As an expressive arts educator and advocate, a central ethos of my teaching approach is to bring ideas to life through multi-media arts expression, referred to as intermodal processing, using the arts as a tool to process themes. This method invites students to connect to ideas intellectually and kinesthetically, to let the ideas begin to live inside themselves, which can stimulate new interpretations of the material.

When I stumbled upon the Project UnLonely Film Festival, I discovered a cross- cultural, intergenerational, intersectional collection of short films exploring themes of loneliness across the lifespan; I laughed, I cried, I reflected; each film offered an impactful lens into human struggles and triumphs.

In my graduate-level teaching at NYU, I have integrated Project UnLonely films into my lessons. To explore themes of aging, Burning Van, the story of nomadic seniors, and Dial a Ride were compelling films on the struggles of aging persons finding safety, shelter, and community. I also showed The Paint Wizzard, a poignant, intimate story of an aging trans female painter finding meaningful work and place in the world.

In my classes on Trauma & Recovery, Sticks and Stones, a film about toxic masculinity, left a powerful impression on students, especially seeing visually through art images how hurtful images get internalized.

The harms and benefits of the digital world is an ongoing mental health theme in my classes; I loved contrasting I Forgot my Phone, a funny, compelling look at our obsessions with phones and what we miss out on in the present moment, with Ms. Diva Trucker, is a beautiful film on how social media builds community for so many isolated people.

Cinema Therapy, a branch of the expressive arts, posits that stories allow us to feel, reflect, and draw inferences about our lives with safety & aesthetic distance. For therapeutic aims, I have also recommended Project UnLonely films to psychotherapists to use as a tool for processing in counseling in my community public health lectures.

Project UnLonely is not only a case study on loneliness across the lifespan but also a model of the future of inclusive storytelling. Screenplay Writer Robert Rippberger says that if you have seen 1000 movies, you have lived 1000 lives. The films of Project UnLonely tell stories about aging, gender identity, immigration, race, sexual health rights, emerging adulthood, and more; they are stories told with bravery, transparency, and life affirmation.

The mission of Project UnLonely is a gift; they understand deeply that the true path to easing our loneliness is through social empathy when we find our shared humanity in the stories of each other.

Every year, Next Avenue awards advocates, researchers, thought leaders, innovators, writers and experts who continue to push beyond traditional boundaries and change our understanding of what it means to grow older. We’re honored that in 2020, our Founder and President – Jeremy Nobel, MD, MPH – was recognized as an Influencer in Aging alongside aging champions like Former Surgeon General Dr. Vivek Murthy, AARP’s Jean Accius, and our very own UnLonely Film Festival stars: Grandpa Chan and Grandma Marina.

Below, read a brief except of the article that was written by Julie Pfitzinger for nextavenue.org.

Harvard Magazine’s January 2021 cover story, “The Loneliness Pandemic,” covered the psychology and social costs of isolation in everyday life. The Founder & President of the Foundation for Art & Healing – Jeremy Nobel, MD, MPH – contributed his expertise having created the UnLonely Project, which increases public awareness of loneliness and lessens its burden for those struggling to cope. The Foundation and its UnLonely Project initiative provide art-focused activities and resources to help people heal emotionally and improve community well-being.

Read a brief except of the article, which was written by Jacob Sweet and harvardmagazine.com, directly below. 

In November 2020, the Founder & President of the Foundation for Art & Healing – Jeremy Nobel, MD, MPH – led a conversation with American Health Policy Institute about COVID-19’s impact on employee loneliness and isolation to help answer the question, What Can CHROs Do to Improve Employee Well-Being? Panelists included Dr. Stuart Lustig, MD, MPH, National Medical Executive for Behavioral Health, Cigna; James Garvie, SVP HR, Total Rewards and Technology, Southern Company; and Dr. Laurie Hommema, MD, Medical Director, Provider and Associate Well-Being, OhioHealth.

Workplace Burnout and Loneliness: What You Need to Know

Understanding the reciprocal relationship between loneliness and burnout.

By Jeremy Nobel, MD, MPH
As published on PsychologyToday.com 

Loneliness at work is often affected by other aspects of an employee’s daily experience, and perhaps no factor matters more than workplace stress and burnout. The relationship between burnout and loneliness is a reciprocal one. Burnout can lead to increased feelings of loneliness. When people feel overwhelmed, exhausted and dehumanized, it heightens their risk for isolation. Loneliness, too, can exacerbate burnout, by decreasing one’s capacity for resilience. It is critical for those experiencing loneliness at work to understand workplace burnout, and vice versa, to best navigate the workplace experience in a healthy, connected, and low-stress way.

In recent years, social psychologists, organizational behaviorists, and human resource personnel have noted a significant increase in the chronic and debilitating state of work-related stress known as burnout syndrome. And burnout seems to be increasing. Two-thirds of full-time workers say they experience burnout on the job and burnout among physicians, with a rate of 78%, has been declared nothing less than a public health crisis.

Most of us who go through a rough stretch at work, perhaps feeling overextended or falling behind, recognize that taking some time away from the workplace gives us the chance to relax and recover. But there are gradations of burnout that are deeper and more pervasive—something that a day off or even a two-week vacation can’t remedy.

The Mayo Clinic describes burnout syndrome as “physical or emotional exhaustion that also involves a reduced sense of accomplishment and loss of personal identity.” According to the World Health Organization, burnout is characterized by increased mental distance, feelings of negativism, and cynicism related to one’s job. Burnout erodes one’s sense of engagement and purposefulness and can breed emotional detachment, self-doubt, and shame.

The hallmark of burnout is exhaustion, experienced as a deep sense of fatigue and the depletion of physical, mental, and emotional resources. It isn’t necessarily the quantity of time spent at work that’s so exhausting, but the quality and nature of the time spent.

Pharmacy employee Sara Cox told The Guardian, a major newspaper in the UK, that burnout symptoms emerged with her increased workload. “Every Sunday, I had that feeling of dread that the next day I was going to have to juggle everything all over again,” she said. “I’d wake up exhausted, it felt like every day I was walking through thick mud.”

Boston Magazine profiles a lawyer who practiced for 15 years before walking away from his career and getting a job at his favorite cheese shop. “It wasn’t so much the amount of time spent in the office that got to me,” he told the magazine. “It was the mental and emotional strain of feeling like it was never enough, and that I had to always be thinking about work.”

The second characteristic of workplace burnout is apprehension that one is not performing one’s job effectively. Lack of control over one’s own working conditions is often a factor, as when employees feel they have no influence over the scope or complexities of their work and no voice in the decisions that shape it. In addition, workers may believe they lack the skills or access to resources required to complete tasks. This results in feelings of frustration, helplessness, and a diminished sense of personal accomplishment. According to the American Psychological Association, “the chances of burnout increase if you feel that you can’t express yourself on the job, or if you are taking on multiple roles that conflict with one another.”

Finally, burnout leaves people with a general sense of futility or lack of purpose causing discomfort— a feeling of: “What’s the point?” Burned-out people often feel disconnected from their jobs, professions, colleagues, and the people they serve, and a general sense of depersonalization. A restaurant manager in a Wall Street Journal article described his experience like being on autopilot, “like you’re just going through the motions.”

Certain workplaces seem to carry a higher risk for burnout among their employees, including healthcare and clinical environments, educational facilities, and community service organizations. What these venues have in common is the tension between the infinite demand for their services and the finite availability of resources. In many cases, complex bureaucratic systems, burdensome clerical and documentation procedures, and the absence of operational processes that facilitate workflow present further obstacles to efficiency and effectiveness. These conditions can compound employees’ feelings of underachievement, futility, pointlessness, and can even make them feel emotionally detached from the recipients of their services.

So, what does workplace burnout have to do with loneliness and isolation? Well, …everything!

Feeling disconnected from the people you serve often disconnects you from yourself, especially for the many of us who are motivated by a sense of mission and purpose. This disconnection can lead to depression, substance abuse and even suicide, all well noted burdens associated with loneliness. So, while loneliness may not in itself be a symptom of burnout syndrome, it is almost universally a consequence. And loneliness can actually cause burnout, as well as one’s susceptibility to it. People in the throes of work-related exhaustion, self-doubt, and defeatism are more likely to withdraw, interacting less and less, and effectively isolating themselves from the people around them. And those who already are experiencing loneliness in their lives may lack the emotional and spiritual resources required to feel replenished and resilient under challenging circumstances.  A person in this position can be vulnerable to even more burnout, compounding the feelings of isolation and loneliness.

Dr. Doug Nemecek, Chief Medical Officer for Behavioral Health at Cigna, explained the current challenges that employers face.  “Stress at work is not new. CIGNA has been supporting employers and employees dealing with workplace stress and burnout for decades. But the rising epidemic of loneliness nationwide is putting even greater demands on individuals, limiting their resilience to burnout and increasing their risk for mental and physical health challenges. This makes it all the more urgent to go “upstream” in addressing stress and burnout preventatively, including fostering a sustained sense of connection and belonging in the workplace for all employees.”

Employers recognize that burnout disrupts performance at the organizational as well as  individual level. Burnout among the workforce is strongly associated with low rates of commitment, productivity, and morale, and high rates of absenteeism and staff turnover.

Fortunately, a growing number of leading employers, many of them large health systems, are beginning to identify burnout as a critical issue that needs to be addressed. For example, the Icahn School of Medicine at Mount Sinai, Stanford School of Medicine, and UC Davis Health have all recently appointed Chief Wellness Officers whose mandates include addressing burnout syndrome among their employees. Non-healthcare employers are also increasingly active in addressing this aspect of wellbeing. The American Bar Association, for example, has a Wellbeing Pledge & Toolkit that guides law firms in addressing the issue.

But implementing such system-wide changes can be challenging, time-consuming, and costly and employers want to know whether the return justifies the investment. A comprehensive meta-analysis published in The Lancet substantiates the benefits of both individual-focused interventions — particularly mindfulness, stress management, and small group discussions — and organizational interventions, such as modifications to clinical work processes, in reducing physician burnout. And in a recent Health Affairs op-ed that was co-authored by 15 leaders in the field of medicine, the group cited “mounting evidence that certain interventions can decrease burnout and depression and enhance optimal well-being.”

It is “good news” that a growing number of programs are being deployed by employers to help employees alleviate stress, prevent burnout, and maintain work-life balance. When these efforts begin to truly reflect a company’s culture and are not “one and done” programs, they can also lead to a reduction in loneliness. Ultimately, feeling a stronger sense of purpose, belonging, and connection in the workplace can strengthen an employee’s ability and willingness to handle work-related challenges, and increase resilience when feelings of burnout surface. Stress-reduction interventions do have costs, but with evaluation and measurement strategies to determine benefits and outcomes, employers can calculate the return on investment that justifies these programs’ continued use.

Employers are beginning to think creatively about new ways to foster connection at work. For instance, the signature initiative of the organization I lead, The UnLonely Project, partners with employers to make available streamable short films from its UnLonely Film Festival platform, that can be used to promote dialogue on the issue. We’ve worked with financial service firms, technology companies, healthcare delivery systems, and municipalities to use these provocative films to foster timely and important dialogues addressing loneliness and burnout.

It benefits individuals and employers alike when workers are given the time and the tools they need to perform their jobs; when they enjoy a sense of belonging and connection; when they come to work knowing that they are valued, they have a voice, and they are heard. We think it’s an opportune time for workplaces of all sorts to begin to address burnout syndrome with sustainable solutions, and to pay greater attention to the loneliness and isolation at work that can result from burnout as well as exacerbate it.

Lisa Schinhofen contributed to the research and writing of this blog post.

This column will be a space for us to examine the broad range of scenarios and circumstances wherein loneliness and social isolation affect people. And although it’s become a social epidemic among Americans as a whole – nearly half of all Americans report feeling lonely or left out and one in four feel that they are rarely or never understood by others – certain populations, such as the elderly, the chronically ill and their caregivers, veterans, immigrants, and college students, are particularly susceptible. 

Going forward, join me and the UnLonely Project in exploring the effects of loneliness and social isolation on these communities and the individuals within them, and the variety of innovative approaches that can be used to foster a sense of connection to one’s self and to others. Together, we can forge new pathways to reduce loneliness and its burdens.

Finding Connection Through “Chosen Family”

Extending your definition of “family” can lead to a growing network of support.

By Jeremy Nobel, MD, MPH
As published on PsychologyToday.com 

When Samantha Nystrom first began questioning her gender identity, she didn’t turn to her parents for support. The thought of losing them wrote Nystrom, was too emotionally traumatic to imagine. So she turned, instead, to her friends. And when she did come out to her family and faced the rejection she had so feared, her friends were there to pick up the pieces. In them, Nystrom found a new family.

Nystrom is not alone. Today, many individuals find themselves navigating uncharted waters as they try to reconcile shaky relationships with blood relatives while simultaneously creating what’s commonly referred to as a “chosen family.”

According to the SAGE Encyclopedia of Marriage, Family, and Couples Counseling, “chosen families are nonbiological kinship bonds, whether legally recognized or not, deliberately chosen for the purpose of mutual support and love.” The term originated within the LGBTQ community and was used to describe early queer gatherings like the Harlem Drag Balls of the late nineteenth century.

The circumstances surrounding the birth of the first “chosen families”—intense loneliness and isolation faced by those rejected by their biological kin—continue today. Nearly 40 percent of today’s homeless youth identify as queer, and a recent study found that roughly 64 percent of LGBTQ baby boomers have built, and continue to rely on, chosen families.

“Chosen families,” though, can form as a result of any person’s experience with their biological family that leaves needs unmet. Friends who become your family of choice may provide you with a healthier family environment than the one in which you were raised, or their proximity may allow you to rely on them when your biological family isn’t located nearby. A chosen family can be part of a person’s growing network, and can help construct a wide foundation of support that continues to grow with time.

The importance of “chosen family” in many of our lives is reflected in the kinds of policies that have been implemented in communities around the country. Last year, New York City began allowing workers to use paid time off to care for anyone they personally define as family, whether they’re “related by blood or affinity.” In doing so, NYC joined other major metropolises like Chicago, San Francisco, and St. Paul, MN, as well as states like Arizona and Rhode Island, in honoring non-biological kinship.

For anyone seeking to surround themselves with chosen family, the task might seem daunting. Thankfully, finding chosen family has a lot more to do with fostering pre-existing networks of support than creating new ones. In the book Families We Choose: Lesbians, Gays, Kinship, cultural anthropologist Kath Weston defines chosen family as consisting of “friends, partners and ex-partners, biological and non-biological children, and others who provide kinship support.”

Chosen families do not come to us in perfect, nuclear packages; their very structure aims to resist the idea of family as something we are given and must accept. These are groups of people made from those we’ve loved, found, and raised. Chosen families are made up of people we share a connection or similar experience with, occasionally falling within the same sub-culture or socio-political demographic. They grow together like vines climbing the side of a house in summer: One day, you look up and realize they’ve bloomed, and there are simply too many to count.

But these groups of loved ones aren’t always a tidy solution to the issue of conflict and trauma with our birth families. Those who find their chosen family of friends, lovers, and children while attempting to maintain contact with biological family often experience a sense of guilt for trying to sustain both. In some cases, biological family members wonder why their relative would choose to spend quality time with anyone else—and might even shame them for their devotion to another group.

Of course, serving as someone’s chosen family can be difficult, too. Trying to nurture and support your own biological family and serving in the role of chosen family can be difficult, demanding, or leave you in a sort of linchpin role of supporting both structures.

While both your biological family and your chosen family might provide you with support, if the stress of being present for both is overwhelming, it will be impossible for you to care for anyone in your life—even yourself. Manage expectations so that the relationships with chosen family can function as self-care that energizes you for time spent with your biological family—and if you have a positive relationship with your birth family, vice versa.

So grow into your chosen family with confidence and grace. Developing these life-long relationships is akin to tilling a garden: You plant the seeds, create the right environment for growth, and see what beautiful things come to fruition. And when you end up growing a community, the investment of time and effort is well worth it.

Eli Harvey contributed to the research and writing of this blog post.

This column will be a space for us to examine the broad range of scenarios and circumstances wherein loneliness and social isolation affect people. And although it’s become a social epidemic among Americans as a whole – nearly half of all Americans report feeling lonely or left out and one in four feel that they are rarely or never understood by others – certain populations, such as the elderly, the chronically ill and their caregivers, veterans, immigrants, and college students, are particularly susceptible. 

Going forward, join me and the UnLonely Project in exploring the effects of loneliness and social isolation on these communities and the individuals within them, and the variety of innovative approaches that can be used to foster a sense of connection to one’s self and to others. Together, we can forge new pathways to reduce loneliness and its burdens.