Having worked with people touched by cancer for many years as a counsellor, I hear many repeated themes of loss, as you may expect.  Loss of a life, loss of a body part, loss of certainty about the future, loss of work, relationships and friendships that just can’t deal with the messy thing that cancer is.  So, I expect that, help people come to live with that.

What I didn’t expect to come into the counselling space time and time again, is clients who struggle with survivor’s guilt following cancer.  Its very real, from the moment your diagnosed your told what to do, where to be, appointments and treatment take over your life, you look to the horizon of being told things are OK, then you get there with such great expectations…… and it doesn’t feel joyful, it feels a best numbing and at worst a overwhelming sense of guilt.  Those around you seem so happy for you ‘you must feel great, relieved, time for celebration’ they say, you smile to cover how your really feeling, probably more afraid than ever of who you turn to now, who will understand?

Counselling for cancer is a way to seek some understanding of what now.

So what is survivors guilt? Survivor’s guilt is something that people experience when they’ve survived a life-threatening situation and others might not have. It is commonly seen among Holocaust survivors, war veterans, lung-transplant recipients, airplane-crash survivors, and those who have lived through natural disasters such as earthquakes, fires, tornadoes, and floods and of course cancer

 The symptoms of survivor’s guilt vary, but here are some possible clues that someone is experiencing it:

Having flashbacks

Feeling irritable

Having difficulty sleeping

Feeling immobilized, numb, and/or disconnected

Being unmotivated

Feeling helpless

Having an intense sense of fear

Experiencing physical symptoms such as headaches, stomach-aches, and palpitations

Having suicidal feelings

In truth, it’s not logical for someone to feel responsible for another person’s fate, but guilt is not something we necessarily have any control over. However, survivor’s guilt is a normal response to loss. Not everyone experiences this type of guilt, but it’s often a feeling that is difficult to shake. It’s been said that some people are more prone to it, such as those with a history of depression and low self-esteem.

There are also other factors that could predispose someone to survivor’s guilt. For example, Alan Siegel (2005) did research on the dreams of firestorm survivors, which offered revealing results. He found that those who were victims of childhood trauma were even more susceptible to dreams about death and that all healthy defences are weakened by trauma. Unresolved past losses often become emotional Achilles heels or vulnerable areas that affect a survivor’s ability to cope. Siegel suggested that for disaster survivors, remembering and exploring dreams can help individuals access and deal with unresolved issues. Recording dreams in a bedside journal is an excellent way to facilitate this process.

 I believe that when experiencing survivor’s guilt, it’s a good idea to simply acknowledge it and call it what it is because it doesn’t go away if one represses these feelings. It’s not about healing the guilt so much as it is about shifting one’s perspective, and the passage of time can help immensely. In his book Guilt, Shame, and Anxiety, Peter Breggin (2014) suggests that we try to remove ourselves from negative thoughts and feelings; and replace them with common sense, rational views, and love.

Here are some coping tips if you (or someone you know) is experiencing survivor’s guilt:

Give yourself time to grieve.

Consider thinking about who was responsible, if anyone.

Remember to take care of yourself physically and psychologically.

Think about what those who are close to you are feeling about the situation.

Remind yourself that you were given the gift of survival and feel good about it.

Try to be of service to someone or something.

Remind yourself that you’re not alone.

Be patient.

Share your feelings with those you trust.

Try to stick to a daily routine.

Consider journaling your feelings.

Get professional help, as needed.

If you’ve survived a harrowing experience like cancer, taking care of yourself, both physically and emotionally, is essential for healing. Eat well, sleep well, move your body, and find support to help make sense of it all.

Guilt has a place in our emotional repertoire—it motivates us to make amends—but with survivor guilt, it’s misplaced. So grieve your losses, but remember that it wasn’t your fault, others are glad you’re still here, and that you can use your survival to pay it forward.