Last weekend I had dinner with a friend who was horribly worried about his 65-year-old mother. She had recently been unusually self-destructive. She began a “live-in” affair with a younger man with a history of serious psychiatric problems (diagnosed bipolar disorder), who had no visible means of support and seemed to now be living on her income. A few weeks ago she deliberately overdosed on prescribed tranquilizers, although she informed everyone as she was doing it, so it was possible to get her to the hospital immediately, and prevent disaster. My friend found himself unable to think about anything else, he was so worried. He wondered what he could do to help. I recognized what I think of as intense “empathy-based guilt” –including a kind of survivor guilt in which you feel you have no right to be happy, or otherwise occupied, when someone you love is in trouble or miserable and unhappy.
I asked a few questions, most importantly: “Does your mother have a therapist?” When someone has even threatened, let alone acted out suicidal ideas, this is more than a friend or family member can or should deal with, this belongs in the hands of a mental health professional. My friend reported that she was involved in some kind of counseling. I responded “So leave a message for her therapist. Make it clear that you don’t expect her to return your call, you don’t want or expect to speak to her in person. Make it clear that you understand that she, mom’s therapist, is bound to keep absolute confidentiality about her clients. You just want to let the therapist know that you are worried and give some examples of what you are worried about. Now the worry is where it belongs. Then try to forget it for the time being.” My friend can’t really change anything for his worrisome mom, but he can let the person who is ostensibly helping her with her problems, know that he is worried. I suggested this for several reasons.
He grew pensive, then asked “Do you think her therapist will tell her that I called?” I replied: “Well she should, after all she is working for your mother, not for you, her loyalty is to your mother.” He looked alarmed, and I got it, he felt really guilty about doing something related to his mother without telling her first, but he was afraid if he told her, she would get wildly angry. He was fearful that calling her therapist might somehow hurt his mother. I tried to reassure him; not only was it the wise thing to do, it would serve another purpose. It would provide a good example for his mother of what to do when SHE felt guilty, overly worried and omnipotent responsibility for someone –and in fact the self-destructive actions he was worried about, were signs that his mother was foolishly trying to take care of yet another person who was using up his mom’s resources inappropriately, the new live-in boyfriend who suffers from a mental illness. His mother was suffering from empathy-based guilt, and he was providing her with a model of how to handle it.
I am so used to studying empathy-based guilt –whether I’m wearing my scientist or clinician’s hat. In research we collect data about guilt, determining with what it is associated. As a clinician, I almost always talk to to my clients about it as it inevitably plays out regularly in their lives, causing a lot of trouble. In truth, guilt related suffering is usually what brings people to see me, or some other psychotherapist or counselor. I forget that my friends like everyone else, myself included, suffer from exaggerated concerns about hurting others, especially people they love. This is the heart of empathy-based guilt and the only people who never feel it are psychopaths, a rare mental disorder. There may be plenty of people who claim they never feel guilt, or who hate for anyone to suggest they feel guilty –they think that if they admit to feeling “guilt” it’s like what happens in a law court. They think it’s an admission of an objective crime they’ve committed. Or they think it’s a sign of weakness. But it’s neither. As a clinician I’ve learned to rephrase this emotion until I know someone for a while, and they know what I am talking about when I use the word “guilt.” Initially, I describe guilt as “worry about someone,” associated with thoughts that they should do something for the person they are worried about, or that they somehow have some responsibility for either causing the source of the worry, or for figuring out a solution.
This kind of guilt, feeling overly responsible and sorry for someone, is based on our ability to identify with others and our compassionate impulses, but it may be the source of great unhappiness, sometimes even depression and serious inhibitions in work life and in relationships. People suffering from excessive or irrational guilt, guilt over imaginary crimes can be absolutely miserable, and some try to talk to some “professional” about it. But many (or probably most) don’t, they just suffer, hold themselves back in a myriad of ways, and find it impossible to experience joy. After all “How can I be happy when my loved one (partner, parent, sibling, best friend, child etc.) is suffering? That’s empathy-based guilt, survivor guilt, broadly defined. This kind of guilt is closely associated with what I call pathogenic beliefs –and particularly with the pathogenic belief that if you are in any way better off than someone else, the other person will suffer simply by comparing themselves to you. In reality, being more successful, being in a happy relationship or successful at work doesn’t make others suffer; their suffering is because of their own inhibitions or other problems that get in the way of their own success and happiness.
Having made clear (I hope) what I mean when I speak of empathy-based guilt, let me describe it more specifically, in terms of how it appears, what it feels like. Guilt appears as a discomforting internal feeling of anxiety and dread that comes across you when you believe you have somehow hurt or failed to help someone you love. It seems to be quite universal, at least in our research in other cultures and nations we find it, although it may be labeled differently. As a psychotherapist/psychologist, it’s my job to help clients deal with this problem at least to the extend that it no longer renders them paralyzed, unhappy, or in what seems like a never ending state of distress. Last weekend during dinner with my friend who was so worried about his mother, it crossed my mind that I should try to define the methods I use to manage my own guilt and that I try to teach my clients. Basically, there are three simple steps to take, to manage guilt.
First is recognition. Guilt hides, but you can learn to read the clues that it’s there. Everyone is different but there are certainly some general patterns that fit many. If you are suddenly down, upset, anxious, worried, obsessing about a situation, or just doing rather stupid, self-destructive things, try to think about when the feeling began, who you were with, and ask yourself if you might be feeling as if you caused or are supposed to resolve someone else’s problems. Get into some self-reflection with this in mind. Simply asking yourself: “Whom am I worried about?” or “Whom do I think I’m surpassing?” will bring surprising results. It may not be obvious at first –for example, you may think you began to run yourself down when interacting with another person. You may have concluded that you were inadequate, pathetic, etc. However, think again about that person you were with, and if you were running yourself down in order to build that person up. This is so common in people prone to feeling shameful or inadequate. The list of people you were overtly worried about, or that you were trying to build up, might be long and include: Your partner, your children (even adult children and grandchildren), your parents, friends, neighbors, acquaintances, someone at work, a rival at work or your boss. Thinking this over consciously will allow you to recognize whom you are feeling guilty to or about, or whom you were trying to build up. Sometimes it helps to write out what you are thinking. That feeling of guilt has been there all along, but under the surface of conscious awareness. However it can be discovered, once you know the clues it always provides.
Second, review your expectations and beliefs connected to the person and the situation. Chances are your ideas are way out of the realm of what is possible. Chances are you have been holding erroneous beliefs –for example, that you perhaps caused the problem(s) facing the person you are worried about, or that you have the power to “fix it” when you don’t. Again, this is a really simple process involving ordinary conscious reflection, speculation. You might find it easier to discuss this with a friend, a therapist or counselor, someone else close to you. You might want to write about it. However you want to handle this part of coping with guilt, do it. So you have made it conscious, identified it, and then you have discovered the irrational beliefs connected to this feeling. It becomes quite obvious that your sense of responsibility for another is overblown, exaggerated, and sometimes simply wrong, incorrect, mistaken.
Third, having clarified the problem (in you), decide if there is anything you can do to help the person you are worried about. I’m not telling you to stop being compassionate. You can’t get rid of compassion; we’re wired for empathy, it’s our nature, and building compassion that is realistic and inclusive is the goal of many meditative practices associated with positive psychological outcomes. So if there’s a real action you can take, make a plan and do it. In the specific situation over which you are suffering from empathic guilt, using cognitive analysis, you surely can figure out if there is anything realistically--that you can do to help.
Fourth, if there is no way to help the person you are concerned about learn to do nothing. Learning that you sometimes have to do nothing but tolerate feelings of worry about someone, feeling empathy and compassion even when you can’t act upon it, is the road to living with guilt and even in part, overcoming it. Learning to tolerate that feeling of guilt, without acting upon it is not easy, but it is within your control. To manage guilt, you need to develop skills in tolerating it, mainly by redirecting your mind to other matters, using methods that won’t harm you or get in the way of your own wellbeing. When people have not learned to tolerate empathy-based guilt, they often sabotage themselves. They may use accusations and anger towards the person they are worried about, or drugs, or new sexual relationships, high intensity and dangerous feats, TV shows, binges with food or shopping, the list goes on and on –all misdirected efforts to quiet feelings of empathy-based guilt. A few weeks ago I wrote about how to have a happy partnership or marriage, and I spoke about the importance of avoiding a blame/guilt cycle. When your partner suggests you have made him or her miserable, you feel guilt and if you can’t tolerate that feeling, you end up defending yourself by blaming your partner. The fighting and discord, escalates. So even in your most intimate relationships, learning to tolerate empathy-based guilt will end up making you a much happier person.
When you learn to tolerate guilt, you are learning “ emotion regulation.” There are many methods known to be successful: Meditation, yoga (another form of meditation), exercise, or talking to a friend or partner. Sometimes psychotherapy or counseling is helpful. We can’t disown guilt, or eradicate it. We need empathy-based guilt because it silently sends a signal informing us that someone is in need of help, even when we are unable to provide the help that is needed. It encourages us to live cooperatively. We need members of our various in-groups to be capable of feeling guilt, in order for them to function collaboratively. So you can’t get rid of it, but you can learn to sit with it and tolerate it, it won’t kill you. It won’t even make you suffer that much, once you’ve identified it, unless you do things that are self-destructive, in an effort to drown it out. Guilt is one of those contradictions we live with –we need to feel something that is quite painful, in order to know what is going on in the world around us and to live a cooperative and happy life.