The Art of Coping with Survivor’s Guilt

Losing a loved one is one of the most tragic experiences we can go through, an experience that has become all too common during the COVID-19 pandemic. The resulting grief and heartbreak have caused an epidemic within the pandemic—a surge in survivor’s guilt.

Survivor’s guilt is the lingering feeling that our own survival, or faring well, while others don’t, means we did something wrong. It is a state born of both grief and trauma. War veterans, first responders and survivors of natural disasters are among those most likely to suffer from it. But the vast reach of COVID-19 has made survivor’s guilt more common amongst the general public.

The Physical and Emotional Costs of Survivor’s Guilt

Survivor’s guilt has a distinctive signature during this pandemic because of our collective and heightened sense of powerlessness. We cannot offer hugs and in-person compassion to afflicted loved ones kept in isolation. We may be left wondering if we could have done more to save those who were lost.

Isolation from loved ones deprives us of the typical rituals of mourning that can help us recover from a loss, which may, in turn, exacerbate feelings of guilt. Survivor’s guilt may also be triggered when we keep our jobs while others become unemployed and struggle to get by. As an article in the journal Psychological Trauma Theory Research Practice and Policy sums it up, “The highly distressing, morally difficult, and cumulative nature of COVID-19 related stressors may be a perfect storm to result in a guilt and shame response.”

The effects of sustained survivor’s guilt, often linked to a diagnosis of PTSD, can be emotionally draining, causing flashbacks, irritability, loss or motivation, or even suicidal thoughts. And its symptoms can have a physical manifestation too: headaches, stomachaches, and problems with sleep are also common.

For some people with survivor’s guilt, medical treatment in the form of psychotherapy and medication are necessary to heal.  And the arts can lend a helping hand.

How Creative Arts Can Reduce Survivor’s Guilt

Artistic expression, regardless of form, can lift people out of the grip of trauma and guilt in a number of ways.

The creative arts provide a safe space to explore traumatic memories and reflect on negative experiences by externalizing our inner world. Through the use of imagery and symbols, the arts help elicit thoughts and feelings too difficult to fully articulate to ourselves or others. And this form of expression makes it easier for us to create a coherent narrative about the trauma, which is crucial to recovery.

Dr. Ilene Serlin—an award-winning psychologist and dance movement therapist who is part of the American Psychological Association COVID-19 Task Force—notes that the mere act of taking raw materials and making something new helps people better cope with an ongoing stressor.

“Creative arts therapy teaches you to be creative and resilient,” she says. Children can especially benefit from it. In one study, children with trauma histories who received trauma-focused art therapy (TF-ART) were directed to create collages or drawings that were then organized in a book format to express a narrative of the child’s life story. The children who received TF-ART had a greater reduction of trauma symptom severity compared to a control group engaged in standard arts and crafts activities.

While there are currently no published scientific articles on how arts can help address survivor’s guilt stemming from COVID-19, research for other populations can provide helpful clues on what might work.

For military veterans with PTSD —where survivor’s guilt is a common manifestation—mask making has been found to alleviate its symptoms. In a study involving 370 service members with PTSD and traumatic brain injury, participants used a variety of materials and images to create masks expressing a range of emotions (for example, conveying inner rage with images of fire, lightning or explosions). These visual representations of trauma helped participants safely explore feelings of guilt and loss of comrades and share these experiences with their families and clinicians.

Music is another potent art intervention for reducing grief and trauma symptoms, whether it is group singing, listening to music or playing an instrument. Some studies have found that listening to music related to forgiveness and grief can help with unresolved forgiveness and grief issues for women who lost a loved one. Singing, in particular, can serve as a narrative vehicle for telling and sharing a story of loss with a community to facilitate closure.

Similarly, journaling is another effective way to help people create a narrative and guide themselves through survivor’s guilt and has been effectively used to self-manage emotions for populations as diverse as survivors of Hiroshima and first-generation college students.

Dance releases guilt sufferers from a negative cognitive loop and a sense of paralysis or “stuckness” that often accompanies trauma. According to Serlin, “As people get moving, they can feel the sorrow of guilt and the helplessness of not being able to do something,” she says. “And then they recover their sense of strength and sense of ‘Yes, I can!’”

The art forms that can help are diverse, but seem to empower those with survivor’s guilt to externalize and express their experience and self-regulate their emotions.  While art is not a cure-all, it can be restorative and self-affirming—something we all need during these trying times.

Art Activities for Coping with Survivor’s Guilt

Feelings of survivor’s guilt following a loss are totally normal and something most people recover from without treatment. Art can be a productive way to look after yourself in times of trauma and grief.  Here are some ways to use art to support self-care strategies for coping with survivor’s guilt:

• Do something you enjoy.  Arts activities are a form of self-care and can help soothe and regulate emotions.  For example, listening to music that you enjoy can help activate brain circuits involved with regulating mood.  Knitting, baking, coloring and gardening all have meditative qualities that help improve mood and decrease stress, which is needed for restoration.
• Process the loss.  Journaling can be used to explore deep feelings in a protective space, organize your thoughts, and make sense of your experience. If you are facing a blank page and trying to figure out where to start, you may also consider dialogue creation.  This approach involves writing a conversation between yourself and someone or something else—even an emotion or a part of your body in pain—and can yield valuable insights. When words fail, drawing, painting or dancing are other outlets to consider. The choice is yours and whatever you enjoy the most will be your best option.
• Grieve and commemorate your loss. Part of a healthy grieving process is redefining one’s relationship with those we’ve lost—by, for example, actively incorporating the memory of the person into one’s life going forward. Scrapbooking or compiling a playlist of songs reflecting your relationship can help commemorate your relationship with your loved one.

If you or a loved one are showing symptoms of PTSD, seek treatment from a licensed medical professional. If you need immediate help, please text SHARE to 741741 to reach a crisis counselor with the Crisis Text Line. You can also call The Lifeline at 1-800-273-8255 to connect with free and confidential support and crisis resources for you or your loved ones.

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This is article is a part of IAM Lab’s regularly updated COVID-19 NeuroArts Field Guide. Be sure to check the Guide for the latest, evidence-based tips on how the arts can support our wellbeing during the pandemic.

We would also like to hear from you: Are you, your loved ones or colleagues dealing with specific issues and want to learn more about art-based solutions? Are you already using the arts to help you cope? 

Please share your thoughts, ideas and concerns with us at covid19arts@artsandmindlab.org. Be well and stay safe.

Lead Image: Pixabay

 

Art Therapy COVID-19 Mental Health