Understanding And Overcoming Survivor’s Guilt
Living through a life-threatening traumatic experience can leave lasting consequences, including when others don't make it. Feeling guilty for living when others pass or go through irreversible damage happens to many people, and you're not alone if you relate. Learning about survivor's guilt by exploring the definition, symptoms, and treatments can be beneficial in understanding your experiences and how therapy might help you cope and validate what occurred in your life.
What is survivor’s guilt?
Survivor's guilt is a phenomenon many people experience after living through a life-threatening situation, often when one or more people do not survive. People experiencing this complicated emotional reaction often feel guilty that they survived when others died or believe they could have done more to save lives or prevent damage, regardless of whether they could have changed the situation.
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), survivor's guilt is not a diagnosable condition on its own. It is instead considered a symptom of post-traumatic stress disorder (PTSD). However, you can have survivor's guilt without PTSD and vice versa. PTSD is a trauma and stressor-related disorder that often develops in people who've experienced a traumatic, life-threatening event.
How survivor’s guilt develops
Living through a traumatic experience when others die or experience damage can have far-reaching consequences that influence your thoughts and behaviors in multiple facets of life. Feeling emotionally disturbed after such an event can be a typical and expected response. Still, it may become a problem when those feelings are overwhelming and intrusively influence one or more aspects of your daily life and behavior.
Regardless of your ability to affect the outcome, you may dwell on your trauma, confident that you "could or should have" done something more to prevent it.
Recognizing survivor’s guilt after a trauma
If you or a loved one has been through a traumatic event, it can be helpful to understand how to recognize the signs and symptoms of survivor's guilt and PTSD.
Common symptoms of survivor's guilt and PTSD may include the following:
- Flashbacks or feelings of reliving the traumatic event
- Obsessive fixation on the event
- Intrusive thoughts about the trauma
- Feeling of helplessness
- Drastic changes in eating and sleep habits
- Physical symptoms like headache, nausea, racing heart, or stomachache
- Irritability
- Decreased motivation
- Mood swings and emotional outbursts
- Suicidal thoughts or actions
- Feelings of shame or guilt
- Complicated grief
- Avoidance behaviors
- Fear of the situation occurring again
Who is at risk for survivor’s guilt?
Many occupations and situations expose people to significant trauma, including the military, first responders, doctors, nurses, and natural disasters. Survivor's guilt is often seen in cancer survivors, transplant recipients, crash survivors, those who lose loved ones to suicide, parents who outlive their children, and survivors of other traumatic experiences.
Not everyone who lives through a life-threatening trauma develops survivor's guilt, though researchers suggest it is a common symptom. According to a 2018 study, researchers found that 90% of the participants receiving treatment for traumatic stress after surviving an event where other people died reported experiencing feelings of guilt.
Treatments for survivor’s guilt
The most common treatment for survivor's guilt is psychotherapy, also known as talk therapy. A few approaches may be used, depending on the extent of the client's symptoms and their goals for treatment, including the following.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy focuses on helping clients identify harmful behavior and thought patterns so they can shift them toward more productive, positive habits, leading to meaningful changes. Numerous scientific studies confirm that CBT substantially improves function and quality of life for many people.
Eye movement desensitization and reprocessing therapy (EMDR)
EMDR helps people alleviate the psychological distress associated with traumatic memories. Studies show that specific eye movements or bilateral brain stimulation while processing traumatic memories can lead to mental and emotional healing with faster results than many other treatments. In addition, EMDR was specifically developed to treat PTSD.
Coping mechanisms for survivor's guilt
In addition to working with a qualified mental health professional, which is often the most effective way to address survivor's guilt, there are several methods you can use on your own to overcome the effects, including the following.
Honestly evaluate your role and responsibility
You may fixate on what you could have done differently or how you could have predicted or prevented the circumstances leading to your trauma. However, the reality might be far from the reality of the event. You are one person and are only responsible for your actions. For example, it may not be kind nor reasonable to expect someone without training as an emergency responder to overcome impossible circumstances and accomplish superhuman feats. Survivor's guilt may cause you to insist that you should have done more, but that doesn't mean it's true.
In addition, if you have made a mistake that led to someone's death or injury in some way, self-forgiveness can still be essential. Although you may be unable to change the past, consider your intentions when the accident occurred and note that you did your best. As people cannot predict what might occur when it happens and may freeze, run, or struggle during a traumatic event, it can be difficult to react with all senses when a trauma occurs. Feeling self-loathing or shame after making a mistake may worsen your mental health and contribute to PTSD. Talking to a therapist in these circumstances may be beneficial.
Coping with regret and avoid "what ifs"
Many people who live through life-threatening traumas often feel regret and struggle with what-if scenarios. For example, many police officers, soldiers, or firefighters may experience regret and obsess over how they might have treated a patient that passed away if they could return in time. In many cases, hindsight bias influences your view of the event and what you might have done differently based on the information you learned after the fact. In addition, you may not have had the information or logic you have now when the trauma occurred, as trauma can cause people to go into shock.
Give yourself time and space to grieve
Part of working through survivor's guilt may be giving yourself the time and space you need to grieve. Your guilt may make you feel you don't have the right to grieve since you're the one who lived. However, identify and acknowledge your feelings. You deserve the opportunity to work on your mental health and are worthy of the efforts it takes, even if your guilt tells you that you're not.
Make a positive impact
Try to make a positive difference in the world. One of the ways you might overcome survivor's guilt is by actively working to impact the lives of people around you positively. When you wonder why you lived when others did not, try to find ways to help others in memory of those lost.
Identify the outside factors causing the event
Identify and focus on the outside factors that caused the traumatic event and let go of the misplaced self-blame. There may not have been much you could have done to have changed the outcome. However, even if you could have changed the outcome, understanding that other factors were at play may be beneficial.
Forgive yourself and practice self-compassion
Practice kindness and compassion for yourself, and learn self-forgiveness even if your actions led to harming someone else. People make mistakes. How you move forward can make a difference in the future.
Know that you aren’t alone
Remember that many people feel guilty after losing someone. While survivor's guilt isn't a diagnosable condition by itself, it happens enough that the mental health community has identified it as a common cognitive phenomenon, giving it an official name, characteristics, and mention in the DSM-5.
How therapy may help you overcome survivor's guilt
Survivor's guilt is a common reaction after living through a traumatic event where your own life was in danger and others didn't live. Working with a licensed therapist through an online therapy platform like BetterHelp may help you process your feelings and learn adaptive, practical ways to cope. Online therapy is often less expensive, has shorter wait times, and offers treatment in the safety and convenience of your own home, on your schedule, and in the best format for you. For those feeling fear related to PTSD, leaving home can be difficult, and internet-based therapy offers a discreet solution.
According to researchers at the American Psychological Association, online therapy is a viable treatment option with results comparable to in-person sessions with a licensed therapist. Many clients report increased therapeutic outcomes with teletherapy, often due to the convenience of attending more sessions and the added distance, making it easier to discuss complicated details with a therapist.
Therapist reviews on BetterHelp
“Roc has been a thoughtful and trustworthy guide for me through several major life transitions. Even when i struggle to follow through on actions we have discussed in a prior session Roc never makes me feel guilty or bad for struggling. Instead he engages in a mindful conversation helping both of us explore the inner workings of my mind and work through whatever personal history and context has taken me to the place i am at today. Don’t judge a book by its cover (or do if that suits you). Roc is a very accomplished professional that knows his craft well and will help and seek to better learn and understand anyone he works with.”
“I use humor as a means to deflect so when I started my therapy with Cyre, I was like--so how long will I be healed? Will it be 6-7 sessions? Cyre has been patient with me as I deflect, invaded and struggled and she focused on helping me deal with my trauma by letting conversations unfold for me. It's a lot and I'm grateful to have her support and guidance on my healing journey. I know now that it will take as long as I need it to be.”
Takeaway
How do you overcome survivor's guilt?
Survivor’s guilt is closely related to post-traumatic stress disorder and may be difficult to manage without the help of a mental health professional. If you’re experiencing survivor’s guilt, you have most likely undergone significant trauma, and overcoming your feelings of guilt may be easier if you seek professional help. A therapist can help you manage painful emotions like guilt and other trauma-related symptoms.
If you’re experiencing the effects of survivor guilt, it is recommended that you not try to manage the problem without help and support from others, ideally a therapist, psychologist, psychiatrist or other qualified mental health practitioner. It may also be worthwhile to leverage your support network to ensure that you have kindness and empathy at hand while you overcome your guilt.
How do you love someone with survivor's guilt?
Supporting someone with survivor’s guilt might seem daunting, but people who are overcoming survivor’s guilt usually need the help and support of their loved ones. One of the best ways to help someone overcome trauma is to be a good listener. Here are a few things to remember about listening to someone with survivor’s guilt:
- The person may need to talk about their guilt repetitively; be prepared to hear the same themes repeated.
- The person may say things that are difficult to hear or provoke strong emotional reactions, depending on what circumstances led to their survivor’s guilt.
- Encourage the person to express their thoughts and feelings openly.
- Do not offer advice or guidance to the person unless they request it.
- Avoid platitudes like “Everything will be okay.” or “Everyone goes through struggles sometimes.”
It may also be helpful to educate yourself about survivor’s guilt, if possible, before speaking with your loved one. When not discussing their traumatic experience, try to do “normal” things you and the person would regularly do. Finally, take steps to manage your own stress; maintaining good self-care can help you gain the extra energy it takes to support someone conquering survivor’s guilt.
Why might survivors of life-threatening situations feel guilt?
The exact mechanisms of how survivor’s guilt develops are not well known. It is closely associated with posttraumatic stress disorder and experiencing a traumatic event. According to one model of survivor's guilt, a person may experience feelings of guilt and shame in response to a perceived unjust positive inequity. A positive inequity is any situation that benefits one person over another, and an unjust inequity is one in which the person benefits unfairly.
Researchers believe survivor’s guilt requires involvement in a traumatic event in which others died, and the chances of overall survival were low, such as surviving a natural disaster. Upon perceiving that their life has been spared unfairly, the person may ruminate to make sense of the situation, increasing the activation of guilt and shame.
For example, war veterans might replay a traumatic event in their mind repeatedly in order to understand why they survived and others did not. They may attempt to correct this by restoring balance or repairing the inequity, such as by living a better life to “earn” their survival. They may also develop false beliefs, like believing their guilt is a just punishment for their survival or that if they don’t feel guilty, they are letting down those who did not survive.
How do you deal with traumatic guilt?
Dealing with traumatic guilt can be challenging sometimes, and you may wish to consider working with a mental health professional to help you address your feelings. Traumatic guilt is often associated with traumatic stress, and experiencing traumatic stressors can lead to several mental health issues, like PTSD. A knowledgeable mental health professional can help you get to the root of your trauma and grief, learn valuable coping strategies, and initiate effective treatments for trauma-related symptoms.
If you’re not interested in pursuing therapy now, leveraging your support network as you process your traumatic guilt may be helpful. Spending time with others can boost your overall well-being and may make your feelings of guilt easier to manage.
How do you help someone let go of guilt?
Letting go of guilt can sometimes be a challenging process. If the person you’re trying to help has been struggling to overcome their feelings of guilt, you may want to recommend that they seek help from a therapist. Guilt, especially guilt associated with traumatic experiences, can sometimes be difficult to address. Supporting someone in their journey may mean reminding them that help is available and effective.
You can also help someone manage guilt by developing strong active listening skills. A person may need to speak about their feelings repeatedly as they process them. If you are willing to listen, projecting a welcoming atmosphere that demonstrates engagement is important. Here are a few tips for active listening:
- Adopt an open posture and make eye contact with the person speaking.
- When the person finishes their current thought, briefly paraphrase it back to them to demonstrate that you understand their feelings.
- If you struggle to understand their feelings, ask polite, clarifying questions after they finish speaking.
- Do not give advice or judgment unless it is requested.
- If the person brings up traumatic events, they may be difficult to hear. Try not to display shock, horror, or other negative emotions.
How do you deal with regret and guilt after death?
Feeling regret and guilt after a person has died occurs frequently. In many cases, someone may feel guilty that they did not take advantage of opportunities to spend more time with the person who died, or they may regret fights or other negative interactions they had while the person was alive. For most people, guilt of that nature tends to fade over time as they progress through the grieving process.
In some cases, guilt can become severe or persistent. This may occur for several reasons, but survivor’s guilt is one of the more common ones. Survivor’s guilt usually occurs when a person is involved in a traumatic event in which others die, or they survive something that typically has a very low survival rate. In cases like those, the survivor may feel that they did not deserve to survive more than others or that surviving was unfair to those who died.
In cases where guilt is associated with a traumatic experience, it is worth considering whether professional help is warranted. Managing feelings of guilt that are associated with trauma can sometimes be challenging. It may mean addressing a traumatic experience directly; outcomes are generally better when working with a therapist.
How can guilt and worry affect someone's life?
Guilt and worry can adversely affect a person’s overall well-being. Both raise stress, and a high stress level is associated with several physical and mental health impacts. Guilt and worry can be intrusive, distracting a person from feeling happiness in daily life. Worrying about the future that is difficult to control may be a sign of anxiety disorder, and worrying about the past may lead to rumination. Rumination is a form of persistent thinking that is overwhelmingly negative and generally difficult to ignore.
If guilt and worry affect your life, it may be worthwhile to prioritize self-care first. Ensuring you eat a nutritious diet, exercise regularly, and get enough sleep can help prevent guilt and worry from compounding. If there is something you can do to address your feelings, take the time to do it, but if your guilt is due to factors beyond your control, it may be worthwhile to consult with a therapist to figure out how to proceed.
How can guilt affect a person?
Guilt can significantly reduce a person’s overall well-being. It is a significant weight to carry and the secret burden of guilt can drastically increase a person’s stress level. Every person will likely experience guilt and its negative sensations at some point in their lives, and evidence suggests that guilt serves an important social function. Feelings of guilt help people change their behavior and act in a more pro-social manner.
Guilt due to factors beyond a person’s control or is overwhelming enough to interfere with a person’s daily life is likely not serving an important social function. Chronic guilt can lead to chronic stress, which is associated with a reduction in physical and mental well-being. Managing guilt is important; if there is anything you can do to directly address what is causing your guilt, it is likely worth taking the time to do so. However, if guilt is long-lasting, persistent, or uncorrectable, it may be worth working with a mental health professional to help avoid the worst effects of long-term guilt.
How do I get rid of my guilt complex?
If you are working to overcome persistent feelings of guilt, it may be worthwhile to consider working with a therapist or other mental health practice. Complex, long-lasting guilt is often associated with depression and other mental health issues. If you have been unable to stop feeling guilty, working with a professional may help you identify the underlying causes of your guilt, what you can do to address it directly, and how you can better cope with your feelings in daily life.
- Previous Article
- Next Article