The Table We Build Together: Companionship as Care

“It is by loving, and not by being loved, that one can come nearest the soul of another.”

—George MacDonald,

In an age marked by disconnection and isolation, the simple act of gathering together has taken on new meaning. As the holidays approach, especially Thanksgiving, many are reflecting on the importance of community and companionship in both our personal and our collective healing. This article explores how loneliness harms health, how companionship functions as a form of clinical and spiritual care, the role of gratitude in healing, and how caregivers and communities together build a “table” of support. The tone remains warm and reflective, grounded in both scholarly research and theological insight. By examining current studies alongside the wisdom of Scottish minister and author George MacDonald, we will see that true healing is a communal, relational process. It is one nurtured as much by presence and love as by any medical intervention.

A Season of Togetherness in a Time of Isolation

Even before the COVID-19 pandemic, experts warned of a growing “epidemic of loneliness.” Recent surveys show about half of U.S. adults report experiencing loneliness (Bell Washington, 2023). This disconnection isn’t just emotionally painful; it carries significant health risks. Chronic loneliness and social isolation are linked to higher rates of cardiovascular disease, stroke, depression, anxiety, and even premature death (Holt-Lunstad, Smith, Baker, Harris, & Stephenson, 2015). In fact, being socially disconnected has a mortality impact comparable to smoking 15 cigarettes a day and is more dangerous than risk factors like obesity or lack of exercise (Holt-Lunstad, Smith, & Layton, 2010). Such findings have prompted public health leaders to label loneliness a “pressing issue” on par with smoking or obesity in its impact on population health (Murthy, 2023).

It is tragically ironic that in a world more digitally connected than ever, so many feel isolated. The pandemic era of quarantine only intensified this loneliness. In 2021, a broad national survey reported 36% of Americans—including 61% of young adults—felt “serious loneliness,” a statistic that highlights how pervasive the problem is across ages (National Academies of Sciences, Engineering, and Medicine, 2020). Taken together, these data paint a picture of a society hungry for companionship.

From a theological perspective, this deep human need for connection is no surprise. In the Christian tradition, humans are created for relationship—with God and with one another. The 19th-century writer George MacDonald likewise emphasized that love for one’s neighbor is essential to escape the prison of self-centered isolation. As MacDonald put it, “This love of our neighbour is the only door out of the dungeon of self, where we mope and mow…instead of issuing to the fair sunlight of God” (MacDonald, 1867/1887, p. 95). In other words, reaching out in love frees us from the dungeon of loneliness. A season like Thanksgiving, centered on gratitude and gathering, thus arrives as a timely reminder of our calling to seek togetherness in a time of isolation. True community offers sunlight to those trapped in the shadows of solitude.

Companionship as a Form of Clinical and Spiritual Care

Ample research now shows that companionship itself can be therapeutic. Companionship—whether through a supportive friend, a family caregiver, or a caring clinician—is associated with better health outcomes across the board. People with strong social support have stronger immune function and lower rates of many illnesses (Holt-Lunstad et al., 2010). One meta-analysis of 148 studies concluded that individuals with richer social relationships had a 50% greater likelihood of survival over a given time period than those with sparse social ties (Holt-Lunstad et al., 2010). Simply put, presence matters: having someone by your side in times of illness can reduce anxiety, improve adherence to treatments, and even speed healing.

Companionship plays a role not just in physical health, but in mental and spiritual well-being. For example, among older adults with depression, those who participated in peer support programs (regularly meeting with a companion who had similar life experience) showed reduced depression and loneliness and improved quality of life (Valtorta et al., 2016). The healing power of “being there” for someone is something even the best clinical medicines cannot replicate. Doctors and nurses observe that patients who receive empathic attention and have family or friends involved in care tend to have better morale and engage more positively in recovery (Fogarty et al., 1999).

From a spiritual viewpoint, companionship is a tangible expression of God’s love in caregiving. George MacDonald wrote, “Few delights can equal the mere presence of one whom we trust utterly” (MacDonald, 1867/1887, p. 4026). In clinical and pastoral settings alike, the trusted presence of a companion can be a source of profound comfort and healing. Healing, in this light, becomes a shared journey. As MacDonald believed, it is often “by loving, and not by being loved, that one can come nearest the soul of another” (MacDonald, 1858, p. 220).

Gratitude as a Healing Practice

Gratitude has emerged as a powerful healing practice backed by research. Psychologists Robert Emmons and Michael McCullough (2003) found that participants who kept a “gratitude journal” reported more positive moods, more optimism, and even fewer physical health complaints than those focusing on hassles or neutral events. In other words, consciously cultivating thankfulness yielded measurable benefits; happier feelings and fewer aches and pains.

More recent studies have extended these findings into clinical populations. For example, in patients with heart failure, a simple gratitude writing intervention led to improved biomarkers of health. Patients who wrote daily about things they were grateful for had lower levels of inflammatory cytokines and greater heart rate variability than those who received standard care (Mills et al., 2015). They also reported better sleep and mood.

In spiritual traditions, gratitude has always been considered salve for the soul. The apostle Paul encouraged early Christians to “give thanks in all circumstances” (1 Thess. 5:18, New International Version), viewing thankfulness as integral to a life of joy and connection. George MacDonald likewise saw gratitude and joy as deeply intertwined. He wrote, “The best thing you can do for your fellow, next to rousing his conscience, is—not to give him things to think about, but to wake things up that are in him” (MacDonald, 1867/1887, p. 360). Gratitude has a way of waking up what is best in us, reminding us of the love we’ve received and inspiring us to reciprocate it.

Building the Table: Community, Calling, and the Caregiver’s Role

Healing is not a solo endeavor. It happens in community, at the “table” we build together. In the caregiving context, this means that doctors, nurses, therapists, family caregivers, faith leaders, and friends all have a seat at the table of healing. Each plays a role in surrounding the patient with a circle of companionship and support. We might think of the caregiver’s role as setting the table for community: creating space for connection, inviting others in, and ensuring that no one endures illness in isolation.

Caregivers often wrestle with the tension between setting healthy boundaries and honoring healthy obligations. Healthy boundaries help caregivers avoid burnout, but healthy obligations remind us of our responsibility to one another. These familial and societal bonds (when not coerced but embraced with love) can serve as powerful motivators for sustained care. George MacDonald often wrote of the sacred duty to love one’s neighbor and bear one another’s burdens. He believed that in doing so, we actually participate in the divine love that undergirds the world. MacDonald wrote, “The love of our neighbor is the only door out of the dungeon of self” (MacDonald, 1867/1887, p. 95). In caring for someone, especially someone who is suffering or vulnerable, we step outside ourselves in a way that is transformative.

To “build the table” means to actively foster community and connection as foundations for healing. Medical professionals increasingly recognize that treating a patient in isolation is incomplete. Healing the whole person involves engaging their family, friends, and faith or community supports. Hospitals now host support groups and involve family in care planning; churches and community centers run visitation ministries to those who are homebound or hospitalized. Each of us can contribute to this communal care. Such small acts help weave a safety net of companionship that catches people who might be falling through the cracks of isolation.

A Table Together

As we approach Thanksgiving, the metaphor of the table is especially apt. The Thanksgiving table is a place where we gather in gratitude, share our stories, and nourish one another… not just with food, but with love and attention. In a profound sense, every caring interaction is a kind of Thanksgiving table. These “tables” of care and community are where true healing often happens. They remind us that healing is a shared feast, not an isolated struggle.

In bringing together the themes of loneliness, caregiving, gratitude, and community, we see a common thread: healing is relational. Modern science and ancient wisdom agree on this point. We are made to heal together through companionship, through giving and receiving care, through practicing gratitude, and through building communities of support. This Thanksgiving, we can genuinely acknowledge the grace of these relationships. We can honor the caregivers who set the table for others’ healing, and we can commit ourselves to pulling up a chair alongside those in need of company. In doing so, we live out what George MacDonald and so many others have taught: that love, expressed in companionship, is at the heart of true healing. As we give thanks this season, may we also remember to give companionship. For it is around the table of community and care that we become whole.

References

Bell Washington, T. (2023, July 14). What doctors wish patients knew about loneliness and health. American Medical Association. https://www.ama-assn.org/public-health/behavioral-health/what-doctors-wish-patients-knew-about-loneliness-and-health

Emmons, R. A., & McCullough, M. E. (2003). Counting blessings versus burdens: An experimental investigation of gratitude and subjective well-being in daily life. Journal of Personality and Social Psychology, 84(2), 377–389. https://doi.org/10.1037/0022-3514.84.2.377

Holt-Lunstad, J., Smith, T. B., & Layton, J. B. (2010). Social relationships and mortality risk: a meta-analytic review. PLoS Medicine, 7(7), e1000316. https://doi.org/10.1371/journal.pmed.1000316

Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015). Loneliness and social isolation as risk factors for mortality: a meta-analytic review. Perspectives on Psychological Science, 10(2), 227–237. https://doi.org/10.1177/1745691614568352

MacDonald, G. (1867). Unspoken Sermons, Series I: “Love Thy Neighbour.” In God’s Words to His Children: Sermons Spoken and Unspoken (1887 ed., pp. 171–189). Alexander Strahan. (Original work published 1867)

MacDonald, G. (1858). Phantastes: A Faerie Romance for Men and Women. Smith, Elder & Co.

MacDonald, G. (n.d.). Quote about presence and trust. In The Complete Novels of George MacDonald (Illustrated) (p. 4026). e-artnow. (Original work by G. MacDonald, 19th century)

Mills, P. J., Redwine, L., Wilson, K., et al. (2015). Gratitude and well-being in heart failure patients: The role of gratitude journaling on biomarkers and quality of life. [Abstract]. Presented at the American Psychosomatic Society Annual Meeting, Savannah, GA. (Study subsequently published as Redwine et al., 2016, in Psychosomatic Medicine, 78(6), 667–676.)

National Academies of Sciences, Engineering, and Medicine. (2020). Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System. The National Academies Press. https://doi.org/10.17226/25663

Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016). Loneliness and social isolation as risk factors for coronary heart disease and stroke: systematic review and meta-analysis of longitudinal observational studies. Heart, 102(13), 1009–1016. https://doi.org/10.1136/heartjnl-2015-308790

Vivek H. Murthy, M.D. (2023). Our Epidemic of Loneliness and Isolation: The U.S. Surgeon General’s Advisory on the Healing Effects of Social Connection and Community. U.S. Department of Health & Human Services. https://www.hhs.gov/sites/default/files/surgeon-general-social-connection-advisory.pdf