Suicide Aftermath

ADDRESS BY DAN NEVILLE TD, PRESIDENT OF IRISH ASSOCIATION OF SUICIDOLOGY, FINE GAEL SPOKESMAN ON MENTAL HEALTH AT THE LAUNCH OF THE BREAKING THROUGH 10TH ANNIVERSARY CONFERENCE, “SUICIDE THE AFTERMATH”.

Tuesday 20th April 2010

A bereavement by suicide falls outside the normal range of human experience. It is an overwhelming loss which leaves the bereaved confused and helpless, overwhelmed by many emotions and many unanswered questions. As well as the normal range of grief reactions the bereaved of suicide often experiences a sense of stigma, shame, loneliness or rejection. The death is sudden, unexpected, violent and extremely traumatic. Consequently the bereaved relatives may also find themselves experiencing the symptoms of post traumatic stress.

Counsellors working with those bereaved by suicide need additional training and extra supports to understand the special needs of those bereaved by suicide and to continue effective ongoing work with them. This is to help them understand the special problems of those bereaved by suicide.

Bereavement by suicide has very particular problems that prolong the grieving process and make it more intense and more difficult. Robleski (1991) writes about some of them in the book “Suicide Survivors” Here are some of the factors that has been identified.

  • The death is sudden, violent and traumatising
  • Unfinished business is left
  • Sometimes there is no body
  • There is Police involvement
  • The body can be removed by authorities
  • The suicide note is removed for the Coroners Court
  • The inquest at Coroners Court
  • Media reporting
  • Blame issues often within the family
  • Scapegoating
  • The management of the funeral
  • The death may be totally unexpected or it may be after years of mental disturbance.

Research compared to those bereaved by suicide with those bereaved in other ways.

The research found that those bereaved by suicide:-

  1. Reported more feelings of stigma
  2. Reported a greater desire to understand the death of the loved one
  3. Blamed more people and groups for the death
  4. Felt more strongly that they could have done something to prevent the death

Those working with people bereaved by suicide need to be prepared for this more complex grief reaction and need to have an understanding of how to respond to it.

Research shows that those bereaved by suicide have a greater desire to understand the death of the loved one than those who are bereaved due to other reasons. Counsellors working with people bereaved by suicide (in a group context) need extra support and training in the skills of group work. Bereaved relatives are unanimous in evaluating it as a helpful experience. They report that the found the group to be safe, supportive environment within which they could explore their pain and their ongoing problems and learn from others in the same situation.

Moreover the group facilitates the bereaved in exploring deeper hidden questions about the disintegration of meaning in their lives and the painful slow research for a new sense of meaning in the light of events that has happened to them. In Canada a Support Group was set up for those bereaved by suicide. Rogers et al 1982 defined the goals of such a group in the following way.

  1. Get the suicide in perspective
  2. Deal with family problems caused by suicide
  3. Feel better about themselves
  4. Talk about suicide
  5. Obtain factual information about suicide and its effect
  6. Have a safe place to express feelings
  7. Understand and dealt with peoples reactions to suicide
  8. Get advice on practical social concerns

The approach of looking at relationships between the deceased and the bereaved poses several questions. Was the suicide apparent, a child, a partner, somebody else in the family or among the group of friends?

For parents the loss of a child is always a tragedy. Losing a child by suicide is a catastrophe. Probably bereaved parents are those suffering most from guilt and remorse.

Few, if any, will ever overcome the feelings of guilt, feelings that in some way distort their grief and at times make the normal work of overcoming grief impossible. One reason why the loss of a child due to suicide is so hard on parents is that basically it is irreconcilable with their role as reproductors. Of course, in general people do not walk around seeing themselves as a link to the ongoing continuity of mankind but subconsciously the death of a child means a break in the chain. In the case of suicide pain and remorse increase because the parents are (again subconsciously) inclined to take upon themselves all the blame for the break.

 

Suicide by a parent has quite serious implications. All research on so called deviant behaviour among children and adolescents underline the negative effects of a “broken home”. There is however huge differences in the effect on the child according to how the home was broken, and also they show that the death by suicide of a parent is the most traumatic event that can ever befall any child. There are several reasons for this. There are the usual reactions such as grief, self reproach, guilt and shame but also the suicide may have a grave detrimental impact on the Childs self esteem. “I cannot be of any value at all when father would rather die than stay with me”. Furthermore and perhaps most importantly is the transition of suicidal ideas. Children learn by watching the behaviour of other, especially of significant others i.e. usually the parents. That is, suicide behaviour may be learned as any other kind of behaviour in this case as a special kind of language or communication and as a way of solving problems. Even very young children will very easily grasp that father killed himself to stop pain and suffering or that mother made a suicide attempt to provoke some change in a difficult or unbearable situation and consequently when they themselves meet with pain and problems, they may tend to use the same solution. It might be that the present increase in suicidal behaviour among adolescents can be seen in relation to the high relative increase in the frequencies of both suicide and attempted suicide that took place.

Losing a partner is a third situation. The effect of a suicide and the pain of the bereaved spouse is perhaps less obvious or unambiguous than when parents or children respectively are involved. The reaction being more dependent on the actual emotional relationship (which is not based on blood relationship) between the two. Lifelong cohabitation is getting more rare than it used to be at least in many modern western countries where changing of partners is becoming more usual in adult life, therefore the time element may be a more important factor when the bereaved spouses are concerned than when we talk about children and parents. The time factor has to do with the suddenness of the suicide and there seems to be at least three groups of survivors of bereaved according to this factor. For one group comprising “pre mourners” the suicide is not completely unexpected. The deceased has long disassociated himself from the family. The family has already gone through so much worry and misery and pain that they have in a way been forced to “right off” the person as a real animate member of the family. That would be the case for example alcoholics or those suffering from a prolonged lethal disease. The bereaved have already gone through some of the grief and the suicide only put an end to a long process and is often a long process. The other group may be termed the “non pre mourners”. In these cases the family is still in close contact with the suicidal person, they have not as yet begun to write him off or on the contrary they have been deeply involved in trying to help him overcome his problem. Example: alcohol abuse or some mental ill-health.

They will be inclined to take upon themselves the responsibility for the person’s life and the greater their efforts the more difficult it is for them to stop thinking “if only I had” and to rid themselves from the feeling of guilty. The completed suicide will in a cruel way undermine their inadequacy and deprive their efforts of any value and themselves of their self esteem. At times, the efforts have been such a heavy strain on the survivor on the bereaved that the suicide comes as an immediate relief which of course brings an additional feeling of guilt. Finally, there are cases where the suicide was totally unexpected and where we talk of “sudden-death-witness”. Those will have a huge acute need to understand. Some will not accept that that was due to suicide and try, sometimes, desperately to provide evidence that this was not the case. The initial phase of shock can be especially trying to this group at the same time, these bereaved have not been involved in a prolonged straining course of events and therefore usually have more strength. The sudden-death-witness will most often initially focus on the suicidal act (also because often he or she will be the one to find the deceased) and only later will arise the need for dealing with grief and feeling of guilty.

For many years I am receiving a magazine from the Loss Programme that’s Loving Outreach to Survivors of Suicide which is edited by Fr. Charles Ruby who publishes the magazine OBELISK at the Catholic Charities of the Archdiocese of Chicago and I would like to quote from a recent article by Fr. Ruby.

“Could there ever be something like “happy ending” I am of the opinion that the journey of grief is never completely over so there is no “ending” of the journey. Is it possible that there can be happiness after the death by suicide of a loved one ? I think that this is not only possible but very probable if survivors worked during the journey of grief. I have witnessed survivors having happy times such as a wedding or the birth of a grandchild or the graduation of another child or the remarriage of a previous spouse who took their life. There are happy events in the lives of people who have lost a loved one to suicide. Happiness did not come about automatically. It came about because these survivors worked very hard in resolving the grief that results from a suicide. We often hear that “time heals all things”. I disagree with this statement because time in and of itself does not do the healing. It is time and a lot of work and a lot of pain and a lot of tears that will result of happiness returning to a survivors life. Survivors need to have a realistic outlook on life.

If a survivor is attempting to get back the life that existed before the suicide occurred then that person will always be frustrated because that part of ones life is over for ever. There is no turning back the pages in getting the old life back. The old life died with the death of that loved one. That does not mean that there cannot be joy again. There can be joy but it will be a different type of joy. There will be happiness but it will be a different type of happiness. The death of a loved one from suicide is a pivotal event. By that I mean that nothing is ever the same after the suicide as before the suicide. This does not mean that there will be no happiness. There can be and there will be as long as survivors traverse the journey and resolve all the feelings and issues that are a part of that journey.