The mechanism of survivor guilt

The mechanism of survivor guilt

What is survivor guilt?

The secret burden of cancer survivorship – survivor guilt. While many celebrate and rejoice, they may also battle with survivor guilt. A complex mix of feelings that is poorly recognized and addressed in survivorship. Survivor guilt can be empathy, sadness, anger, grief, anxiety, pressure, none of the above, all of the above.¬†Here I go into a little bit about why survival guilt happens and why it’s normal.

Why does it happen?

Survivor guilt manifests from the cognitive dissonance that arises when an individual is confronted with their own mortality (via a cancer diagnosis), overwhelming feelings of powerlessness, and a response to grief. I said a lot of words there – let’s break that down.

Emotional defense

A cancer diagnosis usually forces an individual to think about their mortality, something that many people don’t think about at all until later. More often than not, anxiety around cancer stems from a sense of powerlessness and helplessness, a loss of control and this can be extremely distressing. Any part of the cancer journey can trigger these feelings. Survivor guilt can occur as a form of emotional defense against constant feelings of anxiety, sadness, and fear.

Part of the experience of grief

Of course, there’s grief. There are complex interactions between feeling grief and guilt because there are so many facets of both of those emotions. There can be feelings of grief for the loss of others but there can also be grief for the loss of one’s own life (the “would-have-______-if-not-for-cancer”). Grief and guilt can occur separately, together, or in different proportions of each.

I hear all the time from survivors that they “shouldn’t” be upset because others have had it worse and dismiss their own challenges because they don’t feel like they have a right to complain. As in “they should just be grateful they’re alive“. What is happening is that this dismissal of grief and previous traumatic experiences become invalidated through guilt by putting an emotional distance between their own losses and the losses of others.


Survivor guilt occurs because of our human ability to empathize and sympathize. Even though survivor guilt doesn’t nearly get emphasized enough during survivorship, it doesn’t mean it’s not important. In fact, these feelings can impact the quality of life in survivorship greatly.

**This information is not intended to substitute for health professional medical advice, diagnosis, or treatment. It is always recommended to seek the advice of your healthcare provider** 

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