Survivor's Guilt

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

MAY 29, 2018

Survivor's Guilt is a less frequently discussed aspect of recovering from cancer. We think and talk a lot about physical and emotional recovery, but we usually don't dwell on this particular issue. It certainly isn't helpful to obsess about it, but it does come up when we hear about someone who has had a recurrence or died. It is impossible not to wonder Why not me? Why have I been luckier?

Survivor’s Guilt is defined as the feeling that we must have done something wrong to have survived a situation that others did not. The guilt can manifest itself as depression or shame or anger, and is all too common among cancer survivors as well, of course, as survivors of other difficult situations. Hopefully, most of us don’t really think that we did something wrong, but we too often worry that we haven’t earned our good luck  We all know that recovering from cancer treatment has many challenges, and this is one that I strongly encourage you to delete from the list.

This feeling can take many forms. If you have had an early cancer and not needed as much treatment as some others, you may not feel entitled to worry about your own health when others are living with a recurrence. If you have had early prostate cancer, you may not feel entitled to complain about the very difficult side effects of surgery or radiation since the cancer is not an active problem. If you have endured a bone marrow transplant for leukemia and are doing well, you may not feel entitled to acknowledge your exhaustion and fear and changed sense of yourself since others have not been so fortunate in their response to aggressive treatment.

All of your feelings, whatever they may be, are legitimate and authentic and you are more than entitled to have them. However, finding a way to lessen or eliminate any lingering survivor’s guilt will be helpful. Try these strategies:

  1. Yes, the cancer situation could have been worse. However, whatever the specifics of your experience, it has been bad enough. Remind yourself of this frequently.
  2. Most non-cancer people are terrified of the disease. You have gotten through it. Pat yourself on the back and admire your strength and accomplishment.
  3. Make a list of the changes cancer has brought to your life. Include both the good and the bad, and try to emphasize the positives while acknowledging the negatives. The point here is that you have paid your dues.
  4. When you were initially diagnosed, you may have wondered Why me? Or Did I do something to bring this on? As time passes, a new version of those questions may haunt you: Why have I survived? Just as there were no answers in the beginning, there are no answers now. You were not responsible for the cancer in the first place, and you can’t really take credit for your return to health. Cooperating with the recommended medical treatment was smart, and no doctor can accurately predict who will do well and who will not.
  5. Talking about it always helps. The most empathetic listeners are apt to be other cancer survivors or an oncology-savvy therapist. Your friends and family may find it more difficult to appreciate and understand these complicated feelings.
  6. Remember and honor your cancer friends who have died. Running from your sadness and fear will not help.
  7. Above all, cherish your life.