Professional loneliness and isolation aren't problems restricted to people working at home, according to Kerri Palamara, MD, MACP.
“The definition for loneliness is a person's feelings about the adequacy and quality of his or her relationships in particular situations,” she said. “This can occur when you're working alone, when you're working in teams, or when you're surrounded by people.”
At a microsession at Internal Medicine Meeting 2021: Virtual Experience, Dr. Palamara offered advice on overcoming this growing issue.
“This is not a new problem in our workplace, but it's one that we're newly understanding as researchers spend more time diving into this, and one that we are newly experiencing as our world, our societies, and our workplaces change,” said Dr. Palamara, who is director of the Center for Physician Well-being at Massachusetts General Hospital and assistant professor of medicine at Harvard Medical School in Boston.
The challenge of isolation and loneliness at work can be exacerbated by personal and societal circumstances, workplace stressors, and technology, Dr. Palamara said. She noted that while the feeling of loneliness can be a helpful physiologic response in the moment because it might prompt a person to reach out, chronic loneliness can harm physical and mental health.
“Professional isolation and the chronic stress related to it can be equivalent or even worse than smoking 15 cigarettes a day, something many doctors cannot even imagine [doing]. … But in fact, we all may be at risk for that through our professional isolation,” said Dr. Palamara, who is physician lead for ACP's coaching services.
She explained that withdrawing emotionally due to professional isolation and loneliness can start a vicious cycle, leading to less participation in social events in the workplace and fewer invitations. “People stop inviting [you] because they assume you don't want to be there, which then furthers that isolation,” she said. “The disconnection that then happens can lead to self-doubt, insecurity, negative thoughts, rumination, excessive stress. And often people will turn towards what they can connect with, such as drugs and alcohol, rather than who they can connect with.”
Dr. Palamara recommended the UCLA Loneliness Scale, available online, as a starting point to assess professional loneliness. The scale has 10 questions, including “How often do you feel unhappy doing so many things alone?” and “How often do you feel you have no one to talk to?”, that are scored from 1 (never) to 4 (always) and can help quantify one's feelings.
“If you identify that you're feeling lonely, it may help to examine your levels of connectivity,” Dr. Palamara said. Vivek Murthy, MD, the U.S. Surgeon General, has defined three levels of types of connection that sustain us, she noted. Intimate connections are partners, spouses, or very close friends; relational connections are a broader circle of friends and those one wants to spend time with; and collective or community connections are those who are part of a shared identity and make people feel they're part of something bigger than themselves.
“You don't have to have high levels of connectivity in all three of these buckets, all three of these levels,” said Dr. Palamara. “But it might help you understand, ‘Hmm, this one's pretty low, so either I might want to focus on that or I might want to reinforce one of the others, to help sustain me and to help reduce my feelings of loneliness and isolation.’”
She offered 10 tangible steps to reduce loneliness and isolation at work:
1. Buddy up. “Whether there's a buddy system in your institution or whether there's just a person that you've checked in with from time to time, formalize that,” Dr. Palamara said. “Make it a point to check in with them more regularly.” Conversely, she noted, if there's a person who always checks in with you, make an effort to give a little more back in that relationship.
2. Work in teams. If you're excited about a new project (or don't really want to take it on), sharing the work with colleagues can be helpful.
3. Find a mentor. Look for potential mentors, and consider ways that you can be a mentor for others.
4. Don't eat alone. “Rather than scarfing down that salad at your desk, think about ‘Who could I be with right now?’” Dr. Palamara advised.
5. Seek out connections. It might not seem like it, but taking time to connect with others can actually increase productivity. “When we're very busy, our natural inclination is to burrow in our offices, close the door, and try to block out the outside world,” Dr. Palamara said. “I'm going to tell you that you actually will be more productive, more efficient, more creative if you bust out and talk to somebody.”
6. Share stories and listen to them. “Share with others what your experiences are, and listen when others do the same to you and follow up with what you've heard,” Dr. Palamara said.
7. Meet in person whenever possible. “Even better: Go for a walk, so you feel something physical at the same time,” she said.
8. Perform random acts of kindness. “Expecting nothing in return but being surprised by what you do receive in return is another great way to combat loneliness,” Dr. Palamara said.
9. Express gratitude. Show that you are thankful for your connections with other people, as well as everything else that you have.
10. Check in on someone else. “If you're not feeling lonely right now, maybe somebody else is, and that would be a great way to connect with them,” Dr. Palamara said.
Institutions and organizations can also help fight professional loneliness and isolation, Dr. Palamara said. The first step is for leaders to think about and openly discuss these issues. “Ask people in your groups about the loneliness and connectivity that they're experiencing. …What is the isolation that people are experiencing, and what might we be able to do about that?”
Leaders should be educated about loneliness, and organizations should make a point of facilitating connections for new hires before they even start. “Bring them on and let them meet people, let people meet with them, let them get a sense of the culture even before day one,” Dr. Palamara said.
Mentoring and buddy programs should be encouraged, and while formal team-building activities are helpful, organizations should also sponsor lunches with no agenda that just give people a chance to talk. Leaders should also build time for connecting and socializing into meetings, give teams a say in decisions that will affect them, and follow up so that employees know how their feedback has been used, she said.
It's also key for leaders to keep an eye out, Dr. Palamara said. “Look out for people who are isolating, and know that this might not be people who are burrowing or people who are quiet. It could also be people who are abnormally extroverted, different than their usual behaviors,” she advised. “What this means is getting to know your people, and letting them get to know you, so that they'll let you in when they need your help.”