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Mental Wellbeing Dictionary: S is for Survivor’s Guilt

By Malika Noor Mehta

Artwork by Madiha Syed

The second wave of COVID-19 devastated India. In particular, my friend Aria* experienced the consequences of the shortages of oxygen, ICU beds and medication first-hand. She, her parents, her sister and their entire household staff caught the virus. Seema*, the 65-year-old housekeeper, a woman who had lived with the family since Aria was an infant and was a second mother to her, required the most care. As the family desperately tried to find Seema an ICU bed, Aria began to get sicker and also required hospitalization. When a single bed became available in an unknown hospital outside the city, the family struggled with the decision of who should get it – Seema or Aria? In the end, Aria got the bed. Thankfully, the family found a bed for Seema soon after, and both women survived the ordeal. Yet, the guilt that wracks Aria to this day is almost unfathomable.

The guilt that Aria feels is multifaceted and complex. On one hand, she feels the weight of her privilege – the fact that she even got a hospital bed as a 27-year-old is indicative of that. She feels guilty for being the ‘chosen one’ in the family – Seema was older, and by all accounts, needed the bed more than Aria. Finally, the guilt of being a bystander to the devastation caused by the second wave is an overwhelming feeling that consumes Aria to this day; she saw patients pass away right next to her, people who were her age or even younger. She saw doctors scramble to find oxygen. She saw wailing family members escorted out of the hospital. She saw the injustice, the unfairness, the heart-break and the helplessness.

And then Aria thinks about herself and what allowed her to survive. It was the lucky combination of socioeconomic privilege, a family support system, and youth. Aria is acutely, painfully, heart-wrenchingly aware of this fact. She calls her current mental state a case of unbearable ‘Survivors Guilt.’

What is Survivor’s Guilt?

Survivor’s Guilt is a psychological condition that develops in individuals who survive a life-threatening event. These individuals might feel guilty for having survived the event when others did not. They might believe they did not do enough to save others, or feel guilty that another person lost their life trying to save them.

The concept of Survivor’s Guilt originated after the Holocaust, but it can be applied to several other situations, like wars, natural disasters and most certainly pandemics. According to the DSM-5, the current version of the widely accepted diagnostic manual, Survivor’s Guilt is a symptom of Post-Traumatic-Stress Disorder. As such, this immense feeling of guilt might be accompanied by cognitive and mood-related symptoms of PTSD such as irritability, agitation, negative thoughts about yourself, hopelessness, insomnia, difficulty concentrating, nausea, headaches etc. It is, however, important to note that individuals may experience Survivor’s Guilt without being diagnosed with PTSD.

“Survivor’s Guilt is all-consuming,” Aria says. “You wonder what made you more deserving of life than another human being. You spend so much time asking yourself ‘Why me?’… and more often than not, there is no clear-cut answer to that question.”

Guilt, in all its glory

Aria’s words are laced with an almost tangible sense of grief. Her grief is tied to both her privilege – ‘Why did I get a bed over Seema?’- and the pain she witnessed on the ground – ‘Why did I survive when someone younger than me passed away? Was I given more medical resources? What made my body stronger than another person’s body?’

These are only a few of the questions that plague Aria everyday. She is unable to rationally see how so much of what happened to her (and Seema) was entirely out of her control. Her family made the decision to give Aria the first bed, a decision made because of unflinching and understandably selfish love. How does one fault a mother or father for such a decision? Yet, we spend a lot of time doing exactly that – placing blame, throwing around accusations, and allowing that unbearable feeling of guilt to grow within other human beings. Seema, however, does not do that. Her words were kind – “I am like Aria’s mother and I wanted her to get the bed. She has her life to live. I am older and have lived my life.”

To say I cried while speaking to Seema would be an understatement. I sobbed. The tears fell openly and rapidly because Seema reminded me of what the word “good” really means. She also reminded me of why guilt is such a harmful emotion, one that is inherently human and inherently useless. Guilt does not change the past nor remedy the future. Aria, however, has managed to turn her guilt into something productive. After recovering from COVID-19, she spent her time raising money for those without medical resources, donating clothes, shoes, food, drink and electronic gadgets to those without basic necessities, and launching a campaign to ensure that there are enough beds for everyone when the inevitable third-wave hits India.

Aria recognized that guilt, especially Survivor’s Guilt, thrives off of helplessness – the thought that you are not or were not able to save a life or help someone. Aria is actively combatting that emotion through her relief work. Survivor’s Guilt also thrives off of grief - the thought that someone gave up their life for you. Aria feels this way everyday, but she knows that she is unable to change the past. Finally, Survivor’s Guilt thrives off of loneliness – the thought that your support system could never understand what you are experiencing, not because they do not want to, but because they did not ‘harm’ someone the way you did. Aria feels this way but chooses to speak about her guilt with her family and friends because she knows it is the only way to tackle it.

Overcoming Survivor’s Guilt and the emotions that accompany it is a purposeful process; the individual must thoughtfully and actively decide they do not want to feel this way any more.

Aria described the process as such: Accept the guilt’s presence. Acknowledge it. Voice it. Describe the sensation out loud to a friend or family member or to yourself. And then take steps to heal yourself.

One might turn their guilt into constructive action, the way Aria did. Or one might turn to therapy to allow an objective person to reason you out of these feelings. No matter how one does it, the process of overcoming this guilt is personal. The question we, as individuals, must ask ourselves is: do we want to feel this way or not? If the answer is ‘no’ then we must employ every means necessary to turn our guilt into gratitude, joy and a certain zest for life – especially in honour of all those who did not get to live.

*All names have been changed.


About the author

Malika Noor Mehta is a mental health entrepreneur. Before the pandemic, she was engaged in creating a fellowship program that placed mental health counsellors in low-cost schools in Mumbai. Her interest in mental health stems from her teaching experience at Teach for India and her time in Jordan and Greece, creating trauma-sensitive education programs for Syrian refugees. She holds a Master in Public Policy from the Harvard Kennedy School of Government. In her free time, she loves to write and take photographs.



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