Interview with Monsignor Alfons Gea, a graduate in psychopedagogy and humanistic therapist. Expert in grief care. Expert in Pastoral Care of Health, he answers the questions that the students at the end of their master’s degree ask him for the work of developing an application to help the elderly who live in unwanted loneliness.

What are the main causes of loneliness in people over 65 years of age, specifically after retirement or empty nest syndrome?

Well, you have just defined the question very well. There are some facts that affect identity. That is, when a person defines themselves they say: “I am a mechanic”, “I am a doctor”, “I am a nurse” etc., and when they retire they are no longer any of those. And when the children leave home, you are still a father, but you feel that you lose a bit of your identity. These two aspects, both professional and family, give identity.

What does that mean? Well, when those strong points that give you that identity disappear, part of your person disappears. And then you have to reinvent yourself. Reinventing means, first of all, asking yourself who I am. Asking yourself: Who am I?

For example, many divorces occur when children leave home. This does not happen because there is a new environment at home, but because parents do not consider until that moment what I do in a place like this. The same thing happens in the work aspect, although there are many differences between men and women. Why? Well, because many times women used to never retire, in the sense that they were always responsible for the running of the home. And men, on the other hand, collaborated, but did not have the profession of housewife that women could have. This sounds a bit sexist, but it is a reality.

It will also depend a lot on the hobbies or interests that one had before retiring. There are people who enhance them and in the end retirement becomes an extra time. But when there are no such hobbies and there is not much of a social life, for example, when you only lived for work and work absorbed everything, when that person retires, it is as if you take away their identity, they are disoriented, lost and need to reinvent themselves.

Of course, and how do you think prolonged loneliness affects the mental and emotional health of older adults?

Look, prolonged loneliness affects physical health (headache, dizziness, constipation) and nobody imagines how therapeutic a good conversation and a good outing is. In fact, there are people who when they receive the news that they are going to be alone for a few days, they get sick, that is, it affects their physical health, they somatize it. Let’s not even mention their emotional and psychological health, which is the same thing. If we talk about two words that encompass everything, which are anxiety and depression, we can see how that same person with those symptoms in a different environment does not have them. The proof is that there are people who are physically ill all day long, with clear and defined symptoms. And there are also people who go on excursions or have to make or receive a visit and all their ailments go away. For example, there are people who have a lot of anxiety and when they are given the opportunity to go and spend some time in the town where they were born, where they have their immediate family, brothers, sisters or nephews, during that time spent in that town the person changes completely in terms of symptoms. What’s more, there are people who, by doing this, have been able to stop taking medication.

Why? Because they go from being alone to being in a place where they come and go and are in contact with people every day.

Therefore, loneliness, in the sense of isolation, in which you feel that you are nobody to anyone, that sense of becoming invisible to the world is dying. In fact, there are expressions that are in the language, such as the famous “dying of grief.”

And what do you think are the most effective strategies that psychologists recommend to mitigate this loneliness?

All those that are focused on creating bonds of relationship and breaking the isolation. All those that are focused on showing yourself useful to others, thus developing the sense of belonging. For example, who am I for whom? When you are nobody to anyone, even having a family, because the family goes its own way, you feel a little useless. Relationships with others are also important, here we enter into a complicated terrain because that relationship, to go well, would also have to be of quality. There are people, for example, who had been dead at home for several days and who had, through social networks, 5,000 friends. What is that telling us? That we are hyper-connected and at the same time hyper-isolated, so relationships have to be of quality. Receiving 20,000 messages or 10 images in the morning that the world is wonderful and that it only depends on you, well, maybe it makes you feel even worse. Why? Because if you are feeling bad and they are telling you that it depends on you, what they are doing is making you feel guilty for feeling bad and also those messages are still cold because behind them there is only having pressed a button and sent it.

That personal call is different, that more personal contact, even if it is through social networks, but of course, if we talk about a bond, the bond is a rope that is tied from end to end. But of course, that which unites us, that bond cannot be tied to me and the other end be hanging around because I don’t know who it is. When I know who the other end is and that they are watching me or attending to me, then there is a bond, but if not, the bond does not exist, or it becomes something so ethereal that it has no consistency.

So, the strategies that we advise or that we should work on are everything that facilitates, enables that relationship with others. Even if these others are complete strangers to most people, it doesn’t matter, here we are in a field where we have to differentiate between the blood family that is there and that will surely respond, and the others who are not blood family, but who at that moment are suffering from the relationships that one needs. So everything that is relational, fantastic, but relational, personal, not impersonal. The relationship that is impersonal becomes something superficial, that’s fine, but loneliness can be experienced not at an internal level, but at an external level.

And in relation to this, what type of social interaction has a greater positive impact on the well-being of these people?

Well, interaction is what is possible, going back to what we said before, maybe a family reunion is impossible to organize and perhaps proposing an excursion in which you go to a certain place where you are going to see some things and you are going to share the trip and the journey with other people is more possible, everything that can be really feasible.

That is, when designing or thinking about things, we must think about things that are truly feasible. So, some of these plans, such as a company that organizes trips or snacks or whatever. Everything that is possible. Obviously, here in the basic differences of each individual.

As for retirement, of course, if we are talking about a person who is a professional who has dedicated himself to therapy, or a medical professional, and retirement turns it into another way of living his profession, for example, the person participates in events that he could not participate in before and now he can because he has more time. Living in a world beyond the directly professional and commercial ones, we could say, and that develops because he has certain capacities, qualities and interests. Here again there are things that are going to be shared at a generational level, such as the generational gap, whether you are an educated person or not, there will be, it also depends a lot on the personal possibilities that you have. It is that thing that they say that money does not bring happiness, but it helps, right? We can say that, for example, culture does not bring happiness, but it helps, right?

And related to this aspect, how do you think the social needs of these elderly people evolve compared to other stages of their lives?

Well, they evolve at a meteoric level, the needs and the possibilities, because in the past the problem of loneliness was not like it is now. Now it is even a loneliness accompanied, because it is very different from how older people now remember their childhood. In their childhood, grandparents did isolate themselves, so to speak, because they were from another generation, but the needs that grandparents might have were met. One of them was food, well-being, the grandfather was protected, he was calm, right? And he was able to face stages or moments of loneliness throughout the day, knowing that they looked after him, that they were there for him… Nowadays, that large family unit in which three generations can come together, today is rarer, scarcer. It is more difficult for three generations to come together in a house. Now two and be thankful, so that is a big change. Before, it was like a relay race where you pass the baton, where you pass the baton, but now that chain is often broken. One absurd thing, even macabre if you like, is that going to cemeteries is being lost. People tend to cremate the remains of their ancestors and put them anywhere and forget the history of those dead. Before, people would say, this is our family niche with pride, there was a reference of identity with those dead. Now this is being lost, you see the huge cemeteries and you see that there are empty niches because that past has been broken. For example, I now see many old men and women who say “I am going to cremate the remains of my family because when I die I do not want to be buried because no one will go to the cemetery.” So the loneliness is often not physical, but rather an existential loneliness.

Before, for example, a topic that was talked about a lot when I was little among older people, was the dead, the burials… And they would say, oh, what a beautiful burial! And people said: “Well, when I am buried, I want something like that.” They spoke naturally about death and burial, because it was something that continued through generations. Now they say it is the other way around, people say: “Let’s empty the grave because when I go to the cemetery I go alone and the rest of the family no longer go, and when I die they are not going to come to see me. So that no one goes, I prefer to be cremated.” This defines this paradigm shift that increases loneliness, not just physical loneliness, which we have talked about before, but existential loneliness “where will my memory, my legacy, remain.” I have heard a lot among older people the phrase “I know that here in my house I have many memories, but I know that when I die they are going to throw everything in the trash.”

Before, people would leave the farm, they would leave the farm, they would leave the factory… Now it’s the other way around, people think about getting rid of everything they have because when they die they think that no one close to them will keep it.

For example, do you see that photograph? It’s of a child’s first communion. Well, that came to me because I buy items at auctions, especially art. This one cost me six euros, I bought it for the frame at first, but then when I saw the photo (it’s a photo that is worked with a mixed technique between photography and painting) I thought: “this is sure to be someone’s grandfather.” And before it wasn’t like that, before everything was given to the next generation.

That has changed a lot. Even the need to leave a mark has changed. Before it was natural, years ago you left a natural mark on your family, in a house, in a town… Now, no house, no town, nothing, all that is going to disappear. I have not been given things to say: “Look, I am leaving this here because I know that when I die, they are going to throw it away.” The connection with history has been lost. This means that “I am nobody to anyone, that when I am gone, everything is over.”

Even that loneliness is isolation. Imagine that you have a lot of stories to tell and that nobody wants to listen to them, some of them may be your own family, because each object is a story. There are paintings, for example…

Now, not as a psychology professional, but as a collector, I benefit from this art market. There are old works that are selling for very little money. For example, this quartz mineral stone that you see here cost me 50 euros with frame and everything and it is a very high quality oil painting. And that happens because these things are no longer valued. That means that your story will not continue or will be cut short. From faith we can say, I believe in eternal life and, for example, the Jewish people had the idea that continuing in their descendants was good. Not having children was seen as a curse, because they considered that in their children they deposited what they were.

And the fact of seeing that your memory does not continue, increases that loneliness. Because what kills loneliness is the bond, the bond is the opposite of loneliness, feeling like someone for someone.

Feeling valued, right?

Valued, for example, of course. But to feel valued you need not to feel ignored. So, people don’t ignore each other formally, but in practice they do. One of the things that is being done is that older people tell stories to children. The fact of telling stories to children allows them to prolong their legacy. And it’s fine, it’s done in some places and it’s very good, but it would be good for young people to know many things about their grandparents and their history.

And what do you think are the main psychological barriers that make socialization difficult at this stage of life, of old age?

Well, look at one of them, and here we can make a difference between what is a small environment or a large city environment. The main barriers that make it difficult are those that we put in place to relate to others. Here, for example, if we greet each other, because here, if we know each other, we walk down the street and we greet each other, then at most we look at each other and nod or say hello or goodbye. In other places, with people from other latitudes, if you meet someone you know, you don’t greet them with a gesture or a word, but you ask them a question (how are you, how are you doing). You get into a relationship with the other person. It’s like in the villages, at least before, people would stop in the street to talk. That’s why the main barriers are the ones we’ve imposed on ourselves, like “your world is your world and I’m not interested” and “my world is my world and I’m not going to open up either.”

People protect their privacy a lot, maybe we protect ourselves so much that we don’t relate, because relating is a risk, so the way to protect ourselves is not to relate, and sometimes when you get older you acquire more fears, more suspicions and then you isolate yourself more so that they don’t crush you, right?

Above all, they are psychological and invisible barriers. Elective mutism is very common, that is, the “I don’t talk because who am I going to tell things to?” I have dedicated many years to therapy and I can tell you that it was very important to provide the environment for that person to express themselves freely and without rushing, without fear of being judged. Then those people would flow, until sometimes the biggest filth came out that they had perhaps had accumulated for years. I am talking about rape, I am talking about abuse, etc.

I remember that I said to a person who had been in psychiatric treatment for more than 20 years: “and you haven’t explained this to your psychiatrist?” and she answered: “he has never asked me.” Of course, he doesn’t ask you because you don’t say it. In reality, I didn’t do anything special, I just let her flow. They were questions that indicated that I was paying attention to what she was telling me and that I didn’t want to get into something without her wanting to. And then I spoke to the psychiatrists and they answered me: “Well, we don’t have as much time as you do” and I thought: “Well, maybe I can solve the problem much faster than you, who haven’t solved it for 20 years.” Because in the end the time is the same, but the thing is that one achieves some things and the other doesn’t.

And, in terms of the use of technology, how do you think older people perceive technology in general?

I would say that there are two camps, there are those who are fond of it and end up knowing more than teenagers and those who don’t want to know anything. There is no middle ground here. There are those who are using all the gadgets and those for whom the telephone does not exist to call. Having said that, those who obviously have access to it, well, they have their advantages and disadvantages. Those who have access to it, have access to groups of friends, they also have access to events, and for them it is like for young people, technology is an appendix without which they would not know how to live, right? Because everything is managed through the internet and technology is really a help because it allows them to be connected in many ways, even with family, video calls, etc. And that is an advantage for them. Those who don’t, obviously enhance other skills.

Skills like which ones?

Like reading books, they read more, for example, and they go out more. I know many people who don’t know anything about technology, but they spend all day on the street making visits and all that.

Why?

Well, because they do talk on the phone, because the phone is also a technology, but they don’t make up for the time that others can make up for with technology. They also like to see certain things on their cell phone, but, let’s say, they “enhance the shoe” of walking much more, while technology in many cases becomes a cause of loneliness, but by solving it a little or a lot, it makes formal isolation perhaps exist, right? Obviously there are also people who combine everything, because they know how to combine everything and can, but well, there are others who don’t. I would say that technology is just another appendage, one more thing like so many. Like gardening or cooking. Even so, all these activities together would help to make up for this loneliness.

And to what extent can these digital interactions replace or complement face-to-face contact to reduce this loneliness?

Well, never to replace, but rather to complement. As long as that social relationship is focused on achieving a real relationship. Even if it is an annual meeting where we go to see each other, to share and to celebrate. But if virtual interactions do not materialize into something concrete, they become a kind of meal without protein, which we eat, but do not feed ourselves. But as long as the virtual relationship is something concrete that develops in real life, that is, that has an objective of enhancing this face-to-face interaction, speaking and mutually recognizing each other. If, on the contrary, I am only a virtual friend, like artificial intelligence, which when push comes to shove is not going to solve anything for you. That is a deception, that is no longer a proper bond, because in that case the relationship is not beneficial, because when an adverse event happens, the person experiences radical loneliness.

Regarding strategies to combat loneliness, what impact do you think support groups, associations or community activities, such as workshops, have in reducing this loneliness?

Nowadays, they are very important, so much so that they are good and necessary, but indirectly they are indicating the social failure. Because when in order to have friends or to relate to others we need someone to organize our life and a group, it means that society is useless. We have delegated society, we have lost responsibility or we have isolated ourselves and it seems that someone has to come to solve it. But evidently, they are very important, so much so that today our society cannot be conceived without these groups.

Although I see several drawbacks. One of them is the ghetto, that is, they are similar groups in which, by making groups, people identify themselves with specific characteristics. So what will give them the most identity will be the group. And the rest of the things in their life are very blurred, they are not so important, being that what the person will define themselves by. I am exaggerating, but it is to convey to you how society has left it in the hands of professionals to make people relate to each other. The media, apps and social media groups play a big role here. And this is good, because it breaks the isolation, but it creates a ghetto. This is a drawback.

The other drawback is that, perhaps, what I have that worries me, that distresses me, if it is not visible, I do not show it. In the end we end up showing our friendly side, even if we hide our painful side. And we do this to adapt, not to become the protagonists and to feel accepted, because we do not want to feel excluded.

Imagine that when we talk about loneliness, you feel loneliness in the group, this loneliness can be even greater, right? That is, you go to the group and then you leave and you go with your problem that you have not explained and that deep down nobody knows. In the face of many silences you can say many things.

And what role do mental health professionals play in the design of intervention strategies against loneliness?

Each person is a world and it is an art. I am not going to refer to the intervention, but to the conversation, where the other person talks about everything they need. A psychiatrist called Paul Tornier said that “the essence of all psychotherapy is to be able to explain things, just as a small child would explain them to his mother.” Making the person feel seen and feel capable, free to be able to talk about many things and be able to get there.

Imagine that you have to get to the bottom of a mine in a mountain where there is gold. You know there is gold, but you don’t know how to get there, so all the strategies that help you get there are valid.

-torture, of course, ha, ha, ha. A good strategy is that the person doesn’t feel obligated to do anything. I had a patient who came to my office and the first thing he said to me was: “I don’t know why I’m here, because I don’t plan to talk and I don’t believe in any of this.” And the first answer I gave him was: “You’re going to do what you want here, if you don’t want to talk, there’s no problem, don’t feel bad about it, don’t feel bad because you don’t have to talk, don’t worry.” And then that person, deep down, feels that they don’t have to explain anything because they think that nobody is interested or understands them. And when they see that someone takes their words seriously, then they feel confident enough to talk and establish that relationship. And this patient, not feeling obliged to do anything, started talking to the point where I had to end up telling him: “Look, we will have to leave you here because it has been an hour already.” And he answered me: “It has been an hour already? I hadn’t even noticed.” Because in the end, health professionals do not solve anything, problems are solved by people.

Well, you guide them along the way so that they know how to solve them.

Exactly, we help people to clarify things, but what happens? Many times one does not clarify things and sometimes the same thing happens with loneliness, right? Because sometimes loneliness, you say unwanted, but I don’t know… I think that sometimes some people reach unwanted loneliness because they have wanted other things or have not wanted other things. For example, people who have had many alternatives or invitations to not be alone and reject them all because maybe they feel pain or anger against someone or against whatever. So it happens that the anger I feel against that person or against that makes me not want to be with anyone. So it is an unwanted reality, but it is caused. For example, at the family level there are situations that are complex, and unwanted loneliness can be preceded by many causes, which I may not be aware of and I am creating them.

And finally, what psychological aspects should be considered in the design of technological programs to improve the social life of older adults?

Well, all those that are focused on defining what health is. So there are multiple definitions here. You have to ask yourself what health is, well-being and how to achieve it. The final objective in the design of technological programs is defined by being mentally healthy.

Loneliness itself can also be a gift, because you have time for yourself, to remake yourself. But deep down, unwanted loneliness is part, going back to the beginning, of the disease, of some ailments that exist. When we talk about unwanted loneliness we are talking about broken relationships that are affecting health.

What is needed for that? First, you need to have your basic needs covered. There is something as basic as that, many times in old age basic needs become a drama, because having resources is not the same as not having them. Secondly, I would say that it is knowing how to recognize yourself as someone who knows who you are, and that recognizing yourself as someone who knows who you are, is also known by someone else, because you know who you are, but nobody else knows, it is a thought.

And finally I would say that it is having that which can give meaning to life, the “why do I exist?” A purpose, for what or for whom. Without purpose, it is more difficult. We have to delve into ourselves and really see what gives meaning to my life. Flee from standard answers and look for the most real ones, those that are closest to us.

Does the church have a program for this problem?

Fortunately, no. Even the poorest parish is a community. It is a family with its weaknesses and strengths. I am not talking about believers who have not joined the community. But about those who are within. The church is their family. Those who miss you when you miss mass. For thousands of lonely elderly people, daily mass is the only outing they make during the day. It is their reason to go out, socialize, and fill their lives with the love of God. There are groups for the elderly that meet periodically. The elderly person, integrated into the church, finds in it reasons to be for others. Some who were always believers, but were far away, have been able to find people who, without knowing them, welcome them unconditionally.

There is no program because lonely elderly people are a high percentage of parishioners. Another issue is home visits to lonely people. Loneliness is alleviated, but this does not solve the problem.

God never abandons his children. Not even when age advances and strength wanes, when grey hair appears and social status declines, when life becomes less productive and risks seeming useless,” begins the message that Pope Francis published this Tuesday on the occasion of the IV World Day of Grandparents and the Elderly, which will be celebrated on July 28. In the letter, he invites us to “show our tenderness to grandparents and the elderly in our families and visit those who are discouraged or no longer hope that a different future is possible”