out that evolutionary approaches as well as Bowlby’s (1969) attachment theory indicate, clearly, that humans have a basic need for social connection, and that lack thereof is painful, is experienced as loneliness, and thus motivates the individual to ameliorate the situation and create social ties. Feeney and Collins (2015) further suggested that the history of one’s interacting with close (attachment) figures, significantly influences and shapes people’s emotion regulation ability, solicit care and support from their social network, and caring for others, as well as attain personal growth from their supportive social connections.

Pietromonaco and Collins noted that close relationships can protect one’s health by buffering the person from the negative effects of stress and by facilitating recovery and resilience (see also Uchino, 2009). Close relationships, a-la- Feeney and Collins (2015), are a source of strength, and can provide a haven of comfort, especially during hard times. Backing their observation by physiological studies, they added that patients undergoing cardiovascular reactivity (i.e., pulse rate, blood pressure), could be greatly helped and calmed by social support, as can a partner’s caring verbal support reduce cortisol reactivity to acute lab stressors (Collins, Jaremka, & Kane, 2016). Social support has also been shown to reduce susceptibility to infection and illness, especially those occurring under stress (Cohen, Janicki-Deverts, Turner, & Doyle, 2015). Research further demonstrated that those who feel understood and accepted appraise the world around them as less daunting (Oishi, Schiller, & Gross, 2013). Belonging and social connection are not only beneficial during times of stress but also play an important role during nonstressful times, by encouraging people’s well-being, through facilitating goal striving and personal growth (Feeney & Collins, 2015; Lakey & Orehek, 2011). Moreover, those who feel supported and part of a caring social network are able to celebrate positive life events, increasing health promoting effects of positive emotions, and enhance personal strengths that are cultivated during good times (Gable & Reis, 2010; Pressman et al., 2009). Dunkel Schetter (2017) is even more direct when she states that Close relationships are implicated in the onset, severity, and progression of a wide range of diseases, including cardiovascular disease and cancer, and in the severity, progression, treatment, and recovery from mental health disorders such as schizophrenia, depression, and addiction (p. 511). Moreover, indicated Dunkel Schetter, the effects that belonging and especially close social relations have, are reflected on the person’s physiology, emotions, cognitions, and behavior, and ultimately significantly affects one’s health. Research indicated that people in secure and committed romantic relations have a lower risk of heart disease, while its risk is increased in those in nonharmonious relationships (Weir, 2018). Campos and Kim (2017) reiterated that point and asserted that relationships, and especially close ones, are the significant center of the human social involvement, and based on related research have observed that relationship quality and their longevity are of significant importance for our health.

Research has demonstrated that those who reported a higher need to belong experienced decreased loneliness when they were satisfied with their social network. And on the other hand, unsatisfied belongingness needs, may thus lead to social isolation, and loneliness (Mellor et al., 2008). Olds and Schwartz (2009), utilizing the evolutionary perspective of belongingness, asserted that those who are socially connected, live longer, have more robust immune systems, and are better equipped to respond to stress. Medical research indicates that social connection is good and important to our health, or more succinctly, human beings, both as a species and as individuals, survive only through attachment to one another… we are designed to become attached to one another (Olds & Schwartz, 2009, p. 57). Weiss (1973), who is considered one of the main writers on loneliness and relationships, asserted that social relations, and particularly intimate ones, are a rich source of: (1) Attachment—which can be seen in good relationships that may provide us security and commitment. (2) Social integration—which may be felt when companionship and shared activities are part of our social relations. (3) Opportunity for nurturance—is being fostered by relationships that provide us with a sense of being needed, and possibly for nurturing someone else. (4) Reassurance of worth—may be the consequence of a relationship which provides us with a sense of competence and of being valued, and (5) Guidance—when relationships allow us to receive trustworthy advice and