In 1949, Mental Health America successfully lobbied to have May recognized as Mental Health Month in the United States; since then, advances in the field of psychology have identified many new mental health issues. Survivor guilt is just one of them, but it is often overlooked.
According to a study published in the Advances in Nursing Science Journal in January 2015, called, “Survivor Guilt: Analyzing the Concept and Its Contexts,” survivor guilt has begun to appear in nursing, medical and psychological literature more frequently, but is often not defined and poorly described. However, the study states: “Survivor guilt is a valid form of suffering for which effective interventions need to be developed.”
The Cambridge Dictionary defines survivor guilt as “difficult and painful feelings caused by the fact that you are still alive after a situation in which other people died.”
Deby Williamson, a licensed clinical social worker, said she has had her counseling practice in Colorado Springs for five years and specifically chose this field to help military veterans, almost all of whom have some sort of guilt or shame from their time in the service. That guilt stems from a misplaced sense of responsibility and obligation, which is called hindsight bias, Williamson said.
“Hindsight bias is a big thing,” she said. “It means you know now how it turned out and what all those other possibilities are. But you would not have seen those other possibilities up front; otherwise, you would have made a different decision.”
In many cases, the person suffering from survivor guilt had no control over what happened, which is where the misplaced sense of responsibility comes into play, Williamson said. To help overcome that feeling of being responsible, she gives her clients the tools and guidance to reframe the idea that the death or deaths were somehow their fault.
“In a military situation, you may have lost several people under your leadership, but you promised to bring them all home safe,” Williamson said.“There is nothing wrong with the value placed on bringing everyone home safe, but how you apply that value may need to be reframed. You may need to reframe that statement and recognize that you did the best you were able to at the time.
“The only way to make up for these deaths is to honor them by living the best life you can because they cannot.”
Lindsey Courtright and Sam B., both residents of Colorado Springs, said their survivor guilt is strongly tied to the similarities between their lives and those of the people who died.
Courtright, whose cousin was also her best friend, said the parallel between their lives made her cousin’s suicide in 2005 that much more difficult. “We were born three months and two days apart,” she said. “We grew up together, we had the same views, we were both Christians, we had a very tight-knit family. I tried to look at the pattern to see what could have gone wrong, and there was not anything. We just took separate paths in life.”
Courtright said she felt her family was always looking at her and wondering what her cousin would be doing if she was still alive. Living in Colorado, a place where her grandparents promised to take her and her cousin, has been a constant reminder of the suicide, she said.
“My grandparents promised us when we were 9 that they would take us to Colorado,” Courtright said. “She never made it to Colorado, and I freaking live here.”
Similarly, Sam B. said she and her best friend from high school both underwent treatment for cancer at the same time. “My biopsy came back with precancerous cells in my uterus and hers came back as pancreatic cancer,” she said. “I ended up losing my uterus and having a partial hysterectomy, then had treatment after that. My friend underwent lots of treatment and fought for two years but died in February of this year at 42 years old.”
Sam B. said she and her friend were the same age, had the same profession and shared many of the same life goals; but her friend was married with three kids. Sam B. said she felt she should have been the one to die because she does not have a husband or children.
Both women recognize that the deaths of their loved ones was out of their control; however, according to a paper by Kathleen Nader, who holds a doctorate degree in social work, “The idea that one somehow could have prevented what happened may be more desirable than the frightening notion that events were completely random and senseless.”
Williamson said everyone suffering from survivor guilt needs to know one thing: It can be healed. Honoring a person’s life does not mean you have to stay depressed or sad that he or she is no longer around, she said.
Healing might not come from counseling; it might come from having someone to talk to who does not attempt to give advice or make things better, she said. However, if a person begins to show signs of depression, suicidal ideation, begins using drugs and/or alcohol or their behavior is out of the ordinary, Williamson said to encourage that person to get professional help.
“It is OK to ask them if they are thinking about killing themselves,” she said. “You are not going to plant an idea in their mind that they may not have already had.” But getting them to recognize that they need help is imperative, Williamson said.
Sam B. said she has used counseling and her faith to help her begin to heal. She determined that going to her friend’s funeral would be a major step in that healing process, she said. “Talking with my friend’s kids and husband to see how grateful they were that I came to the funeral was really good,” she said. “If I had not gone, my guilt would have been compounded by the guilt of not going to the funeral.”
Courtright said she still struggles with guilt, but has realized that those feelings are entirely fed by her own thoughts and fears. It completely changed how she looked at life.
“Am I a good enough mother?” Courtright said. “Do I deserve to be alive? Yes, my cousin was on drugs but she was an amazing person, so then why am I still here and what do I have to offer? I am not any better than she was.”
However, Courtright said she eventually realized she had to forgive her cousin for killing herself. She will never forget their times together and is sad there won’t be more, but Courtright said she no longer feels unworthy of life.
Sam B. said she built up the idea that her friend’s family would resent her, even though no one did. “I built it up that people who knew our parallel lives would think, ‘Why did Sam survive? She does not have kids and she is not married.’ But no one ever did that. I did it to myself.”
“Healing does not mean forgetting,” Williamson said. “It means figuring out where in your life and pattern that person’s memory belongs.”