The aftermath of war brings complex emotional consequences. Veterans who survive conflict may feel intense and lasting guilt about those they left behind. At the same time, loved ones may struggle to understand, sparking a search for answers on how to help veterans with survivor guilt.

This guilt can lead to a painfully dark place, but it doesn’t have to. There is help and hope for both veterans and their families to process these complicated emotions and chart a path toward healing. Let's take a look at how to help veterans with survivor guilt.

Survivor Guilt Defined

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Before you can decide on how to help veterans with survivor guilt, you need to know what it is. Survivor guilt is an element of grief where someone who has lived through a traumatic experience, especially where others have been killed or injured, feels intense regret, remorse, or shame.

The first cases describing survivor guilt began to appear around the time of the Holocaust. The psychiatric community has since come to understand that it's a condition that has been with us for a much more extended period. Our approach to treating survivor guilt has evolved steadily over the years. That makes it easier for all us, family and friends included, to understand how to help veterans with survivor guilt.

The most important thing for veterans and their loved ones to remember, always, is that suffering from survivor guilt is understandable and part of the natural human experience. It’s when our reactions to survivor guilt begin to impede the way we live our daily lives that it comes time to seek help.

Triggers for survivor guilt

You're right to look out for your loved one and consider ways to help veterans with survivor guilt. War is arguably the most traumatic event any individual can experience. And it doesn't necessarily even have to involve loss of life. Survivor guilt can also occur when a fellow serviceman is injured, as veterans still feel that they were wrongly spared the pain, shock, and strain of recovery.

While people usually associate survivor guilt with soldiers, it's also known to be a factor in many other events. Patients have reported these feelings in cases of sexual abuse or domestic violence, when a loved one dies from a sudden illness, fatal car accidents, and, as Psychology Today notes, when a fellow member of a cancer support group dies, or a refugee from a war-torn region receives asylum but has to leave family behind.

More recently, survivor guilt has been considered a factor in economic change, when downsizings occur. The people who stay feel that they, too, are not worthy and may have done something to cause their friends to lose their job. Those situations can have ramifications for the organizations involved as well, in the form of loss of loyalty or increased anxiety and stress.

History of survivor guilt

The condition now known as survivor guilt first became part of the language of psychology in the 1960s. Initially referred to as survivor syndrome, the concept was formulated by Dr. William Neiderland, following extensive studies of individuals who survived the death camps in Nazi Germany during World War II.

Dr. Neiderland was himself a refugee from Germany and conducted repeated observations of about 2,000 patients who spent time in the concentration camps. At the time, he was a psychiatrist and analyst in New York City. One of his essential observations: "The ego is not so massively shattered in a flood survivor as in the survivor of one year in Auschwitz, but the symptoms are the same."

For a time, the Diagnostic and Statistical Manual of Mental Disorders listed survivor guilt as a psychiatric disorder of its own. Later, it was reclassified as an element or symptom of the much broader condition of post-traumatic stress disorder.

As you seek solutions to how to help veterans with survivor guilt, it’s important to remember that your loved one is not alone. Estimates are that as many as 15 percent of people involved in traumatic situations experience aspects of PTSD, according to CNN.


Survivor Guilt Defined

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As you’ve probably already experienced as you’ve looked into how to help veterans with survivor guilt, this is a condition that puts your loved one under siege from a pattern of negative thinking. And yet, the types of reactions and responses tend to be different for everyone.

One element is common, according to psychologist Nancy Sherman, writing for both Psychology Today and the New York Times: sufferers are confronted by "counterfactual" thoughts and ideas that they are somehow responsible for what happened or could have stopped it, if only they had reacted differently or sooner.

“The emotional reality of the soldier at home is often at odds with that of the civilian public they left behind,” Sherman writes. The counterfactual thinking that Sherman writes about comes to light in a variety of ways. Recognizing these perspectives are important in deciding how to help a veteran with survivor guilt.

Feeling unworthy

In thinking about the trauma, your loved one feels they are "unworthy" of being a survivor or wishes he or she had not been the one to be spared. Your veteran may focus on the notion that surviving means he or she must have left someone behind and express a feeling of helplessness.

Regret

Another common theme of survivor guilt is a feeling of remorse over actions not taken. Your loved one would fixate on the notion of, "if only I had done something differently" as a desperate attempt to reclaim control and reshape the outcome.

Questioning

Conversely, your loved ones experiencing survivor guilt may fixate on actions already taken. They may question, repeatedly, the decisions they made leading up to the traumatic event and injury or loss of life. Their focus may well be on the unanswerable question of “why did I do it that way?”

Physical Symptoms of Survivor Guilt

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Survivor guilt is a complicated phenomenon that also often comes with physical symptoms. These symptoms are common when facing extreme emotional upset. So be aware as you plan for how to help veterans with survivor guilt that there could be other causes. It may not just be survivor guilt.

Some of the primary physical symptoms are difficulty sleeping, headaches, stomachaches, palpitations, or feeling numbness or disconnectedness from your body. Your loved one can also show mental signs of distress, such as an inability to sleep, recurring flashbacks to the event, irritability, and an excessive focus on the purpose and meaning of life.

Remember also that treating these individual circumstances may not alone address the underlying psychological elements of survivor guilt. That's what makes finding help for veterans with survivor guilt so difficult. The emotional and the physical often go together, according to mental health experts, so it’s important to be attentive to both.

How to Help Veterans with Survivor Guilt

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Survivor guilt is a tremendous challenge. You should not ignore the intense and painful feelings it creates. If you notice your veteran showing any signs as described above, it's time to act -- but with love. Your vet is ultimately responsible for his or her well-being, but there are good ways for you to help veterans with survivor guilt.

Give space

The grieving process can be long and complicated and is very personal. Don't impose your vision of how grief should be expressed and processed. Give your veteran the time and space he or she needs to begin to come to terms with what they’ve lost and the experience they’ve survived.

Acknowledge and listen

Probably the most important step is to be a friend. Listen to what they are saying. Don’t be too quick to jump in with a solution. Let them express whatever is on their mind, and follow their lead. More than anything, don't judge.

Promote open communication

As you seek to help veterans with survivor guilt, re-affirm that what they are feeling is a normal part of living through a traumatic event. Be open to who they are and how they want to proceed. It’s important to keep the lines of communication open, as your acknowledgment and understanding can be crucially important to healing.

Encourage professional help

Survivor guilt is a powerful and understandable emotion. You together should not try to solve all the challenges it presents at once. If your loved one continues to struggle, and shows the physical and emotional signs of survivor guilt, gently suggest professional help. Our veterans have many places to turn. You and they are never alone. In fact, that may be the most important tip for how to help veterans with survivor guilt.

One obvious place to start is to seek a relationship with a therapist, a social worker or psychologist, especially one who is well trained in helping clients in cases involving trauma. It’s also a good idea to consider resources geared toward veterans. One of those is the RealWarriors.net campaign, which is an arm of the Department of Defense. The program maintains a Psychological Health Resource Center and provides confidential support. Call 866-966-1020 to speak to trained counselors.

Resource guides fill the site. Real Warriors promotes the idea that reaching out for help is a sign of strength and not a weakness. For example, you can download a wallet card and keep it with you. Finally, if situations get to be more than you or your veteran can handle, consider contacting the Veteran's Crisis Line, staffed by professionals from the U.S. Department of Veterans Affairs. The Crisis Line focuses on suicide prevention. Call 1-800-273-8255 to reach a counselor. That is an ideal place to seek help for veterans with survivor guilt.

Tips for Veterans

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It's always painful to watch your friend or a family member suffer. But the struggle is intensified when the challenge is emotional more than physical.

As you consider how to help veterans with survivor guilt, remember that your loved ones can also help themselves. Here’s some advice we found that may help your soldier, sailor, airman, or Marine climb out of the darkness.

These involve finding alternative ways to think about your pain. It's never easy and takes constant practice. It's also not a substitute for professional help. Your military loved one should never try to go through this alone. Always have them establish trusted relationships with counselors, psychiatrists, or psychologists. That's why we included a sampling of potential resources above. In addition to that, they may be able to help themselves along by thinking differently about their situations.

Origin story

Service veterans have a good understanding of the origins of any conflicts, even as chaos reigns around them. So they should trace the story back to where it started and remind themselves who, or what, ultimately triggered the conflict. The individual servicemember didn’t cause it; they are as much a victim as anyone injured or killed in a war.

Live in the moment

One of the enduring challenges of memory is that we can always think of things we should have done differently. But if your veteran focuses too much on this, they may quickly lose sight of the fact that we all do the best we can. Nobody is able to see exactly what might happen in the future. No matter how often your loved one thinks about it, they cannot change the past.

Reverse roles

We’re always hardest on ourselves. One strategy your veteran might try is to think about what he or she might say to a cherished friend if the situation was reversed. How would you counsel them in cases involving the grief and pain of survivor guilt? If we can talk to ourselves as kindly as we speak to others, we can often work through difficult situations.

Addressing How to Help Veterans with Survivor Guilt

People who have served in conflicts have experienced enormously difficult emotional circumstances. Since their lives are upended, they often feel alone and even to blame. It's important for you to keep in mind these strategies for how to help veterans with survivor guilt.

Remember, there's no shame in getting help. It's essential to move forward and you don't have to do it alone. You're not alone, so use this information and these strategies to connect and work through this difficult time in your life.

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