I want to take a moment to thank my blog followers for sticking with me through these heavy topics. We’re more than halfway through now, and soon, I’ll be moving on to how to write other aspects of mental illness accurately. While it doesn’t mean you can’t take liberties and poetic license, I’ve seen writers bumble through having no idea what they’re writing about. (One of the most woeful examples I can recall is calling a person on the Autism Spectrum a “psychopath.”) The stories are still popular, but for people with the disorders they’re maligning, and the therapists who treat them, it’s cringe-worthy and ruins the story.

Last week, we explored the phase of bargaining in The Psych Writer series. This week, we’ll look at the next one: Guilt.

All together now, say it with me: these phases are organized for the benefit of the clinician. They are not set in stone and the patient will likely not feel these things in order, or one at a time. They might, but they might not. Grief is individualized.

Nearly everyone on earth has experienced guilt and knows how it feels. When it happens in the guilt phase of grief, it manifests in a variety of ways. Here are some of the most common statements I’ve heard from patients in this phase:

“I wish I had spent more time with X before s/he died.”

“I should have been there to take away his car keys.”

“The last thing I said was ‘I wish you were dead,’ and now look what happened!”

“This is all my fault. I had to sign the papers to pull the plug. I killed my X.”

“If I had just noticed sooner, I could have urged them to go to the hospital earlier.”

See a common thread here? The guilt doesn’t typically surround the deceased or the object of loss, rather what the person perceives or feels about their own actions. This is often where the person feels a tremendous burden, a wish to go back in time. Regret. Remorse. As if there was one thing they could have said/not said, done/not done and it would magically change everything.

It won’t.

Guilt from the Patient’s POV
The person feeling guilt has turned inward, usually after bargaining and getting nowhere. Unsuccessful in finding an outward solution, s/he turns inward. There must be something she could have done to change the outcome, right? He will play the scenario over and over in his mind. She will ruminate on what the one thing is she should have changed to prevent “this event” (death, loss, etc.) from happening.

Guilt from the Therapist’s POV
As the therapist, your job is to remind the patient (gently) that loss is not something a person can prevent (unless they actually murdered a person). If there is some reasoning that the person could have prevented it, then it’s your job to bring the patient’s attention back to the present. What is done cannot be undone, as the saying goes. There are no time machines and even if there were, the action the patient believes might fix something may not fix it or even make it worse.

Understand that guilt is selfish, and it’s 100% okay to be selfish in this case. This is also a necessary part of grief as a person recognizes that s/he too is mortal, and not capable of stopping all death from happening.

People are self-centered in the guilt stage, and it becomes about what happened to them or what they could have done to stop the loss. Self-centered attitudes are not necessarily a bad thing as they ensure human survival, and when it comes to guilt, the focus on self is a necessary part of it. If you don’t care for the terms “self-centered” or “selfish,” think of it as “focusing inward.”

What this Means for You, The Writer
This is going to depend on quite a few factors when  you write a character’s guilt over a situation. Did they cause the loss? Do they feel remorse? Are they capable of remorse? Are they traumatized? What level is their involvement in the loss?

As you answer these questions, keep in mind that the character will be focused inward. Keep it to what they believe they “should have” or “could have” done to prevent the loss from happening.

If you came here looking for psychological assistance, please contact your local crisis line. Dial 2-1-1 in the US for the United Way, or contact the Samaritans in the UK. For a list of international crisis lines, click here.

Good luck, and get writing.

All right, just three more of these to go, and then we can get into other wild topics. Hang tough, dear readers! If you’re in need of some lighthearted diversions, check out my Facebook and Twitter. Or for some entertaining fiction that touches on this subject, grab a copy of Exit 1042.