Ask Dr. Leigh: Survivor’s Guilt

A victim of one of the recent disasters that has struck our country wrote to ask me why she is feeling so much guilt over surviving when others were wounded or had family members killed.

Survivor’s guilt is common. So common in fact that it was labeled a symptom in an older version of the Diagnostic and Statistical Manual of Mental Disorders and recognized by clinicians everywhere as a critical aspect of post traumatic stress disorder. Survivor’s guilt refers to feelings that occur when a person perceives themselves to have done wrong by surviving a traumatic event when others did not. Individuals who survived concentration camps, wars, suicides of family members, fires, and other disasters, have reported feelings of guilt, worthlessness, and depression. They wonder why they survived when others were killed and question if they could have done something to save lives.

Survivor’s guilt often complicates the expression of trauma, since survivors don’t believe that they have the right to be traumatized. After all, they and their family members survived unhurt, and they should be grateful. Therefore, they do not allow themselves to have the same emotional responses that, they believe, others who have lost significant other(s) have a right to express.

The capriciousness of evil doings in our world baffles our minds and creates feelings of helplessness and fear. Why did someone a few feet away from us die when we escaped unharmed? Survivors may feel that they should have been the ones to be hurt and are living on borrowed time; since the next time a tragedy strikes, they may not be so lucky.

All of these feelings are a natural part of the grieving process. Denial, anger, guilt, sadness and reconciliation are important stages in the cycle of healing.  Survivors, however, often get trapped in the guilt stage, since they don’t feel as if they have a reason to be grieving. Thus, they may never allow themselves to go past their own guilt and fully resolve their trauma and grief.

In truth, all survivors, whether or not they were injured or lost family members,  are vulnerable to post traumatic stress disorder (PTSD).  Surviving trauma does not give you a pass on developing PTSD. Even if you were a bystander, a witness, or a person called in to help those who were hurt, you are subject to trauma. Trauma occurs when we are exposed to an event that threatens our sense of physical and mental safety.

I once worked with a woman who watched as her husband was engulfed by flames when a gas station pump exploded. She felt immense guilt at not being able to run to her husband to help him, for she froze and was unable to move or utter a sound while she watched as the flames engulfed her husband. She  felt immeasurable guilt for not being there with him, since moments before the explosion she had left the car to use the restroom.The guilt she had over surviving such a disaster was immense. It took quite a while to help her understand that when we are exposed to trauma, automatic systems in our body take over. That means you don’t have full  control over what is happening to you. Further, the fact that she survived did not mean that she had abandoned her husband. She couldn’t have known what was going to happen. Her guilt comes from looking back at the event and desperately trying to make some sense of an uncontrollable and unpredictable trauma. “If only” statements come when the individual is trying to fashion another scenario that will replace what really happened.

I helped this woman understand that her “freeze” response was automatically conditioned in her body. When we experience trauma, a bodily reaction is triggered, called the “fight or flight” response. This response is hard-wired into our brains and is designed to protect us from bodily harm. This response corresponds to an area of our brain called the hypothalamus, which—when stimulated—initiates a chemical release that prepares our body for running or fighting, and sometimes, freezing.

Since these responses are automatic, we can’t predict what we will do in time of trauma.  Some of us will freeze, some will run, some will fight. But again, unless we are trained to respond to disasters, these responses are generally out of our conscious control.

How you responded in a time of crisis does not say anything about who you are as a person. It just means that your response to the crises was hard-wired in your brain. This does not mean that you will respond the same way in another crises since each circumstance is different.

Feeling guilty can also give a survivor a false sense of control. When tragedy strikes, it is often out of our control and therefore, very frightening. A survivor can believe that tragedy can be controlled if he or she could have done something to prevent harm. Survivor’s guilt can also be a means of staying connected to those who have lost their lives and therefore an expression of grief.

Staying focused on guilt rather than moving toward resolution can also be a way of avoiding other issues and emotions such as sadness, anger, and loss. It is often easier to focus on other’s pain and suffering than your own.

If you are experiencing survivor’s guilt, understand that it is a part of your grieving process, but don’t let it stop you from accepting your own experience of the trauma and your emotional responses. Your feelings are valid and your trauma is real.  Visiting with a mental health professional or joining a group of survivors can help you move through you own process of healing.

Survivor’s guilt does have benefits.  It can help the you find meaning and make sense out of tragedy.  Survivors may believe that their lives have been spared in order for them to make a difference in the world. It can empower survivors to do good deeds and to help others who have been victims of tragedies.  And, as I explored in a previous blog on healing from childhood abuse, finding meaning in tragic life events will enable you to rise above the chaos and pain and create something positive for yourself and others.




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