Dr Christian Jonathan Haverkampf M.D.

Friendship enriches life, increases happiness and promotes health. It is the promise of positive future communication. Since communication is how people get their needs, values, wishes and aspirations met, friendship plays an important role also in making people feel safer and more effective in the world.

Keywords: friendship

Table of Contents

Introduction. 3

Empathy. 3

Benefits. 3

Basic Parameters. 4

Loyalty. 4

Communication Patterns. 4

Communication Network. 4

Time. 5

Where To Find Friends. 5

Age. 5

Health. 6

Special Situations. 6

Self-Communication. 7

Boundaries. 7

Communication and Friendship. 7

Self-Confidence and the Sense of Self 8

Dissolution of Friendship. 8

Gender differences. 8

Making a Friendship Last. 9

References. 10


Friendship is basically a promise that a helpful communication will continue into the future. The mutual affection friends experience is part of these benefits. Friendship may involve affection, kindness, love, sympathy, empathy, honesty, altruism, loyalty, mutual understanding and compassion, enjoyment of each other’s company, and trust. All these are a result of an approach of communication patterns and an exchange of meaningful messages.

The companionship, emotional support and stability friendships offer is a reflection of the meaningful information exchange that results from the meeting of compatible communication patterns. Studies have found that meaningful connections with other people have positive health benefits and can be life prolonging. (Haverkampf, 2010) Conversely, loneliness and a lack of social supports have been linked to an increased risk of heart disease, viral infections, and cancer, as well as higher mortality rates overall.


The more familiar we are with another person’s communication patterns, the easier is it to decode and understand his or her emotional signals. In turn, this also means that in a continued relationship one is also easier understood and can feel safer. This is how communication over time can contribute to the benefits derived from friendship and to the sense of safety and security it offers.

Being able to understand how another person feels, brings the internal communication worlds of two people in close contact with each other. Close relationships like friendship turn a person’s external communication increasingly into an extension of his or her internal communication.


Friendship is not only an expectation of future beneficial communication, but it is also a helpful experience in the here and now. Friendship can be a training ground to develop various communication competencies, including empathy and others. Friends are more likely to provide honest feedback than mere acquaintances or strangers. Besides a greater sense of safety in an unpredictable world, friendship supports the development of better and more effective communication patterns in everyone involved.

Basic Parameters

Friends tend to be more similar to one another in terms of age, gender, behaviour, personal disposition, and academic performance. As individuals have to get their needs, values and aspirations met to be happy, satisfied and content, they will seek out people who can help them get these met. In some cases, it could be complementary needs and aspirations, in other cases similar and synergistic ones. But for a friendship, or any relationship, to work over the long run it has to increase the happiness, satisfaction and contentment of all involved. This usually requires an alignment of the basic parameters, the needs, values and aspirations in a beneficial way. Communication in turn which makes it possible to identify them in the first place and then determine whether they match or not.


The expectation of further helpful communication in the future is an important requirement of friendship. Without it, friendship would indeed be impossible. This implies a certain amount of loyalty, which is required to have a positive expectation of the friendship in the future. Without the hope of continued beneficial interactions in the future, the friendship is already dead in the present. If the loyalty is broken it is more difficulty in rebuilding it if there is a lack of faith in understanding one another. Having an understanding of another person’s communication patterns and structure and needs, values and aspirations can make it easier to rebuild trust or decide to end a relationship. Openness and communication can thus make relationships more resilient in the face of conflicts or seemingly diverging interests.

Communication Patterns

The communication patterns are more important than the content. Much has been made of the relational content and the sharing of personal information as a part of friendship. However, it is the communication patterns which are really the important part. It is here where the dynamic is and they are part of the process which leads to changes beneficial to everyone. Friendship has evolved as a framework in which this can take place.

Communication Network

A study performed at the University of Texas at Austin examined over 9,000 American adolescents to determine how their engagement in problematic behaviour (such as stealing, fighting, and truancy) was related to their friendships. Findings indicated that adolescents were less likely to engage in problem behaviour when their friends did well in school, participated in school activities, avoided drinking, and had good mental health. The opposite was found regarding adolescents who did engage in problematic behaviour. Whether adolescents were influenced by their friends to engage in problem behaviour depended on how much they were exposed to those friends, and whether they and their friendship groups “fit in” at school.

To have a benefit communication happens in a network. Friendship is one framework within these networks and it helps to bring about a greater benefit to everyone involved.


The outlook into the future depends on the communication patterns of the individuals involved. (Haverkampf, 2010) Research has shown that earlier friendships up until secondary education do not last as long as later ones. The reason is probably that insight into own needs, values and aspirations is more detailed as one becomes older. This can also mean that matches are better because one knows more about oneself and potentially learns more about the other.

Where To Find Friends

Many people meet and make friends in the workplace. However, they also often feel that they cannot be truly themselves at the workplace. To what extend openness and transparency are possible depends on the communication climate and the expectations at the workplace. If co-workers feel that they are competitors and they cannot communicate openly, making friends becomes more difficult.

Research has shown that a majority values the financial security their jobs seem to offer higher than making friends at the workplace. From a communication perspective this is unfortunate because communication networks are what drives innovation and helps maintain a good climate at the workplace. While it is true that co-workers do not have to be friends but respect each other, a climate where people feel that they cannot form friendships may not lead to the cohesion which makes great organizations succeed.

The majority of adults have an average of two close friends. Numerous studies with adults suggest that friendships and other supportive relationships do enhance self-esteem.


As they age, people continue to experience high levels of satisfaction in their friendships, even as the overall number of friends tends to decline. This satisfaction is associated with an increased ability to accomplish activities of daily living, as well as a reduced decline in cognitive abilities, decreased instances of hospitalization, and better outcomes related to rehabilitation. The overall number of reported friends in later life may be mediated by increased lucidity, better speech and vision, and marital status.


There is a large body of research linking friendship and health, but the precise reasons for the connection remain unclear. Explanations have included that good friends encourage their friends to lead more healthy lifestyles; that good friends encourage their friends to seek help and access services when needed; that good friends enhance their friends’ coping skills in dealing with illness and other health problems; and that good friends actually affect physiological pathways that are protective of health. However, it is also possible that the possibility of an open and non-judgmental exchange with others can have a large effect. Engaging in a dialogue with a friend also helps improve the internal dialogue which is an important determinant in the sense of self and the perception of oneself in terms of self-esteem and self-confidence. Thus, the ability to engage with a friend in a conversation supports the connectedness with the environment and with oneself.

It has been shown repeatedly and consistently in studies that older adults who have a rich network of friends are happier than those who do not. Happiness is thus related to the communication structures individuals have in place. Being connected in a meaningful way with the environment and with oneself contributes to experiences of satisfaction, contentment and happiness. This thus not mean one has to communicate with others all the time, but that there is the opportunity to do so, and that one has a choice of how much to communicate and when.

Among the elderly, friendships can provide links to the larger community, serve as a protective factor against depression and loneliness, and compensate for potential losses in social support previously given by family members. Especially for people who cannot go out as often, interactions with friends allow for continued societal interaction. Additionally, older adults in declining health who remain in contact with friends show improved psychological well-being.

Special Situations

Autism or certain autism features can be an impediment to the communication taking place in a friendship. Since communication is less automatic in individuals with autism, the world seems a more unpredictable place leading to the learning of body language, for example, and more ritualization in daily life. The fears can then also lead to rigidity and fear of change. One can see how different communication structures can lead to greater anxiety and an interference with communication. Breaking this vicious cycle can be an important step in therapy. Attending to social cues is more difficult.

Children with attention deficit hyperactivity disorder (ADHD) may have difficulty forming and maintaining friendships, due to a limited ability to build social skills through observational learning, difficulties attending to social cues, and because of the social impacts of impulsive behaviour and a greater tendency to engage in behaviour that may be seen as disruptive by their peers. This can lead to unstable social contacts or to social contacts with people who have unstable relationships themselves.

Borderline personality disorder (BPD) with feelings of intense and unstable emotions can also interfere significantly with friendships. The fear or a possible loss of a connection makes deeper, and particularly romantic relationships more difficult. However, an awareness for and insight into the communication patterns can help the individual suffering from BPD and his or her relationship partners to avoid these problems.


Internal communication is important in learning more about oneself and making better decisions. Friendships offer a freer external communication than many other relationships which allows for more experimentation with new communication patterns. Since internal and external communication are linked, this also means that the internal communication can flourish, and new communication patterns be developed which are helpful to the individual in meeting needs and pursuing aspirations and values.


It is at the same time important to establish healthy boundaries in friendships. Boundaries means that someone else’s communication patterns do not start taking over the own. Even in a friendship it is still important to keep in mind that there are two individuals with different communication patterns and different basic parameters. If both are aware of this, then they can benefit from each other. Boundaries are thus important to mutually benefit from a friendship.

Healthy boundaries, that is the ability to say what one needs and wants and what one does not want, can help a friendship because the openness and transparency that come with it increase trust on both sides. One also notices faster if one is in a toxic friendship.

Communication and Friendship

Being able to understand the other is an important aspect of developing and maintaining a friendship. After all, friendship is a description of a communication relationship with memories of the past, an actual present and a future.

Language specifies symbols which are then used in communication. In the development and maintenance of friendships this can play an important role. Children with Down syndrome have increased difficulty forming friendships. They experience a language delay causing them to have a harder time playing with other children. Most children with Down syndrome may prefer to watch other students and play alongside a friend but not with them, mostly because they understand more than they can outwardly express. Children with this disability benefit from a variety of interactions with both adults and children. Close friendships are important in developing communication skills in a relatively safe environment.

Self-Confidence and the Sense of Self

Higher friendship quality directly contributes to self-esteem, self-confidence, and social development. A World Happiness Database study found that people with close friendships are happier, although the absolute number of friends did not increase happiness. Other studies have suggested that children who have friendships of a high quality may be protected against the development of certain disorders, such as anxiety and depression. Conversely, having few friends is associated with dropping out of school, as well as aggression, and adult crime. Peer rejection is also associated with lower later aspiration in the workforce, and participation in social activities, while higher levels of friendship was associated with higher adult self-esteem.

Dissolution of Friendship

Since friendship is the promise of a future positive communication relationship. This means the end of a friendship severs a future communication link. The disruption of friendships has been associated with increased guilt, anger and depression, and may be highly stressful events, especially in childhood. However, potential negative effects can be mitigated if the dissolution of a friendship is replaced with another close relationship.

Whenever a friendship ends, a familiar pattern of interactions ceases. Since people used different communication patterns, finding people whose communication patterns match the own can lead to a greater sense of security. The communication with another can also have a beneficial effect on a person’s internal communication. Once the relationship ends, the loss of these benefits often becomes noticeable and leads to an urge for a replacement in the long-run.

Gender differences

In general, female-female friendship interactions among children tend to be more focused on interpersonal connections and mutual support, while male-male interaction tends to be more focused on social status and may actively discourage the expression of emotional needs. However, boys and girls share the full range of human needs, and it is easy for parents to overlook the emotional needs in boys and the achievement needs in girls, for example. Social stereotypes change only slowly, but fortunately they do in many places.

While males and females tend to report comparative levels of satisfaction with their friendships, females report more anxiety, jealousy, and relational victimization and less stability related to their friendships, and males report higher levels of physical victimization. A greater sensitivity to these risks and a greater occurrence of them may both contribute to greater anxiety and fears.

Among older adults, women tend to be more socially adept than their male peers, and many older men may rely upon a female companion, such as a spouse, to compensate for their comparative lack of social skills. Loneliness among elderly single men is a significant health risk for various physical and mental illnesses. Staying socially active and honing the communication skills can both be helpful in reducing the loneliness. Since women at an older age tend to be more engaged socially, they probably also have more communication practice than men. However, also here it should not be overlooked that there are also many elderly women who silently suffer from loneliness.

Making a Friendship Last

Communication is what holds relationships together, and friendships are no exception to this rule. The quantity of interactions may not be as important as the number of meaningful messages that are exchanged. Friendships are thus an opportunity of change for both friends. If there is openness to change, the friendship can adapt and develop in new ways. A combination of meaningful communication and openness to change are thus important ingredients to make a friendship last. Listening can also be a type of meaningful communication.

Dr Jonathan Haverkampf, M.D. MLA (Harvard) LL.M. trained in medicine, psychiatry and psychotherapy and works in private practice for psychotherapy, counselling and psychiatric medication in Dublin, Ireland. He also has advanced degrees in management and law. The author can be reached by email at jo****************@gm***.com or on the websites and


Haverkampf, C. J. (2010). A Primer on Interpersonal Communication (3rd ed.). Dublin: Psychiatry Psychotherapy Communication Publishing Ltd.

This article is solely a basis for academic discussion and no medical advice can be given in this article, nor should anything herein be construed as advice. Always consult a professional if you believe you might suffer from a physical or mental health condition. Neither author nor publisher can assume any responsibility for using the information herein.

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