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Survivor guilt (or survivor's guilt; also called survivor syndrome or survivor's syndrome and survivor disorder or 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, often feeling self-guilt.

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). It may be found among survivors of combat, epidemics, murder, natural disasters, rape, terrorism, accidents, among the friends and family of those who have died by suicide, and in non-mortal situations.

History

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. 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:

"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.

Survivor syndrome

Survivor syndrome, also known as concentration camp syndrome (or KZ syndrome on account of the German term Konzentrationslager), 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, the Rape of Nanking, and the HIV/AIDS epidemic.

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.

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.

AIDS survivor syndrome

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. While AIDS survivor syndrome has not been recognized as a pathologizable illness by the NIH (as of December 2017), scientific research and publications are available that address this issue.

Examples

Waylon Jennings

Waylon Jennings was a guitarist for Buddy Holly's band and initially had a seat on the ill-fated aircraft on The Day the Music Died on February 3, 1959. But Jennings gave up his seat to the sick J.P. "Big Bopper" Richardson, only to learn later 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.

Stoneman Douglas High School shooting

Sydney Aiello survived the 2018 Stoneman Douglas High School shooting, in which her close friend was killed. Aiello subsequently struggled with survivor's guilt, and she had been diagnosed with post-traumatic stress disorder. On March 17, 2019, Aiello died by suicide at the age of 19. Less than a week later, on March 23, 2019, Coral Springs police announced that Calvin Desir, a juvenile male student from Stoneman Douglas High School had been found dead as a result of an apparent suicide.

Stephen Whittle

Stephen Whittle was a Liverpool fan who had bought a ticket for the FA Cup semi-final between Liverpool and Nottingham Forest on 15 April 1989, but sold his ticket to a friend due to work reasons. The friend (who he and his family have left unidentified) was one of the 97 crush victims of the Hillsborough disaster at that game. Whittle subsequently developed survivor guilt, becoming unable to go to football matches due to his guilt and related feeling of responsibility for his friend's death, and committed suicide on 26 February 2011, almost 22 years after the ill-fated match.

Cultural references

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• Numerous episodes of The Twilight Zone series including "King Nine Will Not Return" and "The Thirty Fathom Grave" explored the topic of survivor guilt.
• The 1979 novel Sophie's Choice and the subsequent movie feature a Polish Holocaust survivor who had to choose which one of her two young children was allowed to survive.
• In the 1980 film, Ordinary People, based on the novel of the same name, Conrad Jarrett is a young man who struggles with surviving a sailing accident that killed his older brother. As Jarrett realizes that he is angry at his brother's recklessness, he confronts the very cause of his problems and begins to accept that his own survival had nothing to do with his brother's death.
• In a 1987 episode of Family Ties, Alex Keaton (Michael J. Fox) goes to a therapist to deal with his own survivor's guilt after a friend is killed in a car crash while running an errand that Alex refused to help with.
• The TV series Rescue Me follows the lives of firefighters post 9/11 in New York City, focusing on Tommy Gavin, a 9/11 first responder experiencing severe survivor guilt over the civilians he was unable to save and the other firefighters who died in the attack, many of whom he personally knew.
• An episode of Law & Order: UK is entitled "Survivor's Guilt" and involves one character coping with how his colleague was shot while he survived because he was called away to see his new grandson.
• The 2005 film Stay explores survivor guilt.
• This phenomenon is also referenced several times throughout Kendrick Lamar's 2015 album To Pimp a Butterfly.
• Rise Against, a popular punk band, released a song named "Survivor Guilt" on their 2011 album Endgame.
• In the Hunger Games series, protagonist Katniss Everdeen feels survivor's guilt due to her and Peeta's surviving the games.
• In Doctor Who, the Doctor is apparently responsible for ending the Time War by erasing his home planet Gallifrey. Being the only survivor of his species in the entire universe, he develops survivor's guilt as part of the trauma, which is openly addressed in the episode "Before the Flood".
• Batman's main motivation for fighting crime is an unresolved survivor guilt after a mugger murdered both his parents.
• The Lone Ranger was the sole survivor of an ambush, for which other members of the Texas Rangers (including his brother) were killed, which compelled him to continue the work of his fallen comrades.
• In the 2004 sci-fi action film I, Robot, Will Smith's character of Det. Spooner has survivor's guilt.
• In the TV show Arrow, the main character, Oliver Queen, has survivor's guilt in the episode "Three Ghost".
• In The Book Thief by Markus Zusak, Max Vandenburg displays signs of survivor's guilt in the chapter known as "A Brief History Of The Jewish Fist Fighter".
• In the 2006 movie We Are Marshall, Matthew Fox, Anthony Mackie, and Brian Geraghty all play members of the 1970 Marshall football team who were not on the plane when their team plane crashed. Fox played Red Dawson, a coach who gave his seat on the plane to another coach, Mackie played Nate Ruffin, a player who was injured and did not make the trip, while Geraghty played Tom Bogdan, a player who overslept and missed the flight. All are haunted by feelings of guilt that affect them long after the crash, into their later lives.
• In an episode of TV show Hawaii Five-0, Danny Williams mentions that his life since the September 11 attacks is all "borrowed time", when he and his then-partner Grace Tillwell raided a gang warehouse (without having told anyone about it) in the early morning hours of September 11, 2001, and were tortured by the gang members, who then killed his partner, and were about to proceed on him before being distracted by the sound of sirens outside, allowing Danny to break free and kill the gang members, before running outside to try and flag down a police car, only to see them speeding towards a huge billow of dark smoke.
• In the first season finale of The Cleveland Show, Cleveland Brown mourns the death of his cruel first wife, Loretta, due to her dying from crashing onto the ground in the bathtub, despite the fact that he survived every time it happened to him during Peter Griffin's shenanigans.
• Following the catastrophic June Rebellion, Marius of Victor Hugo's Les Misérables and the musical based on it appears to have Survivor's Guilt, highlighted in his solo Empty Chairs at Empty Tables.
• Survivor guilt is explored in the Stephen King short story "The Things They Left Behind". The main character Scott Staley called in sick from his job at the World Trade Center on the morning of 9/11 in order to enjoy a day off in the sunny spring-like New York City weather that occurred that day. Almost a year later, personal belongings of co-workers who died in the tower begin showing up unexplained in Scott's apartment, accompanied by the haunting voices of their owners.
• In Senki Zesshou Symphogear, the protagonist Tachibana Hibiki suffers from survivors guilt after being one of very few survivors of a huge massacre at a stadium event. Moreover, she is blamed and aggressively attacked by people, who grieve over others lost at the same event, for surviving. As the aggression intensifies, it causes to break her family apart.
• Survivor guilt is a central theme of Alice: Madness Returns. Alice has survivor's guilt after her family's death in a fire, with her guilt transforming Wonderland into a dark and dangerous place.
• In the novel Beloved by Toni Morrison, a former slave named Sethe imagines that she is haunted by the ghost of her baby which she killed to prevent her from getting caught and growing up in slavery. The ghost represents her guilt over the murder and her survival.
• In the 2019 film All the Bright Places, the main character Violet Markey’s survivor guilt is explored extensively as she attempts to heal from the fatal car accident that took her sister.
• In the book Harry Potter and the Half-Blood Prince, It's mentioned to Harry that Tonks may be sad over Sirius' death because she has survivor's guilt.
• In the TV show Pose, the character Angel Vasquez-Evangelista has survivor's guilt discussed in the episode "Something Old, Something New." Her survivor's guilt surrounds being a trans woman who continues to live and thrive, when her friend and sister Candy was killed and fell victim to the high rates of murder and violence against transgender women of color.
• In the final episode of the Netflix South Korean Survival Drama series Squid Game, the protagonist Gi-hun suffers from survivor's guilt after being the winner and sole survivor of a deadly competition in which 456 players compete in a series of children games for a grand prize of 45.6 billion Won (US$38 million) and the losers are eliminated.

See also

• Miklos Kanitz
• Post-traumatic stress disorder
• Stockholm syndrome
• Survivors' Staircase
• Survivorship bias

References

1. JoNel Aleccia, "Guilty and stressed, layoff survivors suffer, too", NBC News, December 15, 2008
2. "1987: Zeebrugge disaster was no accident". BBC News. 8 October 1987. Retrieved 15 May 2010.
3. Bonnie S. Fisher, Steven P. Lab. Encyclopedia of Victimology and Crime Prevention, SAGE, 2010, p. 33, ISBN 978-1-4129-6047-2
4. Ryn, Z (February 1990). "The evolution of mental disturbances in the concentration camp syndrome (KZ-syndrom)". Genet Soc Gen Psychol Monogr. 116 (1): 21–36. PMID 2184095.
5. Walt Odets, "In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS", 1995.
6. Lebovic, Matt; Gross, Judah Ari (18 January 2020). "The only novel written at Auschwitz is finally to be published in English". The Times of Israel. Retrieved 2020-01-21.
7. Raphael Beverley, (1986). When disaster strikes. pp. 90-91. Century Hutchinson, London.
8. Wilson JP, & Raphael B Editors. Theoretical and Conceptual Foundations of Traumatic Stress Syndromes. The International Handbook of Traumatic Stress Syndromes, p. 1. Plenum Press, New York. 1993.
9. "What is AIDS Survivor Syndrome – Lets Kick ASS". Lets Kick ASS. 2016-08-08. Retrieved 2017-11-30.
10. Broun, Stacy N. (1998-06-01). "Understanding "Post-AIDS Survivor Syndrome": A Record of Personal Experiences". AIDS Patient Care and STDs. 12 (6): 481–488. doi:10.1089/apc.1998.12.481. ISSN 1087-2914. PMID 11361996.
11. VH1's Behind the Music "The Day the Music Died" interview with Waylon Jennings.
12. "Waylon's Buddy: Jennings Never Forgot His Mentor". CMT.
13. "Parkland survivor takes her own life just more than one year after deadly mass shooting". Aol. News. March 22, 2019.
14. Madan, Monique (24 March 2019). "Second Parkland shooting survivor kills himself, police confirm". Miami Herald. Retrieved 24 March 2019.
15. Bertman, Sandra L. (1999). Grief and the healing arts: creativity as therapy. Baywood. p. 166. ISBN 978-0-89503-198-3.
16. Corr, Charles A.; Balk, David E. (2010). Children's encounters with death, bereavement, and coping. Springer. p. 210. ISBN 978-0-8261-3422-6.

Further reading

• Encyclopedia of Stress, Academic Press; 1st edition (April 2000)
• Diagnostic and Statistical Manual of Mental Disorders IV, American Psychiatric Publishing; 4th edition (June 2000)

• Symptoms and signs of mental and behavioural disorders
• Post-traumatic stress disorder
• Aftermath of war
• Guilt