A young man attending a concert on October 1, 2017, Scotty Petterson, acted heroically during the horrific Las Vegas mass shooting and saved many people’s lives, but, afterward, he was engulfed by survivor guilt. Tragically, Petterson took his own life in January 2021 at age 31 because, according to his parents, he was overwhelmed by the experience.

With more than 1 million lives lost to COVID-19 in the United States, survivor guilt is something that will afflict thousands of people who recover from the disease when their loved ones do not. Why do human beings suffer survivor guilt and how can it be managed?

Feelings of Fairness

Feelings of fairness are powerful forces that draw human beings together into cooperative groups. Our sense of fairness is the bedrock of our complex legal system, which seeks justice for those who are harmed. Surviving a life-risking trauma when others in the group did not can spark intense feelings of unfairness. Such feelings of guilt are intensified for survivors because there is no way to even the score.

Feelings of Failure

Feelings of failure are the second component of survivor guilt. Survivors will often suffer dreadful feelings that they could have done more to have prevented or to have better coped with the tragedy. Such ruminations fuel a vicious, inescapable cycle. “I shouldn’t have invited grandpa to Thanksgiving dinner during the pandemic,” is an inevitable reaction to a loved one becoming stricken with COVID-19 in this situation. But hindsight is 20/20, and regardless of the circumstances of any deadly traumatic experience, one can always imagine how the tragedy might have been avoided or better managed.

Both feelings of fairness and feelings of failure fuel the most powerful altruistic and heroic actions of people in life-risking situations. The captain of a sinking ship insisting on being the last one to escape to safety or choosing to go down with the ship does so because they could not live with themselves if they did otherwise. Maybe that is why our peculiar species experiences survivor guilt—for the good of the group.

Survivor guilt can be viewed as an aspect of grief or a debilitating symptom of post-traumatic stress disorder, but does categorizing this profound psychological reaction help? The fact is that there is very little research on this serious and very common, potentially life-risking disability.

In my view, understanding is the first step in managing anything. It is important to recognize that survivor guilt is a natural response that is shared by all types of people. Viewed as a consequence of people’s feelings of fairness and failure, survivor guilt is not so perplexing. The best of us are the ones who are stricken.