Together: The Healing Power of Human Connection in a Sometimes Lonely World is a work of nonfiction by Vivek H. Murthy, MD, an American physician and public health advocate who served as the 19th and 21st surgeon general of the United States. Originally published in 2020, the psychology and self-help book interweaves scientific research and anecdotes to demonstrate that loneliness is detrimental to mental and physical health and that human connection is key to physical and mental well-being, particularly in the digital age. A New York Times bestseller, the book received positive reviews from The Wall Street Journal, USA Today, and The Psychiatry Resource.

This guide refers to the 2020 digital edition published by Harper Wave, an imprint of HarperCollins.

Content Warning: The source material addresses depression, anxiety, suicide, self-harm, addiction, violence, and other public health concerns.

Summary

Murthy begins with a brief Author’s Note from March 2020, just before the book went to press, addressing its relevance as the COVID-19 pandemic began to affect the world. In a Preface, he then describes the book’s roots in his first tenure as US surgeon general, when he learned that loneliness was not only a pressing social concern, but one that impacted many other public health issues.

The remainder of Together: The Healing Power of Human Connection in a Sometimes Lonely World is organized into two sections, both of which are divided into chapters. Section 1, “Making Sense of Loneliness,” consists of five chapters describing different facets of what Murthy identifies as a loneliness problem. Murthy describes loneliness as a self-perpetuating cycle that convinces people they are unworthy of love, thereby dissuading them from pursuing the relationships they need most. Chapter 1, “Under Our Noses,” introduces readers to the theme of loneliness and its impact on physical and mental health. Loneliness is not only associated with premature death, but also diabetes, obesity, dementia, stress, and depression.

Chapter 2, “The Evolution of Loneliness,” focuses on the science of loneliness, explaining how it impacts the brain and body. Citing a wide range of sources, Murthy explains that humans evolved to connect with others and that social isolation triggers biological processes associated with stress, anxiety, and depression. Murthy also argues that loneliness weakens the immune system and increases the risk of many physical ailments.

Chapter 3, “Cultures of Connection,” presents loneliness as culturally specific. Murthy divides societies into three types: individualistic, collectivist, and transitional. He notes that socially isolated people in collectivist and transitional societies experience loneliness because their experiences do not match their expectations for social connection. By contrast, socially isolated people in individualistic societies are used to being alone and thus experience less loneliness.

Chapter 4, “Why Now?” addresses social connection in the digital era. Technological change has impacted virtually all aspects of people’s lives, from how they work, to how they shop and socialize. Advances in transportation have allowed people to move far away from their families, while the dependence on screens has reduced opportunities for face-to-face interactions. Although social media offers opportunities to connect with people in distant parts of the world, it is no replacement for traditional friendships. Further, social media can reduce empathy, promote comparison, and fuel low self-esteem. Murthy presents social connection as a tool to combat loneliness, arguing that strong social bonds not only decrease loneliness but can also address pressing social concerns, such as poverty, racial inequities, and climate change.

Chapter 5, “Unmasking Loneliness,” describes different manifestations of loneliness. Murthy explains that loneliness can appear as alienation, sadness, anger, and other emotions. Loneliness can also spark violence. Moreover, it is linked to alcoholism, substance use, and addiction. Murthy presents social connection as a tool to help people experiencing addiction, arguing that forming bonds with other people who have experienced addiction is key to maintaining sobriety.

Section 2, “Building a More Connected Life,” consists of three chapters, all of which provide tools for making and maintaining high-quality social connections. Chapter 6, “Relating Inside Out,” argues that cultivating a strong sense of self guards against loneliness. Solitude offers opportunities for self-reflection, allowing people to tune into themselves, which in turn prepares them to tune in to others.

Chapter 7, “Circles of Connection,” describes three circles of social connection: intimate, relational, and collective. The intimate circle is small and comprises romantic partners and close friends. The relational circle is larger than the intimate circle and consists of casual friends, such as members of sports clubs. The collective circle, the largest of the three, includes colleagues and acquaintances. Murthy argues that all three types of connection are necessary to ward off loneliness.

Chapter 8, “A Family of Families,” focuses on fostering social connections in children. Murthy argues that social contact is central to children of all ages but that societal changes have increased childhood loneliness. Solving this problem requires a multipronged approach. Parents must teach their children kindness and empathy, in addition to supporting their children and monitoring their screen time. Similarly, governments, schools, and nonprofits must develop programs to help children develop social intelligence. Summer camps, for instance, can provide a break from digital distraction by allowing children to reconnect with their inner selves and encouraging face-to-face contact.

Murthy concludes Together with a personal anecdote about his family, who relocated from India to the UK, then to Canada, and finally to the US. Murthy learned about the importance of community from his family, a lesson that serves as the basis for his book.