By Grace Chiang
Humans are a meaning-seeking species. When this experience is limited or entirely excluded, one is deprived of one’s human heritage.
—–Beyond Death Anxiety: Life-Affirming Death Awareness
Loneliness is different from social isolation or solitude. It arises when there is a diversion between one’s desired relationships and one’s actual relationships. Individuals feel disconnected, lack a sense of belonging, and are at higher risk for health problems and early mortality.
Plenty Poor
Poverty is a multi-faceted concept that may encompass social, economic, and political elements. A developed and economically successful community can experience poverty in the form of loneliness. Individuals may be surrounded by plenty and feel that they have nothing.
The devastation and isolation of feeling can become a self-fulfilling prophecy. A meta-analysis studying the link between relationships and health found that individuals classified as lonely had a twenty-six percent higher risk of dying, after accounting for differences in age and health status.
Given that loneliness is quickly becoming an epidemic, some countries such as the United Kingdom have started to screen for loneliness. Social prescribing has become a buzz word – prescribing social activities rather than medications to combat loneliness.
As physicians, our treatment focus might need to shift after exploring psycho-social concerns important to our patients. By identifying loneliness, we might be better able to target interventions intended to prevent or slow the progression of functional decline and disability.
Commentary
In the drawing, the man’s back is turned towards us. His expression and emotions are not open to us. We are left to make our assumptions and to draw our conclusions from the words The most terrible poverty is loneliness…. and being unloved…. running across the picture.
Outside the window we see successful, modern Singapore. The sun shines brightly upon Marina Bay Sands and the financial district, amidst lush greenery and blue waters. The man is separated from this impressive scene by a window. His own surroundings are sparse. His t-shirt is white, as if to blend in with the colour of the wall. His left hand is touching the window as if reaching out to the scene beyond. He is able to observe but unable to participate or to make contact. He is from the outside looking in, or rather, he is from the inside, looking out longingly, feeling unloved and lonely.
—-Dr Grace Chiang
Dr Grace Chiang is a family physician with a background in public health, who is currently practising in a community hospital. Her research and clinical interests include population health, aging in place, and frailty.
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
