This weekend I traveled to my daughter's house to help care for my 1-year-old granddaughter. After the first day, I developed a dizziness that made me need to lie in bed. Eventually, not feeling better, I decided to go home and convalesce there. But I felt so guilty, even though my daughter could not have been more kind, caring, and understanding.
Have you ever felt the need to apologize for being sick? Maybe you felt terrible about canceling plans, worried that your partner would resent you for asking for things, or wouldn't let yourself rest even though you needed to.
It’s bad enough to be sick. Why do we heap guilt on top of it?
It is not uncommon to feel guilty when we are sick. I feel it too. I feel guilty for burdening others. I hate for others to think of me as weak, or lazy, or taking advantage. I hate being unproductive and not helping out. Strangely enough, I like caring for others, and I would never want my loved ones to feel guilty if I needed to care for them.
Of course, we don’t choose to get sick. So why would something beyond our control make us feel as though we’ve done something wrong?
Our early experiences offer clues.
As children, we learn a great deal about which emotions and needs are acceptable to our family and communities, and which are not. If our caregivers responded to our vulnerability with irritation, criticism, or withdrawal, we may have learned that needing help was somehow bad. Even in loving families, children can absorb messages about being strong, independent, and helpful as opposed to being needy, lazy, or self-indulgent.
My mom was loving, but both of my parents were busy working hard. My dad was a physician, so I had to be severely ill to stay home from school and get the attention and care I wanted. Independence was valued, probably because my parents did not want to be burdened.
Apparently, these lessons stay with us into adulthood and form how we feel about being sick and having needs. They become part of our values and emotional wiring. When we get sick and are forced to rest, or to depend on others, we feel guilty, and we don't even know why.
What the Change Triangle Can Teach Us About Guilt
The Change Triangle is a tool I adapted from the academic literature on emotions to help people understand their emotions and what to do with them. It teaches us about four important categories of emotional experience: defenses, inhibitory emotions, core emotions, and a regulated state. The goal of working the Change Triangle is to help us return our nervous system to emotional regulation and, eventually, to spend more time feeling calmer and more confident.
Core emotions, including sadness, fear, anger, joy, excitement, and disgust, are natural responses to life’s circumstances. They provide important information about what matters to us and what we need.
But core emotions also make us feel vulnerable, especially if we haven't received any education about what they are and why we have them. When we learn in our families that certain feelings or needs are unacceptable, we block those feelings with inhibitory emotions, like guilt, shame, and anxiety. These inhibitory emotions interfere with experiencing our core emotions freely. For example, if my parents won't tolerate my anger, I may develop guilt or shame about being angry. But if my parents receive my anger with understanding and set appropriate limits for how to channel it, I will likely make use of anger and express it in healthy ways.
To manage the discomfort of unprocessed emotions, we turn to defenses—anything we do to avoid feeling what is happening inside us. Defenses include excessive drinking, perfectionism, and depression.
Consider Violet, who got the flu just before her sister's wedding.
Naturally, she felt sad about missing the event. She also felt angry about the terrible timing and scared about how sick she was. But instead of simply experiencing her understandable emotions, she felt guilty about disappointing her sister and the rest of the family.
To manage the guilt, she apologized repeatedly, and even considered going to the gathering despite being sick. (They told her to stay home!)
Sadness, anger, and fear got buried beneath guilt. And the guilt led to behaviors that might have actually made things worse. This is why I encourage people to get curious about their guilt instead of automatically believing it.
Not All Guilt Means You’ve Done Something Wrong
Guilt serves an important purpose when we’ve actually hurt someone or violated our values. It can motivate us to apologize and make amends. But guilt can also arise when we haven’t done anything wrong, like when we are sick.
When guilt arises, I suggest asking two questions: Did I actually do something wrong? Or am I feeling guilty because I have a need that makes me uncomfortable? The distinction matters.
Guilt Essential Reads
One of the most helpful things we can do is gently turn our attention toward the emotions underneath our guilt. The next time you’re sick and feel guilty, pause for a moment. Notice where you feel the guilt in your body. Perhaps there’s a sinking sensation in your stomach or tightness in your chest. Then ask yourself, "If I weren’t feeling guilty right now, what else might I be feeling?"
Maybe you’re scared about your health. Maybe you’re sad about missing something important. Maybe you’re angry that your body has let you down. Or perhaps you feel lonely and wish someone would take care of you. Whatever you discover, see if you can accept, validate, and make room for it.
You might say to yourself, "Of course I’m sad. I was really looking forward to that trip." Or, "Of course I’m scared. I don’t know when I’ll feel better." We don’t need to judge or change our core emotions. We need to acknowledge them, understand them, and allow ourselves to experience them in manageable doses.
Experiencing an emotion involves naming it, sensing it in your body, noticing the impulse, releasing the energy associated with the specific core emotion you're working with, and riding the full wave of that emotion until you feel an internal shift, a release. We can all learn to experience our emotions. When we do, we often find that the guilt begins to soften.
Being Sick Is Not a Failure
We live in a culture that places enormous value on productivity, independence, and pushing through discomfort. It’s easy to internalize the belief that resting is lazy or needing help is weak. But bodies get sick. They get tired. They need attention and care. That’s not a failure. That’s biology.
One of the goals of working with the Change Triangle is to move toward the openhearted state of the authentic self, where we have greater access to calm, clarity, compassion, and connection. When we’re in this state, we can recognize that being sick is difficult without adding unnecessary guilt or shame to the experience. We can feel sad about what we’re missing, scared about our health, or frustrated by our limitations, while still treating ourselves kindly. And we can allow the people who love us to help.
The next time you feel guilty for being sick, consider this: If someone you loved were in your situation, would you want them to feel ashamed for needing rest and care? No! Maybe it’s time to extend that same generosity to yourself. That's what I tried this weekend. And it helped!