Sunday, June 15, 2008

A Mother's Survivor Guilt: A Prelude to the Next Post

I've never met a mother who lost a loved and wanted unborn baby or a child who was in their care who did not ask themselves whether they did something to harm their loved one or whether there was something that they could have done to save their child. Particularly when a pregnant mother loses her unborn baby to a miscarriage, there is a period when she recalls and reviews and scrutinizes all that she did, questioning whether she did something to cause her baby's demise, questioning if there is a punishment due. I don't know of a nurse or a doctor worth their salt who fought to save a person from death who does not stop at some point and ask themselves if there was more that could have been done. For the best of doctors and nurses, arriving at the place of realization when all has been done to no avail is hard place that is full of grief and bitter disappointment. It is oft disguised in anger or perfectionism or in laughter and jokes. But I assure you that it is there somewhere.

For those who live in the realization of loss of another's life, these can be haunting questions. They cover you in the midst of the dark night of one's soul as you struggle to make some sense of tragedy. It's not a place that anyone should resign themselves to live.

For those who have had surgery for an ectopic pregnancy or a miscarriage, survivor guilt comes along with the process. Whether it washes over you for a moment from time to time or it drives you deeper into the grieving of the loss of the lifeless child you survive, it does visit you. For those who have suffered this kind of unplanned and traumatic loss, it is a temptation, even long after the event.


What is Survivor Guilt?
(What Long Term Survivors Don't Talk About)

From the Virginia Tech Website:

Survivor guilt, when it occurs, derives from situations where persons have been involved in a life-threatening event and lived to tell about it. It is often experienced after traumatic incidents causing multiple deaths. In the special case of chronic illness, survivor guilt can occur after the deaths of peers who faced the same diagnosis. By definition, there is an implied comparison with people who have endured similar ordeals.

Who experiences survivor guilt?
Anyone who survives can experience these feelings including patients, families and healthcare providers. Survivor guilt explores the other side of the coin of why me? Namely, why not me? Why did I survive when others did not? Those who struggle with it may express the feeling of being an impostor: somehow the "wrong" person survived; it "just doesn't seem right." Many feel that beating the odds makes little sense unless the survivor earned or deserved it in some way. But some survivors emphasize they don't feel especially deserving. To complicate feelings of unworthiness, in the early stages of grief there is a tendency to idealize the deceased, so the survivor may feel even less deserving by comparison.

Why does survivor guilt occur?
Survivor guilt may be reinforced by the frequent use of statistical profiles to predict as well as to describe illnesses. However, people given the very same odds for survival do not necessarily have similar outcomes. When only one survives, it is not unusual to conclude that two persons facing the same threat somehow changed places; that one person's healing occurred at the expense of another; or that there is a debt owed to those who are gone. Some survivors may keep a low profile to avoid spotlighting this contrast of outcomes.

Does survivor guilt have a function or purpose?
Survivor guilt may exist for a reason. It can help people find meaning and make sense out of their experiences. It may help survivors cope with the helplessness and powerlessness of being in a life-threatening situation without the ability to protect or save others. It can also be one way to express a connection to those who have died, a way, for a time, of keeping them alive. Importantly, survivor guilt can co-exist with other responses, such as relief and gratitude, and may occasionally be prompted by them.

What can I do if I experience survivor guilt?
Acknowledge and accept that guilt exists. Feelings of guilt are quite common and represent part of the healing process for persons coping with loss.

When people feel guilty, they tend to isolate themselves. While tempted to keep silent, try to discuss the experience with persons who will not express judgment.

Logic may have little or no impact on guilt, but it is important to do some reality testing with your beliefs. Remind yourself that you are human.

When you find you are comparing yourself with others, try instead to evaluate your situation on its own merits.

Some people try to "work off" their guilt by setting high standards of achievement. This is a very compelling strategy, but it rarely eases feelings of unworthiness.

It may help to find additional ways to keep the memory alive for those who have died by creating a special memory book or holding a service.

Remind yourself that you are struggling to make sense of one of the greatest mysteries of the human race. Rather than explaining it away, try to embrace the mystery.

Source: The Brain Tumor Society

By Roberta D. Calhoun, ACSW, LICSW
© 2001-2008 The Brain Tumor Society