Moving Beyond a Sense of Guilt

Vol 10 #2

Caroline Giroux, MD, FRCPC

Author information:

Associate Clinical Professor, Department of Psychiatry and Behavioral Sciences, UC Davis Health System, Sacramento, CA, [email protected]

Every year around December, there seems to be an overwhelming convergence of deadlines amidst the rush for performing during the winter holiday festivities while at the same time feeling sunlight-deprived in those dark months. It is strange that we so eagerly let ourselves be pressured during a month where conditions are far from optimal. I tend to even drift in a pre-hibernation state, craving for obscene amounts of sweets and sleep. I look forward to celebrating with loved ones and I also want to be left alone. But what often hits the final nail on the coffin of my conscience is a song, like an echo of my superego that once again sounds disappointed in me:


“So this is Christmas, and what have you done?”


I must admit I love this song, those lyrics. They move me every time. They keep my compassion levels and humanism in check, and I wish they would show up a little sooner in the season, to offer me a gentle ultimatum, a final sprint for the materialization of my  good intentions. While some people fear purgatory or hell after death, what my sub-conscious apprehends the most is probably the message from this song. A choir from the dark cave of my core values. Interestingly, this song by John Lennon and Yoko Ono released in 1971 was not only a Christmas song but a protest song, with the choir in the background singing “war is over”, expressing hope for the end of the Vietnam war.


Especially in 2020, when we have been stretched so thin, destabilized by other types of wars, such as the pandemic, uproar from systemic racism, misinformation, extreme divides, this question hits hard. As a psychiatrist, I was lucky to maintain a job while not being overly exposed to high-risk situations (my practice switched to tele-health in March and the only patients I saw in person were during a weekend call). I was able to feel grateful for our health and safety (my family’s and my own) on a regular basis. But knowing other essential workers were thrown in the frontlines everyday, while scientists all over the world were trying to beat the clock by developing a vaccine, a familiar sensation crept in. A phenomenon that is universal in people who can experience empathy (in other words, the vast majority of us). Guilt. I don’t call it an emotion anymore because it is not.


  “Guilt. I don’t call it an emotion anymore because it is not”


Emotions are useful: they are signals indicating that our being is experiencing something, or it is not in balance and we need to attend to it. Emotions are the compass offering messages to decode in order for our willpower to guide the direction of our lives. But guilt? People feeling guilty for not being productive enough, for not being present enough, guilty for being depressed, even guilty for feeling happy? How useful is that? Have you seen anyone being elevated, motivated by guilt rather than crippled by it? Guilt is a secondary experience, triggered by something else, deeper, suppressed. I came to view guilt as a thought or a narrative emerging as an attempt to alleviate a not fully acknowledged or accepted form of suffering, such as a wound called helplessness. The latter being intolerable, our mind defends against it, builds this fortress called… guilt. It stabilizes our psyche for some time, it creates a respite from overwhelming feelings, but people who suffered depression will testify that guilt is an internal purgatory. Unlike anger that can be a motor for change when appropriately expressed, guilt is paralyzing, draining, non-transformative. It cuts people from their aliveness. Guilt is the Moebius ring that can never flatten out, making us trip over and over again in a maddening vicious cycle…


“We must go beneath the surface, we must access the so unpleasant core emotion”


So how do we transcend this? I would say we must go beneath the surface, we must access the so unpleasant core emotion that made us solicit guilt. Sometimes guilt is the expression of the perceived inability to live up to our self-image manufactured from internalizing external pressure, creating a grandiose, distorted persona that tries to shape the soul in a cookie-cutter fashion. Once we let go of the need to control how we appear to the world, once we abandon this illusion of a myth we are not, once we own our shadow figures,  the quicksand of guilt disappears and we are free to be the best of who we really are. This is how we can liberate energies that will unlock the corkscrew of our creativity to effectively problem-solve.


I look back at 2020 and see so much collective guilt around me. I called it “white privilege guilt”. There is most likely shame underneath that guilt. We have a historical debt towards our Native populations, African Americans and other populations that predominantly white groups have oppressed. I can’t help but feel it, when I sit down in front of a person of color, and hear yet again another story of police brutality, sex trafficking, harassment, discrimination, wrongful incarceration, and further traumatization. But what good this guilt has really done, so far? Hasn’t it been even more alienating at times?


With the vortex of major turmoil our world has witnessed, behind-the-scenes I also experienced the slow disintegration of a few initiatives that were promising. Not being able to connect in person seems to have changed everything. American patients losing their medical coverage along with their jobs due to COVID seemed like another atrocious social injustice. It was hard to not feel guilty in front of such a tautologically absurd scenario. Or rather, powerless. Yes, there is no point in feeling guilty. Guilt is like a verdict. Guilty of a crime. Mea culpa. It is inscribed in our sense of self and enchains it like a cannon ball… Powerless is more accurate, potentially more dynamic and hopeful if we think about it. Because when you are powerless, you can try to move away from that, by reclaiming something, by empowering yourself, little steps at a time.


“What I believe is fundamental to change: bearing witness to someone’s suffering.”


My powerlessness probably arose as I looked at the equation between life’s current demands and what I feel I can offer. I have no degree in politics. I am not an immunologist. I am clueless in front ventilators or other such machines. I am a person who is supposed to be equipped to heal others emotionally while I also need healing. The powerlessness seemed very real, and eventually I learned to sit with it. So I continued to show up for life, for work, for my responsibilities. And I reconnected more deeply with what I believe is fundamental to change: bearing witness to someone’s suffering. That is a good start (and a welcome distraction from this old pattern called guilt). Listening to others’ own helplessness and powerlessness stories. Together, by being part of a co-construction called therapy, we can move beyond hopelessness.


Recently, with two medical students, together we did listen to someone in need. We did bear witness to this African American man who had had a functional, relatively privileged existence until he had been victim of police brutality for “resisting arrest”, and violence during incarceration. A fruitful discussion ensued with the trainees who are at the beginning of their experience in psychiatry. We were all once again shocked by the disproportionate use of violence on people based on the color of their skin. Despite the emotions we inevitably experience upon hearing such outrageous accounts, the interviewer had done a wonderful job. I commended his listening skills. “You treated him like a human being. This is why we do this work. We help people by restoring their dignity.”  I had found a powerful guilt-solvent…


In December 2020, interestingly enough, I was waiting for the song. I was ready to embrace it. I could acknowledge my moments of deep powerlessness and my mini attempts towards social justice. I could hold such polarities simultaneously in my mental space. The song no longer sounded accusatory but encouraging. I felt encouraged to continue, even if only one encounter at a time. What if this song in could be decoded differently, what if its subtext would say: “what can you do, right this moment?” There is so much we are able to do, by being who we truly are. I invite you to shift from poisonous ruminations to what really matters through a mindful appraisal of your inner gifts to the world, even before the frantic planning of something that is not even there. Start by your anchor, your breathing, and by being thankful for it. Being in the moment will give it all the space it needs and deserves, with nothing left for a broken past or a frightening, uncertain future. It gives access to the riches that are here, and now, within you.


What can you do, right this moment? What can we, collectively, do, as we speak, as we breathe, as we believe?




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