Exploring Loneliness among people with Complex Emotional Needs (CEN) using Mixed Methods

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Lonely people experience a painful subjective state characterized by a perceived discrepancy between actual and desired patterns of social interaction (1). Loneliness is linked to a wide range of mental health problems; thus, targeting loneliness could alleviate distress and prevent mental health issues (1). Research exploring the link between loneliness and mental health problems has become of great clinical and policy interest. Traits suggestive of a diagnosis of "personality disorder" are common in the general population. This signifies the importance of shifting towards employing a broader term, such as CEN, to describe people with "personality disorder" related traits. The diagnostic label "personality disorder" has also been criticized for being stigmatizing, misogynistic, and implying a defective personality (2). People with relevant lived experience emphasize the pejorative and invalidating nature of the term and suggest that people diagnosable with "personality disorder" are better described as people with CEN, on the basis that their struggles often originate from a history of complex traumatic experiences (4). In acknowledgement of the prevalence of "personality disorder" traits and the strong critiques regarding the diagnostic label, I employ the term CEN to address the needs of people who may have a "personality disorder" diagnosis. Improving quality of care and broadening the range of interventions offered, including socially focused interventions, has been emphasized by people with lived experience of CEN, professionals, and policymakers (15).