Survivor’s Guilt: Definition And Support

Medically reviewed by Paige Henry, LMSW, J.D.
Updated November 27, 2023by BetterHelp Editorial Team

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. 

If you have experienced a traumatic event and have feelings of guilt or conflict after surviving it, you are not alone. Survivor's guilt can affect many people in unique ways. Some research suggests that most people with survivor's guilt recover within the first year after the traumatic event, without having to seek outside treatment. However, there are times when outside help is needed for survivors.

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.

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  • 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.


It can be common for individuals to have questions or experience difficult feelings, such as guilt, after experiencing a traumatic event. However, there are measures you can take to address the symptoms of survivor’s guilt, potentially supporting you in finding a higher quality of life. Online therapy can be a useful tool to support you in your healing journey. BetterHelp can connect you with a therapist in your specific area of need.  

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