Loneliness through the lens of Traditional Chinese Medicine (TCM) and Psychotherapy

I’ve been thinking a lot recently about how loneiness underpins many people’s emotional problems and illnesses. Human purpose is deeply tied to community and when we lack meaningful connection, our psychology and emotions become dysregulated, fundamentally altering how we perceive the world and view ourselves.

Loneliness, or lack of connection, can happen for many different reasons: physical isolation (the culture of remote work, or perhaps moving to a new location, where you don’t know anyone), digital illusion (social media replacing deep, reciprocal interactions), fear of vulnerability (past trauma, rejection or heartbreak that causes people to build emotional walls to protect themselves) and in-grained shame or low self-worth, being just a few examples. Prolonged lack of connection can trigger feelings of worthlessness, despair and helplessness, and without people to connect with and mirror back to us, our sense of self and identity can slowly erode and distort.

The idea of mirroring is of significance psychotherapeutically, with object-relations theorist, Donald Winnicott, observing that when an infant looks at it’s Mother’s face (the term ‘Mother’ here representing the primary caregiver), it needs to see itself reflected back with love and acceptance. When the Mother does not respond in this way, or reflects back distress, impatience or a general lack of care, the infant experiences itself as unlovable and the cause of the Mother’s dissatisfaction: this is a terrifying situation for an infant, as the Mother is the infant's lifeline and greatest source of comfort. In an ideal world, the Mother accepts all of the childs behaviour, however as a child grows it learns that some of it's behaviour is deemed less acceptable and herein lies the roots of the the False Self - the defensive mask that a person creates to protect their true vulnerability from the terror of being unloved or feeling unwanted by their caregivers, and the world at large.

By now many people are aware that emotional and psychological disturbances somatize in the body. The ancient Chinese knew this and related emotional states to specific organs: in its most simplest form, the Lung relates to sadness, the Liver to anger, the Heart to joy, the Spleen to worry and the Kidney to fear.

In TCM, difficulty connecting with other people isn't assigned to one organ alone, it is usually understood through patterns of imbalance relating to several of the organs, notably the Heart and Liver, alongside of the Lung and Kidney; the Shen (Spirit), which is governed by the Heart, is also heavily involved. ❤️ The Heart has a strong relationship with both Blood and Shen, the latter of which TCM associates with consciousness, emotional presence, relationships, and the ability to connect with others. A pattern of Heart Qi/Blood deficiency is traditionally associated with emotional withdrawal, restlessness, or difficulty feeling connected.

🌿 The Liver governs the smooth flow of Qi. A pattern of Liver Qi stagnation may be associated with irritability, emotional constraint, difficulty expressing feelings, or feeling stuck in relationships. A Liverish person might be described as easily angered, irritable or frustrated and can be a challenging person to be around for these reasons.

🫁 The Lung is associated with grief, letting go, boundaries and the relationship between oneself and the external world. Patterns involving Lung Qi may be considered when someone has difficulty opening up or releasing past emotional experiences.

💧 The Kidney is connected with not just fear, but also trust and safety in self. In a TCM framework, deficient energy within the Kidney system can cause insecurity or fear, making vulnerability and interpersonal connection more complicated.

🌾 The Spleen is associated with nourishment and a sense of home, of belonging. Spleen Qi deficiency is traditionally linked with overthinking, worry, and difficulty feeling grounded or supported. Spleen imbalance could mean that a person doesn’t feel ‘at home’ with themselves, making it difficult to feel ‘at home’ and comfortable around others.

Any one of these organs and their related patterns could be involved in feeling a lack of connection to others. That being said, the Heart is often described as particularly vulnerable to the challenges of modern life, largely because of its close relationship to Shen (Spirit). The Heart needs to be able to anchor the Shen, but constant stimulation, in the form of phones, social media, advertising and information overload can keep the Shen continually active, and unsettled. The chronic stress brought about by being constantly ‘on call’ disrupt’s the Heart’s ability to bring the Shen back to a state of calm, especially at night, when it should be quiet and resting. Irregular sleep patterns and insufficient sleep contribute further to an unsettled Heart, which in turn agitates Shen further. On top of this, overwork, lack of rest and inconsistent eating patterns all take their toll, contributing to wider-spread disharmony.

While two people may both feel that they lack connection to others, or are lonely, they may each have different patterns of imbalance, which would inform how the treatment would be approached. One, for example, might be be suffering with a Heart Qi deficiency, while the other might be experiencing Heart Blood deficiency - both patterns involving the Heart, but requiring different treatment protocols.

Generally, a TCM informed approach to treating a person who feels lonely or disconnected might initially emphasise calming the Shen, by reducing stimulation, improving sleep, encouraging meaningful human connection, regulating emotions and supporting Qi and Blood through dietary recommendations. Alongside of Acupuncture, which would focus on redirecting energetic blockages causing patterns of imbalance in the organs, and the warmth of human-to-human conversation, I find it beneficial to incorporate other therapeutic tools, such as Flower Remedies. Flower Remedies (also called Flower Essences) are energetic tinctures (similar to homeopathic medicine) that work on the emotional level and are taken in-between sessions to support emotional wellbeing. The Bach Flower Remedy, Water Violet, is a very good remedy for people who feel withdrawn, like their own company, yet feel isolated from the world. Its positive outcome is that it helps a person build warmer relationships with others.

The great benefit of combining aspects of talking therapy with Acupuncture, Flower Remedies and other tools, is that change can be felt quite quickly. When blocks are released though talking, when the body is instructed to redirect stuck energy though acupuncture needles, and when home-care advice is implemented, balance can be restored to a point where a person feels much more connected to themselves and in turn to the people around them.