Healthy Habits: Survivor's Guilt

We often think about the trauma that is faced immediately after a major event, but we don't always think about the long-term effects. I recently had a chance to interview Psychology Professor Chris Ferguson to learn about long-term issues.

Why is survivor's guilt something that is so often overlooked?

I think people tend to assume that folks are happy or relieved to survive.  And, of course, often they are.  But we don't always know what people *did* to survive in those situation.  We assume every person or teen simply hid, then walked out once the police or rescuers came, maybe terrified, but otherwise on the road to recovery.  But many people are left with lingering feelings that maybe they did something wrong.  Like they didn't do enough to help other people, they froze and didn't know what to do, or maybe they did something they are later ashamed of.  On the outside, we might be compassionate to this and understand that none of us are prepared to behave like an action superhero in a major traumatic event, but for people who go through these things, sometimes it's tough to be generous with ourselves.  

How common is it for responses to tragic situations to occur later down the road instead of the immediate aftermath?

Oh it's not uncommon.  PTSD symptoms don't have an expiration date.  Of course things like suicide are multidetermined so it's rarely only one thing, even a major trauma.  But symptoms of depression and shame can persist and, after not relieving for months or years, eventually people can lose hope and consider more drastic measures.  It can be difficult to predict, but certainly we should understand that people who have been through a major trauma are going to have elevated risk for negative mental health outcomes that can persist for years, particularly without treatment.

How can parents and others be aware of potential warning signs?

With survivor's guilt, some of the things to look for are expressions of shame ("I should have done something more") or unworthiness ("I should have died so that X could have lived.")  Particularly if they persist after the first few days or weeks.  If someone is, months later, expressing that they should have died or they are ashamed of their actions during a trauma, they definitely need some help.  Social isolation or loss of social support can also place extra strain on someone.  Expressions of hopeless also can be a warning sign.  But some kids just clam up too and are embarrassed to admit they are struggling.  So it's important for parents to be willing to open up the lines of communication, communicate love and support and check in with their kids' mental health.  That's true for all parents, but even more so when kids have been through a trauma.