What to Do When Your Child has a Pathological Sense of Guilt

Remorse is a normal and healthy response to the knowledge that we’ve hurt someone else. Feeling guilt helps children learn how to behave appropriately and provides an impetus to refrain from aggressive or destructive acts. For some kids, however, guilt takes on extreme dimensions. Instead of accepting the consequences of their actions, apologizing, and moving on, kids with a pathological sense of guilt fixate on what they’ve done wrong. After even minor infractions, they assume they’re “bad” kids and often go to great lengths to restore a sense of harmony.

Though this behaviour may look like heightened obedience, it’s not a positive trait. Pathological guilt can actually make necessary discipline more challenging; it’s also been linked to problems later in life. Knowing how much guilt is too much – and how you should take action to minimize feelings of remorse – is an important part of safeguarding your child’s mental health.

What does Pathological Guilt Look Like?

Most kids inherently dislike causing their caregivers real distress. Kids usually act out because they’re stressed, hungry, want to assert their autonomy, or lack other ways to express their feelings, not because they want to hurt people. As such, it’s normal for kids to cry, apologize, or need extra reassurance when they realize they’ve upset the most important people in their lives. However, most children are capable of learning from their transgressions and moving on when they understand that they’ve been forgiven. They can use guilt as a constructive tool to aid their growth.

Guilt becomes pathological when kids overreact to minor mistakes or feel they can’t forgive themselves even after complying with consequences. Children suffering from pathological guilt will sometimes elect to punish themselves when given a warning about their behavior (i.e., when they’re told a privilege will be removed if they don’t comply with a household rule or listen to instructions). Rather than focusing on the behavior that needs to be altered, these kids get visibly upset and voluntarily renounce their privileges. Often, attempts to reassure them that everything is all right fall on deaf ears; they become so overwhelmed by their feelings of remorse that they can’t process anything else. They may hold onto their feelings of guilt for hours or even days.

What Causes Pathological Guilt?

Excessive guilt in children is seldom related to how they’ve been raised. Kids fall into this mindset as a result of black and white thinking and a sense of powerlessness. Sometimes this mentality is related to normal developmental changes, but research suggests that some kids are more biologically predisposed to guilt than others. Specifically, having a small anterior insula (the part of the brain that regulates emotional awareness) is associated with excessive guilt and anxiety. In cases where guilt is related to structural differences in the brain, early intervention is especially important: Successfully treating excessive guilt can encourage the anterior insula to grow and develop more normally.

Pathological guilt often develops between the ages of six to eight, a period when kids are mature enough to understand that their actions affect others, but not yet old enough to grasp subtle social nuances. Children in this age group tend to see things and people as being “all good” or “all bad,” with little gray area in between. As such, when they do something bad (even unintentionally), they think they’re “bad kids.” This knowledge is so upsetting that they strive to undo their misdeeds and return to being wholly good. In essence, they think they have to change who they are, rather than just changing their actions. They therefore develop unrealistic standards of perfection and try to live up to them.

This troubling mindset is usually complicated by a fear of repeating negative behaviors. Pathologically guilty children lack faith in their ability to control themselves, so they worry that they will make the same mistakes over and over again, thereby solidifying their status as “bad kids.”

Some young children may experience guilt for being a “cause” of some medical problem or condition that their parents are experiencing. One of my therapy clients, let’s call this child Becky, felt guilty for being responsible for her mom’s diabetes. It took me a while to dig to the root of this bizarre belief. It turned out that when Becky was four, she asked her father when did mom’s diabetes start. When her father replied that it started right after she was born, Becky projected that she is the cause of mom’s condition. Parenting children when you have a chronic disease, be it diabetes, a heart condition, or asthma, is certainly not an easy task, but one has to be very careful when talking about their medical condition to the child, who can internalize the problem and assume the guilt as Becky did.    

Why Pathological Guilt is a Problem

Pathological guilt has the obvious consequence of causing unnecessary pain to your child. Beyond this, it can interfere with how you administer discipline: Some parents make the mistake of thinking that because their child experiences such a high level of natural remorse, they don’t need to punish him. They may worry that punishment will make their child’s unhealthy guilt even worse.

In reality, kids struggling with excessive guilt have an especially strong need for fair, loving consequences. The reason why these kids sometimes choose to punish themselves is because they know punishment is the first step towards reconciliation. When punishment is taken away, these children are forced to live in a state of uncertainty, which only serves to worsen their anxiety. Deciding not to punish your child will also teach him that he can use guilt to manipulate others.

Finally, pathological guilt and the anxiety associated with it have been linked to mental health issues later in life. If extreme guilt is not addressed, it may contribute to the development of depression, anxiety, obsessive-compulsive disorder, or bipolar disorder in adulthood.

How to Help Your Pathologically Guilty Child

There are several interventions parents can use to turn their child’s destructive guilt into constructive guilt:

When you reprimand your child, focus on his actions – not his personality.

Labeling children (for example, calling them “lazy” or “disrespectful”) encourages harmful black and white thinking. It also reinforces feelings of powerlessness: If your child thinks his bad behavior is caused by a core trait within himself, he’ll assume he can’t change it.

When you correct your child, be careful to talk exclusively about his actions, without bringing his character into the discussion. For instance, instead of saying, “I’ve told you to pick up your toys three times – if you don’t stop being lazy, I’ll have to take away your allowance this week,” try saying, “I noticed you haven’t picked up your toys yet even though I’ve asked three times; is there something I can do to help you get started?” Engaging your child’s critical thinking skills will help him focus on finding solutions rather than beating himself up.

Help your child change the way he talks about himself.

When you hear your child calling himself “bad” or “naughty,” take him aside and explain that while it’s okay to apologize, he shouldn’t insult himself. Teach him other phrases to use when he feels bad, such as, “I made a mistake, but I know how to fix it.”

Give your child constructive ways to make amends.

Kids punish themselves because, in their minds, punishment clearly marks the transition from wrongdoing to forgiveness. In situations where punishment isn’t appropriate, having another tangible way to make amends can help kids let go of their mistakes without reprimanding themselves. You might suggest your child write an apology note, draw you a card, or do a small favor for you, for example.

In addition to using these three parenting strategies, try to provide your child with multiple avenues for building his confidence and dealing with difficult feelings. Sports, active play, creative hobbies, and regular one-on-one time with you can all help your child overcome his anxiety. As he learns to believe in his capabilities, he’ll focus less on remorse and more on enacting positive change.