Mother grapples with grief in ‘Where Reasons End’

By Michael Magras

It’s not surprising that someone whose whole life revolves around words would turn to literature in a time of tragedy to make sense of her suffering. The paradox is that the person most likely to seek solace from words is also the most likely to realize their insufficiency.

One such person is the unnamed narrator of “Where Reasons End,” Yiyun Li’s new novel. The 44-year-old narrator is a writer of stories and a grieving mother. For reasons that are never explained, her 16-year-old son, whom she calls Nikolai, “a name he had given himself,” killed himself only a few months earlier — a painful parallel to real life, as Li’s own 16-year-old son committed suicide in 2017

The novel is a series of imagined conversations between mother and son. From the start, we learn that the mother is agonizingly self-aware, both of herself and of the possible futility of these conversations.

That and the parallel to Li’s life are what make the experience of reading this work so powerful: the knowledge that the narrator needs the comfort of words yet senses their limitations. “I was a generic parent grieving a generic child lost to an inexplicable tragedy,” she says in the opening chapter. She seeks specificity, the need to “meet in a world unspecified in time and space … a world made up by words, and words only.”

One of the most arresting aspects of this novel is the way in which Li subverts expectations. One might expect Nikolai to be a sweet boy offering relentless comfort to his grieving mother. He’s a charmer, all right, a precocious son who painted whimsical landscapes, played the oboe and liked classical music and showtunes. And he was a bad speller who labeled a folder of songs “Edith Pilaf.”

But he has a sardonic edge that keeps him from seeming too precious. When his writer mother tells him that so many people miss him, Nikolai says she’s succumbing to the lure of clichés and admonishes her with, “You promised that you would understand.” When he accuses her of wanting him to feel sad for himself, he adds, chillingly, “I’m not as sad as you think. Not anymore.”

The dialogues in “Where Reasons End” cover a wide range of topics. Mother and son discuss love and memory and whether those capacities really do keep people alive forever. They discuss the capriciousness of time. Nikolai chides her for her dislike of adjectives, which she defends by saying that nouns, not adjectives, preserve memories. Besides, “I oppose anything judgmental,” she says, “and adjectives are opinionated words.”

Much of this book is devoted to words, which is not surprising given that its narrator lives by them: “Words said to me. Words not meant for me but picked up by me in any case. Words in their written form. Words that make sense and words that make nonsense.” When one is in search of helpful words, poets are a good place to start, as their facility often crystallizes hard-to-express truths. Indeed, the narrator references many poets, including Marianne Moore, Elizabeth Bishop — the novel’s title comes from Bishop’s poem “Argument” — and Wallace Stevens.

Even poets, however, provide limited comfort, and the mother depicted here knows it. This realization compounds her grief as much as it ameliorates. “Words provided to me — loss, grief, sorrow, bereavement, trauma — never seemed to be able to speak precisely of what was plaguing me,” she says. “One can and must live with loss and grief and sorrow and bereavement.”

Later, she adds, “We feel at a loss for words when they can’t do fully what we want them to.” To which Nikolai offers as wise a defense of words as one is likely to find. “They never can,” he says, but, “Why not make do with the percentage they can achieve?”

The book gets repetitive after a while — much is made of the Latin derivations of words, and some of Nikolai’s dialogue is too stilted even for a sophisticated teen — yet its message is nonetheless a sobering one. Nothing can ever fill the hollows formed by tragedy, yet the desire to fill them is every bit as keen as the loss. If even a fraction of the emptiness is replaced, then the quest is worth the effort.

Late in the novel, the narrator quotes Stevens’s poem “This Solitude of Cataracts”: “He wanted the river to go on flowing the same way, To keep on flowing.” Anyone who has ever lost a loved one — that would be all of us — will relate. If only they were still here to keep the river of our lives flowing as it once had.

Complete Article HERE!

‘I was widowed at 23, young people need to talk about death’

Amy Molloy and husband, Eoghan

By Amy Molloy

‘They say you’ve got three months to live.” These were the words I spoke to my then-fiancé when I was 23 years old after learning that his cancer – malignant melanoma that spread to his liver, lungs, pancreas and brain – was likely to be fatal.

At the time, my only experience of “the end” was watching my parents disappear into a room where my grandparents were lying, and of seeing an empty rabbit hut at the end of our garden after the loss of a pet.

When I was 17 years old my father was paralysed from Hodgkins Lymphoma but, after a stem cell transplant, he defeated the odds and made a miraculous recovery. So, I had faith in the power of modern medicine over mortality.

However, not this time.

I was practically still a child when a doctor ushered me into a private room, whilst my soon-to-be husband, Eoghan, was in a chemotherapy session, and revealed his prognosis. I asked if I could be the one to tell him, and they readily agreed.

Perhaps, even doctors will do anything to avoid saying the T-word. Terminal.

In the next three months, I had a crash course in end-of-life conversation: the jargon, the euphemisms and the social awkwardness.

I froze with fear when I walked into the chemo ward and heard another patient ask my partner, “Have you ever thought about euthanasia?” But, in a way, that was better than the wall of silence.

After my husband died three weeks after our wedding day, even my closest friends evaporated or became stiff in my company. In the next few months, as I rebelled against my grief – drinking too much and becoming promiscuous – nobody dared challenge me or raise the topics I ached to discuss.

What on earth are you doing?

Do you really think this is helping you?

How does it feel to marry a man who is dying?

…Do you want to die too?

Do you know what to say when a friend’s loved one dies? Have you thought about the day your own parent, partner or best friend may no longer be visible? How would you discuss it, in a way that would be supportive, constructive, and even light-hearted?

If you don’t know the answer, you’re not alone.

A new study from the Royal College of Physicians in the UK has urged medical professionals to improve their bedside manner when it comes to discussing death, after identifying that “timely, honest conversations” about patients’ futures are not happening. However it’s not only doctors who need to become more comfortable with these conversations.

It’s been suggested that millennials are the generation most fearful of death, unlike our grandparents, raised through world wars, who learnt that life can be short. As medicine advances and life expectancy increases, we prefer to think of death as our “future self’s problem”.

But is postponing the inevitable increasing our terror of it?

As psychologists report a rise in young people presenting with anxiety linked to death, it’s time for honest, open, educational conversations about loss of life, and how it can look. Its not enough to be aware of Facebook’s ‘death policy’, warn experts.

“Death is still a certainty even if people are living longer,” says clinical psychologist Renee Mill from Sydney’s Anxiety Solutions CBT.

“When treating anxiety, exposure is what works and avoidance increases the problem. Talking about death or visiting a dying person will decrease your fear of death and make it easier to accept that it is a part of life. Every funeral we attend, no matter how hard, actually helps to reduce anxiety in this way too.”

And, it’s never too early to think about the end. Planning in life is important,” says Mill. “We plan our careers, we save, we want to buy property – end-of-life is another part we need to plan. It means we get our wishes fulfilled and gives guidance to our loved ones who otherwise have to pick up the pieces.”

In a good way, change is happening. Since 2017, the multimedia project We’re All Going to Die has encouraged people to embrace their immortality and use it to empower their lives, through educational films and festivals.

The award-winning podcast, GriefCast, hosted by comedian Cariad Lloyd whose father died when she was a teenager, sees entertainers speak with startling honesty – and surprising humour – about death, from the logistics of palliative care and funeral plans to the long-term effects of bereavement.

When we can talk openly about death, we may also increase our chances of reducing suicides. To help people to help each other, Lifeline offer an online course in QPR – the equivalent of CPR for people experiencing a suicidal crisis.

As part of the training – which only takes an hour and costs $10 – people are urged not to tiptoe around the conversations. Instead, be direct: “Do you feel like you want to die?”

In our social circles, we need to discuss worst-case-scenarios. Do you have a will? Do you have death insurance? Are you an organ donor? As an Australian immigrant living 16,000 kilometres from my parents, I always have enough money in my bank account for an emergency flight home. Because, nobody lives forever.

It’s confronting but it’s necessary

During my book tour, I cried on stage for the first time whilst discussing my journey from a 23-year-old widow to a 34-year-old wife and mother of two. Because, for the first time in a decade, I have reached a place where I can talk about my experience of death – and really be heard.

I shared the reason I light a candle in my bedroom every evening and say a prayer: help me to act from a place of love, not fear.

“If my dad’s cancer comes back, on that day I will light that candle,” I said, “If my husband, who is here with my newborn, dies and I am widowed again then I will light that candle to remind myself to act from a place of love.”

We need to talk about death to be active participants in the full spectrum of life: so we can decide who to be when a doctor pulls us into a private room, when we answer the phone to bad news, when we say goodbye for the last time.

We are so scared of death, we don’t discuss what an honour it is to watch someone die; to be present – really present – when someone takes their last breath, to lean in and breathe them in, to put your head on their chest as their heart stops beating and kiss their skin as it transforms.

I hope you all have that experience one day.

We are not meant to say that, but we should.

Complete Article HERE!

Suicide grief:

Healing after a loved one’s suicide

A loved one’s suicide can be emotionally devastating. Use healthy coping strategies — such as seeking support — to begin the journey to healing and acceptance.

When a loved one dies by suicide, overwhelming emotions can leave you reeling. Your grief might be heart wrenching. At the same time, you might be consumed by guilt — wondering if you could have done something to prevent your loved one’s death.

As you face life after a loved one’s suicide, remember that you don’t have to go through it alone.

Brace for powerful emotions

A loved one’s suicide can trigger intense emotions. For example:

  • Shock. Disbelief and emotional numbness might set in. You might think that your loved one’s suicide couldn’t possibly be real.
  • Anger. You might be angry with your loved one for abandoning you or leaving you with a legacy of grief — or angry with yourself or others for missing clues about suicidal intentions.
  • Guilt. You might replay “what if” and “if only” scenarios in your mind, blaming yourself for your loved one’s death.
  • Despair. You might be gripped by sadness, loneliness or helplessness. You might have a physical collapse or even consider suicide yourself.
  • Confusion. Many people try to make some sense out of the death, or try to understand why their loved one took his or her life. But, you’ll likely always have some unanswered questions.
  • Feelings of rejection. You might wonder why your relationship wasn’t enough to keep your loved one from dying by suicide.

You might continue to experience intense reactions during the weeks and months after your loved one’s suicide — including nightmares, flashbacks, difficulty concentrating, social withdrawal and loss of interest in usual activities — especially if you witnessed or discovered the suicide.

Dealing with stigma

Many people have trouble discussing suicide, and might not reach out to you. This could leave you feeling isolated or abandoned if the support you expected to receive just isn’t there.

Additionally, some religions limit the rituals available to people who’ve died by suicide, which could also leave you feeling alone. You might also feel deprived of some of the usual tools you depended on in the past to help you cope.

Adopt healthy coping strategies

 

The aftermath of a loved one’s suicide can be physically and emotionally exhausting. As you work through your grief, be careful to protect your own well-being.

  • Keep in touch. Reach out to loved ones, friends and spiritual leaders for comfort, understanding and healing. Surround yourself with people who are willing to listen when you need to talk, as well as those who’ll simply offer a shoulder to lean on when you’d rather be silent.
  • Grieve in your own way. Do what’s right for you, not necessarily someone else. There is no single “right” way to grieve. If you find it too painful to visit your loved one’s gravesite or share the details of your loved one’s death, wait until you’re ready.
  • Be prepared for painful reminders. Anniversaries, holidays and other special occasions can be painful reminders of your loved one’s suicide. Don’t chide yourself for being sad or mournful. Instead, consider changing or suspending family traditions that are too painful to continue.
  • Don’t rush yourself. Losing someone to suicide is a tremendous blow, and healing must occur at its own pace. Don’t be hurried by anyone else’s expectations that it’s been “long enough.”
  • Expect setbacks. Some days will be better than others, even years after the suicide — and that’s OK. Healing doesn’t often happen in a straight line.
  • Consider a support group for families affected by suicide. Sharing your story with others who are experiencing the same type of grief might help you find a sense of purpose or strength. However, if you find going to these groups keeps you ruminating on your loved one’s death, seek out other methods of support.

Know when to seek professional help

If you experience intense or unrelenting anguish or physical problems, ask your doctor or mental health provider for help. Seeking professional help is especially important if you think you might be depressed or you have recurring thoughts of suicide. Unresolved grief can turn into complicated grief, where painful emotions are so long lasting and severe that you have trouble resuming your own life.

Depending on the circumstances, you might benefit from individual or family therapy — either to get you through the worst of the crisis or to help you adjust to life after suicide. Short-term medication can be helpful in some cases, too.

Face the future with a sense of peace

In the aftermath of a loved one’s suicide, you might feel like you can’t go on or that you’ll never enjoy life again.

In truth, you might always wonder why it happened — and reminders might trigger painful feelings even years later. Eventually, however, the raw intensity of your grief will fade. The tragedy of the suicide won’t dominate your days and nights.

Understanding the complicated legacy of suicide and how to cope with palpable grief can help you find peace and healing, while still honoring the memory of your loved one.

Complete Article HERE!

The Painful But Important Lessons I Learned After My Father’s Suicide

By Christiana Zenner, Ph.D.

Anthony Bourdain; Kate Spade; friends, teenagers, neighbors, veterans; my father. Every suicide is distinct and differently devastating, for those who leave and for those who are left.

Yet there are some commonalities, some moments of recognition both in terms of frequent contributing causes and also in terms of what comes next. Here are the hard and important lessons I’ve learned since my father took his life in 2007—when he was 60, and I was pregnant and in graduate school:

1. Suicide is terrifying.

Suicide is what philosophers and mathematicians refer to as a surd—nonsensical, unexpected, a cavernous impossibility that is nonetheless real.

How often do we presume that other people’s lives are on positive trajectories, if not always totally predictable ones?

Perhaps life looked fine, even good, on the outside (as was the case with Bourdain). Or perhaps friends and family members knew the person was struggling but had sought help, and they seemed to be OK (Spade).

After a suicide, many people will say it “doesn’t make sense.” In many cases, yes, there’s a stunned inability to process that the person is gone. But I think there’s a deeper fear at work here, too: the terror of realizing, “Oh my god, if it could happen to them—could this happen to anyone, even people I love, even me?

It is OK to admit that fear and the cascade of uncertainty it unleashes. Suicide uproots our background assumptions that life makes sense.

2. There are no answers.

There may be generally explicable features in many suicides, but there are no ultimate answers. Hold space for the uncertainty, for the dimensionality of who this person was.

My father was a Navy fighter pilot before he left the military to become a commercial airline pilot. Like many vets, his experiences in Vietnam were traumatizing; he talked about them only rarely, but when he did, the moral and personal agony was palpable. Did he have PTSD? Probably, and society needs to do a better job of destigmatizing veterans and people who have been through trauma. But PTSD isn’t the full story.

The most common response people have when I say that my father killed himself is, “Oh, that’s terrible. Was he depressed?” We don’t know. As a pilot, he resisted seeking psychological diagnoses that would prevent him from flying.

Perhaps he was bipolar, as many family members now think likely. It’s natural to wonder, but we will never know for sure. Posthumous speculation can clarify past patterns. Diagnoses of depression are attractive to people who want explanations. But again: Be careful with the urge to make this “make sense”—because often, that is another way to say, “Oh, this would never happen to me or someone I know.” One of the things that suicide challenges us to do is to recognize that other people’s realities and dimensions far exceed the capacity of our projection.

3. Humility goes a long way.

Check yourself: Avoid explaining what this death means to someone who is grieving a suicide. (This is especially important if you think you have insights or are convinced you are being helpful.) Be present. People in grief need to lean on you, not be lectured by you. And what is true in grief more generally is excruciatingly so when mourning a person who has died by suicide. Frankly, unless we have explicitly said, “What do you think?” it is not at all helpful to hear your speculations or interpretations of what this event means. What we need is the space to grieve and heal in our own complicated realities.

More generally, all of us can work to eliminate unnecessary sayings that are obvious triggers—like “the line at the grocery store was so awful, I just wanted to kill myself!” or making hand gestures that mimic firing a gun into your mouth. It’s been 11 years since my father’s death, and I still cringe at those expressions. Communication evolves with social consciousness, so it’s time to retire those basic expressions.

4. Suicide, I believe, stems from hopelessness—not selfishness.

Some people feel that suicide is a selfish act because it fails to account for the difficulty and devastation wrought on the people who remain. But I agree with the many experts who suggest that suicide is often the result of a total loss of hope and self amid a tsunami of despair.

Suicide may feel selfish to survivors—how could he?—but when someone dies by suicide, they do it not out of selfishness or spite. They do it out of ultimate loneliness and pain so deep that most of us cannot begin to comprehend it because it is on a totally different plane of existence.

5. High-functioning people don’t give many signals. When they do, take those seriously.

My father expressed to a few people that he was thinking of ending his life. Those people, who I know loved him deeply, took him at his word that he would seek help. But I know now that such statements are the high-functioning person’s attempt to seek help—it takes massive effort and will to reach across a divide of loneliness and despair, to entrust someone with such honesty about such heavy burdens. It is another way of saying, “I am alone. I don’t know how to proceed; please help me.”

Take these statements seriously. Accompany the person to get help, right then if possible.

Our society can be very isolating. One antidote that we can give to one another as human beings in moments large and small is in our ability to see one another—to affirm the uniqueness and worth of each individual. We can contribute to bonds and societies that feel secure, safe, trustworthy, and consistent—and perhaps make life a bit less lonely, not just when someone confides in us, but in the caliber and kindness of our everyday interactions.

6. For survivors, some grief is incommunicable.

It is not your job to make your grief legible or to make it conform to other people’s expectations. As a survivor, you will have major triggers that are unrecognizable to most people, and your reactions will vary. I can be totally leveled by the image of my dad’s back in his blue blazer as he strode tiredly away from me at my sister’s graduation, or by how I imagined him leaving the house for the last time, or the first 100-plus times I drove by the fire station outside of which he shot himself. Even the feeling of exhilaration on white water, a delight that he and I shared—these are all particularly potent emotional, geographic, and physical triggers for me, even 11 years later. Most people have no idea.

If you are a survivor, let the emotions surface, and let them pass (not easy: It’s like getting thrashed by a huge wave of rage, sadness, and ugly crying). Let me repeat: You don’t have to hide your emotions, and you don’t have to apologize for them. You don’t even have to explain them. Grief is a shape-shifting, surprising, and (in the case of suicide) often terrifying entity. Lean into people who are trustworthy, nonjudgmental, and who let you be you. And when you meet people who have also experienced the suicide of a loved one or family member, you might find yourself weeping together on top of a mountain during spring ski season (true story). It’s OK.

Presence, care, laughter, and gentleness are salves. I have personally found therapy to be fantastically helpful, and many people benefit from survivor support groups. If you are trying to support someone who is grieving the loss of a friend or family member through suicide, support them with presence and infrastructure. Just hug. Sit. Bring food. Come over to walk the dog together. Call to say you’re thinking of them.

7. Your presence will sometimes make people uncomfortable. Many will react strangely.

People say weird and even hurtful things out of their own profound discomfort after a suicide. Others will disappear entirely from your life. This sucks, but it’s true. Suicide (along with what I call the 3Ds—other forms of sudden death, divorce, and disability) can make people really nervous, and as a result they may react to your presence in all kinds of intense and often unhelpful ways.

One person with whom I was close didn’t call, text, or write me for nearly a year after. Only when I ran into her at a party by chance later did she laugh awkwardly and say, “Yeah, sorry about that. I mean, what could I even have said?” My answer now: “Just call and say you don’t know what to say, and you love me and are thinking of me.”

I have learned that people’s reactions and statements say much more about what they are grappling with than what is true for you. This doesn’t make it easier in the moment, but it does mean you don’t have to take on their stuff. Find your way with the people who let you be you, without foisting their own anxious interpretations onto you.

8. Memorialize in ways that feel right to you.

Just as everyone grieves differently, everyone memorializes differently. In the aftermath of a suicide, ritual and burial are important, though they can take many forms. For some people, traditional religious funeral services may provide important closure. For others, those same services might feel like emotional handcuffs.

As time goes on, trust your creativity and the legacy of the person’s memory. What are the moments that make you think of them with a grin? Consider memorializing a place or an activity that feels like a positive legacy—a meditation bench in a treasured spot or an annual walk with organizations that raise awareness about suicide or mental illness, for example. I have found it meaningful to memorialize my father by consciously giving him a shout out during water sports that we both loved.

Finally: The days around the anniversary of the suicide will be tough. Be gentle with yourself in these times. You also deserve love and kindness.

9. You will change, and your relationships will too.

Suicide is an extreme event that, for survivors, puts much into excruciating texture. For me, my father’s death began a decade-long journey of self-reflection—about myself, my family, my partnership, me as a parent, and society more generally. It has involved devastating anxiety that, with time and therapy and life changes, has given way to profound, gentle, exhilarating clarities. Many relationships, including my marriage, were sundered as a result of this journey.

It has not been easy. Grief doesn’t end, but it does change, and with time it becomes less debilitating, more gently poignant. I wish beyond words that my daughter could have met her grandfather. I also have found ways that my father’s positive legacy lives on in me—and in her.

One aspect of my journey is a radical honesty, forged in agonies that none of us wished on ourselves. I am the person that I am because of many factors. One of them is my father’s suicide.

10. You can be OK.

There are no neat closures to the surd of suicide. But healing can be real. Small or large changes in your life may emerge over time. Sometimes they will surprise you. But I’m here to tell you: There is healing, and believe me—you are not alone. With the life you have, you can narrate the story that you are always unfurling.

If you’re feeling suicidal or know anyone who is, the National Suicide Prevention Lifeline in the U.S. is at 1-800-273-8255.

Complete Article HERE!

Suicide survivors face grief, questions, challenges

By

The recent, untimely deaths of Kate Spade, reportedly from depression-related suicide, and of Anthony Bourdain, also from apparent suicide, came as a surprise to many. How could a fashion designer and businesswoman known for her whimsical creations and a chef, author and television personality who embodied a lust for life be depressed enough to end their lives? Crushing sadness can hide behind many facades.

According to a report by the US Centers for Disease Control and Prevention (CDC), suicide rates for adults in the United States are on the rise; since 1999, suicide rates in 25 states increased by more than 30%. In the US, suicide accounted for nearly 45,000 deaths in 2016.

Each person who dies by suicide leaves behind an estimated six or more “suicide survivors” — people who’ve lost someone they care about deeply and are left grieving and struggling to understand.

The grief process is always difficult. But a loss through suicide is like no other, and grieving can be especially complex and traumatic. People coping with this kind of loss often need more support than others, but may get less. Why? Survivors may be reluctant to confide that the death was self-inflicted. And when others know the circumstances of the death, they may feel uncertain about how to offer help.

What makes suicide different

The death of a loved one is never easy to experience, whether it comes without warning or after a long struggle with illness. But several circumstances set death by suicide apart and make the process of bereavement more challenging. For example:

A traumatic aftermath. Death by suicide is sudden, sometimes violent, and usually unexpected. Depending on the situation, survivors may need to deal with the police or handle press inquiries. While still in shock, they may be asked if they want to visit the death scene. Sometimes officials discourage the visit as too upsetting; other times they encourage it. “Either may be the right decision for an individual. But it can add to the trauma if people feel that they don’t have a choice,” says Jack Jordan, Ph.D., clinical psychologist in Wellesley, MA and co-author of After Suicide Loss: Coping with Your Grief.

Recurring thoughts. A suicide survivor may have recurring thoughts of the death and its circumstances, replaying over and over the loved one’s final moments or their last encounter in an effort to understand — or simply because the thoughts won’t stop coming. Some suicide survivors develop post-traumatic stress disorder (PTSD), an anxiety disorder that can become chronic if not treated. In PTSD, the trauma is involuntarily re-lived in intrusive images that can create anxiety and a tendency to avoid anything that might trigger the memory.

Stigma, shame, and isolation. There’s a powerful stigma attached to mental illness (a factor in most suicides). Many religions specifically condemn the act as a sin, so survivors may understandably be reluctant to acknowledge or disclose the circumstances of such a death. Family differences over how to publicly discuss the death can make it difficult even for survivors who want to speak openly to feel comfortable doing so. The decision to keep the suicide a secret from outsiders, children, or selected relatives can lead to isolation, confusion, and shame that may last for years or even generations. In addition, if relatives blame one another — thinking perhaps that particular actions or a failure to act may have contributed to events — that can greatly undermine a family’s ability to provide mutual support.

Mixed emotions. After a homicide, survivors can direct their anger at the perpetrator. In a suicide, the victim is the perpetrator, so there is a bewildering clash of emotions. On one hand, a person who dies by suicide may appear to be a victim of mental illness or intolerable circumstances. On the other hand, the act may seem like an assault on, or rejection of, those left behind. So the feelings of anger, rejection, and abandonment that occur after many deaths are especially intense and difficult to sort out after a suicide.

Need for reason. “What if” questions can arise after any death. What if we’d gone to a doctor sooner? What if we hadn’t let her drive to the basketball game? After a suicide, these questions may be extreme and self-punishing — unrealistically condemning the survivor for failing to predict the death or to successfully intervene. In such circumstances, survivors tend to greatly overestimate their own contributing role — and their ability to affect the outcome.

“Suicide can shatter the things you take for granted about yourself, your relationships, and your world,” says Dr. Jordan. Some survivors conduct a psychological “autopsy,” finding out as much as they can about the circumstances and factors leading to the suicide. This can help develop a narrative that makes sense.

Sometimes a person with a disabling or terminal disease chooses suicide as a way of gaining control or hastening the end. When a suicide can be understood that way, survivors may feel relieved of much of their what-if guilt. “It doesn’t mean someone didn’t love their life,” says Holly Prigerson, Ph.D., professor of psychiatry at Harvard Medical School and Director of Psycho-Oncology Research, Psychosocial Oncology and Palliative Care at Dana-Farber Cancer Institute.

Support from other survivors

Suicide survivors often find individual counseling (see “Getting professional help”) and suicide support groups to be particularly helpful. There are many general grief support groups, but those focused on suicide appear to be much more valuable.

“Some people also find it helpful to be in a group with a similar kinship relationship, so parents are talking to other parents. On the other hand, it can be helpful for parents to be in a group where they hear from people who have lost a sibling — they may learn more about what it’s like for their other children,” says Dr. Jordan.

Some support groups are facilitated by mental health professionals; others by laypersons. “If you go and feel comfortable and safe — [feel] that you can open up and won’t be judged — that’s more important than whether the group is led by a professional or a layperson,” says Dr. Prigerson. Lay leaders of support groups are often themselves suicide survivors; many are trained by the American Foundation for Suicide Prevention.

For those who don’t have access to a group or feel uncomfortable meeting in person, Internet support groups are a growing resource. In a study comparing parents who made use of the Internet and those who used in-person groups, the Web users liked the unlimited time and 24-hour availability of Internet support. Survivors who were depressed or felt stigmatized by the suicide were more likely to gain help from Internet support services.

You can join a support group at any time: soon after the death, when you feel ready to be social, or even long after the suicide if you feel you could use support, perhaps around a holiday or an anniversary of the death.

Getting professional help

Suicide survivors are more likely than other bereaved people to seek the help of a mental health professional. Look for a skilled therapist who is experienced in working with grief after suicide. The therapist can support you in many ways, including these:

  • helping you make sense of the death and better understand any psychiatric problems the deceased may have had
  • treating you, if you’re experiencing PTSD
  • exploring unfinished issues in your relationship with the deceased
  • aiding you in coping with divergent reactions among family members
  • offering support and understanding as you go through your unique grieving process.

A friend in need

Knowing what to say or how to help someone after a death is always difficult, but don’t let fear of saying or doing the wrong thing keep you from reaching out to a suicide survivor. Just as you might after any other death, express your concern, pitch in with practical tasks, and listen to whatever the person wants to tell you. Here are some special considerations:

Stay close. Families often feel stigmatized and cut off after a suicide. If you avoid contact because you don’t know what to say or do, family members may feel blamed and isolated. Ignore your doubts and make contact. Survivors learn to forgive awkward behaviors or clumsy statements, as long as your support and compassion are evident.

Avoid hollow reassurance. It’s not comforting to hear well-meant assurances that “things will get better” or “at least he’s no longer suffering.” Instead, the bereaved may feel that you don’t want to acknowledge or hear them express their pain and grief.

Don’t ask for an explanation. Survivors often feel as though they’re being grilled: Was there a note? Did you suspect anything? The survivor may be searching for answers, but your role for the foreseeable future is simply to be supportive and listen to what they have to say about the person, the death, and their feelings.

Remember his or her life. Suicide isn’t the most important thing about the person who died. Share memories and stories; use the person’s name (“Remember when Brian taught my daughter how to ride a two-wheeler?”). If suicide has come at the end of a long struggle with mental or physical illness, be aware that the family may want to recognize the ongoing illness as the true cause of death.

Acknowledge uncertainty. Survivors are not all alike. Even if you are a suicide survivor yourself, don’t assume that another person’s feelings and needs will be the same as yours. It’s fine to say you can’t imagine what this is like or how to help. Follow the survivor’s lead when broaching sensitive topics: “Would you like to talk about what happened?” (Ask only if you’re willing to listen to the details.) Even a survivor who doesn’t want to talk will appreciate that you asked.

Help with the practical things. Offer to run errands, provide rides to appointments, or watch over children. Ask if you can help with chores such as watering the garden, walking the dog, or putting away groceries. The survivor may want you to sit quietly, or perhaps pray, with him or her. Ask directly, “What can I do to help?”

Be there for the long haul. Dr. Jordan calls our culture’s standard approach to grief the “flu model”: grief is unpleasant but is relatively short-lived. After a stay at home, the bereaved person will jump back into life. Unfortunately, that means that once survivors are back at work and able to smile or socialize again, they quickly get the message that they shouldn’t talk about their continuing grief. Even if a survivor isn’t bringing up the subject, you can ask how she or he is coping with the death and be ready to listen (or respect a wish not to talk about it). Be patient and willing to hear the same stories or concerns repeatedly. Acknowledging emotional days such as a birthday or anniversary of the death — by calling or sending a card, for example — demonstrates your support and ongoing appreciation of the loss.

Helpful resources for suicide survivors are available at from the American Foundation for Suicide Prevention and the American Association of Suicidology.

Complete Article HERE!

6 Ways to Help Someone Who Lost a Loved One to Suicide

Family members and close friends of someone who dies by suicide are at increased risk of suicide themselves. Here’s how you can help.

By Sarah Klein

There’s a common estimate that every suicide leaves behind six survivors who are the most affected by the death. Not to be confused with suicide attempt survivors, who have taken action toward ending their own lives, suicide survivors or suicide loss survivors are friends or family members of someone who died by suicide.

Suicide loss survivors are themselves at an increased risk of mental health conditions and suicide in the future. One study found that people who knew someone who died by suicide in the previous year were 1.6 times more likely to have suicidal thoughts, 2.9 times more likely to make a suicide plan, and 3.7 times more likely to make a suicide attempt than people who did not know someone who died by suicide.

Family members may be genetically predisposed to suicide, while friends and peers may be influenced by the behavior of a person who died by suicide—or distraught by the “emotional destruction suicide leaves in its wake,” says John R. Jordan, PhD, a clinical psychologist in Pawtucket, Rhode Island, and the author of several books and articles on bereavement after suicide.

To address this increased risk, experts in the field of suicide practice something called suicide postvention. “[Clinical psychologist] Edwin Shneidman coined the term to mean what we do after a suicide has happened to help people who are loss survivors and help reduce their risk of suicide,” Jordan says.

Postvention tactics can include professional measures, like therapy sessions or meetings with a support group. But help can also come from family and friends. If you know someone who is a recent survivor of suicide loss, here are expert-recommended ways you can help.

Be present

“Even though this is changing, suicide is still a very stigmatized death,” Jordan says. “Losing someone to suicide can be tremendously isolating. Many people either don’t know anybody or don’t know they know somebody” who was close to someone who died by suicide, he says. Help break down those isolating walls by being there for your friend or family member

Kim Ruocco’s husband died by suicide in 2005. A Marine Corps pilot, he came back from what she describes as a “pretty difficult deployment” in Iraq with PTSD, depression, and anxiety. Their sons were 8 and 10 at the time.

Ruocco, who has a master’s degree in social work and is now the vice president of suicide postvention and prevention at the Tragedy Assistant Program for Survivors, says she took comfort in people simply being by her side. “The people who were most helpful to me could be in my presence and tolerate my pain and didn’t have to say anything,” she says. “There are no right words really, but it was really comforting to have someone who can be with you with that much pain.”

Deflect feelings of blame

Grief is never easy, but grief in the wake of suicide can be particularly complicated, says Mara Pheister, MD, an associate professor in psychiatry and behavioral medicine at the Medical College of Wisconsin, who has researched suicide prevention and postvention. “There’s the sense that it is a little different than the grief involved in losing someone in general. There can be a lot of guilt, a lot of what if,” she says.

Because a suicide loss survivor may already be blaming themselves for not doing something differently, comments like, “How could you not have known?” or “Why didn’t you stop him?” are particularly unhelpful, Dr. Pheister says. “That’s not something that needs to be said.”

Other survivors may be working through feelings of blame surrounding what turned out to be their final interaction or conversation with the person who died, Ruocco adds. “Help them understand that suicide is a multi-factor event that comes together on a kind of ‘perfect storm’ day,” she says, and encourage them to try to let go of that kind of guilt.

Let them dictate how much detail to share

Although it can be uncomfortable and scary to talk about suicide, avoiding the topic altogether might make a suicide survivor feel like you’re pretending nothing happened. Don’t shy away from talking about suicide—but don’t pry for details, either. Listen to how the survivor is talking about it and take cues from them. “Be there for them if they want to talk about it,” Dr. Pheister says. “It depends on what the person feels like bringing up themselves, what they’re okay talking about.”

That includes how you talk about the person’s death, Ruocco says. “Everyone is different in what kinds of words they want to use in connection with their loved one’s death,” she says. “Listen carefully to how the survivors are talking about the death and use those words.”

When in doubt, ask for guidance. Say something like: “I can only try to imagine what this is like for you. Would it be helpful for you to talk to me, or would you rather not talk about it?” Jordan says. However they respond, treat the person with compassion, as you would anyone who is grieving the death of a loved one, he says.

Celebrate the life the person lived

Put aside your curiosity about how the person died and instead share stories of how they lived. Funny stories of her husband or memories she may not have heard before were most comforting, Ruocco says.

“Use their loved one’s name, remember who they were before they struggled with whatever their issues were, acknowledge that the death doesn’t define them,” Ruocco says. “Talking about the life they lived is incredibly helpful.”

Reassure the survivor their feelings are normal

Alongside the guilt that a survivor might be feeling, there could also be sadness, self-doubt, anger, helplessness, and a wide range of other totally normal reactions, Dr. Pheister says. “Depending on how much the person [who died by suicide] was struggling, the survivor might [also] feel relief, which then induces more guilt,” she says. You can help by reinforcing that these and many other emotions are all well within the range of normal reactions to suicide loss. For example, help them “recognize that relief is the natural response to the removal of stress,” Dr. Pheister says.

Talking about how a person is feeling—and that it’s okay to feel that way—might help stave off some self-judgment and self-doubt, Dr. Pheister says.

Help them embrace their grief

Survivors often expect to grieve for a set period of time and then get over it, Ruocco says, which isn’t always the case. “Grief and loss become a part of who you are; people grieve their entire lives,” she says.

With time, grief can certainly become less painful—but it may still linger, she says. She counsels survivors to think of it in a somewhat more positive light. “Grief is love. You grieve because you loved someone. See it as a connection with a loved one.”

If you or someone you know is thinking about suicide, call the toll-free National Suicide Prevention Lifeline at 1-800-273-TALK (8255).

Complete Article HERE!

Suicide over time and across different cultures

By Dr. Phil Kronk

Is suicide a human characteristic that can never be erased?

Is there more than one kind of suicide…and more than one way to view suicide?

Has suicide been viewed by other cultures in ways different from our society today?

Tamil Nadu, in the southern region of India, has had the highest number of suicides for decades. Over 135,000 individuals killed themselves in a recent year.

The ancient Vikings hoped to someday be admitted to their paradise called Valhalla. Only violent death in battle or suicide could bring you to the heavenly halls of Valhalla. All else were denied entrance.

A form of assisted suicide, which caused death by abandonment, is called senicide. Prior to 1939 and only under extreme conditions, such as famine, the Inuit’s, an Eskimo tribe in Northern Alaska, placed their weak, sick elderly on the ice to die…to save the dwindling resources of the tribe.

We know that the Mayan citizens willingly went to be sacrificed to their gods. Ixtab, a Mayan goddess worshiped in the Yucatan region of Mexico, was followed by those who hanged themselves. To this day, that section of Mexico has the highest rate of suicide by hanging.

We find altruistic suicide throughout history in real life and in literature.

During the second world war, as the troop ship, the Dorchester, was sinking, four chaplains gave up their own life jackets, held hands, singing God’s praise and drowned together. The four included a Roman Catholic priest, a rabbi, a Methodist minister and a Reformed Church in America minister.

In literature, suicide is the solution for love denied in Romeo and Juliet.

Sydney Carton, in Dicken’s novel, A Tale of Two Cities, goes to his death on the guillotine in order to save the life of another. His last thoughts view his sacrificial suicide as “…a far, far better thing I do than I have ever done.”

Schopenhauer wrote of suicide as a question that “man puts to nature, trying to force her to answer.”

Other forms of suicide are sanctioned today.

Some European countries and some states in the U.S. allow “physician-assisted suicide” for those seeking relief from terminal physical illness.

Perhaps, the best book I have ever read on suicide is The Savage God (1970) by Alfred Alvarez, who admits to and describes his own “failed suicide.” Alvarez writes that “…suicide means different things to different people at different times.”

For the longest time in Europe and America, the act of suicide was punished, if it was not completed. Alverez notes that “the savagery of any punishment is proportional to the fear of the act.” And the person who survived his or her suicide was harshly punished. The Catholic church also refused burial in sacred ground for any suicide.

Dante’s 7th circle of hell is “The Wood of the Suicides,” where horrible punishment is meted out for eternity.

For a long time in our society, suicide, much like divorce, was viewed as a failure.

Today, we see suicide as an act of mental illness, a “cry for help” and a result of severe depression. Alverez called suicide due to depression “…a kind of spiritual winter, frozen, sterile, unmoving.”

Some feel that we must guard against turning suicide into a sanitized, emotionally isolated scientific form of epidemiology and record-keeping. There is always this danger when society ‘pathologizes’ a complex human act.

A noted psychoanalyst recently wrote to me about this series on suicide. He noted that it was easy to only think of suicide “as an illness to be cured or prevented.” “Dying, like being born” he wrote, “is an inescapably individual experience. They differ because one cannot choose to be born. Choosing to live in pain or in the face of meaninglessness is an act of will.” He saw choosing not to live as no less an act of will, and “what is important is whether one chooses or is driven.”

We must never forget the suffering that comes before a person attempts suicide. Alvarez notes that at night the depressed person lies down in terror, only to wake up in the morning in despair.

We must continue to hear the voices of those suffering, no matter how faint the cry for help or how disguised the motive…before the final solution of suicide is attempted.

The National Suicide Prevention Lifeline is (1-800-273-8255.)

Complete Article HERE!