Therapy in Indianapolis, Zionsville, and Carmel, IN


There is a difference between loneliness and being alone. Being alone can be a comfortable state of mind. The psychoanalyst Winnicott (1958) postulated that the capacity to be alone develops from the infant and small child's experiences of being quiet in the reliable presence of a mothering figure. The evolution of this capacity is paradoxical because it develops with someone else as they are repeatedly alone together. Over time, the capacity matures, and the person can be at ease with being solitary with or without another person.

However, being on one's own can be accompanied by feelings of loneliness. I will define loneliness as the subjective feeling of being alone and the yearning for more connection with others. Here is another paradox of loneliness: It can be experienced when you are by yourself and when you are in the company of others. There are few among us who haven't experienced it. The majority of us have longed for having more connection with others, at least from time to time. The wish for more may come and go in response to circumstances, but the wish can also be constant and cause prolonged distress that lasts too long to brush off as being only temporary. Relief is wanted. Most of us want to have at least one intimate relationship, be it a spousal partner, an adult child, or a best friend (De Jong Gierveld & Broese Van Groenou, 2016). Many of us want more than one close bond.

It seems that loneliness has become more than a problem of individuals. It has become societal. Loneliness has been identified as an epidemic by the Surgeon General Vivek H. Murthy (2023). More than 20% of our fellow citizens over the age of 18 report that they are often or always feel lonely or socially isolated (Cummins & Zaleski, 2023).

There are two dominant theoretical trajectories to loneliness (De Jong Gierveld & Broese Van Groenou, 2016).The deficit model proposes that having too few supportive relationships is causative. What is needed, therefore, is one or more new ones. The cognitive discrepancy model does not name too few relationships as the problem. Instead, the causative factor is the difference between the quality of desired and the quality of actual relationships. The relationships already developed are lacking in enough connection, and then there is loneliness in the presence of others. What is needed is a deepening and improved quality of existing relationships. Both models agree that, on the whole, partnered persons are more insulated against loneliness than those without partners and living alone.

In my opinion, both the deficit and the cognitive discrepancy models make solid contributions. For some, one model is much more applicable than the other. Others feel an abiding loneliness because of various combinations of too few and too disappointing relationships.

In a 2023 guest essay in The New York Times, the Surgeon General Murthy spoke of his own trajectory toward loneliness. During his first tenure, he deliberately neglected his relationships to focus intensely on work.  Even when with those he valued, he was not fully with them. Instead he was checking messages and the news. When his tenure ended, he was ashamed to reach out to those he had neglected. Fortunately at one of his lowest points, there were those who reached out to him. During his second tenure as surgeon general, he has been been deliberately trying to stay connected to others. He believes he is a better man for it.

As Surgeon General, in this essay, Dr. Murthy (2023) told of the physical, emotional, and communal damage that social isolation can bring.  Risks increase for anxiety and depression, heart disease (29%), dementia (50%),  and stroke (32%). The risk for premature death compares to daily smoking and is greater than for obesity. Social isolation also damages communities by decreasing work productivity, academic excellence, and community engagement.

In a July issue of The New York Times , Cummins & Zaleski (2023) reported that loneliness changes the brain by disrupting the neurotransmitters needed to support human bonding with others. The hypothalamic-pituitary-adrenal axis that reduces stress becomes hyperactive and amplifies stress. The amygdala's function of processing emotions is ramped up. Consequently the brain becomes hypervigilant to potential threat, including that from other people, who are then to be avoided. These changes result in loneliness becoming self-perpetuating and chronic.

Dr. Murthy (2023) warned that the problems associated with loneliness need to be identified as dangers to public heath. He proposed a national effort be made to rebuild social connections and thereby a sense of community. This effort could have three prongs: 1). strengthening  the overall social structure through unifying community programs, 2) renegotiating our relationship with technology to spend more time with in-person contacts, and 3) reinforcing our personal relationships. As part of of this last approach, he included openness with health care providers.

If you are concerned about loneliness and want to understand more about it as well as to consider ways to reduce it through psychotherapy focused on relationship counseling , I would be glad to be your therapy partner .


Cummins, E., & Zaleski, A. (2023, July 16, Section Opinion). If loneliness is an epidemic, how do we treat it? The New York Times , Opinion Section, pp. 6-7.   

De Jong Gierveld, J. & Broese Van Groenou, M. (2016). Older couple relationships and loneliness. In J. Bookwala (Ed.), Couple relationships in the middle and later years: Their nature, complexity, and role in health and illness (pp. 57-76) Washington, DC: American Psychological Association. http://dx.doi.org/10.1037/1489

Murthy, V. H. ( April 30, 2023). Surgeon General: We have become a lonely nation. It's time to fix that. The New York Times, Guest Essay.

Winnicott, D. W. (1958). The maturational processes and the facilitating environment: Studies in the theory of emotional development. International Journal of Psychoanalysis, 39, 416-420 &429.


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