Survivor’s guilt is a psychological response in which a person who has survived a life-threatening event feels guilt, shame, or a sense of undeservedness about having survived when others did not, or when they perceive that their survival came at a cost to others. In the context of cardiac arrest, it can take several forms and is more common than is often recognised.
How it manifests in cardiac arrest survivors
Survivor’s guilt after cardiac arrest is not always about other cardiac arrest victims. It may involve:
- Guilt about the distress caused to the person who performed CPR, particularly if that person was a family member or child
- Guilt about the emotional and practical burden placed on a partner, parent, or carer during the recovery period
- Guilt about workplace colleagues who had to cover responsibilities during a lengthy absence
- A sense of not deserving to have been rescued, particularly if the survivor has complicated feelings about their own life, purpose, or value
- For those who have lost other cardiac arrest victims they have met through peer support, guilt about being alive when others were not
Connection to PTSD and depression
Survivor’s guilt frequently overlaps with PTSD and depression. It can fuel rumination, self-blame, social withdrawal, and low self-worth. If left unaddressed, it can significantly hinder recovery and the willingness to accept support.
Why it is not rational to dismiss it
Survivor’s guilt is not a logical response, but telling someone it is irrational rarely helps. The feelings are real and the emotional experience is valid, even when the logic behind it is not. Acknowledgement and compassionate exploration of the feelings is more effective than reassurance alone.
Support
Psychotherapy, particularly approaches that work with shame and self-compassion (such as compassion-focused therapy or trauma-focused CBT), can be highly effective. Peer support groups, where survivors meet others who share similar experiences, can also significantly reduce feelings of isolation and undeservedness.
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