Most Elders Are Lonely (and Will Die Earlier Than Their Peers)

Oversight Today

Proverbs 17:17 says, “A friend loveth at all times…” (KJV). The problem is, most of us do not have friends like that — especially if we exclude our wife from the count of close friends.

This is one of my longer posts but I feel the subject matter is especially important. I want to tell you why loneliness is such a problem and also report on a survey I ran for a number of months on Oversight Today, assessing just how prevalent this issue is among us before turning to some tactics we can use to address this very real challenge.

Why Loneliness Is a Problem

Loneliness is an experience that cannot be shared with anyone else.

It aches deep within our bodies: sometimes felt, oftentimes unacknowledged. A quiet but dreadful pang often unidentified and frequently buried under a flurry of busyness, numbed by “acceptable” addictions (e.g., food and work) and unacceptable addictions (e.g., pornography).

When I talk to overseers about loneliness one of the more common responses is: loneliness is just part of the work we do. It is a normal part of serving the Lord. And then we turn to platitudes: it really causes us to be more dependent on the Lord.

Brothers: loneliness might be normal, but it is neither biblical nor Christlike.

Our Lord was undoubtedly the most dependent man. Dependent on His God. Did He need friends? We find Him with an inner circle of three disciples. We see one of them leaning on his breast: a sign of deep, platonic love. Then there’s a wider group of 9 more disciples. There’s the home of Mary, Martha and Lazarus and a clear statement in John 11:3 of the Saviour’s love for Lazarus in particular. Without lowering our Lord to buddy status I think we can safely say that He definitely pursued friendship with others.

Do we want to be more Christlike? What if we started by cultivating deep friendships with other men? Even our fellow overseers? Or others in our assembly or communities?

Consider the example of Paul: he consistently travelled in the company of friends. He speaks of Epaphroditus as “my brother and fellow worker and fellow soldier” (Philippians 3:25). Do you have anyone in your life you could speak of on those terms? Other than your wife?

When I ask overseers who their best friend is the nearly unanimous response is to point to their wife. That is great — I am a marriage therapist by trade so I am all over that. And then I ask, “And after her?” They shrug their shoulders: “I don’t really have any close friends.”

Please: I am not here to criticize. I have recognized this very real deficiency in my own life and have made it a matter of prayer and action for the last few years. I still have a ways to go so I am not claiming mastery over this issue: but it is one that we need to address if we want to be healthy, Christlike leaders.

Loneliness Impacts Physical Health

There is a little gnosticism in all of us which is ready to downplay the worth of our bodies in order achieve a higher spiritual plane. This denies the very real benefit that friendship and close relationships can have on our bodies. Remember: God is fundamentally relational in nature. God is triune. And we are created in His image: it follows that we are fundamentally relational beings as well.

What happens when we neglect this aspect of the imago Dei? Several years ago, a team of researchers set out to discover the impact that loneliness has on our physical wellbeing. They studied 2100 adults over 50 years of age and followed them across a six year period. In their research, they found that loneliness was linked to:

• Higher mortality
• Lower resistance to illness
• Higher blood pressure
• Reduced physical ability
• Impaired sleep .

These are very significant physical issues — even fatal. How could this be? As it turns out, there are some fairly obvious causal connections. Loneliness can lead to higher mortality due to social isolation: simply put, a lack of people checking up on you could be the difference between life or death if your health takes a sudden turn.

Lonely people often have poorer health behaviours. Being less active and not having as much reason to look after yourself and your home becomes a contributing factor to both physical and mental health issues.

How significant is the effect of loneliness on health and mortality? Another study in 2010 (Holt-Lunstad et al) noted that people with stronger social relationships have a 50% lower mortality rate compared to those who do not. They found this correlation to be true regardless of age, sex and other health variables.

In a very interesting gospel article on Heaven4Sure in January of this year, Peter Ramsay quoted the Surgeon General of the USA as follows:

Loneliness is a growing health epidemic. We live in the most technologically connected age in the history of civilization, yet rates of loneliness have doubled since the 1980s. Today, over 40% of adults in America report feeling lonely, and research suggests that the real number may well be higher. Additionally, the number of people who report having a close confidante in their lives has been declining over the past few decades…… During my years caring for patients, the most common pathology I saw was not heart disease or diabetes; it was loneliness .

Now: I know there’s a difference between correlation and causation: but if I told you I could offer you an enjoyable way of decreasing your mortality rate by 50% (i.e., fostering friendships), would you be interested?

Loneliness Impacts Mental Health

As you might expect, loneliness impacts more than just our physical health. Looking at mental health, it does not take a lot of research to discover that loneliness is also linked to:

• Higher rates of depressive symptoms
• Lower levels of overall wellbeing
• Faster rates of cognitive decline in old age
• Higher risk of developing Alzheimer’s disease (more than double the risk than for non-lonely people)

Lower wellbeing and higher depression experienced due to loneliness can also be a risk factor for suicide, further increasing mortality rates among the lonely.

Again, what if I told you that you could reduce your risk for Alzheimer’s by half and keep your mind sharper for longer: thus enabling you to serve the people of God for longer in the period of you life when you have the greatest amount of wisdom and experience?

I am just reviewing the tip of the iceberg in mentioning these studies. Loneliness is a real problem with serious consequences. And let me be very clear: as I searched the Scriptures in preparation for writing this article I could not find any passages stating that loneliness was part of God’s design for assembly overseers.

How Did We Get This Lonely?

Before we start looking at the results of my survey and how to address this issue, we need to understand how we got to this place. As it turns out, we are not quite as un-worldly as we would like to think we are…

Urbanization

Back in the late 40’s, three social scientists got together to study how friendships form. What they soon discovered is that a key factor in developing friendships are the brief but frequent interactions which happen going to and from home or walking around the neighbourhood. They concluded that passing each other during the day was much more influential in the development of relationships than having similar attitudes, values or beliefs .

Of course, you can see how smaller assemblies in small villages in New Testament times would naturally foster friendships between believers. In contrast, city assemblies are often gathering in halls some distance from where believers live. Motorized transportation, independent family dwellings, centralization of big-box stores, digital communications, in-home entertainment: all of these things have led to a decrease in interactions and happenstance social encounters between believers. When was the last time you ran into someone from your assembly in the supermarket?

That used to be normal.

I have noted even in our rural assembly that there is one particular group of my peers that are closer friends with each other. Now: they are not cliquey in any way, and I would say that are equally willing to show Christian love and friendship to others but there is a definite group. On closer inspection it turns out this small group of 4-5 men work in the same industry, with jobs that require driving and as they drive they are experiencing these brief, frequent interactions on a daily or near-daily basis. The same concept these sociologists documented in the 40s is alive and well in 2018.

In our travels we noted with interest an assembly in a major metropolitan area of the USA. The believers there are typically driving 30-90 minutes from different directions to get to the hall. In observing the saints there and talking to them it was clear that they were all quite happy with one another. However, the geographical distance between them all translated into a social distance: they simply never saw each other outside of assembly gatherings.

They were a loving but lonely group of Christians.

Socialization

Where we reside is not the only cultural factor that impacts loneliness. As it turns out, there are a number of socialized beliefs, values and attitudes that impact men in particular.

Homophobia Promotes Loneliness

Homophobia, especially among those of us that are a little older, has a significant role to play in male loneliness. Allow me to illustrate from Scripture.

How comfortable are you with David’s description of his affection for Jonathan? Listen to the depth of love captured in David’s lament over the passing of Jonathan: “I am distressed for thee, my brother Jonathan: very pleasant hast thou been unto me: thy love to me was wonderful, passing the love of women.” 2 Samuel 1:26, KJV.

If we were honest, many of us would have to admit that owning that amount of love for another man feels, well, kind of gay. That fear of experiencing the feeling of love for another man is really just homophobia. And that fear holds us back from experiencing deep same-sex non-sexual intimacy: something that God has designed us for and, I believe, intends for us to experience. Think of John laying his head on the breast of the Lord Jesus. Could you lay your head on the chest of another man?

Our culture is just not there, is it? And neither are we.

It is interesting that in parts of the world where homosexuality is still banned or widely unaccepted, the men are much more physically intimate with each other. I do not mean they are sexually interactive: I mean that they touch each other a lot more in friendly, non-sexual ways. For example, in the Luvale tribe of Zambia it would not be uncommon to see two assembly overseers holding hands and chatting with each other after a gathering.

We’ll come back to the importance of physical touch — and the “holy kiss” of Scripture — below.

Emotional Restraint is a Barrier, Too

Another key social issue is emotional restraint. 1 Samuel 18:1 says that “…the soul of Jonathan was knit with the soul of David, and Jonathan loved him as his own soul” (KJV). You cannot bond with another person like that if you are consistently emotionally restrained.

I have to call myself out on this one. Any of you who know my wife will understand what I mean when I say that I married her so that there would be enough excitement and enthusiasm for two of us in our marriage. I am far too restrained. I believe this is a growth area where, in order to become more Christlike, I need to be transformed by the renewing of my mind.

Ah, you say, but men are simply not as emotional as women. Really? Do you mean by design or by socialization?

A 2004 study engaged over 1400 participants to try to determine if women are more emotional than men. The results were very clear: men and women are equally emotional. However: women express their emotions more readily than men. Again: the researchers found clear evidence that the underlying level of feeling was not different, only the expression of that feeling differed .

From an early age, boys are taught to conceal their emotions while girls are taught to express them. We do this when we say things like, “I know that hurts, but you need to man up right now because all the other kids are watching you, son.”

Socializing boys to show emotional restraint translates into stunted relational capacity as adults. This is another reason why we men are so lonely.

There are many other factors, of course. Experiences of betrayal: another boyhood/early adulthood adaptation that causes us to choose to never become vulnerable to pain (or friendship) again. Western individualism is another contributing factor: every man is an island unto himself. We all can look at tools in our garage or shed that we rarely use and yet we know we purchased it because it was easier to buy one than go ask a friend to borrow the same tool. And yet we’d be perfectly happy to share that tool with others!

We assign these aspects of independence to male strength. And yet the Bible teaches:

Two are better than one; because they have a good reward for their labour. For if they fall, the one will lift up his fellow: but woe to him that is alone when he falleth; for he hath not another to help him up. Again, if two lie together, then they have heat: but how can one be warm alone? And if one prevail against him, two shall withstand him; and a threefold cord is not quickly broken Ecclesiastes 4:9–12, ESV.

Loneliness Becomes a Self-Perpetuating Problem

Allow me to make a couple more points about how we arrived at this loneliness problem before moving on to the stats and then to how to solve the issue.

Have you noticed that loneliness can take on a vicious cycle of its own?

Living in loneliness and isolation leads to poor social skills simply due to a lack of practice. That, in turn, can lead to greater anxiety about interacting with people. Do you dread Sundays? This may be one reason why.

When socializing, lonely overseers are often highly self-conscious, fail to pick up on social cues, and at our worst can even begin to act in distrustful, defensive, or even hostile ways.

Even if it does not get that bad, we can come across as awkward when we do interact with people, leading to a higher likelihood of social rejection by the people we want to shepherd. Of course, the more you experience this rejection or awkwardness, the more your loneliness and belief that you cannot connect with other people is reinforced . In this way, your loneliness can become a self-fulfilling prophecy.

How Lonely Are We?

Having noted the seriousness and complexity of the problem, how common is this reality in our world, in evangelical circles, and in assemblies?

In the broadest context, 20 to 40% of older adults report feeling lonely and a further 5 to 7% report intense or persistent loneliness .

These numbers are increasing: in the past 20 years, the average number of close confidants people report having has decreased from three to none. Further, the number of people who report having no one to discuss important matters with has tripled.

Among Church Pastors/Clergy

The loneliness issue is not unique to assemblies. As it turns out, loneliness is also a common struggle among clergy and church pastors, who often experience a sense of isolation due to the unique challenges of their role.

Obviously, their leadership structure and policy is quite different from what we are accustomed to. Nevertheless, in the broader evangelical context specific factors leading to loneliness among church leaders include:

• High expectations and time demands: in this study the majority of pastors interviewed reported feeling overwhelmed by their workload. Additionally, pastor’s wives in this study reported that a major problem was the fact that the pastor is always “on call” to respond to emergencies and issues within the church. 90% of pastors felt that they had little time for their own social needs and were regularly interrupted in their family time.
• Frequent relocation: being required to move from church to church added to the issue.
• Isolation: clergy often report feeling isolated or detached from the people around them, despite being in contact with people every day. Since their pastoral role often involves looking after other people’s needs, pastors can often struggle to establish friendships where they can confide and seek emotional support. Pastoral relationships are naturally quite one-sided .

Other than frequent relocation, it is likely fair to say that similar issues can be experienced by overseers in an assembly context, too. We may use different language to describe our service but shepherding relationships can be equally one-sided, as an example. That is not wrong, by the way, but it does need to be acknowledged and compensated for by having other healthy, mutual, peer-to-peer relationships.

Loneliness Among Assembly Overseers

In the fall of 2017 I posted a survey on Oversight Today specifically inquiring about overseer and overseer wife loneliness. The survey was based upon the UCLA Loneliness Scale .

At the point where I reviewed the results of the survey, 94 respondents self-identified as overseers and 26 as wives of overseers.

Results showed that 71% of overseers and 69% of overseer wives reported above average or higher levels of loneliness.

71% of Overseers are Lonely

36% of overseers and 54% of wives reported high or very high levels of loneliness.

While the sample size is very small and the survey was self-reported and informally conducted, it does appear to indicate that loneliness levels are higher both for overseers and their wives than for the general population.

To me, this represents a legitimate concern and one that we should be actively addressing.

One of the things I have found particularly striking since opening the survey and beginning to ask other overseers about the issue is that this problem appears to be a generally accepted norm. It is believed to be par for the course — a legitimate consequence of taking on the work of an overseer.

I disagree. I do accept that it is normal but I do not believe that just because something is normal it should be accepted. As I mentioned above, God is fundamentally relational in His nature. And why should we expect to abandon that aspect of expressing His image just because we have been called to this particular area of service? I do not see a Biblical case for accepting loneliness as a normative experience among overseers.

So where do we go from here? How do we tackle this loneliness issue?

You Cannot Expect Your Wife To Solve Your Loneliness Problem

My anecdotal observation is that most overseers have turned to their wives to fill the intimacy void. That sounds great, but I am not sure that God intends for one person to meet all of our relational needs. That is a lot to put on our wives. And, your wife needs some close friends too, although she is more likely to have a larger network.

The result of male loneliness is that the friendships we do have are typically less intimate and more superficial than women’s friendships . And, since we are socialized to show emotional restraint and refrain from male-to-male displays of affection, it is more difficult for us to hold onto intimate friendships.

This leaves a void. Indeed, the majority of men wish they had more intimate friendships with other men . I know I do. Further to the point, some studies shows that marriage and family relationships are not sufficient to protect against the harmful effects of loneliness: found that while friend relationships protect against the negative effects of loneliness, family and spousal relationships do not.

We may quickly revert to stating that we do not need as many close friends as women do: but this is more likely attributed to our not wanting to appear weak or dependent on others . Again I ask the question: do we have any biblical basis to assert that men do not need close friends?

Pursue Friendship

I would like to encourage you to prioritize the pursuit of friendship. Think of this as a one or two year project: this is not a situation that can be changed quickly, but one that requires prayer and intentionality.

The wisdom of the Proverbs comes to bear on the topic of friendship: “Oil and perfume make the heart glad, and the sweetness of a friend comes from his earnest counsel. Do not forsake your friend and your father’s friend, and do not go to your brother’s house in the day of your calamity. Better is a neighbor who is near than a brother who is far away” Proverbs 27:9-10, ESV.

“Iron sharpens iron, and one man sharpens another” Proverbs 27:17, ESV.

Tackling Your Personal Loneliness Problem

Addressing our loneliness is going to be a unique process for each of us. Below are some of my thoughts and some research-based ideas: some may work for you and others will not.

For myself, I came to the realization a couple years ago that I was really missing out on solid male friendships. My approach has mainly focussed on prayer (asking God for opportunity, wisdom and grace) and being more intentional about staying in touch with long-distance friends by phone and building local friendships by planning breakfasts and family time together.

I still have a ways to go…

Countering the Effects of Urbanization

One of the things our assembly really benefits from is a weekly dinner meal together at the hall. Our assembly is larger (~100 in fellowship at the moment) and every family is encouraged to bring enough food for themselves and this is shared, buffet-style, after we gather for the Lord’s supper on a Sunday morning.

In our case we live in a rural area so we do have a little more likelihood of a chance encounter but we also have a long and harsh winter that leaves folks more inclined to stay indoors. And by inhabiting a farming region we are quite spread out.

Another assembly I spent some time visiting actually broke up their weeknight meeting into 4 neighbourhoods — meeting separately but concurrently. While this may raise alarms for some, in their context it created opportunity for closer connections during the week and, from my limited perspective, did not have any sectarian consequences (e.g., creating cliques) as far as the Sunday gatherings of the assembly.

Another interesting anecdotal observation from perhaps 15-20 years ago was from an assembly where I heard rumblings about an inside and an outside circle. As I reflected on this I noticed that the alleged “inside” circle was comprised of people who were doing a lot of children’s work together (this was the main outreach of the assembly) and the “outside” circle was not involved. I do not think there was an intention to create two classes of believers but the point is that the children’s work created opportunities for interaction and so it was natural for closer friendships to form among those involved.

Now, in retrospect, it may have been useful to create opportunities for the assembly members to mingle in other ways in order to broaden the possibility of friendships forming but that reality underscores the necessity of frequent interactions.

Research-based Observations

In 2011 a group of researchers completed a meta analysis of interventions into loneliness. I always find these kinds of studies particularly fascinating because they are a study of studies. In other words, they look at the results of many different research groups and compile the evidence.

In this case, they noted two interventions in particular which can help reduce loneliness :

1. Unhelpful Cognitions

The most helpful interventions were those which targeted negative self-esteem and negative beliefs which lonely people often experience. Lonely and isolated people often have very low self esteem and are very wary of making contact with other people, fearing that they will be judged or rejected. These kinds of fears can be particularly relevant for overseers who have been attacked or feel stung by how their flock has treated them in the past.

When these fears are activated in any person, they make one more defensive and reluctant to communicate openly, thus making one more likely to be rejected, leading to the self-fulfilling prophecy described above.

These beliefs and thought patterns can be addressed in counselling or CBT, allowing people to increase in confidence and engage more successfully with people around them.

2. Social Skills

Similar to the above, learning social skills helps people to communicate more effectively without coming across as nervous or distant due to their insecurity. This allows them to make more meaningful connections and friendships.

Frankly, some of us just lack the necessary skills to know how to effectively relate to others. While this may be embarrassing to admit, it is a problem that can be solved through learning and practice.

Strategies Used by Pastors to Reduce Loneliness

Peering back over the fence into the evangelical world, there are some lessons we can learn from our brothers who lead churches in that context.

Looking at another research study, interviewed 80 church leaders regarding the ways they dealt with loneliness. The following strategies were found:

Intentionality

I have mentioned this already but it is validating to see others employing the same approach. 62% of pastors interviewed believed it was important to be intentional about seeking out meaningful relationships. Since their time and energy was in such high demand, pastors would deliberately make time to build and maintain relationships with people they felt could support them, such as other pastors, colleagues they used to work/train with and other trusted individuals. Maintaining these relationships, even across long distances, was a priority.

I think the key part there was that phrase, “maintaining [or creating] relationships with people they felt could support them”.

I believe this is a good reason for an overseer to connect with other overseers from different assemblies. This would be also be a very worthwhile outcome of an event or conference for overseers.

Let’s be forthright that shepherding is a difficult work to be involved in—we cannot function in isolation.

Common Interests

Similar to joining groups above, other pastors identified the need to share common interests with others.

Group Support

To expand on the networking concept, while “group support” sounds like a therapeutic event, many of the Lord’s servants have found it helpful to deliberately meet with other servants who are ministering in the same area. This provides a level of support and accountability and, if meeting with a younger believer, could also offer an opportunity to invest in someone else while experiencing friendship and connection.

In some major cities where there are multiple assemblies it may be helpful to have breakfast on a regular basis with a couple other overseers from other assemblies. That is good for fellowship between assemblies but also very good for friendship between yourselves.

Some who work and serve the Lord in more remote areas choose to cultivate friendships with other believers. While there may be concerns about such an approach, it really is incumbent on each one of us to consider which is the greater risk: isolation and loneliness? Or friendship with others who worship the Lord in a different context than ours? It may be prudent to consider the words of Christ in Luke 9:50 in view of this decision: “And Jesus said unto him, “Forbid him not: for he that is not against us is for us”” (KJV).

Vulnerability and Authenticity

In order for a meaningful friendship to develop, we also need to be honest and authentic in showing who we are, rather than appearing “holier than thou” or acting as if we have everything together.

When we are an open book we set an example for others to be the same. This prompts a reciprocation of openness and honesty that is a powerful force in facilitating friendship. When we show others that we are willing be vulnerable then they are much more likely to feel the same toward us. As assembly leaders, it is not unreasonable for us to believe we should lead by example in this area.

Of course, not everyone is going to respond appropriately to openness and vulnerability. Some of God’s people are harsh, critical and unsafe. It is prudent to be selective about who we confide in.

Pursue Physical Touch

I want to close with a subject area that may be back towards the more uncomfortable end of the spectrum. But it is a worthy challenge: I would like you to consider the amount of physical touch you give and receive.

wNow, in our #metoo world we do need to show caution here to make sure that our touch is always respectful of the other person, distinctly platonic in form and performed with awareness of how it is being received. Frankly, I have had some overseers I really didn’t know rub my back in other assemblies and that was a little uncomfortable for me. But: I do like a good ‘bro hug’ if we have a friendship. If you’re not sure what that is, ask me for a free demo next time I see you!

Touch is important. And we do not get enough of it. Here is a good summary from a recent article that captures a number of references to studies about the importance of touch:

“Loving touch triggers the release of oxytocin, often referred to as the “bonding hormone” (Field, et.al., 1997; Klaus, 2009). Studies in bonding also show that human babies who are held often and touched frequently in their earliest stages of development have higher scores on physical, emotional, and interpersonal scales (Klaus & Kennell, 1976; Field et. al., 1986). The opposite is true of abusive touch or lack of touch. In fact, the absence of loving touch has been documented to have profound impact on the will to live. Death rates for under-touched infants less than one year of age, in institutes during the 1920’s ranged from 30% to 100% (Hunter & Struve, 1998). During the early 30’s, Bellevue hospital in New York challenged the prevailing norms and authorized staff to incorporate physical contact in their care protocols. The mortality rate dropped on that unit from 30% to 10%, and the caregivers proposed the name marasmus (wasting away) for this disease of institutionalized touch depravation (Cohen, 1987)” .

Is this merely an academic assertion? As it turns out, the New Testament exhorts us to “Greet one another with a holy kiss” not once, but four times: Romans 16:16, 1 Corinthians 16:20, 2 Corinthians 13:12, and 1 Thessalonians 5:26. Peter also exhorts us to greet each other with a “kiss of charity” (1 Peter 5:14, KJV).

Pucker up, brothers: we are going to fix this friendship issue very quickly!

No–in all seriousness I believe that the Scriptures here are teaching us to take the normal physical expressions of endearment in our culture and to use them with real intentionality. We can do a lot just my making our handshakes warmer and, when we feel close enough, to embrace one another as well.

Of course, these displays of affection are meant to be conducted in holiness: it is a holy kiss. No sensuality, no pretence, no grudging acknowledgments. Rather, before a holy God let us display a tangible, warm, holy affection for one another: especially those of the same sex. Even with our hand shakes. Brotherhood should be communicated physically.

Why? Because we are commanded to. But also, because God has designed us to benefit from this kind of touch. Friendly touch leads to decreased heart rate, blood pressure and cortisol and increased oxytocin (the body’s love hormone). Touch increases our serotonin levels and may actually alleviate physical pain. It can lead to increased attentiveness, decreased depression and enhanced immune function.

Do we need more touch? Yes. Are we wired for friendship? Absolutely. Remember: you may believe that isolation in service is noble, but can you demonstrate from Scripture that it is godly? Or that loneliness should be pursued?

I doubt it. But: if you disagree, what ever happens, do not feel the need to stew on that alone. Call someone up, print out my article and spend an hour over lunch or coffee deepening your relationship as you prove me wrong. I’ll almost be happy to hear you did so!

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Bibliography

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Zur, O, and N Nordmarken. n.d. “To Touch Or Not To Touch: Exploring Prohibition On Touch In Psychotherapy And Counseling and the Ethical Considerations of Touch, by Ofer Zur, Ph.D.” Accessed April 30, 2018. http://www.zurinstitute.com/touchintherapy.html.

Russell, D. W. 1996. “UCLA Loneliness Scale (Version 3): Reliability, Validity, and Factor Structure.” Journal of Personality Assessment 66 (1): 20–40. https://doi.org/10.1207/s15327752jpa6601_2.

Simon, Robin W., and Leda E. Nath. 2004. “Gender and Emotion in the United States: Do Men and Women Differ in Self‐Reports of Feelings and Expressive Behavior?” American Journal of Sociology 109 (5): 1137–76. https://doi.org/10.1086/382111.

Festinger, L, S Schachter, and K Back. 1950. Social Pressures in Informal Group: A Study of Human Factors in Housing. Stanford, CA: Stanford University Press.

Ramsay, Peter. 2018. “Loneliness in Secular Society.” Heaven4Sure. January 27, 2018. https://heaven4sure.com/2018/01/27/loneliness-in-secular-society/.

Masi, Christopher M., Hsi-Yuan Chen, Louise C. Hawkley, and John T. Cacioppo. 2011. “A Meta-Analysis of Interventions to Reduce Loneliness.” Personality and Social Psychology Review : An Official Journal of the Society for Personality and Social Psychology, Inc 15 (3). https://doi.org/10.1177/1088868310377394.

Andrews, G., F. Cheok, and S. Carr. 1989. “The Australian Longitudinal Study of Ageing.” Australasian Journal on Ageing 8 (2): 31–35.

Bank, Barbara J., and Suzanne L. Hansford. 2000. “Gender and Friendship: Why Are Men's Best Same‐sex Friendships Less Intimate and Supportive?” Personal Relationships 7 (1): 63–78. https://doi.org/10.1111/j.1475-6811.2000.tb00004.x.

Staley, Ryan C., Mark R. McMinn, Kathleen Gathercoal, and Kurt Free. 2013. “Strategies Employed by Clergy to Prevent and Cope with Interpersonal Isolation.” Pastoral Psychology 62 (6): 843–57. https://doi.org/10.1007/s11089-012-0473-9.

Vandervoort, Debra. 2000. “Social Isolation and Gender.” Current Psychology 19 (3): 229–36. https://doi.org/10.1007/s12144-000-1017-5.

Wilson, Robert S., Kristin R. Krueger, Steven E. Arnold, Julie A. Schneider, Jeremiah F. Kelly, Lisa L. Barnes, Yuxiao Tang, and David A. Bennett. 2007. “Loneliness and Risk of Alzheimer Disease.” Archives of General Psychiatry 64 (2): 234–40. https://doi.org/10.1001/archpsyc.64.2.234.

Luo, Ye, Louise C. Hawkley, Linda J. Waite, and John T. Cacioppo. 2012. “Loneliness, Health, and Mortality in Old Age: A National Longitudinal Study.” Social Science & Medicine (1982) 74 (6): 907–14. https://doi.org/10.1016/j.socscimed.2011.11.028.