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Three Ways to Address Guilt When You’re Grieving

Guilt is common in grief but may be even more common during COVID-19.

When the World Health Organization declared COVID-19 a pandemic on March 11, most of didn’t realize how much it would change our lives. In addition to the months of quarantine and millions of lost jobs, it has changed the way we work, socialize, date, and express affection. But an often-overlooked fact is that the virus also has changed the way we grieve.

As of late-June, there have been over 110,000 deaths in the United States and more than 460,000 worldwide as a result of the coronavirus. It has become increasingly common for people to know someone who has passed away from the virus. And, even in the midst of this crisis, people continue to die of more typical illnesses like cancer, heart disease, and numerous age-related causes. There’s a lot of grief to go around.

Unfortunately, our normal ways of mourning often aren’t available. Although somewhat more possible given the slow re-opening of states, because of restrictions on gatherings and people’s reluctance to travel, in-person funerals, memorial services, and religious gatherings still frequently don’t occur, at least not in the form we’re used to. Moreover, due to quarantine restrictions, families are often prohibited from seeing loved ones who have been admitted to the hospital with COVID-19.

I recently spoke with the daughter of an 80-year-old woman who suddenly became ill. She delivered her mother to the hospital only to realize that, if she were to die, the car ride would be the last time they’d see each other. “I feel so guilty,” she told me. “I didn’t even say goodbye!” Luckily, her mom survived. But, for many, their loved ones won’t recover, a fact that can lead to intense guilt. Unfortunately, research shows that guilt is associated with intensified grief and depression.

Guilt isn’t a new part of grieving. Even before the pandemic, it was a relatively common emotion to experience after loss, particularly among family caregivers. Although sometimes there really is something worth feeling guilty about, often this isn’t the case. Instead, guilt frequently results from distorted thinking—that is, being much too hard on ourselves. Caregivers often expect way too much of themselves and beat themselves up when they don’t fulfill those expectations. It’s important to notice this kind of thinking when it occurs, because it can stand in the way of healthy grieving.

Here are three common ways we can be way too hard on ourselves after a loss, along with some tips about how to be kinder to ourselves.

#1. “I didn’t say or do enough.”

People frequently regret having left something unsaid or undone in their relationship with their lost loved ones. We may feel we should have expressed more appreciation for our loved ones, should have said “I love you” more often, or should have taken them to a favorite spot one last time. Particularly in the midst of the coronavirus pandemic, people may feel they should have been there for their loved one’s death, even though that may actually be impossible.

This kind of self-critical thinking is sometimes called the “tyranny of the shoulds.” People often concentrate on what they didn’t do—what they feel they should have done—but forget about all they actually did! There may have been many ways that their relationship with their loved one was strong.

Before the pandemic, I remember the daughter of an elderly man who passed away from lung cancer. She flew across the country four times to be with him, leaving her own work and family behind. When she wasn’t there, she called often to check in with him and her mother. When she heard of a sudden decline in his health, she flew to his bedside only to find that she had missed the moment of his death.

She tortured herself for weeks, accusing herself of being a bad daughter because she “should” have been there. Seeing how hard on herself she was being, her mother finally clasped her hand and said, “Your father didn’t care if you were there or not when he died. He knew you loved him; you showed him that over and over again.” Just as her mother reminded her, it’s important for all of us not to lose sight of what we actually have been able to do for our loved ones.

#2. “I made the wrong decision.”

Some caregivers blame themselves for having made a “wrong decision” in their loved ones’ medical care. I remember one man whose 85-year-old grandmother had always said she wanted to be at home when she passed away. As she grew weaker, he even moved into her home to care for her, so her wish could be fulfilled. But, when she fell and fractured her hip, he followed the doctor’s recommendation to bring her to the hospital by ambulance. The trip to the hospital was traumatic for her, and she cried out in pain and confusion. Unfortunately, just hours after entering the hospital, she passed away. He felt horribly guilty. “I should have kept her home,” he said. “It’s all my fault she died the way she did.”

This is a difficult story. In retrospect, perhaps it would have been better for his grandmother to remain at home. With time, however, he came to realize that he made the best decision he could with the information he had at the time. He didn’t know she was going to die when she did. All he knew was that his grandmother was in pain and the doctor recommended bringing her to the hospital. It wasn’t his fault. His grandmother was very ill.

Similarly, whenever we feel we’ve made a wrong choice, it’s important to ask ourselves whether we made the best decision we could given what we knew at the time. No one is to blame for not seeing the future.

#3. “I’m a terrible person.”

As already mentioned, bereaved individuals often are left with lingering feelings of mild regret or guilt. These feelings are generally manageable and rarely cause long-term difficulties. Feelings of self-loathing are potentially more problematic. When someone believes their loved one’s death is all their fault, they may begin to feel worthless and awful about themselves. Normal guilt comes from wishing we had done something differently. But normal guilt can turn into self-loathing when we believe we are someone terrible.

Just like regret and guilt, self-loathing often results from being way too hard on ourselves. Unfortunately, it is sometimes difficult for people who feel this way to see this clearly. Consequently, when our feelings extend beyond guilt to a sense of self-loathing, it’s often important to speak with someone about it. Whether it’s a counselor, a member of the clergy, or a friend, other people frequently have a clearer perspective on our situation than we do. They can help us realize when we’re being too hard on ourselves.

It’s anybody’s guess how this pandemic will change the way people grieve in the long term. For now, however, if you’re grieving, it’s important to be kind to yourself. We’re at a time in history when many people are cut off from the social rituals and in-person support they normally could access. In these unusual times, even the wisest among us often don't know what the right courses of action are. If you’re experiencing guilt as part of your grief process, it can be important to remind yourself that nobody is perfect, even under ideal circumstances, let alone in the far-from-perfect world we’re currently living in.

More from David B. Feldman Ph.D.
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