Survivor, survivor's, or survivors guilt or syndrome is a mental condition that occurs when a person perceives themselves to have done wrong by surviving a traumatic event when others did not. It may be found among survivors of combat, natural disasters, epidemics, among the friends and family of those who have committed suicide, and in non-mortal situations such as among those whose colleagues are laid off. The experience and manifestation of survivor's guilt will depend on an individual's psychological profile. When the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of posttraumatic stress disorder (PTSD).
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Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, and wide-ranging job layoffs.[1] A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients' suffering.
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save.[2]
Survivor syndrome, also called concentration camp syndrome, or called KZ syndrome on account of the German term Konzentrationslager,[3] are terms which have been used to describe the reactions and behaviors of people who have survived massive and adverse events, such as the Holocaust, the Rape of Nanking, and the HIV/AIDS epidemic.[4] They are described as having a pattern of characteristic symptoms including anxiety and depression, social withdrawal, sleep disturbance and nightmares, physical complaints and emotional lability with loss of drive.[5] Commonly such survivors feel guilty that they have survived the trauma and others—such as their family, friends, and colleagues—did not.
Both conditions, along with other descriptive syndromes covering a range of traumatic events are now subsumed under posttraumatic stress disorder.[6]
Sufferers may with time divert their guilt into helping others deal with traumatic situations. They may describe or regard their own survival as insignificant. Survivors who feel guilty sometimes suffer self-blame and clinical depression.
Early disaster response and grief therapy methods both attempt to prevent survivor guilt from arising. Where it is already present, therapists attempt to recognize the guilt and understand the reasons for its development. Next, a therapist may present a sufferer with alternative, hopeful views on the situation. The emotional damage and trauma is then recognized, released and treated. With growing self-confidence the survivor's guilt may be relieved, and the survivor may come to understand that the traumatic event was the result of misfortune, not of the survivor's actions. Once able to view himself or herself as a sufferer, not one who caused suffering, the survivor can mourn and continue with life.
Waylon Jennings was a guitarist for Buddy Holly's band and initially had a seat on the ill-fated aircraft The Day the Music Died. But Jennings gave up his seat to the sick J.P. "Big Bopper" Richardson, only to learn later of the plane's demise. When Holly learned that Jennings was not going to fly, he said, "Well, I hope your ol' bus freezes up." Jennings responded, "Well, I hope your ol' plane crashes." This exchange of words, though made in jest at the time, haunted Jennings for the rest of his life.[7][8] Jennings, who later became a country music star, expressed survivor's guilt about Richardson's death.
Holocaust survivor Primo Levi, haunted by his experiences in Auschwitz, explored his own survivor's guilt extensively in his autobiographical books, notably in I sommersi e i salvati ("The Drowned and the Saved"). His death was reportedly a suicide, and towards the end of his life he suffered from depression, possibly induced by survivor's guilt.
The 1979 novel Sophie's Choice and the subsequent movie feature a Polish Holocaust survivor who had to choose which one of her children was allowed to survive.[9]
In the Academy Award-winning film of 1980, Ordinary People, based on the novel of the same name, Conrad Jarrett is a young man who struggles with surviving a sailing accident which killed his older brother. As Jarrett realizes that he is angry at his brother's recklessness, he confronts the very cause of his problems and begins to accept his own survival had nothing to do with his brother's death.[10]