We live longer, healthier and often more affluent lives than ever. Why do so many of us feel like failures? Failure to get the job we wanted, failure to keep our job, failure not to be left by a partner, failure not to avoid getting cancer, failure to conceive, failure to stop a loved one dying. The list is endless.

When did so many of the possibilities of human tragedy become our fault?

As therapists, we understand that one function of ‘self-blame’ is that we have a fantasy notion of control when in reality we have very little and in some situations none at all. If it is our fault then we are not at the mercy of the randomness of the universe and we can feel less helpless. Yet unrealistic self-attack comes with a heavy price. We are not psychic but self-blame implies that we should be. ‘I should have known’, ‘I should have seen it coming’ are common cries of despair.

When painful things happen, initial self-blame is pretty normal. Why didn’t I do something differently? This is a common reaction to helplessness in the face of bad news but hopefully a more realistic and kinder view eventually prevails. But many of us can not let go of the belief that somehow it is their failure not to have kept bad things away. In the face of vulnerability and bad news, self-compassion can go out of the window and self-blame comes rushing in.

We like to construct certainty in the face of uncertainty because it is scary living with uncertainty.

Loss of health should surely evoke self-compassion but staying healthy is often written about as if it was an absolute choice we could have made.

Endless articles are written about what we should and should not eat and how much exercise we need to be doing. The implication is that if you follow these guidelines you will stay well.

When Deidre was diagnosed with breast cancer at the age of 40 years she was naturally devastated and fearful. She felt that she had let her children down and kept wondering what had she ‘done’ that this should happen. She attacked herself for smoking in her twenties, for ‘bad’ eating habits. She went on a stringent eating regime and felt that she was taking control. However, any lapses in the regime would fill her with terrible anxiety and self-loathing. I felt that she needed to find for herself the kindness and understanding she would have given a friend in similar circumstances. She was not to blame for her cancer and having such a diagnosis was horrible. She was doing her best in the face of all the unknowns to stay healthy after treatment and no-one can ask for more.

We like to construct certainty in the face of uncertainty because it is scary living with uncertainty. Like the child’s game of not walking on cracks in the street, we tell ourselves that if we avoid alcohol/sugar/fats etc. we will stay well. If that doesn’t work perhaps it is kinder and more accurate to think 'I did my best', rather than blame oneself.

We live in a culture where so much is possible but we do not have much of a language or indeed wisdom for what is not possible. People ‘lose’ the battle against cancer as if someone else could have won it. Atul Gawande’s wonderful book ‘Being Mortal’ is an indictment of how we, in the rich developed world, can see death as something to be fought every inch of the way regardless of the costs and quality of the life. We all die but if even death is constructed as a failure rather than inevitable, we are all going to fail.