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Study suggests feelings of guilt may be a top factor in PTSD was the title of a recent blog by Gregg Zoroya of USA Today.
Often survivors are flooded with a sense of guilt for having survived, or about things they did or failed to do. Guilt can be very destructive psychologically. Indeed, in the first version of the diagnostic criteria for PTSD produced by the American Psychiatric Association in 1980, guilt about surviving or about behavior required for survival was actually included as one of the key symptoms. Guilt was later removed in the 1987 revision because the authors wanted to increase the specificity of the diagnosis of PTSD given how guilt is also seen in other disorders such as depression.
But should guilt now be reintroduced as a feature of PTSD?
No. That would be a mistake. Guilt is an important emotional warning light telling us about ourselves, our behavior and when we perceive ourselves to have transgressed social norms in some way.
Guilt provides a connection between our emotions and the social world. By thinking of guilt as a symptom of disorder, guilt is individualized and the link to the social word is severed. Medicalizing guilt is a way to make social issues dissapear into the person.
After trauma, as people struggle with the meanings and the significance of their own actions they then make new choices for how to behave. Seen this way, it is often through such inner conflict that posttraumatic growth can arise.
Rather than try to eliminate all traces of guilt we have to find ways to transform its destructive power into a transformative positive force.
Sometimes that means living our lives with guilt about what we have done and learning to channel those powerful emotions in new and socially constructive ways.
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