Individuals who survive military combat but have comrades who die often feel guilty and that guilt can last for years. The same thing happens in civilian life when a person survives a catastrophe such as a ship sinking, the collapse of a stadium bleacher, or a mass shooting but loses friends or family. Although this psychological dynamic has always existed it was not recognized and described by psychologists until the 1960s. Survivors of Nazi death camps like Auschwitz or Bergen Belsen carried guilt two decades after their survival because they lived and others did not. The same dynamic is seen in doctors who lose patients, any survivor of an event in which others died, and military veterans who lost comrades in times of war. It is called survivor’s guilt. It is very difficult for these individuals to understand and accept that it is OK to survive.
Survivor’s Guilt
Originally this was a separate diagnostic entity until it was subclassified as part of post-traumatic stress disorder. The dynamic is that people get caught in a feedback loop where they recall a traumatic event. It causes anxiety and depression and heightens painful memories of the event. As the person relives old trauma again and the strength of the feedback loop grows due to strengthening of the neurologic connections in the amygdala, the brain’s fear center. Psychologists have described this condition as PTSD with the addition of guilt. Some veterans constantly relive painful and frightening events in their lives, become depressed, and live in virtually constant fear. Others continually rehash the situation and feel responsible for the deaths of others. When they are able to work through the old events rationally, they realize that they were not at fault and that their friends, comrades would be happy that they survived. Some can take this thought and use it to make something of their life instead of constantly beating themselves up. Others suffer day after day.
Make It Count
In the movie Saving Private Ryan we see a dramatization of a real life situation during World War II. Five brothers from Waterloo, Iowa served on the same US Navy ship, the USS Juneau which was sunk during combat in the South Pacific on 13 November 1942. Subsequently the Navy avoided putting family members on the same vessels. In the movie the Chairman of the Joint Chiefs, General Marshall, discovers that three brothers in the same family have died in combat and that the remaining brother has just gone ashore in the D-Day invasion. A company is assigned the task of finding and saving Private Ryan. In the end Ryan is found and saved but every member of the company who found him dies in combat. The last word of their captain to Ryan is, “make it count.”
Making It Count to Make Sense of Survivor Guilt
One of the worst things for people who survive traumatic events is that there seems to be no meaning and only horror. One of the ways that an individual can more effectively cope with feelings of guilt when they survive and others do not is to work to transform feelings of guilt, meaninglessness, and helplessness into purpose. At No Fallen Heroes we work every day to help veterans with depression, PTSD, substance abuse and other issues get better and not fall into the thought patterns that lead to suicide. Helping others in a meaningful way as a good way to deal with survivor guilt by turning a terrible event and terrible memories into a force to do good.
Putting Events in Perspective Helps Deal With Survivor’s Guilt
We are excited about the prospects of psychedelic medicines for depression and PTSD which are major risk factors for suicide. The way that these medicines work is that they allow a person to work with a coach or therapist to examine their thoughts and feelings about past traumatic events. Without psychedelics old memories are so powerful that the person feels overwhelming depression, anxiety, fear, confusion, and guilt whenever they try to think of what happened years ago. With psychedelics like MDMA and psilocybin, the person is able to examine those memories without being overwhelmed by guilt or fear and put them in perspective. Thus a veteran no longer needs to be overwhelmed by guilt for things that they are not guilty of but rather casualties of during their military service. They learn that it is OK to survive because now they can doing something good and useful.
