The positive side of survivor’s guilt is that it can serve as motivating force for change. Many end up making a donation, volunteering, or joining one or more campaigns to address cancer research and assistance for cancer survivors, including affected caregivers and family members. The psychological toll that cancer treatment takes on patients and those around them is very significant. Depending how one reacts to the consequences of survivorship, however, people might find themselves overextended and overcommitted. This in turn could cause undue stress due to the inability to meet the self-imposed tasks and responsibilities.
I’ve been there
On the other hand, the drive, devotion, and true dedication to making a difference provide a sense of fulfillment to the individual, and many benefits to the organizations or persons with which the survivors work. Having “being there” gives the survivor a sense of identification with those patients, caregivers, and family members “going through it” right now. Here is a little story:
“This guy is walking down the street when he falls in a hole. The walls are so steep he can’t get out.”A doctor passes by and the guy shouts up, ‘Hey you! Can you help me out?’ The doctor writes a prescription, throws it down in the hole and moves on.”Then a priest comes along and the guy shouts up, ‘Father, I’m down in this hole can you help me out?’ The priest writes out a prayer, throws it down in the hole and moves on”Then a friend walks by, ‘Hey, Joe, it’s me can you help me out?’ And the friend jumps in the hole. Our guy says, ‘Are you stupid? Now we’re both down here.’ The friend says, ‘Yeah, but I’ve been down here before and I know the way out.’”
Sometimes it takes one who has been there to help those in need, who are in similar circumstances. Survivor guilt can be a medium and motivator to satisfy feelings of personal responsibility.
A Sense of Responsibility
Individuals with a sense of responsibility for those around them may be particularly vulnerable to guilt feelings. Among this group are individuals in positions of authority (e.g., administrators, supervisors), positions charged with rescuing or maintaining the well-being of others (e.g., police, firepersons), or who habitually feel responsible for others (parents, siblings, children of ill parents, spouses, close friends). For some, responsibility for others is defined as part of the job or part of who they are. People often readily relinquish responsibility to these individuals adding to the sense that it is their charge not only to keep things right but to make things right. As a result, members of this group may feel a sense of failure and guilt even when rescue or well-being are impossible.
Julie, a bank manager, was in her office when a novice and frightened bank robber accidently shot a bank customer and ran out of the bank. Hearing the shot, Julie had her secretary call for help, and she ran out to find the wounded woman bleeding from nose and mouth. Her staff breathed a sigh of relief that she was there. They readily relinquished responsibility to Julie and went with bank patrons to a quiet, safe location in the bank. The wounded woman died before reaching the hospital. Julie’s post-traumatic stress reaction was severe. She entered therapy, and her preoccupation with what she should have done dominated her early treatment experience. Her refrain became, “If only…” (e.g., she had been in the banking area instead of doing paperwork, she could have calmed the young man or talked him out of what he was doing, or even taken the gun away). Rumination about how she could have taken charge of the situation kept her focused on the time before the robber fired his gun.
After a traumatic event, some joyful thoughts or relief about surviving are normal and reasonable for those who were not directly affected: “Thank God it wasn’t me!” “Thank God it isn’t happening here.” For some of those directly exposed to life threatening events, at least temporarily, there may be elation over having survived. For those affected by the event, traumatic symptoms may appear initially or after the elation subsides. For example, Edgardo had to keep moving, as quickly as possible, down the Pentagon hallways in order to survive after the fire erupted in his office as consequence of the plane that struck the building on September 11, 2001. Initially, thinking there was no danger after a few minutes, some well-meaning individuals (including supervisor) sent people back to their offices. Edgardo followed a “gut feeling” and kept going. A large group of other people rushed out along side of him. At one point, a number of people were killed behind him when fire came blazing out of an elevator shaft. Edgardo barely escaped injury and kept rushing down the endless hallways. After assisting some of the injured and for the first few hours after making it home, Edgardo was elated to be alive. It was after watching the news coverage that night of the events at the Pentagon and New York that he realized what he had just experienced. Nightmares, repeated mental images and sounds of the horrors he had witnessed and other symptoms began to undermine his life.
After someone dies and after traumatic events, “survivor guilt” may occur because
- individuals feel guilty for surviving or being uninjured when others were killed or injured
- they were unable to rescue someone or had to leave someone dying in the disaster; or
- it was not possible to overcome the events
Survivors who went through the event may feel guilt because of lack of understanding of why bad things happen to people who do not deserve them, or because of feelings of helplessness or lack of action (“I did not do enough”).
Some survivors continue with rescue work or other efforts and regain a more balanced perspective about what is possible and what is not. Finding a positive approach and positive gains has been of help to some. Long ago, Lucia was given a plaque of a beautiful scene with the words, “Bloom where you’re planted.” written on it. At first, she did not like the plaque. Later, she realized that it did not mean she had to stay in her current circumstances but meant that she could create something good from every circumstance in which she found herself. Discovering new resources, new strengths, and new methods of dealing with difficult problems and reaffirming relationships or making new ones has benefitted many survivors. Some survivors have benefitted from attending support groups. Others have built meaningful memorials or found ways of sharing the process of honoring the dead.
In fact, survival is an achievement. It is a tragedy that so many have been killed in violent events or as result of terminal diseases. It is a blessing to all of us that no more are killed. Although choices may be limited during a traumatic event, the survivor does have choices after the event. They can remain locked in numbness or distress or can use survival as a source of insight and growth. Guilt can be adaptive when it leads to improvements in character and behavior. Unprocessed guilt can make recovery difficult. Therapeutic assistance is important for persistent and/or intense guilt as well as other trauma symptoms that disrupt life.
A Method for Processing Survivor’s Guilt
- Thank goodness, you survived!
- More people than you know are happy that you survived
- We are saddened by so many deaths
- Even if the rest of your life seems insignificant to you, we are relieved that you are alive
- Know that there is no offense in surviving
- It is good to survive
- It is okay to delight in being alive
- Feel free to reassess your life
- Reassess what is valuable to you
- Make the best of your life
- Making the best of your life can be a tribute to your survival and to those who died
- Take the opportunity to reevaluate the meaning of your life
- Is your life all it can be?
- What is or can be your purpose?
- Your talent?
- Your benefit to life?
- Bloom where you’re planted
- Process the traumatic experience and its associated symptoms with appropriate assistance
- Put guilt to good use
- Maintain a healthy realization of you can and can’t do
- Do not overextend yourself by overcompensating trying to do too much beyond your capabilities or resources
- We can do just enough and still bloom where our seeds are planted
- If it is in your nature to do so, CHERISH LIFE
- Treasure being alive
- Whether you survived due to fate, a purpose, luck, chance, or “just did”, long life and kindness are not guaranteed to any of us
- Each day and each act of kindness can be treasured as gifts
- Treasure the best of each day
- Treasure the lesson that the departed have given you
- An opportunity to enlighten your own life
- Be aware of your physical mortality in good and positive ways
- Allow that cherishing life may be easier after recovery from trauma
- Treasure being alive
- Recognize the reawakening of old issues
- Survival may have triggered old feelings of worthlessness or unworthiness
- Surviving may have amplified old messages that you received about not being worthy, about being a nuisance, about not measuring up, and/or about not counting
- If guilt persists or disrupts life, seek appropriate therapeutic assistance
The Positive Side
Whether for acts committed or omitted or for a sense of culpability, guilt can have a significant effect on the spiritual, mental, emotional and physical well-being of the guilty and others affected by the guilty party’s behaviors and attitudes. It can influence demeanor, actions and circumstances. Failure to resolve guilt can result in a multitude of problems including mental health difficulties (e.g., depression), negative responses from others, disrupted relationships, a more pronounced traumatic reaction, and/or immobilization. Staying focused on guilt rather than acting positively and toward resolution can be a way of avoiding facing other issues and emotions. Without resolution, it can hinder and/or complicate traumatic response and recovery as well as the nature of relationships. Guilt can punish more than the guilty.
With the help of a skilled intervener, the level of culpability and the appropriate actions to take can be thoroughly assessed. Guilt can serve as a mobilizer – a call for action. It can move us to reexamine ourselves and our actions and to act in a carefully considered positive manner that benefits the survivor and others who are affected by the event and/or the survivor’s actions.
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