The Widow's Handbook: winner of the Helen Bailey Award 2022
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Survivor guilt: Why not me?

29/11/2022

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Survivor guilt is the guilt that people feel when they are the one left behind after a death. It could be for surviving the accident that killed them. It could be what you felt you should or shouldn't have done before their death. Or it could simply be that they were ill and you were not. Around 90% of people who survive a traumatic event experience survivor guilt.
 
The kinds of symptoms of survivor guilt overlap with those seen with post-traumatic stress disorder (PTSD), and survivor's guilt has been defined as a symptom of PTSD.

  • Guilt for surviving
  • Flashbacks, nightmares and intrusive thoughts
  • Constantly thinking and analysing what happened
  • Wondering what might have happened had things been different – the What Ifs
  • Anger, mood swings and irritability
  • Anxiety
  • Appetite changes
  • Problems sleeping
  • Feeling confused, helpless or disconnected, or having trouble concentrating
  • Physical symptoms, like nausea, stomach-aches and headaches
  • Lack of motivation, depression, despair or suicidal thoughts
  • Desire for isolation
  • Feeling like you can't trust anyone
  • Feeling that you are a bad person and that you are responsible for what happened (even if you weren’t)
  • Feeling that you didn't deserve to be alive
  • Seeing the world as unjust, unfair, cruel or dangerous
 
People who have been through trauma before, who live with mental health, addiction or psychiatric issues, or who lack self-esteem, are introverted or are submissive by nature may be more likely to experience survivor guilt.
 
Survivor guilt generally starts to fade over time. There are a few hints and tips that might help you cope with the feelings:

  • Understand that while the feelings aren't logical, and often aren't true, they are normal, and you are allowed to feel like this
  • Try to process your feelings of grief or guilt
  • Think about the outside factors that may have caused the situation, which might help you to put things in perspective
  • Try to forgive yourself for any role that you played in the situation
  • Talk through how you feel with friends, family or people in your grief support groups
  • Write about how you feel or create some art
  • Be kind to yourself – go for a walk, read a book you love, watch a film you enjoy, listen to music, have a warm bath
  • Try not to resort to self-medication through drugs or alcohol
  • Do something that helps other people – volunteer, give blood, work to improve your local community
 
If your survivor guilt symptoms become overwhelming and mean that you can't function properly, consider talking to a psychotherapist or counsellor.
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What if?

1/8/2022

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There are so many 'what ifs' after we lose someone
  • What if I'd given them a lift?
  • What if I'd noticed their cough?
  • What if I'd gone instead of them?
  • What if I'd looked after them better?
  • What if I'd seen the signs?
  • What if I'd sent them to the doctor's?
  • What if they'd seen a different doctor or had a different surgeon?
  • What if they'd left earlier, left later, hadn't gone at all?
  • What if I had, or what if I hadn't?
  • What if they'd worn a helmet?
  • What if I'd loved them more?
  • What if I had told them to stop drinking, or eat more healthily?
 
I've looked back over some old posts of mine on the Widowed and Young Facebook forums (WOC is short for the Widowed and Young Without Children group).
I have managed to avoid the what ifs so far. Coming up to 14 weeks, they are fighting their way in. He was tired and sometimes out of breath but he was doing a lot of lifting and carrying - what if that was early signs of heart failure and not just him overdoing it. What if the rough night on that last night wasn't just one of his frequent stomach bugs and was the early signs of his heart stopping. What if...
23 May 2018 -14 weeks after his death
 
Having a bit of a wobbly week. Struggling with an upsurge in the guilt and what ifs about Tim's death - what if I had noticed he was more tired, what if I had insisted that we got more help moving books from one storage to another.
Nov 2018 – nine months after his death
 
Can I have a WOC hug, please? Doing a lot of clearing out at the moment. Been shredding paperwork and this morning it was Tim's medical paperwork from some years back. He had hyperlipidaemia and type II diabetes and had an angiogram some years ago. It's brought back the few months before he died, when he was starting to get tired. At the time I though he was just working too hard (we were moving books from one storage unit to another) but now I see that it was the beginning of his heart failure. I am hypersensitive at the moment as I am just a few weeks away from his second anniversary, but I am having major attacks of 'what if...'
Feb 2020 – two years after his death
My mental and health physical health weren't good in the few months before Tim died. What if that was the reason he didn't tell me he felt ill, or the reason I missed it? Or what if being ill meant that I made his last few months unhappy?
 
Coping with the what ifs
I believe that we get these feelings because our brain is trying to explain things, and attempting to deal with our feelings of helplessness. A fellow WOC said to me "what ifs are like demons on the shoulders of our grief, whispering in our ears at times when we are most vulnerable". What comforts me is that Tim and I loved each other, and that he died at my side.
 
When we get what ifs, it's important to remember that hindsight is 20/20, and what-ifs are generally completely unrealistic. It's like looking at a puzzle – when you first glance at it, it seems unfathomable, but once you have the answers it seems so obvious.
 
When you get caught in what ifs and if onlys:
  • Be kind to yourself
  • Learn to recognise what ifs for what they are - nasty weaselly thoughts that invade your head
  • Say to yourself:
    • That was then and this is now
    • I did the best I could based on what I knew at the time; if I could have done differently I would have
    • I was not the person controlling the situation
    • It was not my fault
    • It was not something I did intentionally
    • I was not a mind reader
    • I am not a doctor​
    • They could have made the decision to go to the doctor or change their diet
  • Deal with them as you would other intrusive thoughts, for example using grounding techniques
  • Do something you enjoy or that brings you comfort
  • Do something physical – go for a walk, a run or a swim, dig the garden, clean the bathroom
  • Drown out the thoughts with music, audiobooks or podcasts
  • Visualise slamming the door on the thoughts, or stamping on them
  • Write the thoughts down and tear them up or scribble them out
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    Author

    I was widowed at 50 when Tim, who I expected would be my happy-ever-after following a marriage break-up, died suddenly from heart failure linked to his type 2 diabetes. Though we'd known each other since our early 20s, we'd been married less than ten years. ​

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