Survivor Guilt

Survivor guilt is the term used to identify feelings of responsibility and self-blame in those who experience the death or significant loss of someone that they care about and wonder why they were spared. It is a common theme in literature and entertainment media and is seen both in response to individual losses and to catastrophic events in which many people are killed or injured, such as the Nazi Holocaust. Survivor guilt can be classified into two types: the first is existential survivor guilt. In this type, survivor guilt is frequently part of the post-traumatic stress disorder seen in soldiers who survive the roadside bomb that kills others in their armored vehicle. In such cases, the person is literally left behind when others have died. Survivor guilt is found not just in the survival of the death of others but in the guilt associated with how one escaped from difficult, life-threatening circumstances. The second type is content survivor guilt. In content survivor guilt, the focus is not only on surviving, but on what one did to survive. In either form, survivor guilt is a deviation from the question: “Why me?” to the question “Why not me?” Both questions arise from the same existential attempt to find meaning and re-establish a sense of control over events and circumstances outside of human control. This entry will describe survivor guilt as a form of grief, as well as discuss some of the ways to support those who experience it.

Guilt and Grief

Virtually every author who writes about loss and grief mentions guilt as one of the feelings experienced by those who are bereaved. In some cases, it is associated with an exaggerated grief response, typically that of depression. Guilt in survivors is seen as a part of the anxiety, depression, health impairments, and emotional challenges to those who have experienced significant loss. This is particularly true when the survivor felt protective of the deceased. For example, parents whose children die are at significant risk for survivor guilt, believing that they should have died rather than their child. Parents defer to the “natural order of things” with words like, “I should have gone first.” This is partly a statement of the pain of grief, and largely a statement of self-blame for not having been able to protect the child. Children who lose a sibling frequently experience survivor's guilt, believing that somehow the parents' grief would be less if they had been the one to die instead of the sibling. These children may also experience relief that they did not die, adding to the survivor guilt experience.

Part of the pathology of guilt in survival is a skewing of the ability to relate to others about the survival event. The survivor may hold their guilt inside like a terrible secret. Their assumption seems to be that no one else will understand it, so the survivor needs to hold onto it so that the memory [Page 923]will not be destroyed by others. For these survivors, the guilt becomes a shield to both protect them from other feelings and hold others away from the internalized pain about the survival event. Survivors frequently report subsequent difficulties in relationships with trust and expressing needs. There is a sense that others cannot meet one's needs, and that entering relationships out of need makes one vulnerable again to loss. Often, the survivor works hard in business relationships, but does not enjoy the work or its product because of ongoing feelings of unworthiness and impending doom. Guilt becomes a response to inhibit impulses and avoid fully engaging life. This attempt to control relationships and vulnerability is a normal defense mechanism for bereaved survivors.

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