Can Being Lonely Make You Sick?

Interviewer: Laurie Scudder, DNP, NP; Interviewee: Amy Banks, MD

Disclosures

June 12, 2017

Spurred by a recent study published in Health Psychology that examined the link between self-reported loneliness and viral illness, Medscape set out to examine the current state of evidence on the links between social connectedness and physical health. We invited Amy Banks, MD, director of advanced training at the Jean Baker Miller Training Institute at the Wellesley Centers for Women, to speak with us. Dr Banks has devoted her career to understanding the neurobiology of relationships.

What Do We Know About Relationships and Health?

Medscape: Your research has examined the neurobiology of relationships—the physiology of emotional connections. How has that improved knowledge helped us to understand the role of social relationships in health?

Dr. Amy Banks

Dr Banks: That is a big question that touches on several fields of science. "Relational neuroscience" refers to the intersection of interpersonal neurobiology, relational cultural theory, and neuroplasticity and has emerged in the past 20 years. Technological advances, including functional MRI, single-photon emission CT, and PET, have allowed us to finally see the brain in action and the way in which relationships turn the brain on.

And lo and behold, what has emerged is the identification of very specific neural networks that are dedicated to interpersonal relationships, to connecting, and to all of the specific skills that we need to be in healthy human connection.

Popular Western theories of human development focus on the belief that we are born dependent, and the task of socialization is to raise increasingly independent, individualistic people. This process of development describes separation from others as a sign of maturity. Individuals in this model are able to "stand on their own two feet." My colleagues and I believe that this developmental process has disintegrated or weakened the position of relationship in our culture.

Other cultures, primarily Eastern, focus on the centrality of relationships to all human health and well-being. When human beings are built within the context of human relationships, a much more sophisticated interpersonal neural network is built that allows a person to participate in relationships in a way that calms the stress response system, builds the immune system, and creates a sense of belonging. In this setting, when a person is separated from his group, a warning alarm of pain is issued, telling him that he is in danger.

So, there's a whole physiology there just waiting to be tapped into, if we are setting up social societies in a way that really focuses on the centrality of relationships to health and well-being.

[T]here's a whole physiology there just waiting to be tapped into, if we are setting up social societies in a way that really focuses on the centrality of relationships to health and well-being.

Medscape: Is it too simplistic to compare this with the concept of "use it or lose it"? That is, if these neuropathways are not used, they won't develop?

Dr Banks: That is exactly right. You are referring to the relatively new concept of neuroplasticity—that the human nervous system is malleable, and we can change and develop our brains throughout life.

We are born with rudimentary but profound neural networks that orient an infant to the mother or caregivers. The more these networks are supported by positive, responsive interactions, the more they will blossom into rich neural networks.

The first developmental task of an infant is to develop trust. When trust in others is wired into the autonomic nervous system, the stress response system or the sympathetic nervous system is modulated by contact with safe people. The more safe people an infant and child is in contact with, the stronger the modulation of the stress response.

The first 3 years of life are particularly important for laying down healthy, robust neural pathways for connection. Ongoing responsive relationships lead to the development of complex social skills, such as give-and-take and conflict resolution. However, for children in families with little safety in relationship or poor communication skills, these networks won't develop as fully. This is how the neuroplastic concept of "use it or lose it" plays out on a day-to-day basis through our interactions with others.

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