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Survivor, survivor's, or survivors guilt or syndrome is a mental condition that occurs when a person perceives themselves to have done wrong by surviving a traumatic event when others did not. It may be found among survivors of combat, natural disasters, epidemics, among the friends and family of those who have committed suicide, and in non-mortal situations such as among those whose colleagues are laid off. The experience and manifestation of survivor's guilt will depend on an individual's psychological profile. When the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) was published, survivor guilt was removed as a recognized specific diagnosis, and redefined as a significant symptom of posttraumatic stress disorder (PTSD).
Survivor guilt was first identified during the 1960s. Several therapists recognized similar if not identical conditions among Holocaust survivors. Similar signs and symptoms have been recognized in survivors of traumatic situations including combat, natural disasters, terrorist attacks, air-crashes and wide-ranging job layoffs. A variant form has been found among rescue and emergency services personnel who blame themselves for doing too little to help those in danger, and among therapists, who may feel a form of guilt in the face of their patients' suffering.
Sufferers sometimes blame themselves for the deaths of others, including those who died while rescuing the survivor or whom the survivor tried unsuccessfully to save.
Survivor syndrome 
Survivor syndrome, also called concentration camp syndrome, or called KZ syndrome on account of the German term Konzentrationslager, are terms which have been used to describe the reactions and behaviors of people who have survived massive and adverse events, such as the Holocaust, the Rape of Nanking, and the HIV/AIDS epidemic. They are described as having a pattern of characteristic symptoms including anxiety and depression, social withdrawal, sleep disturbance and nightmares, physical complaints and emotional lability with loss of drive. Commonly such survivors feel guilty that they have survived the trauma and others—such as their family, friends, and colleagues—did not.
Social responses 
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Sufferers may with time divert their guilt into helping others deal with traumatic situations. They may describe or regard their own survival as insignificant. Survivors who feel guilty sometimes suffer self-blame and clinical depression.
Early disaster response and grief therapy methods both attempt to prevent survivor guilt from arising. Where it is already present, therapists attempt to recognize the guilt and understand the reasons for its development. Next, a therapist may present a sufferer with alternative, hopeful views on the situation. The emotional damage and trauma is then recognized, released and treated. With growing self-confidence the survivor's guilt may be relieved, and the survivor may come to understand that the traumatic event was the result of misfortune, not of the survivor's actions. Once able to view himself or herself as a sufferer, not one who caused suffering, the survivor can mourn and continue with life.
Waylon Jennings was a guitarist for Buddy Holly's band and initially had a seat on the ill-fated aircraft on The Day the Music Died. But Jennings gave up his seat to the sick J.P. "Big Bopper" Richardson, only to learn later of the plane's demise. When Holly learned that Jennings was not going to fly, he said, "Well, I hope your ol' bus freezes up." Jennings responded, "Well, I hope your ol' plane crashes." This exchange of words, though made in jest at the time, haunted Jennings for the rest of his life. Jennings, who later became a country music star, expressed survivor's guilt about Richardson's death.
Holocaust survivor Primo Levi, haunted by his experiences in Auschwitz, explored his own survivor's guilt extensively in his autobiographical books, notably in I sommersi e i salvati (The Drowned and the Saved). His death was reportedly a suicide, and towards the end of his life he suffered from depression, possibly induced by his experiences.
References in popular culture 
In the 1980 film, Ordinary People, based on the novel of the same name, Conrad Jarrett is a young man who struggles with surviving a sailing accident which killed his older brother. As Jarrett realizes that he is angry at his brother's recklessness, he confronts the very cause of his problems and begins to accept his own survival had nothing to do with his brother's death.
In the video game American Mcgee's Alice, and the sequel game, Alice: Madness Returns the protagonist, Alice Liddell enters an imaginary world (Wonderland) turned malicious by her guilt of surviving the fire that killed her parents and sister.
The 2012 video game Spec Ops: The Line has the main character Martin Walker send out a distress message in one of the endings of the game. When he brings up the topic of survivors, he simply states "one too many," referring to himself.
In the musical Les Misérables Marius Pontmercy sings "Empty Chairs At Empty Tables" which contains lines such as, "Oh my friends, my friends - forgive me, that I live and you are gone. There's a grief that can't be spoken. There's a pain goes on and on." Marius, along with many other students, fought at the barricades in the June Rebellion, however he is the only one to make it out alive as he is rescued by Jean Valjean.
Julia Hoban's book Willow explores the survivor guilt of a sixteen-year-old girl whose parents died in a car crash where she was driving. Despite the fact her parents knew she didn't have her license and the weather conditions caused the accident, she feels as if the accident was her fault and that she shouldn't have survived, resulting in her participating in self-harm.
Multiple characters in the BioWare science fiction game series Mass Effect express feelings of survivor guilt including Ashley Williams, Garrus Vakarian, and even Shepard him/herself if the Sole Survivor background is chosen at character creation.
In the Family Ties episode, "My Name is Alex", Alex Keaton sees a psychiatrist about his survivor guilt after his friend is killed in a car accident, in part because his friend was running an errand that Alex declined to help him with.
In the "Honest Hearts" downloadable content for Fallout:New Vegas, it is indicated through the journal entries of mentioned-only character named Randall Clark that he suffers from survivor's guilt after the deaths of his wife and son.
The Japanese war film Otoko-tachi no Yamato briefly touches upon survivor's guilt, when the main character Katsumi Kamio returns to Japan after the Yamato is sunk, along with nearly all of her crew of 7,000. Kamio visits the mother of one of his dead friends and shipmates to tell her about her son's death, not believing her son is dead she calls him a liar and then says "How dare you be one to survive" before walking off. The day after she finds him working in the rice field, he kneels before her and begs her forgiveness for being "the only one left". In response to this she drops to her knees and begs his forgiveness for what she said to him.
The Japanese visual novel Fate/Stay Night focuses on the protagonist, Shirou Emiya, who suffers from survivor's guilt after being saved in a catastrophic fire as a child. The story follows how this has warped his perception of morality and his single-minded pursuit of justice as a result and the consequences of leading such a life.
See also 
- JoNel Aleccia, "Guilty and stressed, layoff survivors suffer, too", msnbc.com, December 15, 2008
- Bonnie S. Fisher, Steven P. Lab. Encyclopedia of Victimology and Crime Prevention, SAGE, 2010, p. 33, ISBN 978-1-4129-6047-2
- "The evolution of mental disturbances in the concentration camp syndrome (KZ-syndrom)". 1990-02. Retrieved 2010-12-07.
- Walt Odets, "In the Shadow of the Epidemic: Being HIV-Negative in the Age of AIDS", 1995.
- Raphael Beverley, (1986). When disaster strikes. PP 90-91. Century Hutchinson, London.
- Wilson JP, & Raphael B Editors. Theoretical and Conceptual Foundations of Traumatic Stress Syndromes. The International Handbook of Traumatic Stress Syndromes, p. 1. Plenum Press, New York. 1993.
- VH1's Behind the Music "The Day the Music Died" interview with Waylon Jennings.
- "Waylon's Buddy: Jennings Never Forgot His Mentor". CMT.
- Bertman, Sandra L. (1999). Grief and the healing arts: creativity as therapy. Baywood. p. 166. ISBN 978-0-89503-198-3.
- Corr, Charles A.; Balk, David E. (2010). Children's encounters with death, bereavement, and coping. Springer. p. 210. ISBN 978-0-8261-3422-6.
Further reading 
- Encyclopedia of Stress, Academic Press; 1st edition (April 2000)
- Diagnostic and Statistical Manual of Mental Disorders IV, American Psychiatric Publishing; 4th edition (June 2000)