CMB Focused Discussion

The Anatomy of Loneliness: Suicide, Social Connection, and the Search for Relational Meaning in Contemporary Japan

Speaker: Chikako Ozawa-de Silva
Discussant: Laurence Kirmayer

May 21, 2021

[From Presentation/Slides]

A Global Epidemic of Loneliness (NYT, 09/25/2016)/Loneliness as a Public Health Issue

Evolutionary, Biological and Psychological Bases for Loneliness as a Universal, Social and Culturally Shaped Phenomenon

  • We are social animals: Survival depends on “belonging.”
  • All mammals and birds depend on maternal care.
  • Social rejection and exclusion results in danger or death.
  • We are also individuals: The very structures of subjectivity, consciousness, and selfhood establish a sense of separateness of mind, body, and person (myself from others) that increases over human development (e.g., children develop theory of mind and an awareness that they can know things other people do not know and experience things others do not experience).
  • Together, sociality and individualism result in an inherent tension and potential for loneliness: On the one hand, we have a deep biological and evolutionary need to belong and to “share a world”; and on the other, we have an increasing realization that often, we do not belong, are not accepted, do not share a world.
  • The structures of society as well as cultural expectations and processes can ameliorate or exacerbate this inherent “condition of existence” (Ozawa-de Silva & Parsons, 2020).

What Is Loneliness?
Loneliness is a subjective feeling (more than just cognition). Being alone and being lonely are conceptually distinct, as are feeling loneliness (relational) and feeling depressed (inward-oriented; see also Ozawa-de Silva & Parsons, 2020). According to Ozawa-de Silva, loneliness can also involve places and the environment (not just people). She describes loneliness as  “feelings of dissatisfaction that arise with regard to relationships to others or to the environment.”  Like an emotion, loneliness is “impermanent” and  “always in a state of change,” as well as being derived from everyday relational practices that are themselves “embedded in larger material configurations” (Ozawa-de Siilva & Parsons, 2020).


  • Browner said that the UK declared loneliness a public health problem. Does Ozawa-de Silva have a sense of the longitudinal nature of situation or of the history of the phenomenon in the West? In the UK, when Margaret Thatcher was in office, service and aid were cut back. Ozawa-de Silva wondered if loneliness followed from that. She also said she currently lacked the longitudinal data to address the history of the loneliness phenomenon.
  • Ozawa-de Silva said loneliness appears to be on the rise. People in Japan no longer enjoy lifetime job security and also that it would be interesting to look at loneliness in hypercapitalist societies. She also said she was recently invited by the CDC to join a working group to look at loneliness and social isolation.
  • Luhrmann said that she loved Ozawa-de Silva’s work and it is important. Regarding the different definitions of loneliness, Luhrmann noted that John Cacioppo’s research was driven by UCLA’s Loneliness Scale, which focused on numeric evaluations (how often do you feel . . .).  Luhrmann cautioned against a too-broad definition of loneliness in anthropological research.
  • Kirmayer agreed that loneliness is embodied and shared. Loneliness is a longing or reaching for something, a frustrated action (akin to hunger? see  Tomova et al., 2020). Seeing idealized images of how you are supposed to be together can have an effect on people; they see what they are missing. Ozawa-de Silva agreed that loneliness is a longing and that there are expectations.
  • Tidwell said she is interested in delineation of relationships with others and with the environment or place. Tidwell mentioned wilderness survival and the natural environment – people feel less lonely there and find meaning, self-actualization, and purpose. She also mentioned Sally’s Zoom chat comment about anthropologist Robin Dunbar, who said that a person cannot have more than 150 friends – does that number change? Ozawa-de Silva said an online platform also constitutes place. Seraphin said brain size evolved to accommodate social connectedness.
    Bzdok, D., & Dunbar, R. I. M. (2020). The neurobiology of social distance. Trends in Cognitive Sciences, 24(9), 717–733.
  • Ozawa-de Silva said it is important to have one person in your life  “get you” versus having something like 100 Facebook friends and that the person accepts you. Instrumental values and genuine care matters. The UCLA Loneliness Scale is adjusted for having that important person in one’s life.
  • Snodgrass wondered if loneliness is not necessarily a form of suffering; is it just a state? Kirmayer mentioned the virtues of loneliness and in the Zoom chat, commented with a poem about the virtues of loneliness by William Carlos Williams entitled, “Danse Russe.”
  • Snodgrass said loneliness is not in the DSM as a category of a disorder and that longing is not necessarily a negative experience. Loneliness may drive behaviors that are helpful in different ways. Ozawa-de Silva said she is referring primarily to the suffering aspects of loneliness, which could be a positive (cf. creativity).
  • Snodgrass referred to Kohrt’s earlier talk last month on his work [NB: on predictive psychiatry, April 16, 2021]. In that talk, Kohrt said that loneliness/isolation is common in adolescence. Snodgrass said loneliness can be seen as negative/afflictive, e.g., depression and pain, as well as positive, e.g., as a source of creativity and self-reflection.
  • Thein-Lemelson mentioned existential dread. She said that type of dread seems integral to loneliness. John Bowlby and his idea of loneliness is a cue of threat or danger in infancy. Why focus on depression? Why not anxiety and loneliness also? Ozawa-de Silva said anxiety and loneliness are highly correlated.

[From Presentation/Slides]

Loneliness: Individual Issue or Social Issue?

  • The Lonely Society: High number of people within it feel lonely
  • People don’t feel taken care of: Ozawa-de Silva again gave the example of secure employment in Japan, what has been referred to as “corporate marriage.” “When a society treats its members as having only instrumental value, as merely producers and consumers, then its members come see their worth only through the lens of their productivity or success” (Ozawa-de Silva, Forthcoming, p. 243)
  • Society/community that is lonely as a unit: A society or community that is lonely as a unit, in that it is not closely connected to other societies and to humankind as a whole, or feels abandoned, neglected, marginalized, or disenfranchised
  • N. Ibagari – prefecture in Japan that was significantly impacted by the 2011 earthquake, tsunami, and Fukushima Daiichi nuclear disaster, forcing an entire community’s residents to relocate. These residents felt marginalized and invisible when they relocated.
  • Communities that feel marginalized, ignored, invisible
  • “Galapagos Japan” – Japan is inward-looking
  • Anti-cosmopolitan, isolationist sentiment and tribalism (Brexit, Trumpism, Abe-ism in Japan) – Abe-ism is Trump, Jr.

Role of Culture

Ozawa-de Silva described a shift from seeing loneliness as an individualistic experience (per Cacioppo)  to a public health issue, inherently social and culturally shaped. Culture plays crucial role in forming certain sets of expectation, experience, and expression of loneliness. We need to avoid dualistic notions of individuals as separate from society. Our subjectivity is inherently social – ethnographic studies of loneliness can shed light on the cultural shaping of loneliness experiences and expectation (TP introduction, 2020). Pay more attention to cultural conception of loneliness for future research


  • Kirmayer said this presentation on loneliness raises interesting questions in terms of what extent that we can use loneliness as an anchor of cross-cultural comparison.
  • Kirmayer said there is a normalness of experience. Loneliness implies dissatisfaction but poets and creativity may also follow from suffering and pain. Christmas is a time for feeling lonely for some people who do not feel lonely at other times during the year.
  • Ozawa-de Silva said a person can feel an intimate connection with their own work. She said that there is cultural shaping of expectations. Kirmayer said he misses hugging his children; he mentioned the Japanese word, amae [NB: indulgent dependency]. She said, biologically, we need physical touch. She said that she needs to collaborate with biology scholars.
  • Ozawa-de Silva said the threat of loneliness and ostracism is a social tool – and can be a terrific weapon. We see it in Washington as Republicans turn on each other because of fear of being cast out, which leads to social weirdness. Also, look at the cost of ostracism, e.g., Black Lives Matter and the COVID era. Lockdowns have a psychosocial component that was not thought of.
  • Worthman mentioned Browner’s early comments about the social construction of health.
  • Ozawa-de Silva said she is watching the television show, “Narcos,” on Netflix and she mentioned the Japanese yakuza [NB: gangsters] and how gangs have people who feel out of place.
  • Snodgrass talked about Internet sociality and being too lonely to die alone. He asked: Can the negative emotions of loneliness be lessened by Internet sociality? Ozawa-de Silva’s early work suggests yes but Kirmayer’s work said it is not getting to human tactile needs. Snodgrass mentioned Veissière’s work on tulpas [NB: conjured paranormal sentient beings]. Are they enough to minimize loneliness? Snodgrass talked about how avatars can be experienced as a category of meaningful friends or lovers. He wondered: Can new forms of Internet sociality can work to minimize loneliness and meet basic needs of humans? Ozawa-de Silva said, yes, they can. She said some people have problems with physical contact with other people, that some people like the experience of online connections with others a lot. She said that she initially liked Zoom (can see facial expressions) but is does not feel that way now. Snodgrass mentioned Luhrmann’s earlier comment: How do we measure this stuff? Loneliness can be seen as a negative or as solitude. Snodgrass said the effects and experience of being in an isolated state depends on the person you are. Kirmayer mentioned measuring state as subjective states versus as objective facts. He noted Gendron’s Zoom chat comment on belonging.
  • Kirmayer mentioned dissatisfaction with one’s own life. Thein-Lemelson said she has collected data on emptiness and asked: Has anyone else collected this type of data? Is it symptomatology of depression? Kirmayer said depression is distinct from loneliness. Depression is loss of feeling ordinary responsiveness. If you feel flat all the time, it is emptiness, like depression or some forms of psychosis. Ozawa-de Silva said emptiness is not popping out in suicide group’s language. Instead, what is popping out is not being needed by anyone. People did not say they “feel empty.” She mentioned the Japanese term, jibun ganai, or the feeling of no self. Worthman said there is a Western view of emptiness as vapidity and social meaninglessness or a social critique. Social relationships can be seen as empty social calories or nutritious calories.
  • Worthman mentioned Gendron’s Zoom chat comment on surrogate social lives. Gendron talked about social psychologist Shira Gabriel’s work on parasocial bonds, which are typically one directional, e.g., following celebrities – which is not interactional – can boost self-esteem and feeling of belonging. Gendron said support for Trump is a parasocial relationship. Snodgrass said the notion of parasociality has deep roots in media and communication studies. Gendron said it is weaponized on YouTube. Snodgrass asked: Is that meeting various human needs? Tidwell asked how much is developmental contexts setting baseline that lead to suicide; we have different baselines. In Ladakh, India, Tidwell said she was not used to being that physically close to people. Kirmayer said it is personality and cultural. Snodgrass said joined he and his partner when they were sleeping; it was intense sociality. Worthman reported that she and her husband had a similar experience in India, having been asked, “You only?” Snodgrass said that, in India, if someone is left alone, there is a risk for ghost attacks, which is why you do not sleep alone.