The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders is a comprehensive practitioners’ guide to the diagnosis of 297 mental disorders. Almost all 297 entries assert social impairment is one of several diagnostic criteria or is a potential impact.
A 2020 report based on a national survey of approximately 950 Americans concludes that more than one in three survey respondents (36 percent) reported “serious loneliness”, defined as feeling lonely “frequently” or “almost all the time or all the time” in the four weeks prior to the survey. A staggering 61 percent of young adults aged 18-25 reported serious loneliness.  An epidemic of loneliness is spreading across the globe.
Several recent studies found that:
· Social isolation significantly increased a person’s risk of premature death from all causes, a risk that may rival those of smoking, obesity, and physical inactivity. 
· Social isolation was associated with about a 50 percent increased risk of dementia .
· Poor social relationships (characterized by social isolation or loneliness) were associated with a 29 percent increased risk of heart disease and a 32 percent increased risk of stroke. 
· Loneliness among heart failure patients was associated with a nearly four times increased risk of death, 68 percent increased risk of hospitalization, and 57 percent increased risk of emergency department visits. 
· Loneliness was associated with higher rates of depression, anxiety, and suicide. 
The COVID-19 pandemic, as well as the government’s response to it, has made social isolation and loneliness worse. A 2020 report of the national public health group Well Being Trust have estimated additional deaths due to despair cause by the COVID-19 pandemic to range from 27,644 (quick recovery) to 154,037 (slow recovery), with somewhere in the middle being around 68,000. Most of these additional deaths will be by suicide, alcohol or drug use. Another report from the Brain and Mind Centre at Sydney University, Australia, predicted that the suicide rates will double due to the social and economic consequences of the national lockdown measures. 
The first few pages of Google searches for solutions to loneliness is filled with page after page describing ways to socialize, however, the solution for this increasing isolation must be more than teaching socialization skills and joining online groups. If popularity were the cure for loneliness, there would be no suicide in Hollywood.
"If popularity were the cure for loneliness, there would be no suicide in Hollywood."
We have experienced heartbreak, trauma, and disappointment. We justifiably do not trust others. Many of us project confidence and success disguising deep and abiding fear. We hide fear behind a projection of learned self-defenses. Our inside feelings and thoughts do not match what others observe. Surrounded by people, we are still lonely. We struggle to understand why we avoid some and others avoid us. When our outside does not match our inside getting to know us may feel unpredictable to others, too risky or emotionally unsafe.
Children of alcoholics learn how to survive unpredictability by developing a sixth sense for emotional and physical danger. The sibling that takes on the role of protector for younger or more vulnerable siblings develops a keen awareness. She knows danger is around the corner before it manifests. She intuitively senses danger because of small shifts in schedule, energy or habits. Similar to abused or neglected children, we develop survival skills for avoiding pain, negative emotions or the criticism of others.
Horses have a similar acute sensitivity to danger within a circle of risk that may extend for 20 to 50 yards or more. Horses can identify a scent in the air or a shift in energy and act defensively before danger is exposed. Horses are genetically selected to be very good at this. Intuitive horses will survive in the wild longer, protect that rest of the heard and procreate other intuitive offspring. Horses without intuition are more vulnerable to prey and have fewer offspring. That is natural selection at work for thousands of years as horses became attuned to every anomaly and potential risk posed by appearances that are not as they seem.
As young and innocent children, our outside always matches our inside. Children feel, know, and say what they feel, think and want. This makes people feel safe around children. In childhood or early-adulthood we often experience caregivers, trusted people, or partners that hurt us emotionally or physically. They hurt us when they respond negatively to our vulnerabilities and emotions, or worse, are apathetic toward our thoughts and feelings. With each emotional injury our truest and most authentic emotions and expressions are extinguished. We learn quickly to hide our true emotions behind masks of confidence, high energy, anger, aggressive behavior, overt sexuality, laughter, anxiety, depression, or substance use. We hide to keep from being hurt. We develop strong defenses to guard our vulnerable heart and become more likely to cause harm to the hearts of others. Our inside no longer matches our outside as it did when we were children. On the outside we may be brave and confident while inside we are fearful and apprehensive.
Sensitive people are more easily injured and learn quickly to become wary of people with a distance between their true and projected self. If they have been hurt by the unpredictability of inauthenticity they will learn instinctively to avoid it. Horses sense when our inside does not match our outside. A horse will immediately recognize our inauthenticity and be apprehensive because he will not be able to conclude whether we are safe to approach or possibly dangerous. If we are afraid in the round pen but are inauthentically acting brave the horse will know the false bravery is hiding fear and hidden fear is unpredictable. Unpredictable is dangerous. The horse will remain cautious and stay at a safe distance or test our bravery with their own unpredictable behaviors. He may challenge, ignore, or stomp until we show our authentic self or that we are afraid. Only then will the horse feel safe enough to approach us. Once they feel safe they may approach cautiously to help us know that WE are safe with them. 
I work with clients that have survived trauma, abusive relationships, or grief from the tragic death of loved ones. They live lives desperately maintaining a façade of resilience. Many are deeply afraid; afraid to be hurt, afraid to be exposed, afraid to fail, or afraid of being afraid. When a client acknowledges, “I am afraid,” they can begin to heal. Like in the round pen, once our inner fears are exposed some will feel safe to connect with us. Soon, we will learn to sift them and understand which of our relationships are safe. They will begin to deepen and our loneliness will dissipate. Just like the horse in the round pen that no longer senses danger, others will be more willing to develop more trusted and vulnerable connections with us.
It will never be enough to teach people how to socialize if we do not address the cause of the fear and apprehension that separates our defensive outside from our protected inside. We long so deeply for authentic connection. We are lonely because we disguise our fear or pain to protect our broken hearts and rarely connect. Others with their own experiences intuitively do not trust us and we do not trust them. Inauthenticity is perceived as not emotionally safe. This is the core of this epidemic of loneliness. We must admit we are afraid.
In therapy my clients often feel safe enough to be honest about our fears. Then we work to change the belief that being open, honest and vulnerable is emotionally dangerous. We also learn how to be more assertive and set boundaries with others. This is necessary to be vulnerable AND safe. Treatment can include several evidence-based interventions: talk therapy, Emotion Focused Therapy (“EFT”), Cognitive Behavioral Therapy (“CBT”), Dialectical Behavioral Therapy, (“DBT”), Eye Movement Desensitization and Reprocessing, (“EMDR”), and/or mindfulness.
In the security of more authentic, honest, vulnerable and trusted relationships in and outside of therapy our broken hearts will begin to heal. When our facades fall away our outside can reflect our vulnerable inside. Then we can be both seen and loved by others. Our connections will deepen and loneliness can heal.
“The mass of men lead lives of quiet desperation.”
Henry David Thoreau (1894)
Author Bill Parker is a lawyer and owner-therapist at Experience Matters Counseling, LLC.
Website – www.ExperienceMattersCounseling.com
Phone – (561) 888-9500
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