Monday 27 September, 2021

How to Cope with Guilt when Experiencing Cancer

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By definition, guilt means “the fact of having committed a specified or implied offence or crime, or a feeling of having committed wrong or failed in an obligation.” So why do we sometimes struggle with coping with guilt when going through cancer?

Our cancer is completely unrelated to anything we’ve done wrong, our failures, or offences. We haven’t done anything wrong but we still have cancer. And we still feel guilty. 

When it comes to cancer, guilt can materialize for a variety of reasons, not all unreasonable. In this article, we’ll cover a few different situations that cause us to feel guilty when going through cancer, what kind of guilt they are and how to cope with guilt because of cancer.

What we’ll cover in this blog: 
Guilty for being a “burden” to those around us
Coping with guilt for getting cancer
Guilt for not being who you were/who people want you to be
Survival guilt

Guilty for being a “burden” to those around us

For some, a cancer diagnosis can change your daily life from one day to the next. Checkups, hospital visits, medication at various times a day. Cancer may also introduce fatigue, scanxiety, low mood, and body changes into your life. 

Not only does experiencing cancer entail a range of practical hurdles, but can affect our energy levels and psychological, emotional, and social wellbeing. We may crawl into ourselves when we don’t know how to handle having cancer, or we may not have the energy to make dinner or do the laundry. 

Whatever the instance, we can feel guilty about dynamic changes in our relationships or towards the world around us, especially when we feel that we’re not doing our part or sharing the burden. This is a kind of existential guilt, where we feel guilty for the negative impact we have on others. Where this can stem from varies but may be informed by societal, cultural, familial, or moral expectations that we’ve learned and may not feel like we’re living up to. 

How to cope

If you feel like a burden to those around you, remember that you are probably more of a burden when you feel like a burden. When we feel guilty, we tend to isolate ourselves and those around us feel like their support goes unappreciated or that they’re doing things wrong. By embracing being surrounded and supported by others, we also honor their efforts and love them back. 

It can also be helpful to adopt another perspective that can be more realistic and uplifting. For example, remind yourself that having people who surround you during this time is a blessing, not something to feel guilty about. Good things are meant to be appreciated. We may sometimes feel humiliated or want to hide because we pride ourselves on our independence, but whether you have cancer or not, we all need each other. We are independent in spirit and dependent in love. These realities can co-exist. We were built to be in community together and make it harder on ourselves and others when we fight that.

Finally, think about how if you had a loved one who was going through cancer, you’d want to help and support and wouldn’t want the other person feeling guilty for it. Practice grace and gratitude towards yourself and others.

Coping with guilt for getting cancer

Some people experience feelings of guilt for getting cancer in the first place. This is a typical example of maladaptive guilt – feeling guilty about things that aren’t within your control. This kind of guilt stems from feeling like there was something that could’ve been done, an action that could’ve been taken, to prevent the outcome (in this case, cancer). You can feel this way, even when there’s truly nothing you could’ve done to know that you would get cancer. 

Though not all forms of guilt are bad (like adaptive or pro-social guilt, where you, for example, feel guilty for hurting someone, because you have a conscience), this kind of guilt often has a negative impact on your life and affects your mental health.

How to cope

Instead of thinking in these negative thought loops, reframe the situation and shift your focus from the negative to more realistic, constructive thoughts about your situation. It’s not necessarily productive to shed guilt by simply thinking “positive.” Instead, approach your guilt by letting yourself feel the guilt and exploring where it comes from. Amy, a member of the War On Cancer app, hosts Letting Go practices, helping you confront your feelings and learn to let them go (sign up for the next one here!).

Another helpful way to move past maladaptive guilt is to learn to see your situation through a new lense. What are the ways in which cancer may have helped develop or grow you or made you aware of or appreciate an aspect of life that you took for granted before? Awareness and gratitude are key in freeing yourself of self-recrimination, allowing you to experience all the good that life has to offer.

It can also be very helpful to share what it is you’re feeling with someone close or a professional. It turns out, social support during difficult times can often give you the strength to carry on, and even lead to post-traumatic growth (listen to a podcast episode on that here). Don’t know where to turn to? Download the War On Cancer app to join a community of others who know what it’s like and can help you cope with guilt during cancer.

Guilt for not being who you were/who people want you to be 

Cancer can change you, just like any other experience. However, the expectations we have on ourselves (physically or mentally) or that others place on us may not be so quick to adapt to who we are becoming and how we are evolving. Similarly to feeling like a burden on others, this kind of guilt can stem from a complex mix of societal, cultural, familial, or moral expectations, and is a mix of maladaptive and existential guilt. 

How to cope

Remind yourself that experiences, especially ones as major as cancer, are meant to impact you. You haven’t done anything wrong – in fact, you’re doing something right by letting yourself grow and evolve through your life experiences. Additionally, the expectations you or others set may be informed by outside factors rather than in context of your current life situation. Let go of expectations that negatively impact your mental health and approach the rebuilding of your identity with curiosity, grace, and goals that are realistic and bring you a sense of satisfaction and joy upon completion. In doing so, you’re more able to shed the guilt for not being who you once were, and celebrate who you are becoming. 

Find a person or two who supports your growth and development and be encouraged by them. You can find people who’ve been through something similar in the War On Cancer app who will cheer you on, or turn to a trusted friend or family member. Opening up and sharing about the ways in which cancer has affected you brings your experience out from the dark and into the light – suddenly something you can hear, see and approach, and help shape your world going forward. 

Survival guilt

Survival guilt is a guilt complex that can develop in people who experience a life-threatening situation, including cancer. Simply put, it’s an existential kind of guilt we feel when you survive something life-threatening and others don’t. 

According to the DSM-5 (an expert manual that helps diagnose mental health issues), survival guilt can be a symptom of PTSD, though you can experience survivor’s guilt without having PTSD.

Rumination and regret are two key areas to be aware of and keep in check if you experience survivor’s guilt. Though we think we gain insight into our lives or problems by ruminating, there are some things that we will never know the answer to (like, for example, why we survived and someone else didn’t). Rumination causes us to feel regret and guilt because it is caused by hindsight bias – looking back, we overestimate our ability to have known or changed the outcome of an event. It’s not productive, because we cannot change the past, nor things beyond our control. We are not made to understand everything in this life, nor does everything make sense. Some things are beyond our understanding, just like some things are beyond our control. We need to learn how to cope with, live, and learn from it. 

How to cope

Instead of ruminating, try to seek wisdom in order to reach some sense of acceptance (more about acceptance as a stage of grief here). That being said, allow yourself to grieve. Allow yourself to feel, and then take this gift of life to do something positive – whether that’s for yourself or for someone else. It doesn’t have to be much, but doing good counteracts feelings of guilt. It’s helpful to know that many others experience this feeling, whether they’ve gone through cancer or have survived a natural disaster, war, or other trauma. Feeling guilty doesn’t equate with actually having done anything wrong. Feeling happy about getting a second chance at life and mourning the passing of others are not mutually exclusive events. In fact, there can even be a beautiful synergy between the two. 

If you’re experiencing consistent feelings of survival guilt, are stuck in the same thought patterns, or feel guilt affects your mental or physical health, seek professional help. They can help you with cognitive behavioral therapy which helps you explore automatic negative thoughts that contribute to your guilt and replace them with realistic thoughts and diminish self-blame. Make sure to reach out to someone you trust and share where you’re at – a burden shared is a burden halved. People who find themselves isolated are more likely to experience survivor’s guilt, so don’t try to cope with guilt alone.

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