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Guilt is a strong feeling. It occurs due to a negative assessment of one’s own behavior. Feeling guilt is experienced as a duty to oneself. Such emotions are destructive since they paralyze functioning, provoke arguments and conflicts, and lead to depreciation of oneself and one’s own actions.
Most importantly, survivor’s guilt often affects individuals who were themselves traumatized by the situation, and who did nothing wrong.
Even though it can manifest itself in different ways in different people, guilt is often connected to the feeling of sorrow, shock or sometimes to a feeling of responsibility. Understanding how this feeling evolves, how to cope with it, and where to look for treatment is necessary to overcome this complex syndrome.
So… What is survivor’s guilt?
Survivor’s guilt is a special type of guilt which is followed by the experience of a very life-threatening situation. Survivor’s guilt occurs when the person considers it wrong or unfair that he survived while others did not.
The term was first applied in the 1960s to describe Holocaust survivors. It has since been extended to a number of other situations, including survivors of the AIDS epidemic, car accidents, wars, natural disasters or terminal diseases.
Edith Eger talks about this heavy feeling in her book “Choice”: ‘Until I returned, I was my own worst enemy,’ she says. ‘I not only had survivor’s guilt, I had survivor’s shame. I didn’t need a Hitler out there, I had a Hitler in me telling me I was unworthy, that I didn’t deserve to survive. On that day, I allowed myself to be human – not superhuman and not subhuman. We do things the way human beings do and we make mistakes. If I had known better, I would have done better – I would have, believe me. But unless we acknowledge that we cannot change the past, we cannot really heal and live life.’
Some survivors feel guilty because they survived, while others do not. Some people feel it when they believe that they could have done much more in order to save others. Moreover, others feel guilt that another person died while saving them. Guilt places people on edge of the abyss and evokes a belief that there is no way back.
The term ‘survivor’s guilt’ was first introduced by Stanley Cobb and Erich Lindemann in 1943. They defined this feeling as an existence of tension, loneliness, and heartache, which is caused by visits of close ones, recollection of deceased ones or receiving empathy. Robert Jay Lifton later researched this phenomenon, stating that this type of guilt resembles a ‘psychic stupor’ or cessation of a feeling as a dominant characteristic of those who suffered from someone’s death.
Is guilt felt by someone who survived considered disorder?
Although survivor’s guilt is not considered an official psychiatric disorder, it is associated with post-traumatic stress disorder. In the current version of diagnostic manual DSM-5, survivor’s guilt is a symptom of a post-traumatic stress disorder (PTSD). It can be viewed as a one of the cognitive symptoms of PTSD, which contains a distorted feeling of guilt and negative thoughts about oneself.
What is worth mentioning is that people can feel survivor’s guilt without having post-traumatic stress disorder, and they also can have post-traumatic stress disorder without survivor’s guilt.
Signs of survivor’s guilt
Degree of guilt intensity varies among individuals. Symptoms can either be psychological or physical, while simultaneously often imitating symptoms of PTSD.
The most widespread psychological symptoms are:
- Sense of helplessness: feeling lack of self-efficacy and lack of control over one’s life;
- Apathy, indifference;
- Reoccurring recollections of traumatic situation: manifest through nightmares;
- Social isolation;
- Lack of motivation: it can be hard to fulfill even the easiest of tasks;
- Mood swings and outbursts of anger;
- Obsessive thoughts about the traumatic event;
- Suicidal thoughts;
General physical symptoms can include changes in appetite, sleep problems, headaches, nausea or stomachaches, accelerated heartbeat, exhaustion, excessive sweating.
When a person feels guilty, they are usually reserved and apathetic towards life. Therefore, it is worse when the survivor’s guilt turns into aggression. This could happen if a person directly witnesses a traumatic event (for example, if they witnessed someone’s death).
The study of German scientists suggests that survivors may have false beliefs about their role in the event. Therefore, these people feel a lot of anger towards the situation, the specific perpetrator or even towards themselves, but they cannot express it. They direct the aggression inside, trying to endure this grief, but they are not able to fully get over with it. Over time, these people can go into extreme sports or volunteer in hotspots in wars, constantly exposing themselves to danger.
The human psyche can suppress traumatic events so strongly that a person may not be aware of what is happening to them. Therefore, it is important to monitor the condition and symptoms to prevent the development of post-traumatic stress disorder (PTSD).
Sometimes, people with survivor’s guilt look back and overestimate their ability to foresee the consequences of an event. It seems to them that they could have foreseen what had happened.
Survivor’s guilt rises in individuals who have survived any trauma. However, this feeling does not unfold in all individuals who have experienced traumatic events.
Locus of control plays a role in determination of whether the person will experience survivor’s guilt. Locus of control represents the degree to which a person believes they had control over a situation. In other words, it is a belief regarding whether the results of an action are dependent on what a person does (internal control), or from circumstances which are outside one’s control (external control). Some people are more prone to sense guilt if, when explaining events, they tend to attribute causality to personal choices, not to external forces.
Additional factors that can increase risk of developing survivor’s guilt are:
- The history of trauma. Research shows that traumatic experiences can enhance the probability of negative emotions after life-threatening situations.
- One’s history of depressive episodes. People who suffer from or who have already experienced depression in the past are more prone to feeling guilt and anxiety after a trauma.
- Low self-esteem. Individuals with low self-esteem can appreciate less their own welfare. Having survived when others did not, they more often ask themselves the question of whether they ‘deserve’ to have survived.
- Bad skills at overcoming stress and life difficulties. People are more prone to PTSD if they do not have psychological flexibility, necessary for coping with stress. Such people’s coping or defensive mechanisms often manifest through avoidance and fantasies, which leads to unhappiness. They do not even try to overcome difficulties, since they know that they will fail.
How to cope with survivor’s guilt?
There are some strategies of self-help that appear effective.
Allowing oneself to grieve: it is important for people to allow themselves to mourn those who did not survive. The main rule is to give oneself time and do everything at one’s own pace.
Doing something valuable for others or oneself: communication with people, reading to children, helping those around oneself (for example, helping elderly people or animals in a shelter).
Concentration on external causes of an accident: attention shift to an external cause can help to get rid of self-blame, which initiates guilt
The quote from Edith Eger’s book sums it up perfectly: “Today you can say, ‘If I knew then what I know now, I would have done things differently.’ And that’s the end of the guilt.”
Edith Eger, The choice: a true story of hope, 2018.
Brockner J, Davy J, Carter, C. Layoffs, self-esteem, and survivor guilt: Motivational, affective, and attitudinal consequences. Organ Behav Hum Decis Process.
Hutson SP, Hall JM, Pack, F. Survivor guilt: Analyzing the concept and its contexts. ANS Adv Nurs Sci, 2015.
Wolfe, H. Survivor syndrome: Key considerations and practical steps. Institute for Employment Studies, 2004.