How to Carry on After Loss - The Guilt of the Survivor
by Karen Flood, Ph.D.


Guilt for being alive when someone you care about has died is sometimes one of the dimensions of grief. It may be experienced in anticipation of someone's death or afterwards and it may be felt by those with or without cancer. Other symptoms of grief may include anxiety, helplessness, hopelessness or even relief. Death might act as a catalyst where the search for answers begins in an attempt to understand why one person lives and another dies. ¹

For those with a family member or friend diagnosed with cancer, survivor's guilt may be the result of identifying with that person and may heighten fears about death. When we lose loved ones to cancer, sometimes the effect may be to withdraw in our other relationships, or a reluctance to befriend any other person with cancer. Although this reluctance is understandable, it is important to realize what might be lost are the benefits of having a close connection to another person, even if the relationship, because of death, may end sooner than planned. ²

Gilda Radner deals with the question in, "It's Always Something." In it she writes "the hardest part of becoming friends with people was learning later that someone who had become close had died. The course of cancer isn't always what we hope. I was learning that death is a part of life. But if I hadn't ... think of all the love I would have missed." ³

For those dealing with survivor's guilt, it's important to acknowledge feelings of grief, acceptance and adjustment to the loss.

1. Ask yourself how you feel and be as honest as you can with your grief or guilt. The best time to deal with this begins when you first start experiencing the feelings. In doing so, you will be better able to cope, as denial just delays the issue. Also, realize you may not grieve the same way for each death you experience, and that's okay too.

2. Using grief as a period for practicing self-care will help you work towards acceptance of your loss. Ask yourself what you need, so you can express your feelings and soothe your pain. Participate in rituals of grieving and remember to say goodbye. It is important to talk about or think about the deceased and your relationship to them. Write a note, share your thoughts about the deceased, attend a funeral or celebration of life. If you find yourself grieving many deaths, reach out to others with the same circumstance. Build those supports. Dragon boat teams comprised of cancer survivors enact a lovely ritual after their races of throwing pink flowers overboard, in remembrance of team members who've died. 4

3. Know how to reach out for help and where to look for support. Most bereaved individuals recover from their loss with help from family, friends and spiritual advisors. However, if you experience persistent feelings of depression or anxiety, professional help may assist you moving through the grief. 5

4. Re-invest energy into once again experiencing life. Some find meaning through community events such as fund raising for research, social activism and volunteerism.

Survivor's guilt is an experience to be acknowledged, not a problem to be avoided. It's critical to be open to feel the complex dimensions of grief while remembering the gifts of attachment and a greater connection to others.


1. Holland, J.C. & Lewis, S. (2000). The Human side of cancer: Living with hope, coping with uncertainty. NY: HarperCollins.

2. Benjamin, H.H. (1995). The Wellness Community. Guide to fighting for recovery from cancer. NY: Tarcher/Penguin.

3. Radner, G. (1989). It's always something. NY: HarperCollins.

4. Tocher, M. (2002). How to ride a dragon: Women with breast cancer tell their stories. Toronto, Ontario: Key Porter.

5. Chochinov, H.M., Holland, J.C., & Katz, L. Y (1998). Bereavement: A special issue in oncology. Psycho-oncology (pp.1016-1032). NY: Oxford.