My blog this week is about 'survivor guilt'. It's been mentioned in the papers a great deal, in a year when man-made and natural tragedies have filled our TV screens. The media has picked up on many aspects of post tragedy fall out. One particular aspect that struck a chord, has been ‘survivor guilt’. Those who weren’t killed, or injured, wondering ‘why did I survive, and they didn’t’.
What is 'survivor guilt'?
‘Survivor guilt is common among survivors of traumatic events—such as war, natural disasters, accidents, and even acute or long term illnesses such as cancer. Survivor guilt refers to the sense of guilt or responsibility that can occur when one person survives a traumatic event that others did not’… Cancer can be a traumatic event too…. (Moving beyond survivor guilt, Cancer Treatment Centres of America)
Going through cancer diagnosis and treatment, is only the beginning of learning to live with cancer as a backdrop to the rest of your life. Ideally, as the experience recedes, the uncertainty and fear settles to the back of your mind, and life starts to feel manageable again. This new ‘normal’ has developed its own definition – you become a cancer ‘survivor’ – which holds its own minefield of ups and downs.
Many people have explained to me that this becomes a difficult time. Along with wondering if or when your cancer may return, you become aware of those with cancer around you, who may not be doing so well. The person you befriended in the chemo suite, the colleague with the same cancer, or people discussed in the media who have died from their illness.
Hearing about other people’s stories of recurrence or terminal illness, can trigger a visceral response, where pangs of guilt hit home. Maybe it’s a feeling of unfairness …’they were good people, why them?’…and guilt about ‘why not me?. Ironically, a reverse of those initial feelings often expressed at diagnosis, which is sometimes ‘Why me?’.
This is an area which is currently poorly researched, in psychological terms. One study of 108 lung cancer patients, (aged between 50 – 59 yrs old), found that over 55% of those interviewed, had feelings of survivor guilt. (Survivor guilt: the secret burden of survivorship, Parloff, T, 2015). Which, although hard to generalise from such a small study, suggests that at least one in two people may be feeling some level of sadness and guilt about still being here, relatively unscathed, when others haven’t made it.
How to cope with survivor guilt
- Acknowledge the feelings – the feelings are real and normal, and simply show that as a compassionate human being you feel the pain and loss of others. It can cause or add to feelings of sadness, anxiety or depression, which you may be struggling with on a daily basis.
- Tell someone how you’re feeling – whether it’s a family member, friend or GP/specialist nurse/counsellor. Even just being open and exploring the feelings can ease the sense of anxiety and misplaced guilt.
- Join a support group, and/or visit your local Maggie’s Centre, and learn first hand from others experiences and wisdom. Hearing that someone else feels the same way, can be reassuring in itself.
- Take time out to reflect that every single person with cancer, even if it the same type, stage, grade as yours, will still follow their own unique path. It is tempting to compare yourself with others who you have traveled alongside during treatment and beyond – but you’re not them.
- It may be time to take stock of your life, post cancer. This has been a life changing event, and the path is not an easy one. Someone reading this who hasn’t been affected by cancer, may not be able to appreciate why some of you may be feeling guilt at surviving – as they perhaps imagine getting through the treatment should be a joyous event. However, cancer can be a traumatic event, psychologically and physically, and it can take time to rebuild confidence, self-belief, and a new sense of purpose.
- Remembering and honouring the friends whose cancer travels ended differently to your own, can help with moving on. This might be by keeping a journal, writing to the remaining family, lighting a candle…raising a glass to their memory…whatever works.
- Be kind to yourself – learn to recognise the natural pang of sadness about the few amongst us, whose life has been cut short (be it by cancer, or any other life changing event) – but then try and move forward. Learn strategies that help manage the difficult emotions, and seek help if the thoughts are overwhelming.
And finally, there may be many reading this blog, who are feeling OK, and haven’t experienced ‘survivor guilt’ at all. That’s good…we all cope with things differently, and there are no rights or wrongs here.
If you’d like further support with this issue, do drop into your nearest Maggie’s Centre, or perhaps open a conversation post here online,
Warm wishes
Sue
Original blog written by Sue Long, Cancer Support Specialist, October 2017/updated 2020
Resources
Coping with guilt Cancer.Net
Survivor's guilt - in people with cancer Verywell health
Survivors Guilt - let me count the ways (Angela Long) The Oncology Nurse Jul/Aug 2014 vol 7 no 4