When I first read the part where Galatea completely gets all of her (and everybody's) feelings about Dean out in the open with her rant, Dean didn't seem very affected, and this made me think that he doesn't care about what other people think. But then, when Sal is offended by his comment about being older & advising him on his health, Dean cries, which he never does. So Dean must care about Sal, & about what he thinks.
Also, when Dean meets with Sam and it turns out that he wants to cut the ties between Dean's father & Dean, Dean is losing his connection with everyone. He now hardly has any family, Marylou's left him, Camille's kicked him out...there's definitely a pattern here.