Surviving Survivor's Guilt (2024)

While working with survivors of the Holocaust, psychoanalyst William G. Niederland, himself a refugee from Nazi Germany, began noticing a collective group of guilt-related symptoms. His ‘survivor syndrome’, now more commonly known as ‘survivor guilt’, describes a form of guilt that emerges in those who survive an affliction that others succumb to, or among those who are comparatively less harmed in a traumatic incident than others.

It is typically at its most severe when death has occurred, with Murray (2018) reporting that amongst those whose traumatic incident included a death, 90 percent exhibited survivor guilt. It can be nastily resilient too, with Murray, Pethania, and Medin (2021) citing a statistic that 10 years after the Piper Alpha oil rig disaster, the rate of incidence remained a sizable 31 percent.

Since Niederland’s identification of the phenomena, it has been observed in a range of groups including refugee populations, military veterans, survivors of non-state violence, grandparents who have lost a grandchild, and cancer survivors (Murray, Pethania, and Medin, 2021). It has also been broadened to include issues pertaining to inequity and privilege (Fimiana, Gazzillo, Dazzi, and Bush, 2022). As with many psychological terms, there is disputation about an exact definition (Hutson, Hall, and Pack, 2015).

Niederland's original definition of centered on the "ever present feeling of guilt accompanied by conscious or unconscious dread of punishment for having survived the very calamity to which their loved ones succumbed”. This definition reflected the thinking of the original masters of the term – psychoanalysts. Accordingly, it was framed largely as an intrapersonal force. With the ascent of other branches of psychology, and an expansion in the way the individual was conceived of, survivor guilt became more relational.

Moral emotions as a whole, including guilt, are now largely seen through a social or relational lens. Tangney and Dearing (2002) explain its manifestation in such terms: the feeling of guilt can be seen as form of self-atonement for the misfortune of another, while it might also be easier to feel the pain of guilt than accepting the full pain of loss itself.

As well as being relational, it is believed that survivor guilt is driven by asymmetric outcomes: The survivor is dealt a much more favorable hand than others. The extent to which the guilt is often misplaced is witnessed by the burdens often carried by the survivors, in terms of both the physical and, more often, the psychological consequences of the traumatic event. It is with reason that survivor guilt is associated with Post-Traumatic Stress Disorder (PTSD), with Murray (2018) reporting that the presence of survivor guilt can intensify and entrench it.

Manifestations

A range of symptoms have been found to be associated with survivor guilt including forms of psychological and physical maladies, changes to relationships, as well as existential questioning.

Psychological symptoms include:

• Emotional distress
• Negative self-appraisal
• Rumination (Murray, Pethania, and Medin, 2021)
• Grief
• Sadness
• Anger
• Stress
• Tension
• Anxiety
• Low self-esteem
• Perfectionism
• Somatization (Hutson, Hall, and Pack, 2021)

Physical symptoms include:

• Gastric ulcers
• Headaches
• Insomnia
• Fatigue (Hutson, Hall, and Pack, 2021).

Relationship changes include:

• Avoidance of others
• Overprotectiveness (to avoid another loss)
• Over-giving to others (to atone)
• Projecting guilt on to others (Hutson, Hall, and Pack, 2021)

Intrusive cognition concerns include:

• Intrusive questioning, e.g., “Why me and not them?”
• Counterfactual thinking, e.g., “If only I had…” (Murray, Pethania, and Medin, 2021)

Harnessing Survivor Guilt

There seems to be consensus that identifying survivor guilt and getting it out in the open is essential to resolving it, and beyond that still, potentially harnessing it for good. Before it can be effectively harnessed, attaining catharsis is important; crucial to this end is bringing latent feelings of survivor guilt to the surface. Discussing these feelings, or expressing them in other forms such as writing, can be effective to this end.

Philosophers MacKenzie and Zhao (2022) further the idea of survival guilt as a form atonement when it comes to groups with which one has solidarity, i.e. those with whom a strong sense of in-group identity is shared. They propose two forms of survivor guilt:

1. Luck guilt: a form of survivor guilt that is born of the sheer luck/unluckiness in the received outcomes.
2. Solidarity guilt: a form that arises when the victims are individuals with whom a shared group identity exists. Underlying solidarity guilt is the idea that one should share the fate of such in-group members e.g. co-religionists, co-nationalists, etc.

At the crux of survivor guilt is the reality of asymmetric outcomes, and the moral unease that arises out of this, furthered by a misplaced sense of responsibility for being on the 'favorable' end of this. This then extends into a reaction that, at its core, attempts to address the asymmetry. Fimiana, Gazzillo, Dazzi, and Bush (2022) neatly delineate two potential paths ahead of the survivor: self-lowering strategies, or other-enhancing strategies.

In regards to self-lowering strategies, more commonly-known psychological processes such as self-sabotage and self-inhibition ensue (Modell, 1971). These can be seen as maladaptive and negative responses to survivor guilt, with the survivor acting on a misplaced (and ultimately grossly unjust) sense that they are responsible for the asymmetric outcomes, and ultimately punishing themselves for it.

A positive and altogether more beneficial response lies in other-enhancing efforts. Rather than self-punishment, or self-constriction, there is motivation towards addressing the asymmetric outcomes – which the survivor is not responsible for – and using their relative good fortune to uplift those who were not as fortunate. Acting in this way can serve the adaptive aspect of moral emotions, as a corrective moral force, motivating the individual towards doing good.

MacKenzie and Zhao (2023) write: “According to our account, the function of guilt is not to punish the agent for her own wrongdoing, but to motivate the agent to perform actions that restore the moral balance." This perspective fits with Hutson, Hall, and Pack’s (2015) identification that survivor guilt can lead to an altered identity, in a positive sense. The survivor can shape their identity to accommodate an understanding that they survived for a purpose, such as amplifying a cause, telling the world their story and the stories of others, or engaging in other-enhancing work to address asymmetric outcomes. Meaning is derived from the suffering, and the survivor is able to attempt to make the world a more just place. It is important that these other-enhancing endeavors are driven by a sense of opportunity to do good and help others, rather than a pernicious obligation to atone for an outcome that is not their own doing.