Survivor guilt

G.N., a 15-year-old male high school student, resident of a resettlement area in Iligan City for the Dec. 17, 2011 typhoon Sendong survivors, was referred for evaluation because of chronic severe headache for a duration of  eight months. He used to live in a small island where his home was washed out by the strong current of floodwaters.

On the night that the catastrophic typhoon hit Iligan, G.N. was sleeping in the home of his aunt. When he woke up about an hour before midnight, the floodwater was already up to his chest. The water level was alarmingly rising swiftly so all the people in that house transferred to a nearby two-story house. He was then with his grandfather, nine cousins, an aunt and a niece. This house unfortunately got hit by three huge logs causing it to collapse, throwing all of them to the deadly floodwater. He saw his grandfather drown. He was able to hold on to a tree and when he slipped, he heard his aunt’s voice telling him to rise up. He then was able to assist his aunt to hold on to a log like he did. They were both brought by the strong current out to sea. With every big wave, the distance between them became greater until he lost sight of his aunt who never ceased to pray and sing religious songs.

G.N. was just one of the four family members who survived. He was brought to safety by fishermen. His other family members are still missing and their bodies have not resurfaced. Every day, G.N. experiences headaches. He feels guilty that he survived while the rest of his family including his aunt, disappeared in the sea. He cannot accept that they are all gone.

The story of G.N. is just one of similar sad stories of the survivors of typhoon Sendong in Iligan. Eight months after the disaster, he still manifests survivor guilt and other physical, psychological and cognitive symptoms of post-traumatic stress disorder. By the way, G.N. and the typhoon Sendong survivors, who were placed in the resettlement area at Brgy. Luinab, Iligan City, were again traumatized by typhoon Pablo one year after that tragedy and three days before they were supposed to be awarded their cemented homes built by the Order of Malta-Philippines.

Following the wrath of the Nov. 8 monstrous Super Typhoon Yolanda that literally flattened many structures in Regions 7 and 8 with its catastrophic storm surge, winds and rainfall, it was a common sight to view the stories of woe of survivors. I distinctly recall a middle-aged woman being interviewed by Anderson Cooper of CNN in Tacloban.  She and her family took cover in a truck and after the horrific storm surge, she lost her husband and three children and when she found them, helpless and with no one helping her, she had no recourse but to just cover their bodies with sacks.  She had no food, water and shelter. 

Another distraught man interviewed was appealing to his relatives for help and apologizing to the family of his wife because he failed to hold on to her at the height of the deadly typhoon and she got washed off to the sea by the three-story storm surge.

What is survivor guilt?

Survivor guilt is a mental condition that occurs when an individual perceives himself to have done wrong by surviving a traumatic event when the others did not. It may be found among survivors of war, natural disasters, epidemics, among the friends and family of those who have committed suicide and in non-mortality situations like in the corporate world such as among those whose co-workers are laid off. The experience and manifestation of survivor’s guilt will depend on an individual’s prior psychological profile. Survivor guilt is actually one of the significant symptoms of post-traumatic stress disorder (PTSD).

Why does survivor guilt happen?

How can this be minimized?

According to Nancy Sherman, Ph. D., “The anguish of guilt, its sheer pain, is a way of sharing some of the ill fate. It is a form of empathic distress.”  Why not me? How come I am still alive when all of my family members are gone? Is this my punishment for having done wrong in the past?  Am I to blame for their deaths?

“Survivor guilt may exist for a reason. It can help people find meaning and make sense out of their experiences,” according to Roberta D. Calhoun, ACSW, LICSW (Brain Tumor Society). She advised that in therapy, these are the issues to tackle and process:

1. “Acknowledge and accept that guilt exists. Feelings of guilt are quite common and represent part of the healing process for persons coping with loss.”

2. “Listen to their traumatic experiences but do not express judgment.”

3. “Logic may have little or no impact on guilt, but it is important to do some reality testing with your beliefs.”

4. “Refrain from comparing with others and objectively evaluate the situation on its own merits.”

5. “Some people try to ‘work off’ their guilt by setting high standards of achievement. This is a very compelling strategy, but it rarely eases feelings of unworthiness.”

6. “It may help to find additional ways to keep the memory alive for those who have died by creating a special memory book or holding a service.” 

Commemorative services were done in Cagayan de Oro and Iligan City a year after the onslaught of typhoon Sendong for the survivors to pray for their loved ones, to express their gratitude for their survival and to ask for emotional strength so that they can move on with their lives minus their loved ones.  It was indeed heartwarming to see on television the typhoon Sendong survivors providing relief goods for the Super Typhoon Yolanda survivors.

Now that the nation is in a state of calamity, we should do our share in helping Regions 7 and 8 move on. To all the psychiatrists in the Philippines, please coordinate with the Philippine Psychiatric Association Inc. and the Philippine Society for Child and Adolescent Psychiatry regarding this endeavor. Likewise, to all the members of WAPR Philippines, your help will be greatly appreciated. Above-mentioned associations have Facebook pages.

By the way, to all those engaged in psychosocial rehabilitation of disaster survivors, worth reading is the book Ginhawa: Well-Being in the Aftermath of Disasters. It’s good to hear that Flipreads and WAPR-Philippines have made this eBook available for free on Flipreads.com until Nov. 30 to help disseminate information on psychosocial care for the survivors of Super Typhoon Yolanda.

(You may e-mail this author at nina.halilijao@gmail.com)