Survivor guilt

Survivor guilt refers to an individual’s feelings of remorse at having survived a life-threatening experience that others did not. Examples of such experiences include traffic accidents, shooting incidents at workplaces or schools, or combat situations. Survivor guilt may also affect individuals who have survived an illness or a disease such as cancer; first responders; military personnel; those who have survived rape or other acts of violence; organ transplant recipients; substance abusers; parents who have seen a child die; and individuals who have lost a loved one to suicide. Survivor guilt is a symptom of post-traumatic stress disorder (PTSD).

Survivor guilt is associated with an increased risk of self-destructive actions and suicide. Individuals may experience major depressive disorder, PTSD, or problems with drugs or alcohol. Those close to an individual experiencing survivor guilt should maintain careful watch for signs of suicide and contact a mental health professional and/or call a suicide crisis hotline if they suspect an individual might be considering self-harm.

Background

The idea of survivor guilt arose in the aftermath of World War II (1939–1945). The Nazis executed an estimated 11 million people, including 6 million Jews. As survivors emerged from the concentration camps, many needed psychological treatment to cope with their experiences. Many practitioners discovered that these individuals had survivor guilt. They had lost many friends and in many cases their entire family and asked why they had survived when millions had not. Many survivors whose children died experienced guilt because they had already lived a number of years, while their children had just begun to experience life.

The Holocaust survivors experienced four elements of trauma: annihilation anxiety, object loss, powerlessness, and torture. Practitioners found that many survivors had difficulty confronting their losses, in particular allowing themselves to mourn, because to do so was to re-experience these traumas.

The Jews and others in Europe had little hint that the Holocaust was approaching. The Nazis moved slowly so that by the time many people realized the danger, it was too late to leave. Yet many survivors felt that they might have missed the signs and perhaps could have helped others survive.

Some survivors were haunted by decisions they made, such as leaving others behind. For example, Abba Kovner was a Jewish resistance fighter who led youths from the Jewish ghetto of Vilna in the Soviet Union into the forests. Such harsh survival conditions and resistance activities were suitable only for the young and strong. Kovner and the others left their aged parents behind to fight for the cause, knowing that many in the ghettoes would die. Their choice to fight for the greater good left many agonizing over those who did not survive. Hailed as a hero, Kovner doubted that he deserved such recognition when he felt that he had been a bad son.

Decades later, survivors continued to wrestle with survivor guilt. Many second and third generations of their families felt this guilt as well. In many cases, they acknowledged that they felt pressure to fulfill their families’ hopes as a way to make surviving the Holocaust meaningful.

Overview

Survivor guilt is believed to be common. Studies in the 2010s and 2020s focused on traumatic stress clinic patients who had survived an experience in which others died have found that 90 percent of survivors reported experiencing survivor guilt.

Practitioners say survivor guilt typically develops in one of several ways. These include guilt because they did not die, guilt about how they acted, and guilt about what they did not do.

When individuals feel guilty because they survived while others died, they often feel, “That should have been me,” or “I don’t deserve to be alive.” These thoughts can prevent survivors from talking about the experience. This, in turn, may stand in the way of successful treatment.

Guilt about one’s actions may lead an individual to take on blame for others’ deaths. The person may believe that he or she prevented others from surviving by pushing through a doorway to escape to safety, for example, or finding a place to hide when others were exposed to danger.

Guilt about what wasn’t done often involves a survivor taking on some responsibility for the event as a way to try to maintain control over an uncontrollable situation. Survivors may question their memories of events leading up to the trauma. They may feel that if only they had recognized some signs that the event was going to happen, it wouldn’t have happened, and people would be alive.

Survivor guilt is often an endless-loop thought process. These could have-should have cycles can prevent individuals from processing their trauma and enjoying life. Some symptoms include difficulty sleeping, feelings of helplessness, feelings of numbness, flashbacks, intense fear, irritability, lack of motivation, and suicidal thoughts. Physical symptoms may include headaches, palpitations, and stomach aches.

Researchers believe that people with a history of depression and low self-esteem are more susceptible to survivor guilt. Some researchers have found that individuals who experienced childhood trauma are more likely to struggle to cope and may experience survivor guilt. Other factors that appear to increase one’s risk include alcohol or drug use, mental health issues such as anxiety or depression, a lack of social support, and a family history of psychiatric problems.

Individuals experiencing survivor guilt may benefit from therapy or support groups. Other coping methods include keeping a journal of thoughts and feelings; sharing feelings with trusted friends and family; giving oneself time to grieve; acknowledging who is truly guilty/responsible, if anyone; and finding ways to help others. Self-care includes paying attention to sleep, nutrition, and exercise needs; choosing relaxing activities; and finding creative outlets, such as painting.

Bibliography

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