Why me? Survivor’s guilt and EDs

I was always told that if I worked hard enough, I could recover. With hard work and time, the treatment centers told me, I would get well.

I am, by most measures, doing well. I’m not “fully recovered,” nor do I really understand what that term means. But I am doing well. It’s a fact I’m told I should be proud of. It’s a measure of how hard I worked, how I stuck with it, how I Worked The Program. I can pat myself on the back for a job well done.

Which is why feeling guilty about all of this is so bewildering.

There is, of course, the stereotypical ED sufferer’s feeling guilty about everything that happens, regardless of whether they should. But that’s not what this is. I feel guilty that I’m doing better and so many others that I know aren’t. I don’t understand why I’m doing well, why it is me that is doing well and not other people. It’s a classic case of survivor’s guilt.

Sometime in the 1960s, researchers began to notice that people who survived traumatic events, from surviving the Holocaust to returning from military combat, were experiencing intense guilt about the fact that they were alive when so many people who were in the same situation weren’t. The question “Why me?” plays over and over in their heads. It’s so common that survivor’s guilt is one of the symptoms of post-traumatic stress disorder.

An eating disorder is no different.

  • Why am I able to be in recovery?
  • Why is my health relatively intact?
  • Why did my parents/treatment team not give up on me?
  • Why didn’t I die when I probably should have?
  • Why did I have the chance to get well?

The most frustrating part is that these questions generally don’t have good answers. Why didn’t I die? I have no idea. I really don’t. I did some truly boneheaded things in the name of my disorder, not to mention the medical complications and near misses. I don’t know why my parents and treatment team didn’t give up on me. I don’t know why I got well when others didn’t.

If there was a reason–a good reason–the questions might not be so tormenting. But sometimes the answers have to do more with the vagaries of chance than anything about me or everyone else. Humans want the world to make sense. We want this so much that we create elaborate myths, deities, and superstitions to explain the inexplicable. For the answers of why we survived or why we got well, these answers are lacking.

I know that luck played a big role. I had parents whose own mental health issues and peccadilloes didn’t prevent them from engaging in my treatment and helping me get well. I had the financial resources to access treatment. My family and I had the acumen to know to look for better treatment when nothing was working. I was lucky. This wasn’t anything that I did or worked hard at (as so many professionals would have you believe). I was just lucky.

This isn’t to say that recovery isn’t hard work or you should depend on luck to get well. I know people who had the deck stacked well in their favor and who are still sick today. I have also seen the reverse at work. But someone doesn’t fail to recover because they didn’t work hard enough, which is what must be the case if hard work gets you well.

I can rationalize all this, tell myself that other people’s relapses and deaths have nothing to do with me and my own recovery. I get that. Logically, it makes perfect sense. That doesn’t stop the regular onslaught of guilt, however. It often doesn’t make sense. If so-and-so died, then I should have died, too. Maybe it would have been better if they were well and I were still sick. Maybe I would feel less awful about all of this if I were sick again. Maybe the constant gnaw of hunger is better than the constant knaw of guilt and regret.

Guilt can make you crazy like this.

I searched through the literature and there are no answers about this, scientific or otherwise. Sometimes the guilt goes away, sometimes it doesn’t. Like so many things in life, I think most of us with survivor’s guilt try to accept our newfound companion and quiet its voice and influence, letting it walk along beside us without actually affecting where we travel.

I still don’t have an answer to the why me question, but knowing that there will never be an answer at least keeps me from wasting too much time looking.

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13 Responses to “Why me? Survivor’s guilt and EDs”

  1. I completely relate…and am of the opinion after years of survivor guilt that there will never be the correct answer, just the correct way of dealing with it & coping for ourselves.
    When I was no longer critically ill, I began working with other sufferers, wanting to help them with what had helped me survive many years in the depths of AN both physically and psychologically.
    To cut a long heartbreaking story short, one of the girls I tried to help, died an horrific death directly from the effects of starvation. It sent me into a relapse & the survivor guilt remains, sometimes creeping up to a level that is dangerously unbearable, but usually at a level where I accept the unacceptable & the unanswerable & determine to keep living the life I still have. I am able to do that, possibly only from a point of detachment at times, although at other times I almost feel a kind of peace that comes with the acceptance, somehow, for which I am extremely grateful. It is hard, so hard, I’m just working on making it remain possible.

  2. PS. Carrie, I also agree that we could simply do our heads in with the Why did I survive, Why did they not survive scenario…its true there will never be an answer to that…I engaged in behaviours and dropped to weights that others have died at, so were I to allow my mind to keep going there, it would easily ultimately take away the life I am now fortunate and blessed enough to still be living…and I am DEFINITELY NOT going to let the AN win in that way either! 🙂

  3. I think I get what you mean, although I’m not doing as well as I would have liked to right now. Even then, the “why me” conscience still exists (I think it does in many of us with ED), why am I not as sick as that girl in wheelchairs? Why am I allowed to live, despite having treated my life like a piece of garbage many times, while the girl with leukemia who wants to live her life up is not allowed to? The questioning continues. But like you said, we will never find a reason that’s good enough t make us feel right.

    Either way, I am still truly happy for you that you are doing well right now 🙂 Whether there is a reason for your health for not aside, everyone deserves to be happy (I’m finally being able to come to terms with the fact that I too may deserve to be healthy) so I hope you can embrace it and just smile about it as much as you can 🙂

  4. I’m not sure if it that time of the month is coming or what, but this post actually made me cry. I reallyyy struggle with the idea that I have somehow found a way to do well and so many others have not. Like you said, I don’t know if I will ever feel like I deserve it. Trusting the ideas that everything happens for a reason and that some things will never make sense are difficult for me to wrap my brain around. I think part of my perfectionism is the fact that I need answers for every single thing that happens in life – this idea of why some people do well and others don’t, however, will never have a solid explanation. Thanks for the post. It really got me thinking this morning…

  5. This makes a lot of sense, and I think it also has to do with how we talk about “surviving” or “fighting” illness. The same two people may be working equally hard to “fight” their illnesses (whatever that means exactly) and one may survive while the other doesn’t. Same goes for cancer – we talk about “bravely battling” cancer, or “fighting and beating” cancer….does that mean that the people who died didn’t fight bravely enough?? These are hard questions because human bodies can be either extremely fragile or extremely resilient, and frustratingly diverse in their responses when faced with adversity. And some of that is totally out of our control, no matter how hard we work or not.

  6. I was born in 1950, the same year as Karen Carpenter. we both had anorexia. That beautiful songbird who had so much to offer the world died so young. I lived on to contribute in a minor way to the world. I think that I’ve managed to achieve full recovery. Sadly, my daughter has been battling anorexia for more than four years (likely a lot longer, actually). Will she make a full recovery? I dunno. She works hard at trying for recovery but it’s been a tough journey for both of us. My heart goes out to all those who suffer from ED and I mourn the loss of each precious individual who has lost their lives to these horrible EDs. Why them and not me? I totally “get” the survivor guilt.

  7. I am still at a place where I am easily triggered by this guilt back into behaviors. If I hear of someone not eating, losing more weight, etc, I hear in my head that if they don’t deserve to eat I’m being a pig if I do. I’m no better than them.

    It sounds like there is a place where one doesn’t have to be quite so vigilant about avoiding triggers- where they can be triggered emotionally but not move forward with active ed behaviors.

    I know rationally that it makes no sense for two people to suffer just because one does. Maybe the ed is just using other peoples’ suffering as an excuse to suck me back under- the ed voice is treacherously cunning.

  8. I love your blog so much!! I am in recovery from anorexia as well and your blog is so relatable. You are an amazing writer!! Please check out my blog and let me know what you think<3

  9. Sometimes guilt comes out of a deep sense of compassion and empathy for those who suffer. I really believe that the highest calling in life is to alleviate the suffering of others with compassion. The future is impermanent for us all. Compassion should begin with the self….you are here and now. In all that that means…

  10. I remember in treatment people talking about not deserving certain things. So what came to mind is do you feel you deserve to be healthy? Do you feel you deserve to have had the support you had? Same with the other questions you asked.
    It sounds like you have made a lot of progress.

    • Yes and no. There were lots of times when I felt I didn’t deserve treatment, help, love, food, you name it. So I do hear you, and yes, you’re right in many respects.

      This is a little different and it’s subtle. It’s not that I feel I don’t deserve recovery. It’s that I feel bad that I got better when others didn’t. It’s the *mismatch* that provokes the intense emotions, not the recovery itself. I don’t feel I didn’t deserve the support I got, but I feel guilty that I got it and others didn’t. I’m not saying I never feel undeserving, but that’s not exactly what this is.

  11. I definitely struggle with this. I’ve lost quite a few friends to ED and wonder, why were they taken and I spared, when I see them as being wonderful, loving people who had so much to contribute, and see myself as simply a waste of oxygen. I struggle hugely with guilt about the years of hospital treatment I’ve had, that someone else wasn’t able to access because I was ‘hogging’ the scant services.
    I can’t really get past those feelings.. yet… but I can try and make sure I don’t waste the chances and opportunities I’ve been given.


  1. News You Can Use – September 1-8 2013 « Eating Disorder Pro - September 5, 2013

    […] Why me? Survivor’s Guilt and Eating Disorders  – Sometime in the 1960s, researchers began to notice that people who survived traumatic events, from surviving the Holocaust to returning from military combat, were experiencing intense guilt about the fact that they were alive when so many people who were in the same situation weren’t. The question “Why me?” plays over and over in their heads. It’s so common that survivor’s guilt is one of the symptoms of post-traumatic stress disorder. An eating disorder is no different. Learn More. […]