Transcript: Interview with Dr. Jeremy Nobel

Ayla Fudala: Hello and welcome to Frontiers in Health & Happiness, the official podcast of the Lee Kum Sheung Center for Health and Happiness at the Harvard T.H. Chan School of Public Health. My name is Ayla Fudala, Center Communications Coordinator, and I’ll be asking experts how to live a healthy and happy life.

Today we’re going to talk about loneliness. We all feel lonely from time to time. That’s part of being human. However, there is growing public concern about loneliness as an increasing number of Americans report feeling lonely, especially in the wake of the Covid-19 pandemic. Even before the pandemic, roughly half of American adults reported experiencing loneliness, according to US Surgeon General Vivek Murthy. This is a serious public health issue because studies show that being lonely can have significant negative effects on both mental and physical health.

The Lee Kum Sheung Center for Health and Happiness took action to address this critical issue by inviting loneliness experts from across the country to visit us at the Harvard Chan School and asking them to share their insights and perspectives. Everyone interviewed for our Loneliness and Well-being podcast series is a scholar conducting cutting edge research into the problem of loneliness, as well as into possible solutions, methods for promoting social connection and bringing people together.

Our Loneliness and Well-being theme kicks off with an interview featuring world-renowned scholar Dr. Jeremy Nobel. Dr. Nobel is a faculty member at both the Harvard T.H. Chan School of Public Health and the Harvard Medical School, and he is the founder and president of the Foundation for Art and Healing. In this episode, Dr. Nobel discusses his book Project UnLonely: Healing Our Crisis of Disconnection, and tells me how we can use creativity to connect with one another.

Ayla Fudala: Dr. Nobel, why is loneliness harmful for people and why is it a particularly big issue right now?

Dr. Jeremy Nobel: It’s important to start with what is loneliness? There’s still a lot of confusion. There’s a difference between being lonely and being alone. Being alone means you have no social connections. It’s objective. You can measure that easily. Being lonely is the subjective gap between the social connections you desire to have, what you aspire to, and what you actually feel you have. And it can be very devastating, both mental health and physical health.

So we know that loneliness is a major risk factor for some mental health conditions, the biggest ones being depression, addiction and suicidality. But recent research has indicated that loneliness also increases risk for physical illness. For instance, it increases the risk of heart attack or stroke or death from either by 30%, increases risk for Alzheimer’s by 40%, increases risk for diabetes by 50%. And so, bottom line, loneliness won’t just make you miserable and unhappy. It can kill you, but it doesn’t have to. And that’s really become the focus of much of our work through Project UnLonely, to explore ways that creative expression can engage, empower and inspire people and connect them.

Ayla Fudala: What is the connection between anxiety and loneliness?

Dr. Jeremy Nobel: Anxiety is a mood state that many people have. At its extreme, it can be an illness we call generalized anxiety disorder. It’s a concern about things that might be harmful or that someone’s afraid of that haven’t happened yet that you anticipate. So anxiety is about the anticipation of something very negative happening to someone. You can imagine how that mood state of anxiety could lead people to withdraw from the world around them, from other people, and become less connected and more lonely. Now we also know that when people are lonely, they’re more prone to seeing risk and harm, often interpreting ambiguous signals around them as risky signals. And so being lonely itself increases the risk of being anxious, just like anxiety increases the risk of being lonely. This bidirectionality between loneliness and anxiety is very important for increasing the risk of something we call spiraling. So that’s when you become a little more lonely or a little more anxious and as a result, become lonelier and then more anxious. And you can see how that goes.

Ayla Fudala: What about shame and loneliness?

Dr. Jeremy Nobel: Shame has a very different relationship with loneliness. Shame doesn’t, although it could cause people to withdraw from others because they have low self-esteem or they’re embarrassed. What’s most interesting in our work is how many people who are lonely feel it’s their fault. They feel that they’re lonely because they’re flawed or inadequate. Then they think there’s something they should feel ashamed about because they think they’re inadequate, even though they might not have a way of really characterizing that or knowing what it is that makes them feel flawed.

So a big part of our work is inviting people to view loneliness very differently than something to be ashamed of, but as just a simple signal that there is something they need, in this case, human connection. And we have biological signals of all sorts. So a familiar one to many people is thirst. And that’s a signal. We need water. We need hydration. I’ve meet very few people who were embarrassed and ashamed about being thirsty. Why are we ashamed about being lonely? And the answer is it’s a social and cultural construction. And the good news is, anything that’s a social or cultural construction, at least theoretically, can be reconstructed. And that’s a big part of what we’re hoping to do with Project UnLonely.

Ayla Fudala: Why do you think people are particularly lonely right now?

Dr. Jeremy Nobel: It seems for many people that the pandemic really changed their sense of vulnerability, fragility, uncertainty; sometimes because they have continued concerns about their health or they’re in a hybrid workplace or hybrid school environment, or they feel anxious and at risk being out in the world. And so for many people, loneliness has become a bigger part of their lives. And as they become lonely, they’re at risk for becoming more anxious, in some cases depressed and withdrawing even further. So with that spiraling again, the important thing is to break that spiral so people feel a positive sense of opportunity; connecting with other people, sometimes connecting with themselves.

Ayla Fudala: Are there any groups of people who are particularly susceptible to loneliness and its negative effects?

Dr. Jeremy Nobel: So in the book that Penguin Random House published recently of mine, Project UnLonely: Healing Our Crisis of Disconnection, I identify five territories in which loneliness is often encountered. One is trauma, like military trauma, domestic violence, or even day to day simple traumas when people feel rejected or ignored. Another is illness, catastrophic, life-threatening illness, chronic illness, rare illness. All of these tend to marginalize people, so there are risks for loneliness. Aging is a major risk because people are often aging at a time of loss. They lose friends of long standing. They lose physical and mental capabilities. They feel diminished, often afraid, and that tends to have many of them withdraw. And then we have the world of difference as a territory, whether it’s difference because of race or gender or disability. People feel they’re different, feel excluded or marginalized. First and last is modernity, the modern world itself: everything from social media, to wealth divides, to political divides, to violence in the community, tends to make people anxious, uncertain and often avoidant of other people, increasing their risk for loneliness.

Ayla Fudala: What are the effects of loneliness on society as a whole?

Dr. Jeremy Nobel: That’s a great question. I mean, I think we’re watching some of that play out as loneliness has increased. Are people more impulsive? Are they more marginalized? Are they less likely to compromise with each other, find win-win solutions? Do they become more dogmatic and authoritative in their needs? I think we’re watching a lot of these changes occur. Is it easier to find community solutions? For instance, when people are connected or lonely? I would say it’s easier when they find a sense of commonality that holds them together and has them appreciate the trade-offs and the compromises that are essential to have a civil society.

Ayla Fudala: How do you stop a negative spiral linked to loneliness?

Dr. Jeremy Nobel: Part of how you break a spiral is by sometimes just having people be in the moment. Mindfulness. Awareness. Have them recognize the spiraling. If you can give them a positive sense of connection. That’s where the arts can be very helpful. And so whether it’s a visual art movement, poetry, music, where people can experience a connection to a bigger narrative than their own anxieties, their own fears, and at least for a little bit of time, feel calmer, more centered, more in the moment. And that gives them a chance to take a deep breath, let it out slowly, and maybe slow that spiral down just a little bit.

Ayla Fudala: Can you tell me about the Foundation for Art and Healing?

Dr. Jeremy Nobel: The Foundation for Art and Healing has been around almost 20 years. We will turn 20 sometime this year. I started the Foundation in 2004 with a simple mission to explore and celebrate creative expression as a path to health and well-being for individuals and communities. Our earliest work was really looking at trauma as an area where creative expression was very helpful.

We worked with returning active duty service members from Iraq and Afghanistan, often with traumatic brain injury and PTSD. Creative expression modalities were very effective in assisting them return to healthier and full lives. As we started looking at other areas of trauma, we found that it actually is in very many common circumstances. Aging, for instance, is trauma. Illness is traumatic.

So we began expanding our work and we started getting responses from participants that our arts and mindfulness programs not only reduced their stress and trauma levels, but also made them feel more connected and less lonely. We thought this was fantastically interesting, unanticipated, but something worth pursuing. So we pushed all our proverbial nonprofit poker chips to the center of the table, and went all-in starting Project UnLonely.  

Ayla Fudala: Dr. Nobel, could you tell me a little bit more about Project UnLonely and what sort of work it does?

Dr. Jeremy Nobel: Project UnLonely has three goals. One is to increase awareness of the toxicity of loneliness and its prevalence. Second is to reduce the stigma around it. And the third is to make arts-based programs available widely through community-based organizations who deliver our programming. We have three main audiences: older adults, workplace populations, and those on college campuses. Really, because what many people aren’t aware of is 18 to 24 years old is the loneliest adult demographic. So we’re we’re really expanding our work on colleges.

Ayla Fudala: What is your proudest achievement with the Foundation for Art and healing?

Dr. Jeremy Nobel: Oh, what a great question. I’m so proud of so many things our team has produced, but really one of the wonderful things is we feel loneliness is being taken more seriously and the creative expression can engage people, inspire them, motivate them and connect them is no longer being ridiculed. Now there’s plenty we need to know about it. We need to design carefully. We need to have, you know, good analysis of programs, what works best and what circumstances for what people. But I think it’s now clearly accepted that there’s an important role for the creative arts in making people as connected as they can be healthy and well.

Ayla Fudala: What are your plans for the Foundation going ahead?

Dr. Jeremy Nobel: I think there’s a huge gap now between what we need to address loneliness in our communities and what we have. Awareness is the first step, but we need to put programs out there that can give people the skills, the motivation, the experience of being connected and develop that as something that’s part of their health habits, just like diet, nutrition, and sleep. And I think that’s really what the goal is. It’s not that the arts are the only thing that can make us connected, but for many people, it could be a catalyst for them to move past that very uncomfortable sense that they may be defective or flawed. To recognizing that loneliness is a signal. Just like thirst is a signal, you need hydration and respond to that signal with skills they’ve developed to be connected and authentic and sustainable ways to other people, and often to themselves.

Ayla Fudala: How can people get involved with this important work?

Dr. Jeremy Nobel: The best way to stay in touch with us is to join our email list. And if you come to our website at Art and Healing (all one word) .org, you’ll find easy ways to join our mailing list. And then we’ll keep you updated on various programs, some of which are accessible through our website, like the streaming of short films on loneliness that give you a sense of how loneliness unfolds in people’s lives and ways to address it. We’ll also keep you up to date and other programs we have that you may want to run in a community group near you. If you happen to be part of a college-age organization or a community organization, those are the groups who run our programs, and we would be delighted to have you join our mailing list.

Ayla Fudala: Can you tell me about your book Project UnLonely: Healing, Our Crisis of Disconnection? What first inspired you to write it?

Dr. Jeremy Nobel: I’m just really honored that Penguin Random House agreed to publish my book on loneliness. It came out in October 2023. It’s got really three goals. One is to demystify and humanize loneliness so people have a sense of what it is, why it matters, how it impacts them. It impacts them, but also others in their community, loved ones, family members and so on. But it goes past just creating awareness. It outlines what I think are key principles that anyone who wanted to design their own Project UnLonely would need to take into consideration in order to understand loneliness well enough so that their interventions are effective. So that’s the second goal. It’s really for solution designers for UnLonely Programs, not ours, but theirs. Whether individuals or organizations. And the third goal is really to introduce this very important concept that creative expression can connect us, and it’s available to all of us without a co-pay or a deductible.

Ayla Fudala: Are there any major takeaways from the book that you’d like to share?

Dr. Jeremy Nobel: Well, there are few. So one is that if you’re feeling lonely, it’s not your fault. We’re having an epidemic or a crisis of loneliness. Many people feel lonely ,and there are things you can do about it. You’re not alone in feeling lonely.

And then to begin to understand what type of loneliness you might have. Is it psychological loneliness, where you have trouble having a friend or someone you can tell your troubles to? Is it societal loneliness, where you feel systematically excluded because of race, gender or disability, or something of that nature? Or is it existential, spiritual loneliness, where you’re just not sure where you fit into the bigger universe of human concerns. And so through the book, you can then understand what are the steps you can take to use some creative expression modalities to explore loneliness. And our basic model invites people to be curious about something in the world they’re truly interested in. To use creative arts to make something that reflects their interests and curiosity, so that they have an artifact that they’ve made, that they can then share. And through that sharing, have conversations that are personal, authentic, meaningful, and allow them to be seen by other people and through that, to be connected. That’s the short story.

Ayla Fudala: How has the book been received?

Dr. Jeremy Nobel: It’s so encouraging, we’ve had tremendous feedback. It’s only been out for a few months, and organizations and individuals of all sorts are reaching out. They’re eager to understand how to make sense of loneliness as a signal, not as an illness, because it’s not an illness. And then how to make solutions available so that people can learn to navigate loneliness. We’re all lonely from time to time. The key is to know how to navigate it, so that we don’t end up in a spiral where the loneliness becomes sustained, chronic, and very toxic.

Ayla Fudala: How can creativity be used to counteract loneliness?

Dr. Jeremy Nobel: So one of the things that that the arts do is they put you in the moment where you can really pay attention to what your thoughts and feelings are. Often they’re difficult ones, but then they also give you a way to express that in a way that you could better understand them, for yourself, but also communicate them to other people. And then if you can share those thoughts and feelings through that creative work, it’s a wonderful opportunity to be connected. And it’s all kinds of art. The big four: music, movement, language art and visual art. But even simple day-to-day activities like culinary arts or textile arts or gardening put our imagination to work in some deeply personal, expressive and healthy ways.

Ayla Fudala: Can you tell me about a creative project that you’ve run with the Foundation for Art and Healing?

Dr. Jeremy Nobel: Yeah. So one of the things we’re really focused on now is loneliness on college campuses. And we’ve developed a very simple workshop called Campus Colors and Connection. Takes about an hour all in for a small group to have this experience. It combines some mindfulness experiences and includes some art-making where we have the experience of translating our thoughts and feelings into color. And then you express those colors on a six by six inch piece of heavy cardstock. So you actually have an artifact that captures those thoughts and feelings in some beautiful, expressive ways. And then you have conversations with other people, first in pairs and then in front of the whole group. And then you share your thoughts about the experience. You put all your colored six by six squares together into a beautiful little patchwork quilt of expressive emotion. And through all of that, you feel better connected not just to others, but to yourself.

Ayla Fudala: Dr. Nobel, I believe you’re an award-winning poet. Can you talk about what creative expression means to you personally?

Dr. Jeremy Nobel: I find poetry very helpful personally in making sense of some difficult thoughts and feelings, and then sometimes being able to express those thoughts and feelings through poetic work in a way that other people can make sense of who I am and my circumstances and see some reflection of themselves in what I’m describing. And so when they share that with me, I feel less alone. When they read my poems, they feel less alone. And so what I’ve experienced is that poetry has been an invitation to maybe come out of my comfort zone a little bit, to share things sometimes that I’m embarrassed about or ashamed of in ways that other people can make sense of who I am, and then respond by connecting back authentically. So that’s how poetry works. Whether you ever have conversations with your reader or not, you put it out in the world. People read it. It’s a way to be connected.

Ayla Fudala: Do you have any recommendations for people who are trying to combat loneliness and connect with others in their day to day lives?

Dr. Jeremy Nobel: Sure. And, you know, I cover a lot of this in the book. It really does go into that. So I’ll try to do justice to it. But first of all, it’s to acknowledge, as I said, that if you’re lonely, it’s not your fault, and you’re not alone in being lonely. And then try to understand what type of loneliness you have. Is it psychological loneliness? Existential loneliness? Societal loneliness? What type? How severe is it? How is it impacting your physical health, mental health, or social health? And begin to take some of these steps that I talk about in the book to first be in better touch with yourself and then to be willing to connect with other people in meaningful and authentic ways. And while it can be challenging, anyone really has the tools to do it.

Ayla Fudala: Do you have any exciting new projects planned with Project UnLonely?

Dr. Jeremy Nobel: Well, we have a whole list of exciting projects out ahead of us. We’re exploring new areas where we think there’s a lot of loneliness. Everything from can we have more communal eating, Eating UnLonely? Can we address loneliness and a variety of health conditions like diabetes, where we have done some work, Diabetes UnLonely? Or recognizing that women often are disproportionately exposed to health conditions that are associated with loneliness. To address some women’s loneliness issues directly, we also are looking at new ways to leverage all sorts digital technologies, such as virtual reality, to get people an expanded array of ways they can be creative and connect with other people, with some exciting expansion of how those technologies could be helpful in that way.

Ayla Fudala: Do you have any thoughts about the Lee Kum Sheung Center for Health and Happiness and our Loneliness and Well-Being series?

Dr. Jeremy Nobel: Well, I’m just delighted to see that the Center is focusing on loneliness and social isolation. Or the flipside, connection and belonging as part of being happy, healthy, and well. I’m delighted that that’s not only something you focused attention on, but that I’ve been invited to share my work here and in doing so, become part of that remarkable community that your Center has curated.

Ayla Fudala: Any final parting words you’d like to leave our listeners with?

Dr. Jeremy Nobel: Let me go back to something I said along the way. If you’re lonely, because many people listening to this may be lonely: First know it’s not your fault. Then know you’re not alone. Then realize there are many ways to explore that feeling of loneliness as a signal that you need human connection. We all do. And there are ways to find that human connection by exploring the opportunities around you. I think the arts are a great way. I think nature is a great way. I think serving other people, if that’s something that appeals to you, can be a great way. But it’s important to understand that it’s not your fault and you’re not alone.

Ayla Fudala: The work that Dr. Nobel is doing to combat loneliness and promote social connection serves as an inspiration to us here at the Lee Kum Sheung Center for Health and Happiness. If you want to learn more, we recommend that you read Dr. Nobel’s book Project UnLonely: Healing Our Crisis of Disconnection, and visit the website of the Foundation for Art and Healing.

On a personal note, I hope that whoever you are, wherever you are, listening to this podcast, helps you remember that, as Dr. Nobel said, you’re not alone.

This has been another episode of Frontiers in Health & Happiness, the official podcast of the Lee Kum Sheung Center for Health and Happiness at the Harvard T.H. Chan School of Public Health. To learn about upcoming events, visit our website, sign up for our mailing list, and follow us on LinkedIn, X, Instagram, YouTube, and Facebook.

Stay tuned for our second episode, in which I will interview Dr. Louise Hawkley, a Principal Research Scientist at the National Opinion Research Center. Dr. Hawkley is a leading expert in the field of loneliness and social isolation, and their associations with health during aging. Her research focuses on identifying factors that increase the risk for loneliness.

New episodes in our Loneliness and Well-Being series will air every two weeks. Episodes can be found on the Lee Kum Sheung Center for Health and Happiness website and YouTube channel, as well as on Spotify, Apple Podcasts and wherever else podcasts are found. Thank you for listening.