SOCIAL connectedness

To say that Art and Music highlight the importance of Social Connections would be an understatement.

We provide a couple of examples, but we are sure you do not convincing of this point.

PAINTING

• By Michelangelo – See above, Public Domain, https://commons.wikimedia.org/w/index.php?curid=71427942

MUSIC

https://www.youtube.com/watch?v=f7P8wusL1Z0

Lyrics

Hmm… hmm-hmm-hmm-hmm
Hmm-hmm-hmm-hmm
Hmm-hmm-hmm-hmm-hmm
Sometimes in our lives
We all have pain
We all have sorrow

But if we are wise
We know that there’s always tomorrow

Lean on me
When you’re not strong
And I’ll be your friend
I’ll help you carry on…

For it won’t be long
Till I’m gonna need somebody to lean on

Please swallow your pride
If I have things you need to borrow

For no one can fill
Those of your needs that you won’t let show

You just call on me brother when you need a hand
We all need somebody to lean on

I just might have a problem that you’ll understand
We all need somebody to lean on

Lean on me
When you’re not strong
And I’ll be your friend
I’ll help you carry on…

For it won’t be long
Till I’m gonna need somebody to lean on

You just call on me…

MOVIES

• Being close to an attachment figure “tranquilizes the nervous system” (Schore, 1994).

The ethos of the largest organized sporting event is steeped in Social Connectedness: The Olympic Games.

Is it fun enough to be the world’s fastest person? Or is the fun in sharing this feat with the world?

However, a story that comes to mind comes from the 1998 World Cup when the French Men’s Soccer Team was set to host the Brazilians in the finals in the Stade de France in Paris.

When the French side pulled out of their training grounds, 45 minutes away from Paris, they were met by fans cheering them on.

For the entire 45-minute drive to Paris, there was not a gap in the road – even along the highway – that was not occupied by cheering fans.

Upon entering Paris, about millions of fans were around the stadium and out and about Paris to show their support.

The French team took to the pitch.

Upon entering the stadium, the noise was deafening.

The Brazilian team took to the pitch…

Zinedine Zidane (star French player) said later in an interview:

We knew we had won then. There was no chance that these 11 men could beat 75 million of us.

“THE HAND OF HOPE”

• An image of the hand of a 21-week-old fetus grasping the finger of the doctor during a medical procedure to fix a spina bifida lesion

• By Michael Clancy- See above, Public Domain, https://en.wikipedia.org/wiki/Hand_of_Hope_(photography)#/media/File:Samuel_Armas_Aug19_1999.jpg

“THE RESCUING HUG OF LOVE”

• In 1995, twins Brielle and Kyrie Jackson were born 12 weeks premature.
• Only one was expected to survive.
• At three-weeks-old, one took a turn for the worse and her condition turned critical; they were about to lose her.
• A nurse, Gale Kasparian, got the idea of putting the decided to put the stronger twin next to her sister in the same incubator (this had never been done before because of fear of passing infection from one baby to another).
• Once they were put together, Kyrie, the stronger twin, put her arm around her sister.
• From that moment, Brielle’s vital signs started to stabilize.
• It is believed that without this rescuing hug Brielle wouldn’t have survived.

THE GREAT SALT MARCH A.k.a. “SALT SATYAGRAHA”

• From March 12 to April 6, 1930, in a social act of assertiveness against unfair tax laws on Indians by colonialists, Gandhi and others organized the “The Great Salt March” where rather than buying salt subject to these controversial taxes, Indians walked in masses for miles to the see to make their own salt, as an act of civil disobedience.
• Upon arriving at the seashore, Gandhi picked up a handful of salty mud and said “With this, I am shaking the foundations of the British Empire,” before boiling it in sea water and making “illegal” salt (Gandhi & Dalton, 1996).
• This strengthened the campaign of public assertiveness in India, and was later adopted in the U.S.A. by Dr. Martin Luther King in his campaign against racial inequality.

There are countless examples of how Social Connectedness has shaped all cultures including Canadian culture. One example is provided below.

The Marathon of Hope and the Annual Terry Fox Run

• Wikipedia has a short synopsis of this chapter of our history:

Terrance Stanley Fox CC OD (July 28, 1958 – June 28, 1981) was a Canadian athlete, humanitarian, and cancer research activist. In 1980, with one leg having been amputated due to cancer, he embarked on an east to west cross-Canada run to raise money and awareness for cancer research. Although the spread of his cancer eventually forced him to end his quest after 143 days and 5,373 kilometres (3,339 mi), and ultimately cost him his life, his efforts resulted in a lasting, worldwide legacy. The annual Terry Fox Run, first held in 1981, has grown to involve millions of participants in over 60 countries and is now the world’s largest one-day fundraiser for cancer research; over C$750 million has been raised in his name as of January 2018. (“Terry’s Story”. The Terry Fox Foundation. Retrieved January 29, 2018.)

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The Still Face Experiment

• Initial interactions and responsiveness of parents are key to childrens’ development and success
• Emotional connectedness is seen as safe and secure whereas emotional distance is seen as threatening
• What happens if you don’t mean to be unresponsive to your baby’s cues to interact, but you are because you are distracted by a device?
  • Another reason to put your devices down

What defines a secure bond?

• It doesn’t have to be “perfect” (whatever perfect means)
• It requires one to be (pneumonic is A.R.E.):
  • Available/open, “Are you there for me? Can I reach you?”
  • Responsive, “Will you respond when I call?”
  • Engaged, “Do I matter to you?”
• The quality of encounters will contribute to a person’s attachment style which can dictate how readily the connect socially

The Harlow Study

The Association of Psychological Science summarizes this study.

Dr. Harlow took infant monkeys from their biological mothers and gave them two inanimate surrogate mothers:

• one was a simple construction of wire and wood,
• and the second was covered in foam rubber and soft terry cloth.

The infant monkeys were assigned to one of two conditions:

• In the first, the wire mother had a milk bottle and the cloth mother did not; in the second, the cloth mother had the food while the wire mother had none.
• In both conditions, Harlow found that the infant monkeys spent significantly more time with the terry cloth mother than they did with the wire mother.
• When only the wire mother had food, the babies came to the wire mother to feed and immediately returned to cling to the cloth surrogate.

Harlow’s work showed that infants also turned to inanimate surrogate mothers for comfort when they were faced with new and scary situations.

• When placed in a novel environment with a surrogate mother, infant monkeys would explore the area, run back to the surrogate mother when startled, and then venture out to explore again.
• Without a surrogate mother, the infants were paralyzed with fear, huddled in a ball sucking their thumbs.
• If an alarming noise-making toy was placed in the cage, an infant with a surrogate mother present would explore and attack the toy; without a surrogate mother, the infant would cower in fear.

Secure attachment decreases the pain experience

• functional MRI has shown that the presence of a secure attachment figure reduces the brain’s pain response.
• In this experiment a patient gets a shock 20% of the time when she sees a red light.
• functional MRI images “light up” with the fear,
  • and the presence of a stranger doesn’t modulate the way the brain “lights up”
  • the presence of her husband, with whom she is having marital difficulties, also doesn’t modulate the way the brain “lights up”
  • After her and her husband do couples counselling (Emotionally Focused Therapy) and their bond is rekindles, the functional MRI images in response to the fear of pain and to the shock is greatly reduced; the functional MRI images also “light up” significantly less.

Social Connectedness and endogenous opioid production

• When people feel socially connected the brain deploys internal opioids that effect μ-opioid receptors.
  • These receptors are triggered by deep social connections with others and help to maintain and heighten social relationships with close individuals over time (Inagaki, Hazlett, & Andreescu, 2020).
• Research has found that individuals who have social support from close partners (e.g. boyfriend or girlfriend, or marriage partner) have seen reductions in physical pain felt by simply holding the hand of their partner or even just looking at photos of their partner (Eisenberger, 2012).
  • This is to say that deep social connections can actually help to reduce the physical pain that our bodies feel on a daily basis.

Maslow’s Hierarchy of needs Theory

• This is a theory that conceptualizes a hierarchy of Motivations.
• Social Connectedness is seen as a Psychological Need on which Esteem and Self-actualization depend for their realization

Androidmarsexpress, CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

https://en.wikipedia.org/wiki/Maslow%27s_hierarchy_of_needs

The Default Mode Network (DMN)

• Is a network of brain structures (Angular Gyrus, Anterior Cingulate Cortex, Inferior Parietal Lobule, Middle Frontal Gyrus, Middle Temporal Gyrus, Anterior Cingulate Cortex, Precuneus, Superior Frontal Gyrus, Superior Temporal Gyrus, Transverse Temporal Gyrus, Posterior Hypothalamus, and more) that functionally operate together when you are not actively engaged in a task
  • e.g., the DMN activated when you are not engaged in writing, reading, driving, watching media, conversations, cognitive, social, emotional actions, etc.
• The DMN is kind of an idle state of the brain, but that does not mean that the brain is inactive
• The DMN is very important in giving you the sense of “being you”
  • Your sense of identity and how that relates to others (Supekar et al., 2010)
  • Self-perception
  • Self-reflection
  • Social and family systems
  • Autobiographical memory (where you came from)
  • Dreams and ambitions (where you are going)
    • if that dream is strong enough, other networks of the brain align themselves in an attempt to make that dream come true (Buckner et al., 2008; Spreng & Grady, 2010; Heine, 2012).
  • Understanding others’ intentions
• The DMN are developed in infancy and can be significantly adversely affected by negative early childhood experiences (Thompson & Patterson, 1986).
• There is a lot of overlap between the way the DMN lights up when active and the way the social brain lights up when active (Mars et al., 2012)

By John Graner, Neuroimaging Department, National Intrepid Center of Excellence, Walter Reed National Military Medical Center, 8901 Wisconsin Avenue, Bethesda, MD 20889, USA. – http://www.frontiersin.org/Neurotrauma/10.3389/fneur.2013.00016/full, Public Domain, https://commons.wikimedia.org/w/index.php?curid=25872800

By Andreashorn – Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=34327919

The Default Mode Network and the Social Brain

• It appears that the DMN is involved in our self-identity vis-à-vis the social context of our existence
• That is, our self-identify, and our social surroundings are inseparable just as night is defined relative to day.
• In other words, our brain’s default mode network represents views of self in the context of social roles and social implications to our existences
• This makes me think of the old adage (Just doing a search online shows that every culture has a similar saying):

Tell me who your friends are and I’ll tell you who you are.

The research into Social Connectedness and our health has been growing as our societies face shrinking social networks and social isolation on a large scale relative to previous generations (McPherson, 2006).

• e.g., 33% feel more alone than they would like 25-34 yo (Vancouver Foundation, 2015).

Some of the negative consequences of social isolation include:

• A significant cardiovascular disease risk factor, as significant as any other!
  • Overall, the influence of both objective and subjective social isolation on risk for mortality is comparable with well-established risk factors for mortality (Holt-Lunstad et al., 2015)
• Social support and Coronary Heart disease:
  • looking at artery blockages and social support, researches found there was less blockage in those with social support (Wang et al., 2005).
• Isolation as a risk factor for depression:
  • Loneliness is a more powerful predictor of future Major depressive disorder than even having had depression in the past (Vandereele et al., 2011)
• Interventions specifically designed to create a sense of community and social connection is just as good as other treatments (Elkin, Shea. Et al 1989.)

Some of the benefits to Social Connectedness include (Hold-Lunstad et al., 2017; Martino et al., 2015):

• Interventions for depression specifically designed to create a sense of community and social connection is just as good as other treatments (Elkin, Shea et al., 1989.)
• decreased risk for all-cause mortality as well as a range of disease morbidities
• healthy body mass index
• control blood sugars
• improve cancer survival
• decrease cardiovascular mortality
• decrease depressive symptoms
• mitigate posttraumatic stress disorder symptoms
• improve overall mental health
• Isolation can increase depressive symptoms as well as mortality

1. Make yourself comfortable, notice the sensations in your body as you sit and rest your feet on the floor. You can close your eye if you feel like it.
2. Recall a recent experience in which you felt upset or stressed.
   • Picture the scenario in your mind and replayed what happened that was upsetting.
   • This may be distress in an important relationship or an upsetting event.
   • Notice the emotions, sensations in your body and the thoughts going through your mind.
   • Mentally note how upsetting this feels on a scale of 0 (no distress) to 10 (maximum distress).
3. Now picture an attachment figure with whom you felt safe and secure.
   • This is someone who accepts and values you for who you are.
   • This may be your mother, father, grandparent, sibling, special friend, spiritual figure, mentor or even a pet.
4. Invite this secure attachment figure into the present upsetting situation.
   • Imagine what this attachment figure would look like, say or do to encourage, comfort or reassure you.
   • Try to take this in and notice the emotions, sensations in your body and your thoughts.
   • Mentally note your level of distress in the presence of your attachment figure on a scale of 0 (no distress) to 10 (maximum distress).
5. Try to capture this experience with your attachment figure with one word.

Most parents will tell you that their children were born with their own unique personalities.

• Twin studies have suggested that personality is a result of both nature and nurture (Jang et al., 1996), where half of differences between people can be attributed to nature, and the other half to nurture.
• After decades of research into better understanding personalities, a model was developed known as the “Big 5 Theory of Personality” that helps us efficiently categorize personality traits (Power et al., 2015).

The main dimensions in which personalities can be categorized can be easily remembered by the pneumonic OCEAN:

Openness to experience

Conscientiousness

Extroversion

Agreeableness

Neuroticism

• Keep in mind that when we say Extroversion, for example, we mean Introversion on one end of the spectrum, and extraversion on the other end of the spectrum.
• All of us can be categorized somewhere between these polar opposites in each of these five categories.
• Researchers have found that our position in each of these five categories tends to remain stable from childhood through adulthood (Leon et al., 1979).

Openness to Experience

Characteristics such as imagination and insight describe this category.

People who are high in this category are often seen as:

• creative
• curious
• interested in trying new things and adventure-seekers
• liking new challenges
• comfortable with abstract concepts and shades of grey
• appreciation of arts

People low in this category (i.e., not open to experience) are seen to be the polar opposite (i.e., don’t like change, not imaginative, likes concrete concepts rather than abstract ones, set in their ways, etc.)

Conscientiousness

Characteristics such as self-discipline, steadfastness and goal-directed behaviours describe this category.

People who are high in this category are often seen as:

• always prepared for tasks
• prioritizing work and responsibilities
• detail-oriented
• liking structure and organization
• tenacious
• stubborn
• focused

People low in this category (i.e., not conscientious) are seen to be the polar opposite (i.e., flexible, spontaneous, unreliable, sloppy, procrastinators, etc.)

Extroversion

Characteristics such as being talkative, socially-inclined, enthusiasm and assertiveness describe this category.

People who are high in this category are often seen as:

• enjoying attention
• engaging with others
• popular, social butterflies
• prefer being with others
• tenacious
• energetic
• emotionally expressive

People low in this category (i.e., introversion) are seen to be the polar opposite (i.e., prefer their own company, quiet and low-key, small social networks, not interested in chit chat, prefers to not be the center of attention, thinks before speaking, etc. This does not mean that they are socially anxious or unfriendly, it just means that they are more independent and less socially-dependent.)

Agreeableness

Characteristics such as being kind, generous, helpful and trustworthy describe this category.

People who are high in this category are often seen as:

• empathic and caring about others
• enjoys helping others
• compromising
• soft-hearted
• making people feel at ease

People low in this category (i.e., disagreeable) are seen to be the polar opposite (i.e., placing self-interest above getting along with others, competitive, suspicious of others’ motives, uncooperative, less generous, little interest in others’ well-being, etc.).

Neuroticism

Characteristics such as being prone to negative emotions and being emotionally labile describe this category.

People who are high in this category are often seen as:

• sensitive to stress
• interpreting mundane day-to-day things as stressful
• angry, anxious, depressed
• pessimistic

People low in this category (i.e., calm) are seen to be the polar opposite (i.e., emotionally stable, relatively free of negative emotional states, calm, relaxed, etc.).

How does the Big 5 Theory of Personality relate to Social Connectedness?

Awareness of these 5 categories of personality type can help you understand people better, and manage your expectations of them better.

It can also help you understand yourself more which can be helpful for several reasons:

• You may have to make more of an effort to be Socially Connected (i.e., if you are more introverted or less open to new experiences)
• You may require less Social Connectedness than others (i.e., if you are introverted)
• It will help with acceptance, half of your personality is inherited, and the other half is said to be due to your upbringing.
  • I remember a professor from when I was in medical school from the Department of Psychiatry at the University of Toronto was doing research on this and said that they believe that 80% of personality is genetic.

Attachment Theory

Human-beings seek out relationships with others in hopes to develop intimate and secure attachments. These secure attachments formed will help “make us stronger” in facing life’s challenges, and optimistic in celebrating life’s joys (Mikulincer et al., 2005)

• When these figures (i.e., attachment figures) are available to us we feel more secure to face trials and tribulations.
• Feelings of avoidance and/or anxiety begin to develop when secure relationships are not formed and/or are not available.

Attachment and Childhood

When we were children, how much we could rely on our parents to be supportive, caring and protective predicted how we behaved.

• It’s not surprising that some children behave differently than others, depending on the bonds they formed with their parents, mostly in the first year of life (Ainsworth).
• This motivation for being close to an attachment figure is called the Attachment Behavioural System (ABS).

The ABS explains how emotional regulation in social contexts develops in humans.

• In this model, children can be seen as asking themselves “Is the attachment figure nearby, accessible, and attentive?”
• The figure below shows how the child’s behaviour changes depending on how they answer this question.

According to research done by Ainsworth (Ainsworth et al., 1978), the following categories of children exist in the ABS with respect to their relationships with their parents:

1. Secure
   • Children who appear secure in unfamiliar situations tend to have parents who are responsive to their needs.
   • These children “become upset when the parent leaves the room, but, when he or she returns, they actively seek the parent and are easily comforted by him or her (Fraley, 2018).”
2. Insecure
   • Children who appear insecure in the unfamiliar situations (i.e., anxious-resistant or avoidant) often have parents who are insensitive to their needs, or inconsistent or rejecting in the care they provide
   • These insecure attachments can be further broken up into the following subcategories:
     • Anxious-resistant
       • “These children have a difficult time being soothed, and often exhibit conflicting behaviours that suggest they want to be comforted, but that they also want to “punish” the parent for leaving (Fraley, 2018).”
     • Anxious-avoidant
       • “These children don’t appear too distressed by the separation, and, upon reunion, actively avoid seeking contact with their parent, sometimes turning their attention to play objects on the laboratory floor (Fraley, 2018). “

Attachment and Adulthood

From research on adult attachment, it is believed that the same ABS that predicts the quality of emotional bonds between parents and their children is also at play between adults in emotionally intimate relationships, influencing the thoughts, emotions and behaviours adults experience (Fraley & Shaver, 2000). 

• Whether the influence of our experiences from our first year of life influences our behaviours in all future relationships to some extent, or if those early experiences can be overwritten by future relationships is still a controversial issue (Fraley & Shaver, 2000).

Some of the similarities between child-parent relationships and adult romantic relationships include (Hazan and Shaver, 1987):

• both feel safe when the other is nearby and responsive
• both engage in close, intimate, bodily contact
• both feel insecure when the other is inaccessible
• both share discoveries with one another
• both play with one another’s facial features and exhibit a mutual fascination and preoccupation with one another
• both engage in “baby talk”

Romantic love serves to fulfill attachment needs we have, but also motivates us to take care of our partners and our sexuality.

Adult attachment uses the same categories as used in child ABS (Brennan, Clark, & Shaver, 1998):

• Secure
• Insecure: Anxious-resistant
  • High scores here tend to reflect that people worry whether their partner is available, responsive, attentive, etc.
    • worrying about attachment figures not being available at all to help when stressors arise
    • putting intense pressure on social relationships; coming across as clingy
  • Low scores indicate that one is more secure in how responsive they perceive their partner to be
• Insecure: Avoidant
  • Scoring high here reflects a preference for not relying on others or opening up to others.
    • feeling as though others have (disingenuous) ulterior motives
    • checking out” from social relationships and/or denying the fact that they need additional emotional support (even if it’s not true).
    • disconnecting from social situations so that they cannot be disappointed when people are not available to them
  • Scoring low reflects being more comfortable in intimacy with others and having others depend on them.
  • Avoidant attachment type is split into 2 categories:
    • Fearful avoidant
    • Dismissing avoidant
    • Both appear dismissive, aloof, callous, detached, but the fearful avoidant people have inner anxiety and the dismissive avoidant people tend to refocus their attention on other things then their relationships.

It is believed that whether an adult is secure in their relationship is a partial reflection of their experiences with their parents. For example, secure people tend to believe that others will be there for them because history has shown them that that is the case.

Take the Adult Attachment Style Questionnaire by clicking here.

• The results of this questionnaire will be plotted on the graph below:

Adapted from Fraley, R. C., Waller, N. G., & Brennan, K. G. (2000).

Your attachment style can be plotted as existing somewhere on a two-dimensional scale (see figure above): your degree of avoidance on the Y-axis, and your degree of anxiety on the X-axis.

So why doesn’t everyone seek out partners that are perceived as attentive, warm and sensitive – features that are seen to be most attractive to those seeking out long-term relationships (Zeifman & Hazan, 1997)?

• Some evidence suggests that people end up in relationships with partners who confirm their existing beliefs about relationships (Frazier et al., 1996) – see more below in our section on Core Beliefs.

What does your attachment style have to do with facing medical illness?

• Secure adults are more likely than insecure adults to seek support from their partners when distressed.
• Secure adults are more likely to provide support to their distressed partners (e.g., Simpson et al., 1992).
• How supportive you perceive your partner to be depends more on your Attachment Style than theirs; and likely reinforces your attachment style (e.g., Simpson et al., 1996).
  • E.g., if you have an anxious-resistant attachment type, and you perceive your partner to not be supportive enough (whether others agree or disagree), you are more likely to display more anxious-resistant behaviour.

When people don’t get what they need emotionally from attachment figures

If you look at the Still Face Experiment (See Section “Benefits of Social Connectedness > Importance of Social Connectedness for Babies”) you will see that the children protest to the loss of a perceived secure emotional bond with the attachment figure in a stereotypical fashion. The same sequence of protest can be seen in adults, however, adults will express them differently than infants:

1. Angry Protest

While anger is not necessarily a negative thing, it is important to recognize if we are expressing anger in assertive or dysfunctional ways.

Assertive expression of anger centers around expressing your point-of-view with the aim of coming to a solution. As this is the focus, there is no room for dysfunctional manifestations, but rather, focus is on assertive responses (devoid of aggression and blaming), constructive feedback and problem-solving discussions.

Dysfunctional expression of anger can be seen as retaliating or inflicting punishment (emotional, physical, psychological) on the other party. Aggressive or passive-aggressive modes of communication are often utilized. This can lead to a vicious cycle of negative emotions (despair, anger, despondency, sadness, anxiety) and retaliation.

2. Anxious Clinging

3. Depression of Despair

4. Detachment

We often finds ourselves in social situations that will affect our ability to develop the social networks we desire.

Common examples would include:

• Illnesses (e.g., post-concussion syndrome often makes it harder for people to be surrounded by lights and sounds)
• Moving to a new city/country
• Self-isolation because of public health concerns (e.g., CoVID19)
• Loss/Moving away of close friends/relatives
• Hostile relationships

Some people find the Responsibility Pie exercise helpful in highlighting the things they can influence, and accepting those things that they can’t.

Marriages are a particularly common issue that affects Social Connectedness.

A good marriage carries with it many potential benefits (Shmerling, 2016):

• live longer
• have fewer strokes and heart attacks
• have a lower chance of becoming depressed
• be less likely to have advanced cancer at the time of diagnosis and more likely to survive cancer for a longer period of time
• survive a major operation more often.

Many studies have observed the same (Hold-Lunstad et al., 2010).

However, troubled marriages can have adverse health consequences (Kiecolt-Glaser J. K. et al., 2017).

In fact, Dr. Kiecolt-Glaser, one of the leading researchers in this area points out that how couples behave during conflict can even adversely affect wound healing and blood levels of stress hormones.

The most problematics topics include:

• Money
• In-laws
• Communication issues

Dr. Kiecolt-Glaser points out that it is the quality of the communication (See “How to Get Socially Connected > Emotionally Focused Therapy” and “Assertiveness” for more details) that really predicts health consequences, not whether couples agree or not (Kiecolt-glaser, 2017).

“It ain’t what you don’t know that gets you into trouble.

It’s what you know for sure that just ain’t so.”

– Mark Twain

What are Core Beliefs?

Core Beliefs have been discussed elsewhere on this website (click here to read more) but in general, they are beliefs we hold about ourselves, others and the world that tints (i.e., biases) our views on situations.

How do Core Beliefs Affect our Behaviours?

For example, if you have the general belief (i.e., Core Belief) that people only call me when they want something from me, then, for example, you likely will be:

• less likely to pick up the phone
• less likely to give out your phone number
• less likely to be warm on the phone, etc.
• And it is more likely that people will only contact you when they want or need something, which would further back up what you’re saying to yourself.

The above is just an example of how a Core Belief could affect your behaviours and the situations in which you find yourself.

• However, it could play out many different ways depending on many factors.
• But, basically, it’s not hard to see that certain beliefs are more likely to lead to certain outcomes, and a different set of beliefs are more likely to lead to different outcomes.

Read more about Core Beliefs here.

What are the most common Negative Core Beliefs in Medical Illness?

The most common negative Core Beliefs in those with medical illness revolve around viewing oneself as:

• unlovable
• helpless
• inadequate

Negative Core Beliefs often lead to what are known as Secondary Emotions.

• First, let’s discuss Primary emotions
  • They are the most basic of human emotions that are consistent between cultures (Elfenbein & Ambady, 2002).
  • They are hardwired in some of the oldest parts of our brains like the thalamus, hypothalamus and limbic system (Ekman, 1992).
  • We can easily identify them in others just by watching (Fridland, Ekman, & Oster, 1987).
  • Even babies can express and feel them.
  • These primary emotions are: anger, disgust, fear, happiness, sadness and surprise
• Now, let’s discuss Secondary emotions
  • These are emotions that react to things that we tell ourselves about our situations
  • They depend on the thinking-part of our brains (i.e., the cortex)
  • We can often “fool ourselves” into thinking things that ain’t quite so (see articles on Socratic Dialogue and Language & Recovery) and then we get these secondary emotions
  • The ability to see a thought as a theory (i.e., metacognition) rather than the absolute truth is an important skill to develop to catch and correct these
  • Secondary emotions are: 
    • Guilt, shame, embarrassment, self-criticism
  • So, we have an emotion and then a thought that accompanies this emotion (cognitive appraisal); and then another (secondary) emotion to the thought associated with the first emotion.
  • For example, you’re sad because you’re lonely.
    • Then you tell yourself that you deserve that because you’re not cool
      • Possibly because somewhere along the way you subscribed to the belief that cool people are popular
    • Then you feel self-critical or shameful that you are alone.

What is the effect of having negative Core Beliefs on Social Connectedness?

Having these negative views of oneself decrease the likelihood that someone will connect socially.

• They may lead to a passive communication style. That is, they may lead to “people pleasing” at your own expense.
• They can see you become more focused on more fundamental needs (e.g., physiological needs like rest and nutrition, or safety needs like security and trust issues) rather than venturing to higher levels of the pyramid (i.e., Social Connectedness, self-esteem, power and control to live your life in a way that you prefer, intimacy, etc.) (Resick et al., 2017)

Furthermore, these negative Core Beliefs are likely not accurate in most contexts, something that you are likely discounting.

“REPEAT A LIE OFTEN ENOUGH AND IT BECOMES THE TRUTH”

-Law of Propaganda (Illusion of Truth Effect) often attributed to the Nazi Joseph Goebbels

Like that, we may have many negative Core Belief regarding Social Connectedness that will hold us back from connecting with others in a way that is good for us.

How to Identify and What to Do About negative Core Beliefs?

How to identify and evaluate negative Core Beliefs has been discussed elsewhere on this website.

Creating new positive Core Beliefs seems to be the most efficient way to start getting different results.

“WE CANNOT SOLVE OUR PROBLEMS WITH THE SAME THINKING WE USED WHEN WE CREATED THEM”

– Albert Einstein

Often the help of a psychotherapist and an Exposure Hierarchy can help with the process.

Click here to read our explanation on “What stops people from acting assertively“.

Time constraints are commonly the reason why people forgo connecting socially with each other.

Learn more about deciding your priorities and scheduling your time in the following articles:

Scheduling & Behavioural Activation

Decision-Making Style

Illness is a common reason why people find it challenging to stay Socially Connected.

Common medical reasons why patients forgo socializing include things like:

• Risk of infection (e.g., for those with conditions that make them more susceptible to the consequences of infection)
• Not enough energy (e.g., for those with conditions that cause fatigue)
• Too much stimulation (e.g., lights, sounds, cognitive in post-concussion syndrome)
• Not wanting to interrupt sleep habits (e.g., for those with insomnia)
• Not being able to drive or depending on others for rides (e.g., for those that can’t drive, like in dizziness conditions or others)

Furthermore, many illness have a psychological effects too that can discourage people from connecting socially:

• Depression, making people less likely to be motivated to do things they enjoy
• Thinking they will be a burden on others (i.e., others won’t enjoy their company)
• Feeling hopeless that they can enjoy things
• Believing that they will be hurt by others (i.e., others can’t be trusted)
• Negative Core Beliefs and secondary emotions have been discussed in the section “Negative Cognitions” above.

The problem is that isolating ourselves entirely is worse for our health.

• We end up giving away the power/control to live our lives on our own terms, as well as self-esteem and intimacy, to secure for ourselves a sense of safety and “comfort”.

The evidence is clear that connecting socially helps.

While you may not be able to socialize in the way you used to before (and the way you may socialize again in the future), illness does not mean you cannot connect socially.

Some people find the Responsibility Pie exercise helpful in highlighting the things they can influence, and accepting those things that they can’t.

“I fear the day that technology will surpass our human interaction.

The world will have a generation of idiots.”

-Albert Einstein

There is an organization that focuses on technology’s influence over us: PEW research.

1. Social media and technology can be addictive

• In fact, it is deliberately made to be addictive by many. This is the topic of NYU Professor Adam Altar’s book “Irresistible”.
• How the architecture of technology is deliberately designed to grab our attention and guide our actions is also the topic of the Netflix Documentary Social Dilemma.
• The lure to social media seems to be more prevalent to those from more dangerous neighbourhoods with data from PEW research reflecting that black and Hispanic American kids spend about 50% more time in front of screens than white American kids.

2. Impacts of Technology on our Physical Health

• Increase in sleep problems (Chang et al., 2015; Carter et al., 2016)
  • e.g., Evening use of light-emitting eReaders like an tablet (vs reading the same in a book) suppresses melatonin and leads to a 90-minute circadian rhythm shift.
  • 90% of Americans uses devices within 1 hour of bedtime.
• Obesity through increased sedentariness

3. Impacts of Technology on our Psychological Health

• Being very interested in politics increases the odds of being not too happy about life by 8% after controlling for income, education, age, gender, race, marital status and political views (General Social Survey, 2014).
• GDELT project monitors the tone of our world’s news. The “tone” of the news has been changing and is becoming increasingly negative.
• The “Instagram impact” has made people less satisfied with their lives by exploiting the “grass is greener on the other side” philosophy.
• Non-phone activities are generally associated with greater levels of happiness when compared to phone activities (Twenge, World happiness report, 2019)

4. Impacts of Technology on our Education

• The use of technology media for learning has skyrocketed in the last 4 decades
• This has had serious implications on the way we learn (Twenge et al., 2018)
  • “There’s no lack of intelligence among young people, but they do have less experience focusing for longer periods of time and reading long-form text,” she said. “Being able to read long-form text is crucial for understanding complex issues and developing critical thinking skills.”
• Many of the CEOs of big tech companies don’t even allow their children to own phones and send their kids to tech-free schools (Lopez, 2020).

5. Impacts of Technology on our Social Lives

• PEW research has shown that devices have the potential to interrupt social encounters.
• Phubbing (ignoring the person that you are with so that you can use your device) and its adverse effect on connecting socially with others has been observed in the research literature (Chotpitayasunondh et al., 2018)
• Kids nowadays are less likely to get enough friends and hang out with friends; are less likely to date; and are more likely to feel lonely.
• Face-to-face interactions are still generally needed to prevent friendships from decaying (Dunbar, 2016).
  • “There’s no lack of intelligence among young people, but they do have less experience focusing for longer periods of time and reading long-form text,” she said. “Being able to read long-form text is crucial for understanding complex issues and developing critical thinking skills.”
• Many of the CEOs of big tech companies don’t even allow their children to own phones and send their kids to tech-free schools (Lopez, 2020).
• One of the early senior executives at Facebook, Chamath Palihapitiya, has been very vocal about the dangers of social media in our society; see a segment of an interview he did alongside former president of Facebook, Sean Parker, below.

While technology and social media does have many benefits:

• sending and receiving information is now at our fingertips
• it can save us time
• it can help us connect with people
• it can be used to educate ourselves

The dangers of social media to our health and our ability to connect socially with one another needs to be recognized.

• It is imperative that we develop a balance between screen-time and non-screen activities.
• It is also important that we minimizing the power we give technology to lure our attention away from a more conscious way of living where our time is used to serve ideals that really matter to us.

From the beginning of our lives, we are wired to connect.

• Oxytocin is the hormone produced in nerve cell bodies in the hypothalamus and then released into the bloodstream from the posterior pituitary.
• First, as a newborn, the sound of her baby’s cry, prompts the production of oxytocin in the mother.
• This hormone serves as a signal for the mother to bond with her child, as it causes milk let down for breastfeeding.
• Oxytocin is not just released in a mother when she hears her baby crying, but it also has other functions in addition to milk let down.

Oxytocin continues to be released throughout our lives

There is evidence that oxytocin is released with:

• holding hands
• hugging
• massaging
• sexual intimacy
• seeing other people in need
• petting animals

The effects of oxytocin include (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012):

• Feel more comfortable in approaching strangers in social situations or distressing situations
• Allows us to feel more comfortable helping others
• “It increases eye contact, empathy, face memory, trust, social skills, positive self-perception, and generosity and decreases depression”
• Facilitate a social attunement, activating more for social stimuli (faces) and activating less for nonsocial stimuli (cars) (Martino et al., 2017)
• Has anti-stress effects as it helps to reduce the glucocorticoid levels
• Can increase functioning of the gastrointestinal tract allowing for better digestive function, growth, and restoration

Oxytocin has “feel-good” effects

There is evidence that oxytocin improves our health by working cooperatively with other neurotransmitters:

• γ-aminobutyric acid (GABA)–inhibitory neurons for anti-anxiety
• serotonin, a neurotransmitter involved in mood regulation
• dopamine, a neurotransmitter involved with the nucleus accumbens and the reward system creating feelings of pleasure

Oxytocin and pets

• Studies have shown that interacting with animals specifically with dogs can have a positive effect on the level of oxytocin in people. This is generally more effective for woman.
• Stroking a dog for five to 24 minutes saw increases in oxytocin, dopamine, prolactin, and phenylacetic acid. This effect was stronger for those with a stronger connection/bond to the dog. i.e., Actually owning the dog vs. not owning it. (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012)
• Interactions between the dog and women saw increases in oxytocin levels after coming home from work but not for men. (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012)
• Stroking and talking to a dog for three minutes helped to increase oxytocin levels in female owners. (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012)
• As such human to animal interactions can be beneficial in providing an individual with a reduction in fear, stress, anxiety and it can help to reduce physiological stress responses. (Beetz, Uvnäs-Moberg, Julius, & Kotrschal, 2012)

The popular book by Dr. Gary Chapman “5 Love Languages” has helped a lot of people reconnect.

The premise is that we all think differently. And we all speak differently. And we all have different tastes and preferences. We all have unique ways in which we prefer to express love and receive love.

Like this, each person can be seen as speaking a different love language.

• What happens if you don’t get lucky and wind up dealing with someone with whom you speak the same (love) language?
• Is it doomed to failure?
• Or can you learn their (love) language? And them yours?

Learn your love language so you can show people what works for you.

• Learn others’ love languages so you can draw the best version out of them.
• The encounters will be more fun and fulfilling.

The Five Love Languages

Words of affirmation

This refers to the receiving of affirmations

One may have to teach loved ones what works for them by using positive language and feedback, or by setting an example. Additionally, learning your loved ones’ languages, and practicing them, can aid in setting up a more dynamic and positive relationship.

This can include things like:

1. Giving compliments
   • can be very helpful in getting people to relax and respond to you assertively, and in fostering and maintaining positive relationships.
2. Words of encouragement
   • Inspiring courage in another individual.
   • This does not mean to pressure someone into doing something.
   • Rather it is to aid them using encouraging language when they express a desire to commit to a new job, task, or activity.
3. Kind Words
   • Words of affirmation, kindness, and empathy are often better than words of anger, harshness, and contempt.
   • Choosing to act in forgiveness can often aid in moving relationships forward rather than holding onto the past and holding grudges.
   • Tone of voice is important when discussing situations in which one has been wronged (either you or another). The way in which something is said can cause someone to act very differently.
4. Humble Words
   • Requests instead of demands are more likely to foster and improve relationships with others.
5. Speaking kindly about others will often reverberate and come back to you.
   • E.g., saying a nice thing about a friend, partner, etc. to their mother, boss, another friend etc. Can improve your relationship with that person and adds to a culture of positivity.
6. Keeping track of words of affirmation that you hear in day-to-day life
   • to add to your repertoire can give you more tools in feeling happier and more connected to others.

Quality Time/Focused attention

1. Providing your partner with focused attention…

while also informing them of your desire for focused attention – can also aid you in setting up a relationship that flows more smoothly.

• Giving people undivided attention and allowing yourself to be present in the moment is a good way to maintain a positive relationship with the individual you are connecting with. Additionally, doing this will aid you in feeling more joy out of the situation and being more mindful.
• Listening to and hearing people out for what they are saying. Asking genuine questions and trying to see their point of view and frame of mind is often more helpful than attempting to solve their problem.
• Active listening is a skill that often requires practice and honing
  • A common exercise is for patients to describe a challenge they faced, or something they went through, and then the listener has to sift through it all to find the positive aspects,
    • e.g., I failed the dental school exam 3 times…  That shows a lot of persistence and determination (rather than the negative aspect, maybe you’re not cut out to be a dentist.)

2. Language is important

The way in which we speak is important to a assertive conversation. Expressing oneself and allowing oneself to express emotions and feelings can help in developing personal relationships. Telling someone how you felt during a situation rather than trying to identify what happened in the situation is an important way to progress conversation. You can only truly ever know your own perspective and/or emotions, and even then, that’s not always the case.

• Be open to trying new activities with another person.
  • This does not mean that you have to like the activity, but if you would like to continue spending time with this person it may be beneficial to continue partaking in the activity.
  • E.g., many parents find their childrens’ childish games boring, often not knowing the rules of the game their kids invent on the fly. However, many are not sorry for being open and available to the game as many cute stories and excellent bonding comes from it. Many focus on the cuteness of their children, their innocence, their presence, their appreciation for their complete attention, and recognize that this won’t always be the case. Positive reframe of situation can help to strengthen bonds and formulate memories.

Giving/receiving Gifts

Gift giving is a way in which one can express love and appreciation for another individual.

• Often the gift represents sacrifice: that you appreciate that person enough to spend your time, money and/or effort to give them a thoughtful gift.
• Thoughtful gifts are often validating of a relationship; often showing the person that you have paid attention their tastes and preferences, and that you are celebrating it with them.
• We refer to this spirit of gift giving when we say “it’s the thought that counts”.
• Sometimes the best gift we can give is the gift of being present.

Acts of Service

Acts of service are things that you do for others.

• Making requests of people rather than demands is often better for developing long lasting and caring relationships.
• It is important to recognize that this “Act of Service” is made in the spirit of not expecting anything back in return; it is not a barter system.
• For an act of service to qualify as one of the love languages, one must do acts of service with the idea of love in their mind; love being the purpose of the act, in and of itself.
  • A desire to do these actions because we actually care about the person and have a desire to do them is important. Not just to do something because we think it is right, or are afraid of what would happen if we did not do them.

Physical Touch

Sometimes small appropriate touches can be beneficial in the development of relationships with others.

• These consensual and appropriate touches can be as simple as giving a hug when seeing someone, or putting your hand on a shoulder, or touching their back, etc.
• In most cases these touches will likely be seen as more intimate and will be dictated by the context of the relationship.

The premise to Emotionally Focused Therapy is that secure bonds with attachment figures efficiently improves our physical and psychological health.

• Secure bonds have been shown to even decrease fear and the pain experience on functional MRI images (discussed above in the first section “Benefits of Social Connectedness > Social Connection and the experience of pain”.

What defines a secure bond?

• It doesn’t have to be “perfect” (whatever that means)
• It requires one to be (pneumonic is A.R.E.):
  • Available/open, “Are you there for me? Can I reach you?”
  • Responsive, “Will you respond when I call?”
  • Engaged, “Do I matter to you?”

According to Dr. Susan Johnson (2019), she says we need to learn to step out of negative patterns and shape A.R.E. conversations.

While this approach can be used for all relationships, her approach to this in couples is:

1. Recognizing Demon Dialogues

• Vicious cycles in relationships, kind of like themes to your fights
  • “The more you do this, the more I feel that”
  • Fight or flee takes over
• Demon Dialogues are the enemy of secure connection.
• Partners need to stand together against them. Help each other see them and slow them down.
• When we reach for someone, we take a risk and become vulnerable.
  • If that person doesn’t respond, we may start coping in other ways like angry blaming or other methods that were learned in early relationships.

2. Finding the Raw Spots

• These are sensitivities from temperament, attachment histories, present relationship, traumas, etc.
• Vulnerability comes with love. Choice is in how to deal with this.
  • In secure bonds, we can share and soothe sore places, trust deepens.
  • With more insecure bonds, we end up feeling helpless, abandoned, rejected, etc.
  • We then turn up negative emotions up (anger to feel more in control) or off (we detach and avoid so they can’t hurt us)
  • And we hit each other’s raw spots and make the other feel
  • And we enter into demon dialogue

3. Revisiting a Rocky Moment

• In therapy, the therapist revisits a rocky moment with the patients.

4. Engaging and Connecting

• Collaboratively, the patient(s) and the therapist rescript Demon Dialogue to create an A.R.E. conversation by
  • honouring peoples vulnerabilities and needs for a secure bond.
  • helping foster support for vulnerabilities and emotional needs that will facilitate a secure bond.

5. Forgiving Injuries

• Forgiveness has been discussed elsewhere on this website.

6. Keeping Your Love Alive

• There are many ways to commemorate your secure bond and practice A.R.E. conversations.
• This is collaboratively done between the patient(s) and the therapist.

Cognitive Behavioural Therapy can be helpful in becoming more aware of some of the things you’ve been telling yourself about Social Connectedness:

• And whether those things are actually accurate?
• And whether those things are actually helpful?
• And if there is a more adaptive way of seeing things that will see you getting on better in a way that you would prefer

We have discussed this in greater detail in other places in this website:

• In this article, the section “Hurdles to being Socially Connected > Negative Cognitions”
• Socratic Dialogue
• Language & Recovery
• Cognitive Behavioural Therapy (CBT)

Have you seen retired people change their minds and go back to work?

There is this old Japanese philosophy known as Ikigai that explains this.

• In fact, pretty much all cultures have a similar philosophy (“Joie de vivre”, etc.) but Ikigai has gained traction internationally in the last decade so we will go with it.

A brief summary of Ikigai

• A way of balanced living that promotes physiological and psychological harmony
• Ikigai – an ideal state of being – is the reward, in and of itself, to living at the intersection of the four domains illustrated below:

en:User:Nimbosa derived from works in the PUBLIC DOMAIN by Dennis Bodor (SVG) and Emmy van Deurzen (JPG), CC BY-SA 4.0 <https://creativecommons.org/licenses/by-sa/4.0>, via Wikimedia Commons

Social Connectedness and Ikigai

Choosing to include all 4 of these categories in your quest for Ikigai will necessarily see you connecting socially with others. As such, Social Connectedness can be seen as one of the paths to Ikigai.

Social Connectedness and Altruism

Altruism can be seen as comprising of some or all of the subsets of Ikigai in the diagram above: it really depends on your perspective.

I’m reminded of something my grandmother told me that stuck with me:

“You have to give love to get love”

Providing altruistic acts to others means to act selflessly. It activates the reward system in our brain. This again makes us feel better and more positive despite not actually receiving anything.

It has been called “the gift of giving.” It can be a very strong motivator for human action. Some examples:

a. Chuck Feeney gave $8 billion away to those less fortunate, and kept $2 million for his family.

b. Gandhi made it his life’s purpose (by spending his time, effort and money) to serve his country and the ideals of freedom.

c. Bob Marley, having passed away at the young age of 36 was said to have been motivated by helping others. Countless examples have been given in the media, and Jamaica commemorates his birthday on February 6th each year.

This is what Bob Marley had to say about wealth:

Studies have shown that people actually prefer to see other people succeed with them rather than just succeeding alone.

• A study showed that when offered the opportunity to lose money that would be in turn given to a charity, it brought donor happiness and saw more reward activity in the brain than the group of people who received the money (Liberman, 2013).

“If you would like to be selfish, you should do it in a very intelligent way. The stupid way to be selfish is the way we always have worked, seeking happiness for ourselves alone and in the process becoming more and more miserable. The intelligent way to be selfish is to work for the welfare of others.”

-The Dalai Lama

Assertiveness is a interpersonal communication style that is borne from self-esteem.

Assertiveness is defined as:

Assertive self-expression is direct, firm, positive – and, when necessary, persistent – action intended to promote equality in person-to-person relationships. Assertiveness enables us to act in our own best interests, to stand up for ourselves without undue anxiety, to exercise personal rights without denying the rights of others and to express our feelings and needs (affection, love, friendship, disappointment, annoyance, anger, regret, sorrow) honestly and comfortably (Alberti & Emmons, 2008).

Assertiveness allows us to express ourselves in a way that sees thought, word and deed harmoniously aligned.

To have the freedom to express ourselves will give us more comfort and confidence in connecting socially. The ability to feel free to express ourselves steeped in self-esteem in different contexts depends on our:

1. skills in assertiveness, and/or
2. awareness of our assertiveness skills, so that we consciously use them as many of us discount the strengths we have.
   • Discounting our strengths is known as the “Taking-strengths-for-granted Effect” (Niemiec, 2013, p.29).

For example, we once worked with a senior executive who found himself working 6 days per week after succumbing to pressure from his superiors to ignore medical advice regarding return-to-work planning, and that the company needs him. This was adversely affecting his health and he resented his boss and himself for allowing this to happen.

• We had him model what he would say to his boss in advocating for himself (i.e., that he needs to follow medical recommendations and not work this much).
• After he played out what he would say, we asked him how he thinks that went over?
• He said that it didn’t go over well.
• We invited him to have another crack at it.
• This time he was satisfied with his performance. The interesting thing is that he between these two takes, he did not have any Assertiveness training. In fact, in hindsight (i.e., it was obvious after the second take) that he had all the assertiveness skills he needed, but he just wasn’t using them.

Assertiveness Training

Some of us could use Assertiveness training to help equip us with the skills to express ourselves in a way that sees thought, word and deed harmoniously subservient to our self-esteem.

Others could use more awareness that we have the skills sitting there for us to use, we just have to consciously engage them.

The connection between Social Connectedness and our health was suspected even 60 years ago.

The psychiatrists Holmes and Rahe wanted to study the connection. In doing so, they were able to devise the Social Readjustment Rating Scale (or the Holmes and Rahe Stress Scale).

The premise is that many things we do and/or face will take a toll on our health, and everyone has a limit to how much they can “go through” in a year. In fact, on average, they find that we can have an annual allowance of 150 points where each event is assigned a score proportional to how stressful it is.

You can check out the Social Readjustment Rating Scale (or the Holmes and Rahe Stress Scale) here. Note that children and adults have different scales.

Many stressful events involve changes in Social Connectedness:

• Death of a spouse (100 points)
• Divorce (73 points)
• Marital separation (65 points)
• Death of a close family member (63 points)
• Fired at work (47 points)
• Marital conciliation (45 points)
• Retirement (45 points)
• Gain of new family member (39 points)
• Death of close friend (37 points)
• Son or daughter leaving home (29 points)
• Trouble with in-laws (29 points)
• Begin or end school/college (26 points)
• Change in residence (20 points)
  • There is a link between moving houses in childhood/teenage years and health outcomes (Webb et al., 2016)
• Change in school/college (20 points)
• Change in recreation (19 points)
• Change in church activities (19 points)
  • While prayer is a hard thing to study, many people find it helps them on many levels
  • one-on-one in-person prayer has been seen to be helpful for depression and anxiety (Boelens et al., 2009)
• Change in social activities (18 points)

For Children, the same pattern is highlighted except that change in Social Connectedness is more impactful (i.e., carry higher stress scores)

• e.g., Change in acceptance by peers (67 points)

HOW TO USE THIS SYSTEM TO MAKE MORE INFORMED DECISIONS

Many of us were not aware that seemingly mundane, everyday occurrences can be so taxing on our “stress buffer system”.

Knowledge of this can go a long way in helping you make decisions so that you don’t go “over budget”.

It also normalizes how we feel so we don’t unnecessarily criticize ourselves for being “weak”, etc.

• For example, say you move houses as part of downsizing when your kid goes off to college, and as a result, have changed your religious congregation, your chess club and also your exercise routine.
• Maybe it’s not accurate to write it off as “getting old” or “first-world problems”.
  • We know that these lifestyle changes are associated with a certain amount of stress and wear down our resilience.
  • We also know that self-criticism is a secondary emotion (discussed above in the section “Hurdles to Being Socially Connected” that is counterproductive and can worsen our physiological and psychological health (Selby et al., 2008).
• Perhaps, this would not be the year that you should retire, or perhaps it’s worth the drive to your old religious congregation for the first year if you don’t want to overburden your “resiliency bank”.

We all have things we have to do every day.

Incorporating social engagement in the context of what we are already doing can be an efficient way to take care of our business, but also reap the benefits of Social Connectedness.

Many of the things we have planned for our days can be scheduled in a way to leverage social interactions.

1. Eating

• We can make an effort to eat together.
• People often comment that the food tastes better when they can enjoy it with others.
• Some studies show that there is a positive association between the frequency of family meals and academic performance and general well-being (Eisenberg et al., 2004).
• It has been romanticized by many artists.

2. Chores, drives to work

• While doing house work or other tasks you can reach out to friends and family over the phone (and practice your 5 love languages:)
  • If staying close to your family or someone is a priority, and you’re short on time, this is a good opportunity to use your time efficiently and put a deposit in your “relationship bank account”

3. Exercise

• Exercising with other is motivating and more likely to see us stick to a regimen.
• It also sees people generally in a more relaxed mood so that you tend to have a better social interaction.
• It may be something you start looking forward to.

4. Asking for help/giving help

• Often, many of us have unique strengths, and we have other areas where others may be stronger than us.
• This is a great opportunity to help one another leverage each others strengths to save time and also socialize.
  • e.g., if you mom is good at hemming pants and you are better at manual labour, you could arrange to bring your pants over for her to hem while you mow her lawn and then you can have lunch together before you go home to your other tasks.

5. Projects

• Finding like-minded people with whom to share projects can help satisfy many agendas including Social Connectedness.

Keep in mind that We tend to tap out around 3 hours/day of social activity

1. Make it a goal and start planning more social activities

• Your goal will generally be any antonym of loneliness, i.e., sense of community, family, belonging, social equity, social capital
• If you want social stuff to happen man, you need to plan social stuff
• Feel free to use the Input-Output Chart for this process.

2. Avoid ruminating

• Ruminating about things that make you feel bad, or simply ruminating over feeling bad itself, can lead to you to take on dysregulated behaviours in order to distract from rumination (Selby et al., 2008).
• Co-ruminating (ruminating with someone else) is also unhelpful.

3. Beware of secondary emotions

• These have been discussed in the section above (“Hurdles to Being Socially Connected”)
• Often people who feel lonely criticize themselves or feel embarrassed.
• We know that secondary emotions are counterproductive to our physiological and psychological health including our self-esteem (Resick et al., 2017).

4. Ostracism

• Ostracism is often is not based on any moral benchmark, but rather, to get rid of discomfort by the majority (of a group), even if at your own expense.
• Ostracism is real, and often acceptance is a good first step to free yourself from its grips.

5. Maybe your reasons for not being more Socially Connected could require more thought

• Critical thinking is often helpful in deciding if your decision is really accurate or in your best interests.
• Central to this is metacognition, or the ability to see your thought as a thought, and not necessarily a fact
• Maybe, upon further thought, it is in your best interests to be more Social Connected and the reasons you have been giving yourself for not doing it are overly emphasized, or discounting more important counter arguments.
• Some articles that discuss this further are:
  • https://torontoconcussion.ca/terminology/decision-making-style/
  • https://torontoconcussion.ca/terminology/socratic-dialogue/
  • https://torontoconcussion.ca/terminology/language-recovery/

6. Take the UCLA Loneliness Scale to gain some objectivity

• Sometimes having a scale gives you a sense of where you are now and where you want to go.

7. The Kitchen counter paradox

• Kitchen counters used to be made of arborite which had seems and swelled up (not as pretty), but there were a lot of people around them.
• Nowadays, we have fancier counters but nobody is there (everyone is working!)
• We have to recognize that we have to make an effort to socialize since our culture has become work-driven.

8. Put down your devices

• Communication is an interactive process that supports growth and development. When the child or a person reaches out and there is no response. The detrimental effect of interrupting facial responsiveness is demonstrated by the research of University of Massachusetts’s Distinguished University Professor of Psychology Edward Tronick (Goldman, 2010; Tronick et al, 1975)
• Nonverbal components comprise a significant part of the communication (Lapakko, 2007; Kendon, 2004).
• Recognize that being distracted by cellphone notifications and not being present are emotional bond breakers, thus implement behaviors that build social connections.

9. Check for hearing loss

• Hearing loss can be associated with becoming more socially isolated (Mick et al., 2018).

10. Beware of complaining and reassurance-seeking

• Over-disclosure can be off-putting and steer people away from you
• It can also be a sign of lack of assertive behaviour or anger management issues

11. What’s your relationship “cash flow”?

• Are you making deposits in your “relationship bank account”? Or are you making more withdrawals?

12. Character criteria for friendship

• “There is nothing which causes people to display worse carelessness, and pay graver penalties, than their selection and acquisition of friends.”  – Cicero
• That is to say, do not be too quick to form an attachment; make quite sure first that you are not attaching yourself to someone who does not deserve the association.
• The people who merit your friendship are those who genuinely possess some characteristic capable of inspiring devotion.

13. Do a portfolio analysis

• for those patients that do have a social network, but it needs to be tweaked a bit, just like when a financial portfolio needs to be optimized.
• That is, good relationships can receive more time/effort investment, worse relationships can be receive less.
• You will need to answer what defines a relationship as good for you…what are you hoping to get out of this relationship? Are you getting it?

14. Accept friend “shifts”:

• Accept the times change and people change. e.g., Just because you were friends in highschool doesn’t mean you have to stay friends now.

15. Adult sibling relationships

• e.g., Cain and Abel had issues
• At a genetic level, no two kids have the same parents
• you don’t have to create secondary emotions (i.e., embarrassment, shame, guilt, self-criticism) if you don’t have the “ideal” relationship with siblings.

16. Favoritism creates tension

• displays of favouritism towards one child can have long-term health implications on the child who did not receive thesame affection.
• Research has shown that dads who play favourite may precipitate more adverse consequences than moms who do the same (Gilligan et al., 2013).

17. Matrilineal advantage

• It is normal to feel closer to our mom’s family.
• Mothers are usually the key figure in child rearing.
• Grandchildren are usually closest with their maternal grandma (Pashos, 2017)

18. Transcend hurt

• Sometimes forgiveness is the most useful approach.
• Remember, forgiveness does not mean you condone the action
• Maybe you got a point, and your wife shouldn’t have done that 10 years back, but is there another priority that trumps dwelling on that nowadays?

19. Share novel experiences (rather than generic experiences)

• New experiences tend to be more memorable and create more of a bond.

20. Beware of cognitive vulnerability

• During major life events/transitions, you may pick up another person’s cognitive style (and its consequences) just by associating with them (Haeffel et al., 2014).

21. Get a pet

• Pet therapy is a real thing with two medical journals devoted to the topic.

22. Minimize moving houses

• There is a link between moving houses in childhood/teenage years and adverse health outcomes (much more depression, substance use, suicidal ideation and violence) if the move was far enough to move schools (Webb et al., 2016).
• If you have to move, it’s better to do so before the teenage years, but generally, the earlier the better.
• The risk of increasing adverse effects from moving starts to increase around 8-years-old.

23. Liven up your décor/surroundings

• Feel-good music and pictures, less politics, etc. can increase your self-esteem.

24. Use a Point system

• Email communication can be 1 point; Phone call can be 10 points; Face-to-face can be 25 points; etc.

25. Practice assertiveness and other love languages (positive emotions)

• Affection, admiration, sympathetic joy (e.g., I’m really happy your child was born healthy), gratitude, reminiscing, apology, loyalty, etc. can be helpful.

26. There are limits to socializing

• We tend to tap out around 3 hours/day of social activity

The dangers of new technology on our lives was discussed in the section “Hurdles to being Socially Connected”.

As such, one of the first steps in safely Socially Connecting virtually is to safeguard our time and attention from overly obtrusive technology use.

Safeguarding our lives from Overly obtrusive Technology Use

1. Legislation: SMART Act (USA) targets acts that exploit human psychology:
   • Infinite scroll or auto-refill (e.g., like used in many social media platforms)
   • Autoplay (e.g., like used by online movie streaming sites)
   • Badges and other awards linked to engagement with the platform
2. Learn to strike a balance between leisure and school/work
3. Set a good example for your kids
4. Monitor and/or block screen time
   • e.g., “Rescue Time” App can monitor your time on specific apps on your computer or your phone. It can also provide you with reports and insights about how you spend your time throughout the day.
5. Earn screen time:
   • e.g., www.yourmodernfamlyshop.com
6. Digital detox:
   • Try to take time away from your devices through digital detox methods. Locking away your phone in a container and taking up physical socialization activities is a good way to reconnect with yourself and others.
   • quitting Facebook leads to higher levels of well-being.
   • Screenfree.org has a campaign kit you can download to help you with digital detox, and you can get a certificate of achievement too.
7. Formal CBT:
   • CBT has been found to be promising in the treatment of a broad range of internet addictions (Wölfling et al., 2019).
8. Replacing negative internet addictions with positive ones like running or learning a language using Duolingo.
   • There are many gamified learning apps, e.g., Duolingo, Khan Adacemy, Coursera, Udemy, Tinycards, Blinist, Sololearn, etc.
     • These applications are engaging, educational, fun, and provide many opportunities for people to interact and socialize with.
9. Consider using organizational tools like Google Calendar to more effectively focus your time and provide yourself with a schedule that you can follow.
10. Judiciously engage in Social Media apps.
    • Good and responsible use of social media can help us to feel more connected to other people. Use facebook, twitter, instagram, etc. to join groups in your community and to begin feeling more connected with others.
    • Consider the use of watchparty applications like  the appropriately named “watchparty” or the netflix companion extension “teleparty”. Both of these can be added to your computer so that you can watch shows with friends or family who may not be at home with you or who live far away.
    • Many board games have online variants that can be played with friends and family even when people are not nearby or in the same household. (e.g. Catan, backgammon, Skribblio).
    • Exercise clubs and apps can help you feel part of something bigger, or be part of a team, as you work towards your goals.

ZOOM

As a result of the CoVID-19 virus, many of us have taken to zoom to meet professionally and personally.

Dr. Erik Peper in his blog, The Peper perspective, reviews many helpful hints to allow us to Social Connect more over zoom:

1. Arrange your camera so that your face and upper torso is very visible, there is no backlight and glare, and you are looking straight at the camera.
2. Provide dynamic visual feedback by exaggerating your responses (nod your head for agreement or shake your head no for disagreement).
3. When presenting, have a collaborator monitor the Chat, and if possible have them shift back and forth between share screen and speaker view so that the speaker can focus on the presentation.
4. Use a separate microphone to improve sound.
5. If the screen freezes or the sound warbles often an indication of insufficient bandwidth, turn off the video to improve the sound quality.

Safeguarding your human interactions from being hijacked by devices

Dr. Peper also offers the following tips to help facilitate social bonding in the age of beeping devices and social media.

1. Share with your friends that you feel dismissed when they interrupt your conversation to check their cell phone.
2. When meeting friends, turn off the cell phone or put them away in another room so not to be distracted.
3. Schedule digital free time with your children.
4. During meal times, turn off cell phones or put them in another room.
5. Attend to the baby or child instead of your cellphone screen.

Ainsworth, M., Blehar, M., Waters, E., & Wall, S. (1978). Patterns of Attachment. Hillsdale, NJ: Erlbaum.
Alberti, Robert; Emmons, Michael. Your Perfect Right: Assertiveness and Equality in Your Life and Relationships. Impact; 9th Edition (May 21, 2008).
Alter, A. (2017). Irresistible: The rise of addictive technology and the business of keeping us hooked. Penguin Press.
Boelens PA, Reeves RR, Replogle WH, Koenig HG. A randomized trial of the effect of prayer on depression and anxiety. Int J Psychiatry Med. 2009;39(4):377-392. doi:10.2190/PM.39.4.c
Brennan, K. A., Clark, C. L., & Shaver, P. R. (1998). Self-report measurement of adult romantic attachment: An integrative overview. In J. A. Simpson & W. S. Rholes (Eds.), Attachment theory and close relationships (pp. 46-76). New York: Guilford Press.
Brignull, H. (N/A). Types of Dark Pattern. Dark Patterns. https://www.darkpatterns.org/types-of-dark-pattern
Buckner RL, Andrews-Hanna JR, Schacter DL. The brain’s default network: anatomy, function, and relevance to disease. Ann N Y Acad Sci. 2008;1124:1-38. doi:10.1196/annals.1440.011
Busby, M. (2018). Social media copies gambling methods ‘to create psychological cravings’. The Guardian. https://www.theguardian.com/technology/2018/may/08/social-media-copies-gambling-methods-to-create-psychological-cravings
Carter B, Rees P, Hale L, Bhattacharjee D, Paradkar MS. Association Between Portable Screen-Based Media Device Access or Use and Sleep Outcomes: A Systematic Review and Meta-analysis. JAMA Pediatr. 2016;170(12):1202-1208. doi:10.1001/jamapediatrics.2016.2341
Chang A-M, Aeschbach D, Duffy JF, Czeisler CA. 2015.Evening use of light-emitting eReaders negatively affectssleep, circadian timing, and next-morning alertness. ProcNatl Acad Sci. 112:1232–1237.
Chotpitayasunondh, Varoth & Douglas, Karen. (2018). The effects of “phubbing” on social interaction. Journal of Applied Social Psychology. 10.1111/jasp.12506.
Demos, John N. Getting Started with EEG Neurofeedback. W.W. Norton & Company; 2nd Edition (2019).
Dunbar, R.. (2016). Do online social media cut through the constraints that limit the size of offline social networks?. Royal Society Open Science. 3. 150292. 10.1098/rsos.150292.
Eisenberg ME, Olson RE, Neumark-Sztainer D, Story M, Bearinger LH. Correlations between family meals and psychosocial well-being among adolescents. Arch Pediatr Adolesc Med. 2004;158(8):792-796. doi:10.1001/archpedi.158.8.792
Eisenberger, N. (2012). The neural bases of social pain: Evidence for shared representations of with physical pain. Psychosomatic Medicine, 74(2), 126-135. doi: 10.1097/PSY.0b013e3182464dd1
Ekman, P. (1992). An argument for basic emotions. Cognition and Emotion, 6(3-4), 169–200. https://doi.org/10.1080/02699939208411068
Elkin I, Shea MT, Watkins JT, et al. National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. Arch Gen Psychiatry. 1989;46(11):971-983. doi:10.1001/archpsyc.1989.01810110013002
Elfenbein, H. A., & Ambady, N. (2002). On the universality and cultural specificity of emotion recognition: A meta-analysis. Psychological Bulletin, 128(2), 203–235. https://doi.org/10.1037/0033-2909.128.2.203
Fraley, R. C. (2018). Adult Attachment Theory and Research: A Brief Overview. University of Illinois at Urbana-Champaign, Department of Psychology. Retrieved from http://labs.psychology.illinois.edu/~rcfraley/attachment.htm.
Fraley, R. C., & Shaver, P. R. (2000). Adult romantic attachment: Theoretical developments, emerging controversies, and unanswered questions. Review of General Psychology, 4, 132-154.
Fraley, R. C., Waller, N. G., & Brennan, K. G. (2000). An item response theory analysis of self-report measures of adult attachment. Journal of Personality and Social Psychology, 78, 350-365.
Frazier, P. A., Byer, A. L., Fischer, A. R., Wright, D. M., & DeBord, K. A. (1996). Adult attachment style and partner choice: Correlational and experimental findings. Personal Relationships, 3(2), 117–136. https://doi.org/10.1111/j.1475-6811.1996.tb00107.x
Fridlund, A. J., Ekman, P., & Oster, H. (1987). Facial expressions of emotion. In A. W. Siegman & S. Feldstein (Eds.), Nonverbal behavior and communication (p. 143–223). Lawrence Erlbaum Associates, Inc.
Gandhi, Mahatma; Dalton, Dennis (1996). Selected Political Writings. Hackett Publishing Company. ISBN 978-0-87220-330-3.
Gilligan, Megan & Suitor, J. & Kim, Seoyoun & Pillemer, Karl. (2013). Differential Effects of Perceptions of Mothers’ and Fathers’ Favoritism on Sibling Tension in Adulthood. The journals of gerontology. Series B, Psychological sciences and social sciences. 68. 10.1093/geronb/gbt039.
Goldman, J.G. (2010). Ed Tronick and the “Still Face Experiment.” Scientific American, Oct 18.
Haeffel, G. J., & Hames, J. L. (2014). Cognitive vulnerability to depression can be contagious. Clinical Psychological Science, 2(1), 75–85. https://doi.org/10.1177/2167702613485075
Hazan, C., & Shaver, P. (1987). Romantic love conceptualized as an attachment process. Journal of Personality and Social Psychology, 52(3), 511–524. https://doi.org/10.1037/0022-3514.52.3.511
Heine L, Soddu A, Gómez F, et al. Resting state networks and consciousness: alterations of multiple resting state network connectivity in physiological, pharmacological, and pathological consciousness States. Front Psychol. 2012;3:295. Published 2012 Aug 27. doi:10.3389/fpsyg.2012.00295
Holt-Lunstad, Julianne & Smith, Timothy & Baker, Mark & Harris, Tyler & Stephenson, David. (2015). Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review. Perspectives on Psychological Science. 10. 227-237. 10.1177/1745691614568352.
Holt-Lunstad J, Robles TF, Sbarra DA. Advancing social connection as a public health priority in the United States. Am Psychol. 2017;72(6):517-530. doi:10.1037/amp0000103
Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7(7):e1000316. Published 2010 Jul 27. doi:10.1371/journal.pmed.1000316
Inagaki, T. K., Hazlett, L. I., & Andreescu, C. (2020). Opioids and social bonding: Effect on naltrexone on feelings of social connection and ventral striatum activity to close others. Journal of experimental psychology, 149(4), 732-745. DOI:10.1037/xge0000674
Jang KL, Livesley WJ, Vernon PA. Heritability of the big five personality dimensions and their facets: a twin study. J Pers. 1996;64(3):577-91.
Johnson, S.M. (2019) Attachment Theory in Practice: Emotionally Focused Therapy (EFT) With Individuals, Couples, and Families. New York: Guilford Press
Kendon, A. (2004). Gesture: Visible Action as Utterance. Cambridge, England: Cambridge University Press ISBN-13 : 978-0521835251
Kiecolt-Glaser JK. Marriage, divorce, and the immune system. Am Psychol. 2018;73(9):1098-1108. doi:10.1037/amp0000388
Kiecolt-Glaser JK, & Wilson SJ (2017). Lovesick: How couples’ relationships influence health. Annu Rev Clin Psychol, 13(1), 421–443. doi:10.1146/annurev-clinpsy-032816-045111 [PMC free article] [PubMed] [Google Scholar]
Kiecolt-Glaser JK. (February 2017). Do Social Ties Affect Our Health: Exploring the Biology of Relationships. NIH: News In Health. Retrieved from https://newsinhealth.nih.gov/2017/02/do-social-ties-affect-our-health.
Lapakko, D. (2007). Communication is 93% Nonverbal: An Urban Legend Proliferates. Communication and Theater Association of Minnesota Journal, 34, 7-19.
Leon G. R., Gillum B., Gillum R., & Gouze M. (1979). Personality stability and change over a 30-year period—middle age to old age. Journal of Consulting and Clinical Psychology, 47, 517–524. 10.1037/0022-006X.47.3.517
Lindsay-Smith, G., O’sullivan, G., Eime, R., Harvey, J., & van Uffelen, J. G. Z. (2018). A mixed methods case study exploring the impact of membership of a multi-activity, multicentre community group on social wellbeing of older adults. BMC Geriatrics 18(1). https://link.gale.com/apps/doc/A557668333/AONE?u=king56371&sid=AONE&xid=afce9895
Lopez C. (March 5, 2020). 6 tech executives who raise their kids tech-free or seriously limit their screen time. The Business Insider. Retrieved from https://www.businessinsider.com/tech-execs-screen-time-children-bill-gates-steve-jobs-2019-9.
Mars RB, Neubert FX, Noonan MP, Sallet J, Toni I, Rushworth MF. On the relationship between the “default mode network” and the “social brain”. Front Hum Neurosci. 2012;6:189. Published 2012 Jun 21. doi:10.3389/fnhum.2012.00189
Martino J, Pegg J, Frates EP. The Connection Prescription: Using the Power of Social Interactions and the Deep Desire for Connectedness to Empower Health and Wellness. Am J Lifestyle Med. 2015;11(6):466-475. Published 2015 Oct 7. doi:10.1177/1559827615608788
Mcpherson, Miller & Smith-Lovin, Lynn & Brashears, Matthew. (2006). Social Isolation in America: Changes in Core Discussion Networks Over Two Decades. American Sociological Review – AMER SOCIOL REV. 71. 353-375. 10.1177/000312240607100301.
Mick P, Parfyonov M, Wittich W, Phillips N, Guthrie D, Kathleen Pichora-Fuller M. Associations between sensory loss and social networks, participation, support, and loneliness: Analysis of the Canadian Longitudinal Study on Aging [published correction appears in Can Fam Physician. 2018 Feb;64(2):92]. Can Fam Physician. 2018;64(1):e33-e41.
Mikulincer, M. & Shaver, P. R. (2005). Attachment theory and emotions in close relationships: Exploring the attachment-related dynamics of emotional reactions to relational events. Personal Relationships, 12(2), 149-168.
Niemiec, R. M. (2013). VIA character strengths: Research and practice (The first 10 years). In H. H. Knoop & A. Delle Fave (Eds.), Well-being and cultures: Perspectives on positive psychology (pp. 11-30). New York: Springer.
Orlowski, J. (director). (2020). The Social Dilemma [Film]. Exposure Labs. https://www.netflix.com/watch/81254224?trackId=14170286&tctx=2%2C0%2C79e28bdb-5924-45a8-bf78-6784fa3d3dd6-6240249%2Cb37a0ad1-2045-4c29-ad43-dc1069024ef9_5549912X3XX1603393030847%2Cb37a0ad1-2045-4c29-ad43-dc1069024ef9_ROOT%2C
Pashos, Alexander. (2017). Importance of Maternal Grandmother. 10.1007/978-3-319-16999-6_1192-1.
Peper, E. (Oct 13, 2020). Breaking the social bond: The immobilized face. The Peper Perspective. Retrieved from https://peperperspective.com/2020/10/13/breaking-the-social-bond-the-immobilized-face/.
Power RA, Pluess M. Heritability estimates of the Big Five personality traits based on common genetic variants. Transl Psychiatry. 2015;5:e604.
Resick, P. A., Monson, C. M., & Chard, K. M. (2017). .Cognitive processing therapy for PTSD: A comprehensive manual. The Guilford Press.
Schore, A. N. (1994). Affect regulation and the origin of the self: The neurobiology of emotional development. Lawrence Erlbaum Associates, Inc.
Selby, Edward & Anestis, Michael & Joiner, Thomas. (2008). Understanding the relationship between emotional and behavioral dysregulation: Emotional cascades. Behaviour research and therapy. 46. 593-611. 10.1016/j.brat.2008.02.002.
Shmerling, R. H. (Nov 30, 2016). The health advantages of marriage. Harvard Health Publishing: Harvard Medical School. Retrieved from https://www.health.harvard.edu/blog/the-health-advantages-of-marriage-2016113010667.
Simpson, J. A., Rholes, W. S., & Nelligan, J. S. (1992). Support seeking and support giving within couples in an anxiety-provoking situation: The role of attachment styles. Journal of Personality and Social Psychology, 62(3), 434–446. https://doi.org/10.1037/0022-3514.62.3.434
Simpson, Jeffry & Rholes, William & Phillips, Dede. (1996). Conflict in Close Relationships: An Attachment Perspective. Journal of personality and social psychology. 71. 899-914. 10.1037/0022-3514.71.5.899.
Spreng RN, Grady CL. Patterns of brain activity supporting autobiographical memory, prospection, and theory of mind, and their relationship to the default mode network. J Cogn Neurosci. 2010;22(6):1112-1123. doi:10.1162/jocn.2009.21282
Supekar K, Uddin LQ, Prater K, Amin H, Greicius MD, Menon V. Development of functional and structural connectivity within the default mode network in young children. Neuroimage. 2010;52(1):290-301. doi:10.1016/j.neuroimage.2010.04.009
Thompson, M. G., & Patterson, P. G. (1986). The Thompson-Patterson Scale of Psychosocial Development: I. Theoretical basis. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 31(5), 387–397.
Thompson, Michael; Thompson, Lynda. Functional Neuroanatomy. The Association for Applied Psychophysiology and Biofeedback 2015.
Tronick, E., Adamson, L.B., Als, H., & Brazelton, T.B. (1975, April). Infant emotions in normal and pertubated interactions. Paper presented at the biennial meeting of the Society for Research in Child Development, Denver, CO.
Twenge J M. (March 20, 2019). Chapter 5: The Sad State of Happiness in the United States and the Role of Digital Media. World Happiness Report 2019. Retrieved from https://worldhappiness.report/ed/2019/the-sad-state-of-happiness-in-the-united-states-and-the-role-of-digital-media/.
Twenge J M, Martin MA, Spitzberg, . (August 20, 2018). “Trends in U.S. Adolescents’ Media Use, 1976-2016: The Rise of Digital Media, the Decline of TV, and the (Near) Demise of Print”. Psychology of Popular Media Culture.
Umberson, D. & Karas Montez, J. (2010). Social relationships and health: A flashpoint for health policy. Journal of Health and Social Behavior. 51(S), 54-66.DOI: 10.1177/0022146510383501
Vancouver Foundation. (2015). Connections & Engagement Closer Look: 25 to 34-year-olds: Not exactly the time of their lives.
VanderWeele TJ, Hawkley LC, Thisted RA, Cacioppo JT. A marginal structural model analysis for loneliness: implications for intervention trials and clinical practice. J Consult Clin Psychol. 2011;79(2):225-235. doi:10.1037/a0022610
Wang, Hui-Xin & Mittleman, Murray & Orth-Gomér, Kristina. (2005). Influence of social support on progression of coronary artery disease in women. Social science & medicine (1982). 60. 599-607. 10.1016/j.socscimed.2004.05.021.
Webb RT, Pedersen CB, Mok PL. Adverse Outcomes to Early Middle Age Linked With Childhood Residential Mobility. Am J Prev Med. 2016;51(3):291-300. doi:10.1016/j.amepre.2016.04.011
Wilkinson A, Bowen L, Gustavsson E, et al. Maintenance and Development of Social Connection by People with Long-term Conditions: A Qualitative Study. Int J Environ Res Public Health. 2019;16(11):1875. Published 2019 May 28. doi:10.3390/ijerph16111875
Wölfling K, Müller KW, Dreier M, et al. Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial [published correction appears in JAMA Psychiatry. 2019 Sep 4;:]. JAMA Psychiatry. 2019;76(10):1018-1025. doi:10.1001/jamapsychiatry.2019.1676
Zeifman, D., & Hazan, C. (1997). A process model of adult attachment formation. In S. Duck (Ed.), Handbook of personal relationships: Theory, research and interventions (p. 179–195). John Wiley & Sons Inc.
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