Social connectivity and its role within mental health nursing

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Social connection is a concept relating to belonging and feeling close to others. Pavey et al (2011) suggest this is a core psychological need that is necessary for life satisfaction. This striving for connection begins at birth and continues throughout our life. Our ability to effectively communicate through voice, and non-verbal signs, such as touch and facial expression, register in our brains so we are able to parent and care for others in our social groups to help us adapt and propagate survival of the species.

Bowlby (1979) wrote on social connectedness and the quality of family dynamics in regards to attachment, bonding and care giving in pairs and in parenting. He was influenced by Freudian thought and the power of deep personal attachments in shaping how the mind looks at the social world, with its assumptions about trust and intimacy formed from early experiences within the family. He identified these as: a secure attachment style that is loving and warm and trusting; an anxious attachment style, where the person is worried and feels like people are going to abandon them; and the avoidant attachment style, which is shown by people who remain distant and possibly dismissive.

Shaver and Mikulincer (2002) have analysed different cultures and observed that secure attachment is essential for happiness so people can trust, are comfortable with intimacy and more likely to remain in stable relationships as they are more likely to be optimistic, forgive their partners, and offer social support. People who struggle are more likely to have an anxious attachment pattern and be more prone to depression, anxiety, drug abuse and eating disorders, for example (Mikulincer and Shaver, 2005).

Attachment status and resulting happiness helps shape the circuitry and systems related to nurturing in the brain when positive interpersonal interaction is delivered and received. Rifkin-Graboi (2008) discovered from the three identified attachment styles that if people received either good or bad feedback, there was a difference in response depending on their attachment status. When participants with anxious attachment style received negative feedback, there was an increased alarm response; however, avoidant attachment respondents elicited an aloof and disinterested reaction, coupled with a corresponding reduced boost of dopamine when any positive feedback was received, lowering joy and pleasure.

Developing Connections

Science indicates that one of the most effective ways to positively improve our happiness is to develop new connections with the people around us, as well as reaffirming those with people we already know (Huppert, 2008; Seligman, 2011) (Box 1). Humans live in groups, pair bond and through connections socialise, share ideas and resources – in fact our survival depends on it. Though interpersonal connection and its interpretation of non-verbal communication may manifest itself differently throughout various cultures, research has suggested our moods are contagious as we are wired to connect with those around us to help understand their feelings and intentions though mirrored neurons (Enticottetal, 2008)Pavey et al (2011) points out that reflecting on feelings of connection increases motivation to help others and therefore increases happiness and improves relationships.

Box 1. Activity: social connections

  1. Create a mind-map with the names of people who make up your healthy network of social connections. They are the ones who support, energise, enrich and enable you. They may be:
    • Family and friends
    • Colleagues or managers
    • Professional contacts
    • Online contacts
  2. Make a point to keep in contact with your healthy relationships
  3. Consider ways in which to stop or reduce contact with those who criticise or are unsupportive.

Adapted from Breines (2014)
Interpersonal interaction

Penner et al (2005) focused on how factors such as ethnicity and gender affected prosocial response. Adding to that body of evidence are further interaction studies that demonstrate how positive cues are given. These can enable us to make the most of face-to-face opportunities when required, such as being supportive to a distressed client, collaborating with colleagues and, delivering person-centred physical care or reacting empathetically in a traumatic situation (Box 2).

Box 2. Activity: interactions

It usually takes five positive interactions to balance up one single negative one.

  1. Now focus on one of the positive people from your above network
  2. List five positive specific things you could say to them through text, telephone or even better face to face (eg ‘You are so good at…’, ‘Seeing you reminds me of the fabulous time we had at…’
  3. Ask them to return the compliment – help to build your own self-compassion.
  4. Plan a kind action to show they are not taken for granted (eg plan a small surprise, help them relax, give them an evening off) and be mindful of using positive body language.
  5. Show interest in their life – what is a day like in their shoes?

Loneliness

Diener and Seligman (2002) interviewed people about their levels of happiness and other aspects of their life and properties of their personality. They concluded that very happy people tended to have rich and satisfying relationships and they spent little time alone, relative to people with average levels of happiness. Social relationships form a necessary condition for high happiness. Csikszentmihalyi (2013) validated this claim by commenting when people are asked how they are doing on a day-to-day basis that contributes to their happiness, the things that are most strongly related to feeling happy is talking with friends.

There have been studies (Newall et al, 2013Courtin and Knapp, 2017Leigh-Hunt et al, 2017) that conclude loneliness shows itself through an increase of symptoms of poor physical health, such as reduced immune response and erratic sleep patterns. Scans have shown activated brain activity is the same area of the brain regardless of whether the person is in social or physical pain (Lieberman and Eisenberger, 2008). Conversely, studies on the effect of touch show an increase in recovery rates, immunity and wellbeing, with a 47% increase in weight gain in premature babies and reduced symptomatology in people with Alzheimer’s disease. These are thought to be due to an increase in release of oxytocin (Wardell and Weymouth, 2004).

Oxytocin in relationships

Oxytocin (the ‘cuddle’ hormone) is a sequence of nine amino acids that are produced in the brain and also move through the blood stream, affecting target organs in the body. Graustella and MacLeod (2012) reviewed the delivery of oxytocin via nasal sprays and concluded it impressively impacted on social cognition by improving the early detection of affect from social cues, particularly positive social cues.

In relation to the benefits of social connection in reducing stress and the cost of stress, Taylor (2006) showed that high levels of oxytocin tended to reduce stress hormones in the bodies such as cortisol, by quietening the cardiovascular response. Feldman et al (2013) found that affectionate touch between parents and offspring increases oxytocin release. This may be extend to society at large to improve trust, generosity, solve conflict more constructively and sharpen emotional intelligence. Kogan et al (2011) investigated genes relating to oxytocin and how they help in emotional intelligence as part of the continuing physical development within the human race that help with connectedness and forming attachments. Furthermore, Wagner et al (2015) note that humans have a strong tendency to affiliate with others, especially in emotional situations. They suggest the perception of sharing emotional experiences is positive and regulates individual emotion as a result of activity in the brain’s reward circuitry.

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