Suicide Loss

IF YOU ARE HAVING SUICIDAL THOUGHTS, PLEASE SEEK HELP!

GROUP SUPPORT FOR SURVIVORS OF SUICIDE LOSS:

We offer peer-to-peer support groups in the Medford/Ashland area, as well as periodic suicide loss workshops. You can learn about groups by clicking here.  Please call our office for more information:  541-552-0620

Suicide Loss Helping Yourself

“Death by suicide is not a gentle deathbed gathering; it rips apart lives and beliefs, and it sets its survivors on a prolonged and devastating journey.”
~ Dr. Kay Redfield Jamison

    • Get help. It’s common to feel like you are alone in your grief. Support groups— especially for suicide loss survivors–bring together people who have lived through what you are experiencing. Individual support/counseling can also be very helpful.
    • The wide range of difficult emotions and possible trauma you may feel is very common: guilt, deep sorrow, fear, a crisis of faith, blame, anger, rage, recurring thoughts about the death, abandonment and helplessness.
    • In your own time, deal with the facts of the suicide. The longer they are avoided or denied, the harder the recovery will be. Get the facts straight; it is important to be honest with yourself and face the fact that the death was a suicide.
    • Don’t be afraid to say the word suicide. It may take time, but keep trying.
    • Read recommended literature on suicide and grief. The reading will offer understanding and suggestions for coping.
    • Your grieving process will not be linear and acceptance of this loss is likely to be a more complex process than it would be if your loved one had died of something else.
    • Don’t assume that everyone is blaming you or thinking ill thoughts of you. They may see your pain and grief, but are uncomfortable about what to say or how to say it.
    • Be prepared for seemingly cruel and thoughtless words from relatives and friends. They are experiencing their own anger, pain and frustration and may not vent their feelings in gentle ways.
    • You may want to “forget” about the suicide and not talk about it. Studies show this is the least effective and usually most damaging approach to dealing with your feelings and questions. You need to express them so they can be faced and dealt with.
    • Suicide carries a stigma in our culture. It is often the result of untreated mental illness, and/or his/her problems became too overwhelming to be able to sort out other possible options.
      • People may be afraid to talk with you about your loved one’s death.
    • Learn to think of your loved one by the way they lived rather than the way they died.
    • It’s OK for you to live again. It is what your loved one would want for you.

Downloadable PDF Suicide Loss Helping Yourself

“When my son committed suicide, I experienced the same things that all other suicide families experience—friends avoiding us, people judging us, little ‘pep talks’ from clueless coworkers about ‘moving on’ and maintaining a ‘professional attitude’ at work (which, I found, means never cry, never appear to be having a bad day, at least not after six months)…”

~Mother interviewed by Hollander, Journal of Loss and Trauma (1999)

Suicide Loss crisis intervention strategies

Strategies for Crisis Intervention with Survivors after Suicide (those left behind) From the work of Shoshana Alexander* – Volunteer for WinterSpring

“He was great because he just let me cry and carry on and didn’t try to ‘fix it,’ he didn’t try to make it better.  I told him that since he had no pat answer and no smooth solution—he just listened—it was marvelous!

~From Silent Grief: Living in the Wake of Suicide, by Christopher Lucas, 2007

Establish Empathic Connection

Do say:  “I’m so sad for your loss.”
Do listen, actively, with presence, without judgment
Don’t say: “I know how you feel.
Don’t give advice or try to cheer up client
Don’t say: “Things will get better; they always do.”

Assess Using ABCDE Model*

Affect:
  • Most common feelings are:
    • Shock and numbness
    • Hysteria (unable to stop crying)
    • Sadness and sorrow
    • Rage (This is unfair…why did God let this happen?)
    • Anger at self or at the deceased loved one (Why did I let this happen?  How could s/he do this to me?)
    • Guilt (I did something to cause the suicide.)
    • Shame (Suicide is a disenfranchised loss)
    • Denial (This can’t be true.)
    • Helplessness and feelings of abandonment
  • Assure client that intense emotions are normal
  • Ask gently:  What else are you feeling/experiencing?  And what else?
  • Reflect feelings back to them so they know you are listening.  “What I hear you saying is…”
Behavior Disorganization:
  • Confusion and disorientation
  • Withdrawal from friends and social interaction (No one wants to listen.  I’m not sure what to tell people about the death.)
  • Trouble sleeping and loss of appetite (nightmares, mental agitation)
  • Physical symptoms (nervous, jumpy, headaches, stomach aches, unusual sensations, weight loss, weight gain, etc.)
  • Difficulty concentrating
  • Self-medicating with alcohol, drugs; abuse of prescription drugs
  • Inability to work, go to school, attend to daily tasks
  • Overwhelm and inability to make decisions about logistics following the death
  • If there are suicidal impulses:
    • Ask directly and without judgment:
      • Have you thought about hurting yourself or ending your own life?
      • Do you have a plan?  The means to carry it out?  A time when you intend to do it?
    • Say: I care and don’t want to you die.  Explore options other than suicide.
    • Explore ambivalence, focusing on connections and purpose in life
    • Create together a “No Harm” contract
    • Be prepared to stay in touch often and on-going
    • Brainstorm and suggest supportive resources
    • On-going assessment and measures
    • In extreme cases, contact 911 or call 1-800-273-TALK (8255)
Cognitive:
  • Encourage client to reveal and explore thoughts, beliefs, conclusions (e.g., I don’t deserve to live.  He must be suffering in hell.  I could have done something to stop her.)
  • Ask:  What are you thinking now?  What else is going through your mind?
  • In response to their sharing, ask:  How was that for you?
  • Assure client that the suicide was not his/her fault
Developmental:
  • Client may feel s/he doesn’t have the right to continue to live fully or embrace life again.
  • Assure client that their loved one would want them to live fully
  • Encourage returning to or moving forward with projects or dreams when they feel ready; gently explore and affirm the possibility; help them think of first steps
  • Acknowledge their strengths; e.g., say: “I noticed that you have reached out for help and this shows incredible courage.”
Environmental:
  • Explore all areas of support: family, friends, counselors, clergy, support groups, on-line chats and blogs from survivors; provide your own contact information, if appropriate
  • Recommend websites, emergency services numbers, books (e.g., Unfinished Conversation: Healing from Suicide and Loss, by Robert LesoineMarilynne Chöphel)
  • Recommend activities each day:  journaling, art, exercise, meditation, slow breathing

Ongoing Support:  Let client determine the pace; build on all positive steps.

Downloadable PDF Suicide Loss crisis intervention strategies

*This information was adapted by Shoshana Alexander from her Master’s program at Southern Oregon University and draws from the ABCDE model developed by Barbara G. Collins and Thomas M. Collins, Crisis and Trauma: Developmental-ecological Intervention, Brooks/Cole, 2005.

Suicide Death and Your Kids

(Adapted from resources at the Dougy Center and the WinterSpring experience)  Download this handout

Whether it’s a family member or someone you and your children know in the community, a death by suicide can be very difficult to navigate.  Remember that grieving takes time.  Please call us if you need additional help.

  1. Be honest. With access to social media, it’s easy for kids to get information from other sources about a suicide death. As adults, you build trust by telling the truth.  They don’t necessarily need to know every single fact about a death, but they do need to hear truthful answers and information. Start with a short explanation of what has happened, and let their questions guide how much detail you provide.
    1. Share information about depression and mental illness. Suicide is not usually a random act; it occurs in a context. Although no one knows what causes suicide, most people who die of suicide have experienced some form of depression or mental illness. It helps children to know that the person who died was in fact suffering from a kind of illness in his or her thinking.
    2. Sometimes families choose not to divulge whether a death is suicide, such as the suicide of a teen, yet we often find that rumors spread. Thus, you can let them know that you don’t know for sure whether it was suicide, and continue to talk openly about suicide.
  2. Expect and accept their range of feelings. Feelings and grief reactions are influenced by many factors, including the age, personality and developmental level of the child. You may see a broad spectrum of emotions in children and teens, including anger, frustration, guilt, numbness, shock, sadness, relief, confusion, shame, fear, loneliness and embarrassment. Sleep problems, changes in eating, and acting out are common.
  3. Help break the stigma. Our society continues to stigmatize suicide, as well as the families of those left behind. It is often an uncomfortable and shocking topic that can leave people unsure of what to say. In light of this challenge, it is critical that kids have safe places where they can talk openly about the death without judgement and awkwardness, with you, with a counselor, and/or in a support group.
  4. Talk about and remember the person who died. Don’t be afraid to talk about and remember the person who died. Kids benefit from sharing memories.
    1. Remember that people are complex, and for some kids, the person who died may have let them down in some way. It’s OK to share negative memories, too. Provide a safe space for this type of sharing, because it will help release difficult emotions; sometimes this release opens up the way for deeper feelings of sadness.
  5. Be prepared for fears. After a suicide death, children may have fears and bad dreams. During these times, it is helpful for trusted adults to stay connected and listen to their questions and concerns. Offer reassurance without making promises. You can say, “ I’ll do everything I can to keep myself and those we love safe.”
  6. Provide outlets for play, physical activity, art. Play is a natural outlet of expression for children. While adults tend to talk out (or hold in) their grief, children are more likely to express it through play. This is one way you can validate their experiences and help them regain a sense of balance and control.  If you play with them, reflect back what you see and hear, without judgment.  And exercise can help release deep emotions.
  7. Respect differences in grieving styles. Children’s grieving styles, even in the same family, can be very different. Some kids want to talk about the death, while others want to be left alone. Recognizing and respecting that each person grieves in his or her own way is essential. Provide an “altar” place in your home where the children can see pictures of the loved one, and express grief by drawing a picture or writing something. Children grieve in doses, so giving them a place to express on their own time is helpful.
  8. Hold a memorial service. No matter how difficult or painful the deceased person’s life or death may have been, grieving children and teens need the opportunity to honor the person’s life and say goodbye.
  9. Inform the child’s school about the death. Children spend a lot of time in school and a death affects not only family life but school life. That is why it’s important to inform a child’s teacher, counselor, coaches, and any adult support person in the school setting about the death. Talk with your child about what they would like in terms of sharing the news with their classmates and others in the school.

Coping with a Violent Death

Thanks to beliefnet.com, dyingmatters.org, and victimsofcrime.org. ©WinterSpring 2014

Violent deaths, including murder, suicide, and accidents, are particularly difficult to grieve because of the complications involved with such a death.  This experience is confusing, terrifying, and life-changing. You may feel powerless; your trust in the world and in other people may be shattered. You may face challenges with the judicial and medical systems, as well as the media, which further complicate the grieving process for a long time.

 Common experiences:

  • Overwhelming shock manifesting itself as numbness, anger, despair, disbelief, guilt, anxiety;
  • Denial – this is not happening;
  • Sometimes guilt for being alive (survivor’s guilt), or self-blame;
  • Yearning to see the person or child again;
  • Restlessness, loss of concentration, loss of confidence, loss of interest in life; lethargy;
  • Hypersensitivity; hyper-vigilance (jumpiness);
  • Inability to sleep or eat;
  • Extended periods of crying and sobbing; overwhelming emotions;
  • Reduced ability to express emotions;
  • Irrational thoughts and actions;
  • Social withdrawal;
  • Terrified of being left alone;
  • Fear and vulnerability;
  • Anxiety and panic attacks, nightmares and exhaustion;
  • Constant thoughts about the circumstances of the death;
  • Depression, sometimes as a cover for anger;
  • Questioning of faith.

How to cope:

  • Get help—especially with this kind of loss, don’t try to cope alone;
    • Talk with a trusted friend or others who’ve experienced a similar ordeal;
    • Seek help with a therapist that specializes in violent death; EMDR is one treatment that may work well to ease the violent memory;
    • Join a support group—sharing with others can help ease your pain;
    • Let yourself experience all of the complicated emotions;
      • Find a quiet, safe place to let the feelings come out;
      • Use safe tools, such as a pillow to punch, or a swim noodle to hit against a table;
      • Write your thoughts and feelings in a journal;
    • Become comfortable with your lack of control—around the lack of safety in the world, no matter how careful we are, and around the unexpected nature of death;
      • For some, meditation and/or prayer can help with this;
    • Know that the depth of your pain is not forever.  Know that it takes time.  Your grief will never completely go away, but you will be able to get on with your life.
    • Reach out to help others.  Be an activist; helping others avoid a similar death can be therapeutic.
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