Abstract
Survivor guilt is a common experience following traumatic events in which others have died. However, little research has addressed the phenomenology of survivor guilt, nor has the issue been conceptualised using contemporary psychological models which would help guide clinicians in effective treatment approaches for this distressing problem. This paper summarises the current survivor guilt research literature and psychological models from related areas, such as posttraumatic stress disorder, moral injury and traumatic bereavement. Based on this literature, a preliminary cognitive approach to survivor guilt is proposed. A cognitive conceptualisation is described, and used as a basis to suggest potential treatment interventions for survivor guilt. Both the model and treatment strategies require further detailed study and empirical validation, but provide testable hypotheses to stimulate further research in this area.
Highlights
Survivor guilt is a commonly used term in both clinical descriptions and lay language, and has been identified in a range of trauma-exposed populations, often linked to more severe posttraumatic mental health consequences (e.g. Murray, 2018)
Survivor guilt was once considered a symptom of post-traumatic stress disorder (PTSD), according to DSM-III (Diagnostic and Statistical Manual of Mental Disorders, 3rd edition; American Psychiatric Association, 1980), reflecting the influence at the time of research focused on Vietnam war veterans, who reported high levels of survivor guilt
This paper briefly summarises the current literature on survivor guilt and related fields
Summary
Survivor guilt is a commonly used term in both clinical descriptions and lay language, and has been identified in a range of trauma-exposed populations, often linked to more severe posttraumatic mental health consequences (e.g. Murray, 2018). Guilt is a self-conscious affect and moral emotion characterised by negative self-evaluation (Tangney and Dearing, 2003; Tangney et al, 2007) and is a common post-traumatic experience. This paper briefly summarises the current literature on survivor guilt and related fields. This will be used as a basis for outlining a cognitive conceptualisation of survivor guilt which can generate testable hypotheses about the origins and maintenance of the problem, as well as ideas for intervention strategies. The conceptualisation outlined in this paper draws on work by other theorists in related fields such as cognitive models of PTSD ( Ehlers and Clark, 2000, and Resick and Schnicke, 1992, 1993), trauma-related guilt (Kubany and Manke, 1995; Lee et al, 2001), traumatic bereavement Rather than aiming to replace these existing models, this article aims to apply understanding generated from such frameworks to the experience of survivor guilt
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