What internal thoughts reflect unbearable loneliness? We are conducting a line of investigation centered on the premise that loneliness is accompanied by distress due to the tendency to experience frequent automatic thoughts about being and feeling lonely. That is, extreme loneliness can reflect an internal world reflecting Sadler’s (1978) contention that loneliness is an intensely private experience and, clearly, it is one that carries a heavy cognitive load.
Our emphasis on the internal dialogue is in keeping with prior work linking lone-liness and rumination, including the results displayed previously in Table 1.1. It has been found in several studies that loneliness is linked with ruminative brooding as described by Nolen-Hoeksema and colleagues (e.g., Zawadzki et al., 2013). However, some earlier research on the cognitive manifestation of loneliness also documented the presence of measurable and meaningful individual differences in rumination about loneliness (Vanhalst et al., 2012). This research with a sample of 370 university students from Belgium showed that loneliness-related rumination was linked with peer-related loneliness and depression, but not with parent-related loneliness and this form of rumination. Moreover, rumination about loneliness mediated the link between peer-related loneliness and rumination. More recent qualitative research also attests to the salience of loneliness-related rumination (see Yun et al., 2023). The findings have clear clinical implications in terms of needing to remove uncontrollable ruminative thoughts about loneliness. The Loneliness Automatic Thoughts Questionnaire we developed is comprised of nine thoughts that possibly reflect the current experience of loneliness. The con-cept of loneliness-related automatic thoughts was informed by case accounts of lonely people characterized by ruminative thoughts and tendencies (e.g., Cheng & Merrick, 2017; Tarocchi et al., 2013). It was also informed by the work by Horowitz and associates (1982). They described a “fuzzy set prototype” for loneliness that seemed to inextricably link loneliness with depression and associated negative judg-ments of the self. Relevant themes include a sense of being different from others, something being wrong with the self, and a sense of “I cannot” in terms of failing to establish personal connections with other people.
Box 1.2 lists the nine thoughts represented on the LATQ. Participants are asked to indicate the frequency of these thoughts over the past two weeks. The unbearable nature of loneliness and not being able to tolerate it are best represented by thoughts such as “I cannot stand to feel this alone,” and “I cannot handle feeling alone,” while the negative self is implicated in feelings of being helpless and weak and unable to escape these thoughts.
Research results involving the LATQ are summarized in Rose et al. (2024). The first study with the LATQ evaluated 462 university students from Israel during the pandemic (see Besser et al., 2022). The LATQ was found to have one factor based on a principal components analysis with data from 462 university students from Israel. Item loadings ranged from 0.68 to 0.82. The alpha was 0.79. Correlations showed that the LATQ scores were linked positively with dependency, self-criticism, lower self-esteem, and measures of feelings of not mattering to others. Importantly, as anticipated, the LATQ was also strongly correlated with a measure of loneliness. It was also associated significantly with more frequent negative automatic thoughts (r = 0.57) and less frequent positive automatic thoughts (r = 0.40). More recently, we examined the characteristics of the LATQ by including this measure in two studies conducted by our second author as part of her dissertation work. It was confirmed in both samples that the LATQ consists of one factor, and the items are measured with an adequate degree of internal consistency and do not suffer from social desirability response bias. Correlations suggest links between elevated scores on the LATQ and measures of social hopelessness, persistent and intrusive negative thoughts, and unbearable psychological pain (i.e., psychache).
One regression analysis indicated that significant unique variance in LATQ scores was predicted by social hopelessness, feelings of not mattering, and psychache. Our findings indicate that many students with high levels of loneliness experi-ence an ongoing internal dialogue involving thoughts that will make feelings of loneliness highly salient at a cognitive level. The persistence of these thoughts con-tributes to enduring loneliness but in ways that can make feeling lonely seem simply unendurable. When abject loneliness is experienced in this form, it really is no won-der that loneliness can translate into significant stress-related health and mental health problems. It is difficult to imagine students with these tendencies having much success, either in college or university or in life, if they do not receive effec-tive treatment and counseling that addresses their loneliness in general and feelings of unbearable loneliness and related thoughts in particular.