notes / kortina.nyc

Murthy // Together

Vivek Murthy’s Together: The Healing Power of Human Connection in a Sometimes Lonely World is the type of popular non-fiction that usually just sends me on a youtube search for a 60 minute talk by the author that usually captures the core argument of the book. This talk is exactly the sort of thing I’d prefer to this sort of book.

But since the topic is loneliness – which I agree with the author is probably the root cause of a huge number of other problems in our society today – I decided to read the full thing.

I can’t say I recommend the book over the youtube, but here are a few of my favorite bits…


Different people respond differently to hypervigilance:

In our ancestors’ tribal world, this perceptual narrowing served the critical purpose of securing a sense of belonging and protecting a clan’s members against befriending possible enemies. But what happened if they strayed from their tribe or got stranded alone, perhaps among the very outsiders they’d now learned to distrust? This, Cacioppo said, was when the hypervigilance that underlies loneliness would kick in.

At the first sign of isolation, whether alone or among strangers, the stranded individual’s sympathetic nervous system would go on alert, triggering fear and immediate preparation to fight or flee the situation. Central to this stress response is a surge in hormones known as catecholamines, such as epinephrine. These course through the body, causing the pupils and airways to dilate and increasing heart rate and blood flow to the muscles, heart, and brain. The hypothalamic-pituitary-adrenal (HPA) axis is also activated. Starting from the hypothalamus in the brain, signals cascade to the pituitary gland, then the adrenal glands, triggering the release of mineralocorticoids and cortisol, which in turn raise our blood pressure and increase blood sugar levels so we have energy readily available. In this sense, our bodies read isolation, and often even the threat of isolation, as an emergency.

With the senses on heightened alert it was possible for our stranded ancestors to detect the slightest noise or smell or shift of light that might signal a predator. The lungs were able to take in more air. The muscles were able to generate more power and speed. The heart was able to get more blood and oxygen to vital organs. And the immune system was activated in case of injury and infection. In this state, the whole body was engaged in self-preservation, narrowing attention to immediate signals, ignoring more leisurely thoughts, such as desire or wonder or reflection, and keeping sleep shallow and fragmented, lest a predator attack in the night.

Such hypervigilance could be lifesaving in moments of acute danger, but it placed a lot of stress on the body. Nor was it sustainable for long periods. However, that time-limiting feature alone helped motivate the stranded to quickly rejoin their tribes.

Over millennia, this hypervigilance in response to isolation became embedded in our nervous system to produce the anxiety we associate with loneliness. When we feel lonely, our bodies still react as if we were lost on the tundra surrounded by wild animals and members of alien tribes. When loneliness persists, the same stress hormones that surged to provide short-term protection instead begin to produce long-term destruction as they increase cardiovascular stress and inflammation throughout the body. This, in turn, damages tissues and blood vessels and increases the risk of heart disease and other chronic illnesses. Studies have also found that loneliness leads to changes in gene expression in white blood cells, which in turn results in increased inflammation and reduced defenses against viruses.16


When our ancestors were separated from the safety of the group, they needed to react defensively even to marginal threats, since they might well turn out to be lethal. But in modern life that same hypervigilance causes us to misread harmless or even welcoming people and situations as threats. Fleeing into self-preservation mode, we’ll avoid people and distrust even those who reach out to help us. With prolonged loneliness, we’ll decline invitations and stop answering the phone.

Hypervigilance also creates an intense preoccupation with our own needs and security, which can appear to others as self-involvement. These two elements—the threat perception shift and the increased focus on self—are key parts of the hypervigilance story that make it difficult to engage with others when we’re lonely.


Tom Tait believes that one way to support our uniqueness while fostering a sense of belonging is to nurture a culture of kindness. Tom was a member of the city council in Anaheim when this idea first occurred to him more than a decade ago. He’d been noticing a mysterious poster campaign on walls scattered around the city. Each poster read: MAKE KINDNESS CONTAGIOUS. There was no ad that followed. No company listed as a sponsor. Just the message.


Tom didn’t even know most of his own neighbors, and he’d lived in the same place for ten years. So he initiated his “Hi Neighbor” program on his own street. Because it felt so awkward knocking on a neighbor’s door to introduce himself after living there for so many years, he literally wrote a note: “Hi neighbor, I think it’s important that we meet so we can look out for each other when needed.” His wife, Julie, slipped this under each neighbor’s door with an invitation to come over to their house one evening.


In the blue zone of Okinawa, Japan, Buettner discovered an inspiring social system called the moai. The term, which means “meeting for common purpose,” originally described a communal pool of funds that supported the whole village, but it’s evolved to describe a social support network of close friends. In traditional times, Okinawan parents initiated a moai by bringing infants of similar ages together in groups of five, as if they were siblings. The families of these children supported one another, so the group grew up together and relied on one another, continuing as adults to meet daily or weekly. Today’s moais still help one another financially, when needed, but the “common purpose” now has more to do with companionship and advice. A moai is like a second family.


In his book The Men’s Shed Movement: The Company of Men, Barry Golding described it: “Women talk face to face while men talk shoulder to shoulder.”20