Facing Guilt While in Mental Health Rehab

Facing Guilt While in Mental Health Rehab

Facing guilt while in mental health rehab is imperative

Mental health disorders and guilt often exist together and can form an unfortunate vicious cycle. You may feel guilty over failing to do something or take care of someone. Maybe you can’t forget a past conflict that wasn’t managed well. You may even feel guilty or full of shame for simply being mentally unwell. Whatever the source of your feelings, facing them will be an essential part of your recovery journey when you enter mental health rehab

Shame, false guilt or true guilt? What’s the difference?

The first important step is to determine whether the self-criticism you’re feeling is shame, false guilt, or true guilt. Although they can overlap and be defined in different ways, one way to think of the difference is that shame is a general feeling of unworthiness, and guilt is a feeling of remorse for specific behavior. 


Often shame is related to who we think we are, and guilt is what we think we’ve done. Sometimes feelings of shame arise from things we can’t control, like aspects of our physical appearance or who our parents are. Guilt tends to be a moral judgment based on things we think we should have done differently. 

Often shame is related to who we think we are, and guilt is what we think we’ve done.

If what you’re feeling is shame, addressing it is likely to be multifaceted, but some simple practices can help you begin the process of seeing yourself in a different light. Simply writing out affirmations like “I’m attractive” or “I’m not my father” can be surprisingly effective at changing your mindset if done consistently. 

True guilt or false guilt?

If what you’re feeling is guilt, the next step is to determine whether it’s appropriate or inappropriate. Sometimes these are called true and false guilt. If what you’re feeling is true guilt, you can pinpoint the action or actions that caused harm, accept that you were responsible, and make a plan to change future behavior and make amends. False guilt may be related to trying to meet unreasonable expectations.

Don’t be afraid to ask for mental health help.

Whatever the source of your feelings, reaching out for help is a great step in the right direction. It’s deciding to do all you can to become the best version of yourself. While you’re in treatment, professionals can help you separate true guilt from false guilt or shame. During mental health rehab, your therapist may ask you to collect information to determine the validity of your beliefs about things you’ve done wrong. You may also be encouraged to determine if the feelings of guilt might be masking other emotions. 

Be honest with the people trying to provide mental health help

Sometimes feelings of guilt make it hard for people to be honest with their counselors. This can limit progress. Remember that the practitioners you’ll be working with have heard many stories from many people, and they aren’t likely to be shocked by anything you might share. Trust that they have the training and experience needed to help you see your situation objectively and plan to address what needs to be addressed. 

A plan to address true guilt is likely to include working on ways to reduce the likelihood of negative patterns being repeated in the future. It may also involve asking someone for forgiveness or making amends in some way, if possible. 

Forgive yourself

During mental health treatment, you may be encouraged to give to charity in memory or honor of someone or participate in a confession or atonement ritual. Learning to forgive yourself may also be part of the program. Dealing with guilt isn’t easy, but it’s worth the effort, and you’ll have plenty of help along the way. 


None of us get through life without doing things we wish we hadn’t done. We can’t re-do the past, but we can learn from it and move forward with new skills and a fresh slate. Every moment of life holds within it the possibility of starting again.

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