With approximately 30,000 suicides happening each year in the US, countless people are grieving the loss of loved ones who have taken their lives. The grieving process is different to those who have lost a spouse, father, sister, or friend to cancer, heart disease, or a stroke. Many “suicide survivors” are left to process their emotions in private because the topic of suicide is still so taboo in this country.
One great resource is the Grief Support Services of the Samaritans of Boston. They recently conducted an interview with Dr. Jack Jordan on the topic of grieving a loved one who has committed suicide. Dr. Jordan is a licensed psychologist in private practice in Pawtucket, Rhode Island, and Wellesley, Massachusetts, where he specializes in working with loss and bereavement. He is coeditor of the 2011 book Grief After Suicide (Routledge) and the Clinical Consultant for Grief Support Services of the Samaritans of Boston (www.samaritanshope.org), where he is helping to develop innovative outreach and support programs for suicide survivors. I have obtained permission to reprint the interview here, specifically for Psych Central readers.
Q. Your book notes that “suicide survivors” can include people who are not on close terms with the deceased. Can you explain?
A. Immediate kin are the most likely to be affected, but it’s not just them. It could be a next-door neighbor who saw the person every day. Or a subway train driver could be traumatized after someone jumps in front of a train. Or a high-school student may have had no personal relationship with another student who died by suicide, but may have somehow identified with that person. In general, a survivor is anyone who felt responsible for the death or for not preventing it, or who was deeply and negatively impacted by the death.
Q. How is grief after suicide different from other kinds of grief?
A. It depends on what aspects of grief you’re talking about. After any type of death, there is a yearning for the deceased. After sudden death, there is shock or disbelief; people have trouble accepting the reality of the death. After a sudden, unexpected, violent death (such as a homicide or suicide), people focus on the horror or trauma of the death. There is a preoccupation with, “What did my loved one go through during their final moments?” But with suicide, there is a whole struggle with, “Did they know what they were doing? Why did they choose this? Didn’t they know how much this would hurt me?”
Q. How does the stigma that’s associated with suicide affect suicide survivors?
A. Many societies have ostracized, shunned, or punished the family of the person who died by suicide. In the developed world, that’s beginning to be replaced by social ambiguity. As mental illness becomes increasingly destigmatized, people may not condemn someone who died by suicide, but suicide creates much social awkwardness. Many people hold back because they don’t know what to say to someone who has lost a loved one to suicide. For example, they may wonder if it’s okay to mention the person’s name or use the word suicide. Also, survivors can self-stigmatize because of their own guilt and shame. So it becomes a vicious cycle. People don’t know what to say or do, so they avoid the “elephant in the room.”
Q. Your book discusses research suggesting that support groups for suicide survivors may be particularly helpful. Why do you think that is?
A. There has not been much research on suicide survivors, and most of it has involved people in support groups, so it’s a self-selected sample. That being said, I’ve found in my own research and practice that contact with other survivors can be very helpful. It counteracts a sense of stigma and isolation. Participants learn from each other about coping skills. And people may have a better chance of getting an empathic response than they would in their usual social networks. A woman who has lost a child to suicide may find that talking to another mother offers more comfort than talking to her own husband. There’s also a role modeling effect: New survivors need some inspiration or hope that they can survive this tragedy.
Q. Your book profiles several programs that support survivors, both here in the United States and around the world. What common threads do you see in these programs?
A. In the United States, most support groups are led by survivors. In Europe and Australia, they are more professionally led. All involve bringing survivors together to talk to each other. Many provide information about psychiatric diseases, suicide, and grief. Cutting-edge programs are reaching out proactively to new survivors: First responders such as emergency medical technicians and firefighters may have brochures about support services, and funeral directors and clergy people may know about such services. And new programs being developed include teams of trained volunteer survivors who will visit with new survivors in their homes, rather than survivors having to make an appointment with a therapist or find a group to attend.
Q. Many people might think that working with suicide survivors would be depressing. What keeps you going?
A. I see people get better. The people I work with have had something terrible happen to them, but they also have a lot of resilience, which is inspiring. In addition, I have a strong sense of my own spirituality. When I was younger, I considered going into the ministry, and I see my work as a type of ministry. Suicide raises profound religious and philosophical issues, and I feel like I’m working at the spiritual edge of life. Walking with people at this very difficult time in their life, and seeing that help make a difference in the healing process of many survivors, is very personally satisfying to me.