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Survivor guilt or survivor's guilt (but also survivor syndrome, survivor's syndrome, survivor disorder and survivor's disorder) is a mental condition that occurs when a person believes they have done something wrong by surviving a traumatic or tragic event when others did not. [1]
The experience and manifestation of survivor's guilt will depend on an individual's psychological profile. When the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of post-traumatic stress disorder (PTSD).
Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, terrorist attacks, air-crashes and wide-ranging job layoffs. [2] A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients' suffering.
Stephen Joseph, a psychologist at the University of Warwick, has studied the survivors of the capsizing of the MS Herald of Free Enterprise which killed 193 of the 459 passengers. His studies showed that 60 percent of the survivors suffered from survivor guilt. Joseph went on to say: [3]
There were three types:
- first, there was guilt about staying alive while others died;
- second, there was guilt about the things they failed to do – these people often suffered post-traumatic 'intrusions' as they relived the event again and again;
- third, there were feelings of guilt about what they did do, such as scrambling over others to escape. These people usually wanted to avoid thinking about the catastrophe. They didn't want to be reminded of what really happened.
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save. [4]
Survivor syndrome, also known as concentration camp syndrome (or KZ syndrome on account of the German term Konzentrationslager), [5] are terms which have been used to describe the reactions and behaviors of people who have survived massive and adverse events, such as the Holocaust, or the Rape of Nanjing. [6]
In 1949, Eddy de Wind, a Dutch psychiatrist and survivor of Auschwitz concentration camp, introduced the term "concentration camp syndrome" regarding the psychological consequences of persecution, describing the "pathological after-effects" unique to former prisoners of Nazi concentration and extermination camps. The subsequently well-documented syndrome among Holocaust survivors includes anxiety and depression, intellectual impairment, social withdrawal, sleep disturbance and nightmares, physical complaints and mood swings with loss of drive. Several studies have examined the "chronic and progressive" nature of the condition, with symptoms increasing in intensity as survivors age. [7] [8]
Commonly such survivors feel guilty that they have survived the trauma and others – such as their family, friends, and colleagues – did not.
Both conditions, along with other descriptive syndromes covering a range of traumatic events are now subsumed under post-traumatic stress disorder. [9]
AIDS survivor syndrome refers to the psychological effects of living with the long-term trajectory of the AIDS epidemic and includes survivor's guilt, depression, and feelings of being forgotten in contemporary discussions concerning HIV. [10] While AIDS survivor syndrome has not been recognized as a pathologizable illness by the NIH (as of December 2017 [update] ), scientific research and publications are available that address this issue. [11]
American musician Waylon Jennings was a guitarist for Buddy Holly's band and initially had a seat on the ill-fated aircraft on February 3, 1959, which would later come to be known as "the day the music died". Jennings, however, gave up his seat to the sick J.P. "Big Bopper" Richardson, only to later learn of the plane's crash. When Holly learned that Jennings was not going to fly, he said, "Well, I hope your ol' bus freezes up." Jennings responded, "Well, I hope your ol' plane crashes." This exchange of words, though made in jest at the time, haunted Jennings for the rest of his life. [12] [13]
On February 14, 2018, Nikolas Cruz went into Marjory Stoneman Douglas High School in Parkland, Florida, and shot randomly at students and staff, killing 17 people and injuring 17 others. Sydney Aiello, whose close friend was killed, struggled with survivor's guilt, and was later diagnosed with post-traumatic stress disorder. On March 17, 2019, Aiello died by suicide at the age of 19. [14] Less than a week later, on March 23, Coral Springs police announced that Calvin Desir, a juvenile male student from Stoneman Douglas, had been found dead as a result of an apparent suicide. [15]
Stephen Whittle was a Liverpool F.C. fan who had bought a ticket for the FA Cup semi-final between Liverpool and Nottingham Forest F.C. on 15 April 1989, but sold his ticket to a friend due to work reasons. The friend (whom he and his family have chosen to leave unidentified) was one of the 94 victims of the human crush at that game. Whittle became unable to go to football matches due to his guilt and related feeling of responsibility for his friend's death, and died by suicide on 26 February 2011, almost 22 years after the ill-fated match. [16]
The term collective trauma calls attention to the "psychological reactions to a traumatic event that affect[s] an entire society." Collective trauma does not only represent a historical fact or event, but is a collective memory of an awful event that happened to that group of people.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
Stockholm syndrome is a proposed condition or theory that tries to explain why hostages sometimes develop a psychological bond with their captors. It is supposed to result from a rather specific set of circumstances, namely the power imbalances contained in hostage-taking, kidnapping, and abusive relationships. Therefore, it is difficult to find a large number of people who experience Stockholm syndrome to conduct studies with any sort of validity or useful sample size. This makes it hard to determine trends in the development and effects of the condition, and in fact it is a "contested illness" due to doubts about the legitimacy of the condition.
Psychological trauma is an emotional response caused by severe distressing events that are outside the normal range of human experiences, with extreme examples being violence, rape, or a terrorist attack. The event must be understood by the affected person as directly threatening the affected person or their loved ones with death, severe bodily injury, or sexual violence; indirect exposure, such as from watching television news, may be extremely distressing and can produce an involuntary and possibly overwhelming physiological stress response, but does not produce trauma per se.
Complex post-traumatic stress disorder (CPTSD) is a stress-related mental disorder generally occurring in response to complex traumas, i.e., commonly prolonged or repetitive exposures to a series of traumatic events, within which individuals perceive little or no chance to escape.
Leo Eitinger was a Norwegian psychiatrist, author and educator. He was a Holocaust survivor who studied the late-onset psychological trauma experienced by people who went through separation and psychological pain early in life only to show traumatic experience decades later. He devoted a long period studying posttraumatic stress disorder among Holocaust survivors, which had led Holocaust survivors including Paul Celan (1920–1970), Primo Levi (1919–1987) and many others to commit suicide several decades after the experience. Eitinger was a pioneer of research into psychological trauma among refugees, and also laid the foundation for Norwegian military psychiatry research with emphasis on psychological trauma among soldiers.
Post-concussion syndrome (PCS), also known as persisting symptoms after concussion, is a set of symptoms that may continue for weeks, months, years after a concussion. PCS is medically classified as a mild traumatic brain injury (TBI). About 35% of people with concussion experience persistent or prolonged symptoms 3 to 6 months after injury. Prolonged concussion is defined as having concussion symptoms for over four weeks following the first accident in youth and for weeks or months in adults.
Gender is correlated with the prevalence of certain mental disorders, including depression, anxiety and somatic complaints. For example, women are more likely to be diagnosed with major depression, while men are more likely to be diagnosed with substance abuse and antisocial personality disorder. There are no marked gender differences in the diagnosis rates of disorders like schizophrenia and bipolar disorder. Men are at risk to suffer from post-traumatic stress disorder (PTSD) due to past violent experiences such as accidents, wars and witnessing death, and women are diagnosed with PTSD at higher rates due to experiences with sexual assault, rape and child sexual abuse. Nonbinary or genderqueer identification describes people who do not identify as either male or female. People who identify as nonbinary or gender queer show increased risk for depression, anxiety and post-traumatic stress disorder. People who identify as transgender demonstrate increased risk for depression, anxiety, and post-traumatic stress disorder.
Chaim F. Shatan was a Jewish-Canadian psychiatrist born in Włocławek, Poland.
In applied psychology, interventions are actions performed to bring about change in people. A wide range of intervention strategies exist and they are directed towards various types of issues. Most generally, it means any activities used to modify behavior, emotional state, or feelings. Psychological interventions have many different applications and the most common use is for the treatment of mental disorders, most commonly using psychotherapy. The ultimate goal behind these interventions is not only to alleviate symptoms but also to target the root cause of mental disorders.
Rape trauma syndrome (RTS) is the psychological trauma experienced by a rape survivor that includes disruptions to normal physical, emotional, cognitive, and interpersonal behavior. The theory was first described by nurse Ann Wolbert Burgess and sociologist Lynda Lytle Holmstrom in 1974.
Stress-related disorders constitute a category of mental disorders. They are maladaptive, biological and psychological responses to short- or long-term exposures to physical or emotional stressors. The National Institute of Environmental Health Sciences categorizes Obsessive-Compulsive Disorder (OCD) and Post-Traumatic Stress Disorder (PTSD) as stress-related disorders. However, the World Health Organization's ICD-11 excludes OCD but categorizes PTSD, Complex Post-Traumatic Stress Disorder (CPTSD), adjustment disorder as stress-related disorders.
Prolonged exposure therapy (PE) is a form of behavior therapy and cognitive behavioral therapy designed to treat post-traumatic stress disorder. It is characterized by two main treatment procedures – imaginal and in vivo exposures. Imaginal exposure is repeated 'on-purpose' retelling of the trauma memory. In vivo exposure is gradually confronting situations, places, and things that are reminders of the trauma or feel dangerous. Additional procedures include processing of the trauma memory and breathing retraining.
PTSD or post-traumatic stress disorder, is a psychiatric disorder characterised by intrusive thoughts and memories, dreams or flashbacks of the event; avoidance of people, places and activities that remind the individual of the event; ongoing negative beliefs about oneself or the world, mood changes and persistent feelings of anger, guilt or fear; alterations in arousal such as increased irritability, angry outbursts, being hypervigilant, or having difficulty with concentration and sleep.
Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary modes of transmission are the uterine environment during pregnancy causing epigenetic changes in the developing embryo, and the shared family environment of the infant causing psychological, behavioral and social changes in the individual. The term intergenerational transmission refers to instances whereby the traumatic effects are passed down from the directly traumatized generation [F0] to their offspring [F1], and transgenerational transmission is when the offspring [F1] then pass the effects down to descendants who have not been exposed to the initial traumatic event - at least the grandchildren [F2] of the original sufferer for males, and their great-grandchildren [F3] for females.
Post-intensive care syndrome (PICS) describes a collection of health disorders that are common among patients who survive critical illness and intensive care. Generally, PICS is considered distinct from the impairments experienced by those who survive critical illness and intensive care following traumatic brain injury and stroke. The range of symptoms that PICS describes falls under three broad categories: physical impairment, cognitive impairment, and psychiatric impairment. A person with PICS may have symptoms from one or multiple of these categories.
The effects of genocide on youth include psychological and demographic effects that affect the transition into adulthood. These effects are also seen in future generations of youth.
Secondary trauma can be incurred when an individual is exposed to people who have been traumatized themselves, disturbing descriptions of traumatic events by a survivor, or others inflicting cruelty on one another. Symptoms of secondary trauma are similar to those of PTSD. Secondary trauma has been researched in first responders, nurses and physicians, mental health care workers, and children of traumatized parents.
Post-traumatic stress disorder (PTSD) results after experiencing or witnessing a terrifying event which later leads to mental health problems. This disorder has always existed but has only been recognized as a psychological disorder within the past forty years. Before receiving its official diagnosis in 1980, when it was published in the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-lll), Post-traumatic stress disorder was more commonly known as soldier's heart, irritable heart, or shell shock. Shell shock and war neuroses were coined during World War I when symptoms began to be more commonly recognized among many of the soldiers that had experienced similar traumas. By World War II, these symptoms were identified as combat stress reaction or battle fatigue. In the first edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-I), post-traumatic stress disorder was called gross stress reaction which was explained as prolonged stress due to a traumatic event. Upon further study of this disorder in World War II veterans, psychologists realized that their symptoms were long-lasting and went beyond an anxiety disorder. Thus, through the effects of World War II, post-traumatic stress disorder was eventually recognized as an official disorder in 1980.
Sexual trauma therapy is medical and psychological interventions provided to survivors of sexual violence aiming to treat their physical injuries and cope with mental trauma caused by the event. Examples of sexual violence include any acts of unwanted sexual actions like sexual harassment, groping, rape, and circulation of sexual content without consent.