Survivor Guilt: Why Me? After Earthquakes and Accidents

What is survivor guilt and why does it happen? Signs, practical suggestions and ways to get support for those who survived an earthquake or accident.

"Our building stayed standing; the block opposite was flattened. Everyone says 'Thank God' to me, but I can't feel thankful." After the 6 February 2023 earthquakes, we heard this sentence many times, in many different forms. Some people who come out alive from a disaster, an accident or an event in which others lost their lives experience heavy guilt instead of the relief of having survived. Survivor guilt is an experience intertwined with grief and trauma that shows itself through thoughts such as "Why them and not me?", "I don't deserve to live" and "I could have done more." In this article I look at what this feeling is, why it arises, how it appears in everyday life and the ways of learning to live with it.

What Is Survivor Guilt?

This concept describes the feeling of guilt and injustice a person experiences because they came out alive, or relatively unharmed, from an event in which others died or were seriously harmed. It is not a separate diagnosis; it is often seen as part of post-traumatic reactions, complicated grief or depressive symptoms.

There may be no logical explanation for this feeling. The person knows that the earthquake damage came from the ground the building stood on, or that the accident came from the speed of the other vehicle. Even so, a voice inside keeps saying, "You were saved and they weren't; that isn't fair." This voice opens a deep gulf between what the mind knows and what the heart feels.

This guilt can take different forms:

• Guilt about existing: The question "Why am I alive?"; feeling that being alive is an unfair privilege.
• Guilt about what was or wasn't done: "I could have got them out too", "Why didn't I open the door?", "If only I had been driving"...
• Guilt about being lucky: The discomfort felt by people whose home stayed intact, who were out of town that night or who changed their plans at the last minute.

Why Do We Ask "Why Me?"

The human mind searches for meaning. A disaster that seems random shakes the belief that "The world is a fair place; bad things don't happen to good people." When this belief collapses, the mind tries to find a reason that explains the event. Blaming yourself is painful; but strangely, it can feel more bearable than accepting that what happened was entirely random. Because guilt makes us feel as if we could have controlled something.

Then there are the difficult decisions made in the moment itself. Which voice under the rubble to turn to first, whom to give first aid to after a crash, whose hand to grab in floodwater: decisions made within seconds like these can be questioned for months afterwards. They were usually made in impossible conditions; yet the mind judges them as if they had been made calmly at a desk.

Guilt is also an extension of love and attachment. The bond we feel with the people we have lost can lead us to perceive our life continuing without them as a kind of betrayal. Laughing, making plans, moving into a new home, even eating a hot meal can be overshadowed by the thought "They can't do this."

In Turkey this feeling is sometimes fed by cultural expressions as well. Well-meaning sentences such as "God protected you in their place" or "Your time hasn't come yet" can, for some people, turn surviving into a debt they must earn: "Since I was saved, I have to do something to deserve it." This thought can push a person to keep proving themselves and to forbid themselves rest and enjoyment.

Surviving is not a crime but an outcome; guilt is often the painful face of the love you feel for the people you have lost.

Who Experiences This Feeling?

This feeling is not limited to major disasters. In clinical practice it comes up through a range of experiences:

• Earthquake and disaster survivors: People pulled from the rubble, people who lost some members of their family, or people whose own home was undamaged while their neighbours lost their lives.
• Survivors of road or workplace accidents: Those who were in the same vehicle or on the same shift and lost a friend.
• People who have survived a serious illness: Those who recovered while some of the patients treated on the same ward lost their lives.
• Search and rescue workers and healthcare staff: Those who cannot forget the people they could not save.
• Those who migrated and those left behind: People who were able to leave a war or disaster zone while part of their family stayed there.
• Those watching from afar: People who were not in the earthquake zone but feel guilty for spending that night in their warm home.

Let us say a university student spends the night of the earthquake not in their halls of residence room but at a cousin's house, revising for an exam. The halls are badly damaged and their roommate loses their life. Even months later, meeting a new roommate, or even getting a good mark in an exam, unsettles them rather than making them happy. The question "What would have happened if I had been there that night?" keeps spinning in their mind in a loop with no answer.

Signs: How Does This Guilt Show Itself?

Although this experience varies from person to person, there are some common signs:

• Constantly replaying the event and the "if onlys" in your mind
• Experiencing a sudden wave of sadness or guilt in happy moments
• Avoiding celebrations, religious holidays and birthdays
• Neglecting your own needs, even behaving as if you are punishing yourself
• Feeling ashamed to meet the relatives of those who were lost, or hiding from them
• Seeing yourself as worthless, as someone who doesn't deserve to live
• Sleep problems, nightmares, changes in appetite
• Excessive self-sacrifice; constantly working for others and leaving no room for yourself

These signs do not on their own amount to a diagnosis. However, if they persist for a long time and noticeably affect daily life, an assessment by a professional with regard to post-traumatic stress, complicated grief or depression is important.

Anniversaries, Holidays and Happy Moments

This guilt often intensifies at the most unexpected moments. Many people find their sleep disrupted as February approaches, or feel their stomach knot when they see the word "anniversary" on news sites. An empty chair at the bayram (religious holiday) table, a wedding invitation, even the birth of a baby can stir up the thought "They didn't get to see this."

For this reason some people forbid themselves joy: they don't go on holiday, don't buy new clothes and avoid sharing a happy photo on social media. The thought "It would be shameful for me to laugh" combines, especially in small communities where everyone knows each other, with worry about what others will say. Yet feeling joy does not mean forgetting those who were lost. The two can sit side by side in the same heart.

You may also find helpful the article on grief and guilt, where I look in more detail at how guilt becomes intertwined with grief after a loss.

What Can You Do to Cope with Survivor Guilt?

The suggestions below are not intended to make the guilt disappear in an instant, but to help you build a gentler relationship with it.

1. Separate responsibility from guilt

On a sheet of paper, draw two columns: "Things within my control" and "Things outside my control". The soundness of the building, the time of the earthquake, the speed of the other vehicle and the course of an illness go into the second column. When they write this list, most people see that most of what they blame themselves for was actually beyond their control.

2. Think "with what I knew at the time"

Looking back, because we know how the event ended, we see the options we had at the time far more clearly than they really were. Ask yourself: "At that moment, with that information, in the grip of that fear, what could I have done?" This question makes visible how unfair it is to judge yourself with knowledge gained afterwards.

3. Build an inner dialogue with the person you lost

Writing a letter to the person you lost, or thinking about what they would say to you, can be a powerful experience. Most people know that someone who loved them would not say "I wish you had died too", but rather "Live, live for me too."

4. Turn remembrance into a meaningful act

Directing guilt towards remembrance rather than self-punishment can be healing. Planting a sapling in the name of the person you lost, contributing to a charity they cared about, carrying on one of their habits, or getting together with those who loved them on the anniversary are examples of this.

5. Allow yourself joy in small steps

Having tea with a friend, listening to music you love, going for a walk... If guilt arrives in these moments, don't try to push it down; you can say to yourself, "Right now I am both missing them and enjoying this moment."

6. Don't carry it alone

Talking with people who went through the same event strengthens the feeling that "I am not the only one who feels this." However, it is important that this sharing happens at your own pace, in a setting that will not shake you all over again.

7. Don't neglect your body's basic needs

People who feel guilty often regard looking after themselves as a privilege too: they skip meals, don't mind putting off sleep and neglect health check-ups. Yet regular sleep, nourishing meals and short walks form the ground the mind needs in order to carry this heavy feeling. Looking after yourself is not turning your back on those you lost; it is preserving the strength to remember them.

How can the people close to you help?

Those around you often don't know what to say and try to console you with sentences like "Look, you survived, be thankful." Instead of easing the guilt, these sentences can deepen it. What helps more is listening without trying to fix the feeling, being able to say "That must be so heavy to carry" and being there in practical matters. If someone close to you is going through this feeling, suggesting small, quiet get-togethers rather than pushing them into crowded celebrations can also be good for them. If you are the one experiencing it, don't hesitate to tell the people close to you what you need; most people want to help but don't know how.

When Should You Seek Professional Support?

If the feeling of guilt is not easing as the months go by but is instead growing, and if it noticeably affects your work, your relationships and the way you look after yourself, it is important to get support from a professional. The following situations in particular call for attention:

• The thought "I should have died too" becoming frequent and intense
• Thinking about harming yourself or ending your life
• Turning to alcohol or other substances
• Being unable to sleep or eat for a long time
• Withdrawing completely from the relatives of those who were lost and from the community

This feeling can sometimes turn into a sense that life is meaningless. If you are having thoughts of harming yourself or ending your life, please call 112 (emergency services) without waiting and let someone near you know. Whether medication is needed is decided by a psychiatrist.

How Is Survivor Guilt Addressed in Therapy?

The first goal in therapy is to listen to the guilt without judgement and to acknowledge the magnitude of the loss the person has experienced. Many clients feel great relief when they hear, for the first time, the sentence "It is understandable that you feel this."

In cognitive behavioural therapy, the thoughts that feed the guilt are examined in detail: what information the thought "I could have saved them" is based on, what options were really available at that moment, and which part of the responsibility belongs to the person and which to the circumstances are assessed together. Traumatic memories can be worked through within a safe framework during this process. With some clients we draw a "responsibility pie" to see how much of the guilt truly belongs to them: every factor that played a part in the event, from building inspections to the weather, from the other driver to chance, is divided into slices. While the person initially assigns almost the whole pie to themselves, by the end of the exercise they may realise that their own slice is much smaller. This realisation does not make the feeling disappear at once, but it gives it a more realistic size.

Grief work is also an important part of the process. It is possible to go on living without severing the bond with the person who was lost, by giving them a meaningful place within your life. Over time, some people are able to draw new meaning and values from this painful experience; I discuss this in the article on post-traumatic growth. You can find out how we work in processes where mood is markedly affected on the depression and mood page.

Frequently Asked Questions

Is survivor guilt a grief reaction?

It is often intertwined with grief, but slightly different from it. Grief contains the pain of the loss, while survivor guilt contains the sense of injustice that comes from being alive despite that loss. When the two appear together, the process can feel heavier.

I wasn't in the earthquake zone, yet I still feel guilty. Is this normal?

Yes, this is also a common reaction. Many people who watched the images, read the calls for help and were in their warm homes that night experienced a similar guilt. This feeling is a sign of your empathy; however, if it has begun to weigh you down for a long time, it is important to work with it.

Is laughing or being happy disrespectful to those I lost?

No. Joy and grief can exist at the same time. Remembering the people you lost and living your own life are not rivals; most people know that their loved ones would not want them to be unhappy.

How long does this feeling last?

There is no set length of time. The scale of the loss, the way the event happened and the support you receive all affect how long it lasts. For many people the intensity eases over time; however, it may rise again at times such as anniversaries. This ebb and flow does not mean going backwards.

• #survivor guilt
• #earthquake
• #grief
• #guilt
• #after trauma

Yazar

Eda Erkan Alapala

Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.

Eğitimler