Traumatic Grief and Survivor’s Guilt

Written By Canh Tran

What is Survivor’s Guilt

Survivor’s Guilt is the experience and phenomena of when an individual survives a life threatening, traumatic, and/or overwhelming experience. Essentially, someone else’s experience were not your own. Not everyone who survives a traumatic experience will develop survivor’s guilt. Research and training in this area of survivor’s guilt is still relatively new.

American Psychological Association Definition

survivor guilt: remorse or guilt for having survived a catastrophic event when others did not or for not suffering the ills that others had to endure. It is a common reaction stemming in part from a feeling of having failed to do enough to prevent the event or to save those who did not survive. Survivor guilt is also experienced by family members who are found not to carry deleterious genetic mutations that have led to disease and, often, death in other family members, or by family or friends who feel that they did not do enough to succor their loved ones prior to death

Symptoms of Survivors Guilt

  • Flashbacks

  • Difficulty sleeping

  • Disassociation (feeling numb, outside of your body, disconnected)

  • Fear

  • Nightmares

  • Risk taking behaviors (e.g. substance use)

  • Difficulty concentrating

  • Confusion

  • Anger

  • Irritability

  • Sadness

  • Loss of meaning

  • Guilt

  • Persistent focus on the past and what could have been

  • Somatic symptoms (headaches, stomach aches)

Common Thoughts Survivors Have

  • Why didn’t it happen to me?

  • Why was my life worth saving?

  • I’m a bad person.

  • Nothing really makes sense anymore.

  • I’m so confused.

  • What just happened?

Examples Of Survivor’s Guilt Can Include:

  • Refugees & Asylum Seekers (Pre-Migration & Post-Migration Trauma)

  • Natural Disaster Survivors (e.g. Hurricane Katrina, 2004 Sri Lankan Tsunami)

  • War Veterans

  • 9/11 Survivors

  • AIDS Survivors (Post AIDS Syndrome)

    • AIDS Survivors Syndrome describes the experience of those who survived and lived through the HIV pandemic (1980s-1990s). 

  • Internment Camp Survivors

  • Parents Who Outlive Their Children

  • Orphans

  • When A Loved One Receives A Life Threatening Illness

  • Survivors of Mass Shootings & Other Types of Violence

  • Thriving During Covid-19 As Others Struggled

  • Growing Up Poor & Now Middle Class & Upper Middle Class (Financial Class Privilege & Guilt)

  • And More

When Might I Need Therapy or Counseling For Survivor’s Guilt?

  • When symptoms of depression and anxiety interfere with your relationships, job, and day to day living

  • When your emotions and thoughts are overwhelming and difficult to manage

  • Difficulty sleeping and/or an increase in nightmares

  • An increase in risk taking behaviors and/or addiction or substance use

  • An increase in anger, rage, and/or irritability

  • Appetite changes


How Therapy For Survivor’s Guilt Can Help

  • Help you understand what is occurring through psychoeducation of “normal” responses to traumatic grief

  • Provide you skills and tools to regulate your emotions and feelings

  • Exploring ways for you to take care of yourself (mind, body, spirit, soul)

  • Acknowledging and validating your emotions

  • Process feelings such as guilt, anger, shame, and fear

  • Differentiating between helpful and unhelpful guilt (“I should have been able to do something more”)

  • Practicing more self compassion and kindness

  • Learning more about your stories, narratives, experiences

  • Re-writing your prior beliefs and thoughts about the past into a more helpful, realistic manner

  • Grieving everything you’ve lost and miss most

  • Identifying and exploring your values and actions to get you closer to these values in life

  • Moving from “Why did this happen?” To “What does it mean to me?”

  • Post Traumatic Growth: Integrating loss into your life in the way that makes most sense for you (e.g. volunteering, giving back, changing careers, expressing your pain into art, writing, building stronger relationships with others)


Therapy For Survivor’s Guilt in Seattle, Washington

While the pain of loss will never go away, with time, work, and patience, your relationship to loss will transform and change. You will be able to manage feelings. You will be able to heal. There is life after loss.

Healing from trauma and loss takes time and is nonlinear. Some months and years will be fine, while others will be more painful.

Canh Tran
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