Life can still halt for certain U.S. citizens when faced with traumatic memories, as thousands of people continue to struggle with the traumatic effects of September 11, 2001.
The last couple of years alone have witnessed more than 1,100 people sign up for services through the city hospital system’s World Trade Center Environmental Health Center, which caters to people who lived or worked within a mile and a half of ground zero. Nearly half the program’s 7,735 patients enrolled in the past five years (Dailymail.com, September 2014)
About 60 percent of patients in the program are struggling with symptoms of post-traumatic stress disorder, anxiety or depression attributed to 9/11 and about 40 percent have sought treatment for a mental health condition.
The delayed enrollment has apparently been largely characterized by the reluctance of survivors to bring attention to their psychological trauma.
“There was tremendous survivor guilt,” said Dr. Nomi Levy-Carrick, the program’s mental health director. “So people who survived didn’t feel worthy of wanting to seek care. The fact that they had survived, they felt, should have been enough.”
Survivor’s guilt is a common response to a loss and/or traumatic experience with significant victimization, such as terrorist acts and war. Events resulting in severe traumatic reactions often lead to multiple losses where in addition to deaths, parts of an individual’s nature are altered as well (Survivor Guilt: What Long-term Survivors Don’t Talk About)
Such guilt can become a complicated part of trauma; it may intensify or complicate trauma and the associated reactions (Nader et al., 1990). Hopelessness, depression and other problems such as self-harm, suicidal feelings and substance abuse often result.
When only few survive, it is not unusual to compare them with those who didn’t. One person’s survival occurred at the expense of another or there is a debt owed to those who are gone. Some survivors may keep a low profile to avoid such contrast of outcomes.
When facing a catastrophe, the body responds neurochemically, initiating protective actions such as counter-aggression, stillness or flight. Survival is the priority. In the chaotic situation of a traumatic experience, people may be left behind and there are some who die.
This was the case during and after the terrorist acts of September 11 where some narrowly escaped fires or debris that killed others standing near them. The uncertainty as to when the building might collapse caused many to rush towards the exits leaving behind the slower moving individuals such as pregnant women and the disabled. The resulting casualties and the uncertainty surrounding the fates of those left behind resulted in guilt.
Studies suggest that, after an event, people overestimate their pre-existing predictive knowledge of the event (Fischhoff, Crowell & Kipke, 1999). This overestimation can lead to an inaccurate assessment of their responsibilities in the situation.
Survival is an achievement (Lifton, 1993). Although choices may be limited during a traumatic event, the survivor does have choices afterwards. People can remain captives to survivor’s guilt or use their survival as a source of future growth. Guilt can be adaptive when it leads to improvements in character and behavior (Schiraldi, 2000). Unprocessed guilt can make recovery difficult. Therapeutic and professional assistance is important for persistent and/or intense guilt as well as other trauma symptoms that disrupt daily functioning.
If you or a loved one is in need of therapy due to survivor’s guilt of any kind, the 24/7 Recovery Helpline is available to help you every step of the way. Our representatives are committed to connecting you with the best treatment plans and aftercare programs that best suit your individual needs. Call us at 855-441-4405.