A Biography of Loneliness and the course of a (research) life

Finally, my new book A Biography of Loneliness: The History of an Emotion has landed.

I used to roll my eyes at the idea of birthing a book, perhaps because metaphors are so emotionally charged and my own pregnancies, births (and miscarriages) were traumatic. But there was something about this book’s process that has been about transition, birth and death and everything in between: the ‘pinch points’ of experience that mark us in such different ways.

Loneliness has a biography in its own right - and it intersects with our own biographies, hence the book’s title. I started writing this book as a cultural historian intrigued by the panic about loneliness: had it really become worse? I discovered that loneliness came about at a distinct historical moment. That it could be linked to social and economic changes, as well as theological ones. That it was shaped by individual circumstance and experience but also by political ideology.

Many people seem to be lonely: the married and the single, the young and the old, the bereaved and the homeless, the mentally ill and the outwardly happy. Sometimes loneliness is transitory and other times it is chronic. Sometimes it causes illness, other times it is a blessing. And we cannot understand what loneliness means without appreciating its historical and personal evolution.

During the research for the book I questioned whether I was lonely too, and I thought about its causes. Between submission of the manuscript and the publication, I moved house, changed jobs and divorced. I found happiness in a new city, a new job and a major new research project.

Significant life changes or pinch points are transformative by their nature: they force us to consider what we need from ourselves and others, what we will and won’t tolerate, the people we want to be connected to and the communities that matter to us.

This is important because though loneliness has no opposite, it is remedied by community: physical, symbolic, practical and emotional. It is not the number of connections that matter, it is the nature of those connections. It is whether there is empathy, compassion, understanding and a sense of ‘community’, a word itself that means many different things, as my book shows.

A Biography of Loneliness traces the emergence of loneliness as a ‘new’ emotional state under neoliberalism, as well as the incidence of loneliness in the lives of historical others: Queen Victoria, Sylvia Plath, Virginia Woolf as well as some lesser-known names. It shows that loneliness is a social as well as a psychological emotion; that it can be ‘a disease of the blood’ as Plath put it, but how it can also be a source of liberation and creativity.

I talked to Canada’s CTV recently about why a loneliness pill isn’t the way to solve a so-called loneliness epidemic. Our solutions need to be social and collective as well as individual. And that means taking responsibility and accountability for others - in the online and offline worlds.

It is the nature of the individualistic West not to be accountable for others, to see this lack of accountability as ‘natural’ somehow. So we pretend not to see the suffering or others, or to know that someone is unhappy. We tell ourselves stories about why people are homeless or alone or depressed. We choose not to look beyond the charming man facade, to see the abuse that it might hide.

We turn a blind-eye to the troubles of others because neoliberalist society tells us that’s OK. Or at least a vocal enough section of that society that passes as the norm. Libraries closing? So? We don’t use them. Social and housing benefits slashed? Scroungers should find jobs. Elderly people having nobody to change their bandages? Their families should do it. No work? Must be the immigrants. Teenagers struggling? Blame social media. Kids in cages? Not our kids.

I wonder how loneliness would be reframed in an age of compassion, if we acted as though we were each conjoined, somehow, in a bigger project of human kind. And is that so preposterous an idea? ‘No man is an island’, no woman either., as the poet John Donne put it in 1624: ‘We are each ‘a piece of the continent, a part of the main’. (MEDITATION XVII Devotions upon Emergent Occasions.)

What would happen to loneliness if we embraced collective responsibility to one other with the commitment and bravery of a 16-year-old girl crossing the Atlantic on a yacht?

To find out more, check out A Biography of Loneliness. You can pre-order from the Oxford University Press website directly with a 30 per cent discount using this code: AAFLYG6


About face: An update

I am delighted to announce that Dr Victoria Hoyle will be joining Dr Stef Eastoe as a PDRA on my UKRI FLF project “About Face: the affective and cultural history of Face transplants.”

Stay tuned for some exciting developments taking place in the next month, including new clinical partners, the first Advisory Board meeting in September and a project launch event in October.

About Face will explore the psychological and cultural meanings of face transplants as well as the broader histories and ethics of disfigurement and surgery - and the meanings of the face in 21st-century culture. We will be asking a LOT of questions, like:

What does disfigurement mean mean to you?

Is your identity in your face?

Would you give away the face of a loved one?

What are the ethical limitations of innovative surgery?

How do concepts of gender, ethnicity, beauty and culture Influence the “value” of a face?

What makes a face, a face?

Our social media and website will be up and running in the next month and I can’t wait to share what’s happening and ways you might like to get involved.

Face perception at the University of Iowa (2011)

Face perception at the University of Iowa (2011)

Why a Loneliness pill is not the answer: my INTERVIEW wIth ctv newS

The problem with a loneliness pill, which has been promised by some researchers (with the best intentions) is that it medicalises and pathologises loneliness. It suggests that loneliness is a single state rather than a complex and historically-situated social one.

We need to understand loneliness in relation to the complex theme of belonging rather than presume it is inevitably connected to depression or anxiety. Sometimes loneliness is positive. Sometimes it is temporary. Always it is linked to our engagement and sense of belonging in the social world. Alleviating the negative symptoms of loneliness with a pill just takes us further away from understanding its complexities. And branding a perceived increase in loneliness as “an epidemic” is damaging because it presumes we have no control. Loneliness “happens to us” in this model, rather than being a product of modern life and individualism.

I explore these themes in some detail in my book A Biography of Loneliness which will be out on 12 September. In the meantime, Please link the below link to see my brief interview with CTV News Canada on the limitations of a “loneliness pill”.



A pill for loneliness? Interview for the National Post

I was interviewed recently by Sharon Kirkey on the subject on loneliness. I’ve had some amazing conversations with Sharon before about face transplants so it was a lovely coincidence to discover she was writing a piece about loneliness in Canada.

Like many places in the Western world, Canada is experiencing high levels of loneliness, especially in women in their 30s. One of the problems in assessing loneliness, however, is that there is little analysis of the ways we collect data and the categories used. How many women in their 30s complaining of loneliness are new mums for instance, for whom loneliness is an inevitable part of life sometimes - especially those “pinch points” where we transition from one way of being to another.

Other pinch points include adolescence, university life, marriage, parenthood, divorce, redundancy, retirement, widowhood - any of the moments that require us to reevaluate who we are and our place in the world.

We need a more nuanced approach to the “loneliness epidemic”. That includes who loneliness affects as well as the different emotions involved and the role played by time, gender, class, health and ability.

Sometimes loneliness is chronic and damaging, other times it is transitory and manageable (even pleasurable) and that is why we need a far more sophisticated approach to loneliness than we have at present. And we also need to consider the political function of loneliness: not only how political choices (like withdrawing benefits and closing libraries) can increase loneliness, but also how loneliness can serve an important political function. It can even give rise to populism and totalitarian governments.

Check out the article, which includes other key researchers in modern loneliness, including Susan Matt and Luke Fernandez. And consider: is the loneliness pill really a solution? I will discuss this more fully in my next post, which includes a live interview I gave for Canadian news organisation CTV.


Loneliness in Canada: a national epidemic?

Loneliness in Canada: a national epidemic?

Ideas worth Spreading at TEDSUMMIT 2019

I just returned from an exciting and fascinating experience of the TED Summit. I will be blogging my thoughts about that event over the next few weeks, and uploading my talk when it’s available online. For now, here’s a summary of my session - and what a privilege to share a stage with the First Minister of Scotland Nicola Sturgeon and the comedian Omid Djalili.

For a preview of what I spoke about - and what others in the session had to say - follow this link.

Me and the sign2.jpg

An emotional history of face transplants

I am delighted to share the news that I have been awarded a Future Leaders Fellowship by UK Research and Innovation. This was announced on 7 May by the Science and Innovation Minister Chris Skidmore. You can read about the remit of the awards here and what they promise to bring to the future of UK research and innovation.

My project will create a new cultural framework by which we can understand the emotional and ethical impact of face transplants internationally - and in the UK. There have been close to 50 around the world, but none so far in the UK, despite the fact that the UK has long been a leader in facial reconstruction work, and in preparing the ground for face transplants.

More details on my project are available here

One of the most emotionally challenging aspects of the project is the trauma that people receiving face transplants have undergone, and the transformative potential of this extraordinary surgery. The youngest person to receive a face transplant to date is Katie Stubblefield, who was treated at the Cleveland Clinic. Her story was written and documented by the writer Joanna Connors and the photographer Maggie Steber for the National Geographic.

You can learn more about Katie and her journey in the video below.

Please be aware that this video contains images and experiences that you may find upsetting.

interoception and the emotional body. or, how do we know what’s going on inside?

On March 1 2019, I convened a workshop on the visceral bodywith Professor of Psychology, Manos Tsakiris. Exploring the cultures of interiority and interoception (the subjective awareness of what is happening inside the body), papers drew on a wide range of historical, social, psychological, neuroscientific and artistic considerations. They explored the visual history of interiority – from medieval anatomy to 20th-century brain scans – and considered the relationship between subjectivity and objectivity, the meanings of ‘self’ and society, and how the two connect.  

 What struck me, as stories weaved from Jack Hartnell’s account of the 13th-century Abbey of Maubisson to Katerina Fotopolou’s research at the 21st-century London Neuropsychoanalysis Centre, was the different ways bodily subjectivity has been accessed and interpreted objectively. Most notably from the 19th century, with the emergence of scientific medicine, but also through the distancing lens of the other, as I discussed in my own contribution on the heart of Harriet Martineau (see also my book, This Mortal Coil.) Perceptions of emotions are no different. Modern neuroscientific accounts of emotion tend to focus on the brain rather than the heart – replacing the cardiocentric model of emotions that dominated Western medicine for two centuries. But the viscera are back: heart-brain and gut-brain interaction are becoming reintegrated into new interoceptive models.

Interdisciplinary events like these allow us to explore key areas like interception in new and exciting ways. And to consider the ways that historical ideas about medicine and health tend to find their way back into modern analyses. You can download the podcast of the day’s talks here: https://backdoorbroadcasting.net/2019/03/dissecting-the-visceral-body-across-time-and-disciplines/

I talk more about the emotional body in my forthcoming book with Oxford University Press on the history of Loneliness:, entitled A Biography of Loneliness: The History of An Emotion. Having submitted the monograph last July, the wait has seemed interminable. But copies will be available for pre-order soon, and I’m delighted to be able to share the cover with you at last.


Writing women: World War 2 and the Railways

I haven’t posted for a while. I have been busy with writing and thinking and funding bids. Time has lost its regularity and its meaning as I play the waiting game. So I did what I do when I struggle for inspiration - talk to other writing women about what inspires them. This blog will feature on the History Girls website, for which I write on the 15th of each month.

For today’s blog I spoke to Susan Major, who has written a fabulous book about women working on the railways during World War 2. This book is important because although we know that women took on many traditional men’s roles during the war, very little has been published on women in the railways. Railways were a reserved occupation, so in theory men continued to work on the railways while their counterparts in other industries were sent off to war. In reality, the men working on the railways were often old and disabled. The issues confronted by women workers were those that existed in other activities:  economic, sexual, social and temporal, their lives being changed by the new habits and relationships brought by the war, as well as its ending. Susan’s book is a welcome addition to our understanding of the lives of working women in the Second World War, as well as its gender politics. 

Susan Major completed a PhD with the Institute of Railway Studies & Transport History at the University of York in 2012. Drawing upon material from the National Railway Museum and the British Library, she focused on early railway excursions. Her book based on this research, Early Victorian Railway Excursions, was shortlisted for the Railways and Canal Historical Society Book of the Year Awards 2017. Her latest book, Female Railway Workers in World War II, was published by Pen & Sword in 2018. Susan was a programme consultant for the BBC series Railways: the Making of a Nation, taking part in the episode on leisure. She is retired and lives in York.

Fay: “So Susan, what drew you to the subject of women on the railways?” 

Susan: “Well I completed my doctorate, which later became a book, on Victorian railway excursions. Later, when doing some research about railway voices I discovered the National Archive of Railway Oral History at the Railway Museum, which contains many different  interviews with  people working on and associated with the railways. Quite a lot of this material has been digitised and indexed and transcribed. Among all the men recorded, there were some women and I realised that their voices had not really been listened to. And there were enough women talking about the wartime period, and about working in what were commonly perceived as ‘men’s jobs’, to form the basis of a book. And remember that even so-called ‘women’s’ jobs in those days, like working as a clerk, had been men’s jobs when in the railway context. And I wanted to know not only what everyday life was life for those women, but also how they were looked at by other people, by the companies who were employing the women as well as commentators in newspapers of the time.” 

Fay: “ Are there any particular women that stand out for you?Any stories that were especially memorable?” 

Susan: “There was a female porter at York station, when it was bombed in 1942. A train was also bombed on its way into the station, and these were terrible conditions to work in. The social conditions could be difficult too; she tells a story of a parcel foreman that the female workers had problems with and they sorted him out by giving him some chocolate, which happened to be laxative chocolate.”

Fay: “What can you tell us about the kind of women in these roles, their age or class for instance?”

Susan: “Well it’s a very select sample, dependent on who was chosen to interview. And these women would all have been young at the time, because the older women would have died by the time the stories were recorded. And they described liking the companionship of other women, the responsibility, and, unlike factory, work the variable and different activities involved.”

Fay: “Were the women all unmarried? I’m thinking about other roles of the time, which had very strict union rules”.  

Susan: “Yes. If you got married you had to leave. Most of these women were aged between 16 and 22 and often they met a railway man and got married and that was the last we hear of them. By contrast the newspaper reports were keen to tell readers about those women who might have 12 children and still carried out a role. And there was a sense that a woman wasn’t quite acceptable in publicity unless she had some link to a railway man. Women were not treated as individuals in their own right.” 

Fay: “Were most of these women working class women?”

Susan: “Not necessarily. Many were working class though there were also reports of quite posh women working on the railways. The ones that were interviewed were mainly ordinary women, who had a clear sense of their roles and their relationships with other women and you get a real sense of the culture of the workplace through the stories that they tell. Compared to other work, like factory work, the duties could be varied and interesting”.

Fay: “What do these interviews say about how it was to be a woman in a traditionally male environment?”

Susan: “There is some discussion about workplace harassment, much of which was taken for granted. For instance one of the accounts describes the experience of a typistThey had to go down and check their work with one of the men in the office. She said “And there were never enough chairs. So we used to share a chair with a man. And I think the feminists these days would be horrified. They'd probably be having all the men done for harassment. But we used to call it fun”

[Pause for reflection and a little teeth-gnashing]

Fay: “So these women would have to sit on their boss's lap.” 

Susan: “Yes, or share the chair. And there are a lot of examples of that. And women would talk about how they worked all day while their male supervisors stood around talking about sport. And at the end of the working day the women would get ready to go home and the men would say “overtime now”. And the men got paid more for the overtime, while the women had often families to get home to.There was also this concept of the “railway family”, which other historians have written about. Employees were encouraged to think of the railway as a family, and there were magazines prompting this image. And there was a sense that you could only get a job in the railways if your father put you forward, for instance, and while that wasn’t necessarily so in practice, it was how people thought about the railways as paternalistic employers”. 

Fay: “After the war did these women get sent away from the jobs, as they did in other industries?” 

Susan: “They were dispensed with, yes. Although I’ve focused on women working, the last chapter of my book is called: “and then the men came back”, which draws attention to the way women workers were dismissed. One woman, a guard, was sent a letter thanking her for her service. Only it wasn’t sent to her but to her boss. She had to travel a long way on the train to get to his office after a long shift, where she was shown this piece of paper, which he then kept, before trekking all the way home again”. 

Fay: “Thank you for a fascinating introduction to the book”

If you want to win a copy of Susan’s book, then check out the History Girls website on 15 February, when I will be running a competition for readers.

Railway women. To find out more  click here

Railway women. To find out more click here

The art and science of the heart

I recorded an interview for Radio 4 this week for their upcoming programme on the Art of Living, which looks at the work of artist Sofie Layton and bioengineer Giovanni Biglino at Great Ormond Street Hospital. Sofie and Giovanni worked with patients on visual images and stories about the heart, as an object of science and a metaphor for emotions. As an interdisciplinary art project, The Heart of the Matter is an important intervention into the different ways we look at, and think about the heart as both a pump and something so much more.

In Matters of the Heart: History, Medicine, Emotion published by Oxford University Press in 2010, I explored the reasons why we focus so much on the heart in popular culture - why the heart stands for authenticity, truth, meaning and emotion (especially love) - when it is widely regarded as a pump. The answer lies in the 2,000 years of medical history, when the heart was not only the warming centre of the body under humoral medicine, but also held a significant role in mediating the demands of the soul that worked in and through the physical body.

For the Ancient Greeks, as well as for the Ancient Egyptians and Mesopotamians, a Cardiocentric or heart-centred model of the body predominated. The heart swelled to attract all that was good and contracted to repel all that was evil; an early attempt to account for the sheer physicality of emotions as lived experiences. Not until the 19th century, when the brain was erected as the organ of the self par excellence, did the heart begin to diminish as an explanation of feeling and emotion, though the metaphors have continued, as I discussed in an interview in The Atlantic.

The rise of Cardiology, the parallel rise of Psychiatry and Psychology - as I explored in This Mortal Coil: The Human Body in History and Culture - these were the processes by which the heart’s scientific status was limited to a passive rather than an active organ. The heart responded to the brain’s desires, but it did not have a life-force of its own; it as motivated by reflex rather than the soul.

The origin of these changes can be traced back to the seventeenth century, and the popularisation of the circulation of the blood by the physician William Harvey. I say popularisation because, contrary to popular wisdom, it was an Arab physician, Ibn Al Nafis, who discovered pulmonary circulation in the thirteenth century. This historical oversight reinforces the great man of Western medicine model at the same time as it diminishes the significant impact of Islamic medicine and culture on the West for thousands of years. Yet it took the Renaissance and the flowing of visual arts and books on human anatomy, most notably by the Flemish anatomist Andreas Vesalius, for the idea of circulation to take off in the West.

One could argue that it was not until artists made visible new ways of thinking about and imagining the physical body that physicians were able to see and create alternative narratives of the body and the heart. This is a reminder that science does not simply reflect the body “as it is” but partakes of the wider cultural context in which it takes place. Science works in conjunction with popular narratives and beliefs - such as the well-entrenched idea of the heart as the centre of emotion, feeling and the self - even as it rebuts them. I spoke to one eminent heart surgeon who was unable to contribute to a discussion about the metaphorical heart for a simple reason: it would be impossible to remove the heart from a human chest if it was the site of the self, or love, or emotions. And yet medical students often report anxieties about dissecting the heart - just as they do the brain. Both are weighty organs, after all.

Art and science are always linked, which is what this exhibition makes clear. Part of the reason is the shared languages, metaphors and visual images that provide hooks for our understanding; that help to make the interior visible, and coherent. Hearts are objects of the self and emotions as well as pumps. And after all, though we schematise hearts as pumps versus hearts as metaphorical symbols, physicians are aware of the two-way process between the hearts and the emotions. We do not have to go as far as cellular memory theorists, and the belief that the heart has more neurons than the brain (and is therefore capable of physical memory) to understand the significant ways the heart impacts on feeling. The brain-heart connection is a deep, enduring part of the chemistry of the human body.

That connection is also based in language and metaphor. Hearts were furnaces, now they are pumps. But they are also receptacles of feeling and compassion, and linked to our fears and anxieties around transplantation, and where the limits of the human might be. In other cultures, too, besides the West, hearts matter. The heart (or Anahata) is the fourth Chakra of the body in Hindu, Yogic, Shakta and Buddhist Tantric traditions. The heart Chakra is associated with balance and calmness, as well as truth. In Chinese medicine the heart is a yin organ, that governs joy among other emotions. As in the West, ‘heart’ means more than a mere organ.

Talking about the meanings of the heart is important. It reminds us not only that the body carries symbolism and meaning that is more than the sum of its parts, but also that the stories we tell are also carried along with us. As patients, parents, lovers and friends, as much as artists, philosophers, medics and scientists, we are all curators of an ongoing discussion of what the heart means in the 21st century.


Tending to the lonely body - or when 'social prescribing' might make a difference

As the government turns, piecemeal, to ‘social prescribing’ as a way of countering loneliness, I wrote this piece for the Guardian that emphasises the importance of the body as well as the mind. Tending to the body, I argue, is every bit as important as focusing on talking; after all, it is relatively recently that mind and body were conceived as separate states.



An Interview with Amanda Vanstone at ABC National Radio

I talked recently to Amanda Vanstone, the Australian former politician and ambassador to Italy, now presenter of “Counterpoint” for the Australian Broadcasting Corporation (ABC). Our subject was the neglected history of loneliness. You can listen to and download the programme here.

Why not get in touch to let me know what you think?


Sylvia Plath's Letters, Volume 2

I have just finished reading the second volume of Sylvia Plath's Letters, published by Faber and Faber. They make for sober reading. The first volume, published in 2017, covered the period 1940-1956. In those, a smiling, bikini-clad Plath beams out from the front cover, while the pages are filled with the optimism and hope of youth. There are pockets of doubt and difficulty, the hint of rape and a suicide attempt, but also Plath's growing certainty of herself as a writer, a woman and an equal to the towering figure of Ted Hughes, with whom she is forever linked.

It is evident from the book jacket that the second volume will be a more serious affair. Gone is the summer sun and the happy expression. Viewed from the side and in monochrome, Plath's expression is serious, her hair tied up in a no-nonsense style. In nearly 600 letters, we follow Plath's marriage to Hughes, their movement around the globe and the UK, her library successes and his more immediate recognition, childbirth and child loss, a breaking-down marriage and her suicide at the age of 30.

To Plath, Hughes was a giant, a genius, a literary God. He must be fed steak for breakfast and waited on, his needs tended to. Yet she also resented her domesticity, her entrapment to the demands of her husband - first moving to Devon because he wanted space, searching for childcare in order to write,  and juggling the demands of that writing along babies, cooking, cleaning and tending to Hughes. The marriage was intense. It was also violent. She wrote to her psychiatrist that Hughes beat her when she was pregnant, causing her to miscarry their second child. 

In the foreword to the book, their daughter Frieda meets these claims head on. She writes in defence of her father, justifying his apparent violence towards Sylvia - which is also recorded in Plath's journals - on the problematic grounds that what was meant by 'a beating' is unclear (a hit, a swipe, a push?) and that her mother had been difficult, needy, disruptive. It is difficult to read this perspective, and to compare it with the plaintiveness of Plath's own journals, the constant fretting about existence that hovers at their margins, her need to do right, live right, be right. 

Yet it is clear in Frieda's foreword how difficult it must be to have parents so utterly in the public eye and simultaneously capable of creating division. Plath was better known after her death than in life, with her books The Bell Jar (a semi-autobiographical novel about a nervous breakdown) and her poetry. Her writing is said to have contributed to the development of the confessional style in literature. And yet it is Hughes who is remembered in Westminster Abbey, not Plath.

Plath's final letters were written just a few days before she died by suicide in her London flat. She had successfully moved back to the city after being left by Hughes (he was unfaithful with their tenant Assia Wevill, who, in a terrible mirroring would kill herself and her daughter in the same way that Plath died). Plath seemed to be getting better; she had been knocked by Hughes' infidelity and the subsequent rejection of some friends, and she struggled with Frieda missing her father. She was convinced that her daughter had 'latent schizophrenia', and she fretted constantly about her wellbeing.

It took such effort on the part of Plath to reestablish herself, to find childcare, to push herself back into the London scene, that the exhaustion is apparent on the page. Her letters to people become repetitive as she tells one after another about Hughes' adultery and abandonment, the money he is to pay, his family's turning on her, her living in Yeats' house and how that was fate, and finally, the endless illness, colds and flu of her children. 

In the main, Plath's letters have an enforced jollity even when she is struggling. From time to time she was angry and critical with her mother, but she also felt responsible for her, writing to her sponsor, the American author Olive Higgins Prouty, not to pass on information that might cause Aurelia worry. Prouty had suffered with mental health problems too, so Plath felt she was an ally. Plath was convinced that Hughes wanted her to kill herself, something she refused to contemplate. 

But by the beginning of 1963, despite all her contrived hope and determination, Plath was sleep deprived, unwell, lonely and depressed. On 11 February, having previously convinced herself, and her psychiatrist that she was no longer a suicidal 'type', she left out a snack for the sleeping children, took precautions to seal the kitchen and gassed herself in the oven. 

Two years after her death, Plath's collection of poems Ariel was published by Ted Hughes. These poems, including the eponymous poem written on her 30th birthday, drew on the pain of abandonment and loss that had followed her marriage breakdown. This is the writing for which she is best remembered. 


And now I

Foam to wheat, a glitter of seas.

The child's cry 

Melts in the wall. 

And I

Am the arrow, 

The dew that flies 

Suicidal, at one with the drive 

Into the red

Eye, the cauldron of morning. 

Available from  Faber and Faber

Available from Faber and Faber

Libraries as a lifeline for the lonely

I have been thinking a lot about libraries and their links with loneliness. It seems that often we defend libraries on the basis of their links to literacy and equal opportunity, and I couldn’t agree more.

However libraries are more than spaces filled with books etc. I posted here for the History Girls collective on why libraries are also a lifeline for the lonely.

What do libraries mean to you? What was the first library you visited? Do you still visit the library, and if not, why? I would love to hear from you. 



Oswestry library: my childhood saviour 

Suicide and loneliness

For the past couple of years I have been blogging regularly for the History Girls, a collective of bestselling fiction and non-fiction writers who cover every imaginable period of history. This week I blogged about the suicide of Anthony Bourdain, and the ways we talk about suicide in the twenty-first century. You can read that blog post here

One of the reasons I was thinking about Bourdain, aside from the terrible sadness of his death and the challenges we have as a society in framing suicide, was how alone he must have been in his final moments. I have just submitted my history of loneliness for Oxford University Press, in which I explore the meanings of loneliness across cultures and time periods. Being alone - not necessarily physically, but emotionally - recurs time and time again in discussions of suicide.

The language of suicide can be blaming - a person 'commits' suicide because it was a criminal offence until 1961, just like murder or rape. This terminology is outdated and unhelpful and it creates the sense that the suffering person is somehow selfish or wilful, rather than a person whose pain outstrips their coping mechanisms. 

Suicide, like loneliness, is difficult to talk about. Both states carry the whiff of shame because of the way they are talked about in the 21st century. Terms like 'Billy no-mates' or 'loner' create a gulf between the self and others. And like loneliness, suicide is linked with intense depression and a feeling of being shut off from the world; of seeing the world through glass. A population-wide study found close associations between feelings of loneliness and suicidal ideation, or an unusual preoccupation with thoughts on suicide.

Emotional separation, alienation, an unwanted sense of being alone, these are human experiences, but they need not be universal. The 'Time to Change' campaign has highlighted the importance of other people in reaching out to someone who is lonely or depressed. For people who are socially isolated, that is a challenging bind; the separateness from others creates an additional invisible barrier between the self and the rest of the world. 

The campaign to reduce the stigma associated with mental health has been credited with some success. Attitudes towards the mentally ill are harsher in climates of economic instability, however, when the most vulnerable members of society - like refugees - are the most common victims of scapegoating. And there is a limit to the effectiveness of encouraging people to talk while mental health budgets are being slashed. What must be more isolating than being ready to talk, yet finding nobody to hear? 

What Bourdain's death from suicide tells us, like that of the designer Kate Spade just days before, is that external manifestations of success or happiness are no real indicator of emotional contentment. I do not know whether Bourdain or Spade were lonely, though people can be loneliest of all when surrounded by other people. Dying alone, from whatever cause, is a lonely way to go. 

The ways we talk about suicide and loneliness matter. It can isolate people further, or create a welcoming space in which blame has no place. This is especially important when people are disconnected from others, when it seems impossible to talk because there's a gulf of experience, and language. It's not always good to talk; sometimes it's good to listen. 

A Biography of Loneliness will be published by Oxford University Press. 

Samaritans mental health hotline is open 24 hours a day, seven days a week. It can be contacted at any time from any phone for FREE on 116 123. 


Loneliness in history: the case of Queen Victoria

This post also features on the History Girls blog: http://the-history-girls.blogspot.co.uk

Loneliness is a 21st-century problem; an epidemic of global proportions, linked variously to heart problems, mental health crises and dementia among the old. We are social animals, psychologists say; we are supposed to be around other people. Thanks to social media, cuts to social care and a growth in living alone, however, many of us are alone for vast swathes of time.

There are old people who only see another human being once a month, according to some recent studies, and an unknown multitude too shy, too depressed, too unwell or incapacitated to make meaningful social connections. That's the rub, you see: the connections have to be meaningful. Not in an abstract sense, and to other people, but to us, as individuals.

Loneliness has seldom been explored as a historical problem, but it is one. It's all very well to lament the rise of loneliness in the digital age - one of many themes I explore in my forthcoming book on the subject - but people have been lonely, in one sense or another, in earlier times and cultures. One of the chapters in my book describes the loneliness of widowhood and old age, with one of my case studies being Queen Victoria.

Why was Victoria lonely? There have been many literary and visual adaptations of her life, but few have addressed this problematic question. She was lonely because she lost Albert, the man she relied upon in so many aspects of her life, at a relatively young age. And suddenly.

Victoria and Albert had married young - just 21 and 20 respectively, though Victoria had inherited the throne at 18 years old. Together they had nine children, and became inseparable by all accounts; he developed a reputation for public causes such as educational reform and the abolition of slavery, though he had only the role of consort.

When Albert died, aged only 42, Victoria entered a deep state of mourning, and wore black for the rest of her life. It did not matter that due to her rank and status Victoria was one of the least alone women of her age, or that she was attended by a multitude of servants, family members and hangers-on. She missed that special connection she had enjoyed with Albert, the sense that the two of them were unified in their emotional, political, familial and practical lives. Maybe that's why Mr Brown was so important to her; a man she could confide in about anything at all, a man who didn't only see the queen but also a woman.

There is something very specific about losing a husband, Victoria complained when her daughters later married and moved on with their own lives. Nobody could understand it, until they have experienced it. I would extend that further by acknowledging there is something very particular about losing a partner, a perceived 'soul-mate' especially when one imagined growing old with that person; being able to look back on a life lived when one is old and worn.

Queen Victoria wrote in her journal on 20 June 1884: "The 47th (!!) anniversary of my accession. May God help me, in my ever-increasing loneliness, & anxieties'.

Loneliness cares not for status. And it changes over time, depending on our age, networks, expectations, religious belief and health. Concepts of loneliness have also changed, from the 18th century to the present day. So, too, have perceptions of grief, and an appropriate time to mourn.

 Queen Victoria was the subject of considerable criticism in her day about the length of time she spent in mourning, her choice of black garb, her reluctance to be seen in public. She became known nationally and internationally as a sad and lonely figure, even though she regained some public affection in her later years. The loss she felt over Albert's death, as well as her palpable resentment, anxiety and depression about being abandoned, never ended, though Victoria lived to be 81 years old.

In part, Victoria's critics were right. She didn't move on from Albert's death, which was an understandable and conscious choice. For all intents and purposes, the rituals of the household continued as though Albert had not died: from his clothes being laid out each morning to the marble hand, a cold replica of the real thing, that sat on Victoria's bedside table.

On a regular basis, Victoria would get out all the photographs of Albert; the gifts he had given her, sentimentally recalling memories that made her sad and happy in equal measure. She would visit his mausoleum and statutes and speak of him again and again to anyone who would listen. However painful it might have been, Victoria breathed in his absence every day. And perhaps that had a function; keeping the shadow of loneliness about her was the only way to keep Albert alive.

A Biography of Loneliness will be published by Oxford University Press

Victoria ( r. 1837-1901)

Victoria ( r. 1837-1901)

Gender, surgery and silencing women: why the ‘mesh scandal’ is depressingly familiar

On 12 March, BBC News reported on the case of Lucinda Methuen Campbell, a woman who had been treated in 2014 with a mesh implant. Campbell had consulted the surgeon privately, ‘desperate for a solution to the pain’ she was experiencing, linked to ‘complex’ problems with her bowel and womb. She wanted to avoid having a hysterectomy, and a surgical mesh promised a solution.

Campbell’s surgeon, Tony Dixon, was one of the pioneers of the use of a surgical mesh to fix prolapses of the bowel. A mesh is a woven sheet that is used as a permanent or temporary support for internal organs and tissues. Since the 1990s, meshes have been used in a range of reconstruction and repair surgeries, especially for pelvic and vaginal wall reconstructions in women.

Some meshes are intended to degrade in the body and others are more permanent. All are increasingly controversial. Polypropelene meshes in particular have been associated with severe discomfort and internal problems. More than one woman has died from complications linked to the use of vaginal mesh treatment.

Chrissy Brajac, just 42 years old, died of sepsis after repeated, antibiotic resistant infections linked to a mesh that she received. In her case, as in that of thousands of other women, this extreme and dangerous treatment was presented as a solution to minor stress incontinence after childbirth: the kind of condition that can be treated by a course of physiotherapy.  

Because of cases like Brajac’s, the vaginal mesh scandal, also referred to as the 'new thalidomide scandal’ (thalidomide being the anti-sickness medication once given to pregnant women with catastrophic effects) has attracted considerable attention. There are class action suits being brought around the world. An estimated 10,000 women every year in Britain alone receive a mesh implant for prolapse, hernias or incontinence, and despite fears over its safety, the operation is still being performed.

Somewhere between 10 and 40 per cent of women are believed to have experienced problems with mesh implants: not just chronic pain and loss of sex life, but also, as a recent article in The Independent noted, ‘organ erosion, perforation, implants slicing into vaginal walls, debilitating infections’ and more. Women report being dismissed and ignored or treated as hysterical when they draw attention to their suffering; surgeons defending the treatment maintain that no device is perfect, and that they offer patients a 'choice'.

In 2017, Parliament rejected cross-party calls for a suspension to mesh treatment. After a tremendous campaigning effort, the government finally agreed in January 2018 to review all cases of mesh implants (more than 100,000 cases), dating back to 2005.

This story is depressingly familiar. In the 1950s, when silicone implants were developed, they were announced as a saviour for women with breasts that were too small. Indeed, the condition of ‘hypomastia’ or pathologically small breasts was invented by psychiatrists at the same time as male cosmetic surgeons and silicone manufacturers came up with a solution: silicone implants, that could look and feel like the ‘real thing’.

The first woman to receive silicone breast implants, Tammie Jean Lindsey, agreed to be a guinea pig after she went to see cosmetic surgeons about her sticking out ears. The surgeons who were working on the silicone implants – and had successfully implanted them into a dog – offered to pin her ears back for free, provided they could pop in some silicone implants at the same time. Lindsey hadn’t realised her breasts needed enlarging until the surgeons pointed it out to her. She agreed and spent the next few decades  in agony.

Since that time, there have been multiple questions raised about the ethics and safety of implants, including a moratorium on silicone implants in the US, and the PIP scandal in Europe. In the latter case, thousands of women reported psychological and physical problems linked to the implants, which were not made of medical-grade silicone, but the same material used to stuff mattresses. Nevertheless, silicone breast implants continue to be in demand, along with a wide range of cosmetic interventions.

It is not unusual for women’s complaints of ill-health to be rejected. There is a long tradition in medical history of hystericizing women’s experience, or reducing it to psychological causes. The term ‘hysterical’ itself comes the Greek word hysterika, meaning womb. The Ancient Greeks believed that a wandering womb that moved around the body caused a variety of mental disturbances. How often is the term ‘hysterical’ used today to dismiss a woman’s experience? There is more than one book on the history of women’s voices being ignored within medicine.

What the mesh scandal tells us is that yet again women’s health is being risked by a medical procedure that is demonstrably flawed. Women’s stories have been denied and not heard by professionals invested in the continued use of the mesh. It is only now that NHS records acknowledge a 'shocking' rate of failure that the mesh is under scrutiny. A similar neglect for women’s voices has been seen historically in the dismissal of conditions like endometriosis and the over-use of hysterectomies to treat a wide range of ailments.

Time and again in history, women’s bodies have been treated as a series of parts; in the case of urinary and gynaecological complaints, organ removal is often seen as an easy or convenient solution that requires less investment of time, and arguably money, on the part of healthcare providers. Since women are principally viewed through the lens of reproduction, why keep parts that are no longer functional?

There is no better illustration of this, than in the treatment meted out to Lucinda Methuen Campbell. Unbelievably, Dixon is said to have removed Campbell’s ovaries during her operation. He did so without her permission, and apparently without remorse. When she asked why, his justification was simple: she didn’t need them, and they were ‘in the way’. When Campbell expressed shock, the surgeon apparently said he had done her ‘a favour… I thought you know, a woman of your age [she was 54] wouldn’t really need ovaries’.

Ovaries are not merely designed to produce the eggs that lead to babies and women’s function is not entirely to reproduce. Ovaries perform a complex hormonal regulation of the body, and their removal has serious side effects that range from depression and anxiety and a decreased sex drive to premature death. 

How shocking that a surgeon’s convenience should be seen as more important than a patient’s systemic health, as well as her rights over her own body. And how familiar this is to other aspects of invasive medical treatment without consent – including, for instance, the little known but widely practised policy of giving anaesthetised women pelvic examinations for student training purposes.

‘My life is absolutely ruined’, Campbell reported after receiving the mesh. Sadly, she died at home in Swansea on 22 January, leaving two children, according to the South Wales Evening Post. The cause of her death is still being investigated. Dixon has been suspended by the NHS from performing this and related surgeries, and he has been referred to the General Medical Council for investigation.

The mesh scandal reflects an international crisis in confidence around medicine, surgery and women's health. Importantly, this is not a story about the universal indifference of surgeons to the suffering or rights of patients. Many surgeons care deeply about the impact of their work, and about the broader socio-political context in which they engage with women’s health. Which is why we need to hear more from and about these surgeons, especially those who speak out about invasive treatments that are ethically questionable, of unproven efficacy, and potentially damaging to health. 


Why do we send Valentine's cards? Take heart and ask Galen - or a medical historian

Last Sunday I gave a talk to the Sunday Assembly East End, which organised a theme on the heart. This community-focused, heart-warming event used poetry, music and story telling to explore the meanings of the heart in forging relationships. My talk provided some historical context of some of the things we take for granted, including the language of “heart felt feelings”, rooted in the body as well as the mind. The heart is, after all, the first sign of life, detectable in the embryo and heard even before birth, thanks to medical technologies. 

But why is it so ubiquitous in the language of romance? And why do we send Valentine’s cards that are covered in hearts that look nothing like the organ we associate with our heartbeat? To understand this, and the whole world of iconography of the heart in the modern West, we need to know something of its medical and cultural history. For thousands of years, a humoral theory of the body dominated understanding of how emotions, personalities and experiences were formed. The Greek physician Galen, working with the writings of Hippocrates, envisaged the heart as the centre not only of the physical but also the psychological body ("psyche" then meaning soul). Head and heart were not separated, as they are today, into different realms. The heart was the furnace of the body, the place where humours were concocted, and where the soul moved in pursuit of its desires.

That is why the beating of the heart was so fundamental in showing the movement of the soul, and the desires of the individual. The heart was an active organ, pulling the soul towards what was good and away from what was evil. In this humoral landscape, hearts could be hard and soft, warm and cold; hearts and spirits lifted together or were crushed by grief. The iconography of the heart - not as the organ of science and a pump that emerged in the Victorian period, but as a blood-red, symmetrical symbol we now associate with Hallmark greetings cards - has become ubiquitous, especially around Valentine's Day.

St Valentine is usually remembered as a third century Roman priest, killed for marrying couples against the wishes of the Emperor, who believed single men made better soldiers. By the medieval period, the Valentine tradition of 14 February was commonplace, perhaps originating as an effort to Christianise the pagan celebration of Lupercalia, which was held in February. 

The sentimentalism of the Victorians secured modern Valentine’s Day its convention of exchanging greetings cards in order to demonstrate love. Like the one that is depicted here, courtesy of Wellcome Images. And in keeping with the humoral tradition it is the heart that is placed at the centre: the organ that even now, while generally regarded as a pump, retains its traditional status as the organ of the self, personality, emotions and love. 

We may not give much thought to why we celebrate with the heart rather than any other organ. Though the modern separation of mind and body, and the belief that emotions are mostly products of the brain, suggests we might have moved away from the heart to the brain as a cultural symbol of love. Admittedly the results would be rather less aesthetically pleasing. "I brain you" carries a rather different meaning. 

To find out more about the history and cultural meanings of the heart as symbol and organ, why not check out my book, Matters of the Heart, which is available here.  You can also listen to a recent interview on the subject I recorded in Westminster Abbey for Radio 4 here.

Happy Valentine's Day!