Örneğin, yaşanan büyük bir deprem sonrası hayatta kalan kişiler hayatta kalma suçluluğuna sahip olabilir. “Neden ben de ölmedim, önce kardeşimi çıkarmaya çalışsaydım yaşayabilirdi, bu suçluluğum ancak benim de enkaz altında kalmamla geçer.” gibi düşünceler, hayatta kalma suçluluğu yaşayan kişilerde görülen düşüncelerdir. Hayatta kalmaya dair suçluluk düşünceleri; korku, kaygı, panik, öfke gibi duygularla beraber gözlemlenebilir. Kişinin yaşanan travmatik olayda ölen kişilerin kendisinden dolayı öldüğünü, zarar gören kişiler için yeterince çabalamadığını ve bencil biri olduğunu düşünmesi gibi sürekli tekrarlayan düşünceleri olabilir.
Hayatta kalma suçluluğu yaşayan kişiler genellikle kurtarmaya çalıştıkları kişinin ölmesinden ya da diğer ölen kişiler için bir şey yapmadıkları için suçluluk duyar, onların ölümlerinden kendilerini sorumlu tutarlar. Özellikle karşısındakinin acı çekmesine ya da ölümüne şahitlik etmek bu suçluluğu pekiştirir. Travmatik olay anında kendilerini kurtaran arama kurtarma ekibine karşı saldırganlık gösteren bir mağdur ya da hastasının acısı karşısında kendisini sorumlu tutan doktorlar hayatta kalma suçluluğu yaşayan kişilere örnek olarak verilebilir. Yoğun şekilde hayatta kalma suçluluğu yaşayan kişiler, kendilerine zarar verebilir, yaşamayı hak etmediğine dair düşünce ve davranışlar gösterebilir. Örneğin bir deprem sonrası yakını ölen bir kişinin, ölen kişinin ne kadar aç kaldığını, ne kadar uykusuz kaldığını düşünerek kendisini saatlerce, günlerce aç ve uykusuz bırakması yaşanan bu suçluluğun belirtisi olarak karşımıza çıkabilir.
Fakat hayatta kalma suçluluğu yaşayan kişilerde sağlıklı düşünme mekanizmaları yetersiz şekilde çalışır ve bu şekilde düşünemezler. Bu nedenle travma sonrası stres bozukluğu, anksiyete, sosyal olarak geri çekilme, uyku bozuklukları, fiziksel şikayetler, depresyon ve dürtü kaybı gibi problemler gözlemlenebilir. Bu suçluluğu yaşayan kişiler, yakınları ile bir arada bulunma oranı ne kadar artarsa ve günlük rutine dönmesi için ne kadar çok destek görürse sağlıklı düşünme mekanizmalarını o kadar çabuk devreye sokabilir.
Bu noktada Sosyopat kişiliğe sahip bir bireyle beraber olan kişi karşısındaki kişinin davranış örüntülerine dikkat etmesi gerekir. Karşısındaki kişinin söylediklerinde tutarsızlık fark ettiğinde, toplum normlarına uymayan davranışlar sergilediğinde pişmanlık ve suçluluk gibi duygular hissetmediğini fark ettiğinde ya da sürekli manipülasyona maruz kaldığını hissettiğinde karşısındaki bireyle sınır koyabilir, bireyi hayatından çıkarabilir ya da bunları yapmakta zorlanıyorsa psikolojik destek alabilir.
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