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Context

I have just been watching a documentary about survivors of the Japanese earthquake and tsunami of March 2011. Specifically the interviews with ordinary residents of the towns affected.

One thing came through time and again was the notion that was best stated by a friend of mine*- a volunteer firefighter on duty in one of the affected towns on the day of the tsunami:

what gives me the right to survive, when so many others died?

Question

Obviously, this doesn't just occur in Japan, it seems to happen a lot, where people seem to feel guilty to have survived and feel a sense of responsibility for those who perished. What is the psychological basis behind this?

Are there any studies that have addressed this?

Side notes

I lived in Japan for 4 years and have many friends from the affected area, this friend of mine was and is still inconsolable that he, in his own mind, could not save more people.

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2 Answers 2

1. Psychological basis of survivor guilt

Psychosocial and evolutionary perspective on survivor guilt

Survivor guilt may be a psychological response that is associated with depression. Loss of a beloved one, which constitutes a psychosocial attachment, can precipitate a proneness towards experiencing survivor guilt. In clinical samples, the clinically depressed tend to suffer from pathogenic cognitions in which they view themselves as harmful to others are an effect of feeling guilty from surviving a beloved one's death (O'Connor et al., 2002). In that regard, we can hypothesise that survivor guilt is probably a self-protective mechanism involving self-denunciation to combat guilt about surviving a beloved one's death.

Tendency toward self-reproach which death invariably leaves among the survivors (Freud, 1987, cited in Ernest Jones, 1960)

Survivor guilt could have evolutionary roots as well: survivor guilt may be a product of evolutionary pressures with living in small groups as a means to promote social organisation (O'Connor et al., 2002). The loss of an individual within these close socially-knit arrangements creates dysfunction and survivor guilt is an evolutionary means to understanding the changes experienced.

Existential crises, anxiety and ambivalence

Drawing from logotherapy, survivor guilt can be understood further from an existential point of view by referring to existential dynamics (Tate et al., 2012):

Mental health is based on a certain amount of tension [or existential dynamics], the tension between what one has already achieved and what one still ought to accomplish, or the gap between what one is and what one should become. (p. 104)

Survivor guilt may be the tension created between an individual's past experiences and future possibilities. Past experiences such as traumatic events create tension with an individual understanding his or her existence compared to future potentialities. A person narrowly escaping death may physically survive the traumatic experience but in the present moment, they experience excessive amounts of worry about why they are here and what the future holds. This cognitive dichotomy of being shameful about the past and fearful of the future can lead to survivor guilt.

2. Studies on the psychological basis of survivor guilt

Post-traumatic stress disorder (PTSD), cognitive distortions and survivor guilt

Jones and Okulate (2006) conducted a study on the relationship between PTSD and survivor guilt by administering a questionnaire to 1,131 patients from the 68 Nigerian Army Reference Hospital, Lagos, Nigeria. Of these, 194 (22.09%) met the criteria for current PTSD. Survivor guilt was found in 336 responders (38.26%). The following explanation is given by the authors:

The reason for the very high rate of survivor guilt may be related to the intra-group identification and cohesiveness that usually develops in combat-effective military units after several years of training together. Unfortunately, loss of men resulting from death or injury in battle is inevitable. For those who survive, witnessing the death of comrades is additional psychosocial stressor to the combat situation itself, and the survivor guilt that may result is understandably very distressing.

Survivor guilt and chronic illness

Vamos (1997) provides cases on patients and their experiences of survivor guilt in the face of chronic illness and witnessing other people's illnesses:

Miss A had visited her frequently and had repeatedly had the experience of trying to bright- en her friend by accounts of shopping expeditions or other excursions, only to feel profoundly guilt-ridden that she could still be enjoying herself when her friend’s life was so limited. Since the death, she had been unable to weep but had found herself compelled to clean both the house and herself repeatedly, and had often wondered whether she should take a ‘break’ from dialysis

References

  • O’Connor, L.E., Berry, J.W., Weiss, J. & Gilbert, P. (2002). Guilt, fear, submission, and empathy in depression. Journal of Affective Disorders, 71(1), 19-27
  • Tate, K.A., Williams, C. & Harden, D. (2012). Finding purpose in pain: Using logotherapy as a method for addressing survivor guilt in first-generation college students. Journal of College Counselling, 2012, 16(1), 79-92
  • Okulate, G.T. & Jones, O.B.E. (2006). Post-traumatic stress disorder, survivor guilt and substance use – a study of hospitalised Nigerian army veterans. South African Medical Journal, 96(2), 144-146
  • Vamos, M. (1997). Survivor guilt and chronic illness. Australian and New Zealand Journal of Psychiatry 1997, 31, 592-596
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Survivor's Guilt as a medical condition:

Are there any studies that have addressed this?

There have been many studies on Survivor's Guilt, in fact Survivor's Guilt or Syndrome; known as concentration camp syndrome or KZ syndrome, was a recognised condition in the DSM, it has been removed and replaced as a symptom of Post Traumatic Stress Disorder.

...where people seem to feel guilty to have survived and feel a sense of responsibility for those who perished. What is the psychological basis behind this?

The concept of social guilt:

An approach to guilt as a social, rather than individual process. Survivor's guilt is borne from human beings, as a social species, as opposed to being an individual cognitive crisis. It has been demonstrated that guilt serves as a social emotional safety net; ensuring the strong protect the weaker, an important dynamic for the survival of our species.

Multiple sets of empirical research findings on guilt are reviewed to evaluate the view that guilt should be understood as an essentially social phenomenon that happens between people as much as it happens inside them. Guilt appears to arise from interpersonal transactions (including transgressions and positive inequities) and to vary significantly with the interpersonal context. In particular, guilt patterns appear to be strongest, most common, and most consistent in the context of communal relationships, which are characterized by expectations of mutual concern. Guilt serves various relationship-enhancing functions, including motivating people to treat partners well and avoid transgressions, minimizing inequities and enabling less powerful partners to get their way, and redistributing emotional distress (1)

Effects of being spared:

The concept that random as opposed to deserved misfortune serves to motivate human beings to strive harder, in accord with an appreciation of their good fortune, at having been spared.

This case refers to the effects of arbitrary redundancies within the workplace, but still illustrates the effects of survivor's guilt.

This study explored the effects of layoffs on survivors. We assessed subjects' work performance as a function of whether a co-worker had been laid off and the circumstances of that layoff. Consistent with equity theory, subjects worked harder when they believed that a co-worker's dismissal was based on a random process rather than on the relative merits of their and their co-worker's prior performance. Data drawn from questionnaires lent further support to equity theory as an explanation of these results. (2)

Guilt of being spared:

In some circumstances guilt may be borne in the individual being saved, at the seeming expense of another individual (this is most clearly defined in the holocaust "Selection Parades"), more subtle in the case of escaping a fire and being unable to rescue another in the process. In other cases it may stem from decisions, which resulted in the loss of a loved one, where the survivor feels the guilt of helping to change the course of that person's life, even though they would have no real knowledge that it would lead to that person's death.

Exaggerated sense of responsibility:

It seems the survivors over exaggeration one's human abilities in the face of tragedy. Overlooking our human frailties and utter powerlessness in some situations. Personalising the death of another; as if they could somehow have made a diFference, coupled with the concept, of why am I more deserving than another?. The relief of being saved is mixed with guilt at the loss of others and apprehension (possibly a form of dissociation) of it could have been me.

Disruption of the grief process:

In cases where people lose close ones, the grief process is disrupted; conflicting emotions surrounding grief can be amplified for example the relief of freedom felt when a young man's father dies and he feels he is an autonomous being; flooded by guilt at feeling this, in the face of such disaster.

Long term effects:

This sense of guilt can increase, rather than become ameliorated, over time. The psychological damage from Survivor's Syndrome can be passed onto the next generation.

The stigma of KZ-syndrome is present in a second generation in different forms: personality disturbances, emotional and/or social immaturity, social disadaptation, higher frequency of neurotic states, divorce, alcoholism, and suicide. The camp stress has left in human nature traces so painful that they cannot disappear when the generation of former prisoners is gone. (4)


References:

  • (1) Guilt: An interpersonal approach.
    Baumeister, Roy F.; Stillwell, Arlene M.; Heatherton, Todd F.
    doi: 10.1037/0033-2909.115.2.243

  • (2)Layoffs, Equity Theory, and Work Performance: Further Evidence of the Impact of Survivor Guilt
    Joel Brockner et al doi: 10.2307/256193

  • (3) The Sense of Guilt within Holocaust Survivors
    Ruth Jaffe http://www.jstor.org/stable/4466613

  • (4) The evolution of mental disturbances in the concentration camp syndrome (KZ-syndrom).
    Ryn Z

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