Survivor’s guilt: what it is and how to manage it

The emotional impacts of cancer can last long after treatment is completed.

Guilt is just one of the many emotions that may come up for cancer survivors. If you feel this way, you’re far from alone.

“Experiencing survivor’s guilt is incredibly common,” says Catherine Powers, Ph.D., a licensed clinical psychologist in Palliative, Rehabilitation & Integrative Medicine. 

Ahead, our experts talk more about survivor’s guilt, why it occurs and how to cope.

What is survivor’s guilt, and why does it occur?

Survivor’s guilt refers to feelings of guilt or sadness after surviving a cancer diagnosis, Powers says. She notes this feeling can be triggered by thinking of others who have not survived cancer. 

“Patients often dismiss their own experience or believe they didn’t suffer enough when they learn about others who are doing worse or who have passed away from cancer,” she says. 

Another common reason Powers says people may experience survivor’s guilt is thinking about the toll their cancer had on family and friends.

Senior social work counselor Kendolyn Shankle adds that survivor’s guilt can make you feel like you’ve done something wrong, especially if you have family or friends still undergoing treatment.

“Survivor’s guilt may occur because a patient is thinking of the friends and loved ones still completing cancer treatment. This may include the friends they made during treatment," she says.

How to handle survivor’s guilt 

Powers and Shankle offer several suggestions for managing survivor’s guilt. 

Understand that what you are feeling is normal

First, know that it’s OK – and even normal – to experience guilt after finishing cancer treatment.

While these feelings can be heavy and uncomfortable, Powers says they are often signs of empathy and the mind’s way of making sense of your cancer experience. 

“When we do well, we want others to do well too,” she says. “We often think life is fair, and when we see that it is not, it is difficult to process."

Process your emotions

It can be tempting to avoid examining difficult emotions. But addressing your feelings can help you process them, Shankle says. 

Processing emotions looks different for everyone. Some prefer to process their feelings alone, while others prefer to talk about them with loved ones. 

Additionally, Powers says there are a variety of coping techniques that can be used when dealing with uncomfortable emotions.

Some coping techniques she recommends include:

• Yoga
• Meditation
• Visualization
• Mindfulness
• Exercise
• Seeking social support   

“Focus on what is in your control and learn healthy coping techniques for what you are not able to control,” Powers says.

Still others process emotions through creative expression. MD Anderson’s Integrative Medicine Center offers music therapy and journaling classes, but you don’t need to be an MD Anderson patient to benefit from these practices. Listening to music, playing an instrument, singing, journaling and crafting are just a few creative practices that can be used to process feelings and emotions.

Pay it forward

Another way Powers recommends managing survivor’s guilt: pay it forward! 

Here are some ideas you might consider:

• Volunteer at an organization that is meaningful to you.
• Offer encouragement to others facing cancer.
• Make a care package with products that made treatment more comfortable for you. 
• Send flowers to a friend or loved one going through treatment.
• Share your experience with others in treatment through a program such as myCancerConnection, MD Anderson’s one-on-one cancer support community.

Practice self-care

Self-care can help relieve the physical and mental challenges of cancer survivorship.

This practice can take on many forms. For example, Powers says participating in activities or work that give you meaning is a form of self-care.

Here are other ways to practice self-care:

• Learn a new self-soothing technique.
• Eat healthy foods. 
• Add physical activity to your routine.

Join a support group

If you’re experiencing survivor’s guilt, you may also benefit from connecting with other cancer survivors.

Support groups, such as MD Anderson’s cancer survivorship groups, provide an opportunity for connection, reflection and healing. 

Seek professional help

Sometimes, emotions like survivor’s guilt can feel like too much to handle alone. That’s where professional counselors can help.

Current and former MD Anderson patients can reach out to their care team to be referred to a professional.

“If you feel like you need help, don’t hesitate to reach out to a therapist to guide you in putting words to your feelings and establishing coping techniques,” Shankle says. 

Request an appointment at MD Anderson online or call 1-877-632-6789.