Tag Archive for: social connection
Last year, the U.S. Surgeon General published an advisory on the healing effects of social connection and community. This advisory was based on decades of research on the impact of social connection on mental and physical health and brought nationwide awareness to the importance of creating and maintaining relationships for a long, healthy life.
“Most of us recognize that exercise and healthy eating are important for our longevity; however, if you’re doing those things by yourself, you’re missing out on the benefits of another pillar of health—social health,” says Steven Crane, MS, research scholar and head of Social Engagement pillar of Stanford Lifestyle Medicine. “Strong relationships are the bedrock of our well-being, and they are just as important for our health as going to the gym or eating healthy food.”
Social health refers to the quality of our relationships and how often we interact with others. Since social connection is in our nature as humans, when we are isolated and feel a lack of connection, research shows that our mental health can be affected. For example, we can experience a myriad of negative emotional states such as loneliness, depression, anxiety, or anger when the quality of our social health is poor, sometimes leading to substance abuse and addiction.
Mental health and well-being are not the only aspects affected. Research also shows that our social health profoundly impacts our physical health.
The Impact of Loneliness on Physical Health
Loneliness and social isolation have a significant impact on health and mortality. For example, research shows loneliness increases the risk of heart disease by 29 percent, dementia by 50 percent, depression by 77 percent, premature mortality by 29 percent, and diabetes by 49 percent.
Crane explains that social health impacts our physical health in two ways. First, loneliness itself is a stressor. Since early humans evolved to be interdependent and rely on each other, they often did not survive when they were isolated. Therefore, when we feel as though we don’t belong, it can feel like a threat to our survival.
“Due to our evolution, humans have a drive to connect and seek out relationships. So, just like other drives linked to survival, such as hunger or thirst, loneliness signals that something is wrong, and we need to change our behavior to address it as soon as possible,” says Crane. “And just like these other survival-based stressors, when loneliness becomes chronic, cortisol levels stay elevated and thus increase the risk of heart disease, hyperglycemia, metabolic disorders, and other illnesses that are consequences of any chronically elevated stress situation.”
Secondly, there are a lot of stressors in our daily lives, and Crane says we can better handle them when we have the support of close, caring relationships. During challenging times, a few close friends can listen while we talk through our problems and offer guidance around possible solutions.
Social Health Obstacles and How to Overcome Them
Various factors prevent us from prioritizing our social health. From being overly busy with work and family obligations to being an introvert with a fear of rejection, there are many reasons why we don’t pick up the phone and reach out.
Here are three obstacles to social connection:
1) Fear of social situations
When people experience recurring feelings of exclusion and loneliness, they perceive social threats more severely than people who don’t feel as lonely.
“There’s a vicious cycle that happens when people feel lonely. People become more afraid of social situations and then become more likely to avoid them, which makes them lonelier,” says Crane. “This downward spiral can lead to chronic loneliness and isolation.”
To overcome the fear of social situations, Crane recommends exploring cognitive-behavioral therapy (CBT) to work on social cognitions. This work can help people overcome fear of rejection or anticipatory anxiety about social events. “One of the most effective treatments for chronic loneliness is CBT because it can help re-write the scripts we tell ourselves that keep us from engaging in relationships,” he says.
2) Busyness
Amidst our busy schedules, many people let their friendships languish and aren’t proactive about keeping them strong. Even if they want to, it may seem too difficult when other items on the to-do list, such as family or work obligations, take higher priority.
“In the U.S., people work more than most other countries where social health is better. With more widespread adoption of remote or hybrid workplaces, it’s been harder to create meaningful relationships at work.” says Crane. “I’m currently working with a nonprofit called Sunny to help make workplaces more of a socially connected environment where we can fulfill our social health right there in the workplace—where we spend thousands of hours each year.”
Crane says the best way to overcome this obstacle of busyness is to make social connection an equal priority to our other healthy behaviors, such as getting good sleep, exercising, and eating nutritious meals. He recommends we build healthy habits to connect, like scheduling routine monthly gatherings with your local friends, weekly calls with your important relatives, and a daily text to somebody you appreciate.
3) Technology
We have never had so much digital entertainment so easily at hand as we do today. Videos, games, and infinite social media feeds are so compelling in the moment that most of us spend far more time on our devices than we want to. Indeed, the sophisticated algorithms that drive what appears next are optimized for prolonged engagement. To help with this, Crane and collaborators at the Stanford Behavior Design Lab developed Screentime Genie.
Without boundaries and strategies to manage our device use, we often retreat to digital entertainment to bypass the activation energy of social engagement or the friction and difficulty that real-life relationships inevitably entail. Crane is concerned that many young people are not learning the skill of navigating conflict, which is essential to strengthening relationships.
“The moment there is discomfort in a social situation, like breaking the ice with new people at a party, many young people escape into their phones instead. But difficulty is part of all human relationships, so we shouldn’t be afraid of engaging with it, and it’s important to be able to work through our differences in order to feel more connected,” says Crane. “A TikTok feed is never going to challenge you, but it also won’t give you the rewards of a fulfilling, authentic relationship.”
By Nikki Molumphy and Sharon Brock, MEd, MS
The “epidemic of loneliness” has exacerbated feelings of disconnection and isolation, especially within the past five years. Among U.S. adults, 53 percent say they have between one and four close friends, and 8 percent say they have no close friends. The digital age has undoubtedly threatened in-person interactions, resulting in shallower connections and increased isolation. Driven by his commitment to nurturing meaningful relationships, Chaplain Bruce Feldstein, MD, BCC, Adjunct Clinical Professor at Stanford University School of Medicine, created a spiritual fitness exercise called “Key Relationships” to improve well-being and foster a deeper sense of connection.
“The Key Relationships practice is about living life in a meaningful and openhearted way,” says Dr. Feldstein, head of the Gratitude & Purpose pillar of Stanford Lifestyle Medicine. “When we ask ourselves, ‘How can I sustain myself and my well-being during times of stress?’ The answer is that we cannot do it alone, but we can cultivate these five key relationships to support us.”
Practice of the Month: Fostering 5 Key Relationships
- Self
- Soul Friend
- Therapist
- Colleague
- Transcendent
How to Foster the Relationship with:
1) Your Self
The relationship with ourselves is multifaceted, encompassing not only our physical bodies but also the mental, emotional, social, and spiritual aspects. Dr. Feldstein says that developing a healthy relationship with ourselves includes nurturing all of these aspects, recognizing that we can accomplish more than we can imagine while accepting the limitations of our physical bodies.
“Let us appreciate that we are finite beings. On one hand, we can only do what our body and being allows us to do. On the other hand, it is also true we can do more than we can possibly imagine or dream,” says Dr. Feldstein. “Supporting a positive relationship with the self includes practices of self-awareness, self-acceptance, self-respect, self-forgiveness, practices for grit, resilience, and endurance, as well as practices for gratitude, celebration, and focusing on the good in your life. Developing a healthy relationship with self includes embodying ‘the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference’.”
Journal Prompt: How can I foster the relationship with myself?
2) Your Soul Friend
We live in relation with others: family, friends, people in the community, and people at work. A soul friend is someone you connect with at a level of deep meaning and understanding. Someone with whom you can share freely, be vulnerable, and be listened to without judgment. Soul friends include people you can turn to at two o’clock in the morning during a crisis. A soul friend can be someone you’ve known for years, but also a new friend.
“A soul friend is someone you connect with at the level of soul, in a soulful way, which means with full acceptance and unconditional positive regard,” says Dr. Feldstein.
Some examples include:
- A friend from childhood
- A grandparent
- A romantic partner
- A best friend
Journal Prompt: How can I foster the relationship with a soul friend?
3) Your Therapist
This relationship can be with a licensed therapist, but for this exercise, you can think of the word “therapist” as an individual who allows you to thoroughly process your inner feelings, hardships, triumphs, and all the ebbs and flows of life. Dr. Feldstein checks in regularly with his therapist with whom he reflects on his current situations and inner life. As a chaplain, he also provides this kind of relationship to a wide range of people.
“For me, working with a therapist is akin to a baseball player who works weekly with a batting coach to monitor his swing and mental attitude at the plate,” says Dr. Feldstein. “The therapist relationship allows me to observe and talk through my stories, fears, uncertainties, joys, gratitude, or moods and gain perspective and guidance.”
Some examples include:
- Counselors
- Chaplains
- Psychologist
- Psychiatrist
- Life Coach
- Social Worker
- Spiritual Director
Journal Prompt: How can I foster the relationship with a therapist?
4) Your Colleague
Colleagues refer to those who have shared day-in and day-out life experiences, such as a workplace, school, or community group. They often have a shared commitment such as a mission statement of a company or a volunteering goal.
Some examples include:
- A co-worker
- Another individual in your same profession
- Someone you’re taking a class with
- Someone you’re volunteering with
- A teammate
Journal Prompt: How can I foster the relationship with a colleague?
5) The Transcendent
As human beings, we periodically experience moments of awe, inspiration, intuition, gratitude, and grace. We are in relationship with something greater than ourselves—something sacred that cannot be named or fully understood. Typically, we are fully present in these moments, and sometimes they feel like time is standing still.
These experiences can be a “once in a lifetime” moment, such as climbing to the top of Mt. Everest. But they can also be ordinary moments, like encountering a rainbow, observing the sunlight on flickering leaves, being enthralled by the taste of chocolate, or feeling touched by an unexpected act of kindness. You nurture your relationship with the transcendent when you experience a sense of connection with what you define as divine or sacred—which is personal to you.
Dr. Feldstein says, “Possibilities for transcendent moments are abundant. They can happen anytime and anywhere – in nature, while making or appreciating art or music, during movement, prayer or meditation, volunteering, reading something inspirational, or laughing with a loved one. Anything that makes your spirit happy and brings you joy.”
Some examples include:
- The experience of elation after a hard workout or dance session
- The feeling of “awe” while looking at art or nature or listening to music
- Engaging in a passion project
- Spiritual rituals, such as meditation or prayer
- Mindfulness practices that bring your mind into the present moment
Journal Prompt: How can I foster my relationship with the transcendent?
What if I Don’t Have All Five Relationships in My Life?
Amidst busy schedules and social fatigue, it’s understandable that you may lack some of these relationships. Life is inevitably hectic, but if you desire deeper connections, consider these ideas:
- Volunteer at a local food, animal, or homeless shelter.
- Sign up for an intramural sports team or group fitness class.
- Plan a get-together, cocktail party, or BBQ with close friends and new friends.
- Organize an outing with work colleagues, such as hiking local trails, playing a round of golf, or facilitating a book club.
- Make reoccurring plans with people in your life, such as a monthly happy hour with friends, weekly phone call with parents, and a daily text with a loved one.
“Having at least three of the key relationships solidly in place is important to feel emotionally supported in case a life challenge occurs,” says Dr. Feldstein. “All five is ideal, but having at least three in place at any given moment is essential to feeling emotionally supported.”
Journal Prompt: Which of the five key relationships are strong in your life and support your well-being? Take a moment to feel gratitude for these solid relationships. For the key relationships that need more attention, what is one action step you can take to establish or nurture that relationship?
For additional resources for social and spiritual well-being, see Dr. Feldstein’s Spiritual Fitness Toolkit.
Also, here are more practical tips on how to build and enhance relationships, created by members of Dr. BJ Fogg’s Behavior Design Lab at Stanford University.
By Nikki Molumphy
Reflect on the last time you formed a genuine friendship. It’s perfectly fine if it feels like it has been a while–the average U.S. adult hasn’t made a new friend in 5 years even though 61 percent of them say having close friends is very important to live a fulfilling life.
To meet this desire to make new friends, and help you get out of a friendship recession, we’ve created a checklist and recommendations to offer gatherings where people can make new friends and nurture old ones inspired by the book The 2-Hour Cocktail Party, How to Build Big Relationships with Small Gatherings. In this book, author Nick Gray has perfected the formula for throwing two-hour cocktail parties to efficiently and effectively create meaningful relationships. We know that hosting gatherings can be stressful–what if nobody shows up!–but if you follow the tried-and-true checklist, your gatherings are sure to be a success!
“Coffee meetings are one-on-one and take about an hour,” says Gray. “Dinner parties often have four to eight guests and can last an entire evening. But a two-hour cocktail party lets you connect with fifteen people all at once. In the time it takes to watch a movie, you can improve your relationships with a room full of people.”
Checklist for Planning a Cocktail Party, Mixer, or Happy Hour
- Choose a Monday, Tuesday, or Wednesday evening (7 p.m. to 9 p.m.) roughly three weeks out and put the event on your calendar.
- Gray says three weeks is the perfect “sweet spot” for preparation. It is not too far off but well enough in advance that potential guests should have some flexibility in their schedules.
- Planning three weeks out will allow for inviting more guests if some reject your invitation.
- Choose a platform to send electronic invitations, like Mixily, Paperless Post, or Evite, and title your party something like “Cocktails and Icebreakers to Celebrate Spring.” Construct social proof by assembling a guest list.
- People are generally more available on weekdays, which makes it more likely they will say, “Yes.” Avoiding the “heavy-weight days” of Friday and Saturday nights also decreases the pressure.
- Ending the party around 9 p.m. allows guests to go home early enough without feeling guilty on a work night.
- Host the event at your home since your home is personal and allows guests to learn more about you in a casual yet in-person setting, especially in our digital age. (If your home doesn’t work for you, a park, community center, or an apartment common space are other suitable options.)
- Standing in an open environment (such as your living room) fosters conversation among many people instead of sitting at a lengthy restaurant table that can hinder the spontaneous flow of conversation.
- Invite roughly 15 guests.
- Invite your “core group” first, which includes up to five trustworthy and dependable friends who will make you feel comfortable.
- If possible, have the remaining 10 guests be people who don’t know each other. Strive to add “occupational diversity” to your guest list by inviting folks who work in various industries, allowing for potential networking opportunities.
- Tidy up beforehand and prepare your ambiance with calming lighting and upbeat music.
- Empty your trash bins before your party begins. If your trash bins are full early on, guests may leave their trash on tables, which results in more clutter and clean-up later on.
- Set up your beverage area beforehand with ice, cups, and snacks in bowls. Be sure to offer non-alcoholic options and mixers.
- Upon arrival, offer guests a name tag, which is essential in that they facilitate easy introductions.
- On the name tag, write the guest’s first name in big, black text, and try to ensure all guests wear their name tag so that no one feels embarrassed for wearing one.
- Plan a few icebreakers to facilitate structured interactions from the start and promote a light-hearted atmosphere. Strive for three icebreakers throughout your 2-hour party.
- Use a bell or something unique like a harmonica to grab the attention of your guests before beginning an icebreaker.
Nick Gray’s Party Planning Do’s and Don’ts
Preparation:
- DO: plan your gathering three weeks out so people can plan
- DON’T: send out a formal invitation before confirming that a few key people can attend
Who to Invite:
- DO: welcome friends, classmates, colleagues
- DON’T: invite brand new acquaintances or high-risk business clients
Expectations:
- DO: include information about name tags and icebreaker activities in the event description
- DON’T: make name tags or icebreaker participation optional
Icebreakers:
- DO: go first to set the expectation and ask the person to your side to go after you
- DON’T: randomly call on guests to get them to engage
After you’ve thrown a few of these events, Gray says the benefits of hosting go beyond the two hours of the evening. “Because you’re the one who has the courage to bring people together, you’ll start to build your reputation as a natural connector,” he says. “You’ll get introduced to interesting people, sometimes when you least expect it. It’s one of the most surprising follow-up benefits new hosts tell me about.”
By Yasaman Nourkhalaj and Sharon Brock, MEd, MS
Research has shown that social isolation not only negatively impacts our mental health but can also take a toll on our physical health. This association has piqued the attention of healthcare professionals, leading some to participate in social prescribing. Social prescribing is the act of healthcare professionals recommending that their patients put effort into engaging in more social activities, such as reaching out to family members for phone calls, striking up conversations with neighbors, or making coffee dates with friends.
Stanford Medicine psychiatrist Douglas Noordsy, MD, founder of the Stanford Lifestyle Psychiatry Clinic, often recommends social activities to his patients to improve their mental health.
“I take a collaborative approach when working with patients in the lifestyle psychiatry clinic. I educate them on the health benefits of social activities and help them choose which social activities they are motivated to engage in. It’s a shared decision-making process,” says Dr. Noordsy, Stanford Professor of Psychiatry and head of the Stanford Lifestyle Medicine Cognitive Enhancement pillar.
How Do Social Activities Improve Health?
Social connection can improve one’s overall health, well-being, and longevity. This study showed that in those with depression frequent participation in social activities improved metabolic and brain health. A cross-sectional observational study used surveys from people aged 65 and over from 16 different countries to investigate the impact of social connection through hobby engagement. The results showed a reduction in morbidity and healthcare burden, with higher life satisfaction for participants who engaged in their hobby in groups. Researchers from another study expressed how the lack of social connection can be more detrimental to health than common conditions like obesity and high blood pressure.
At the neurological level, there is evidence that experiencing positive social connections releases “feel-good” hormones in the brain, such as oxytocin and dopamine. We also know that physical exercise increases dopamine levels. So, Dr. Noordsy often recommends that his patients improve their health and well-being in a time-efficient way by engaging in physical activity that is also a social activity, such as participating in a team sport or going on a daily walk with a neighbor.
Examples of Social Prescriptions
- A patient with self-doubt or discouraging thoughts may be experiencing some level of depression, which can become more detrimental with isolation. In this case, Dr. Noordsy recommends the patient make an effort to reach out and spend quality time with family and friends.
- A person taking care of their elderly parents at home and isolating themselves from the rest of their community would be advised to go to a coffee shop three times a week to be around a variety of people.
- A remote worker who feels anxious from too much alone time is recommended to work in a public place by going to a café or a shared workspace a couple of times a week.
- Someone who is shy and struggles with communication would be advised to join a local hiking group where communication can happen while walking side by side. This prescription not only promotes social connection, but also physical exercise.
“Each patient is different. During a careful initial assessment with each patient, I assess their current lifestyle behaviors and figure out how to best integrate new lifestyle practices (such as social prescribing) into their lives. I assess which behaviors are problematic for their mental health and which behaviors might be beneficial for this specific individual,” says Dr. Noordsy. “The most important thing about social recommendations is making sure they are tailored to the individual. A person is more likely to engage in social activities of their choosing, and over time, we can track behavior changes and optimize their outcomes.”