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.