The guilt reaction of parents of children with severe physical disease.
- R A Gardner
- The American journal of psychiatry
The Use of Guilt as a Defense Against Anxiety Richard A. Gardner, M.D. The purpose of this paper is to (1) discuss the utilization of guilt as a defense mechanism in handling some of the anxieties of human existence, and (2) to describe the employment of this type of guilt reaction in certain psychoanalytic, social and religious phenomena. The term, existential, as it will be used in this paper, refers only to its dictionary meaning, viz., that which pertains to existence. Existential anxieties, then, are those which arise in man by virtue of his existence in the world. They include anxieties regarding death and harm from one's fellow man as well as from overpowering forces of nature. They are the anxieties which man experiences as the result of his relative impotence in controlling these inevitabilities. The term does not refer to the more specific use given it by the “existentialists,” although some comments made in this work will share much with the thinking of this group. Although many neurotic and psychotic mechanisms are considered devices to ward off, protect against and handle anxiety,2,8 guilt is not usually included. The use of guilt as an alleviator of existential anxiety has been only infrequently noted in the literature. Kierkegaard6 described a type of guilt which he equated with responsibility. According to him, the concept of fate leaves man impotent to change his environment, but with guilt and its implication of personal responsibility the individual commands a certain degree of control over his milieu. May7,8 refers to Kierkegaard and in discussing this type of guilt he mentions chronically ill tubercular patients who become panicky when reassured by well-meaning friends that the disease is due to accidental infection by the tubercle bacillus. “If the disease were an accident, how could they be certain it would