Keeping Kids From Feeling Guilty Or Ashamed For Having Medical Issues

Guilt is not all bad!

We actually teach children to feel “moral guilt” for specific intentional actions in order to help them develop morals and keep them from aggressive, antisocial behavior. For example, we might tell a child that she has made her friend cry by taking her friend’s toy. Our goal is for her to feel just bad enough that she will begin to realize that harming others is not nice or acceptable.

Children typically develop this ability to see another’s perspective -- called “Theory of Mind” -- around age 6. This ability to understand another’s perspective also leads to the development of empathy. Before age 6, their ability to feel guilt will be less sophisticated.

At the same time, we don’t want kids to feel badly about themselves or to feel guilty for things that they have no control over. In other words, we want them to feel a certain level of guilt over intentionally harming others, but we do not want them to feel guilty for things that they have no power over.

This detrimental type of guilt can lead to dwelling on it and feeling stuck or paralyzed by it. That chronic feeling of being at fault can lead to anxiety, which often leads to depression. We often see guilt or shame accompanying depression.

Feelings of shame occur when kids are made to feel badly about themselves or guilty about things in front of others, or if the behavior or quality in them is known to be generally unwanted in their community. Commonly, kids will feel ashamed when parents point out their faults in front of their siblings, extended family, friends, or community members.

Kids and teens with chronic pain tend to be very high on the empathy scale. Thus, they are also prone to feeling guilty more easily. I often hear from my clients that they feel guilty that their parents are spending so much time and money on their chronic health issues. This internalized guilt definitely leads to anxiety and depression, which then exacerbates their pain, in a vicious cycle.

Some kids also feel ashamed that they are not functioning as well as their siblings or that they hold the family back from vacations or outings. Clients have told me that their parents chide them in front of their siblings about not achieving high enough levels academically, socially, athletically, and so on. Comparing your child to his or her siblings causes even more feelings of shame.

Your child’s guilty feelings about the effects of their chronic health circumstances on the family can only make their health worse. Remember, we want kids to grow up feeling healthy guilt about purposely harming others, but not feeling guilty about circumstances that are outside of their control.

While participating in their treatment is within their control, what’s not within their control is having the pain in the first place or the cost of health care. So, it is important to be aware of statements or behaviors that imply that they are responsible for the problems that their health issues cause. Your child is not purposely giving you a hard time—your child is having a hard time!

Here are some do’s and don’ts:

• Do not discuss finances in front of or within earshot of your child.
• Do not argue with your spouse about how to handle health issues within earshot of your child.
• Tell your child that it’s your job to take care of them, which includes finding and paying for practitioners.
• Let your child know that you feel better when they are getting the help they need.
• Do not compare your child to their siblings or peers.
• Be aware of the fact that your child is probably more sensitive to feelings of guilt than most people -- and respect that.
• Apologize and repair if you have made your child feel guilty in the past. Children are very forgiving, and it will help, even after the fact.