Coping with bereavement: Survivor's guilt

The paper deals with survivor's guilt (SG). The purpose was to describe the phenomenon and to study some of its correlates, functions and consequences in the context of the caretakers of cancer patients. The first part is an introduction to SG, presenting its definition and focusing on its frequency and the circumstances in which it has been observed. The second part presents findings of two empirical studies of SG. The participants in the first study were 195 caretakers of cancer patients, to whom questionnaires were administered 2-3 weeks before the patient's death and 2-3 weeks following it. Interviews were conducted with 42 caretakers 6 months later. SG was reported by 65.4% of the caretakers. The major results were that SG is distinct from the emotions of guilt and remorse, and that it is largely unrelated to demographic, emotional, and circumstantial variables as well as other characteristics of the relationship to the deceased. Interviews after 6 months showed that most of those with SG were engaged in voluntary pro-social activities and showed evidence of enhanced "contact" with the deceased whose presence was maintained in their life space. A second study was done in order to explore deeper affective layers of the individual's personality in which SG may be rooted. In this study the cognitive orientation approach was applied for identifying core themes characterizing those individuals who manifest stronger SG. The participants were 62 caretakers of cancer patients who were administered a cognitive orientation questionnaire prior to the patient's death and an assessment of SG about 4 weeks afterwards. The questionnaire focused on assessing beliefs with a major motivational role in regard to SG. Its scores provided a significant differentiation between those with and without SG. The major components that contributed to the prediction were beliefs about rules and norms, general beliefs, and to a smaller degree also goal beliefs, as well as themes, such as shared responsibility, the dependence of the individual human being on the collective, and the importance of giving unto others without awaiting rewards. The results of the two studies were interpreted as supporting partially the theories of SG offered in the frameworks of the psychoanalytic, the social-evolutionary and existentialist approaches. SG is to be considered as an integral component of the bereavement process, manifesting concern for the community and enabling the maintenance of contact with the deceased.