Survival Guilt

Dr Ruwan M Jayatunge 

There is a higher incidence of depression in veterans who had been in combat and lost a friend. Survival guilt is an especially guilt invoking symptom. “Survivor guilt” is the term used to describe the feelings of those who, fortunately, emerge from a disaster, which mortally engulfs others. On an irrational level, these individuals wince at their privileged escape from death’s clutches(Harvery, 2007).

Private K is a soldier who was severely troubled by the survival guilt. He joined the Army in 1992 and served in the North. While serving in the combat his buddy was shot in front of his eyes near the Punani station. He fell down and lost his consciousness. Although Private K wanted to help his friend, he could not reach the friend due to heavy fire. Along with the other soldiers, he attacked the enemy and eventually went near his friend. But he was dead. This incident made him so upset. He felt guilty that he could not help the buddy.

By 1997, he often experienced headaches, intrusions about his dead friend and showed a marked depression. He became irritable and gave a startling reaction to any slightest sound. Private K felt uneasy with the military duties and wanted to avoid military situations. In 2003, he was referred to the Military Hospital Colombo and diagnosed as having PTSD.   Private K’s condition improved following drug therapy (SSRI) and psychotherapy (CBT and EMDR). By 2005, he was free of most of the PTSD symptoms. After cognitive restructuring, he got the insight and now Private K knows that he was not responsible for the death of his friend.

Did I bury him alive?

Private Lx26 became pitiful when he witnessed the death of his fellow soldier who got killed by a sniper shot. The troops had no means to bring the body back. After confirmation of death, Private Lx26 was ordered to bury the body. When he touched his friend’s body, he could feel the body warmth may be due to the hot Northern climate. Private Lx26 dug a pit and buried his friend’s body in the mist of sorrow. Then they advanced towards Omanthai. After a several days, Private Lx26 had an irrational and guilty feeling that he had buried his friend alive. He suppressed this painful feeling for a long time. Gradually it became a distressing thought, which he could not bear anymore. In 2003, he experienced a severe depressive reaction following survival guilt. He had full-blown symptoms of clinical depression. He was treated with Rational Emotive Therapy in which his irrational and illogical ideas were confronted via a friendly and therapeutic mediation. After the therapeutic intervention, Private Lx26 was free from devastating psychological burden that he had carried for long years.

My Sergeant died in my arms: says Private RS

I was born in a small village in Pollonarwa and often our village became the LTTE target. Several times the LTTE attacked our village slaughtering men women and little children. We had mass funerals after these attacks and most of the villagers felt utterly sad and insecure.  As a child, I saw these horrendous things around me. At night, we did not sleep in houses, for security we slept in the jungle. I did not see a way out for these tremendous problems except joining the military. So I was determined to join the Army. Our family had to face many financial hardships and that affected my education. I could not study further and I joined the Army. After my basic training, I served in Welioya and Vavunia.

In 1997, I participated in Jayasikuru (Victory Assured) operation and we were given a task to capture the Mankulam highway. We fought the enemy face to face. The gunfire lasted for nearly 3 hours. A commando unit came for our support and we were able to advance further. Sergeant L who was my senor NCO and my mentor was behind me. He taught me many combat skills. We always fought the enemy together. He used to cover me and I used to cover him. Both were lucky for many years. However in Mankulam he was hit by a bullet. Sergeant L was bleeding profusely. I helped to evacuate him. I carried him while praying for his life. His breathing became shallow. I could not reach the medics, half way he died in my arms.

After his death, my conscience blamed me for not saving him. I felt guilty. I wish I could have taken him to the Medical Point on time. If I had done that, it could have saved his life. But I was late and Sergeant L died. I was troubled by this guilty feeling and combat related nightmares and various intrusions. My life became to a standstill. I was filled with sorrow and repulsion of combat events. I was disgusted with all these issues and once I wanted to shoot myself and end the suffering. Somebody or some power saved me from self-harm and showed the way towards life. Again, I saw light.

(Private RS was found with PTSD comorbid with depression.  Following intensive treatment, he was able to recover. He became free of survival guilt that had troubled him for a long time. Now he is serving in his unit without firearms and doing light duty. )