Survivor’s Guilt is a deep feeling of guilt often experienced by those who have survived a catastrophe that took the lives of others. In part from feelings of being unworthy relative to those who died.

Under-recognized Little studied Rarely discussed as a consequence of

survival Dismissed Minimized

SURVIVOR’S GUILTSURVIVOR’S GUILT

WH

Y? W

HY

? WH

Y?

WH

Y?

Loss of a fellow cancer survivor companion News of a recurrence in a fellow survivor Learning you are BRACA + Being an earlier stage relative to fellow

survivors Having fewer or less invasive treatments Receiving “good news” in the presence of

others Not doing cancer “well” Not being “enough” of a survivor Not having an epiphany or life-changing

moment

DIFFERENT TYPES:DIFFERENT TYPES:

SURVIVOR’S GUILT DECODEDSURVIVOR’S GUILT DECODED

Empathy

Sadness

Grief

Anxiety

Pressure

PTSD

AM I GRIEVING? RECOGNIZING SYMPTOMSAM I GRIEVING? RECOGNIZING SYMPTOMS

Crying Lack of energy Uncertainty Changes in sleeping or eating habits Feeling withdrawn or unmotivated Irritable, demanding, underlying “buzz” of

anger Hyperactivity, fear of slowing down Decreased productivity, trouble

concentrating Avoidance of others or fear of being alone

THROUGH THE MIDDLE OF GRIEF…THROUGH THE MIDDLE OF GRIEF…

SELF CARE: SADNESS. ANGER.SELF CARE: SADNESS. ANGER.

What helps you feel safe enough to be really sad? People? Location? Comforts?

Pay very close attention to what it is (thought?) that makes you stop crying? Why….

Anger is energy. What can you do with that energy?

Do you know your triggers? Have you taken the time to really understand

those trigger thoughts?

SELF CARE: ANXIETY, PRESSURE SELF CARE: ANXIETY, PRESSURE

Can you recognize what the anxiety and pressure feel like in your body?

What are you thinking? Is that thought accurate…

Separate your experience from that of another.

Ground yourself in your value, worth, uniqueness (get affirmation of those truths!)

SELF CARE: GUILT, PRESSURESELF CARE: GUILT, PRESSURE

Most survivors with guilt feel an strong need to find meaning for their survival.

Critically think about what you are/feel capable of doing to support others.

Is there someone you trust who can mentor and support you in new ventures.

Assumptions “Shoulds”/“Musts”/”Oughts” All or nothing thinking Over-generalizing Unfavorable comparisons Personalizing Dwelling on the negative Disqualify the positive Fortune Telling Catastrophizing

THE DIRTY LITTLE HABITS OF OUR THOUGHTS…THE DIRTY LITTLE HABITS OF OUR THOUGHTS…

Remember your feelings about talking about your diagnosis will likely change day to day.

Try not to ignore your need to share your worries, fears and questions.

Often talking with others helps you work through concerns or uncertainties in a natural way.

Try not to put on a “happy face” if you are not feeling that way. Your true feelings are more helpful to everyone.

Remember when others have awkward or hurtful responses it likely has nothing to do with you but is more related to their own feelings or past experiences.

Talking about cancer can be complicated. Most conversations are not a one shot deal, they are an ongoing dialogue. Keep being as open as you can.

1. Listen to yourself. Come to understand what you are feeling, thinking and needing.

2. Learn how to care for yourself. 3. Decide who the best audience is for you

today related to what you need to express.4. Prepare yourself for important

conversations.5. Know your emotional “hot spots”.6. Reach out to good friends or a therapist to

help you better understand your feelings and support you as you

IN SUMMARY:IN SUMMARY: