Survivor’s Guilt: The Dark Side of Good News

If you live with a serious illness, then you may understand this post.  Because this post is about how serious illness can bring  monsters that lurks under the bed during a times when other people expect you to be happy.  Let me explain that a bit further.  Being diagnosed with a serious illness is terrifying.  Many of the treatment courses are brutal, or exhausting, or both.  But during diagnosis and treatment, most of the people who care about you are frightened too.  They (hopefully) make space for your fear.  It makes sense to them.

But after treatment, particularly if you have a good prognosis, most of the people in your life begin to celebrate.  They begin to relax, and to move on.  That can be easier said than done when it’s your body that has been under siege.  Back in April, I wrote about the challenges of recurrence fears.  Today, I’m going to explore another tough issue that you may face–even if your own medical news is pretty good–survivor’s guilt.  Guilt is not an unusual feeling for those with serious illness.  In fact, in this beautiful piece by Suleika Joauad, the author does a great job of exploring the “constant companionship” of guilt during cancer.

Survivor’s guilt is a special category of guilt.  It is particularly insidious because it takes something that should be a joyful subject–your continued survival–and adds a layer of oozy, uncomfortable self-doubt.  Some of the ways that survivor’s guilt can sneak in look like this:

  • Why did my cancer go into remission, but my mother, neighbor, co-worker, support group friend died?  Why was I spared when s/he wasn’t?
  • Why did I escape serious complications when I took a mental vacation from managing my diabetes, when others have died or had permanent consequences?
  • Why was I finally able to conceive when I know so many other couples who are still struggling with infertility?
  • Why have I been able to remain comparatively mobile with my MS when others are completely invalid?

Ultimately, the root of survivor’s guilt boils down to this: so much of what happens within our bodies is a mystery.  Making healthy lifestyle choices isn’t a guarantee of good health.  Making unhealthy lifestyle choices isn’t a guarantee of illness.  There are a lot of genetic and environmental lottery factors at play that have nothing to do with how deserving or good or hard-working we are.  The things we don’t know mean that many wonderful people die.  It is heart-breaking.  But it is not your fault.  Here are a few suggestions for coping when you feel overwhelmed by guilt:

  • Honor memories.  If your survivor’s guilt is about a specific person, try to remember the spirit of that person.  Spend some time with their family.  Do their favorite activities.  I’m going to go out on a limb and guess that this would feel like a better memorial to them than beating yourself up for being healthy.
  • Make space for sadness.  Sometimes survivor’s guilt is a mask for all of the grief and anxiety that we carry after our own diagnosis and after the loss of a dear friend.  Taking some time to journal or discuss your feelings in a supportive setting can help you sift through the layers of feelings.
  • Remember that this is not under your control. You couldn’t avoid getting sick, and it is not through a design or an intent on your part that you have survived when others did not.  That is part of the unpredictable nature of life–we just don’t get guarantees.  This may seem obvious, but it’s important to remember.
  • Connect and name the experience.  Guilt flourishes in the dark spaces in our hearts & minds.  When we connect with one another and talk about the experience, we learn that it’s universal.  And sometimes, being able to extend compassion to others helps us extend compassion to ourselves.

Do you have other suggestions for coping with survivor’s guilt?  I’d love to hear them.


Image Credit: Survivor Guilt by _william via Flickr

26 thoughts on “Survivor’s Guilt: The Dark Side of Good News

  1. Ann,

    What a terrific post! Survivor’s guilt, as I’ve experienced it, sometimes feels like being haunted. This is especially true if the woman who has died is younger than I am, or if she has left young children behind. Why, I think, am I still here when these young children needed their mother to help usher them into adulthood?

    Usually my answer comes in a two part form 1) grief, for the life that was lost and everything that life meant, to husband, friends, children, and 2) acceptance of both the loss and the divine mystery of the unknowable. Sometimes this transforms into a deeper spiritual awareness. But if the grief is not yet finished, or other sorrows come in its wake, all the feelings are revisited – and another cycle begins, each one deeper than the last.

    Thanks so much, Ann, for helping us look at a difficult survivorship issue.


    1. Jody,

      Being “haunted”–what a poignant description of this experience. I appreciate your thoughtful reflections–this seems to be a topic that you have explored deeply.


  2. Ann,
    Thank you for writing about this topic which is another one that mystifies many. Survivor’s guilt is very real and for me it’s part of the reason I shy away from calling myself a survivor. As someone else so eloquently recently bloogged, it feels like I’m “erasing” those who don’t survive when I call myself a survivor. I’ll have to dig out my old post on this topic. As always, acknowledging the feeling and talking about it are always good first steps. Thank you for allowing us to do both right here.

    1. Nancy,

      I would love to see your post on the topic–please feel free to include a link to it here. I think that Lori did a good job of describing a survivor as “anyone who has been through a diagnosis.” And thank you for being part of the conversation–you bring a lot to the table.


  3. Ann,

    What a wise and important post. I think it touches on such an important matter, and one that many of us struggle with. Unfortunately I gotten over whatever “survivor guilt” I may have felt with a subsequent stage IV diagnosis. As I’ve said on my own blog, to me a survivor is anyone who lived through the experience of diagnosis…a day, a week, a year or one hundred years. From that context, I think survivors who are no longer in treatment should know that they can serve a very powerful role for those of us who are. Of all the people in my life, there is no one who understands my path or can share my fears more completely than other survivors, no matter their current health (or at least the survivors I have the great pleasure of knowing). Like me, they have looked death in the face, wrestled, and chosen to embrace every day. Their support is, often, a lifeline. In addition to your excellent suggestions, being present, open and giving to others is another healing opportunity for survivor guilt.

    Thanks for letter me share!

    1. Lori,

      I appreciate your voice so much. You do a lovely job of capturing a broad and inclusive definition of survivors. I also appreciate your pro-active and caring suggestion for survivors who are not in treatment–what a way to help them transition into the role of a Rachel Cheetam-Moro variety “Fearless Friend.” Thank you.


  4. Powerful post, Ann. Survivor’s guilt can come at unexpected points in life. Knowing that it can occur can make it easier to deal with rather than asking “Why am I feeling this?”. Thank you for sharing these coping mechanisms.

  5. You make a great point that the “why me?” question can come up even after hearing good news, and you’re right – it’s harder to find support for exploring that question when those around you expect you to be happy and grateful. I think acknowledging rather than burying the feelings is very important.

  6. While I certainly have had my share of “survivor’s guilt,” sometime I think of it this way: Eventually everyone has illness, sorrow, death in their life. My guilt does not help those who are suffering now. My sorrow does not help those who are bereaved – they still have to travel their journey as best they can. I have learned the hard way that no matter how sad others feel for me, my sadness is not mitigated.

    My turn has been here before and it will come again. Meanwhile, I try not to dampen my good fortune of a given moment when a good moment appears.

  7. Ann,

    Hello again. I dug out that old post I mentioned and decided to share it as you so kindly suggested I should do. Thank you. I wrote it last year at the 10 year 9/11 anniversary. Here’s the link:

    It generated quite an interesting discussion. What you said is so true, survivor’s guilt is a special category of guilt, adding an oozy and uncomfortable layer during a time when we are supposed to be feeling celebratory about still being alive. That’s it exactly. I think part of survivor’s guilt is that we know we don’t “deserve” survival more than those who don’t survive. We know we aren’t more worthy and might even be “less worthy.” That can be hard to grapple with. Ultimately so much of life is a mystery and out of our control isn’t it? Thanks again for addressing this important topic and for offering some tips on how to deal with it.

    1. Nancy,

      Thanks for sharing. I’m so glad to have your wisdom here as an additional resource. Tonight’s discussion should be a good one.


  8. Thank you for your very insightful and well written post.
    I just wanted to share with you something that helped me cope with this process from the beginning: I really never asked Why me? But I asked What for?
    My illness made me stop in the tracks of my comfortable “normal” life and ask myself what was it that I needed to change to just keep on living a meaningful existence…
    I have lost many good old and new friends, but after the grieving process, asking myself what for I am still here, has given me not only hope, but also has helped with my guilt of “surviving”. I am truly grateful for everyday and every experience life brings…it takes time, but eventually you are just happy to be alive!

    Health and love

  9. You touched a raw nerve. For many of us, the call was too close to home. We still remember, see the physical and mental scars and acknowledge how fragile life is. When we speak, advocate, educate, assist those who need to learn quickly how to navigate this horrific challenge, we relive our own experience and acknowledge our own mortality.
    I’m a RN, I’ve never said, ‘Why me?’. Why not me. I’ve shared my story with many….If I can survive…so can they.
    Everyday vertical is a blessing. I’ve learned it’s a lot about medicine…and all about FAITH.

    Debbie Hennessy
    Stage 4 Metastatic Melanoma 2006. NED 2008 Surviving and Thriving.

  10. This is a lovely post on a tender subject. Other folks may have a lot of ideas of when we should feel better and this may be exactly when we need more room to feel the enormity of it all, including feeling bad or guilty.

    Maybe it all comes down to trying to love and accept ourselves no matter what. Such a hard thing task.
    Warmly, Allison

  11. Dear Ann,
    You are so eloquent about this. I especially like your suggestions for dealing with the guilt. I will be happy to share this with friends of mine who have recovered from serious illness.

Leave a Reply