Psychological mechanisms and treatment approaches for survivor's guilt

Survivor Guilt

Overcoming Survivor Guilt

This paper discusses the various sources and psychological remedies for survivor's guilt, which often manifests alongside (or as a part of, depending on the psychological perspective) major depression and post-traumatic stress disorder. Typical survivor guilt-inducing events are discussed, and a brief overview of the psychological mechanisms that produce feelings of guilt as a part of depression/post-traumatic stress is also provided. The paper focuses primarily on the means and methods of overcoming survivor's guilt, including intensive psychotherapy, grief counseling, and the benefits of increased spiritual awareness and connectedness that is advised by several psychological practitioners and scholars.

Introduction

The Holocaust that took place during World War II, the terrorist attacks of September 11th, 2001, and the virtually countless wars and "conflicts" that have occurred in the past hundred years all have something in common beyond the senseless violence, destruction, and death that they brought to the world -- they also all left survivors. Though many people are of course grateful to have survived such terrible ordeals, many others feel an initial and often persistent feeling of depression, not simply because they have lost a loved one or because their world and perspective has been irrevocably altered, but because these things have occurred and left these individuals alive while taking life away from those around them. These feelings are quite appropriately known as survivor's guilt.

Large-scale traumatic events such as those listed above are not the only means of creating feelings of survivor guilt -- domestic abuse and rape victims, as well as other victims of isolated or more directly personal incidents also suffer from similar feelings (Herman 1997). Especially since the downgrading of survivor's guilt in the American Psychological Associations Diagnostic and Statistical manual of Mental Disorders, feelings of shame have been identified as a strong factor in post-traumatic stress disorder, and has been closely linked to the feelings of guilt evinced by survivors of many such incidents (Leys 2007, pp. 6). Despite -- or ironically, perhaps because of -- the reduced sense of importance and primacy given to survivor's guilt by the American Psychological Association, this aspect of Post-Traumatic Stress Disorder and depression has become better understood in recent decades.

Processes for Overcoming Survivor's Guilt

Fortunately, the very source of survivor's guilt also points to a major avenue for effecting recovery. Studies have shown that the better the personal support system for an individual with survivor's guilt feelings is, the faster and more effectively that individual will recover from these feelings (Herman 1997). Though counseling and individualized therapy can also be hugely important and effective -- as will be discussed momentarily -- no psychological practitioner ever could (or ethically should) replace a network of family and friends to provide ongoing support and security to those suffering from survivor's guilt (Khouzam & Kissmeyer 2006; Herman 1997). Reducing feelings of isolation and providing a sense of the lost security are both important steps in assisting recovery from survivor's guilt.

One of the most effective therapeutic methods for dealing with feelings of survivor's guilt is, strangely, to have the survivor relive the traumatic event(s) that have led to these feelings, and to have them express -- and therefore fully acknowledge and come to accept -- their feelings regarding the incident (Herman 1997, pp. 181-5). This allows the traumatic memory to be transformed, not by altering the details or attempting to erase the most traumatic portions, but rather by allowing these memories to become less traumatic through increased yet controlled exposure. This process is enormously important in aiding recovery, as guilt essentially stems from an inability to face one's feelings about oneself, and these therapeutic techniques focus on facing one's feelings regarding the trauma.

There are also techniques that have proven surprisingly ineffective. The use of pharmaceuticals to treat depression and even post-traumatic stress disorder has achieved no small measure of success in recent decades, yet pharmaceutical therapies seem uniquely unsuited to handling the issue of survivor's guilt and can actually exacerbate the condition (Khouzam & Kissmeyer 2006). Instead, individualized therapy and even an emphasis on rekindling and reinvigorating spiritual beliefs, regardless of the specifics of these beliefs, are all far more effective treatments for handling survivor's guilt than the use of pharmaceuticals (Khouzam & Kissmeyer 2006). Spirituality, like the closeness of family and friends, provides a sense of connection and security that is distinctly lacking in these that suffer from survivor's guilt, making it highly important in addressing the issue (Khouzam & Kissmeyer 2006; Herman 1997). These findings should of course not be interpreted to mean that anti-depressants and other pharmaceuticals should not be prescribed to handle post-traumatic stress-related issues, but it does suggest that such remedies alone do not create an effective process for dealing with the realities of survivor's guilt.

Conclusion

Survivor's guilt can be one of the most debilitating outcomes of a traumatic experience. With the proper care and an appropriate network of support, however, the damaging effects of this guilt an be overcome. Healing always takes time, but the proper processes can help speed recovery.