Together, by Vivek Murthy

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In response to my newsletter talking about Radical Friendship, a friend suggested I read this book, subtitled “The Healing Power of Human Connection in a Sometimes Lonely World”. Dr. Murthy became the Surgeon General of the United States in 2014, and was initially focused on all the usual health problems of heart disease, diabetes, opioid addiction, cancer, etc. But when he went on a listening tour to ask “How can we help?”, he discovered “Loneliness ran like a dark thread” through many of these issues:

“In some cases, loneliness was driving health problems. In others, it was a consequence of the illness and hardships that people were experiencing. It wasn’t always easy to tease out cause and effect, but clearly there was something about our disconnection from one another that was making people’s lives worse than they had to be.”

“So many of the problems we face as a society – from addiction and violence to disengagement among workers and students to political polarization – are worsened by loneliness and disconnection. Building a more connected world holds the key to solving these and many more of the personal and societal problems confronting us today.”

I found this book to be personally moving, as his descriptions of loneliness resonated with me, as did his suggestions on how to create that “more connected world”. I was also inspired by the memorable stories he shares of how people creating connection in unlikely circumstances, and intrigued by insights from research on loneliness.

The first section of the book is “Making Sense of Loneliness”, as Murthy explains why loneliness is not just about being alone, but about different kinds of interactions that humans need as social beings. He writes “human relationship is as essential to our well-being as food and water. Just as hunger and thirst are our body’s ways of telling us we need to eat and drink, loneliness is the natural signal that reminds us when we need to connect with other people.”

Murthy shares research suggesting that we need three kinds of connection: intimate or emotional connection with a trusted confidante or partner, relational or social connection with quality friends for companionship and support, and community or collective connection with people who share your purpose or interests. Like a well-balanced diet, we need each of these in our lives to feel fully connected, and if we don’t have one of these ingredients, we can feel lonely even if we are surrounded by people. This really resonated with me, as I have a wonderful family, but am realizing that parenthood and the pandemic has made it harder to spend time with my friends, and I lost much of my community connection when I left my job to go solo as a coach.

When we don’t have that well-balanced diet of connection, we experience loneliness, and “our bodies read isolation, and often even the threat of isolation, as an emergency.” Murthy theorizes that this goes back to our days on the savannah, when a lone human had little chance to survive against the predators without the security of the tribe. If you were alone, you had to be hypervigilant, alert to every sign of danger, sleeping shallowly for fear that a predator would sneak up at night. “Such hypervigilance could be lifesaving in moments of acute danger, but it placed a lot of stress on the body. Nor was it sustainable for long periods.” And yet many people now live in this state of hypervigilance and stress for years on end, which leads to the health consequences that inspired Murthy to investigate loneliness.

Sadly, the hypervigilance then perpetuates the loneliness that caused it. “Our threat perception changes when we’re lonely, so we push people away and see risk and threat in benign social opportunities. … Hypervigilance also creates an intense preoccupation with our own needs and security, which can appear to others as self-involvement. These two elements -— the threat perception shift and the increased focus on self — are key parts of the hypervigilance story that make it difficult to engage with others when we’re lonely.” So once we are lonely, we are more likely to stay that way because we get wrapped up in our own survival story, and other people are seen as threats.

So how do we change that hypervigilant stance? The answer is simple, but not easy: love and kindness. One person Murthy talked to said “To be kind in the deepest way is to be with others and build connection with them.” Another “considered love to be the opposite of loneliness. Love was the solution to a lack of connection.” These were people who built wonderful communities, shifting the story of themselves and whole groups of people, by developing relationships with each others as humans first.

Murthy shares the story of Derek Black, raised as a white supremacist in the KKK, who went to college and started going to a shabbat dinner each week with people on his dorm hall. By meeting these people first as people, and not as the Jews he had been taught to hate, they forged an unlikely friendship that caused him to start questioning and eventually rejecting what he had been taught. Black later said that “You find your community first, then you get persuaded”; when people meet first as fellow human beings, not as political positions, they find points of shared value and concern, and their “minds and hearts open to each other”.

In other words, we create much of our own loneliness because we have an idea of how our relationships “should” go. We comes up with reasons of what we “deserve”, or why we are special or different so we can’t connect with the person in front of us (I’m often guilty of this). And yet, we have a chance each day to create the world anew by connecting with our loved ones, our friends, and even strangers in the street with love and kindness.

We can also apply that generous stance to ourselves. Murthy writes a chapter on “Relating Inside Out” as “we all need to learn to treat ourselves with the kindness, encouragement, and candor that we would offer a good friend.” But to do that often requires a loving connection with others: “Caring for others may also strengthen our sense of purpose and meaning, as it shows us that we have the ability to make others’ lives better. In these and many other ways, friendship creates a positive feedback loop, teaching us to relate to ourselves with love even as we relate to our friends.”

People that take that stance can spread that generosity to the communities they serve. A researcher showed that “even momentary high- quality interactions can make people more likely to share information and resources and to help one another. …These exchanges take only seconds, but they can create a meaningful sense of connection, and they subtly reaffirm our self- worth by reminding us that we have purpose and value for others.”

When we can connect with others as humans with love and kindness, we create stronger relationships and greater community, which makes us feel more connected, which improves our health and well-being, which allows us to invest more into our relationships and community. It’s a wonderful, positive feedback loop that contrasts with the vicious cycle we see too often in present-day America, where we see others as the enemy, so we become hypervigilant and suspicious, which saps our energy and connectedness, leaving less energy to overcome our biases and connect, which increases the hypervigilance and risks our health.

I appreciated this concluding challenge from Murthy to choose which of these worlds we want to create by consciously deciding how we live each day:

“Creating a connected life begins with the decisions we make in our day- to- day lives. Do we choose to make time for people? Do we show up as our true selves? Do we seek out others with kindness, recognizing the power of service to bring us together? This work isn’t always easy. It requires courage. The courage to be vulnerable, to take a chance on others, to believe in ourselves. But as we build connected lives, we make it possible to build a connected world.”

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