Statements like these are so common among the women I see in my practice, I've come to expect them. This past week alone, I found myself having the same conversation with four different women. Each was concerned about her lack of close friendships and the anxiety, distress, and loneliness she experienced as a result. Each seemed relieved by my assurance that this was a common experience and not necessarily indicative of any deep seated or unresolvable problems.
What's interesting is that, although I speak to an equal number of men and women in my practice each week, men rarely raise concerns about friendships. That doesn't mean they don't have these concerns. Simply that they don't typically raise them in session.
So it's possible that this is a common experience for both men and women, and I suspect it is to some extent. I also wonder if there isn't more to the puzzle here. In part because we've seen this phenomenon in psychiatry before. Not with women reporting a lack of female friends per se, but with women expressing discontent with societal shifts and concern that, because they are lonely or distressed, there's something wrong with them. In the past, psychiatry often seemed quick to reinforce these notions by creating diagnoses and treating women for conditions that seemed to reflect societal, rather than personal, problems.
Freud, for instance, popularized the diagnosis of " female hysteria" based on the women he "treated." He used this term to describe women who reported symptoms of nervousness, insomnia, shortness of breath, and an increased desire for sex. Additionally, Freud suggested that the hysterical woman is unable to establish mature relationships and often uses her hysterical behavior for "secondary advantages." In hindsight, Freud's diagnosis appears wildly off base - female hysteria is no longer a diagnosis recognized by the American Psychological Association and many critics have since accused Freud of pathologizing women's reactions to sexual and societal oppression.
The 60s and 70s showed a similar trend in psychiatry with the rise of minor tranquilizers (primarily Valium, which was introduced in 1963) that were disproportionately prescribed to women. Valium was popularly referred to as "mother's little helper" in a song by The Rolling Stones and it fast became the intervention of choice for doctors treating women distressed by motherhood, singledom, and everything in between.
Generally speaking, I think it's always concerning when people from a specific demographic (in this case women) report being less than fulfilled by their lives in very similar ways. Given the history above, I find it particularly disturbing when women seem concerned that their reactions to their environment necessarily reflect psychological problems rather than normal reactions to a stressful situation.
Rather than "what's wrong with me," a better question might be, "what is it about today's society, and Silicon Valley specifically (I heard similar concerns from women in my practice in Seattle, but to a much lesser degree) that might explain this phenomenon?" I see plenty of explanations for why women, particularly those in Silicon Valley, are feeling lonely, isolated, and potentially dissatisfied. And none of them have anything to do with their character or mental health:
1. Many who live in and around the Bay have moved here from somewhere else. The families and school friendships that might serve as a person's social network are not immediately available.
2. The Valley is an international hotspot, not just a national one. Only a handful of my clients are native to the United States, much less California. U.S. culture places a much lower value on socialization than many other cultures in which community, friendships, and extended family are prioritized alongside if not above work.
3. The San Francisco Bay Area has more people between the ages of 25 and 39 than just about anywhere in the country. As such, many women in Silicon Valley are of childbearing age. It's not surprising that these women often find themselves homebound or struggling to find other women with whom to connect.
4. Young families today, particularly those trying to afford the cost of living in the Bay, often require the income of two parents. Again, a young mother who is juggling breastfeeding, daycare, and a full-time job isn't likely to have tons of opportunities to make friends. If she recently moved here from another state or country, her chances are even slimmer.
So does it make sense that women report feeling isolated and alone in our community? Of course! Does this mean that they are ungrateful, selfish, or failing to fit in? Not at all. Feeling isolated from others can certainly increase symptoms of anxiety and depression, but a lack of close friends is not an indication of mental illness.