John C. Rhead, Ph.D.

Review of A Cry Unheard:  New Insights into the Medical Consequences of Loneliness by James J. Lynch.  Bancroft Press, 2000, 345 pages.  Originally published in Voices: The Art and Science of Psychotherapy, Winter 2000.

Shortly after I finished writing the article entitled “Symptoms, Symptoms, Everywhere,” which appears elsewhere in this issue of Voices, I received a flyer for a new book by Jim Lynch.  His earlier books, The Broken Heart:  The Medical Consequences of Loneliness, and Language of the Heart:  The Body’s Response to Human Dialogue, were powerful reports of the scientific evidence linking loneliness to heart disease and death and left me with much respect for what this man has to say.  The flier for the new book, A Cry Unheard:  New Insights into the Medical Consequences of Loneliness, promised to extend the findings reported in the earlier books, which I found intriguing enough.  It went on to suggest that the way we structure our educational institutions and practices can be demonstrated to have fatal results for many people.  This suggestion really got my attention, since one of my daughters had just decided to start attending school for the first time in her life.  

I have had some fleeting contact with Jim Lynch over the years, so I fired off a check to him for a pre-publication copy of the book.  I enclosed a copy of “Symptoms, Symptoms, Everywhere,” along with a note suggesting that perhaps he and I were working opposite sides of the street since I am writing about the facilitation of intimacy and he is writing about the crushing effects of its absence.  The book arrived back within a few days, along with a note indicating that Jim thought we are in fact working the same  side of the street.

I think he is right.  This book not only details the amazing ways in which the lack of intimacy kills, but offers many ideas about how psychotherapy, education, and other interpersonal contexts can be changed for the better–i.e., made less dangerous to the health of the participants.  Yes, Martha, there is some evidence that psychotherapy can be physically harmful under certain circumstances. 

Central to what this book presents are the hypotheses that (1) people need “heartfelt dialogue” to survive and (b) many people develop potentially fatal patterns of physiological reaction to any kind of dialogue.  Talk about a catch 22!   When things are going well people engage in meaningful dialogue about their inner states and their blood pressures show a regular pattern of moderate increase while speaking and decrease while listening.  This ideal pattern is called the “physiology of inclusion.”  However, for many people certain early experiences set up their body to react to dialogue with the “physiology of exclusion,” which involves abrupt and enormous elevations in blood pressure during dialogue.  These spikes in physiological reactions in turn do grave damage to the cardiovascular system.  Such people are also prone to substantial chronic elevations in blood pressure, which makes matters worse.

In general, it appears that the development of a pattern of the physiology of exclusion is a result of experiences that have profoundly damaged one’s self-esteem.  This can be a result of the kinds of verbal abuse during childhood that we would expect to have such results.  However, it can also be the result of perceiving oneself to be a relative loser in the great competition we call formal education.  The association between premature death and low educational achievement is stunningly repeated in study after study, even when other factors one might expect to account for such a correlation are eliminated.  It would seem logical to assume that people with more education would live longer because of having more money to purchase better food and health care, or because of being smarter so that they refrain from unhealthy lifestyles and the like.  This is not the case.  Relative lack of formal education kills in a very subtle way, irrespective of all other studied variables, and I think this book goes a long way toward explaining the mechanism.
Besides being an excellent psychologist and scientist, Jim Lynch reveals himself to be a poet and a priest.  He relates many concepts having to do with the physiology of inclusion/exclusion to biblical stories, without  its sounding like too much of a stretch.  He also gives beautiful descriptions of the flowing together of tributaries to form a great river, thereby communicating poetically the information originally reported in scientific journals in terms of multivariate analysis of variance.  

In spite of reporting a mountain of data from medical research, this book is as engaging as a novel.  It is, after all, a murder mystery.  There are many twists and turns in the plot, particularly as the area of research has expanded enormously over the past two decades, and of course, there are many clues.  Most compelling of all is the fact that each of us is a potential victim.