Chronic Illness and Guilt

Lawrence Kron, Ph.D.

In the years that I’ve worked with the family members of patients with chronic illness, I’ve noticed how frequently they blame themselves in one way or another for the difficulties that the patient experiences. These feelings of guilt can be highly detrimental to family relationships. And they are rarely justified. Let’s look at a few of the more common situations.

Parents often worry about the possibility of a genetic factor being involved in the onset of the illness in their children. Even when there is a hereditary predisposition, it is doubtful that heredity is the sole cause of the illness. And even if the illness is hereditary, how can we blame ourselves for something that we also inherited? The reality of this circumstance is that the patient and family members are all victims of bad luck.

Another form of guilt shows itself in the idea that a family member should not permit himself or herself to have fun if the patient cannot also do so. It is part of the “misery loves company” myth. If you, as a family member, deny yourself for this reason, you will most likely produce a sense of guilt or responsibility in the patient. Rather than helping to make the patient more comfortable, you will have added to the burdens of the illness.

Many family members have a sense of guilt because they feel well, and were lucky enough not to be stricken with the illness. I think of this as akin to “survivor guilt”. In reality, everyone has to deal with the illness of a family member sooner or later. Would your family situation be improved if you also had a chronic illness? The family is actually lucky if only one member is ill. You can use the healthy energy you have to make adjustments in the family routine from time to time. This will enable the family to adjust most effectively to the ups and downs of the illness.

One of the more natural responses to dealing with a chronic illness in the family is a sense of frustration and resentment. Feeling guilty for having such reactions to the illness just adds fuel to the fire. Often the reactions occur because we have undertaken more tasks than the limitations of the illness require. There are many situations where the patient can help share some of the responsibilities. If you discuss your feelings with the patient, you will relieve some of your tensions in a more effective way. And, you will also avoid inducing a sense of guilt in him or her. You don’t need an answer for every situation. Just speaking openly and honestly with the patient is often all that both of you need.

Often family members chastise themselves when the patient’s illness flares up again. They ask, “What did I do to cause this? Could I or should I have acted differently in some way?” In an odd sort of way, we probably wish we were responsible. Then we would have the ability to change our behavior and positively affect the outcome of the illness. The truth is that many illnesses follow their own course, for the most part. There will be ups and downs, no matter what we do. We do know, however, that stress can create an environment in which chronic illness can flourish. We can do something if we help the patient to identify what is stressful for him or her. It is futile to try to guess what bothers a patient in every situation, and then attempt to avoid stress. Stress is highly individual and cannot be completely avoided. It’s matter of how we deal with it. Each of us, patient and family member, have to do that for ourselves, but it also helps to be supportive of each other.