Survivor guilt (or survivor’s guilt; also called survivor syndrome or survivor’s syndrome) is a mental condition that occurs when a person believes they have done something wrong by surviving a traumatic event when others did not. It may be found among survivors of murder, terrorism, combat, natural disasters, epidemics, among the friends and family of those who have died by suicide, and in non-mortal situations. The experience and manifestation of survivor’s guilt will depend on an individual’s psychological profile. When the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of post-traumatic stress disorder (PTSD).
Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, terrorist attacks, air-crashes, child abuse and wide-ranging job layoffs. A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients’ suffering.
Stephen Joseph, a psychologist at the University of Warwick, has studied the survivors of the capsizing of the MS Herald of Free Enterprise which killed 193 of the 459 passengers. His studies showed that 60 per cent of the survivors suffered from survivor guilt. Joseph went on to say: “There were three types: first, there was guilt about staying alive while others died; second, there was guilt about the things they failed to do – these people often suffered post-traumatic ‘intrusions’ as they relived the event again and again; third, there were feelings of guilt about what they did do, such as scrambling over others to escape. These people usually wanted to avoid thinking about the catastrophe. They didn’t want to be reminded of what really happened.”
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save.
Survivor syndrome, also known as concentration camp syndrome (or KZ syndrome on account of the German term Konzentrationslager), are terms which have been used to describe the reactions and behaviors of people who have survived massive and adverse events, such as the Holocaust, the Rape of Nanking, and the HIV/AIDS epidemic. They are described as having a pattern of characteristic symptoms including anxiety and depression, social withdrawal, sleep disturbance and nightmares, physical complaints and mood swings with loss of drive. Commonly such survivors feel guilty that they have survived the trauma and others – such as their family, friends, and colleagues – did not.
Both conditions, along with other descriptive syndromes covering a range of traumatic events are now subsumed under posttraumatic stress disorder.
AIDS survivor syndrome
AIDS survivor syndrome refers to the psychological effects of living with the long-term trajectory of the AIDS epidemic and includes survivor’s guilt, depression, and feelings of being forgotten in contemporary discussions concerning HIV. While AIDS survivor syndrome has not been recognized as a pathological illness by the NIH (as of December 2017), scientific research and publications are available that address this issue.
Holocaust survivor Primo Levi was haunted by his experiences in Auschwitz and explored his survivor’s guilt extensively in his autobiographical books, notably in I sommersi e i salvati (The Drowned and the Saved). Towards the end of his life he suffered from depression, and his death may have been suicide.
In 1945, the USS Indianapolis was torpedoed by a Japanese submarine and sank in the Philippine Sea. Most of the crew survived the sinking but were left adrift for days. Only 317 survived the whole ordeal. The Captain of the USS Indianapolis, Charles B. McVay III, was court-martialed for hazarding his ship. Despite the captain of the Japanese sub standing up for McVay, he was convicted of gross negligence. Living with survivor’s guilt and hate mail for years, McVay killed himself in 1968.
In an interview on Lifetime TV’s Unsolved Mysteries, Lawrence “Larry” Geller, one of Elvis Presley’s closest friends, reported that Elvis, as a “twinless twin”, was plagued by guilt over the death of his infant brother, Jesse Garon, who was stillborn. Elvis had confided to Geller about his concerns that maybe he had absorbed more than his share of the nutrients while he was developing inside his mother’s womb, causing his twin brother to starve to death before he was born. Elvis had also related to Geller about how his mother had tried to comfort her son by assuring him that “they would all meet in Heaven” after their lives on Earth were completed.
I suffer from survivor guilt because I survived all the abuse I was subjected to as a child from the paedophile ring organised by my parents whereas other children were murdered. I feel so strongly that I should have been able to save them but could not. Why did I survive and they did not. It haunts me every day and leads to self-harm and numerous suicide attempts one as recent as last week. It is an extremely difficult psychological condition to deal with.