Psychopathology of social isolation

Article information

J Exerc Rehabil Vol. 10, No. 3, 143-147, June, 2014
Publication date (electronic) : 2014 June 30
doi :
Department of Psychiatry, Ulsan University Gangneung Asan Hospital, Gangneung, Korea
*Corresponding author: Sang-Bin Baek, Department of Psychiatry, Ulsan University Gangneung Asan Hospital, 38 Bangdong-gil, Sacheon-myeon, Gangneung 210-711, Korea, Tel: +82-33-610-3189, Fax: +82-33-642-3189, E-mail:
Received 2014 June 18; Accepted 2014 June 19.


The most important defining factor of being human is the use of symbolic language. Language or communication problem occurs during the growth, the child will have a higher risk of social isolation and then the survival will be threatened constantly. Today, adolescents and youths are familiar with computer and smart-phone devices, and communication with others by these devices is easy than face-to-face communication. As adolescents and youths live in the comfortable and familiar cyber-world rather than actively participating real society, so they make social isolation. Extreme form of this isolation in adolescents and youths is so-called Socially Withdrawn Youth. In this study, the psychopathological factors inducing social isolation were discussed. Development stages of social isolation in relation with types of social isolation, Ego-syntonic isolation and Ego-dystonic isolation, were also considered.


The most important defining factor of being human is the use of symbolic language. Human being is a social animal who lives based on the communication using symbolic language. That is, the quality of human being is determined by the acquisition of proper language, the ability of communication, the adaptation to the social network, and the position. If a child has wrong language development, distorted communication, and fail to develop social skills, then the future will be placed in the great danger. That is, if language or communication problem occurs during the growth, the child will have a higher risk of social isolation and then the survival will be threatened constantly (Bateson, 1972).

Humans suffering social isolation respond in two aspects. One aspect, he (or she) does not concern or worry about their isolation and satisfies to their conditions, and the other aspect, he (or she) thinks that isolation is a big problem and becomes nervous in order to escape from isolation. Such extreme opposing attitude to social isolation will appear differently according to ego-syntonic or ego-dystonic. In ego-syntonic, the personality adapts to social isolation. That is, isolation is natural and unforced, and he (or she) is uncomfortable and embarrassing in the situation of interaction with others. On the other hand, in ego-dystonic, the personality is oriented to adaptive value of socialization, so, he (or she) thinks that isolation is negative, and constantly tries to socialize with other people and make efforts to acquire the social skills (American Psychiatric Association, 2013).

When accidentally placed in social isolation situation, the power of endurance is different in each person. Isolation is the most intensive stress that human can endure. Humans as a social animal experience severe stress in three situations. First is the separation with spouse by death. This stress is due to loss and it is the most stressful event in short-term duration. Second stress is when one’s parent dies in one’s early age or one is abandoned by the parents. This stress is due to the separation and the one is harassed in one’s life. And third stress is isolation. Social isolation is the severance of the usual social situations. If isolation persists for long-time, the possibility that one returns to his ordinal life decreases (Kaplan and Sadock, 1998).

Today, adolescents and youths are familiar with computer and smart-phone devices, and communication with others by these devices is easy than face-to-face communication. As adolescents and youths live in the comfortable and familiar cyber-world rather than actively participating real society, so they make social isolation. Extreme form of this isolation in adolescents and youths is so-called Socially Withdrawn Youth. This phenomenon is new social pathology and come into the spotlight, and then new model of social isolation appears in a cyber-world society.


Ego-syntonic isolation

Ego-syntonic isolation is a very interesting form. From a common-sense point of view, it is irrational that human as a social animal has positive attitude to one’s isolation. But, isolation as this type exists definitely and ego-syntonic isolation is occurred when separated real world from mental world. That is one’s subjective mental world is separated from a real world under any circumstances, so, two worlds lose the coherence and separate each other. In the attack, one’s subjective mental world has the main power. Therefore, one’s subjective mental world dominates a real world. So, ego-syntonic isolated person has no interest to the outside world and dose mot want to interact with others, and only, is absorbed in and settle for his (or her) own inner world constantly. Furthermore, he (or she) tries to distort the meaning of the outer world by his (or her) own inner world. This phenomenon appears in daydreamers and stick-in-the-fantasy, and by extension, appears in a Socially Withdrawn Youth and appears in a person who has a psychotic disorder such as schizophrenia.

Ego-dystonic isolation

If a human in social isolation tries to escape from isolation, he (or she) is in the ego-dystonic isolation. In this case, we classify into two types. One type is that isolation is due to outside environment. That is, a human in social isolation does not want isolation, but, he (or she) is isolated forcedly by outside environment. The other type is that isolation is due to oneself. That is, even though the surrounding environment does not isolate him (or her), isolation appears due to own factor inevitably.

The representative example of isolation due to outside environment is outcast or bullies. Outcast or bullies is a big issue among recent adolescents. This phenomenon is that many surrounding people estrange and isolate someone on purpose. Because a bully-victim’s social desire is frustrated and isolated constantly, he (or she) suffer emotional distress, and eventually gets into a depression.

In the ego-dystonic isolation, most interesting phenomenon is isolation develops due to oneself rather than outside environment. In this case, isolated person does not acknowledge or accept that own isolation is due to oneself and tries to escape constantly, but fails repeatedly. The cause of this type isolation is his (or her) personality disorder. He (or she) avoids new relationship with others and attributes his (or her) own interpersonal problems to other people. Or, he (or she) breaks off a preconceived relationship abruptly. And then, isolation from oneself is a depressive disorder. A depressed person suffers from isolation and loneliness, but because a depressed person has no power to fix, he (or she) dose not attempt to escape from isolation, and he (or she) is engulfed in chronic helplessness and hopelessness that he (or she) could not have somebody’s help.


Oedipus complex: two-person relationship vs three-person relationship

Infant develops an attachment relationship with his (or her) mother naturally. In early developmental stage from birth to 3 years old, mother is the only perfect attachment object to infant. Infant develops a two-person relationship through attachment relationship with his (or her) mother. This two-person relationship is a perfect symbiosis that could not be separated each other absolutely. In other words, there is no difference between you and I. Infant feels that he is a perfect and omnipotent one is united with mother. But, this two-person relationship is broken by father’s appearance. Freud named this process Oedipus complex. Three-person relationship is that child is separated heteronomously from his (or her) mother through father’s appearance. At this time child experience a big trauma. Child feels the stability and omnipotency from acquisition with mother is broken and realizes that he, himself (or she, herself) is insecure and imperfect.

But, even though this trauma, child can develop the base to socialize in Oedipus complex period. The reason is that child can make relationship with the third person through separation with his (or her) mother. In other word, only if child escape from the fantasy that only he (or she) is united with mother is secure, perfect, and omnipotent, child realize that he (or she) is one genus of thousands of people and identify himself (or herself) objectively, accept the other person in the same presence, and can communicate and interact each other genuinely. The essence of growth in Oedipus complex period is that subjective two-person relationship is changed to three-person relationship by father.

If so, problem is the failure of growth in Oedipus complex period. Child fails to make three-person relationship and grow up and persist within two-person relationship all one’s life, eventually, a fatal defect develops in social development. A person who fails to make three-person relationship makes any object like mother makes with two-person relationship throughout adulthood, persist to be united to this object and make coincidence relationship. But this object may be a human, or something and a belief. But, because nothing can substitute mother in an early stage of developmental period really, all attempts of substitution fail consistently. Nonetheless, because the one could not make three-person relationship, he (or she) repeatedly finds the object to substitute a mother. Like this, a person fixed to two-person relationship fails in mental development, and structurally is being living in social isolation throughout life-long time.


Child separate from primary care-taker and is individualized on growing. In this process, child’s interest shifts from parent as primary care-taker to peer-group and child seeks autonomy. If a child fails separation-individuation process, a child depends on parent excessively, responds to the surrounding environment passively rather than actively. That is, child fails separation-individuation process depends on parent excessively, and fails to adjust to society throughout adulthood and is being in isolation. Therefore, substantial restrictions and problems occur in occupational, social, and family life. The typical example is so-called mummy’s boy and papa’s girl.

Pathology in communication: double-bind

Child learns rational communication methods during normal developmental process. A child who acquires rational communication methods from parents can communicate easily with others outside the home. But, if parent communicate irrationally, a child experience a serious problem in communication with others outside the home, such as school or peer-group. The most serious case is a double-bind theory, that is, mother’s pathological method in communication causes a child’s psychotic disorder. According to this theory, some mothers of schizophrenia patients give a double message to their child and throw their child into confusion, also, uses communication that brings double-bind situation. In this situation, a child is punished even if child follows any messages.

Failure in attachment: detachment

Attachment develops in infant naturally. The quality of attachment persists throughout the life. Even though a person become old or mature, a person needs attachment figure consistently, and at the time of severe trials, a person can overcome the trials depending on attachment figure. But, if a person fails in attachment with primary care-taker, he (or she) could not establish a deep relationship with others and feels left out place.

Severe mental trauma: abuse

Any abuse during an early childhood may destroy the victim’s mental world and leaves a severe mental trauma that continues throughout life. A victim of abuse is afraid of anyone and experiences a severe fear or anxiety when encounter a similar stimulus and situation that associate with the memory of abuse during an early childhood. A victim of abuse is restricted in interpersonal relationship and suffers from chronic depression and isolation.



Schizophrenia is the most common disease in psychotic disorders. Main symptoms of schizophrenia are divided into positive symptoms and negative symptoms. Positive symptoms are delusions and hallucinations, etc., and any abnormalities in thinking and perception. Negative symptoms are apathy, social withdrawal, and shrinking symptoms. Because of negative symptoms, patients do not involve in any other activities, enjoy long solitary behaviors, avoid contact with outside world, and remain within their own psychotic inner world. Social isolation of schizophrenic patients is ego-syntonic, so the patients do not suffer from isolation.


Depressed patients think them worthless, low self-esteemed, and make social isolation by themselves. And, depressed patients withdraw from social activities due to low energy and apathy, and finally, socially isolated. But, depressed patients suffer from social isolation, that is, isolation of depressed patients is ego-dyntonic.

Post-traumatic stress disorder

Post-traumatic stress disorder occurs after an intense stressful situation such as fatal disaster, captivity, and sexual abuse, etc. This patient suffers from psychic numbness, autonomic arousal symptoms, and reappearance of stressful memories. Due to these symptoms, social isolation is deepening and this patient has a social phobia. But isolation of post-traumatic stress disorder is ego-dystonic, so this patient suffers from social isolation.

Schizoid personality disorder

Some people are unconcerned with interpersonal relationship. These people enjoy solitary activity and living away from social relationship. And these people are more interested in subjective inner mental world rather than objective outside world, avoid social activity, and do not reveal their emotion. And these people do not enjoy the companionship of any family members and friend, and they are indifferent to other’s appraisal. They have no concern about their isolation and ego-syntonic.

Schizotypal personality disorder

Person of schizotypal personality disorder is usually eccentric. These people do not enjoy the companionship of others like schizoid personality disorder. Typically they have eccentric and magical thinking, experience an unrealistic perception, and express their own bizarre experience to others. These people could not make friends with others except family members and appear odd and eccentric appearance and behavior. They have no stress about their isolation and ego-syntonic.

Avoidant personality disorder

Person of avoidant personality disorder is fearful about other’s rejection. They have a strong desire of socialization, but because of strong fear of other’s rejection, they are not close with others and they want to have relationship with only whom they can trust who will not reject them absolutely. And these people sell themselves short as that “I’m inappropriate and inferior.” So, they are intimidated and fall into a social isolation and suffered from isolated condition. Their social isolation is ego-dystonic.

Narcissistic personality disorder

Person of narcissistic personality disorder have no concern about others. These people think themselves as the center of the world and the supreme. To them, others are only the object of utilization, so they exploit others as tool or object. They are self-centered and always want other’s praise and favor. They superficially make friends with useful people and someone who can give praise to them temporally. But, they immediately block the relationship if someone lose the use of valuable or does not give praise anymore. They are only one who can immediately block the old relationship without any reason or explanation. They seem to be a normal social life, however, they are falling into a social isolation because of insisting a snobbish-attitude. They are afraid of being rejected and ego-dystonic, but, dose not realize that they are already isolated. And even if they know the isolated status, they do not ever admit their isolation.


Outcast or bullies

Outcast is the unique phenomenon that surrounding people let intentionally any person to isolate and alienation. Victim of outcast never want isolated situation and usually have no psychopathology enough to result in isolated. Nevertheless, this situation can occur because the surrounding social environment is pathological condition. Overwhelmed stress makes adolescents want to project their own neurotic condition to any person, that is, victim. Victim is the one who has the weakest force to the bullying. And because today’ adolescents are self-centered due to the only child undergone a special treatment and decrease the ability to become sympathetic to others, they can not reflect even if they be an attacker. This social situation increases the risk of triggering bullies. So, the bullies is a social psychopathology not a personal one. Therefore, efforts to resolve this psychopathology need more than individual therapeutic approach. Not only the bully’s victim but also attacker need a treatment and above all, social effort to improve the rearing environment is needed to prevent the developing child and adolescence to fall into a neurotic state.

Socially withdrawn youth

Socially withdrawn youth is the person who wants to be outcast even though he (or she) has no any psychopathology. These people mainly are at home and only active in cyberspace. In real life they make little relationship except family. They sleep during the day and begin full-fledged activities in the night. At first, they do not hang out with others and prefer alone to has the game and forego the internet. But, gradually, if students refuse go to school and if workers, refuse go to work. If this situation persists for more than 6 months, they can be called as Socially Withdrawn Youth. They are frequently addicted to the game. It is necessary that game-addiction must be treated by priority and see whether they are alone or bystander even in cyberspace. If Socially Withdrawn Youth is active in cyberspace, his (or her) hidden social desire may be high. In this case if someone help him (or her) to actualize his (or her) own social desire consistently, he (or she) may do good work. If he (or she) is alone or bystander in the cyberspace, the problem becomes serious. So, in this case, it is necessary to help him (or she) to make relationship with others even in the cyberspace and strive to escape from being alone or bystander rather than to induce to participate in real world immediately. Today, interaction in cyberspace becomes a general trend rather than interaction in real world. This trend is hidden sides of civilization.


Isolation is an abnormal psychopathology to human. Isolation is not a pathological symptom but isolation is a phenomenon of pathological factor or situation, and it may be the only survival method to someone. So, the viewing point of isolation must be a cause and background of isolation at first. Isolation may be a situation not for specific person but for everybody, and it may be a worthwhile situation. For those who are tired of tension and fatigue due to social life, it is necessary to require a certain amount of privacy to maintain mental health. Even though isolation or solitude is an opposite to social adjustment and social activity, sometimes human needs a certain amount of isolation or solitude to maintain self-stability. According to whether or not isolated person realizes his (or her) isolation and whether or not he (or she) is positive to his (or her) isolation, many forms of isolation exist. So, defining isolation as the words or as absolute negatives can yield dangerous bias in an understanding of human. Our society, especially such as today’s nuclear family should establish variety points of viewing isolation and embrace the isolated person.


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