Abstract:
Background: Loneliness is a growing health concern (Mann et al., 2022; Murthy et al., 2017) and adults with substance use disorders (SUDs) form a vulnerable population (Lim, 2020; Holt-Lunstad et al., 2015). Loneliness and SUD share a unique, bidirectional relationship (Wootton et al., 2021; Ingram et al., 2020). The period of recovery is marked with increased risk of alienation, isolation, and existential loneliness (Oleskowicz, 2023). Lack of self-regulatory capacities earlier provided by substances (Wing et al., 2020), along with the increased burden of reconstructing a sense of self away from the "addiction/spoiled" identity (Gligorov, 2025; McIntosh, 2000), act as unique stress factors. Existing frameworks, such as cognitive (Hawkley & Cacioppo, 2010) and social-identity of loneliness (Evans et al., 2022 Motta, 2023), do not adequately account for the multiple variables associated with loneliness, including traumatic experiences, self-disruption, relational difficulties, socio-cultural factors, and adaptive capacities (e.g., meaning-making, personality strengths). Furthermore, no studies in the Indian context have been conducted to examine the role of loneliness in adults with SUD. The present study aims to explore the lived experiences of loneliness in adults with substance use disorders and its impact on personality-functioning during the early recovery period.
Method: The study employed a cross-sectional, qualitative design using reflective thematic analysis. Purposive sampling was used to recruit 10 participants aged 18-45, currently in early recovery (3-12 months) from a clinical setting. Data was collected using in-depth interviews. An interview guide with 6 theory driven domains was formulated. Analysis of the data involved an iterative process of coding individual datasets, creating patterns of meaning through reflexive engagement by the researcher.
Results: Analysis resulted in four themes, including Loneliness and fragmented Self-system, disrupted
Intersubjectivity and Relational Disconnection, Substance as Regulatory and Relational Substitute, and Recovery as Reconstruction of Self Identity. Participants also demonstrated emerging adaptive capacities, including reflective meaning-making, therapeutic engagement, spirituality, and creative expression.
Conclusion: This study provides a nuanced picture of the challenges in the recovery process. It highlights the need for integrating and addressing loneliness in addiction treatment, encouraging explorations of the experiences around loneliness in therapy and routine assessments. Cultural and social dimensions of loneliness, such as perceived marginalization, stigma, and a lack of belongingness also emerged, hinting at a broader definition for recovery in addiction treatment.
Keywords: loneliness, personality functioning, substance use, adulthood, recovery
Biography:
Garima Dhyani (She/Her) is a PhD Scholar and a junior consultant at the Department of Clinical Psychology at the National Institute of Mental Health and Neuro Sciences, Bangalore, India. She has completed her Masters in Clinical Psychology from Christ University, Bangalore, India. Currently, she is working with the Centre for Addiction Medicine (CAM), NIMHANS. Her thesis focuses on the area of loneliness in the adult population with substance use, with an emphasis on theory generation. Her general research interests include self and identity, queer population, and addiction. Particularly, her interests have been in examining how social and psychological processes shape experiences of the self and interpersonal (other) functioning.
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