The guilt that one experiences when they survive something painful, such as the current pandemic or a large-scale disaster, can cause long term trauma and must be handled with care and compassion, writes Poonam Chawla

Recently, I spoke to a relative who lost her dearest friend to the pandemic. “Please don’t offer me condolences. Please don’t talk to me, write to me or leave care packages at my doorstep. All I want is to bore a hole in the ground and bury myself in it. Why should I see the light, seek food and comfort when she is locked in darkness?” She cried brokenly.

We all know someone who has tested positive for Covid-19 and died from it. However, not everyone can tell you the self-flagellating story of those left behind to face the loss. Yes. Survivor guilt is a thing. And it affects the human psyche like an ill wind that sweeps your house and destroys both your furniture and your repose.

What exactly is survivor guilt?

On a fundamental level, survivor guilt is exactly what the words suggest — the feelings of guilt one experiences when they survive something painful.

It can run rampant as a contagion amongst survivors of large-scale, (manmade or natural) disasters such as the current pandemic, the partition, forest fires, and major earthquakes. Or it may knock down one person here, another there. Like the sibling who survives domestic violence. Or a car crash. The parents who outlive their children. The list goes on and on. So does the trauma.

Not bound by time

The victim of trauma may sleep as one person but wake up as another — a bedraggled, unsure version of one’s former self. Parched of joy. Covered in loneliness. In the mirror, he will see the same face, except for the imprint of absence.

The symptoms of survivor guilt, however, can be as multi-faceted and dramatic as the individuals who feel the guilt, and just as difficult to pin down. Over the next few days, or months, or even decades (as documented in a study of Holocaust survivors) they may fester like depression, erupt like anger, flare up like an ulcer, or react like a child overpowered by an adult.

When my little boy was eight years old, he witnessed an accident. He was roller-skating with a friend in the neighborhood. A passing car, driving at a speed limit way beyond the requisite ten miles per hour in a residential zone, whizzed past at the exact moment that his friend skidded down the sloping driveway. He breathed his last right there on the asphalt.

It is hard to process the fact that you cannot tip open the doors to someone’s life ever again and feel their human print on yours. My son wet his bed for weeks. He expressed his anguish with quivering incoherence: “I should have not gone to his house, right?”; “We should have played at home instead, right?” And the unasked question that flooded his eyes and broke my heart — am I somehow responsible? Grief is the seed form of survivor guilt. And it does not favour adults over children.

The blame game

When someone passes, you are left holding the urn of their unfulfilled longings, their unrealised dreams. You feel simultaneously bereft and responsible.

If you are introspective by nature, you agonise not only over how they died but also why they had to lose their lives and not you. It may well be flukish luck, but the guilt begins an endless drum beat of counterfactuals-thoughts that you could have or should have done otherwise, though, in fact, you did nothing wrong. And you may find yourself buried under an added weight of questions about the very nature and purpose of human existence.

Your world is turned upside down. It no longer feels like a safe place. Guilt keeps the fear at bay. It is a story you tell yourself over and over, like a mantra, until you start believing it.

Subjective guilt — quoted verbatim from Nancy Sherman Ph.D. — is associated with this sense of responsibility, is thought to be irrational because one feels guilty despite the fact that one knows one has done nothing wrong. Objective or rational guilt, by contrast-guilt that is “fitting” to one’s actions-accurately tracks real wrongdoing or culpability: guilt is appropriate because one acted to deliberately harm someone, or could have prevented harm and did not. Blameworthiness, here, depends on the idea that a person could have done something other than he did. And so, he is held responsible, by himself or others.

Trauma — past and present

In some cases, however, survivor guilt can also make you blame others — blame God; blame the neighbour’s dog... Often it stems from feelings of inadequacy, bitterness, and lack of control — as if your life is careening off the highway. It is a symptom of Post Traumatic Stress Disorder but the experience can work independently of a PTSD diagnosis.

When Malavika (a feisty character in my book The Slow Disappearing) loses her chronically depressed mother to suicide, her father all but blames her for his wife’s passing. “It took me a day or two to realise our father did not wish to speak to me. At first, I thought it was a temporary meanness, the byproduct of sudden death. But he was committed. Committed to treating me like a criminal,” she says.

Blaming someone else is the chador some survivors pull over their heads to cover their themselves, their failures and their loss. Every day is a day fraught with unforeseen occurrences. Those lucky enough to be raised in a stable environment may come out of a loss, if not unscathed, at least not marred for life.

That survivor guilt may be heightened by a history of trauma, such as childhood abuse is not difficult to understand. To find yourself in the midst of a threatening situation when you suffer from preexisting issues such as anxiety or depression can be like adding salt to your wounds. Some families have a history of psychiatric disorders or alcohol or drug abuse (a modern-day bane that surely deserves its very own feature). With their coping mechanisms already at a low, how well they survive explosive situations can be anybody’s guess.

It is not a coincidence, that many doctors are now looking at a holistic, a body-mind-soul approach to health. Because, in the end, we are nothing if not our stories. Shaped by the sins of our fathers. Reflected in the behaviors of our children.

Other survivor behaviours

If you are a reader, or a movie buff, a keen observer of life, or, God forbid, a victim of trauma, you may be familiar of the plethora of symptoms that survivors of guilt display:

•  Flashbacks of the traumatic event
•  Obsessive thoughts about the event
•  Irritability and anger
•  Feelings of helplessness and disconnection
•  Fear and confusion
•  Lack of motivation
•  Problems sleeping
•  Headaches
•  Nausea or stomachaches
•  Social media isolation
•  Thoughts of suicide
•  Insecurity. Wanting to hide from the world.

According to Timothy J. Legg, Ph.D., CRNP: People who continue to experience intense guilt, flashbacks, disturbing dreams, and other symptoms of PTSD should consider getting professional help, such as talking to a doctor or a psychotherapist who specialises in trauma.

Therapy remains the primary treatment for PTSD, but some people may also require medication. Treatment can help people begin to regain control of their lives and experience relief from symptoms.

Survivors who have thoughts of death or suicide or have attempted suicide should, needless to say, seek immediate medical attention. Research indicates that surviving a traumatic event that involved a loss of life can increase the risk of suicide.

Moving forward with baby steps

I once confessed to our Swamiji of feeling overwhelmed in the face of a crisis. His response was one I have carried like prasaad to guide me through the haze. One must accept the situation, first and foremost, he said. Recognise what is before you can step toward what next. Most counselors will agree.

You have survived a life-threatening situation. Others have not. Shock and denial is the first stage of grief. Make acceptance the first stage of your healing.

Some of the other gems I have gathered along life’s turbulent passage:

•  It is okay to appreciate and feel relief at your survival even while you grieve. To know that life on earth is still beautiful. That it still ignites your passions with the rising sun. And casts enchantment with the nightly stars. Celebrate the life you have.
•  Yes, the world as you know it, no longer exists. But like the movements of the earth around the sun, the turning face of the clock, the ebb and flow of the waves, your routines too must continue. Taking baths, reading, meditating, journaling, eating, exercise... the activities of quotidian life are restful, and meaningful. Self-care paves the way to normalcy.
• There is no shame in sharing your feelings of guilt, whether in person or a safe space on social media. It can bring relief as well as foster a feeling of community. What’s more, it’s a purely voluntary activity, entirely within your control. And who knows, the hand you take in yours might one day walk you home?

A doctor who had the misfortune of not being able to save his own parents from Covid-19, believes serving others has helped him survive their loss. Where he spent sixty hours a week tending to his patients, he now spends about a hundred. He shaves in his car, sleeps standing up in elevators, and sustains himself on black coffee and sugared cereals. “One more life,” he says. “If I can only save one more life!”

That there is no one-stop-shop for curing survivor guilt is a given. And every one grieves differently. And, yes, proverbs can be annoying, even tedious. But here’s one that has stuck with me: God helps those who help themselves.

Doing something good for others, in the end, make you feel better about your life — and less helpless in traumatic circumstances. When you participate you are no longer the outsider looking in. By donating your blood or giving your time, offering hot food or warm conversations you are preparing a place for yourself in the sustaining hearth of life.

And finally: Let your breath guide you back to well-being. To the blessings, you have accrued thus far. And to a future, rife with possibilities. Inhale sabr, exhale shukr.

The writer is the author of The Slow Disappearing. Her previous books include Mumbai Mornings, The Shenanigans of Time