Theories for Improving Peer Support: Theory 1 - Common Humanity Theory
A very important article has just been published about why peer support is so effective at helping people (Kotera, Llewellyn-Beardsley, Charles, & Slade, 2024). Dr. Kotera from Birmingham University and colleagues point to a new set of research on the concept of “common humanity” to give a very practical explanation for how for good peer support works.
The term common humanity refers to a set of beliefs that people may or may not have – beliefs that are associated with higher levels of compassion for self and others. Specifically, common humanity refers to the beliefs that (1) all humans are the same in their basic needs and desire to avoid suffering, and (2) that suffering is a universal human experience (Strauss et al., 2016).
These beliefs are used by people to interpret their life experiences that involve suffering. For example, for a person who holds these beliefs, the experience of dealing with a physical or mental illness and the associated losses and suffering will be interpreted as something other people also experience – not something that isolates that person (Ling et al., 2020).
The experience of illness and loss, and the common association with stigma and self-stigma, often leads people to feel isolated. Common humanity beliefs are associated with greater social connection and more mutually supportive relationships (Gilbert & Leahy, 2007). People who have a strong sense of common humanity are less likely to feel isolated due to the illnesses, setbacks, and failures they experience, recognizing that others face similar challenges, and that everyone faces significant challenges of some sort. They see challenges as something that they share with others, and so are opportunities for connection to other people. They see that talking openly about challenges will often lead to positive connection to other people who share similar challenges.
Common humanity beliefs represent a protective factor, shielding us feelings of shame and inadequacy, and so can be seen as a key part of resilience, and a desirable corrective factor helping people cope with new illnesses in themselves or in others.
Common humanity beliefs can be induced by different types of experiences. In research studies, common humanity beliefs have been encouraged using brief films or stories that involve experiences of suffering by other people and/or people talking about their own views of common experiences across people (Ling, Olver, & Petrakis, 2020).
These brief induction experiences of common humanity have an impact that can be seen even on research measures. In one experiment with socially anxious young adults (n = 63), an experience that emphasized common humanity resulted in reduced anxiety and increased self-compassion (Slivjak et al., 2022). In another experiment involving 75 healthcare workers, a similar intervention increased compassion among those workers (Ling et al., 2020).
Peer Support Relies Heavily on Common Humanity
Common humanity beliefs are associated with resilience and quality of life (Dreisoerner et al., 2021; Kotera et al., 2021; Wilkes et al., 2022), which are targeted in the core practices of peer support work (Stratford et al., 2019). Peer support involves sharing of personal suffering. Peer Support Specialists have one central job requirement: that they have personal experience of suffering and recovery, and are willing to talk openly about that suffering.
The most widely used format for peer support is the self-help group in which people meet regularly to openly share their experience of their suffering and efforts to recover. These groups typically specialize in different experiences of suffering, allowing attendees to hear from other people who experience similar types of suffering.
A common ‘curriculum’ for many peer support groups is the 12-steps. From a Common Humanity perspective, the 12-steps can be seen as forcing attendees to an acknowledgement of common humanity – we all suffer and have to face our suffering in order to recover.
Peer Support Specialists and others providing peer support in any setting should consider the following logical implications for Common Humanity Theory:
1. Common Humanity Theory reminds us that the key element of peer support is the open sharing about personal suffering. As a Peer Support Specialist, you have a variety of interventions you can provide including peer counseling, advocacy, education. It will be crucial for you to ensure you stay focused on your key responsibility of sharing openly about personal suffering in all of these roles.
2. Recovery stories are the most common way that Peer Support Specialists share personal information about suffering. Those stories can vary widely in what they include. I have worked with peers whose stories focused much more on their experience of recovery than on their experience of illness and loss, and the associated suffering. There is likely a natural temptation to emphasize one’s recovery over experiences of illness and loss, as recovery is associated with more positive experiences and emotions relative to illness. Common Humanity Theory suggests that sharing openly about experiences of illness and suffering will be the most impactful, and any urge to focus more on recovery to the exclusion of illness should be resisted.
3. The fact that Common Humanity beliefs can be induced by fairly brief stories or films suggests that these beliefs can be quite variable in how available they are to people. Clinical programs would be wise to include experiences that encourage common humanity beliefs at repeated points in treatment. For example, in a 2-week day hospital program, interventions that emphasize community should be included at repeated frequencies, possibly daily. The inclusion of peer support groups and Peer Support Specialist within daily programming will facilitate this.
4. Peer Support Specialist, clinicians and others should be aware of factors that undermine common humanity beliefs and address those in treatment settings. Specifically, experiences, stories or voices that emphasize the view that suffering is not universal, that illness or negative experiences reflect something to feel isolated or shame about, should be actively refuted. Stigma and self-stigma interventions are closely tied to these interventions. The common divide between clinicians and “patients” can function in this destructive way.
5. Peer Support Specialists who facilitate or participate in peer support groups want to work to protect those groups from behaviors that undermine Common Humanity beliefs. A relatively common complaint by people who attend peer support groups is that group members make comments that suggest there is a hierarchy in the group. This may be reflected in comments comparing people’s suffering (e.g. who has the worse form of cancer, who had the worst ‘rock-bottom’ experience, who has been in recovery longer). Creating status inside of groups is a common temptation, but it undermines the Common Humanity beliefs, Another common complaints is that a support group is divided by cliques. When groups divide into subgroups in a way that reduces the connections in the larger group, it again undermines that belief that the experiences are “universal”. Group facilitators need to evaluate any group dynamic based on how it supports or detracts from Common Humanity beliefs. Move quickly when group members act in a way that undermines those beliefs.
6. There is growing comfort among public figures about acknowledging personal mental health struggles. This is wonderful, as that open sharing supports Common Humanity beliefs, and reduces stigma. Peer Support Specialists may want to become familiar, and refer to the long list of public figures who have acknowledged personal experience with various mental illnesses, physical illnesses, and other forms of suffering can find valuable examples at the following website: (https://www.namikenosha.org/education/famous-people-with-mental-issues/) .
I find theories to be like maps – a good theory can help me find where I want to go. Common Humanity Theory is a great example of an excellent map that help guide us toward more effective peer support, and alert us when we are moving in the wrong direction.
REFERENCES
Dreisoerner, A., Junker, N. M., & Van Dick, R. (2021). The relationship among the components of self-compassion: A pilot study using a compassionate writing intervention to enhance self-kindness, common humanity, and mindfulness. Journal of Happiness Studies, 22(1), 21–47. https:// doi. org/ 10. 1007/ s10902- 019- 00217-4
Gilbert, P., & Leahy, R. L. (2007). The therapeutic relationship in the cognitive behavioral psychotherapies. Taylor & Francis Group. http:// ebook centr al. proqu est. com/ lib/ notti ngham/ detail. action? docID=
356246. Accessed 30 June 2022
Kotera, Y., Cockerill, V., Chircop, J., Kaluzeviciute, G., & Dyson, S. (2021). Predicting self-compassion in UK nursing students: Relationships with resilience, engagement, motivation, and mental wellbeing. Nurse Education in Practice, 102989-102989.https:// doi. org/ 10. 1016/j. nepr. 2021. 102989
Kotera, Y., Llewellyn-Beardsley, J., Charles, A., & Slade, M. (2024). Common humanity as an under-acknowledged mechanism for mental health peer support. International Journal of Mental Health and Addiction, 22(3), 1096-1102.
Ling, D., Olver, J., & Petrakis, M. (2020). Investigating how viewing common humanity scenarios impacts compassion: a novel approach. The British Journal of Social Work, 50(6), 1724-1742.
Slivjak, E. T., Pedersen, E. J., & Arch, J. J. (2022). Evaluating the efficacy of common humanityenhanced exposure for socially anxious young adults. Journal of Anxiety Disorders, 87, 102542. https:// doi. org/ 10. 1016/j. janxd is. 2022. 102542
Strauss, C., Taylor, B.L., Gu, J., Kuyken, W., Baer, R., Jones, F. and Cavanagh, K. (2016). What is compassion and how can we measure it? A review of definitions and measures. Clinical Psychology Review, 47, pp.15-27.
Stratford, A. C., Halpin, M., Phillips, K., Skerritt, F., Beales, A., Cheng, V., Hammond, M., O’Hagan, M., Loreto, C., Tiengtom, K., Kobe, B., Harrington, S., Fisher, D., & Davidson, L. (2019). The growth of peer support: An international charter. Journal of Mental Health, 28(6), 627–632. https:// doi. org/ 10. 1080/ 09638 237. 2017. 13405 93
Wilkes, J., Garip, G., Kotera, Y., & Fido, D. (2022). Can Ikigai predict anxiety, depression, and well-being? International Journal of Mental Health and Addiction. https:// doi. org/ 10. 1007/ s11469- 022- 00764-7