Social Ties and Social Support

The benefits of social ties are plentiful. These ties can be a source of social support. Social support is defined as the perception that one is cared for, esteemed and valued, and part of a network of communication and mutual obligations. Social support can assume any of several forms, including tangible aid (giving a friend a ride to a job interview, for example), useful information (such as receiving feedback on how one may improve one's speaking abilities), and emotional support (such as letting a person know that you are there for them during a stressful time). These are all forms of social support that can readily be recognized, appreciated, and even reciprocated.

But there are a few costs to these kinds of explicit support, inasmuch as they require the effort, time and attention of at least one other person. If the recipient of the support is aware of these costs, that awareness may undermine some of the psychological and social benefits that would come from the support; feelings of guilt or obligation may result, for example. As such, when social support is received without the recipient being fully aware of the support, the benefits may be greater because the weight of these potential costs is absent; this situation is referred to as invisible support (Bolger & Amarel, Reference Bolger and Amarel2007). Much of the support that people routinely receive throughout a day is likely to be of this kind. One may be only dimly aware of person who holds the door when one is struggling with several bags of groceries. A goodbye hug or kiss from one's partner may be part of the customary morning routine, but it can nonetheless be soothing. Over the course of a day, several such helpful encounters may actually provide measurable psychological (improving mood) and physiological effects (such as reducing anxiety-based arousal).

Just as positive social relationships have clear psychological and biological benefits, so negative or ambivalent relationships can be toxic for mental and physical health. The simple advice would be to eliminate these relationships, but that is not always possible: a toxic family relationship that complicates family gatherings, a person one finds difficult who is nonetheless regarded favorably by one's friends, or a person with whom one must associate or collaborate at work despite a fervent desire not to do so are circumstances that are not easily avoided. Social skills for managing these situations are essential. Moreover, such skills need to be cultivated as early in life as possible. Studies suggest that bad relationships early in life can foster adverse biological functioning that can last long after the relationships have ended (Repetti et al., Reference Repetti, Taylor and Seeman2002).

Several biological systems reliably respond to both positive and negative social experiences. The first is the sympathetic nervous system. In response to stress or excitement, hormones are secreted, especially epinephrine and norepinephrine, that result in increased heart rate, blood pressure and other indicators of arousal. The hypothalamic-pituitary-adrenal (HPA) system is also activated and can help restore the body to its normal state of functioning. These systems are important, in part, because their long-term and repeated activation in response to chronically stressful encounters represent pathways to adverse health consequences. These systems, in turn, can affect immune functioning, which itself is responsive to the social environment. Common stressors, such as public speaking or a first date, can temporarily compromise the ability of the immune system to mount an effective response to stress, leading to a vulnerability to illness. Over time, repeated such stressors may produce a cumulative toll that interferes with an effective and modulated stress response to new challenging or stressful circumstances. In such situations, strong social ties can act as a buffer against the adverse effects of stress.

Forming Social Ties

The origins of social ties are several. Although little research attention has been paid to this issue to date in humans (there are a number of animal studies), there are certainly genetic bases of the ability to form social ties. Twin studies and other paradigms designed to identify the role of genetics will elucidate these origins over the coming years. Exposure of animal infants to nurturant mothering and its effects on peer relations is another well studied route to strong social ties. In humans, the early family environment is known to play a major role in the ability to form enduring and meaningful relationships. In well-functioning families, infants and children learn that other people will help to provide for their emotional security and their physical safety and well-being. Children learn first how to extract the support that will help them meet these needs, as by crying or fussing, and later, when they become proficient with language, they develop more varied and sophisticated behaviors that signal exactly what their needs or intentions are with respect to other people. Importantly, they also learn to read the social signals sent by others regarding those others' needs and learn how to respond with help, comfort, or in some cases, rejection.

Not all families provide a social environment conducive to developing these skills, however. Repetti et al. (Reference Repetti, Taylor and Seeman2002) characterized what we termed "risky families", namely family environments characterized by overt family conflict, recurrent episodes of anger and aggression, and deficient nurturing, especially cold, unsupportive, and neglectful parenting. Families with these characteristics are "risky" for several reasons. Among the primary issues are that they raise children who cannot read social signals well or sense the social norms that govern expected and appropriate behavior in social settings. Moreover, they leave their children vulnerable to a variety of mental and physical health issues (See Repetti et al., Reference Repetti, Taylor and Seeman2002, for a review).

Effective Social Support

The fact that social contacts can be supportive but also a source of mental and physical health risks raises the question of when social ties are most likely to provide benefits. Having a partner provides the strongest psychological and health benefits. Most of the research that comes to this conclusion has focused on married couples. And, leaving a marriage, not having a partner, or being in an unsatisfying relationship have mental and physical health costs (Kiecolt-Glaser, Reference Kiecolt-Glaser2018). There is, however, no good reason to think that these conclusions are confined to marital relationships; any strong primary loving relationship can provide the benefits of social support, and its dissolution may likewise have similar health and mental health costs.

To be effective, the expression of social support must be tailored to the recipient's needs at the time and must come from the right person. For example, support from a stranger may be limited in the benefits it confers. And most people have had the experience of seeking comfort from a close friend or partner and receiving advice instead. Thus, both the source of support and the type of support provided are critical to benefits that social support efforts provide.

People vary in how successful they are in forming supportive social ties. Some people can go into a new social setting with strangers and come out with three new friends whereas others take longer to form those bonds, and a single encounter may produce no lasting ties. People also vary in how well they extract the support they need from others. Genetic factors appear to be involved in this skill, as studies of twins have revealed similarities in how they perceive and use social support that exceeds that of unrelated people matched on age and gender. Under conditions of high stress, these genetic factors may play an especially important role in the construal and use of social support.

These observations also lead to a very important point, namely that much of social support's benefit stems from simply perceiving that social support is or will be available as the demands of potentially stressful situations increase. These social cognitions underlying potential support, whether it is activated or not, have benefits of their own. It is emotionally reassuring to believe that there are people who can come to one's aid, whether or not that is true. Indeed the perception that one is part of a socially connected network may be more important for mental and physical health than the network's characteristics itself, given that perceptions can often be sustained with less evidence that reality requires.

Nonetheless, the threats to adequate social support are many. To begin with, relationships can be fragile, not only because it is hard to make relationships work, given people's different needs, but also because the environment poses challenges that undermine the abilities to form and sustain relationships. For example, several current trends conspire to deprive people of the opportunities to develop and use social support. Increasingly, people are living alone for long stretches of their lives, in some cases because of changes in their social support systems, such as divorce or estrangement from families, or due to changes in the environment, such as needing to relocate geographically for work. It may take some time to build up the new contacts that help to address the new challenges. The social isolation and loneliness that results can confer major health and mental health risks (Cacioppo et al., Reference Cacioppo, Grippo, London, Goossens and Cacioppo2015).

Social support needs can change abruptly. For example, a serious health threat that requires visits to multiple physicians and facilities can place a sudden and unexpected burden on both a patient and his or caregivers. Like all familiar relationships and routines, old ways may not at first be sufficiently flexible to meet the changing circumstances. And the threats themselves raise emotional demands, such as anxiety or depression, that must be addressed. Professionals skilled in the underlying issues can help address unmet emotional needs. People facing the same issues can also be a source of social support, as through support groups. At one time, such groups met face-to-face, but it is now very common to find and participate in a virtual support group on the Internet.

Providing Support to Others

Social support is not a one way street. Although many close relationships do not depend critically on reciprocity, anyone who takes without giving back is ultimately headed for difficulty in their relationships. Moreover, there are not only benefits of receiving social support, there are benefits from giving social support. For example, a study with older adults found that people who gave help to friends, relatives, or neighbors were less likely to die over the next 5 years (Brown et al., Reference Brown, Nesse, Vinokur and Smith2003). Still, there are limits to the benefits of giving support. An example of this point is caregiving. The medical systems of many countries are not well suited to providing adult caregiving. Many chronic diseases that become prevalent in old age create substantial custodial as well as emotional demands. In part because women are often younger than their husbands and may also have better health, women are more likely to take on the caregiving role than men. The typical caregiver, according to the research, is in her sixties taking care of her elderly spouse. Much of this care is long-term and demanding, and so caregivers may have unmet mental health needs as well as risks to their physical health.

Implications for Intervention and Policy

The previous analysis suggests manifold ways of addressing social support needs on both the individual and societal levels. Individually, helping people to increase their social networks or to make better use of the networks they have is one target. Creating social occasions for others, inviting people out, asking questions about their lives can all enhance existing relationships. Encouraging people to mentally rehearse their social support, such as thinking through who will be available during a stressful time, and even activating soothing memories of people who may no longer be alive but inferring what their help might be can be a source of information and support. Having a "conversation" with a deceased parent, for example, might provide a new perspective on a problem. Another approach involves enhancing social skills, such as helping people to become better listeners and provide empathy, rather than using their fallback position of giving advice.

Giving social support needs public attention and giving potential interventions visibility are also important. Often people think of their relationships as nice things to have without recognizing how critical they are to their health, and, as noted there are manifold ways to increase social support that people can use to their advantage. Health contexts represent an important context for social support, and medicine is moving in directions that may inadvertently undermine the intrinsic support that has historically been part of the therapeutic relationship. Numerous articles have recently touted the benefits of telehealth and telemedicine, namely the ability to provide health evaluations and medical care remotely. To what degree social support benefits are experienced when the caregiver is not physically present is currently unknown.

Many issues remain for social support research to explore over the next decades, and social support is itself changing as changing societies pose new challenges to relationships. A constant in this changing research and policy landscape is the intrinsic value that social support has for binding people together in both happy and trying times.