Survivor's guilt is generally defined by the American Psychological Association as “remorse or guilt for having survived a catastrophic event when others did not — or for not suffering the ills that others had to endure”.
Initially, survivor's guilt was considered by many to be a stand-alone diagnosis. Today, however, it is classified as a symptom related to post-traumatic stress disorder (PTSD). We do want to note that not everyone who experiences survivor's guilt is diagnosed with PTSD.
We've summarized helpful strategies and methods for recovery below.
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Who Can Experience Survivor's Guilt?
People who may experience survivor's guilt include, but are not limited to:
- Emergency/First Responders: Individuals who respond to emergencies may experience guilt when patients do not survive. Ongoing supportive talk therapy can be a helpful way to move past these feelings and find a greater degree of comfort in their daily lives.
- Transplant Recipients: While people on a transplant list know that, in most cases, the organ they will receive will come from a deceased person, it can feel more overwhelming when the transplant takes place. These individuals can experience survivor’s guilt as they are using someone else’s organ to live. Transplant recipients may receive counseling both on-site and after the transplant to help potentially mitigate these feelings.
- Witnesses To A Traumatic Event (Such As Murder, Suicides, or Natural Disasters): When a traumatic event occurs, many people initially feel a sense of shock. However, once the event has ended and the danger has subsided, the feeling of shock may be replaced by guilt for those who escaped the event. Grief counseling or trauma counselors can support these individuals in living well, even after the time of stress has passed.
If you or someone you know is experiencing suicidal thoughts, help is available. The National Suicide Prevention Lifeline can be reached by dialing 988 and is available 24/7.
- Parents Who Outlive Their Children: When people become parents, they may have dreams of watching them as they grow into adulthood and enjoy their lives. When circumstances occur that result in the untimely death of a child, it can result in deep feelings of guilt and sadness. Counseling can be a helpful tool to assist grieving parents in preserving the memory of their child and continuing life as regularly as possible after the passing.
- War Veterans: While casualties of war may be expected, it does not mean that it is something easy to accept. Many war veterans return home and feel guilty because they survived their tour, and their comrades did not. This can be made complex with the presence of any other underlying condition, such as PTSD or depression. Additionally, survivors' guilt among war veterans is not exclusive to the loss of friends and fellow service participants. In times of war, soldiers may be required to take someone else's life to safeguard their own life or the lives of others. In either case, medication and therapy can be supportive methods to help returning veterans adjust well to life out of the service, especially if they’ve experienced any losses or trauma.
Symptoms Of Survivor's Guilt
Survivor's guilt can manifest in several different physical and emotional symptoms. While everyone’s experience is unique, one common symptom that has been identified in many patients is a feeling of dread or “doom” associated with being the one who survived.
Other common symptoms associated with survivor's guilt can include:
- Obsessive thoughts about the event
- Feelings of hopelessness or helplessness
- Lack of motivation
- Difficulty sleeping
- Headaches or chronic pain
- Unexplained nausea or stomach aches
- Flashbacks of the event
- Social isolation
Moving Forward From Survivor's Guilt
There are many different strategies you can use as you work to move through the experience of survivor’s guilt. The recommendations listed below are designed to fit easily into your schedule, complimenting any choice of therapy you may choose. We’ve listed a list of strategies below:
- Supporting Other People. Survivor's guilt can be associated with the regret of being unable to help someone who was harmed or died after a traumatic event. Doing good things for others can have a positive impact on both you and the recipient of your good deed, allowing you to take tangible control of the emotional experience as you help another person. You may choose to do this by finding an outlet that is meaningful and personal for you. This can vary from person to person. If you aren’t sure where to begin, you may choose to start by simply making calls to check on people who are unable to get out as much as they’d like, visiting with the elderly, or volunteering at a local event.
- Connecting With Others. Talking with others about your feelings may allow you to acknowledge what you went through in a healthy and constructive way. You may choose to start this by talking to friends or family, or whomever you feel comfortable and open with. If they are not supportive or find it difficult to understand your feelings, you may choose to seek out local support groups that support those living with the effects of trauma and stress-related incidents. If you are not yet comfortable talking face-to-face with others, there are many online communities that can allow participants to ask questions and tell their experiences.
- Accepting Your Own Feelings. Survivor's guilt can affect an individual's outlook regarding many aspects of their life. While guilt can be a valid response to some traumatic events, acceptance is often the first step to overcoming this feeling, depending on the individual and circumstances. You may consider taking some time to process your feelings. You can also seek help and support from loved ones or a professional.
- Taking Care Of Yourself. People who experience survivor's guilt may neglect their own care. It may be related to anxiety disorders or depression that may follow trauma, or from overwhelm.
Regardless of the root cause, we do want to note that self-care is very important, especially during times of emotional difficulties. If you aren’t sure where to start, consider tasks such as eating a well-balanced diet, getting plenty of rest, and trying to meditate or journal. All of these factors are ways to care for yourself and begin creating balance in your life once again.
When Is It Time To Get Help?
If you are overwhelmed or notice an increase in the number of symptoms that you’re experiencing, it may be time to seek professional support from a licensed therapist. Counselors and therapists are generally trained to recognize emotional distress and can help you learn effective coping mechanisms which may promote a higher quality of life.
How Can Online Therapy Support Those Experiencing Survivor’s Guilt?
People living with survivor’s guilt may have trouble leaving the house or completing tasks, as symptomatic manifestation can feel overwhelming. In these cases, online therapy can provide survivors with the ability to connect with a licensed therapist from any safe place with their smart device — potentially offering a more available and affordable option to many who need extra support.
Is Online Therapy Effective To Support Those Living With Survivor’s Guilt?
Research suggests that online therapy can play a powerful role in helping people process and recover from past trauma. A study published in BMC Psychiatry found that patients who participated in internet-based cognitive behavioral therapy (CBT) experienced significant reductions in symptoms related to trauma. Over 5 weeks, participants self-reported reduced symptoms related to anxiety disorders, dissociation, and distress.
The study’s authors concluded that online CBT was generally a viable treatment for trauma-related conditions and observed that the study had low levels of drop-out and high ratings of therapeutic alliance by participants.
What is an example of survivor guilt?
Survivor guilt is a psychological phenomenon experienced by individuals who have survived a traumatic event, especially when others did not survive. An example of survivor's guilt could be a soldier who returns from combat while some of their comrades lost their lives in the same battle. The survivor might feel an overwhelming sense of guilt and sadness for having survived when others did not, even if they had no control over the outcome. They might feel guilty or question why they were spared while others suffered, leading to feelings of unworthiness and a sense of responsibility for the outcome.
In a different scenario, consider a survivor of a natural disaster who managed to escape while their neighbors or a loved one were not as fortunate. The survivor might struggle with feelings of guilt for being alive, wondering why they were spared and what they could have done differently to change the outcome for others. Similarly, in car accidents where one person survives and another person in the car does not, the survivor may feel guilty. Survivor guilt can be complex and emotionally distressing, a survivor may experience feelings of sorrow, confusion, and a sense of moral responsibility, or a mixture of emotions.
How long can survivor's guilt last?
The duration of survivor's guilt can vary widely from person to person. For some individuals, survivor's guilt may be a transient and short-lived response to a traumatic event. For others, it can persist for an extended period, even lasting years in the case of mass shootings or other large-scale traumatic events, especially if not addressed and processed effectively. Several factors can influence how long survivor's guilt lasts:
- Severity of the Trauma: The intensity of the traumatic event and the degree of loss involved can impact the duration of survivor's guilt. More severe events might lead to longer-lasting feelings of guilt.
- Individual Resilience: Personal coping skills, emotional resilience, and the ability to process emotions play a role in how long survivor's guilt lasts.
- Support Network: Having a strong support network of friends, family, and mental health professionals can aid in processing and resolving survivor's guilt more quickly.
- Coping Strategies: Effective coping strategies, such as therapy, support groups, and self-care, can contribute to the resolution of survivor's guilt.
- Grief Process: Survivor's guilt can be intertwined with the broader process of grief. The duration of both experiences can be interconnected.
- Trauma Processing: In some cases, people blame themselves If the underlying trauma is not processed and addressed, survivor's guilt might persist.
If survivor's guilt is interfering with daily functioning, causing significant distress, or lasting for an extended period, seeking help from mental health professionals may be recommended to help cope with negative emotions.
What are the 2 types of survivor guilt?
Survivor's guilt is generally categorized into two main types:
Specific or Event-Based Survivor's Guilt: This type of survivor's guilt occurs when an individual believes that they could have done something specific to prevent the traumatic event or to save the lives of others. They might focus on actions they took or didn't take, feeling responsible for the outcome. For example, a survivor of a car accident might feel guilty for not driving a certain route or not insisting on different travel arrangements.
General or Existential Survivor's Guilt: General survivor's guilt is a more generalized feeling of guilt that can arise when someone believes they don't deserve to be alive or to have survived when others in the world did not. This type of guilt doesn't necessarily involve specific actions or decisions. It can be related to a sense of unworthiness or a feeling that one's survival is unjust compared to the fate of others.
Both types of survivor's guilt can be complex and emotionally challenging. They often involve feelings of sadness, shame, and a sense of moral responsibility. It's important for individuals experiencing survivor's guilt to seek support and professional help from mental health professionals, friends, and support groups to process their feelings and work through this aspect of their psychological response to trauma.
How do you heal survivor's guilt?
Healing from survivor's guilt is a complex process that requires time, self-compassion, and often the guidance of mental health professionals. While everyone's journey and recovery process is unique, here are some steps that can help in healing from survivor's guilt:
- Acknowledge Your Feelings: Recognize and validate your emotions. Allow yourself to feel the guilt, sadness, and any other emotions that arise without judgment.
- Seek Professional Help: Consult a therapist or counselor experienced in trauma and guilt. They can provide a safe space to explore your feelings, develop coping strategies, and lead you in working through the guilt at your own pace.
- Challenge Negative Thoughts: In specific survivor's guilt, you may challenge your belief system by targeting unrealistic beliefs about your ability to control the outcome. Recognize that you couldn't have predicted or prevented every outcome.
- Practice Self-Compassion: Be kind to yourself. Understand that your survival doesn't diminish the value of others' lives. Treat yourself with the same compassion you would offer to a friend.
- Talk About It: Express your feelings with supportive friends, family, or support groups. Sometimes, expressing your thoughts and experiences can help alleviate the weight of guilt.
- Process Grief: If survivor's guilt is intertwined with grief, allow yourself to mourn the loss of others while also honoring your own life.
Can you get PTSD from guilt?
Yes, it is possible for intense feelings of guilt to contribute to the development of Post-Traumatic Stress Disorder (PTSD). While guilt alone might not directly cause PTSD, it can be a significant factor in the onset or exacerbation of the disorder, especially when guilt is related to a traumatic event. Here's how guilt can be linked to PTSD:
- Trauma-Related Guilt: If an individual feels responsible for a traumatic event or believes that their actions or decisions caused harm to themselves or others, the resulting guilt can become intertwined with the trauma memory. This can intensify the emotional impact of the event and contribute to the development of PTSD symptoms.
- Rumination: Prolonged rumination on guilt-related thoughts can contribute to the persistence of PTSD symptoms. Constantly replaying the situation and feeling guilty can exacerbate feelings of distress, anxiety, and emotional dysregulation.
- Avoidance Behaviors: Guilt-related avoidance of reminders, people, or situations associated with the traumatic event can reinforce the symptoms of PTSD. Avoidance is a significant symptom of PTSD which prevents the individual from processing their emotions and integrating the traumatic experience into their memory.
- Intrusive Thoughts: Guilt-related intrusive thoughts, where the individual experiences distressing and unwanted images or thoughts about their perceived responsibility for the trauma, can contribute to the re-experiencing symptoms of PTSD.
Addressing guilt and its role in trauma is crucial for effective PTSD treatment. Therapies like Cognitive Behavioral Therapy (CBT) and trauma-focused therapy can help individuals process their guilt, challenge negative beliefs, and develop coping strategies to manage both the guilt and the PTSD symptoms.
What is another name for survivor's guilt?
Another name for survivor’s guilt is survival syndrome. Other synonyms include remorse, sorrow, and self-reproach.
Can you be diagnosed with survivor's guilt?
While "survivor's guilt" is not an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), mental health professionals often recognize and consider it as a significant psychological response to trauma. Survivor's guilt refers to the complex feelings of guilt, remorse, and distress experienced by individuals who have survived a traumatic event when others did not.
Although survivor's guilt itself is not a standalone diagnosis, it can be a symptom or a feature of various mental health conditions, including Post-Traumatic Stress Disorder (PTSD), depression, anxiety disorders, and adjustment disorders. If survivor's guilt is causing significant distress and impairing daily functioning, a mental health professional might diagnose an appropriate condition based on the symptoms and provide appropriate treatment.
What is survivor shame?
"Survivor shame" is a term used to describe the feelings of shame experienced by individuals who have survived a traumatic event when others did not. It is a psychological response characterized by a sense of unworthiness or self-blame for having survived while others suffered or lost their lives. Survivor shame is closely related to survivor's guilt but specifically focuses on the emotion of shame rather than guilt.
People who experience survivor shame may feel that they don't deserve to be alive, that their survival was somehow unjust, or that they are responsible for the suffering of others. This can lead to a profound sense of shame and self-judgment, often accompanied by feelings of isolation, self-criticism, and a belief that they are somehow inherently flawed.
Survivor shame can be a complex and distressing emotional experience, often contributing to feelings of low self-esteem, depression, anxiety, and difficulty forming meaningful connections with others. Addressing survivor shame may involve therapy, self-compassion practices, and support from mental health professionals, friends, and support groups to help individuals process their emotions and challenge negative self-perceptions.
Why do people get survivor's guilt?
Survivor's guilt arises from a complex interplay of emotions, thoughts, and perceptions following a traumatic event. There are several psychological and emotional factors that can contribute to why people experience survivor's guilt:
- Sense of Responsibility: Individuals might believe that they had some control over the outcome of the traumatic event and feel responsible for the lives of others who were affected.
- Unfinished Business: Survivors may feel guilty about things they wish they had done differently or words they wish they had said to those who did not survive.
- Empathy and Identification: People often empathize with the suffering of others and feel a deep connection to those who didn't make it through the trauma.
- Attribution of Worth: Survivors might question why they were spared while others weren't, leading to feelings of unworthiness and self-doubt.
- Comparative Suffering: Witnessing the pain and loss of others can lead to a sense that one's own survival is undeserved in comparison.
- Moral Dilemmas: Situations involving difficult moral choices can lead to guilt if individuals believe they made the "wrong" choice, leading to consequences for others.
- Identification with Victims: Seeing oneself as part of a larger group affected by the trauma can intensify feelings of guilt and responsibility.
- Cultural or Religious Beliefs: Cultural or religious teachings may lead individuals to believe that their survival carries a deeper significance or purpose.
- Personal Coping Mechanism: Some individuals may unconsciously use survivor's guilt as a way to cope with the overwhelming emotions and distress of the traumatic event.
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