Confidence with Chronic Illness: Reducing Guilt & Shame
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, children’s ability to feel guilt will be less sophisticated.
At the same time, we don’t want kids to feel badly about themselves or guilty for things 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 they have no power over.
This detrimental guilt can lead to dwelling on it and feeling stuck or paralyzed. 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 feel bad about themselves or guilty about things in front of others or if their behavior or quality in them is generally unwanted in their community. Children commonly 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 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!
Some dos 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 care for them, including finding and paying for practitioners.
- Let your child know you feel better when they get the needed help.
- Please do not compare your child to their siblings or peers.
- Be aware 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.
