A Guide to Working Through the Grief After a Loss by Suicide.
There is no easy prescription for recovering from the loss, but there are things you can do to better cope with and ease the pain.
People give you all kinds of advice when a loved one dies: "You have to go on with your life." "Your loved one would want you to be happy." "You are strong and brave and you can get through this." "You have to be strong for your siblings, children, and other loved ones." These words of encouragement are stated with the best intentions in mind. They are meant to convey comfort and optimism during difficult times.
Grief is overwhelming at best, no matter the cause of death, but loss by suicide is particularly complicated. Survivors of loss by suicide face the same painful emotions as others who grieve a loss, but they also have to cope with messy and complicated emotions, like guilt, shame, and anger, to name a few. They are forced to confront the stigma associated with suicide every time they answer a question about their loss.
It was 21 years ago that my father died by suicide, alone in his office on the last day of April. The initial shock that enabled me to go through the necessary steps to bid my father farewell was soon replaced with overwhelming feelings of guilt, despair, and utter disbelief.
I was 23 years old at the time, and nearly one year into the master of social work program at the University of Pennsylvania. I knew the symptoms of depression and the warning signs for suicide, but I never saw it coming. He didn’t wave a single red flag before he died. I would grapple with that guilt for years to come.
Recent data shows that suicide is the 10th leading cause of death overall in the United States, the second leading cause of death among individuals between ages 10 and 34, and the fourth leading cause of death among individuals between ages 35 and 54. (1) Deaths by suicide are on the rise.
In her new book, Life After Suicide: Finding Courage, Comfort, and Community After Unthinkable Loss, ABC News Chief Medical Correspondent Jennifer Ashton, MD, examines this tragic epidemic and recounts her own first-hand experience with a tragic loss. Dr. Ashton writes about the personal trauma that she and her family experienced when her ex-husband died by suicide in 2017.
“This is a book about hope, and strength, and resilience, and growth, and how, with a lot of help and love, we found our way out of a darkness I was sometimes afraid might swallow us whole,” Ashton writes.
While there is no prescription for “getting over” loss, you will get through this. In time, you will find that you are not alone in this catastrophic loss, and connecting with others can help you feel less isolated. There are things you can do to better cope with the emotional turmoil that accompanies a loss by suicide. Grief is a journey that changes over time, but doesn’t necessarily end.
Many people benefit from psychotherapy as they work through their grief following a loss by suicide, while others take comfort in groups for survivors.
There is no right way to grieve this kind of loss, and no perfect words to ease the pain of those left behind. The following guide is intended to help survivors of suicide take the steps that work best for them and their loved ones.
Chapter 1: Understanding That Your Loved One’s Suicide Is Not Your Fault
There’s plenty of guilt to go around when it comes to picking up the pieces following a suicide. According to a review published in June 2012 in the journal Dialogues in Clinical Neuroscience, research has shown that in addition to the typical sadness and disbelief expected with all grief, overwhelming feelings of guilt, confusion, rejection, shame, and anger are prominent among survivors of loss by suicide. There also tends to be an immense need to make sense of the loss.
Survivor’s guilt is a huge obstacle on the path to recovery. It’s natural to get caught up in intrusive thoughts telling you that you could have done or said this or that when confronting the stress of this kind of trauma, but it’s essential to remember that intrusive thoughts aren’t accurate thoughts. These thoughts don’t paint the complete picture.
Repeat after me: I am not responsible for my loved one’s suicide.
Write yourself a note. Text yourself reminders. Ask a close friend to remind you of this often. You are not responsible for your loved one’s death.
Coping With the 'What Ifs?'
The “what ifs?” will keep you up at night. They’ll sneak up on you when you least expect them. They’ll ruin what you think might finally be a somewhat regular day.
What if I made that phone call?
What if I didn’t start that fight?
What if I didn’t file for divorce?
What if I didn’t yell at my child over that poor grade?
What if I had been more understanding?
What if I paid more attention?
What if I insisted on therapy?
The “what if” statements that trigger feelings of guilt are seemingly endless. The truth is, it’s easy to look back and hyperfocus on the perceived missteps along the way. When people look for errors, they generally find them. But the “what ifs?” following suicide are more like false accusations. The “what ifs?” force survivors to look inward in self-blame, thereby increasing the feelings of guilt and shame.
Chapter 2: Being Aware That Feelings of Shock Can Make Even Daily Tasks Challenging
The shock that occurs upon learning of a loss by suicide feels overwhelming and possibly never-ending. It might seem like it consumes you. Questions course through your mind as you attempt to pick up the proverbial pieces. You might feel frozen, like you don’t know how to do the things that once came naturally to you.
Shock can make things like eating, showering, and sleeping feel impossible. You might find that you ignore your daily personal needs as you go through the motions of getting through each day. This is one of the natural reactions to traumatic information. This is actually one way the mind processes tragedy and protects you from experiencing overwhelming responses all at once. Shock allows you to function as you come to terms with the enormity of the loss.
Shock can weaken your natural defenses. Given that you might find it difficult to eat and sleep as you normally would, this can put you at risk for illness, exhaustion, and poor emotional health. While shock is natural, it’s important to call your doctor if it persists, to avoid health risks.
What Are the Signs and Symptoms of Depression?
People don’t always know how or when to help when friends or loved ones are coping with a suicide. They might attempt to give you space out of respect, but chances are you need hands-on support during those first few weeks.
Ask a close friend or loved one to help you generate a list of practical support to help get you through the shock. Do you need groceries, meals, or other errands? Does a dog need walking? Do you have kids who need extra support? Do you need people to help make phone calls to share the information about funeral arrangements? It can be difficult to ask for help when coping with tragedy, but social support will help you get through this.
Your shock will subside as you get through the initial phase of grief, but everyone has their own timeline. Take your time.
Chapter 3: Finding the Road to Healing After Facing a Loss by Suicide
You might be wondering when the “right” time is to seek help, or if you even need help at all. The truth is that it’s never too soon to seek support. Coping with a loss by suicide is complex. All people work through grief in their own ways, but because loss by suicide does come with a stigma, survivors of suicide can feel alone in their grief.
Consider these strategies as you figure out how to work through this difficult time:
Rely on Your Support System
Think about people who have supported you in the past. Consider close family members, friends, colleagues from work, people from your faith-based community (if you have one), and parents of friends of your children (if you have kids). It helps to think about your close friends first, and then zoom out.
Sometimes people resist relying on their support systems for help because they don’t want to be a burden. That’s an added layer of guilt that can sneak into the grief process, but accessing social support will help you feel less alone and relieve some of the stress of the day-to-day to-do list that feels overwhelming when you’re grieving.
Create a Support Map
Sometimes it’s difficult to know where to begin. One thing you can do is identify the places you have built in support systems and start there. If you belong to a church or temple, for example, write that down on a piece of paper. Underneath it, write down one or two supportive people there. Make another spot for family, work, and other important areas of your life. You’ll likely find that you already have a solid support system.
Acknowledge and Accept Your Emotions
You might expect to feel sadness, but loss by suicide can also trigger feelings of anger, guilt, shame, loneliness, shock, anxiety, confusion, and sometimes relief. It’s important to pay attention to and accept all of your emotions. All of these feelings are to be expected and can come and go as you work toward healing.
Seek Professional Help
Professional psychologists and psychotherapists can help you verbalize and work through your emotions about the loss and help you build adaptive coping skills. There are professionals who specialize in grief, suicide, and certain age groups. If there are grieving children, it’s best to seek a therapist who specializes in the child and adolescent population. Family therapy can also be beneficial as the family learns how to rebuild and comes to terms with their new life after suicide.
Seek Out Other Survivors
Suicide can be difficult to understand if hasn’t touched your life, but other survivors of loss by suicide can be a great source of support through difficult times. Whether you connect with one other survivor or find a suicide survivor’s group, processing your emotions with others who can understand you can be beneficial.
Take Care of Yourself
Grief can rob people of the ability to attend to the mundane. Things that people take for granted, like cooking healthy meals, suddenly feel overwhelming and unnecessary. You do need your strength to ride the emotional roller coaster of life after suicide, and that begins with mindful attention to your physical and emotional needs.
Enlist a buddy to help you practice self-care during this time. A lunch friend, walking partner, or goodnight texter provides support and reminders to attend to your needs.
Chapter 4: Learning How to Tackle the Harmful Stigma Surrounding Suicide
If you want to clear a room in an instant, mention suicide. People have all kinds of reactions to discussions of suicide and mental health, many of them blanketed in discomfort. We, as a society, don’t know how to talk about these isolating topics, so we tend to talk around them. But talking is exactly what we need to do to destigmatize suicide and mental health and relieve survivors of the unfair burden of protecting the emotional reactions of those around them.
Watch Your Words
Words matter to suicide loss survivors. While a simple turn of phrase might not seem like a big deal, certain phrases can feel judgmental and isolating. If you are in the position of helping a loved one who suffered a loss by suicide, consider these changes in language:
Use “died by suicide” instead of “committed suicide.”
Only use the word “suicide” when you’re discussing suicide. Phrases like “social suicide” and “career suicide” can be hurtful to suicide loss survivors.
Use “suicide attempt” instead of "failed suicide" or "successful suicide."
Share Your Story
When the shock begins to subside, survivors of loss by suicide are left to put their lives back together and attempt to carry on. This is a heavy burden in the face of tragedy. Just as a person who loses a loved one to cancer needs to talk through his or her feelings, survivors of loss by suicide need to tell their stories, too.
Once you’ve learned to use the phrase “died by suicide,” begin talking to a trusted friend or family member. Start small. If you’re riding the waves of shock, say that. If you’re feeling anger or confusion, say that.
The more comfortable you feel opening up to your support system about your loss, the more you reduce the stigma within your social circle. You can widen that circle as you feel comfortable, but don’t push yourself. While some survivors of loss by suicide take comfort in joining advocacy groups and speaking about loss by suicide, others need more time to heal before sharing their stories.
Chapter 5: Knowing That Teens Are Affected by Suicide, Too
Many teens who attempt or die by suicide have a mental health condition that can make it difficult to cope with stressors such as failure, rejection, breakups, social issues, academic stress, and family discord. When teens lack coping skills or support systems to rely on when they’re struggling, they might have difficulty envisioning a solution to their problems.
There are red flags for teen suicide, but it’s important to remember that some elevated risks are difficult to detect. Many teens are adept at concealing their pain from their families and close friends.
Red flags include:
Writing or talking about suicide, online or face to face
Increased use of drugs or alcohol
Social isolation
Feelings of hopelessness
Increased risky or self-destructive behavior
Giving away possessions
Personality changes, including increased agitation, anxiety, or depressed behaviors
Talking to Teens About the Loss of a Friend by Suicide
There’s a common misconception that talking to teens about suicide can have the unintended consequence of encouraging suicide. This is a myth. In fact, breaking the tension and talking openly about suicide can actually help teens open up about it.
Often, teens are more comfortable talking about suicide and mental health than adults, but it’s different when teens are the survivors of loss by suicide. There’s no perfect way to discuss this kind of loss, but it is important to be honest, use direct language (don’t try to sugarcoat it), empathize, and be prepared for questions.
You can open the conversation by asking your teen a question, such as:
Did your school talk about the death by suicide?
How did you feel when you heard the news?
Did any of your friends have reactions that surprised you?
Do you ever feel depressed? Do you ever think about suicide?
This is not a one-time conversation. You should check in with your teen regularly and normalize the wide range of emotions your teen is likely to experience.
Chapter 6: Recognizing the Prevalence of Suicide Among Men
According to the latest data compiled by the American Foundation for Suicide Prevention (AFSP), in 2017 men died by suicide 3.54 times more often than women. (3) Statistics show that white males accounted for 77.97 percent of deaths by suicide in 2017.
There are risk factors for men, but, as with teens, it can be difficult to spot the red flags. In fact, not all men who experience suicidal ideation seek help or show any outward signs of struggle.
Suicide in men is most strongly associated with depression, physical pain and illness, isolation, and feelings of hopelessness. It helps to know the potential risk factors:
Depression or other mental health disorders
Drug and alcohol use to cope with stressors, loss, or other emotional issues
Social isolation
Difficulty forming or maintain relationships
Divorce
Unemployment
Loss
Imprisonment
Access to firearms
Feeling disconnected or alone, feeling like a burden to others, and feeling hopeless about the future are all red flags for the male population. Midlife stress can be debilitating for men. Job loss, financial difficulties, relationship problems, and illness are all common problems among this population. How men learn to cope with this difficult phase of life is important. Offering support in the workplace or making accommodations to seek help during work hours can make a difference.
The stigma among men is overwhelming. Men continue to face societal pressure to brush off emotional issues and remain strong in the face of adversity. This sets men up to hide their struggles and suffer in silence. It’s essential to talk openly and honestly about mental health and coping skills as a family, early and often, to help boys and young men learn to seek help when they need it.
Chapter 7: Turning to Religious Professionals for Help After Facing Loss by Suicide
The decision to seek counseling can be a difficult one. It’s hard to open up to a complete stranger, particularly about something as personal as working through a loss by suicide. It can feel less overwhelming to seek help through your religious organization if you belong to one.
Pastoral counseling is a branch of counseling in which trained ministers, priests, rabbis, imams, and faith-based counselors provide therapy services. Pastoral counselors often integrate modern psychological methods with traditional religious training.
Seeking help from clergy can actually help destigmatize mental health services. People may feel comfortable with their faith leaders and might be more likely to seek help within their religious organizations. Faith leaders that are trained to spot the signs of mental illness or red flags for suicide are also a first line of defense. They have direct contact with their congregants, often on a weekly basis, and can offer support to someone who appears to be struggling.
Not all pastoral counselors are licensed mental health providers. Another option is to seek faith-based therapists who weave spiritual beliefs into the therapy process. Check with your religious organization to find a faith-based therapist in your area.
Chapter 8: Understanding the Phenomenon of Suicide Contagion
Suicide contagion, or “copycat suicides,” refers to the phenomenon that exposure to suicide or suicidal behavior within one’s family, one’s peer group, or through media coverage of suicide can result in an increase in suicides or suicidal behaviors. News of comedian Robin Williams’s death by suicide, for example, was associated with a nearly 10 percent increase in similar deaths by suicide, according to a study published in February 2018 in the journal PLoS One. (4)
Media coverage of high-profile deaths by suicide can be triggering for people struggling with depression or at risk for suicide. Media coverage tends to focus on the sound bites, but suicide is complex and involves many factors.
Changes to media coverage of suicide can make a difference. Media coverage should avoid oversimplification of the suicide, such as focusing on recent negative life events or current acute stressors. Media reports should not divulge detailed reports of the method of suicide or glorify the event. Media outlets can offer help to those struggling by providing direct links to suicide hotlines and emergency contacts.
If people are exposed to death by suicide or suicidal behavior within the family or a peer group, it’s important to offer support from a mental health practitioner. This ensures a proper evaluation of the survivor of loss by suicide and assists with building coping skills to work through the loss.
Talking openly about the suicide and building support systems for the survivors of the loss by suicide can help decrease suicide contagion. Discussing the many complex factors that contribute to suicidal behavior and attempts helps people understand the scope of the problem. Talking about mobilizing help and learning how to cope offers hope to those who struggle with their mental health and might be considering suicide.
Chapter 9: Helping a Friend Who Has Lost Someone They Love to Suicide
It’s hard to know what to say to help a friend or loved one who lost someone to suicide. Though you can’t relieve your loved one’s pain, there are things you can say and do to help your loved one through this difficult time. Simply checking in, even by text, offers a line of support.
It can feel awkward to start conversations about suicide, but survivors of loss by suicide need friends who are willing to listen. Don’t be afraid to show up with support, even if your friend or loved isn’t asking for help.
There are several things you can do to help:
Express your concern. A simple, “I know this is difficult for you. I’m here when you need me,” shows your loved one that you are there for support.
Be direct. Don’t dance around the issue. Use the word “suicide” and be prepared to listen.
Empathize. Reflecting your friend’s feelings shows support and empathy. Statements like, “You’re feeling shocked and angry about this,” communicate that you’re listening.
Ask how you can help. It can be overwhelming for people to ask for help. More often than not, they don’t know where to start. Ask specific questions to offer help. “Can I pick up some groceries for you? Do you need a ride to an appointment? Can I help you get the house organized?”
Offer to help find support. Chances are your friend or loved ones need extra support at this time. Offer to help your friend find someone to talk to or a support group to attend, and be sure to offer to go with your friend.
Listen. The most important thing you can do is listen. You don’t have to have all the answers; you simply have to listen and offer support.
If you notice that your friend or loved one communicates feelings of hopelessness or unbearable emotional pain, encourage professional help right away. It is common for grieving people to feel depressed, isolated, confused, and angry. Professional mental health practitioners can help your friend work through and cope with grief following suicide.
If you or someone you love is considering suicide or shows warning signs for suicide, contact the Suicide Prevention Lifeline (1-800-273-8255) or call 911 for immediate assistance.
The original article can be found HERE.
