Not uncommonly, therapists tend to view guilt as a toxic emotion. They are often over-sensitized to the psychological effects of too much guilt—of unwarranted guilt—yet often under-sensitized to the interpersonal effects of someone having too little guilt—the absence of guilt when it is warranted, or someone prone to muddled outward expressions of guilt that achieve little interpersonal resolution.
Even more problematic is the practice in the world of cognitive behavior therapy of viewing guilt as a symptom that needs to be eliminated. For instance, in one of the American Psychological Association’s recommended treatments for PTSD, Cognitive Processing Therapy, guilt is essentially viewed as an irrational belief that needs to be challenged and eliminated. Along these lines, if a returning combat veteran is plagued with guilt for having acted brutally, or witnessing comrades acting brutally, during wartime, this is seen as an unwarranted irrational belief that needs to be eliminated, rather than a moral feeling that needs to be struggled with to achieve some measure of self-forgiveness. Insofar as mental health professionals do not sign on to witness and work with such guilt feelings and assist clients with inroads towards self-forgiveness, it can work against clients achieving true emotional resolution.
It is important to remember that among other things, guilt is one of the primary social emotions that keeps people socially aware and appropriately self-conscious. It signals us when we have acted badly and need to make amends to get our relationships back on track.
In the plainspoken words of the philosopher Herant Katchadourian in his mesmerizing book, Guilt: The Bite of Conscience: “guilt makes us feel bad to make things better.” It realigns the power imbalance that has occurred in relationships due to hurtful actions through the “redistribution of distress.” Knowing that the person who has hurt us feels bad about his or her actions, and desires to make amends, makes the hurt he or she has caused us more bearable. Their guilt results in the distress in the relationship being more evenly distributed. It’s not just me feeling bad when she acted badly. She also feels bad for having acted badly, and the pain is shared. In a sense, we feel better by the transgressor feeling worse. The transgressor’s guilt is the emotional catalyst for them to desire to make amends. Knowing that the pain is shared makes us receptive to their reparative gestures.
Guilt can serve a prospective and a retrospective function in bolstering relationships. Feeling guilty as we are about to act badly and potentially harm the relationship makes us hold back and think twice. Prospective, or anticipatory guilt, can be an indication of psychological maturity. It entails a rapid processing of potential interpersonal events: “Oops, if I say this in that way I know I’ll just make her feel bad. Maybe there’s another way of saying it; or, do I need to say it at all?”
It’s how psychologically mature people strive to balance honesty with kindness, truth with tact. To be “brutally honest,” as the saying goes, is still to be brutal, to render social feedback that might be useful, useless.
When a person feels guilty after some questionable misdeed, in the best of circumstances, it galvanizes them to want to make things right. Many clients get mired in guilt. They get stuck just passively feeling badly for their transgressions. Oftentimes inquiry into whether as children they witnessed parents “make up” after thorny conflicts reveals nothing of the kind. Therapy can raise their awareness of retrospective guilt being a signal for proactive apologizing and making amends.
Apologizing is just the initial step, what Katchadourian considers “an emotional down payment for what must follow.”
Ineffective apologies can be re-injurious. There’s the quick insincere apology to circumvent being the object of bad feelings: “Okay, I called you lazy. I’m sorry. Can we move on,” in an angry tone that does not convey any real quotient of remorseful feelings. Then there’s the one-time, emphatic, sincere apology made with the expectation that the slate will be wiped clean, leaving no emotional debt. This can be very effective with small transgressions and lapses in trust, but with larger acts of deception and betrayal can lead to intensified conflict.
Effective apologies come from the mouths of people who are obviously pained by their misdeeds and language their remorse with full awareness of the pain caused by those misdeeds: “I know I lied to you. It was wrong of me. I realize it is on me to make myself trustworthy moving forward. I feel so bad about what I did.”
In therapy, one of the most beneficial steps we can take with clients when there has been insensitivity, deception, or betrayal, is to help the offending partner effectively express diffuse or muted guilt, be moved to apologize with true awareness of harm felt and caused, and realize that it is the active making of amends—making things right with the offended person—that is truly restorative for the relationship.
Therapists also have a responsibility to fess up to their own insensitivity with clients. The good therapist aims for consistent empathy with clients. When therapists act in heavy-handed, less than sensitive ways, or offer inaccurate interpretations of clients’ experiences, or take charge of the therapy based on their own impatience or need to be productive—all failures in empathy—therapists need to take clients’ protestations seriously. Wording becomes important here. Saying, “I can see you are disappointed in me” reflects incomplete ownership of hurtful actions. Saying, “I was not fully present and aware of what you were trying to communicate to me and I can tell this hurt you” models more ownership of hurtful actions in ways that can help clients attain a capacity to express guilt feelings effectively and move towards relational reconciliation in their lives.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.