Kenneth J. Doka Ph.D.
When Marie began counseling, her conversation was filled with “if onlys.” If only I had brought him to the doctor sooner. If only I could get him to stop smoking. If only I had been more patient as I was caring for him in his final days.
Of all the emotions we experience in grief, guilt can be one of the most common and most corrosive. Guilt can gnaw at us—troubling our already raw grief. And studies have shown that excessive amounts of guilt can lead to complicated forms of grief.
Like Marie, we can feel guilty about many things. In fact, two researchers, Alice Demi and Margaret Miles, identified six different types of guilt. One form is “death causation” guilt. Here we may feel guilty that our acts of omission or commission caused the death. If only I had brought him to the doctor sooner. If only I could get him to stop smoking. These feelings may not be rational but they are real. We sometimes imagine that we have much more control over events than we really do.
Other times, we may feel guilty over our role. In “role” guilt, we wonder if we could have been more patient or caring. We fret over what we said—perhaps in anger or frustration—or what we failed to say. We feel guilty that we were not a better brother, sister, mother, wife, husband, or friend.
Sometimes we may even experience “moral guilt”—feeling guilty that whatever happened was a punishment for something we had done—feeling God, or some sort of bad karma was punishing us for some past offense by our loss. We may even feel guilty that we survived, that we are still living, when someone we loved died—”survival guilt.”
Our grief may be a source of grief as we feel we are not grieving enough, or grieving too much, or not grieving in what we perceive to be the right way. Miles and Demi label these forms of guilt as “grief” and “recovery” guilt.
So how do we handle our guilt? First, it helps to understand that such feelings are part of the grief journey. By acknowledging our feelings are natural, we become less afraid to explore or even share these difficult emotions.
Sometimes sharing our grief and our guilt in a group setting can be therapeutic. As we share, we recognize not only that others too experience guilt; we learn how to cope with such difficult feelings.
Exploring our guilt can also help. Often when we really examine our guilt, we find it has little basis. Marie learned that as we spoke about how she could have stopped her husband from smoking. She had pleaded, cajoled, and even offered to accompany him to a cessation program. As I gently challenged her on what else she could have done, she was able to accept that only her husband had power over whether or not he ceased smoking.
Other times we can do something to ease our guilt. It may be writing a letter to the deceased, or speaking at graveside. Sometimes we can do a symbolic act or participate in a ritual. Marie, for example, made a contribution to a cancer group to assist in a prevention campaign.
Finally, if our guilt continues to trouble us, we may find it helpful to speak to someone who can offer perspective and comfort such as a counselor. The journey of grief is difficult enough. We do not need to undertake it laden with guilt.
Miles, M. & Demi, A. (1992). A comparison of guilt in parents whose children died of suicide, accident, and chronic disease. Omega: Journal of Death and Dying, 24, 203-215.