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Tuesday, February 1, 2011

Treatment Tuesday - Survivor's Guilt 101

This week's assessment is for Jennifer. She wrote in about her current WIP featuring two brothers. The hero feels he is to blame for his brother's death. His brother was driving the car and they were having an argument about the hero's irresponsibility when they got into an accident. The hero's brother died, leaving the hero with survivor's guilt. To add insult to injury, the hero's brother was considered the "perfect" brother, the responsible one--yet he was the one who died. Enter the heroine, who was the girlfriend of the deceased brother. She finds out she is pregnant, and the hero wants to "make things up" to his brother by marrying her and giving the baby a name.

Jennifer wants to know: Would this reaction make sense? Are there any other common factors found in people experiencing this type of guilt?

Before we get to your specific scenario, a brief overview of Survivor's Guilt might benefit my readers. Survivor's guilt is a phenomenon that occurs when a person experiences a traumatic event and lives when one or more people died. This could be war, a car accident, terrorist attack, hurricane--any event where some people die and others do not. The survivor perceives himself to have done wrong just by surviving.

Survivor's guilt used to be it's own diagnosis in the Diagnostic and Statistical Manual until 1994 when it was subsumed under Post Traumatic Stress Disorder. It carried with it many of the same criteria as PTSD does now, including depression, anxiety, sleep disturbances, withdrawal, nightmares, episodes of uncontrollable crying/laughing, and a loss of interest in things that one brought pleasure. (Very similar to PTSD.)

This type of trauma response can result from 1 of 3 situations: (1) individuals feel guilty for surviving or being uninjured when others were killed or injured; [your hero fits here] (2) they were unable to rescue someone or had to leave someone dying in the disaster; or (3) it was not possible to overcome "the bad guys" (Holen, 1993; Simpson, 1993).

Some of the questions your hero will be thinking:
  • Why did I live when the he died?
  • Should I have died so he could live?
  • Would he have had a better life, more to live for? 
  • What more could I have done to save him?
What makes your story doubly interesting is that your hero has both active and passive survivor's guilt. According to clinical psychologist Yael Danieli, there is both "real" and "imagined" guilt. She distinguishes between them in that real, conscious guilt comes from an actual act of commission or omission on the part of the survivor that may have contributed to the emotional endangerment/harm/death of the other. The fact that your hero and his brother were arguing in the car might indeed have hindered the brother's driving reflexes in some way.

Imagined (also called passive) guilt is guilt a person's feels when they wish they could have acted differently, maybe more heroically, and as such would have prevented the harm that befell the other person who died. Usually this guilt happens in the absence of having knowingly acted in a harmful manner (i.e., the person didn't do anything that would have hurt anyone else), but not always. Your hero could have been talking about roses on the side of the highway when the other driver hit them and there was absolutely no fault of his in the accident. But because of his passive guilt about the argument, he's moved on to active guilt about playing a role in the actual accident.

[A caveat: one question to ask yourself about your hero is this--is he a control freak? You mentioned he wasn't the most responsible of brothers, which would lead me to the conclusion that he's not a control freak, but I ask this question because those people who are frequently have an even harder time dealing with survivor's guilt. The feeling of utter helplessness in the face of what might seem to be a random, senseless event leaves them unable to cope. They would rather believe that they could have done something differently to counteract their feeling of ineffectualness.]

So he's got this beast called survival's guilt. Would it lead him to want to marry his brother's girlfriend to give the baby a name? Short answer? Sure. Many survivors try to join in the "recovery effort" after a traumatic event--and trying to help others impacted by the loss is a major way to do this. It might be a proactive way he could relieve the guilt, assuming that relief is something he actually wants. But for some reason, this doesn't ring especially true to me, almost as if I'd think he'd rather wallow in the guilt, you know? You mentioned that he was some sort of slacker. Irresponsible. That his brother was the "perfect" brother.

My gut tells me that your hero would have many dormant feelings of worthlessness or not being as worthy as his brother emerge after the accident. Old messages of him never "measuring up" or not being as good as his brother might have been triggered, which would possibly illicit all manner of self-condemnation, inner turmoil, or acting in such a way as to prompt rejection or disdain from others so that his internal feelings and external factors gel.

So for a guy like this (if I indeed pegged him right), marrying the girlfriend would have to serve some greater purpose. You didn't mention anything about love in the character sketch, and a pregnancy is time-limited, so it appears that the marriage would be very close to the death of the brother--within the year. I got to thinking that if he had loved this girl all along that would make the marriage all that more bittersweet and tormenting, like he finally got what he wanted--but at the expense of his brother. That's emotionally intense!

How would your character make an arc that leaves the reader satisfied that he'd dealt with the guilt and moved on?

Aaron Haas wrote about survival guilt in Holocaust survivors in his paper (found in Lemberger, 1995). In it, he writes, "Guilt is the penance one pays for the gift of survival." Psychologist Donna Marzo wrote that instead of having a person focus on their guilt, they should focus on the gift of survival. In your book, that could mean a gift for your hero to change his ways, mend his relationships, be better than he was. It's a second chance. Let his internal arc swing this direction to give your reader a nice cathartic conclusion as he embraces life and living.

Good luck with this! Any other questions, leave them for me below. Hope this helps.

Don't forget to enter the giveaway for Janice Thompson's new release, Stars Collide. Click here!

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Jennifer Shirk said...

Oh, Jeannie, this is SOOOOOO good! Thank you so much. You've given me a lot to think about!

Unknown said...

I found this very useful too. I'm writing about PTSD combined with amnesia. That adds a lot of confusion, untied and untidy emotions.

Shannon said...

It's funny how rarely survivor's guilt comes up in the novels I read. I'd almost forgotten about this aspect of human psychology. Thanks. It's given me something to think about for something I'm writing.

Jean Fischer said...

Thanks for this post, Jeannie. I'm currently writing a nonfiction chapter about cancer survivors' guilt. Your information and thoughts here have been helpful.


Jeannie Campbell, LMFT said...

you're welcome jean! glad you found it helpful. :)

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Both comments and questions are welcome. I hope you enjoyed your time on the couch today.