In line with PTSD Awareness Day (June 27th 2022), we wanted to talk about the guilt and shame that often is a part of Post-Traumatic Stress Disorder (PTSD) Common regrets are about decisions made, feeling responsible for your actions and the impact of your mental health on others. Much of the root of the guilt is buried within things that you had no control over. This can make it difficult to deal with. How can you cope with guilt that you didn’t even create? 


What is the difference between guilt, shame & regret?


The words guilt, shame and regret are often used interchangeably. The feelings caused by each of them and the instinctive behaviour they induce are very similar. It is instinctive to feel embarrassed and not want to discuss issues that make you feel guilt, shame or regret. There is a tendency to deny these aspects of ourselves exist. There is a certain amount of stigma attached to them and that you may not be accepted if others knew. 

Although guilt, shame and regret are each an emotion associated with something wrong that happened, each one has a different relationship to the wrong. So, what exactly are they? 

Guilt is about something you did; ‘I feel bad because I did something wrong’. 

Shame is about you and your suffering; ‘I feel bad because I feel I will be judged by others for what I did’.

Regret is grieving for something that did or didn’t happen; ‘I feel bad because I wish this had happened instead of this’.

Much of what is described as trauma related guilt is not guilt at all. It encapsulates incidents and events which you did not do – it is not your guilt to own. So, this is incorrectly termed. However, it does not make the feelings any less painful to know it is not guilt you are feeling!  


What is trauma-related guilt?


Trauma related guilt feelings are those that develop after one or several incidents of trauma. You may have feelings of regret that the incident happened. For example, you may regret that you walked past the shop at the same time as the person bullying you. You may have feelings of guilt that you could have prevented the incident from happening. For example, a war veteran may feel guilty they were not able to save the life of their friend. You may have feelings of guilt over something you did. For example, you may have been driving the car that crashed and killed your partner. You may have feelings of shame over the incident. For example, you may feel shame that your father sexually abused you for years.

You may have feelings of regret over something you didn’t do. For example, a rape victim may regret they didn’t fight back against their attacker. You may have feelings of survivor guilt because you survived the incident and someone else didn’t. 

Trauma feelings are always valid

Anything that is registered as traumatic is likely to have some form of trauma related guilt, regret or shame associated. There are no scales of severity associated with trauma. Your brain either considers it traumatic or not and any emotions you feel alongside the trauma are valid. Our brain constantly scans our environment for threats and will create trauma templates as a guide. These templates can become thresholds in that if something similar occurs the brain will think you are being threatened. If these templates are outdated then we need to tell the brain that this template is no longer needed. Read our earlier blog on traumatic experiences here for more details. 


What is the impact of trauma related guilt?


The impact of constant feelings of guilt, shame and regret are serious. These feelings are negative and are often associated with poor mental wellbeing. They can induce low self-worth, low self-esteem, self-harm, addictions, eating disorders, depression, anxiety and many other disorders. 

Not all the guilt associated with PTSD comes from the trauma. You may have strong feelings of guilt associated with the PTSD itself. Having a mental condition is not easy. The condition affects you and those close to you. It is therefore not uncommon to feel guilty about how your condition affects those you love. You may think you are a nuisance; a burden and people would be better off without you around. (You’re not, and they definitely wouldn’t!)

Long term feelings of guilt, shame and regret can in some cases lead to suicide. Constant negative thoughts and feelings can can erode and diminish self-worth  and if this is the case, someone may start to feel that they have no value. It is important that if you, or someone you know, feels like this, that help is sought urgently.


The impact of trauma related shame


Shame is when we have learnt it is not ok to be who we are. As with trauma related guilt, it will impact on your mental wellbeing and is linked with multiple disorders. Shame is slightly more complicated as it is usually based on a distorted view of yourself. So, a person who has grown up in an emotionally abusive home may have been constantly told they are stupid. The person genuinely feels they are stupid and are ashamed of this. They will try and hide their stupidity by working twice as hard to become perfect. Alternatively, they may develop self-destructive or self-sabotaging behaviours to hide the stupidity, for example getting drunk or starting fights. 

Shame can be linked to anger, rage, self-criticism and self-blame, self-neglect, self-destructive behaviours, self-harm and self-sabotaging behaviours. It is also linked to believing you do not deserve good things or relationships with good people. This can create a self-fulfilling prophecy meaning you only have relationships with people who reinforce your beliefs. Many school bullies suffer from trauma related shame. They unconsciously repeat the cycle of abuse on the victim using rage and criticism. 


How can we treat trauma related guilt and shame?


PTSD treatment should always work with the trauma patterns that have been laid down in the brain. Trauma patterns are very one-dimensional and flat. This means that someone’s perception of the memory is likely to be distorted. Specific techniques can help the brain to re-process the memory so that the whole picture is revealed, and allow the strong emotion in the memory to fade and become more distatnt. This often removes the guilt, because a person’s actions can be put into perspective and become understandable. 

Cognitive behavioural therapy (CBT) focuses on your thoughts and consequential interpretation of a situation. CBT tools can help you to become more aware of your thoughts and how biased and unjust they can be. Once the traumatic event has been re-patterned by the brain, you can use CBT tools to become more self-compassionate and accepting of the historical event. This can help you to move forward with your life. 

Self-compassion is the antidote to feelings of guilt and shame. Learning to be self-compassionate and how to forgive yourself are very powerful tools. They are absolutely essential steps to take to become emotionally healthy and improve your wellbeing. 

I hope you’ve found this article helpful. If you know of anyone who would benefit from reading it please share it with them. And if you’d like to speak to Russ or myself about your trauma, then simply head over to our website where you can contact us. 

With warmest wishes


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