PS I think Cancer Survivor's Day is the first Sunday of June. - J

http://www.tbts.org/virtual_html/longtermsurvivors.htm
What Long-Term Survivors Don't Talk About

by Roberta D. Calhoun, ACSW, LICSW
In recognition of Cancer Survivors' Day in June, each year the summer
edition of Heads Up includes at least one article about long- term
survivorship. Last year we profiled four brain tumor survivors; this
year we address one of the tougher aspects of survivorship: the issue of
survivor guilt. While survivor guilt is not experienced by everyone, and
may vary a great deal in intensity, it appears to be a common
experience.

Q. What is survivor guilt?
A. Survivor guilt has been described in Holocaust survivors, war
veterans, rescue workers, transplant recipients, and relatives spared
from hereditary illness. Relatively little discussion of survivor guilt
has taken place among long-term survivors of acute and chronic illnesses
such as brain tumors.

Survivor guilt, when it occurs, derives from situations where persons
have been involved in a life-threatening event and lived to tell about
it. It is often experienced after traumatic incidents causing multiple
deaths. In the special case of chronic illness, survivor guilt can occur
after the deaths of peers who faced the same diagnosis. By definition,
there is an implied comparison with people who have endured similar
ordeals.

Q. Who experiences survivor guilt?
A. Anyone who survives can experience these feelings including patients,
families, and healthcare providers. Survivor guilt explores the other
side of the coin of why me? --namely, why not me? Why did I survive when
others did not? Those who struggle with it may express the feeling of
being an impostor: somehow the "wrong" person survived; it "just doesn't
seem right." Many feel that beating the odds makes little sense unless
the survivor earned or deserved it in some way. But some survivors
emphasize they don't feel especially deserving. To complicate feelings
of unworthiness, in the early stages of grief there is a tendency to
idealize the deceased, so the survivor may feel even less deserving by
comparison.

Caregivers can experience their own brand of survivor guilt for not
being the one with the brain tumor. Relatives in some cases are more
aware of illness-related changes than the patient, who may have lost
insight as part of the disease process. Additionally, patients suggest
it is easier to cope being the one with the tumor than the one who
stands by feeling helpless. Many caregivers, perhaps feeling that they
have no right to add to the burdens of the patient, tend to set
perfectionistic standards for themselves that no one could possibly meet
("I should never feel frustrated by what my loved one is doing.") Then
they feel guilty for violating these standards. Parents and siblings can
have a particularly tough time of it, in part because of the
strongly-held belief that children should not have to experience illness
and death.

Q. Why does survivor guilt occur?
A. Survivor guilt may be reinforced by the frequent use of statistical
profiles to predict as well as to describe illnesses. However, people
given the very same odds for survival do not necessarily have similar
outcomes. When only one survives, it is not unusual to conclude that two
persons facing the same threat somehow changed places; that one person's
healing occurred at the expense of another; or that there is a debt owed
to those who are gone. Some survivors may keep a low profile to avoid
spotlighting this contrast of outcomes.

Survivor guilt can also arise if the tumor was benign, accessible and
operable, uncomplicated, caused no deficits, etc. Persons in this
situation can feel as if their concerns are trivial, and experience
guilt for having any needs at all, which may go long unexpressed.

Q. Does survivor guilt have a function or purpose?
A. Survivor guilt may exist for a reason. It can help people find
meaning and make sense out of their experiences. It may help survivors
cope with the helplessness and powerlessness of being in a
life-threatening situation without the ability to protect or save
others. It can also be one way to express a connection to those who have
died, a way, for a time, of keeping them alive. Importantly, survivor
guilt can co-exist with other responses, such as relief and gratitude,
and may occasionally be prompted by them.

Q. What can I do if I experience survivor guilt?

A.
Acknowledge and accept that guilt exists. Feelings of guilt are quite
common and represent part of the healing process for persons coping with
loss.
When people feel guilty, they tend to isolate themselves. While tempted
to keep silent, try to discuss the experience with persons who will not
express judgment.
Logic may have little or no impact on guilt, but it is important to do
some reality testing with your beliefs. Remind yourself that you are
human.
When you find you are comparing yourself with others, try instead to
evaluate your situation on its own merits.
Some people try to "work off" their guilt by setting high standards of
achievement. This is a very compelling strategy, but it rarely eases
feelings of unworthiness.
It may help to find additional ways to keep the memory alive for those
who have died by creating a special memory book or holding a service.
Remind yourself that you are struggling to make sense of one of the
greatest mysteries of the human race. Rather than explaining it away,
try to embrace the mystery.