The survivors of the attacks in Paris, like those of Charlie in January 2015, tell it: it took a centimeter half an hour, sometimes a tiny detail, to escape the bullets of the terrorists. Surviving an attack, taking a hostage, a natural disaster or something else can be a miracle, but it often does not prevent you from feeling guilty. Guilty of being alive, in the place of others, or of not being dead with them. This feeling is called the survivor's guilt. The explanations of Hélène Romano, doctor in psychopathology and psychotherapist referent of the specialized psychotrauma consultation of the CHU Henri Mondor in Créteil (94).
Interview by Anne-Laure Vaineau
Who can be touched by this survivor's guilt?
Hélène Romano : There is in the guilt of the survivor a projective identification with the dead which can concern a lot of very different people. Those who lived through the drama and survived, of course, but also those who should have been there and were not there. It could also be someone who was passing by a few minutes before or someone who thought he could have been in the place of the victims, because he recognizes himself in it, as a target for example.
Does it express itself in the same way for everyone?
The guilt of the survivor is major and mainly expressed by those who have actually escaped death, those who were present at the time of the tragedy and were exposed to a major traumatic event, the first level of break-in in their psyche. In addition, some are personally bereaved if the victims were loved ones or loved ones, whose lives they were exposed to. To all this is added their guilt of the survivor. For them, more than for those who project themselves in a secondary way, the troubles may be more accentuated.
How does the survivor's guilt translate?
Without systematizing, because we do not all have the same resources, the same story, and we do not all evolve in the same way, trauma-related disorders are most often: revivals, nightmares, anxieties, unexplained fears, anxiety with every sound that can evoke the memory of the drama. All so-called hyper-vigilance symptoms related to reliving the event. The feeling of guilt is reflected in rehasitions, ruminations: to say that one should have died in the place of the other, or with the other. To this is generally added an asthenia, that is to say a loss of vital momentum: we no longer feel legitimate to live, more legitimate to be there, we no longer manage to project ourselves into positive things because we feel guilty for living.
Does this require consultation?
Not necessarily, and not just anyone. It is better to turn to a therapist trained in this type of care. But one can also find personal, family, sufficient resources. Not all victims need therapy. I think we should not be psychiatric at all events if the reactions are adapted and people are surrounded by sufficient resources to help them overcome the horror. The cursor is when the troubles become so invasive that we can not live, leave home, invest, and that the suffering is so important that the family can no longer wear it , and to bear it.