In Going Deeper, Rachel Samson shares how to maintain joy and relief at the same time—without the guilt.
Dear Rachel,
I am in remission after cancer treatment and I am so grateful to be here. But lately, I’ve been feeling guilty when I hear about others who didn’t survive the same diagnosis. How can I maintain the joy and relief of my own recovery while carrying the burden of those who have not had the same results?
Dear Reader, what you describe is often called “survivor’s guilt” and is a common human reaction to what others have experienced and survived. When we face suffering so directly, our hearts can expand. Gratitude can deepen, but so does understanding loss. The very capacity that allows you to experience relief and joy also allows you to experience grief. The depth and complexity of emotions that survivors often experience is what keeps them tender in the face of loss and life.
From the perspective of traditional Buddhist approaches and modern therapeutic approaches such as Acceptance and Commitment Therapy (ACT), painful thoughts and feelings are not problems to be overcome, but practices to make room for them. Your mind is trying to make sense of survival in a world that can feel painful, unfair, and unpredictable. Thoughts such as “Why them and not me?” or “I don’t deserve my happiness” may arise because the human brain is wired to seek meaning and, for most people, justice. Acceptance approaches invite us to observe our thoughts as thoughts, not truths or facts from which we must be guided, but transitory and transitory events. You can gently say to yourself, “I guess I shouldn’t feel happy,” or “Other people must have felt the same way,” or “It’s not fair.” This small shift can create space between you and your thoughts, allowing you to approach them with curiosity. I often ask people I sit with in clinic to visualize their mind as the sky and their thoughts as the changing patterns of weather or clouds. The sky is a space where rain or clouds come and go, but the sky is not clouds. Similarly, you are not your thoughts, your mind is the space where your thoughts come and go.
Acceptance also motivates us to be ready for what happens. Grief for others and gratitude for one’s own life are not exclusive situations. They can live together in a day, minute and moment. The well-being or gratitude of the survivors does not betray those who did not survive. Feelings of sympathy and sadness do not diminish the gratitude of being alive. Mental resilience is the ability to move through difficult emotions while continuing to live in harmony with what is most important. Your gratitude, your sadness can be while you live a full and meaningful life. It’s not about not having these emotional experiences, it’s about learning how to live with them.
Compassion-focused therapy, developed by Paul Gilbert, offers us another lens through which to see. Our brains evolved with threat systems designed to detect danger and prevent harm. After a serious illness or loss, that system may remain sensitive and look for signs of loss, injustice, or vulnerability. At the same time, humans have a great capacity for empathy, love, compassion and care. Survivor’s guilt often occurs when our empathy is activated without a clear place of direction. Our heart asks: “What can I do with this love and compassion that they don’t have?”
Instead of turning compassion into self-criticism—for example, “I shouldn’t be alive when they aren’t”—Gilbert encourages the cultivation of compassion: responding to our own suffering with the same warmth that we offer to a friend. You can put your hand over your heart and admit, “This hurts. I’m sad. And I’m allowed to be here.” Compassion is not a limited resource, your survival does not diminish your concern for others. In fact, self-care helps keep compassion alive in the world.
One of my own Zen teachers, the late Thich Nhat Hanh, wrote that joy and suffering “go hand in hand.” One cannot exist without the other. When we carefully drink tea, we become aware not only of its warmth and aroma, but of the rain, soil, and hands that made it possible. Likewise, your recovery exists alongside the reality of illness and loss. To deny yourself joy is to deny life itself. To ignore suffering is to turn away from our shared humanity. The trick is to keep both.
Mindfulness offers a gentle way to do this. When gratitude arises, we can allow ourselves to feel it fully – the breath entering our lungs, the simple miracle of being alive. When grief arises, we can allow it to move through us like the weather. No state is permanent, they are also visitors. Thich Nhat Hanh often taught: “Breathing, I know that I am alive. Breathing, I smile at life.” This smile is a beautiful and simple act of respect for life.
Finally, consider that sin often arises out of compassion and love. If you didn’t care deeply, you wouldn’t feel this intensity. Sometimes guilt is grief and love. Instead of judging sin as a negative, you can thank it for revealing your humanity and gently make room for it to flow freely, and also allow yourself to move and live freely.
