Seven Strategies for Reducing Guilt
By Bruce Campbell
Guilt is a common reaction to ME/CFS and FM. Some people blame themselves for getting sick, thinking they might have avoided becoming ill if they had lived differently. Other people feel guilty about no longer contributing as they used to, while others lament that they aren't the spouse or parent they wanted to be.
True and False Guilt
If you experience guilt associated with being ill, what can you do to ease the burden? You’ll find below seven strategies used by people in our program. They are based on the distinction between true guilt and false guilt.
True guilt is the negative feeling we have when we harm others. False guilt, on the other hand, is a negative feeling triggered by not living up to standards that are no longer realistic or because of things outside our control. For example, we may blame ourselves for getting sick or feel guilty because we think we are no longer contributing to our family or to society.
The first strategy below is addressed to true guilt, the other six to false guilt.
If You're Wrong, Apologize and Make Amends
Guilt can be helpful if it motivates you to take better care of yourself in the future and to treat those around you with more care. One person said that if she does something to hurt her husband or her children, like lashing out at them verbally, she apologizes.
If being undependable bothers you, you can use guilt over canceling out on commitments as an impetus to be more consistent in pacing. Another person said, "I was so embarrassed by canceling out on people that I promised myself I would do better. That commitment motivated me to be more consistent in pacing and to become a more dependable person."
Adjust Your Expectations
Guilt is often triggered by perfectionism, holding ourselves to standards that don't fit our new capabilities. Rather than adjusting our standards to meet our new limits, we may measure our performance against either the person we used to be or the person we had hoped to be.
We may say things like "I have to do things perfectly" or "I have to be the best at everything" or "My kids deserve everything from me that other children get."
You can reduce guilt by adjusting your expectations so that they match your new level of functioning. How do you do that? One place to start is by doing a reality check on your expectations. On the left side of a piece of paper, list all those things you no longer do but think you should do, for example, fix elaborate meals, drive kids to their activities or earn a living. On the right side, write your judgment of whether the expectation is realistic.
Reframe (Change Self-Talk)
Part of the process of adjustment is changing our internal dialogue or self-talk, so that it supports our efforts to live well with illness rather than generating guilt.
One person in our program says that she used to chastise herself for taking a nap. Her self talk was "you are weak and lazy for having to rest." Now, when she goes to take a nap she tells herself, "I am helping myself to be healthy. I am saving energy to spend time with my husband or to baby sit my grandchildren."
Similarly, when feeling tired, you can say "This fatigue is not my fault; it came with CFS. So I don't need to feel guilty about not being able to do everything I used to." Or: "I didn't ask for FM, so why should I feel shame when it prevents me from doing things."
You can change your habitual ways of thinking about yourself to make them more accurate and more friendly. For step-by-step directions, see the article Changing Self-Talk.
When Feeling Guilty, Shift Your Attention
Even if feeling guilty is inevitable, we can control how we respond when feelings of guilt arise. One person in our program said that when she feels guilty, she asks herself, "Is this feeling productive?" In some cases, the answer will be "Yes." Guilt can draw our attention to ways in which we have failed to live up to our standards and can motivate us to act differently.
If the feeling is not productive, however, it may be better to respond to guilt by turning our attention elsewhere. As another person wrote, "It's better not to go some places in your head, so I've learned how to control my own thoughts."
Another said that when she is caught up in feelings of guilt, she tells herself things like ‘this isn't my fault' or ‘these feelings will pass as long as I don't allow myself to act on them'."
Educate Others (Within Limits)
In addition to adjusting your expectations for yourself, others expectations of you will have to change as well. People in our groups have suggested several strategies for doing this. One is to educate people about ME/CFS and FM, emphasizing that they are long-term conditions that impose significant limits and require adjustments of the person who is ill and those around her.
One person in our program gave each member of her family a booklet on CFS from the CFIDS Association and asked them to read it as their birthday present to her one year. The process of educating family and friends is usually a gradual one, often taking several years.
Learn Assertiveness
Another strategy for reducing guilt is to be assertive, standing up for yourself by stating what you will and won't do. A person in our program says that her family now accepts it when she says "I am sorry I can't do that." She tells about a family outing she and her husband went on with their adult children. At the end, her husband invited the children over to their house.
"In the past," the woman says, "I would have gone along with it, seething inside at myself for not saying anything and at them for not knowing I couldn't do it."
Instead, she told everyone that she needed to rest and she suggested that her husband spend the evening at one of the children's homes. So that's what the family did. The woman took a nap at home while the rest of the family went to a daughter's house to watch a movie.
Practice Relationship Triage
A final strategy is to reevaluate your relationships, practicing what we call relationship triage: making explicit decisions about whom to include in your life, concentrating on the more valuable or necessary relationships and letting others go.
You may decide that some people will never understand your condition or accept that you are ill. In some cases, you might choose to end a relationship. For relationships you decide are necessary, you might limit the frequency of contact.
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