Survivor Guilt and Re-Opened Wounds

One young man, a survivor of the recent mass shooting was called upon to carry a message. He was called the “lucky one.” In reality, no one who survives a trauma can be considered lucky in any sense of the word.

The recent mass shootings have opened the dark door of past experiences for many people struggling with survivor guilt.

Memories of losses and pain are embedded deep within our minds and are triggered by similar events. This reaction is the nature of human experience and the survival of the species depends upon our remembering past events as lessons and thereby protecting ourselves from repeating those mistakes.

In the domain of survivor guilt, the lessons are painful reminders and may stimulate the dormant symptoms that are the trademarks of survivor guilt: aches and pains, changes in sleep patterns, appetite, less interest in sex, increased use of alcohol or drugs, overeating and the powerful emotions of fear, shame, guilt, depression, hyper vigilance, emotional numbing, flashbacks and more.

Progress has been made in diagnosing and treating PTSD and the survivor guilt that has prompted numerous suicides, particularly in members of the armed forces.

The range of treatments is expanding with brain research and yet the disabling and sometimes deadly symptoms are always beneath the surface of what may appear to be a modest recovery and re-integration of the shattered self.

The Cycle of Pain

The dreadful memories and sensations are often triggered by similar events and the cycle of pain begins anew.

Although medication and alternative strategies are often utilized, they are out of context with our Western perspectives, mores and value system. As such, they may not be fully incorporated by the individual into his or her socially-prescribed, Western consciousness.

When a person practices, for example, meditation or yoga to reduce anxiety, to minimize flashbacks or numbing, the exercises may not become as embedded because of conflicts with our social values and ideals.

For example, in the Western world, we celebrate and promote independence, self-reliance, competition and a striving for the ideal and for perfection. We are self-centered. Our value system stimulates a relentless search for improvement, for power, for achievement and we are mostly anxious and dissatisfied with ourselves.

When we “fail,” we fall down into a deep well of disappointment with ourselves and when we make mistakes, our feelings of guilt can be lasting and devastating.

Being unable to act, being helpless is perceived as massive mistake by many in our culture. It is a failure of will, of individual strength and it is regarded as a lack of courage and judgment.

When an individual in our society is unable to act in a deadly, dangerous situation, there are also strong feelings of shame and the person experiences humiliation and the painful sense that the core of his/her “self” is bad.

This perception is a burden carried on the person’s  shoulders who is expected and assumed to be independent, self-reliant and constantly improving themselves.

The Western image of the “perfect” person is impossible to replicate when one is unable to act, to change the situation or to save lives in a catastrophe.

In Western culture, survival guilt embeds itself deeply in the mind and body and our very culture provides little protection.

Broadening Knowledge

Looking at Eastern cultural traditions is one way of broadening our knowledge about survivor guilt and PTSD.

It also offers applicable methods of helping people who suffer from these conditions and is a way of obtaining resilient and protective factors for clinicians and caregivers.

Visitors to Eastern countries are struck with how relaxed and satisfied their people are with life in general. They are able to experience life as it is–without trying to change their circumstances and feelings.

Striving for an ideal or perfect state is not their goal. The Asian “ideal” is to behave in ways that promote “UNHAE” or the interdependence of the community.

An individual’s duty and responsibility is communal and extends to family, community, ancestors and to nature. The experience of harmony is valued above all things and the natural balance of feelings and thoughts is supported without fail.

It’s easy to see the difference when the pressure to be first in line, to make no mistakes, to approach the perfect, individual state is absent.

This perspective is not the only protective factor that works to shield individuals from feeling guilt and shame. The Buddhist belief in Karma is also a mediating factor.

It is this belief system called Karma that gives consolation, hope, reliance and moral courage to a Buddhist. When the unexpected happens and he meets with difficulties, failures, and misfortune, the Buddhist believes that he is wiping off a past debt.

Instead of resigning himself, leaving everything to Karma, he makes a strenuous effort to pull the weeds and sow useful seeds in their place, for the future is in his own hands.

Teaching by Example

People who suffer with survival guilt and PTSD are particularly sensitive and aroused by the atmosphere around them, such as visual and auditory stimuli. They are also sensitive to tones of voice and to gestures and behavior.

Clinicians and others can pay attention to how they speak, move and the office setting when they are helping a survivor. These are things that are often overlooked in the busy world of therapy but they are extremely important when helping a person with survival guilt.

The initial goal when interacting with a survivor is to build the trusting relationship based upon who they are and whatever their feelings may be. This emphasis is not new for clinicians but can be emphasized in words and in behavior that conveys the message of welcome acceptance. For survivors, clear and simple communication helps them to manage their emotions.

In the course of helping the survivor and following the example of Eastern guides, it’s important to convey that the expectation for recovery and healing is to bring positive values and goals into a new and satisfying state.

This process does not annihilate the old program but adds new and positive themes for balance and resilience–leading to a “new normal” realizing it will not be a “perfect” of ideal emotional and cognitive state.

The individual can be encouraged to reflect upon the Western belief system that encourages striving competitively for perfection and to consider that there are more comfortable ways to experience life.

Memory plays a vital role in helping the survivor re-write the script of the trauma in a way that is safe and as comfortable as possible .

Memories for traumatic events are stored in long term memory and re-surface in consciousness when triggered or aroused. When they surface, they are the dominant focus of attention and fragile. They engage visual and auditory components of the memory system and can be amenable to change.

This process is strenuous for clinician and client when it is the primary focus of therapy but can be approached in a simple and more comfortable way. In the Eastern tradition, the individual who becomes anxious uses the strategy of chanting, praying, and engaging in a simple ritual that effectively shifts the attention focus to a positive domain.

This shift is a useful technique to practice with clients and can use the resources of their imagination and past positive experiences to construct the ritual or “chant” that best suits them.

Finally, our Eastern guides are powerfully connected to the outer environment of family, community, nature, the spiritual and ancestral world.

For those whose survivor guilt has caused ruptures in family relationships and isolation from social activities, the re-integration process can begin with use of episodic memory. People can be encouraged to recall positive experiences with family, friends, pets and nature and then describe them in as much colorful detail as possible.

Bringing these episodic memories forward will re-direct attention and working memory to the experiences. With repetition, they will open the door to writing a new a positive story that mediates the fear response of PTSD. This creative process exercises many systems within the mind to support flexibility and resilience.

Soldier photo available from Shutterstock

Survivor Guilt and Re-Opened Wounds