The Guilt And Shame Pandemic

As the founder of the Long Haul COVID Fighters community on Facebook, Amy Watson is familiar with the havoc the virus can wreak on a person’s body and mind. For the last 10 months, she has struggled with a long list of neurological, respiratory, cardiac, and gastrointestinal issues, along with malaise and fatigue. Trouble remembering words? She’s taken to using a thesaurus. Burning pain in the skin? She recently tapered off a medication for small fiber neuropathy — just one in a long list of neurological, respiratory, cardiac, and gastrointestinal issues she's experienced. Persistent feelings of guilt? She knows that one, too.

“I infected two of the people I love most in the world before I even knew that I had COVID,” says Watson, who received a positive test result on April 13, referring to her partner and her college-age daughter. She worried, too, about the domino effect that she might have inadvertently caused. “My partner was working in elder care at the time, and I had this thought of being responsible for infecting an entire community of elders in a memory care facility, which, thankfully, did not happen,” she says.

Watson’s partner and daughter made quick recoveries, and those first pangs of guilt subsided over time. But others have popped up, like the parental guilt of being too sick to help move her daughter into her first real home. Others in the long-hauler community feel guilty for not being able to take care of their families and houses and for returning to work and not being as productive as they once were. They feel guilty when they’re trying to rest and can hear their kids crying on the other side of the door.

The experience of guilt and shame around COVID-19 is by no means limited to those who have been sick for a long time or those who have been sick at all. Our guilty consciences have been ablaze throughout the pandemic in a staggering number of ways.

There’s the guilt of making it through the year without any health issues. The guilt of sending kids to school in-person and the guilt of keeping them home. The guilt of having a work from home job and the guilt of having someone else do your grocery shopping so that you can pick it up curbside. The guilt of feeling tired and emotionally wrecked when, by all counts, you have it pretty good. The guilt of chiding friends for socializing in a high-risk way and the guilt of letting them off the hook just to avoid conflict. The guilt of traveling to see family for the holidays. The guilt of skipping out on family gatherings and missing weddings. The guilt of not visiting ailing loved ones in the hospital. Lately, the guilt of receiving a vaccine before others. For every life stage and situation, it seems, there’s a guilt to be had.

“Everything is just raw nerves,” says Rajiv Rimal, the Health, Behavior, and Society department chair at the Johns Hopkins Bloomberg School of Public Health. He has been moved by the intensity of people’s negative feelings over the past year — no doubt amplified by isolation and 24-hour child care — and has observed COVID guilt particularly among people with older parents. People feel guilty for not being able to see and take care of their parents, and they feel guilty for putting them at risk if they do. “There’s a no-win situation there,” he says.

There are ways in which guilt can be a productive emotion, says June Tangney, a psychology professor at George Mason University and the co-author of Shame and Guilt. Guilt, or feeling bad about a particular action, can motivate people to make things right by apologizing, confessing, or coming up with a concrete plan to change behavior. Shame, meanwhile, is more inwardly focused, more painful, and often harder to overcome, she says. “I am a bad person” rather than “I did a bad thing.”

COVID guilt might make a person reassess a particular decision and then behave in a safer way moving forward — swearing off indoor parties until we’re all vaccinated, for example. Feeling guilty about still having a job (plus all the free time once spent commuting) might push you to help others in your community by joining a mutual-aid network.

From a public health standpoint, though, generating guilt as a motivator — even to keep people safe — is counterproductive, says Rimal. It can create shame and stigma, which pushes unhealthy behaviors underground and places blame on individuals rather than on the systems that aren’t working.

Shame about having COVID has the potential to create “really dangerous dynamics,” notes Theresa Robertson, an associate professor of management at Stony Brook University who studies group dynamics and social ostracization. When people feel shame, they often try to limit the spread of information that could jeopardize their reputation and status. In the case of COVID, Robertson writes in an email, “It might mean they try to hide their diagnosis from others if they do receive a positive test — which could mean that they try to pretend things are normal, interacting with other people as they normally do and possibly infecting them, rather than quarantining properly.” Or they might avoid getting tested at all.

Considering the damage that stress can do to the immune system, could feelings of intense guilt and shame also put you at greater risk during a pandemic? “There is some evidence linking either chronic or short-term experiences of shame with inflammation,” writes Sally Dickerson, a professor of psychology at Pace University who co-authored a study on the subject in 2004, in an email. But, she adds, it’s not clear whether these changes in inflammatory activity would be enough to alter disease course for someone with COVID.

Rather than simply reinforcing people’s bad feelings, public health officials are better served by incentivizing different behavior. “In health communications, we talk about ‘motivation and facilitation,’” Rimal says: First you highlight the risk so that people are spurred to act (if you don’t get vaccinated, you might get COVID), and then you provide them with a solution (here’s how to do that). Advertisers use this technique all the time, he points out, recalling one TV spot that opened with a scary home invasion scene and ended with a comforting explanation of the product, a home security system. It’s also important to help differentiate actions people are personally responsible for from those that really are beyond their control, he says.

“I think we’re almost hardwired to feel guilty about things that we don’t have responsibility for because one thing we always search for when bad things happen is reasons,” Tangney says. “We do a lot of counterfactual thinking. Counterfactual thinking is thinking: ‘Gee, if only I’d left home a little bit later, then I wouldn’t have gotten in a car accident.’... It’s adaptive, to think: How could you undo this so that you don’t do it again?”

A friend of mine spent five months feeling guilty about being physically separated from his wife while she helped care for her mother, who is severely immunocompromised due to cancer, and her family. Staying with his own family not far away, he says, “I tried to do as much as I could — I’d come over and talk to her from the sidewalk most days, we’d talk on the phone every day, we’d FaceTime, but there’s only so much you can do when you can’t be there.”

When the protests following George Floyd’s death took off this summer, he felt another kind of guilt from deciding not to attend in the interest of minimizing COVID risk for his wife’s mother, as well as a member of his own household who is a government official. Donating to causes supporting the Black Lives Matter movement, my friend, who is white, says, “didn’t make me feel any less guilty about not going out and taking part in something so important.”

Another friend spent months agonizing over whether to attend a close friend’s indoor wedding reception and felt horrible when she decided against it, even though the bride was very understanding. But on the day of the wedding, my friend felt that guilt leave her system: She had pushed the limits of her own comfort zone just by participating in the ceremony, and her friend was so busy with guests that her absence didn’t seem like a big deal. Some guilt just keeps on giving, though.

“Even as I’m talking to you, in my head I’m like, ‘I didn’t do anything wrong, right?’”

Ben Breier, who works in advertising in New York, was due to start a new job in March. His start date coincided with the first day of the company’s voluntary office closure, and most people were working remotely; HR wanted to know if he was comfortable going in to pick up his company-issued laptop or if he wanted it shipped to him. Breier had just gotten over what felt like a cold or flu and, he says, “I thought it was important to show up. If I had the information I have now, I obviously wouldn’t have made that decision.”

He went in, got the laptop, and met an IT employee who was still in the office. A few days later, his body crashed. He had a high fever and was sleeping for 12 hours and waking up exhausted. A music and art venue where he’d attended an event prior to lockdown posted on Instagram that someone at that party had tested positive for COVID. Breier’s doctor said she couldn’t get a test for him but told him to assume that he was positive. She provided him with a note to update his workplace on his status, and shortly after, the company sent out an email saying that someone in the New York office had COVID. “When that email went out from work, I wanted to puke,” Breier says.

Many months and one positive antibody test later, he’s still struggling with his decision to go into the office that day. He talks about it in therapy. He wonders if he was in denial about the nature of his illness, if there was a red flag in the back of his brain that he was ignoring. He knows that he’s treating March’s decision with his present-day knowledge, but these questions continue to needle him.

“Did I need to just show face? I definitely did not need to do that, but the question is, did I do something wrong? Did I willfully do something wrong? I don’t know. I can’t answer the question because I don’t feel like my brain will let me answer the question,” he says. Any time the subject comes up in conversation with someone new, Breier feels like he’s internally searching for validation from that person. “Even as I’m talking to you, in my head I’m like, ‘I didn’t do anything wrong, right?’” he says.

Assuring people that it’s all right to feel guilty, scared, and angry has been a large part of Ezra Seligsohn’s job over the past 10 months. An associate rabbi at the Hebrew Institute of Riverdale in the Bronx, he says, “One thing that I try to focus on in my sermons and in my teachings is — and this is probably just being a child of therapy — that feelings are OK. They’re not things we have to be afraid of.”

As for what to do with all the guilt in the atmosphere, Seligsohn says the literature on Yom Kippur — “a day dedicated toward guilt” — offers two pathways. “The first is to see it as [an accident]: You take responsibility, you’ve felt the feelings, you’ve tried to make amends with whomever you’ve caused harm to, and then it has to be that this was an accident of my story… I can release the guilt.” The second version of the text, he says, is about turning your guilt into merits. This is about saying, “These choices I made are me. I can learn from them, and I can make different choices next time and grow from those experiences.”

Seligsohn was surprised how joyful Yom Kippur was this September. It was one of the first times that he’d done in-person services for the broader community — mostly outdoors in backyards with masks on, with some masked, distanced indoor services — and the overwhelming mood was of relief and gratitude for the opportunity to be together. (When I asked if he felt they missed out on the day’s more serious side or whether he simply looked at it as a different experience, he laughed and said, “What do you think I’m going to say?”)

Guilt can be such an isolating feeling — shame even more so — but community can help us deal with it. Amy Siniscalchi, who belongs to the Long Haul COVID Fighters support group, says that when parents post about not being there for their kids, “We’ll try to rally around them and say, ‘Look, your kids are watching you go through something and get through something that they’ll admire you for someday, when they can understand it.’”

Siniscalchi, the chief program officer at a nonprofit in Westchester, New York, that serves victims of domestic violence and human trafficking, got COVID early — one source of guilt, Siniscalchi says, “because I treated it pretty cavalierly in the beginning” — and after seeming to recover for a few weeks, she relapsed and ultimately had to go on leave for her health. She recently returned on a “very part-time” basis because she hasn’t been approved for short-term disability and needs the income. Much of Siniscalchi’s guilt stems from leaving her colleagues in the middle of a crisis, knowing her responsibilities are falling on them. “They already have big jobs themselves, so there have been times where my guilt has made me get on phone calls I probably shouldn’t have gotten on,” she says.

It helps to think about the times she’s filled in for others; Siniscalchi, who has no children, has never begrudged anyone their parental leave. And to remember that trying to carry her weight at work only slowed her recovery. “What sometimes stops me in my tracks is that I made myself sicker by working past when I should have,” she says. “Sometimes that helps with the guilt.”