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Perspectives in Biology and Medicine 45.3 (2002) 460-463

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Book Review

A Cry Unheard:
New Insights into the Medical Consequences of Loneliness

A Cry Unheard: New Insights into the Medical Consequences of Loneliness. By James J. Lynch. Baltimore, MD: Bancroft Press, 2000. Pp. 345. $26.95.

James Lynch is a psychologist and scientist on a mission: he wants to make sure that in our obsession with medical data such as cholesterol level, blood pressure and heart rate, we don't "miss the forest for the trees." He intends that we understand the crucial and possibly causal role that social isolation, sadness, and shame play in people who show signs of early cardiac disease. He describes his theories and findings in a fascinating new book titled A Cry Unheard: The Medical Consequences of Loneliness. This is a 25-year follow-up book, bringing [End Page 460] together data further affirming the theory and data in Lynch's first work, The Broken Heart (1977). In the 1977 book, Lynch proved to be a pioneer in recognizing the link between loneliness, recent bereavement, and heart attacks. Even after his first book was published with its compelling findings, the medical literature of early cardiac disease continued to ignore the findings about the dangers of social isolation. Instead, study after study was done looking at the details of cardiac risk factors without attending to marital status or social isolation as key risk factors. Now that Lynch has written a second book—and much more data has accumulated proving that he was correct back in 1977—we must ask ourselves why we as a society are so resistant to admitting that loneliness could be a serious medical problem.

I think our resistance to acknowledging the dangers of loneliness has deep cultural roots. The United States is a country of "tie breakers" who left the old country to achieve liberty and economic freedom. Our constitution's emphasis on freedom has slid into an emphasis on self-sufficiency and individualism with some disdain for the mutual dependency of the Old World. When we find that we have had an overdose of self-sufficiency causing loneliness, most Americans are embarrassed to admit it, feeling they are losers almost to the point of being un-American.

And this brings us to another of Lynch's surprising revelations in his new book. He gives us compelling information indicating that early school failure, with its concomitant shame, correlates with early cardiac death. This, Lynch feels, is because people with early school failure (flunking, being held back, or dropping out before graduating high school) are more anxious and uncomfortable with dialogue (in fact, it causes larger increases in their blood pressure when they speak than for the rest of us), so they isolate themselves socially and have heart disease earlier. Lynch's theory explaining these people's early school failure is that many have experienced what he calls "toxic talk" from their parents in their preschool years, leaving them nervous and pessimistic about the usefulness or pleasure of dialogue. Thus, he thinks they are less likely to do well in school settings, where the ability to be verbal is essential. He also thinks that many of these people go on to become blue-collar workers, and that these workers are, in fact, the real Type A personalities to whom we should give early cardiac preventive medical care, rather than targeting the business executives who are less likely to have early cardiac disease. All of these theories are propounded in clear prose with proper discussion of the counter-arguments.

Lynch rarely comes across as a dogmatic polemicist, although he is very passionate about his theories. One of the author's professors in graduate school, W. Horsley Gantt, helped shape his interest in cardiology and the behavioral interactions around blood pressure and heart rate back in 1962. Gantt showed that petting a laboratory dog could cause immediate reductions in the dog's blood pressure and heart rate of 50 percent. Gantt also found that dogs who were artificially stressed...