Snow muffled the start of a new day. The river was frozen, and the view from Anita’s window was reliably gray.

Slowly she unwound and stared at the ceiling. Then she grinned at her fat, sleepy, ginger cat.

“Where’s my breakfast in bed, Joshua?”

Joshua wasn’t the cat. The cat was called Whiskey. Joshua was a fantasy boyfriend she had created.

Anita was a photographer. She took pictures of abandoned spaces. Born and raised in Brooklyn, she moved, after art school in the Midwest, to Germany impulsively. She lived in a lofty flat, big enough to use as her studio. She was regularly invited to parties, and she had time to visit galleries and museums for inspiration. All considered, there was nothing she needed to worry about.

But Anita created Joshua on a day when three times in a row a stranger in the street didn’t return her greeting, a boy didn’t show up for a date, and her mother asked her when she would finally get married. The invention of an imaginary companion helped her deal with her parents’ insistent concerns about her still being single but was also a way to mitigate her solitude and fantasize about what she wanted in a man. Even if he was unreal, Joshua halved the weight of Anita’s worries.

* * *

Loneliness is a world epidemic. A comparative survey has shown that in less than two decades, from 1985 to 2004, at least in the United States, the number of people who had no confidant to talk to about important matters almost tripled. On the other side of the pond, the scenario is not brighter, the UK being among the most lonely countries in Europe.

Loneliness can be a risk-factor for mortality, just like smoking, obesity, lack of exercise, or air pollution. It harms our bodies and changes the way we perceive and interact with the world. It has been found to be connected to a series of conditions from fatigue, anxiety and depression to elevated blood pressure, sleep disruption, inflammation and a weakened immune system. It may also lead to cognitive decline and ultimately to dementia.

Anita felt the burden of loneliness as a relentless grip in her chest. A chronic sufferer of heartburn, at night she hyperventilated, coughed, and was occasionally short of breath.

We steer our minds and carry our bodies in relationship to events and others. We inhabit, share, perceive, and interact with the world through the totality of our bodies, not just with the brain.

While the sympathetic nervous system is “on” when we need to deal with danger or an emergency, the parasympathetic nervous system dominates when we can afford to relax. It carries out functions that don’t need our attention, such as cardiac movements, respiration, and digestion.

If, out of worry or stress, we are constantly vigilant, the parasympathetic nervous system resents it. We can’t relax. Not only that, some of the simple automatic functions it carries out go awry too.

Anita’s chest pain and shortness of breath were not only a result of what she ate or how much coffee or gin she gulped. They were also a response to her loneliness, as well as to her preoccupation with it. 

* * *

At the park, at parties or in cafés, even at the supermarket, Anita found herself staring at other couples as they stroked each other with blades of grass, made out with their eyes closed, and as they checked off their shopping list.

What did they have that she didn’t? What made them ready to connect?

Could other people read on her face that she was lonely? Might her loneliness have scared people away?

Loneliness obfuscates. It becomes a deceiving filter through which we see ourselves, others, and the world. It makes us more vulnerable to rejection, and it heightens our general level of vigilance and insecurity in social situations.

Too much isolation interferes with our capacity to scan, understand, and interpret emotions. When faced with images depicting four basic emotions—happiness, fear, anger, and sadness—lonely people are less good than nonlonely people at interpreting them. The lonelier they are, the worse their ability to distinguish them. When lonely, we are also less capable of capitalizing on positive experience. Instead of concentrating on the joyful or positive aspects of things, we focus on the negative. We stress more easily. We are less optimistic.

Loneliness begets loneliness, in a cycle. One of the most pervasive and perverse effects of isolation is that the more time we spend in it, the harder it becomes to overcome it.

* * *

Authentic, meaningful bonds with people who can be trusted are great providers of health (better than possessions and comfortable financial conditions).

The need for proximity and sensitivity to abandonment are universal across the animal kingdom. Fruit flies live longer if they experience social interaction. Separate a litter of newly born mice or rats from their mother and they will protest loudly, with incessant squeaks and cries, under considerable stress, until they are reunited with her.

It seems that today we live in a society that is collectively making human interactions extremely difficult to achieve, even though we know they work like magic to improve the quality of our lives.

When we are constantly deprived of something we are thirsty for, we tend to lose confidence completely. We become anxious about the possibility that our wishes might never be fulfilled. When we feel anxious, it’s more difficult to remain hopeful. But when dealing with something entirely out of our control, the best thing to do is to remain open, with all our senses, and to sideline our intentions. This doesn’t mean we must suddenly believe in fate or take the first option available. It means we should make room for the unexpected, which is usually around the corner.

By doing so, we also have a chance to refocus our attention on the present and what makes us stronger and happier on our own. Priorities will align better too.

On some days, Anita had her art as a consolation. On others, the replacement for Joshua would be found in friends, travel, and other daily pleasures. Whiskey wasn’t going anywhere.

Perhaps intimacy always begins and ends with ourselves.

From TOGETHER, CLOSER: The Art and Science of Intimacy in Friendship, Love, and Family by Giovanni Frazzetto, published on July 4, 2017 by Penguin Books, an imprint of Penguin Publishing Group, a division of Penguin Random House LLC. Copyright © Giovanni Frazzeto, 2017.