Therapists: working with guilt

image of crying woman to represent guilt


Guilt is a negative emotional experience that occurs when we think we have done something wrong or failed to do something right. It’s one of those areas where, as therapists, we truly need to ‘work with what the client is giving us’ since every situation will be unique, but knowing more about what guilt is, and its underlying purpose, can help you decide how to support a client who experiences it.

 

What is guilt?

Psychologists suggest guilt comes from 'cognitive dissonance', in other words when our actions are not in keeping with our self-image. For example, if you think of yourself as a kind person you are likely to feel guilty if you say no when asked for a favour. Guilt can also be caused by breaking a rule (personal, ethical, social, legal or moral) or feeling responsible for others having done so; by doing less than your best (or thinking you have); or causing emotional or physical harm to others.

Guilt can often be associated with other issues as well, such as

  • anxiety
  • low self-esteem or confidence
  • depression
  • stress
  • grief
  • PTSD (e.g. survivor's guilt)

 

True guilt and perceived guilt

We can experience guilt whether or not our perceptions of the situation are shared by other people because guilt is about us judging ourselves rather than being judged by others. From this perspective, then, there are two kinds of guilt.


True guilt 

is what someone feels when the objective facts of the situation support their interpretation, in other words when their guilt is (at least to some extent) justified. An example would be throwing something when they are angry and breaking their partner’s favourite vase; they did not specifically intend the breakage but it happened as a direct result of their actions.

True guilt is broadly healthy, it’s our conscience and the purpose is that next time we try to do better.  In order to assuage it, and preserve something important to us, like a relationship or our self-esteem, we need to make amends; to acknowledge that we did something wrong; to seek forgiveness from ourselves or others or offer some kind of reparation.

If this is difficult or impossible to do in reality (which it can be, depending on context), then it can be achieved symbolically. For example, within hypnotherapy, you could consider allowing the client to apologise to the person they have wronged in their imagination if this is not possible in reality, and I find the ‘empty chair’ technique useful as well. If it is possible to put things right in the real world you can offer the client whatever support they need to do so – courage, perhaps or confidence to speak out. Identifying and future pacing coping strategies that allow them to handle similar situations better in the future will be helpful as well.

Pointing out to clients that only good people feel this kind of guilt is often worthwhile and acts as a nice reframe. If they were like a James Bond villain, with no morals or boundaries, they would feel no guilt about their actions at all.

Problems arise with true guilt if it’s out of proportion for the situation. At this point, it may be necessary to look at what part of the guilty feeling could be ‘perceived’ instead of ‘true’.

 

Perceived guilt (sometimes called false guilt) 

is what we feel when we assume responsibility for something that we really had no control over, or when our actions have unexpected or unforeseeable negative consequences.

It may be due to a genuine misinterpretation of our role in a situation, or a way of safely expressing a worse feeling or experience to which unconscious defence mechanisms have been applied. The latter is often the case if there are elements of both true and perceived guilt about the same experience.

Reframing can also help in this instance, as can release metaphors and the use of cognitive techniques such as thought diaries, challenging negative self-talk or assumptions etc. The goal is not to negate any genuine responsibility but to allow the client to safely release feelings that are not a reflection of reality. Useful questions to encourage the reframing include:

  • If a friend was in the same situation, would you judge them as harshly as you do yourself?
  • How reasonable or fair are the standards you are applying to yourself in this situation?
  • How much control did you really have over the situation?
  • At the time, did you understand what the consequences of your actions would be?
  • What alternatives were there? Why didn’t you take them?
  • If you had been on the other side of the situation, how would you respond?
  • How would you deal with this differently in the future?
  • What have you learned from this? How will that help you in the future?
  • How important will this experience be five years from now?
  • Can any harm that occurred be corrected?
  • How else could you make amends?

You can also use analytical techniques like the affect bridge regression or parts to find out why the client has been so strongly affected.

 

Denial, rationalisation or making excuses isn’t emotionally healthy and sometimes clients need to learn to understand their responses and actions better, and forgive themselves. If they find this difficult, point out that forgiveness does not imply that you agree with what was done. It simply means that you accept things happened that cannot be changed, and that you’re ready to apply self-compassion and move on.

Bear in mind that some issues that present as guilt are an indicator of a wider problem, for example, an affair is not just the behaviour of one person, there is almost certainly something not right within a relationship. In this case, a referral of one or both parties to suitable resources such as relationship counselling would be appropriate.

 


References

Mindtools Content Team. (n.d.). Dealing With Guilt: Gaining Positive Outcomes From Negative Emotions. [online] Available at: https://www.mindtools.com/pages/article/dealing-with-guilt.htm [Accessed 20 Feb. 2021].

Whitbourne, S.K.. (2012). The Definitive Guide to Guilt. [online] Available at: https://www.psychologytoday.com/gb/blog/fulfillment-any-age/201208/the-definitive-guide-guilt. [Accessed 20 Feb. 2021].

Lancer D. (2016). Is Your Guilt True or False? [online] Available at: https://psychcentral.com/lib/is-your-guilt-true-or-false#4 [Accessed 20 Feb. 2021].


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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion and Their Worlds, Your Words and a co-writer of the Hypnotherapy Handbook, all of which are available from Amazon.
Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi accredited hypnotherapy practitioner training, taster days and foundation levels.
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