Written by Jennifer Harris, LICSW on August 29, 2019
Of all the emotions that families endure in a crisis, guilt seems to be one of the hardest to resolve. Guilt is a feeling or a thought in which you have or perceive that you have harmed or wronged someone. In many circumstances, guilt comes on as a result of doing something to someone that requires forgiveness in order to heal.
However, in the instance of family coping with a loved one’s burn recovery, the guilt that one can experience is often a result of burdensome thoughts we place on ourselves. It is what I call the “coulda, shoulda, woulda” effect. It is the magical thinking that helps regain some control of a situation that is out of our control.
When I work with families on the burn unit, I always hear such comments as “If only I had done...,” “I should have...,” “I wish I could have... .” While the rational part of us knows we cannot go back to change events, the compassion and loving side of us holds on to the guilt. It is part of how we cope with making sense of what has happened. While some guilt is helpful to motivate us to positive action to care for our loved one, unjustified guilt can become overwhelming and interfere with well-being.
So, who experiences guilt? Parents, siblings (old and young), spouses, extended family, witnesses of the event—anyone can experience guilt Guilt is part of the healing process. It is perhaps how our thoughts and emotions try to gain control when we have been thrust into a trauma that has taken away much of our control. But the guilt we experience is often not just related to the burn event itself; it also comes and goes during our loved one’s recovery.
Anyone in a family may experience feelings and thoughts of guilt, including:
Survivor guilt (your loved one was injured and you were not)
Guilt that you can’t visit more/spend time with or support your loved ones as much as you would like
Guilt that you are not visiting because doing so makes you anxious
Guilt that you are jealous that you are not getting as much attention as before
Guilt that you resent how life has changed as a result of the injury
Guilt that your loved one is being stared at or treated differently in public
The worry or guilt of a child who thinks they did something to cause the injury and/or could have done something to prevent it
Does any of this sound or feel familiar? If so, do not worry. Anyone can have thoughts or feelings of guilt. It is how we make sense of what is going on with a disruption in our life. But if guilt takes over and keeps you from engaging in the life that you deserve, that is a cause for concern.
While you may know that you are having these feelings and thoughts, how will you know if someone else in the family is too? Look out for symptoms and behaviors such as these:
Loss of interest in friends or favorite activities
Increased irritability or anger
Poor performance in school or work
Decreased ability to focus
Acting out or being rebellious
Use of substances or increase in alcohol intake
Intrusive thoughts or behaviors to control a situation
Of course, it’s important to know that there may be other symptoms or behaviors that could be added to this list and to realize that not everyone will have noticeable behaviors. You should also keep in mind that these behaviors are a means of coping with intense feelings or thoughts of guilt.
However, if they are not helpful in the healing process, it’s important to consider seeking help before these behaviors put someone’s well-being at risk. That negative effect on well-being will become noticeable when the completion of normal or everyday activities becomes hindered on a regular basis.
Many families ask how they can avoid the use of disruptive coping mechanisms. I suggest they validate the thoughts and feelings that members of their family are having. While reading this article, have you felt a slight sense of relief from knowing that you are not alone in your experience of grief, or even just learning that guilt is a normal process of coping with trauma? If so, that is because you experienced validation. Having a safe space to share your thoughts and feelings is crucial to experience validation. Everyone needs a safe space to share their thoughts and feelings of guilt. You can provide this to your family simply by creating a space to just listen, without using judgmental language. If it feels too intense to create or maintain this space, then you might consult with the burn team about enlisting the support of a mental health clinician.
In addition to validation, there are some other healthy coping strategies that can help families deal with guilt:
Maintain normalcy and routine (as much as possible) at home, particularly when children or teens are involved as it allows them to have alone time with you.
Provide honest and accurate information about the injury.
Sustain positive self-talk or self-affirmations.
Stay connected with family, friends, community, and school.
Keep a journal or write reflections of positive things or things for which you are grateful
If talking becomes overwhelming, keep a family dialogue book, where everyone can share their feelings without the intensity of having to talk about it.
Remember that your loved one most likely does not blame you for what they are going through, and if you asked, they would probably tell you as much.
Finally, and probably most importantly, give yourself permission to take care of yourself. You have experienced this trauma too. Incorporating a regular schedule of self-care will give you a space to clear your mind and rejuvenate. We know that including a few minutes to be present in the moment allows our thoughts and feelings to be less intense and heal. I know, that’s easier said than done, and possibly feels like it might create more guilt that you are being selfish. But you will not be able to support your loved one if you do not take care of yourself.
Think about incorporating a few minutes a day, every other day or weekly, of some activity that you identify as self-care. It does not have to be an elaborate experience, such as a massage or facial. It could be as simple as taking a walk, getting coffee with a friend, coloring, cooking a nice meal, meditating, or another activity that helps create a space to be present and reboot.
Combating the “coulda, shoulda, woulda” effect of coping with trauma is not easy and takes some work. The propensity to allow the magical thinking of guilt to creep into our coping and consume us is strong. But, you do have the tools in your coping “toolbelt” to help ease the intensity of guilt so that you can begin to heal from this traumatic event.
The key is to utilize those tools in any capacity to keep from dwelling on the things that are out of your control. Guilt may feel inevitable, but having space in your life and your family for self-care, validation, normalcy, and community will support you in your healing.
Jennifer Harris, LICSW, is a clinical social worker who previously worked at Massachusetts General Hospital Burn and Reconstructive Plastics Services in Boston, Massachusetts. She has recently transitioned to private practice and remains involved with the Phoenix Society for Burn Survivors