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Surviving Survivor's Guilt After Cancer

When the question “Why did I get cancer?” becomes “Why did I survive cancer, while others did not?” the guilt reflex is turned on its head.
“There's no problem so awful that you can't add some guilt to it and make it even worse." - Bill Waterson from "The Complete Calvin and Hobbes"

Why me? Cancer survivors have an interesting relationship with these two words. As bookends to the cancer experience, their implications and impact are crucial to understanding the psychology of a life-threatening illness.

Even the most stoic among us must have at some point allowed the question "Why me?" to cross his or her lips or mind. Not only is it normal to question the arrival of such a traumatic event, it is the reflexive response of a mind honed for survival. I've found that resisting the urge to ask this inevitable question causes more problems than it solves. As a cathartic exercise, shouting to the heavens with a fist shaking, wanting to know the point of it all, helps to clear the way for a more heart-centered approach to healing.

At the other end of the cancer continuum, "Why me?" takes on tones of irony, empathy and longing. When the element of having done something wrong is added to the questioning of one’s survival, we end up with survivor's guilt. Here, the struggle is not coming to terms with illness, but an existential wrestling match with the meaning of life. Under normal circumstances, this quest for understanding would be both noble and liberating. That survivor's guilt is lumped into the category of “things I can live without” speaks to the corrosive nature of this self-shaming activity that often has very deep roots.

The origin of the word guilt means, crime, sin, moral defect or failure of duty. There are those who contend that guilt (in small doses) can actually serve as a self-correcting mechanism when one’s moral compass no longer points to true north — the self-punishment seldom fits the crime. Left unchecked, self-correction becomes self-condemnation that opens the floodgates of depression.

When the question “Why did I get cancer?” becomes “Why did I survive cancer, while others did not?” the guilt reflex is turned on its head. What is there to feel guilty about? No offense has been committed, no moral code broken and no failure of duty took place. How does the victim become a perpetrator? What purpose is served by calling into question the right to awaken to yet another day?

Talk about this article with other patients, caregivers, and advocates in the General Discussions CURE discussion group.
Mike Verano is a licensed professional counselor, licensed marriage and family therapist and thymic cancer survivor with over 30 years experience in the mental health field. Mike has had articles published in national and international magazines and is the author of The Zen of Cancer: A Mindful Journey From Illness to Wellness. In addition, he maintains the blog, Confessions of a Pacifist in the War on Cancer. He and his wife, Kathy, live in Lanexa, Virginia.
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