Survivor Guilt and PTSD

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Today at my psychotherapy session we dealt with survivor guilt which has been plaguing me recently on many different levels. I was the victim of a paedophile ring organised by my parents in the 1960s and 1970s in Ireland. I witnessed many other children being abused and several being murdered. I blame myself for not stopping them being abused and killed. I know the logic of the fact that I was a victim myself and only a child so what could I have done but that does not stop me from feeling wracked with grief and guilt for those other children. I see their faces everyday. I essentially am suffering from survivor guilt. Why them and not me? Why did I survive and they didn’t?

What is Survivors’ Guilt?

On a basic level, survivor guilt is exactly what it sounds like: a sense of deep guilt that comes when one survives something.  If you have heard of survivor guilt before what likely comes to mind is survivors of wars, natural disasters or other traumas such as child abuse.  Survivor guilt was actually first documented and discussed after the Holocaust and what has become clear in the decades that have followed is that survivors’ guilt is far more common than was initially understood.  Survivor guilt was previously a diagnosis in the DSM, but was removed and now is a symptom of PTSD.  That said, one can experience survivor guilt independent of a PTSD diagnosis.

What makes survivor guilt especially complex is that the experience varies dramatically for each individual.  Whether a person experiences survivor guilt, its duration and its intensity all vary from person to person.   But the underlying feelings are similar: feeling guilty that you survived when someone else died and that you do not deserve to live when another person did not.  In some cases, this includes feeling you could have done more to save another person, in other cases it is feeling guilty that another person died saving you. I feel that I should have been killed so one of the other children survived.


So when might one experience survivor guilt?

Some of the familiar circumstances one experience survivor guilt are:

After surviving war
Surviving an accident
Surviving natural disaster
Surviving an act of violence
Surviving kidnapping
Surviving childabuse

Some less-discussed circumstances that can trigger survivor guilt are:

After surviving an illness that is fatal for others
After a fellow drug-user dies of an overdose
When a parent dies from complications of childbirth
After receiving an organ transplant
After causing an accident in which others died
Guilt for not being present at the time of an accident to potentially save the person who died.
When a child dies before a parent
Death of a sibling, especially in the case of an illness

As with so many types of guilt that arise in grief, some survivor guilt is rational and some is not.  There are circumstances in which our action (or lack of action) did impact the death of another.  In these cases, there is a rational source of the guilt. In other cases, the guilt isn’t tied to something a person did or didn’t do. Instead, the person feels guilty about what they perceive they could or should have done.This kind of guilt often defies all logic. Some theorists have suggested that this may be because people would prefer to blame themselves for things outside their control than to accept that they are helpless.  Also worth noting, when people believe your survivor guilt isn’t rational, they may try to minimize it by telling you not to feel guilty which can be kind of frustrating.

One of the significant questions that can plague someone experiencing survivor guilt is ‘why?’.  This can take the form of asking why this happened but also, ‘why me’?  So many experiencing survivor guilt struggle to understand why they survived and others did not.  It is common to feel that one was not worthy of survival.  Additionally, as someone feels relief and appreciation for their survival, they often simultaneously feel guilt and shame for having those feelings when others did not survive.

One important thing to remember is, rational or irrational, survivor guilt is normal.  In and of itself it isn’t a sign of unhealthy grief, despite the fact that some people will make you feel like it isn’t okay to feel guilty.  That said, sometimes survivor guilt doesn’t begin to resolve naturally over time.  Sometimes it becomes overwhelming or obsessive, the guilt thoughts become so intrusive that you can’t function.

 

 

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I would love to hear from you so please leave a comment. All feedback is much appreciated. Thank you. Erin