Managing Guilt

Guilt is a common feeling for parents of children with cancer. Parents naturally want to protect their children. When children suffer, parents may blame themselves and feel powerless when they can’t take away the pain.

Sources of Guilt

Guilt can come from a variety of sources throughout the cancer journey. Some parents struggle with feelings of guilt much of the time. Others may find guilt creeping in during times of stress or when time or decision demands are highest. Some common triggers for parental guilt during cancer include:

• Being powerless to take the cancer away
• Feeling like signs were missed or not knowing the child was sick sooner
• Making the “right” choices for care and treatment
• Being unable to stop the immediate or longer lasting side effects of treatment
• Concern that cancer is hereditary and genes caused the cancer
• Fear that something preventable caused the child to get sick or will make the child’s condition worse
• Worry about making parenting mistakes
• Spending less time with siblings and worry that siblings are being neglected
• Spending time away from the sick child to take care of work, home, and family responsibilities or to take time for themselves

Guilt is often not rational or logical. Many well-meaning people will say, “You shouldn’t feel guilty.” However, the feelings are real, and dealing with guilt can be particularly challenging for parents of children with cancer.

Steps for Dealing with Guilt

It is important to address feelings of guilt rather than ignore them. Occasional guilt is normal for parents. However, feelings of guilt can have a number of negative effects. Feelings of guilt can contribute to parental anxiety and depression and make it harder to cope during stress. Guilt can interfere with decision making, especially related to treatment and care needs. Parents may become overprotective, which can affect a child’s physical, social, and emotional health. Feelings of guilt and blame can also be a barrier in marriage and family relationships. However, there are ways to deal with feelings of guilt more effectively.

Recognize guilt

A first step in managing guilt is to acknowledge specific feelings around guilt and self-blame. This includes identifying your specific triggers for feeling guilt and when guilt tends to be worse. Understanding both the feeling and the cause is important for developing a plan to cope.

Find a trusted person to listen

Many parents just need someone to listen. Admitting feelings out loud can be a relief, especially if you tend to keep negative thoughts and feelings to yourself. A close friend, family member, therapist, religious leader, or another parent in the same situation may provide a safe place to voice guilt, self-blame, or worries about doing the right thing.

Identify what you can control, and acknowledge the unknown

Guilt is often related to feeling helpless or uncertain about medical care and health needs. It may not be possible to take those feelings away completely. However, the care team can be an important resource. Talk about questions and concerns related to treatment, side effects, genetics, or other medical issues with the care team. Write down questions and answers. Keep a notebook of the plan and next steps. This can give reassurance that you and the care team are doing their best in a difficult situation.

Lower expectations of yourself

For many parents, guilt is related to too many demands and an inability to accomplish everything. Parents feel pulled in all directions when life is normal. During cancer, this can become unmanageable. It is not possible to balance everything all the time. Focus on your top priorities for the short-term, and identify what you need to take care of in the near future (today, this week). Then, set smaller, more manageable goals that are realistic for your current situation. Lowering expectations is not failure; it is a positive response to dealing with a difficult situation.

Learn to let go

For someone dealing with guilt, letting go is not easy. It isn’t easy to let go of the past. It isn’t easy to let go of control over decisions. It isn’t easy to let go of children as they get older and make their own choices. But, letting go – at least to some extent – is important to move past guilt. Letting go means different things. It can mean giving yourself time to think about guilt but setting limits on thoughts for the day. It can mean being active in decision making but trusting your doctor’s recommendations. It can mean allowing a spouse to participate in parenting or treatment choices. It can mean forgiving yourself or others for mistakes. Learning to let go allows you to share responsibilities and be more engaged in what is most important.

Focus on the positive

It can be hard to be positive when you feel guilt. Self-blame makes it seem you are doing everything wrong. However, intentionally focusing on the positive has several benefits. It improves mental and physical health, creates an atmosphere of hope, increases confidence, and promotes quality of life for patient and family. Acknowledging what you are doing right, can help keep guilt from taking over. Some ways to focus on the positive include:

• At the end of each day, write down ways that you were able to help your child and family. 
• Keep a gratitude journal of good things throughout the day.
• Find small ways to praise and appreciate your spouse or children. 
• Write a to-do list in the morning that includes things you routinely do but take for granted such as making your child laugh, giving your child snuggle time, watching a show together, providing special attention to siblings, sending a “thinking of you” text to a friend or loved one.
• Use inspirational quotes, pictures, and songs as reminders to be positive.

These steps to manage guilt are not always easy. You might focus on one or two as a start. A source of guilt for many parents is taking time for themselves. However, taking time to pray, meditate, exercise, be alone, or spend time with friends is a source of strength. Some parents also find that journaling thoughts and feelings can help uncover and express emotions in a more personal way. Support groups can be another important resource for parents dealing with guilt. However, if guilt continues to be a struggle, seeking help from a mental health professional can help parents work thought difficult emotions and process feelings of guilt.