SHARING THE SAME FATE: The social bond between the self and fellow sufferers in the context of peer support

Peer support has become a growing source of consolation for individuals in contemporary social life. This article examines the social bond between selves and their fellow sufferers ‘sharing the same fate’ in support groups and personal networks. Analyzed fateful conditions include serious illness, premature loss of a spouse through death or abandonment, infertility and family disruptions. The results show that selves colonized by agonizing life experiences confront social isolation and turn to their fellow sufferers in order to find understanding. A distinct kind of social bond is proposed between fellow sufferers involving sharing at the level of generalized experiences. Further analysis of different states of the bonds and their consequences is drawn from Thomas Scheff's distinction of the social bond as one of three states: attuned, engulfed or isolated. When attuned to fellow sufferers, peer support can be genuinely self-empowering and healing, but also other consequences emerge. In engulfed bonds with fellow sufferers, the particular self stands at risk of being overpowered by others. Isolated bonds with fellow sufferers may not be capable of breaking the lonely state of suffering. This paper provides an elaborate empirical understanding of the interplay between fate, the social and the individual in the context of peer support. The data is made up of repeated in-depth interviews with 22 Finnish women and men that contain narrated life stories, accompanied by information about their network, of significant others and support contacts.

The social bond between those sharing the same fate has long been recognized, as this quote from Thomas Mann's classic novel The Magic Mountain (1924) shows. It is from young Hans Castrop, talking about his stay in the patient community of Berghof, a sanatorium for the ill located on the mountain ‘up here’, as opposed to the ordinary life ‘down below’. A fatal illness has brought patients to the sanatorium, where their being is characterized by both imminent life and death in the continuous flow of time, as opposed to organization of ordinary everyday life. Today, fellow sufferers actively search for each other in support groups, internet columns and other social circles. In contemporary life the social exchange between fellow sufferers¹ is actively used as a means to support people in their difficult life situations.

Peer support has become a widely institutionalized practice aimed at helping people to cope with difficult transitions and diverse kinds of loss, illness and other suffering. Support groups are organized around common life experiences by numerous voluntary and public organizations, but common experiences connect people in their personal networks as well (Damen et al.2000; Ketokivi 2008). The idea behind peer support is self-empowerment of people that professional treatment is unable to foster (Walter 1999). However, it has also been claimed that advocating peer support is in part a result of a cost-effective social policy (Riessman 1997).

Researchers who study support groups may use different terms that carry different connotations, including mutual help or aid (Walter 1999; Arminen 2004) and self-help (Kessler et al.1997; Riessman 1997; Damen et al.2000; Williams 2004). By using the term ‘peer support’ I wish to draw attention to the social bond between fellow sufferers as a peer relationship where a common life situation connects them as peers. In sociology, peer has typically been used to refer to those of the same age and class who offer an alternative source of socialization to young people in particular (Riesman 2001[1961]: 21). In the case of peer support, peers are defined differently: they are the people who have a common ‘fate’ and gather together to share their experiences in order to find consolation. At the same time, they discover new ways to perceive their personal situation (Walter 1999: 192). Severe illness, unexpected family disruptions and other such experiences sometimes wound selves to the extent that they lose their sense of self entirely. When suffering selves mobilize themselves to seek recognition of their experience from others who share it, it is the search for the self that is the central determinant of the social bond (Ketokivi 2008).

The main interest of this article is to examine the relationship between fellow sufferers as a specific form of social bond. The focus is on the suffering self's bond to her² fellow sufferers. Thus, methodologically I draw upon a symbolic interactionist perspective that views the self as profoundly social in nature, as well as upon a narrative approach to illness and suffering (e.g., Charmaz 1983; Frank 1995). To unveil different dynamics of the bond between fellow sufferers, I first consider the notion of ‘fate’ and social isolation that suffering selves are often forced to confront. These two conditions form a basis for the ways in which fellow sufferers connect to each other and gather to practice peer support in both support groups and personal networks. Instead of elaborating peer support as such, I place it in the context of individual biographies and examine in detail how suffering selves are bound to their fellow sufferers. Finally, I take under scrutiny the varying states of the bond between selves and their fellow sufferers, drawing from Scheff's (1997) model of social bonds as attuned, isolated or engulfed that have divergent consequences on the selves.

I draw from data containing repeated biographical interviews of 37 Finnish adults (in total 80 interviews), accompanied by detailed information about the interviewees’ configurations of all of their significant others. The configuration places individual narratives in the context of their current actual relationships. The data set comprises two to four transcribed interviews with 24 women and 13 men, including the longitudinal data from seven interviewees. The interviewees differ in terms of education, occupation and social situation. They are 30–76 years old and live in urban or suburban settings in southern Finland.

Material from 22 biographies was examined. Kindred to each were the subject's confrontation with wounding circumstances, crises conceptualized as ‘fate’ and the subsequent need for support. The different experiences included life-dominating illnesses, the premature loss of a spouse, depression, abandonment of a spouse, infertility, and the experience of having a mentally ill or disabled child. Second, they all have taken part in peer support (face-to-face) either in a group and/or in personal relationships with fellow sufferers. Third, the focus of the interaction between fellow sufferers is inner-directed, aiming at healing rather than at political interests, which sometimes can be the main focus (Walter 1999: 188). The analysis concentrates on the emotional (or therapeutic) aspect of the inner-direction (Damen et al.2000: 333). The sample includes different styles of peer support, although loners and people who discuss their experiences exclusively with a therapist or as anonymous contributors to internet discussion groups are not considered.

More than half of the interviewees were recruited from support groups. The rest were discovered with the ‘snowballing’ technique, beginning with informal networks of people. Depression patients from a support group for coping with depression in everyday life were secured from a psychiatric unit for outpatients, as were mothers of mentally ill (adult) children from a group organized for family member of the mentally ill. Both of these groups were led by professionals, but seen as forums to meet fellow sufferers by interviewees. Snowballing provided access to a young widow support group, a volunteer who had started a group for the transition to motherhood and its challenges and several people who experienced illness or unexpected family disruptions. Although different experiences have their peculiarities, all the accounts shared the sense of being forced to accept a given ‘fate’ and the loss of the self (Charmaz 1983). There will be no focus on particular experiences or support contexts, but the study contextualizes the analysis by describing the particular settings of the cases. Studying the general instead of the particular is less adept at accounting for details, but it may provide richer analytical understanding, as Goffman (1990[1963]: 174) has suggested in his classic analysis of the stigmatized.

The method draws from different qualitative research traditions. It owes most to the narrative tradition used in the studies of illness and the self (Frank 1995), but is informed also by the configurational approach to social relationships (Elias 1970; Widmer et al.2008).³ Data were coded with inclusive descriptive themes, using Atlas-Ti software. Examples of general codes are: fateful experiences, the reactions of others, opening up, group experiences, experience in personal relationships and themes of discussion. Abstract coding categories were added later and included categories such as sharing, individuality, boundary-work, comparisons between experiences and personal consequences. The analysis proceeded from describing the different dynamics and boundaries of sharing between the fellow sufferers to the more analytical elaboration of the social bond and the self in the context of peer support (see Scheff 1997: 100).

In the Finnish language and culture the phrase kohtalotoveruus (fellowship of fate) is commonly used in the context of peer support, and some participants in this study used this term. It proposes a bond between fellow sufferers of the same fate, referring to the way a person's life unfolds in given ways outside the control of the individual or perhaps any human agent. Prime examples of kohtalotoveruus are soldiers fighting side by side in the same war and the tuberculosis patients in the Magic Mountain sanatorium. An example from the data gathered here is provided by a mother of a disabled child about whether she had people to talk to when the topic was silenced by the family: ‘Well yes, there were these kohtalotoverit (fellows in fate, referring to other parents of disabled children) from different hospitals’.

Fellow sufferers share a given fate, such as a certain illness, a certain loss or another certain hardship. The phrase kohtalotoveruus does not only indicate a bond of fellowship between the fellow sufferers, but suggests generalization of the bond as existing between any fellow sufferers of any given fate. This was evident also in the way interviewees discussed their bond with fellow sufferers.

Sociological discussions tend to focus on social structure as a counterpoint to individual agency and fate is not a popular topic. In addition to structure, however, life is inherently uncertain regardless of individual oand social efforts to calculate risks and control it. Giddens (1991: 109–12) has discussed these concepts and he views the meaning of term fate as referring to preordained determinism, to which the modern outlook stands opposed, fatalism being an attitude that resigns holder to acceptance that events should be allowed to take their course. Fate in the notion of kohtalotoveruus implies a certain resignation to the given circumstances and a loss of individual agency, as the extracts from the interviews show: ‘He just left’ (from a woman left by her husband with two children), ‘There is nothing’ (from a young widow left with two children) or ‘It just got worse and worse. Before you know it, they recommended temporary retirement.’ (from a retired man suffering serious depression). These events are fateful because they are particularly consequential for the individual (ibid.), but opposite to Giddens’ notion, this study shows that coping with these incidents is calling for social efforts to ‘hold on to the world’ (Honkosalo 2006: 36) rather than individual action. In fact, in the preceding expressions the individual agent is left powerless in front of the give fate.

Charmaz (1983) proposes the concept of loss of self to describe the fundamental form of suffering faced by people who are chronically ill. According to her, loss of control and action due to a given illness, and the restrictions and isolation the illness pose, accumulate to a loss of self – losing the foundation on which to construct the sense of self. I use this notion in order to grasp the experiences of fate that the interviewees here address as colonizing their whole lives. At a personal level, this means a state where selves become passive sites of events losing their sense of self and its worth. At the social level, it refers to the loss of the viable self that takes part in social life and receives respect from others (ibid.) This can be seen as yet another dimension of fate where the reaction of others isolate the sufferer from regular social interactions (Goffman (1990[1963]: 54).

To elaborate on the social bond between sufferers, this study utilizes Scheff's (1997) model of the social bond as based on the concepts of attunement, mutual identification and understanding – all qualities that are essential to the idea of peer support as empowering. Scheff holds that attuned bonds are secure and involve a balance between the viewpoint of the self and the other. Threats to secure bonds come in two different formats; either the bond is too loose (isolated) or too tight (engulfed), respectively. Isolated bonds result from mutual misunderstanding or rejection, while in engulfed bonds an individual is subordinated to the other and accepts the other at her own expense by rejecting parts of herself (ibid.: 76–7).

Several authors have noticed that the participation of peer support groups is related to the support received in personal relationships. One constant finding is that people with less supportive social networks are more likely to search for fellow sufferers (Kessler et al.1997; Damen et al.2000: 343). When studying disruptive life events in the context of significant relationships, I found that suffering has the tendency to emotionally alienate even close people from each other (Ketokivi 2008; see also Charmaz 1983; Mathieson and Stam 1995; Walter 1999). Isolation was a common experience across different fateful experiences, adding yet another dimension to an already painful fate:

The different kinds of suffering analyzed here share this socially isolating tendency. Fateful experiences almost consistently resulted in alterations in personal networks. Some people labelled significant others as former friends and relayed disappointed accounts of insensitive or indifferent reactions to their suffering.

Frank (1995: 101–2) suggests that there is a wider cultural pattern by which suffering is accepted only when framed as a narrative of restitution: No one wants to hear chaotic stories where the painful contingency of life is taken as inevitable. Rather, people tend to deny it and assert ways in which one could escape the given. It is easier to open up to someone who has similar experiences. This is indicated by a young widower taking part in a quite active support group of young widows:

From this account one gets an impression that not finding understanding in personal relationships drives suffering selves to search for fellow sufferers who can understand their experiences, which in turn potentially loosens the bond to the intimates living in the ‘ordinary world’. Similar accounts are given by sufferers of quite different conditions. A woman suffering from infertility says ‘I know this is a cliché, but if you haven't had the experience, it must be hard to really realize how difficult it is’. She has found a fellow sufferer in her personal network and opens up to her much rather than to her other friends or family members, whose responses to her fate have been either too indifferent or too intrusive.

Walter (1999: 189) describes support groups as creating ‘a community of fellow feeling’ that separates members from the ordinary mass society and even from their own uncomprehending families. The fellow feeling creates a bond between fellow sufferers. This feeling is not expressed as clear verbal statements, but as constant references to fellow sufferers when interviewees discuss their own lives and experiences. A woman left by her husband for another woman referred to a fellow sufferer when asked about her own experience: ‘When it really got to me, I would call her (laughs) and she only needed half a word to understand how I felt …’. From the similar accounts of fellow sufferers, I argue that the personal relevance of this sharing with fellow sufferers is not dependent on the context where it takes place, whether in an actual support group or in personal networks of people. What counts is that there is someone who understands within the reach of the suffering self. This is indicated by a sufferer of postnatal depression who found a fellow sufferer in her network of friends: ‘There was someone who understood what this is’. She is no longer fully isolated.

Suffering from a condition uncommon among other people is isolating for several reasons, but paramount among these is the constant finding in research on illness and bereavement that people are reluctant to incorporate suffering and dying into their view of life (e.g., Charmaz 1983; Frank 1995; Mathieson and Stam 1995; Walter 1999). Charmaz’ (1983) much quoted study on the chronically ill concludes that ill people are left behind because they do not have the time, energy or concentration to sustain relationships, which also applies to people suffering from loss or other disruptive life events. This challenges the normal expectations of reciprocity between people and distinguishes those who are willing to sustain a relationship beyond the ordinary from those who are not (Ketokivi 2008). In most cases, the isolating experience did not mean full withdrawal of people, but rather feelings of loneliness and silence within the existing relationships. The state of isolation is unbearable to most people and hence drives people to search for understanding outside their existing relationships. The bonding among fellow sufferers is unique: it breaks the boundaries between intimates and strangers, but also refutes the notion of selves as unique, as in terms of their life-dominating fate they are the same.

Peculiar to the social bond between fellow sufferers in the contemporary practice of peer support is its foundation in a selfish need. Hence, belongingness, as such, is not valuable, but rather it is only valuable insofar as it conveys help to the suffering selves. This is not to say that fellow sufferers would not feel true sympathy toward each other, but the practice of peer support is deliberately organized for those who need support. In personal relationships this is not as clear-cut, because the practice of peer support is embedded in other forms of social interaction, but insofar as the social bond is grounded on peer support, it is based on sharing the same experience fateful enough to connect previously unconnected people.

The following testimony from a young widower is a good example of the notion that fellow sufferers share not only something similar, but in fact the same experience:

The young widower pictures people who have lost their spouses prematurely as going through the ‘same things’. He talks about his own personal experiences that have been recognized, confirmed and shared, including his fellow sufferers by using the passive form, ‘your head is just too full’. He generalizes his particular experience to involve everyone, indicating that suffering selves are parts of the same social body going through the same experiences.

The bond between fellow sufferers actualizes through sharing one's own situation with others. This is done by exchanging stories. Frank (1995: 183) states that ‘the wound [illness, for example] is a source of stories, as it opens both in and out: in, in order to hear the story of the other's suffering, and out, in order to tell its own story. Listening and telling are phases of healing; the healer and the storyteller are one. … The sufferer is made whole in hearing the other's story that is also hers, and in having her own story not just listened to, but heard as if it were the listener's own, which it is’. In some of the analysed cases, this seems like an accurate interpretation: even the most personal experiences can be portrayed as universal and sharable. The social bond between fellow sufferers cannot deny the given, but through exchanging experiences the agonizing given becomes a subject of making that can be made more tolerable.

Suffering selves share information about their everyday struggles, the reactions of others, their overwhelming feelings, physical reactions and fears. I interpret this kind of sharing to remove the selves from their particularities to a more general level – the one of generalized selves who could be anyone, if they were confronted with the same situation. Similarly, in theory, the supporting peers can be anyone. After sharing stories, one is less troubled about the lonely state of embodied suffering, because there is now a whole social body of selves carrying the burden of the self that is living in her or his particular setting. This generalisation of selves when based on a true match between particular experiences may have the empowering force that peer support is advocated for, because it enables removing the blame for one's suffering outside the particular self (cf. Weinberg 2001).

Most social bonds are embedded in more or less fixed social structures and webs of relationships that cannot be entered and exited based on individual preferences only (Widmer et al. 2008). This is certainly the case for workplaces and families. Friendship can in principle be seen as voluntary and vulnerable to life changes, but even friends tend to develop long-term expectations toward each other over time (Spencer and Pahl 2006). The relationship between fellow sufferers is not one free from social rules; quite the contrary, it is defined by mutual sharing and rules about help. But it is self-driven in the sense that it is entered into in order to find support for the self and is meaningful only in so far as it is able to do so (Wuthnow 1994).

Although the bond between fellow sufferers is not personal in its essence, it resembles Giddens’ characterization of a pure relationship. It is not anchored in external conditions of social life; it is sought out for what it can bring to the ones involved; it works as a context of self-exploration; and it persists as long as it satisfies the people involved (Giddens 1991: 89–97). In a sense, it is even purer than pure relationship, as it is not based on personal feelings and commitment to others as particular persons, but is more abstract in its nature. Hence, it can be entered into and exited according to the needs of the self.

Ongoing personal lives are likely to break the bond between fellow sufferers at some point of time. Even the life-dominating power of permanent events such as losing a spouse or having a disabled child tends to depreciate as the self adapts to her or his fate. In this process, peer support may play an intensive, even life-altering role, although over time, the relationship would fade away. Hence, when the bond between fellow sufferers is examined from other points of time in the biographies of the self, it often appears as short-lived, albeit intensive, as the following example shows.

A mother of a disabled, now adult, child recalls how, after giving a birth to a disabled child, she found fellow sufferers – that is other parents of disabled children – at the hospital and kept in contact with them for some years. With them she could talk about her life-dominating theme that she felt was silenced elsewhere. They developed personal relationships based on their common situation, but these were dropped little by little, as their situations normalized. Now, almost 20 years later, she still included these other parents as significant others in her life story. In her case, sharing the same fate was a strong enough connector at the time when their common fate was life-dominating, but is no longer a sufficient basis for a continuing bond. Over time, different fates that were once common to different sufferers may diverge due to different circumstances or responses. In fact, many interviewees have participated in peer support practices according to the current themes of their lives that are in motion over time.

The bond between fellow sufferers can be characterized as unique, but the ways in which it actualizes in particular situations and between particular people are divergent with diverging consequences for the selves. Drawing from Scheff's (1997: 77) distinction of social bonds as attuned, isolated or engulfed, this study elaborates on the different actualized outcomes of peer support practices from the viewpoint of individual selves. It argues that the context of peer support when seen as social bonds between selves and their fellow sufferers is particularly vulnerable to the misinterpretations of individual selves due to the notion of fellow sufferers as not particular, but generalized selves. This creates an impression that the self and the other are the same in essential terms which obscures the very distinction between the self and the other – one essential to an attuned bond and a positive outcome resulting from the bond.

The data includes cases of all three states of bonds between selves and their fellow sufferers. With providing examples of each kind of the bond, this study shows patterns through which the personal intensity of the experience, and the actual match or mismatch between fellow sufferers’ experiences mediate the social bond, and, hence, also its outcome on the self. These different kinds of bonds should not be seen as stable, but rather as ideal-typical and dynamic, meaning that certain people and certain bonds may encompass elements of each in different situations and points of time.

A bond is three attuned when there is a mutual balance between the self and the other. This is the ideal situation. A young widower testifies three years after his wife's death: ‘The peer group of other widows has been the key factor for me in terms of making it, definitely’. Scheff (1997: 100) suggests analysing the relative balance between the individual and collective personal pronouns as signs of the state of the bond. In the following extract, the same young widower explains why his bond to the group has been so important:

The young widower uses the passive form of you when describing his experiences, a generalization of his experience indicating a match with the experiences of others. The predominant use of general and collective terms (‘you-passive’) can be interpreted as a sign of a tight bond with the fellow sufferer (ibid.). This can also be seen in his configuration of significant others, where he places other young widows very close to him; in fact, right behind his children, his deceased wife who is still included, and his new partner, who is also a fellow sufferer. Despite his tight identification with the generalized experience, the bond appears as genuinely attuned, because he easily shifts from the common level (‘you’) to the personal (‘I am’) and back. The intensity appears mutual. Moreover, he talks about the group of widows with an enthusiastic tone and a sense of humour that marks his relaxed and comforting bond with them. Through the tight sharing, chaotic fragments of fate have transformed into clear expressions that can be exchanged without a feeling of chaos (Frank 1995). It is not just him ‘falling to pieces’, but all those who are experiencing such a loss. This metaphor captures ‘loss of self’ that describes the experience of ‘former self-images crumbling away without a simultaneous development of equally valued new ones’ (Charmaz 1983). In the ‘assembly of a whole new person’, the peer group has been crucial.

How is an attuned bond with fellow sufferers empowering then? Walter (1999: 191–2) holds that support groups create their own subcultures that help their members to challenge the mainstream culture. The mainstream culture considers loss, for example, as a process of restitution, whereas bereaving people often see it as a permanent part of their lives (ibid.). Fellow sufferers create collectively alternative ways to make sense of their experience. This is indicated by a response from a young widow who was interviewed. When asked whether she still feels the presence of her deceased husband, she replied: ‘Yes, a lot of us feel it afterwards … those of us who have lost someone. I think it is often real, his presence’. As the interviewee realized that her experience is very alien to ordinary life, she not only speaks for her self, but backs up her reply by indicating that ‘a lot of us’ who have lost someone feel that way. Like in the previous example, the interviewee claims the common (‘us’) as her own (‘I’). This pattern indicates a bond or a fellow feeling – she is not alone, but allied with many others, and this is used as a bulwark against the mainstream. Internalization of the bond between fellow sufferers transforms the self's lonely experience into a collective front that protects the self in her encounters with ‘ordinary’ others.

Another empowering mechanism is to locate the source of the suffering outside the self with attuned agreement on the external factor. In the following example, a woman recovering from postnatal depression reflects on her experiences in light of her friend's experience:

Like in the two previous cases, also here the interviewee begins by describing the other person's experience, then goes on to generalize it and finally claims the experience as her own. She is making sense of her own suffering through the experience of her fellow sufferer and her subsequent generalization of it. The self was unable to recognize herself – lost and unable to act. Retrospectively, the illness is seen as replacing the self as an agent, causing its suffering. In postnatal depression ‘that's how it goes, you panic’. There is no way to escape this; the self is not to be blamed. The experience of others confirms the inevitable logic of the illness. This enables the self to see herself as a morally accountable person (cf. Weinberg 2001). It is through the similarity of others’ experiences that the self is legitimatized. The suffering self is not impotent, but lost to be found again through reflection with fellow sufferers. This can be seen as a narrative reorientation (Hänninen 1996) that contributes to the healing of the self.

Lost selves are unable to recognize themselves. This threatens an attuned social bond between the fellow sufferers. If the self does not know what is happening to it, how can there be a balance between the viewpoints of the self and the others (Scheff 1997: 77)? This is not a problem if their viewpoints are, in fact, the same as the peer support presumes, but this is not always the case. Some people may be in a desperate state when entering peer support and the voices of the others may override the self, misleading their ability to making sense of their situation and self.

A drastic example of this was provided by a mother who desperately sought to understand her son, who had begun to act strangely. After searching through his belongings and finding an unfamiliar pipe, she began to suspect that her son was a drug addict. She sought help from various places and ended up in a support group for family members of drug addicts. Now retrospectively she says: ‘I was blind … I was just so shocked about this drug thing’. She went to a group that dearly welcomed her and affirmed her stories of her son's weird behaviour as similar to theirs. She continues: ‘I was so worried. I told them he'd been asking for money and they said addicts would sell their grandmother if they had to. When I got home from the meeting, I was always so afraid that he would ask for money’. In this case, the views of the peers directed her actions and reactions, and now, looking back, she feels she was brainwashed. When her son later asked for money, she acted furiously. One night the situation got critical and her son, after breaking some property, left armed with a knife. That same night the police apprehended him and he was admitted to a mental hospital.

After being misled by the parents of drug addicts to believe her son was an addict, she learned that her son was, in fact, mentally ill. At the hospital she met a mother of a mentally ill son who described similar behaviour. Now her beliefs were affirmed by a real fellow sufferer and professionals, and she switched to an authentic peer group. She has since blamed herself for cruel behaviour that she feels worsened her son's condition.

This example shows that selves sometimes suffer from a complete loss of understanding as to what they are going through. Desperation leads to an engulfed bond with others that provides assistance, but without the intended consequences. The bond to others appears engulfed. There is no distance to the others and no reflection on how the contact with fellow sufferers might help the self. Rather, she just simply switches from one group to another, as if the bond to fellow sufferers were given. In this example, the desperation and the engulfed bond with the others prevented her from interpreting her situation in an open-minded way. This had critical consequences for her, her son and their whole family.

Walter (1999: 187–93) notes that even among authentic fellow sufferers the collectively constructed way to make sense of it in a support group does not suit everyone. He suggests that people join support groups if the story created there helps them make better sense of their experiences than stories available elsewhere. He concludes that people not finding correspondence to their experiences simply leave the group. However, his underlying assumption is that suffering selves are attuned to themselves in order to recognize what they are going through and to decide what is best for them, but sometimes suffering selves are completely lost, unable to recognize their state, and to defend it against others. The bond between fellow sufferers, where stories are offered up as personal material, has the power to override and blame the self, as well as to empower it.

Another example of an engulfed bond and powerlessness in the face of others comes from a man who suffers from chronic depression. His experience with peer support was not empowering, just the opposite:

This man feels that he is not morally worthy when compared to his fellow sufferers. He describes first the experiences of others (‘they’) as in the previous examples, but here the inference is quite unfavourable to the self (‘I’). He is vulnerable to the others, because he takes other experiences’ legitimacy as given and deduces from them that his own are not. Others’ experiences are the absolute standard to which he interprets his own. In his case, the same power of the bond between fellow sufferers that is used to empower the self turns into a power to deprive the self.

I argue that the idea of generalized experiences makes peer support especially vulnerable to engulfment, as it advocates the loss of boundaries between the self and the other. Moreover, desperate selves seeking support have the tendency to cling to anything that might relieve their lonely burden.

Whereas in engulfed bonds the fellow feeling overrides the self, isolated bonds are too loose to create a sense of fellowship in the first place, leaving the self to a lonely state of suffering even when taking part in peer support. In an isolated bond, the social distance between people is too wide to provide them with a sense of empowerment. Scheff (1997: 87) suggests that the condition of having no secure bond in one's life is so painful that it is usually banished from people's consciousness. This can explain why some people keep participating in peer groups, even though they are not gaining from it. If the source of the self's suffering is in the experiences that are not common – contrary to the underlying, but sometimes unrealistic assumption of peer support – the self remains isolated, preventing empowerment.

An example of an isolated bond comes from a woman suffering postnatal depression, who joined a support group for coping with the challenges of motherhood. The scope of support in the group was explicitly limited to the ‘ordinary’ challenges of motherhood by the founder, an interviewee of mine, who just followed the rule of the voluntary organization prepared to offer ‘light’ support for ‘ordinary’ families. Subsequently, the woman interviewed silenced her chaotic feelings of depression in the group. She did not want to pour such matters on ‘strangers’. She suffered from complete loss of her self for four months, until she almost accidentally found a website with criteria for postnatal depression and recognized herself. In her case, the other mothers in the support group were seen as strangers rather than as fellows with respect to her depression. However, the restraining pattern in the group left her isolated and there is no way of knowing whether the other mothers may have had similar experiences.

This case illustrates how the pre-defined purpose of group a regulates experiences. The definition of the group was probably well-meaning, confirming some people's experiences while expelling others (Walter 1999: 190). Post-natal depression was not recognized as an ordinary experience for a mother and was thus excluded as a topic (see also Martiskainen de Koenigswarter 2006). In such a group, it remains a private and lonely burden of the self.

Another account of the isolated bond with fellow sufferers comes from a mother of a mentally ill adult child. She states that she could not talk about all her experiences in her peer group of parents of mental patients, because ‘theydon't really know me’. ‘They’ do not have an impact on ‘me’. Opposite to the examples of attunement and engulfment, the self restrains herself with no positive or negative impact from the others’ experiences, with emotional detachment from the fellow sufferers. Moreover, in her view, the group members are each burdened with their own problems and cannot really take the load of others’ problems. There is no time for deeper support, because the time has to be divided among several people. She feels she can discuss her agonizing experiences better with a friend, but her experience is fateful enough to make her stay in the group.

The particular sides of the selves, with their excessive feelings, are left to be dealt with in private life (Wuthnow 1994: 204) or with professionals, apart from peer support. In several accounts the same people sought support both from their fellow sufferers and professionals, especially therapists. People also are different in the sense of how much they wish to discuss their suffering with others in the first place. The above quoted woman suffering from post-natal depression felt that talking extensively about her feelings just pulled her deeper into them. Although this prevented her from recognizing her state earlier, it was also her way to cope until she was able to diagnose herself and then receive medical help.

The analysis began with the notion of fate as one suffering from an illness, a loss, a family disruption or some other personally wounding experience that is further accentuated by isolation from ordinary social life. Frank (1995: 176) suggests that suffering unmakes the intactness of the self and opens up extensive fears making an opening to others that could enable remaking of the self. The fact that many suffering selves find themselves in situations uncommon to their significant others drives them to search for fellow sufferers in new contexts. As in other peer relationships, fellow sufferers provide a source of direction in personal lives (Riesman et al. 2001[1961]). In uncommon situations, peer support groups offer the selves these fellows. In order to understand the actualized consequences peer support has on particular selves, this study analysed the social bond between the self and her fellow sufferers. The bond between fellow sufferers (kohtalotoveruus) was found to be as follows.

First, the bond requires a common experience that is fateful enough to mobilize the sufferer to social interaction with fellow sufferers. The fact that this common ground is tightly linked to the current experience of the self makes it often short-lived in the spectrum of our on-going personal lives. Second, the connecting power of fateful experiences to fellow sufferers gains some of its power from the social isolation suffering selves confront in their personal relationships. Third, the bond in peer support relies on the idea of mutual help from fellow sufferers (Walter 1999; Arminen 2004). Fourth, the bond is openly self-driven in the sense that the reason people seek it out and enter into it, is to get support for the self personally (Wuthnow 1994: 188). Fifth, the bond actualizes at the level of generalized experiences and selves, as opposed to particular ones. Subsequently, in principle it is able to work as a source of support only insofar as the experience is, in fact, the same.

Following Scheff's (1997) notion about the social bond, this study further analysed the actualized bonds between the selves and their fellow sufferers as either attuned, isolated or engulfed, along with the respective consequences on the selves. When attuned with fellow sufferers, meaning a balance between the self and the other, peer support has been genuinely empowering for many. The experiences of the others provide legitimating material that helps in transforming a flow of agonizing experiences into a self-story that works as resistance against the ordinary, making sense of the self and rebuilding it. In an attuned bond with fellow sufferers the self finds validation for her particular experiences through generalization of them that in turn helps her to claim them as her own and incorporate the given fate into her sense of self in a secure bond with others. In such cases, fate does not imply fatalism as a fully resigned attitude, can be seen as an active effort to reclaim agency with the help of others, to transform the given into something made that ‘holds on to the world’ even when it is fragile (Honkasalo 2006: 36). Hence, after being able to share and generalize the private burden the self finds new strength to make something out of the given in her particular life – to choose new elements, actions and directions – not freely, but within the given circumstances.

This study argues that the practice of generalizing an experience in order to provide empowerment is not only the strength of a social bond, but also its frailty. Selves suffering without social validation may experience loss of self (Charmaz 1983) and a desperate need for the validation. In an ordinary life situation, one might be vulnerable to others, but as the signals from others living in the same situation are various, the self is not fully dependent on any given source. In the case of an uncommon fate, however, fellow sufferers are often limited to one setting, where the generalization of experiences is not able to account for all particulars. Especially when isolated, the need for generalization of experience makes selves extremely vulnerable to fellow sufferers – as outside them there are no others whose different experiences would loosen this dependency. This is the case in engulfed bonds with fellow sufferers where the viewpoints of the others overpower the self. Someone in an ‘ordinary’ state would most likely leave a voluntary bond in such a situation (Walter 1999: 192), but lost selves are not able to do so. Rather they cling to these others who may be the only ones willing to validate their suffering. As a result the selves make sense of their experiences following the sometimes inaccurate or random views of others with harmful consequences. In such cases the selves’ need and the idea of peer support as generalization of experience turn against them.

In isolated bonds where selves restrain themselves from opening up to their fellow sufferers, generalization does not occur and or involve the self, nor relieve its burden. In their case, the selves remain emotionally isolated even with fellow sufferers. The underlying general observation across all three states of the bond in this dataset is that the selves need generalization of experience in order to heal. This opens up the discussion on whether the self is profoundly a social creature and how so.

Elias (1970: 118–21) views all individuals as relatively open, interdependent processes, as opposed to static and bounded entities. He asks: ‘Where and what is the barrier which separates the human inner self from everything outside, where and what substance does it contain?’ (ibid.). In the case of sharing the same fate, the substance of the self and the other is essentially the same – the same experiences, the same feelings and the same suffering. Although fellow sufferers are physically locked in their own embodied suffering in their particular settings, they can transgress this isolation by exchanging stories of suffering making them the weight of many.

Peer support in a defined setting is focused on dealing with a fate shared by others. Drawing from Elias (1970) and the preceding analysis, I conclude that when the self and the other are, in fact, inseparable, these others may become the fate of the self – a phenomenon much like the one in the sanatorium of Magic Mountain where the ill are trupped with their given fellow sufferers. It is for this reason that the social bond between fellow sufferers is so crucial to understand.

I thank two reviewers, Riitta Jallinoja, Anna Bagnoli and Pamela Kaskinen for helpful comments and the Academy of Finland and Emil Aaltonen Foundation for funding the study.

Kaisa Ketokivi is researcher at the Department of Sociology, University of Helsinki. She is currently completing her doctoral dissertation examining the ways in which selves are vulnerable and bound to their significant others in the contexts of biographical disruption, estranged family bonds, peer support and intimacy. Her interests include empirical study of close relationships, relational selves and suffering, as well as theoretical questions of the self, the other and the social bond. She is a member of the editorial board of Sosiologia, the main sociological journal in Finland. She is the author of ‘Biographical Disruption, the Wounded Self and the Reconfiguration of Significant Others’ and a co-author of ‘Introduction’ (Widmer, Eric and Jallinoja, Riitta (eds), Beyond the Nuclear Family: Families in a Configurational Perspective, Peter Lang 2008). She has published articles and book chapters on family and extended youth in Finnish forums, such as Sosiologia and Finnish Youth Research Society.