Ultimate (evolutionary) explanations for the attraction and benefits of chronic illness support groups: Attachment, belonging, and collective identity
About a century ago, there was a shift from humans contracting and dying from infectious diseases to living with non-infectious chronic diseases. Through advancements in medicine, chronic diseases are manageable, however, they are life-long and often debilitating. When chronically ill individuals struggle to adjust, and make sense of their disease, they are likely to benefit from participating in illness support groups. The benefits of support groups are usually explained by proximal factors such as social support. We explore three sets of evolutionary adaptations to provide ultimate explanations for the value of social support: attachment, group membership, and collective identity. These three concepts suggest that support groups assist with regulating emotions, belonging, and integrating chronic illness into one’s identity. Although attachment theory highlights important aspects of coping with chronic illness, it is framed in dyadic terms, which is ill-fitting for support groups. Support groups are beneficial because they capitalize on the ancient adaptations of belonging and collective identity. Practical applications of these evolutionary concepts for chronic illness support groups are discussed.
KeywordsAttachment Group membership Collective identity Social support Support group Chronic illness
Compliance with Ethical Standards
Conflicts of Interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
There was no procedure to obtain informed consent as this article does not contain any studies with human participants or animals performed by any of the authors.
- Arthur, H. M., Wright, D. M., & Smith, K. M. (2001). Women and heart disease: The treatment may end but the suffering continues. Canadian Journal of Nursing Research Archive, 33(3), 17–29.Google Scholar
- Boehm, C. (2008). Moral origins: The evolution of virtue, altruism, and shame. New York: Basic.Google Scholar
- Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. London: Routledge.Google Scholar
- Brewer, M. B. (2008). Depersonalized trust and ingroup cooperation. In J. I. Krueger (Ed.), Rationality and social responsibility (pp. 215–232). New York: Psychology Press.Google Scholar
- Brewer, M. B., & Caporael, L. R. (2006). An evolutionary perspective on social identity: Revisiting groups. In M. Schaller, J. A. Simpson, & D. T. Kendrick (Eds.), Evolution and social psychology (pp. 143–161). Ann Arbor: Psychology Press.Google Scholar
- Cacioppo, J. T., & Patrick, W. (2008). Loneliness: Human nature and the need for social connection. New York: W. W. Norton.Google Scholar
- Cohn, D., & Morin, R. (2008). Who moves? Who stays put? Where’s home? Retrieved from Pew Research Center website: http://www.pewsocialtrends.org/files/2011/04/American-Mobility-Report-updated-12-29-08.pdf
- de Cremer, D., & Van Dijk, E. (2002). Reactions to group success and failure as a function of identification level: A test of the goal-transformation hypothesis in social dilemmas. Journal of Experimental Social Psychology, 38, 435–442. https://doi.org/10.1016/S0022-1031(02)00009-4.CrossRefGoogle Scholar
- Decety, J., & Ickes, W. (Eds.). (2009). The social neuroscience of empathy. Cambridge: MIT Press.Google Scholar
- Hawkley, L. C., Burleson, M. H., Berntson, G. G., & Cacioppo, J. T. (2003). Loneliness in everyday life: Cardiovascular activity, psychosocial context, and health behaviors. Journal of Personality and Social Psychology, 85(1), 105–120. https://doi.org/10.1037/0022-3518.104.22.168.CrossRefPubMedGoogle Scholar
- Henrich, N., & Henrich, J. (2007). Why humans cooperate: A cultural and evolutionary explanation. Oxford: Oxford University Press.Google Scholar
- Hinnen, C., Schreuder, I., Jong, E., van Duijn, M., Dahmen, R., & van Gorp, E. C. M. (2012). The contribution of adult attachment and perceived social support to depressive symptoms in patients with HIV. AIDS Care, 24(12), 1535–1542. https://doi.org/10.1080/09540121.2012.672714.CrossRefPubMedGoogle Scholar
- Huber, J., Muck, T., Maatz, P., Keck, B., Enders, P., Maatouk, I., & Ihrig, A. (2017). Face-to-face vs. online peer support groups for prostate cancer: A cross-sectional comparison study. Journal of Cancer Survivorship, 1–9. https://doi.org/10.1007/s11764-017-0633-0.
- Kenrick, D. T., Neuberg, S. L., Griskevicius, V., Becker, D. V., & Schaller, M. (2010). Goal-driven cognition and functional behavior: The fundamental-motives framework. Current Directions in Psychological Science, 19(1), 63–67. https://doi.org/10.1177/0963721409359281.CrossRefPubMedPubMedCentralGoogle Scholar
- Kessler, R. C., Mickelson, K. D., & Zhao, S. (1997). Patterns and correlates of self-help group membership in the United States. Social Policy, 27(3), 27–46.Google Scholar
- Kurtz, L. (2004). Support and self-help groups. In C. D. Garvin, L. M. Gutiérrez, & M. J. Galinsky (Eds.), Handbook of social work with groups (pp. 139–159). New York: Guilford Press.Google Scholar
- Martin, C. M. (2007). Chronic disease and illness care. Canadian Family Physician, 53, 2086–2091 Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2231531/.PubMedPubMedCentralGoogle Scholar
- Putnam, R. D. (2000). Bowling alone: America’s declining social capital. In L. Crothers & C. Lockhart (Eds.), Culture and politics (pp. 223–234). New York: Palgrave Macmillan.Google Scholar
- Schmidt, S. D., Blank, T. O., Bellizzi, K. M., & Park, C. L. (2012). The relationship of coping strategies, social support, and attachment style with posttraumatic growth in cancer survivors. Journal of Health Psychology, 17, 1033–1040. https://doi.org/10.1177/1359105311429203.CrossRefPubMedGoogle Scholar
- Seppala, E., Rossomando, T., & Doty, J. R. (2013). Social connection and compassion: Important predictors of health and well-being. Social Research, 80, 411–430.Google Scholar
- Tajfel, H. (1981). Human groups and social categories. Cambridge: Cambridge University Press.Google Scholar
- Ward, B. W., Schiller, J. S., & Goodman, R. A. (2014). Multiple chronic conditions among U.S. adults: A 2012 update. Preventing Chronic Disease, 11. https://doi.org/10.5888/pcd11.130389.
- Williams, K. D. (2007). Ostracism. Annual Review of Psychology, 58, 425–452. https://doi.org/10.1146/annurev.psych.58.110405.085641.CrossRefPubMedGoogle Scholar