How to manage guilt and shame when you've spread COVID to someone else

An excellent read originally posted by Dr. Ahona Guha.

As we enter the third year of the pandemic, many of us have now contracted the virus or know people who have tested positive.

In addition to the health risks associated with catching COVID, there can be emotional ramifications — especially if you happen to spread the virus to someone else.

Many people who inadvertently transmitted COVID have described feeling intense guilt and shame, especially if they infected someone who has additional risk factors.

It is helpful to consider the psychological processes inherent in managing this guilt.

Guilt is an emotion involving a recognition that we have done something wrong, and the consequent sadness or distress.

Shame is related to guilt, but the feeling is often stronger and even more paralysing. When we feel shame, it can feel like our entire self is wrong or flawed.

When considering the feelings which arise after transmitting COVID, it may be beneficial to consider a few principles.

Be on the lookout for 'hindsight bias'

If you've tested positive for COVID, you might be questioning yourself. 

You might be ruminating what you could have done differently — or feeling anxious for those who may become unwell.

For instance, you might think that you would not have caught and given someone else COVID if we had not attended a party — easily forgetting that you had no way of knowing you would have contracted COVID at the party.

This is known as hindsight bias.

Cognitive distortions like these are psychologically dangerous, as they can influence our perception of danger, change our thinking and lead us to develop unhelpful emotional responses.

Remember what you control — and what you don't

Generally speaking, COVID-19 is a highly contagious disease. While we have a range of ways to mitigate risk, it's still difficult to protect against.

It is important to remember the general principles of engaging in actions within our sphere of control (such as wearing a mask) but also accepting that the outcome may be out of our control.

It is important to take basic steps to protect ourselves and those around us, while also holding the recognition that the nature of the virus means that we may yet be exposed to it despite our best efforts.

Similarly, while we can attempt to keep other people safe, this outcome is not guaranteed.

Put a name to your feelings

It is helpful to reflect on how we might be feeling and to determine whether we are feeling sad, angry, regretful, guilty, ashamed, or fearful.

All these emotions are different, and it can be helpful to set aside some time to think about how you are feeling and to name your emotions.

It's also helpful to build the skill of questioning your emotions and to remember that emotions are habitual responses to the world based on learned patterns.

For instance, if you feel a deep sense of regret, it may be helpful to pause and consider if you could have really done much differently with the knowledge you had at the time.

Learning to question and gently challenge our own thinking is an essential skill, as unhelpful thoughts can lead to strong emotions.

Be gentle on yourself

We often have a range of natural emotions after a difficult event, such as sadness that we have given someone COVID.

Occasionally, we have problematic thoughts about these events, such as "I should have been more careful, I was just selfish for going to that party".

These thoughts are likely to change our natural emotion of sadness into more problematic ones such as shame, making it harder to process the feelings.

It's helpful to avoid labelling ourselves or our behaviours — or criticising ourselves too harshly.

Sometimes we make difficult situations worse by berating ourselves.

It is important to remember that punishing yourself is unlikely to make the situation better.

Instead, being self-compassionate and recognising the inadvertent nature of any transmission will be more helpful.

Support those around you

When feeling sad or regretful, we can become absorbed in our own feelings.

If experiencing strong emotions after transmitting COVID, it may be helpful to create some distance from our own thoughts and feelings.

An effective way of doing this is by finding a way to support someone else, perhaps even the people we infected.

Sending people care packages, making telephone calls, apologising for inadvertently infecting someone — these are all ways we can connect with someone, demonstrate care and manage our feelings in a helpful manner.

Dr Ahona Guha, DPsych, is a clinical and forensic psychologist in Melbourne, Australia. She writes about a range of psychology topics at Psychology Today. You can find her on Instagram. She is currently writing a book about trauma to be released in early 2023.