Guilt is defined as the “unpleasant feelings of regret stemming from the belief that you could or should have done something differently.” When referencing trauma-related guilt, this feeling is typically related to the idea that you could or should have done something differently in the moment of your trauma. This can also reference the immediate time before or after that moment, which would have changed the outcome of the event. Of course, the reality in these situations is that we have no control over our ability to change our past. There is also the reality that we do not know if our shift in behavior would have made any change to the outcome of our trauma, be that change good, bad, or indifferent.
Trauma-related guilt has been associated with shame, which is why shame is a part of this three-part series, depression, social anxiety, low self-esteem, significantly decreased quality of life, and even thoughts of suicide. Guilt is also a concept that not only negatively affects our emotional state, but our cognitive state as well. Emotionally, one can experience secondary feelings of sorrow, regret, and disappointment in themselves. Cognitively, a person can begin to believe that they have violated a moral standard and are responsible for that violation or the events that led up to it. This allows the guilt to focus on your own actions, or lack of action, causing the emotion to live on for a longer time period. Theory suggests that these other symptoms are maintained by trauma-related guilt in the sense that guilt-related thoughts follow trauma memories, which can occur at any time because an individual has no control over when they surface. When these memories occur, they are followed by a negative or painful emotional response. This process obviously encourages an aversive response to the initial trauma memory and a want to avoid that memory in the future, explaining why the idea of ‘it will get better with time’ does not work. As a result, guilt is often found in people who are experiencing a variety of trauma symptoms, as well as diagnoses of PTSD or Major Depression.
Cognitive – Behavioral Therapy is most useful when confronting the emotions and thoughts that can stem from guilt. Guilt and shame are highly intertwined with each other, which only makes it that much more challenging to conquer them both concurrently. However, with the help of a specially trained psychologist, both can be effectively addressed and overcome. Challenging guilt, in both a cognitive and emotional way, focuses on the reality of the situation. In therapy it will be necessary to address questions like:
- Who owns the actual blame for the trauma?
- Is it fair to use the information you have now against yourself?
- What was the reality of the situation then and the reasons for the choices you made in the moment?
- What self-expectations would be appropriate, given the context and details of the trauma that was happening then, not using the hindsight you have now?
Addressing these questions in therapy with a trained provider is important because recovery will likely necessitate an outside perceptive the first few times these questions are addressed. Being honest with one’s self and one’s own experiences is a very challenging task. Typically this is because there are a number of additional thoughts and emotions that accompany the original guilt. Although the process can be a difficult one, therapy and support can be very effective in helping you to return to having a life worth living, a life you deserve to live.
Authored by: Kaitlan Gibbons, PsyD