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!

How To Talk About Suicide Safely

The way we discuss suicide can unintentionally cause harm, but it doesn’t have to

By Leah Fessler

[M]any people are discussing and grieving fashion designer Kate Spade’s death, apparently by suicide. And in these moments, it becomes essential to discussing suicide as safely as possible.

Whether you knew the person who lost their life personally or as a public figure, whether you’re speaking in private, public, or as a member of the press, the way you discuss suicide can affect those around you. By following a few guidelines outlined by suicide prevention specialists and public health practitioners, you can minimize some risks.

What is suicide contagion?

According to the US Centers for Disease Control, suicide rates among adolescents and young adults have increased sharply in recent decades. Suicide is now the second-leading cause of death among young people 10 to 24, and lesbian, gay, and bi-sexual youth are almost five times as likely to have attempted suicide. In a national survey by the National Center for Transgender Equality, 40% of transgender adults reported having made a suicide attempt in their lifetime and 92% of these individuals reported having attempted suicide before the age of 25.

Adolescents and young adults who die by suicide are less likely to be clinically depressed or to have certain other mental disorders that are important risk factors for suicide among persons in all age groups, says the CDC. This reality has motivated research on other preventable risk factors for suicide among young people.

“One risk factor that has emerged from this research is suicide ‘contagion,’ a process by which exposure to the suicide or suicidal behavior of one or more persons influences others to commit or attempt suicide,” the CDC explains. “Evidence suggests that the effect of contagion is not confined to suicides occurring in discrete geographic areas. In particular, nonfictional newspaper and television coverage of suicide has been associated with a statistically significant excess of suicides. The effect of contagion appears to be strongest among adolescents, and several well publicized ‘clusters’ among young persons have occurred.”

How to talk about suicide

According to the National Alliance on Mental Illness, there are three primary tips to follow when discussing suicide with peers or on social media:

Colloquial as the phrase “committed suicide” has become, it’s inappropriate because it’s largely linked to the Catholic doctrine that suicide is a mortal sin. So by saying someone “committed suicide,” you can unintentionally imply that this person committed a kind of crime.

Excluding graphic details of the way someone took their life is advised because doing so can glamorize the act, and become triggering for those who are living with depression or suicidal ideation. The same principle applies to describing suicide notes, or locations of death, which can be especially damaging when the person who has taken their life is famous, as the general public’s fixation with learning all the details can easily make the tragic, deeply complex act seem more like a television drama.

How to write about suicide as a reporter and on social media

The imperative to discuss suicide safely is particularly important for journalists, as media descriptions feed impressions of a public figure’s death. According to ReportingOnSuicide.org, “more than 50 research studies worldwide have found that certain types of news coverage can increase the likelihood of suicide in vulnerable individuals. The magnitude of the increase is related to the amount, duration, and prominence of coverage.”

Organizations such as Samaritans and the CDC, provide highly specific media guidelines and the research behind why careful language can help prevent contagion. Here are some of the most-cited guidelines reporters, producers and social media contributors should follow:

Keep your writing concise and factual. This helps avoid simplistic explanations for suicide. “Suicide is never the result of a single factor or event, but rather results from a complex interaction of many factors and usually involves a history of psychosocial problems,” explains the CDC. “Public officials and the media should carefully explain that the final precipitating event was not the only cause of a given suicide. Most persons who have committed suicide have had a history of problems that may not have been acknowledged during the acute aftermath of the suicide. Cataloguing the problems that could have played a causative role in a suicide is not necessary, but acknowledgment of these problems is recommended.”

Do not glorify or sensationalize suicide. “News coverage is less likely to contribute to suicide contagion when reports of community expressions of grief (e.g., public eulogies, flying flags at half-mast, and erecting permanent public memorials) are minimized. Such actions may contribute to suicide contagion by suggesting to susceptible persons that society is honoring the suicidal behavior of the deceased person, rather than mourning the person’s death,” the CDC continues. The CDC cites the danger of repetitive and ongoing coverage and the presentation of details or dramatic photographs related to the suicide, including photographs of the funeral, the deceased person’s bedroom, or the site of the suicide.

Do not only focus on the deceased person’s positive qualities. “For example, friends or teachers may be quoted as saying the deceased person ‘was a great kid’ or ‘had a bright future,’ and they avoid mentioning the troubles and problems that the deceased person experienced,” writes the CDC. “As a result, statements venerating the deceased person are often reported in the news. However, if the suicide completer’s problems are not acknowledged in the presence of these laudatory statements, suicidal behavior may appear attractive to other at-risk persons—especially those who rarely receive positive reinforcement for desirable behaviors.”

Highlight research based on data. Instead of referring to recent suicides as “epidemic” or “skyrocketing,” describing a suicide as inexplicable or “without warning,” or quoting and interviewing police or first responders about the causes of suicide, discuss suicide as a public health issue backed by the most recent CDC statistics and less colorful words like ‘”rise” or “higher,” ReportingOnSuicide.org advises. Avoid oversimplifying the causes or perceived triggers of suicide—like a single accident, loss of job, breakup, or bereavement.

While some people who die by suicide do not display warning signs, the vast majority do. Share links to organizations like the National Alliance on Mental Illness, which provide detailed education on suicide warning signs and risk factors.

Provide suicide prevention resources. While people often avoid discussing mental health issues, talking about suicide is key to preventing it. Any reporting on suicide should include the message that depression is treatable, suicide is preventable, and ending the stigma around mental health requires honest dialogue. Resources such as Crisis Text Line and the American Foundation for Suicide Prevention provide education, resources, and crisis intervention. These resources are free of charge and available any hour of the day:

Complete Article HERE!

Veteran? Terminally Ill? Want Death With Dignity? That Could Get You Evicted.

By JoNel Aleccia

[C]alifornia voters passed a law two years ago that allows terminally ill people to take lethal drugs to end their lives, but controversy is growing over a newer rule that effectively bans that option in the state’s eight veterans’ homes.

Proponents of medical aid-in-dying and residents of the Veterans Home of California-Yountville — the largest in the nation — are protesting a regulation passed last year by the California Department of Veterans Affairs, or CalVet, that requires that anyone living in the facilities must be discharged if they intend to use the law.

That’s a position shared by most — but not all — states where aid-in-dying is allowed. As more U.S. jurisdictions consider whether to legalize the practice, the status of terminally ill veterans living in state-run homes will loom large.

“It would be a terrible hardship, because I have no place to go,” said Bob Sloan, 73, who suffers from congestive heart failure and other serious cardiac problems. He said he intends to seek medical aid-in-dying if doctors certify he has six months or less to live.

“I’m not going to be a vegetable,” said Sloan, a Vietnam War-era veteran who moved into the Yountville center five years ago. “I’m not going to end up living in so much pain it’s unbearable.”

A CalVet official said the agency adopted the rule to avoid violating a federal statute that prohibits using U.S. government resources for physician-assisted death. Otherwise, the agency would jeopardize nearly $68 million in federal funds that helps run the facilities, said June Iljana, CalVet’s deputy secretary of communications.

California is not alone. Three other states where aid-in-dying is legal — Oregon, Colorado and Vermont — all prohibit use of lethal medications in state-run veterans’ homes.

In Montana, where aid-in-dying is allowed under a state Supreme Court ruling, officials didn’t respond to multiple requests about whether veterans would be able to use the law in the residences. However, Dr. Eric Kress, a Missoula physician who prescribes the lethal medication, says he has transferred patients to hospice, to relatives’ homes, even to extended-stay hotels to avoid conflict.

In Washington, D.C., where an aid-in-dying law took effect last summer, the Armed Forces Retirement Home won’t assist patients in any way. Those who wish to use the law would be referred to an ethics committee for individual consideration, spokesman Christopher Kelly said in an email.

Only Washington state has a policy that allows veterans to remain in government-run residences if they intend to ingest lethal medications.. At least one veteran has died in a state-run home using that law, said Heidi Audette, a spokeswoman for the state’s Department of Veterans Affairs.

Paul Sherbo, a spokesman for the U.S. Department of Veterans Affairs, said the choice is up to the states.

“VA does not mandate how states comply with federal law,” Sherbo said in an email. “There are a number of ways individual states can choose to handle such situations and still be in compliance.”

To date, none of the 2,400 residents of California’s veterans homes has formally requested medical aid-in-dying, said Iljana. That includes the more than 900 residents of the Yountville center, located about 60 miles north of San Francisco.

“We would respectfully and compassionately assist them in transferring to a hospice, family home or other location,” Iljana said in an email. “We will readmit them immediately if they change their minds.”

But Kathryn Tucker, executive director of the End of Life Liberty Project, an advocacy group that supports aid-in-dying, said that CalVet is interpreting the federal regulations too broadly and denying terminally ill veterans the right to choose a “peaceful death” through medical assistance.

“Nothing exists in the federal statute’s language that would prohibit a resident from receiving aid-in-dying services at state homes, so long as they are not provided using federal funds or employees,” she said.

Ed Warren, head of the Allied Council, a group representing veterans at the Yountville site, co-signed a letter to CalVet officials protesting the ruling.

“My point of view is that it is inhumane to expect people in the last stages of dying to go through the hullabaloo of leaving their homes,” he said.

In Washington state, a 60-year-old man diagnosed with terminal chronic obstructive pulmonary disease, or COPD, died in June 2015 after ingesting lethal drugs at the Washington Soldiers Home in Orting, where he lived.

“It was all done very much in the open,” said Chris Fruitrich, a volunteer with the group End of Life Washington, which assisted the man.

There has been no indication that the policy jeopardizes the nearly $47 million the agency receives each year in federal funds, said Audette, the state VA spokeswoman.

In California, additional protests have centered on allegations that CalVet suppressed information about the aid-in-dying law.

Critics at the Yountville home contend that CalVet passed the discharge rule quietly, with little public input. Then the agency refused to broadcast a public meeting about medical aid-in-dying on KVET, the center’s state-run, closed-circuit television station.

Iljana said the Aug. 21 meeting, led by Tucker and Dr. Robert Brody, also a supporter of aid-in-dying, violated state rules that prohibit using public resources to promote political causes.

“Free speech is great and criticizing the government is great, but not using the government’s own resources and paid staff to advocate for a change in the law,” Iljana wrote in an email to prohibit the broadcast.

That decision, however, prompted Jac Warren, 81, who has been KVET’s station manager for eight years, to resign last month in protest, citing censorship.

“What is at issue is whether a state may completely suppress the dissemination of concededly truthful information about entirely lawful activity,” Warren wrote in an email to CalVet.

The hour-long meeting, attended by about 50 people, was not propaganda, Tucker said, but “an educational event with information provided by an attorney and a physician who both specialize in their respective fields in end-of-life care.”

Bob Sloan, who works as an engineer at KVET for a $400 monthly stipend, disagreed with the decision not to broadcast the meeting on the system that serves residents of the Yountville home.

Sloan said he knows other residents who would like to be able to use California’s aid-in-dying law if their illnesses progress.

“The only other option that people have in this state is committing suicide,” he said. “If I can’t find some way of doing it legally, I’ll do it illegally.”

Complete Article HERE!

Musings on Mortality: Difference between suicide, medical aid in dying

By Deborah Alecson

There is a profound difference between suicide and medical aid in dying, otherwise known as death with dignity. It is not a matter of semantics.

Death with Dignity Campaign

In a death-phobic culture such as ours, one in which we prevent ourselves from projecting into our dying time, we cannot grasp the distinction. True, both result in the taking of one’s own life, but one is an act of desperation and self-destruction, while the other is an act of self-love. How can choosing death over life be motivated by self-love, you are wondering. We will explore this later in the column.

People commit suicide often in the prime of their lives because living for them is unbearable. Unlike the terminally ill who choose medical aid in dying, people who seek to commit suicide are not in their dying time but in their living time. More often than not, there are underlying and unresolvable emotional and psychological torments. There is depression or a psychiatric illness that has not been or cannot be treated. For the elderly, suicide can be motivated by the suffering that comes from living a compromised life without the support of family, friends, or community. Loneliness and feelings of abandonment are factors in suicide, especially for the elderly.

Suicide is considered a failure of the person and of our society. Help was needed and not found. In our culture, suicide is to be prevented at all costs including the involuntary psychiatric hospitalization (or incarceration depending on how you view that which is “involuntary”) of the person who discloses his or her suicidal thoughts. There are consequences for a patient in therapy to even talk about suicide: The therapist must report him or her to the authorities. The horrible irony is that the one place a suicidal person can get help to understand his or her own feelings, with a therapist, is the one place where he or she can’t talk about these feelings.

In a death-phobic culture, thoughts of suicide are considered aberrant. But let’s be honest, who hasn’t thought about suicide at least once in their life?

The will to live is an instinct of such force that human beings kill other human beings to stay alive. Human beings accept life-prolonging treatments during what would be their natural dying time that in the end, diminish the quality of time that they had bought with more treatment. People will do unbelievable things to ensure their own survival.

So, choosing to die under the weight of the instinctual and societal will to live is either accomplished out of sheer terror of life itself or incredible courage. Courage to venture into the unknown.

Since most of us have not been around dying people and as I wrote earlier, rarely imagine ourselves in that situation, we have no idea what dying is like. We don’t understand what it asks of us and what it takes out of us. While hospice care can be a possibility for how we live our dying time, it is not for everyone.

Medical aid in dying is now possible in five states. This means that people who are dying of a terminal illness can request a lethal dose of medication to end their own lives. Those few terminally ill patients who request and qualify for medical aid in dying do so to have a dignified death on their own terms. That’s all. This choice is a logical, sound, and deeply compassionate act of relief, not a desperate escape of a circumstantial situation as suicide often can be.

How can choosing death over life be motivated by self-love? When your dying time comes, you may want to spare yourself and your loved ones a prolonged and brutal decline. This to me is self-love. It is not suicide.

Complete Article HERE!

Grieving a Suicide Death

By Eleanor

cemetery angel

 

According to Centers for Disease Control and Prevention in 2013 there were 41,149 suicides in the United States.  This rate is equal to 113 suicides each day or one every 13 minutes.  Surveys have shown that 40% of adults know at least one person who has died by suicide and upwards of 20% of adults report their lives have been significantly impacted by suicide.

I’m sorry we didn’t write this post sooner.

I have a lot I want to cover, so I won’t waste time on introductions.  I do realize, though, that some of you won’t read this post all the way through.  For those of you who know yourselves well enough to know you won’t finish, I want to let you know that I will link to additional resources at the end of this post.  Also, I want to invite anyone who has been touched by suicide to share your experiences in the comments below.  Although we can offer general thoughts on this subject, it is your insight that adds truth and nuance to this discussion and helps those facing similar circumstances feel less alone.

First things first, our usual disclaimer…

Although commonalities exist amongst people who have experienced a certain type of loss, individual grief is unique to the person experiencing it and their relationship with the person who died.  Although we can talk in averages and generalities, no article, grief theory, or set of symptoms will ever perfectly sum up your grief experience. Further, although you might be able to relate to aspects of another person’s grief (and vice versa), no one can completely understand how anyone else feels. With this in mind, we recommend you learn what you can from your commonalities with other grievers, but take differences with a grain of salt.

How we talk about suicide…

Although we may have a long way to go in understanding suicide and effective suicide prevention, thankfully progress has brought us far beyond the dark days when suicide was looked upon as a crime or religious offense.  Progress, though, is multifaceted and while our understanding of suicide has grown more compassionate, our language has not.

For this reason organizations like the World Health Organization, National Institute for Mental Health, American Association for Suicidology, American Foundation for Suicide Prevention and countless others have been working to shift suicide-related terminology.  Although there are many fine points to this conversation, I simply want to impress the following upon you…

When referring an individual’s death from suicide…

Don’t say…She committed suicide.”

Do say… “She killed herself” or “She died by suicide”

I know most of you are used to saying “committed suicide” and you certainly aren’t alone.  Many people in our society have yet to get this memo, but now you have.  Please, the time has come for us to choose language around suicide that does not condemn or stigmatize the person who has died or those who love them.

Suicide as a traumatic loss…

When a loved one kills themselves, the death is often experienced as traumatic.  We typically use Wortman & Latack (2015) definition of traumatic loss…

“A death is considered traumatic if it occurs without warning; if it is untimely; if it involves violence; if there is damage to the loved one’s body; if it was caused by a perpetrator with the intent to harm; if the survivor regards the death as preventable; if the survivor believes that the loved one suffered; or if the survivor regards the death, or manner of death, as unfair and unjust.”

This definition touches on many experiences common to suicide death including the death being sudden, untimely, violent, regarded as preventable, etc. However there are other traumatic loss risk factors associated with suicide such as feelings of blame, witnessing the death, and finding the body.  Deaths that are also potentially traumatic events can result in trauma and grief responses compounding and intertwining.  These may manifest as the following (these are just a few so if you’d like more information on grieving a traumatic loss, head here):

  • Recurrent intrusive thoughts about the death
  • Shattered assumptions about the world, onself, and others
  • Feelings of guilt and blame
  • Fear and avoidance of grief and trauma reactions, etc.

It’s important to note, it is not the nature of a death that makes it traumatic, rather how the event is interpreted and processed by the individual. This means that, regardless of the circumstances around the death, it is not a given that it will be experienced as traumatic. One cannot underestimate the impact of personal factors like emotional regulation, cognitive responses, secondary stressors, coping style, prior history of trauma, and access to support and resources in determining how a person responds to an event.

when people are suicidal

When grieving a suicide death one may experience…

The search for answers:

In the wake of death, people often seek to construct a meaningful narrative that helps them to find peace and understanding in what happened.  So asking questions like “what if?”, “why?”, and “what’s the point?” is a common grief response.

After a suicide death, as with any other type of death, the bereaved seeks to make sense of what happened.  However in this instance they may find that many of their questions are either unanswerable or lead to undesirable conclusions (whether these conclusions are true or not).

Until the question of “why” can be answered, grieving family and friends may continue to search and ruminate.  It is not uncommon for themes of personal blame to arise as a person questions their role in their loved one’s suicide and what they could have done to prevent their death.  Unfortunately, the bereaved may vastly overestimate their own role and the role of others (i.e. what family and friends did or didn’t do), as opposed to blaming things like mental illness which is quite often present.  Whether rational or not, grieving family and friends may struggle with distressing thoughts like…

  • I never really knew him.
  • She didn’t feel comfortable confiding in me.
  • She was in intense pain
  • I’m to blame. I should have done more to prevent his death.
  • I’m to blame. I pushed him into the decision to kill himself.
  • She didn’t love me enough to live.
  • My family members are to blame.

The impact of expectedness…

Although suicide is often sudden, it is not always unexpected and so not all who experience the death of a loved one struggle to answer the question of “why?”.  In many instances there has been discussion of suicidal thoughts or past suicide attempts.  Maple et al (2007) found in interviews with suicidally bereaved parents that “preparedness” was linked with an ability to anticipate and explain their child’s death.  They note,

“Once they had acknowledged the inevitability of suicide they were able to weave this possibility, unwelcome as it was, into their life story to develop a coherent explanation.”

Family conflict:

Family can be an incredible source of comfort and healing after a death.

Family be a source of distressing conflict and misunderstanding after a death.

Which of these statements is true?  Both…sometimes within the same family at the same time!

Regardless of the circumstances surrounding the death, things like complicated family dynamics, shifting roles, and different coping styles can test and challenge a family. After a suicide death additional conflict may emerge because…

  • The deceased’s mental illness and suicidal behavior created disruption and placed strain on the family as a whole.
  • Family members disagree about how they want to acknowledge the death publicly or how they want to discuss the death privately within the family.
  • Different family members come up with different explanations for why their loved one killed him- or herself
  • Blame

Feelings of rejection and abandonment:

Evidence has shown that suicidally bereaved individuals experience higher levels of rejection compared with other bereaved groups.  In grief, feelings of guilt, blame, regret, and rejection defy all logic and reason. Even when it’s evident that the suicide was not an act of intentional abandonment, it may feel that way to the people left behind in death’s wake.

Worries about developing mental illness:

Approximately 90% of those who die by suicide have one or more mental disorders.  When the deceased is connected to the bereaved through genetics, especially in the instance of a child grieving a parent’s suicide death, they may worry that they too will develop mental illness and some day make the choice to kill themselves.

Indeed, some research has indicated that a family history of suicide increases suicide risk.  So if you know a child, or adult for that matter, struggling with these concerns don’t immediately disregard their worries.  If you are someone grappling with this concern, know that it is normal and if you’re really worried then it never hurts to seek out a little support and psycho-education from a therapist or counselor.

Fear of grief reactions:

After a death mourners often feel as though they are going crazy, and, as noted, those who have experienced a traumatic loss often experience intensified and prolonged grief/trauma reactions.  If a person interprets their symptoms as dangerous, threatening, or indicative of a larger mental or physical problem, they are more likely to fear and inhibit their reactions.  Concerns about one’s own reactions following a death add to existing emotion by causing additional anxiety, depression, anger or shame.  Those who are fearful of their reactions may also engage in maladaptive and persistent avoidance of triggers or reminders which can contribute to the development of postraumatic stress disorder and which prevent the mourner from finding meaningful ways to continue their bond with their loved one.

Relief:

It is common for a person to feel relieved after a loved one dies when the loved one had been living in pain and suffering. For those who die from illness, the relief comes from knowing they are no longer in physical pain.  And when a person dies from something like suicide or overdose, the relief may come from a place of knowing that their loved one is no longer struggling with emotional pain.

One may also feel relief if the loved one’s suicidal behavior (or other types of behavior) had previously put a strain on the family.  This doesn’t mean that the person grieving the loss wouldn’t trade their relief to have their loved one back for just one moment, or that they don’t also feel intense pain and sadness.  Relief is simply one response in their big, messy, hurricane of grief.

Feelings of isolation, stigma and/or shame:

Sadly, there is a stigma attached to mental illness and suicide.  Others can’t imagine the mental and emotional pain that would cause a person to kill themselves and so they might make assumptions or judge the deceased’s actions, calling them weak or selfish or who knows what else.

This being the case, it’s no wonder that many people choose not to open up about their loved one’s death.  Stigmatized losses may also be referred to as disenfranchised losses, which you can read more about here.  The following are just a few potential causes for isolation, stigma, and shame following a suicide death:

  • Isolation and shame may result from the family’s decision to keep the suicide a secret.  Feeling unable to acknowledge the truth, those grieving the loss may feel as though they have to lie or live in silence.
  • Shame may result from thoughts of personal blame and responsibility.
  • Shame may result from the belief that one can’t control or manage their own grief reactions.
  • Isolation and shame may result from a lack of social support or because others don’t acknowledge the death.
  • Shame, isolation and stigma may be felt in response to messages from media and broader society about suicide
  • Isolation may result from perceived rejection and thoughts of worthlessness.

Complete Article HERE!