The Impact Feelings of Guilt can have on PTSD Symptoms

‘Tilghman-Osborne, Cole, and Felton (2010) define guilt as involving “moral transgressions (real or imagined) in which people believe that their action (or inaction) contributed to negative outcomes”1)Tilghman-Osborne C., Cole A. D., & Felton J. W. (2010). Definition and measurement of guilt: Implications for clinical research and practice. Clinical Psychology Review, 30, 536–546. doi:10.1016/j.cpr.2010.03.007, p.546 as discussed in Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202’. Guilt is a common emotional response experienced by people who have been through traumatic experiences. This article seeks to explore the relationship between guilt and trauma. 

PTSD used to be thought of as an anxiety based disorder, however recently some new thinking has been happening within the research around Post Traumatic Stress Disorder (PTSD). ‘A growing body of evidence now indicates that a wide range of other emotions [including guilt] accompanies PTSD and may be central to its development and maintenance.2)Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202

Post trauma guilt is a self destructive way of responding to trauma. Tied up in the response is a lack of self love and self worth. Often trauma is accompanied by the belief that what happened was brought on by victims themselves. Victims may look for ways in which they brought the trauma on so that they can begin to blame themselves. Victims of domestic abuse may ask questions like, “perhaps I did something to deserve it?”, rape victims wondering, “did I lead them on?” and children of divorced parents thinking that they are somehow to blame for their parents separation. Blame is often taken on by the victims of trauma rather than given to the perpetrators. 

Guilt has been consistently associated with trauma and the development and maintenance of PTSD symptoms. In a 1997 study looking at veterans with PTSD, Henning and Frueh found that combat related guilt ‘positively correlated with re-experiencing and avoidance symptoms of PTSD, as well as with a general measure of PTSD severity.3)Henning K. R., & Frueh B. C. (1997). Combat guilt and its relationship to PTSD symptoms. Journal of Clinical Psychology, 53, 801–808.’ Another more recent study done in 2011 looking at women who had experienced intimate partner violence also found that there was a positive correlation between guilt related distress and cognitions and PTSD severity.4)Beck J. G., McNiff J., Clapp J. D., Olsen S. A., Avery M. L., & Hagewood J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: Shame, guilt, and PTSD. Behavior Therapy, 42, 740–9. doi:10.1016/j.beth.2011.04.001 as discussed in Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202

Occasionally traumatised victims of abuse can be manipulated into feeling like they are to blame by the perpetrator of the abuse. It is not uncommon in stories of abuse to hear that the abuser has convinced their victim that they have heroically saved them from evil and controlling family ties or from their own previously colourless existence. Konstantin Bub and Miriam J.J. Lommen conducted a study in 2017 that looked exactly at the impact being made to feel like you were guilty may have on post traumatic stress. They told a group of students that a computer had crashed and consequentially lost a lot of vital data. They then told half of the students that they were personally responsible for the crash and had in fact caused it. They other half were told that it was a technical fault and nothing could have been done about it. They assessed the levels of guilt within the students both before and after the incident as well as any associated distress that occurred as a result of the incident. They found that those who were personally blamed for the incident showed higher levels of guilt and associated distress than those who were not blamed.

The results demonstrate that guilt, even when it is unwarranted, can lead to increased PTSD symptoms.5)Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202 

References   [ + ]

1. Tilghman-Osborne C., Cole A. D., & Felton J. W. (2010). Definition and measurement of guilt: Implications for clinical research and practice. Clinical Psychology Review, 30, 536–546. doi:10.1016/j.cpr.2010.03.007, p.546 as discussed in Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202
2, 5. Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202
3. Henning K. R., & Frueh B. C. (1997). Combat guilt and its relationship to PTSD symptoms. Journal of Clinical Psychology, 53, 801–808.
4. Beck J. G., McNiff J., Clapp J. D., Olsen S. A., Avery M. L., & Hagewood J. H. (2011). Exploring negative emotion in women experiencing intimate partner violence: Shame, guilt, and PTSD. Behavior Therapy, 42, 740–9. doi:10.1016/j.beth.2011.04.001 as discussed in Bub K, Lommen MJJ. The role of guilt in Posttraumatic Stress Disorder. Eur J Psychotraumatol. 2017;8(1):1407202. Published 2017 Dec 5. doi:10.1080/20008198.2017.1407202

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