The world grows ever smaller, more connected, more crowded, and ironically, increasingly lonely for many of us.  This is a problem with a whole host of unhappy consequences, not just for the individuals who experience it, but for society as a whole.

It’s important to point out before I go any further that loneliness is not the same thing as being a private person, or a “loner,” because some of us actually both need and enjoy a lot of time to ourselves.  Loneliness, instead, refers to the difference between the amount of social contact and intimacy you have and the amount you want.  It’s about feeling isolated, like an outcast.

(That said, the opposite of loneliness isn’t popularity either – you can have dozens of “friends” and still feel lonely.  True intimacy and feelings of relatedness are much more about the quality of your relationships than the quantity.)

Persistent loneliness is not only emotionally painful, but can be more damaging to our physical and mental health than many psychiatric illnesses.  For instance, lonely people sleep poorly, experience severe depression and anxiety, have reduced immune and cardiovascular functioning, and exhibit sings of early cognitive decline that grow more severe over time.

Not surprisingly, psychologists have created dozens of interventions designed to try to tackle this epidemic of loneliness.  The approaches taken are varied, but can be broken up, roughly speaking, into four different categories.

There are interventions aimed at:

Improving social skills. Some researchers argue that loneliness is primarily the result of lacking of the interpersonal skills required to create and maintain relationships.  Typically, these interventions involve teaching people how to be less socially awkward – to engage in conversation, speak on the phone, give and take compliments, grow comfortable with periods of silence, and communicate in positive ways non-verbally.

Enhancing social support.  Many lonely people are victims of changing circumstances. These approaches offer professional help and counseling for the bereaved, elderly people who have been relocated, and children of divorce.

Increasing opportunities for social interaction. With this approach, the logic is simple:  If people are lonely, give them opportunities to meet other people.  This type of intervention, therefore, focuses on creating such opportunities through organized group activities.

Changing maladaptive thinking.  This approach might seem surprising, and its rationale less obvious than the other approaches.  But recent research reveals that over time, chronic loneliness makes us increasingly sensitive to, and on the lookout for, rejection and hostility.  In ambiguous social situations, lonely people immediately think the worst.  For instance, if coworker Bob seems more quiet and distant than usual lately, a lonely person is likely to assume that he’s done something to offend Bob, or that Bob is intentionally giving him the cold shoulder.

Lonely people pay more attention to negative social information (like disagreement or criticism). They remember more of the negative things that happened during an encounter with another person, and fewer positive things.

All this leads, as you might imagine, to more negative expectations about future interactions with others – lonely people don’t expect things to go well for them, and consequently, they often don’t.

Interventions aimed at changing this self-fulfilling pattern of thinking begin by teaching people to identify negative thoughts when they occur.  Whenever they feel anxious about a social encounter, find themselves focusing on everything that went wrong, or wondering if they’ve made a bad impression, a red flag is raised.

Next, they learn to treat these negative thoughts as testable hypotheses rather than fact.  They consider other possibilities – maybe everything will go smoothly, maybe it wasn’t all bad, perhaps everyone liked me after all.  They practice trying to see things from the perspective of others, and interpret their actions more benignly.

Take the case of Bob the Distant Coworker.  With thought retraining, lonely people learn to ask themselves questions like “Am I sure Bob doesn’t like me?  Could there be other, more likely reasons for his quiet, reserved behavior at work?  Could he simply be preoccupied with some problem?  I know sometimes I get quiet and distracted when something is bothering me.  Maybe Bob’s behavior has nothing to do with me!”

Once the negative thoughts are banished, lonely people can approach new relationships with a positive, optimistic outlook, see the best in others, and learn to feel more confident about themselves.

With four approaches to curing loneliness, the obvious question is:  What works?  Thanks to a recent meta-analysis of 50 different loneliness interventions, the answer is clear.  Interventions aimed at changing maladaptive thinking patterns were, on average, four times more effective than other interventions in reducing loneliness.  (In fact, the other three approaches weren’t particularly effective at all.)

It turns out that fundamentally, long-term loneliness isn’t about being awkward, or the victim of circumstance, or lacking opportunities to meet people.  Each can be the reason for relatively short-term loneliness – anyone who has ever moved to a new town or a new school and had to start building a network of friends from scratch certainly knows what it’s like to be lonely.   But this kind of loneliness needn’t last long, and new relationships usually are formed… unless you’ve fallen into a way of thinking that keeps relationships from forming.

More than anything else, the cure for persistent loneliness lies in breaking the negative cycle of thinking that created it in the first place.

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