Most people think of loneliness as a painful state of mind. They may not realize that it is also bad for one’s health. Loneliness puts people at increased risk of depression, dementia, and alcoholism. It can worsen just about every mental health disorder. We are tribal animals, and we require positive human connection in order to thrive. A Harvard study (which was started over 80 years ago and has followed a large cohort throughout their lives) found that good relationships were one of the most powerful predictors of well-being. According to Dr. Robert Waldinger (bit.ly/HappyLifeLessons), who currently leads the study, close relationships are more powerful than money, fame, genes, or IQ in predicting happiness, longevity, and mental health. “Loneliness kills,” he said.
A 2018 study of 20,000 people by the insurance company Cigna and its partners (bit.ly/surveyloneliness) reports that loneliness has the same negative impact on health as smoking 15 cigarettes per day, and that individuals 18 to 37 are the most lonely people. More than half of the respondents, 54 percent, always or sometimes felt that no one knew them well. Nearly as many sometimes or always felt alone or left out. And nearly 40 percent reported that they were no longer close to anyone. Mental health and a sense of connection appear to be enhanced by in-person contact, and so it is no surprise that mental health problems have soared in the setting of the pandemic.
The Cigna study suggests that loneliness is diminished by “frequent, meaningful, in-person interactions.” With increasing frequency of this kind of interaction, there is increased physical and mental health. (Exercise, physical health, the right amount of time with family, a balanced work life with high-quality engagement with co-workers, and good sleep are all associated with lower loneliness scores, and increased well-being as well.)
If you feel that deep friendship is lacking in your life, you are not alone. The Cigna poll found that the average person has not made a new friend in the past five years, and 45 percent of adult respondents reported that they found it difficult to make new friends.
A friend recently sent me an article by Arthur C. Brooks on friendship (bit.ly/DeeperFriendship). Brooks posits that there are two kinds of friendships: real friendships and deal friendships. He cites a poll of 2,000 people (bit.ly/FriendsPoll), in which respondents reported having an average of 16 friends. “Of these,” he says, “about three are ‘friends for life,’ and five are people they really like. The other eight are not people they would hang out with one-on-one.” He infers that those eight are a different kind of friend whom he calls “deal friends.” Deal friendships are those in which both parties gain something from being friends — job satisfaction, social connections, efficiency in negotiating day-to-day chores. Without these mutual gains, the parties might not be friends. Deal friends might include work associates, social friends who expand your network, donors to a cause that you are invested in, or parents with whom you share the carpooling of children. Real friendships, on the other hand, are described by Brooks as “the intimate friendships that bring us deep satisfaction … These friendships are not instrumental to anything else … pursued for their own sake and fully realized in the present.”
The friend who sent me Brooks’ article happens to be my brother, but these days, I would describe us primarily as real friends. As he and I talked about the article and measured the qualities that make our friendship click, we came up with 10 ingredients we believe are essential to a real friendship.
- Caring. Perhaps above all, caring for others and feeling cared about by others is essential to human well-being.
- Trust. No deep, caring, open, and committed friendship can fully exist without the knowledge that the space between two people is sacred and safe.
- Commitment. Or another way to think about it: Responsibility. Remember that the average person has three friends for life. Real friendships endure, but need to be cultivated and nurtured.
- Honesty. How can there be a real friendship without both friends being real, honest, and open?
- Ability to listen with openness and curiosity.
- Acceptance. Feeling safe, known, and connected requires the absence of judgment.
- Admiration. Everyone has qualities that are worthy of admiration. Real friends know each other’s weak points, but admire each other overall.
- Affection. Real friends express their affection to one another with words and actions.
- One-on-one engagement. Groups can be enormously enriching, eye-opening, and fulfilling, but one-on-one engagement often allows for greater intimacy and depth of love.
- Balance and mutuality. Real friends adhere to all of the other nine items on this list. At best, with real friends, there is no need or desire to keep score.
Real friendships often also share humor, creativity, joy in aesthetics, philosophy and spirituality, and a certain chemical spark. While all relationships include boundaries and a certain amount of “you scratch my back, I’ll scratch yours,” real friendships go beyond this to an openhearted generosity that expects no tit for tat. By these standards, if you are fortunate, real friendships can be found with siblings, children, romantic partners, work and school partners, ministers, psychotherapists, and other healers. For many people with a spiritual or religious foundation (or who have a relationship with a “higher power”), there is also the experience of real friendship with an entity beyond themselves. Exchanges between real friends tend to be energizing, memorable, and unburdening. Time together often leaves such friends feeling lighter, calmer, and uplifted. For me, that kind of feeling is a hallmark of the most meaningful friendships.
“In contrast to … real friendships,” Arthur C. Brooks writes, “deal friendships … are less satisfying. They feel incomplete because they don’t involve the whole self. If the relationship is necessary to the performance of a job, it might require us to maintain a professional demeanor. We can’t afford to risk these connections through confrontation, difficult conversations, or intimacy.” He goes on to note, “If you find that your social life is leaving you feeling a little empty and unfulfilled, it might just be that you have too many deal friends, and not enough real friends.”
Brooks suggests that deal friendships may have largely replaced real friendships, and that people would be well-served by making some new friends who could become real friends. He suggests three steps toward enhancing friendship. First, “give yourself a friendship checkup.” How many people can you talk with about deep, personal issues? When was the last time that you had one of those conversations?
Second, “go deep or go home.” If conversations with certain friends never move beyond superficial topics such as the cost of real estate on Martha’s Vineyard, whether the Steamship Authority is doing a good job, or who went where for vacation, perhaps these are never going to be real friends. Conversely, conversations that feel emotionally vulnerable or move “toward issues of happiness, love, and spirituality,” in Brooks’ words, are signs that there is a potential for real friendship. You don’t have to shun the first kind of friend, but you might want to focus more on the second.
Third, “Make more friends that you don’t need … Strike up a friendship with someone who truly can do nothing for you besides caring about you and giving you good company.” Brooks concludes that one of the highest compliments that a friend can offer is “I don’t need you. I just love you.” The sentiment is inspiring, yet I wonder whether it’s wholly accurate. My deepest friendships inspire ideas, offer comfort, and leave me feeling understood — all things that have a powerful impact on my sense of overall well-being; so in fact, I feel I do need such friendships. Perhaps in the most cherished friendships, there is an innate chemistry such that friends meet each other’s needs automatically, without effort, manipulation, or planning.
When I think about the number of people who meet all of the criteria that my brother and I listed, the number is relatively small. But then I think about all the people I love, and who love me, and it’s a much bigger group. With many of them there is some kind of exchange, so in a sense they are deal friends; but they also meet many of the 10 criteria for real friendships, so they are perhaps a bit of both. They may not be forever friends with whom I can be 100 percent open and myself, but they matter to me, and I am glad to have them in my life. Awareness of the difference between deal friends and real friends (and those friends who are a bit of both) allows us to be more aware of where people fit into our lives, how important they are, and where we want to take those relationships. But the simple fact is that our diverse friendships are all valuable to our emotional and physical health, and they are all worth treating with kindness, respect, and appreciation. Friendship is at the core of what makes us human, and allows us to be fulfilled mentally, physically, and spiritually.
Dr. Charles Silberstein is a psychiatrist at Martha’s Vineyard Hospital and Island Counseling Center, where he is the medical director. He is board-certified in general, addiction, and geriatric psychiatry. He writes regularly about issues Islanders have with mental health. Laura Roosevelt is a poet and journalist who writes regularly for Arts & Ideas magazine and Edible Vineyard. She currently curates The MV Times “Poets’ Corner.”