Loneliness is a negative emotional experience resulting from a discrepancy between “one’s desired and achieved levels of social relations” (Perlman & Peplau, 1981, p. 32). Loneliness is tied more closely to the quality of social interaction and exchanges rather than the frequency or amount of social interaction (Cacioppo & Hawkley, 2009). One does not have to be alone to feel lonely.
An overlooked analysis by Joiner et al. (2002) revealed that loneliness has two distinguishable components; people can feel lonely as a form of painful disconnec-tion but it can also reflect a lack of pleasurable engagement with other people. Joiner et al. (2002) showed that this lack of pleasurable engagement was more relevant in terms of the link between loneliness and depression onset in adolescents. However, painful disconnection can be at the core of loneliness for some young people. One interview study found that some adolescent girls characterized depression as a blend of depression, disconnection, and loneliness culminating in a sense of “only-ness,” a poignant term which depicts the felt undesirable experience of standing apart from others (see Hetherington & Stoppard, 2002).
We believe another overlooked aspect of loneliness is its temporal component. When someone is experiencing extreme and chronic loneliness, they typically proj-ect this into the future. Lonely people find it very difficult to keep their hopes up and when they experience chronic loneliness, they tend to see little chance of escaping future loneliness. Below, we describe some evidence that links loneliness with social hopelessness. We also briefly describe a new measure of severe and enduring loneliness that was the focus of dissertation research by the second author (see Rose, 2024). Evidence confirmed a robust link between severe and chronic loneli-ness and a lack of hope. This research signifies considerable risk for lonely people with high levels of hopelessness and is in keeping with research suggesting that hopelessness is a critical yet under-recognized variable that links both loneliness and suicidal tendencies (see Joiner & Rudd, 1996).
The experience of loneliness should, of course, be differentiated from solitude and simply being alone without social interaction. Although there are associated negative feelings that tend to accompany loneliness, these feelings can also motivate and propel us to seek reconnection with others (Cacioppo & Hawkley, 2009; Qualter et al., 2015). Loneliness not only has motivational and emotional consequences but it also has significant cognitive and behavioral consequences (see Hawkley & Cacioppo, 2010), and as such, it can involve multiple forms of impairment that can have a debilitating impact on people. Cacioppo and Hawkley (2009) observed that once loneliness is activated, it oper-ates more like a stable and enduring trait rather than a state, even when loneliness has been induced and has not naturally occurred. They further noted that when lone-liness is activated, it seems to entail what they describe as “a ‘lonely’ social cogni-tion – that can make every social molehill look like a mountain” (p. 231). This tendency to process life experiences through a “loneliness” lens ought to influence cognitive and emotional self-regulation so as to accentuate negative experiences and blunt or minimize positive experiences.
Loneliness is especially maladaptive and potentially deadly when it is severe and persistent. It is possible to identify a group of persistently lonely people using tra-jectory analyses to analyze longitudinal data (see Vanhalst et al., 2013). People with chronic loneliness have considerable levels of heightened risk. When it comes to viewing loneliness as a risk factor for mortality (Holt-Lunstad et al., 2015; Rokach, 2019), persistently lonely people have been found to have a slightly greater mortal-ity risk using a Cox proportional hazards model with time to death as the outcome variable and loneliness as the predictor (Shiovitz-Ezra & Ayalon, 2010). These results were found even after controlling for potential confounding factors such as age, gender, education level, medical conditions, functional impairments, and depression. Park and associates (2020) analyzed their data and proposed that chronic loneliness is accompanied by maladaptive chronic stress responses that in turn trig-ger inflammatory pathways in the body and poor health behaviors.
Scales that assess loneliness tend to focus on its level and do not assess chronic loneliness. Accordingly, as noted above, a measure that taps enduring chronic lone-liness and severe loneliness was the focus of recent dissertation work conducted by the second author of this chapter. Rose (2024) found that enduring chronic loneli-ness in emerging adults was associated with lower reported adaptability to the expe-rience of loneliness, feelings of not mattering to others, unbearable psychological pain, worry, depression, and self-stigma for seeking help. Moreover, a series of regression analyses showed that two subscales of this new measure (i.e., enduring chronic loneliness and severe loneliness) predict significant unique variance in sev-eral of these measures beyond the variance attributable to a brief eight-item version of the UCLA Loneliness Scale. Notably, analyses of data from a second sample revealed that the subscale measuring an enduring chronic form of loneliness was uniquely predictive of a lack of hopefulness above and beyond the regular UCLA Loneliness Scale.
While loneliness and mental health issues have now been studied for many years, an influential early review by Heinrich and Gullone (2006) focused on the clinical significance of loneliness that has proven to be prescient in anticipating ensuing research (also see Cacioppo et al., 2015). They highlighted more than a decade and a half ago the high prevalence of loneliness and concluded that loneliness is actually more prevalent, though at times less noticed during the adolescent years. Their anal-ysis focused on the central role of loneliness in understanding poor social relation-ships and their sense that because loneliness can have severe mental health consequences, clinicians should make this neglected phenomenon more of a key focus. As suggested above, loneliness has been linked to a multitude of mental health problems including various types of anxiety, depression, and suicide ideation. Accordingly, it has been concluded recently that loneliness is transdiagnostic and the presence of one or more clinical conditions is linked with substantially elevated levels of loneliness (see Hickin et al., 2021). The association between anxiety and loneliness is believed to be due to a heightened vigilance to social threat among people prone to loneliness (see Ingram & Kelly, 2022). Perhaps not surprisingly, the link between loneliness and social anxiety has been long recognized and exten-sively studied (see Jones et al., 1990). Further, a central focus over several decades is empirical research evaluating the relationship between loneliness and depression. Erzen and Cikrikci (2018) described a meta-analysis based on data from 88 studies and over 40,000 participants, and it was concluded that loneliness had a moderately significant association with depression.
Similarly, a meta-analysis established that loneliness is also linked longitudi-nally with subsequent levels of suicide ideation and suicidal behavior (see McClelland et al., 2020). Clearly, there are myriad physical and mental health con-cerns linked with loneliness. Given the well-established link that persistent, long- term loneliness has with health problems and earlier mortality (see Cacioppo & Patrick, 2008), it seems essential to routinely measure self-reports of chronic loneli-ness in research and in individual assessments of people in counselling and clinical settings.
We now turn to an analysis of the role of the negative self in loneliness. Why focus on the negative self? Our decision to do so reflects not only what can be gleaned from case accounts and research evidence but also the sense that bolstering a negative sense of self should be a key element of treatments, preventions, and interventions.