Dealing with Guilt - Final Presentation.pptx

Dealing with Guilt - Final Presentation.pptx

1. Dealing with Guilt

2. Guilt- The Crippling Emotion ASK YOURSELF All of you people present here, please take a moment and think of one thing you still feel guilty for. Now think about how it still effects you on a conscious or sub-conscious level. Have you tried to silently ‘compensate’ for it? Does it weigh you down? Do you feel the need shed it off but find it hard to do so?

3. Guilt is defined as A feeling of responsibility or remorse for some offense, crime or wrong behavior whether real or imagined. This may then lead to a sense of having to pay a debt or repair something. In more severe forms of guilt we may feel that we need to be punished. Clinically, the distinction between real and imagined acts is crucial. Someone may feel guilty about something they have actually done or about something they imagine they have done or something they simply thought about.

4. The many faces of Guilt There are several types of guilt, including but not restricted to: Pain or hurt caused to 3rd parties – e.g children caught in a divorce Infidelity to our own values and beliefs – e.g , initiating a divorce when commitment is a major value Referred – e.g , victim of abuse internalizing responsibility Social or cultural – e.g , drinking alcohol in an Islamic country 3rd party values – e.g , not living up to parental expectations False or pseudo, the idea that what you feel must be true – e.g , if I feel guilty them I must be guilty. Helplessness or empathy-based– e.g , we see someone else in pain but are unable to help despite our empathy Practical – e.g , transgression of law or regulation, particularly when not found out.

5. Problems with guilt: Clinical manifestations Guilt might turn into Depression- when internalized Anxiety or social phobia- when personalized guilt turns into shame Obsessive compulsive Disorder- when guilt is overcompensated for Conversion Disorder- when the guilt is not expressed. Survivor Guilt- when one survived a traumatic event while others didn’t. Addiction/ Substance use- when avoided. Suicidal ideation- when its not resolved.

6. Guilt and Blame Attribution One of the indigenous manifestation of guilt could be a woman going through a miscarriage and her guilt takes a form of blame attribution directed towards herself ( Batool and Azam , 2016) In a qualitative study a woman expressed similar emotions ( Batool and Azam , 2016), “My father arranged a religious ceremony at home. People were invited to recite holy Quran there. I refused to go there due to a personal reason, and I had a miscarriage on the same day. I had to bear this loss because of refusing to recite Quran….. I am a sinful person, God is angry with me. ( Asma , 23 years)”

7. Guilt and over-compensation In a research study the content of obsessions was studied in a sample of 113 participants diagnosed with OCD, predominantly having religious obsessions, blasphemous thoughts and obsessions regarding the idea of ‘ Napaki ’ for which the compulsions served as the compensatory behaviors sometimes by means of excessive praying to compensate for thoughts that cause conflict with religiosity or sometimes by excessive hand/body washing ( Saleem and Mahmood, 2016). The percentage of reported guilt was 85.84 % among these patients.

8. Case study Salma is a 26 year old female admitted in a psychiatric facility presenting with loss of sensation in the lower side of her body starting just below her chest. She reports frequent muscle aches and an episode prior to the current episode where she could not talk even when she tried. She has been tested for any organic cause for the symptoms and has had an MRI done as well but there were no abnormalities that could explain the symptoms. Upon probing, the stressor was identified that could be causing the conversion symptoms. She revealed that she had secretly married a man and she had conceived shortly afterwards, for which she had to undergo an abortion. No-one in her family knew about this and it was becoming hard to keep the secret along with the stress. She mentioned feeling guilty for ‘killing’ her child and that there was no redemption for what she has done

9. Therapeutic approaches to deal with guilt Cognitive Behavior Therapy Eliciting the thoughts Self monitoring Evaluating and challenging the thoughts Blame Pie Attaching meanings to events Defense Attorney Role playing with both sides of the thought Evaluating assumptions and rules Evaluating the value system

10. Continued Evaluating worries Time machine Looking at it from the balcony Schema focused therapy Identifying schema compensation and avoidance Activating early memories that are schema sources Writing letters to the source Emotional Processing techniques Written ventilation

11. Continued Narrative Therapy Re-authoring/Re-storying (re-establishing the meaning assigned to things/events) Deconstruction- ( chunking the big problem down into smaller much more manageable problems and sorting it one by one) Externalization (you are not the problem, they problem is the problem) Visualization (imagining what your life would be like in a week, 2 months or 2 years from now and embracing new meaningful directions moving, past the past) Outcomes- (transforming problem-saturated narrative into resilience-rich meaning)

12. Thankyou