Let's Talk About It: Breast Cancer (Survivor’s Guilt)

The question of “Why me?” often exemplifies the experience of survivor’s guilt. Feeling survivor’s guilt is more common than you may think and can be triggered in different ways. Your positive news at a follow-up visit, regaining strength when treatment ends and manageable side effects are all events that may counter-intuitively lead to stress or even shame. Feeling the sting of hurt when others share good news and you feel the anguish of your losses, by comparison, can be hard to acknowledge and know how to manage. The loss of a fellow survivor naturally gives rise to grief which can be compounded by guilt. Let’s Talk About It.

1. SURVIVOR’S GUILT
Julie Larson, LCSW - www.julielarsonlcsw.com

2. SURVIVOR’S GUILT IS A DEEP FEELING OF
GUILT OFTEN EXPERIENCED BY THOSE WHO
HAVE SURVIVED A CATASTROPHE THAT
TOOK THE LIVES OF OTHERS. IN PART FROM
FEELINGS OF BEING UNWORTHY RELATIVE
TO THOSE WHO DIED.
Julie Larson, LCSW - www.julielarsonlcsw.com

3. SURVIVORS
GUILT
§UNDER-RECOGNIZED
§LITTLE STUDIED
§RARELY DISCUSSED AS A
CONSEQUENCE OF
SURVIVAL
§DISMISSED
§MINIMIZED
Julie Larson, LCS - www.julielarsonlcsw.com

4. BUT… IT’S SO MUCH
MORE
§LOSS OF A FELLOW CANCER SURVIVOR
COMPANION
§NEWS OF A RECURRENCE IN A FELLOW SURVIVOR
§BEING AN EARLIER STAGE RELATIVE TO FELLOW
SURVIVORS
§HAVING FEWER OR LESS INVASIVE TREATMENTS
§RECEIVING “GOOD NEWS” IN THE PRESENCE OF
OTHERS
§NOT DOING CANCER “WELL”
§NOT BEING “ENOUGH” OF A SURVIVOR
§NOT HAVING AN EPIPHANY OR LIFE-CHANGING
MOMENT
Julie Larson, LCS - www.julielarsonlcsw.com

5. SURVIVOR’S GUILT DECODED
EmpathySadness
GriefAnxiety
PressurePTSD
This Photo by Unknown Author is licensed under CC BY
Julie Larson, LCS - www.julielarsonlcsw.com

6. WHY? WHY? WHY? WHY?
WHY NOT ME?
Julie Larson, LCSW - www.julielarsonlcsw.com

7. THE “WHY ME”
STRUGGLE
•MANY SURVIVORS STRUGGLE TO UNDERSTAND
WHY THEY SURVIVED, AND OTHERS HAVE NOT.
•NOT WORTHY OF SURVIVAL (DOING WELL)
•FEELINGS OF RELIEF OR APPRECIATION FOR
SURVIVAL/HEALTH ALONGSIDE SHAME OR
GUILT FOR THOSE FEELINGS.
•FEELING SHAME FOR PERSONAL STRUGGLE IN
THE PRESENCE OF OTHERS WITH MORE
ADVANCED DISEASE.
•NOT NECESSARILY A SIGN OF UNHEALTHY
GRIEF
•WHEN THE FEELINGS BECOME INTRUSIVE, SEEK
SUPPORT
Julie Larson, LCSW - www.julielarsonlcsw.com

8. AM I GRIEVING?
RECOGNIZING SYMPTOMS
§CRYING
§LACK OF ENERGY
§UNCERTAINTY
§CHANGES IN SLEEPING OR EATING HABITS
§FEELING WITHDRAWN OR UNMOTIVATED
§IRRITABLE, DEMANDING, UNDERLYING “BUZZ” OF ANGER
§HYPERACTIVITY, FEAR OF SLOWING DOWN
§DECREASED PRODUCTIVITY, TROUBLE CONCENTRATING
§AVOIDANCE OF OTHERS OR FEAR OF BEING ALONE
Julie Larson, LCSW - www.julielarsonlcsw.com

9. WHAT CAN I DO?
ACCEPTANCE – GUILT IS A NORMAL FEELING.
STIGMATIZED AND OFTEN MADE TO FEEL WRONG FOR
FEELING.
YOU ARE NOT ALONE – MORE COMMON THAT
ACKNOWLEDGED.
TWO FEELINGS CAN EXIST AT ONCE – GRIEF AND
APPRECIATION FOR YOUR LIFE CAN BE EXPERIENCED
TOGETHER.
ALLOW FOR GRIEF RESPONSE – HONOR WHAT YOU
HAVE LOST.
“WHAT IS” VS. “WHAT IF/WHY”? – ENGAGE WITH THE
PRESENT MOMENT, CATCH WHEN THE PAST OR FUTURE
DISTRACT YOU FROM RIGHT NOW.
This Photo by Unknown Author is licensed under CC BY-SA
Julie Larson, LCSW - www.julielarsonlcsw.com

10. THROUGH THE MIDDLE OF GRIEF…
Julie Larson, LCSW - www.julielarsonlcsw.com

11. TOXIC
POSITIVITY
FROM
OTHERS
§SHUTS DOWN THE CONVERSATION
§FOCUS ON PROBLEM SOLVING OR FIXING
§AVOIDS DISCOMFORT
§MISUNDERSTANDS THE PRESENCE OF MORE THAN ONE
FEELING
§MISSES AN OPPORTUNITY FOR REAL CONNECTIONJulie Larson, LCSW -
www.julielarsonlcsw.com

12. TOXIC POSITIVITY FROM YOURSELF
§FEELING GUILT OR SHAME FOR
STRUGGLING
§“SHOULDS” (WITH FEELINGS OF
SHAME)
§COMPARING TO OTHERS (LACED WITH
SELF CRITICISM)
§RIGID EXPECTATIONS OF SELF
§MINIMIZING OR DISMISSING STRUGGLE
§PRETENDING YOU ARE OK WHEN YOU
FEEL DIFFERENT.
Julie Larson, LCSW - www.julielarsonlcsw.com

13. SELF CARE
§MANY SURVIVORS WITH GUILT FEEL A STRONG
NEED TO FIND MEANING FOR THEIR SURVIVAL.
§CRITICALLY THINK ABOUT WHAT YOU ARE/FEEL
CAPABLE OF DOING TO SUPPORT OTHERS.
§IS THERE SOMEONE YOU TRUST WHO CAN
MENTOR AND SUPPORT YOU IN NEW
VENTURES.
Julie Larson, LCSW -
www.julielarsonlcsw.com

14. •MEANING AND PURPOSE OF WELLSPRINGS OF
HOPE.
•WHEN WE RECOGNIZE OUR VALUE TO
SOMEONE (OR SOMETHING) ELSE IT GIVES US A
PLACE TO FOCUS THAT IS OUTSIDE OF OUR
UNCERTAINTY.
•HOW DOES THE LIFE AROUND YOU STILL NEED
YOU DESPITE THE UNCERTAINTY YOU FEEL?
Julie Larson, LCSW - www.julielarsonlcsw.com

15. §LISTEN TO YOURSELF. COME TO UNDERSTAND
WHAT YOU ARE FEELING, THINKING AND
NEEDING.
§LEARN HOW TO CARE FOR YOURSELF.
§DECIDE WHO THE BEST AUDIENCE IS FOR YOU
TODAY RELATED TO WHAT YOU NEED TO
EXPRESS.
§KNOW YOUR EMOTIONAL “HOT SPOTS”.
§REACH OUT TO GOOD FRIENDS OR A THERAPIST
TO HELP YOU BETTER UNDERSTAND YOUR
FEELINGS AND SUPPORT YOU AS YOU
Julie Larson, LCSW - www.julielarsonlcsw.com