Living after loss by suicide

I wish we could say that, somewhere in the world, suicide does not exist. If there were such a place, scientists would investigate to find out what helps keep people safe from taking their lives and then the world would know what to do by way of prevention. We can propose a few ideas about life circumstances that promote overall mental and physical health; e.g. violence-free families and communities, adequate food and shelter, trusting bonds with others, and meaningful pursuits. It is a mystery how, even with the best of circumstances, illness of all manner can still emerge, depression and suicide included.

Losing a loved one to suicide is a horrible experience. The death of someone we love is painful enough when we know what happened, whether it was a terminal illness or a fatal accident. But suicide introduces a horrible mystery into the mix. We ask, “Why?” “Were there signs I missed?” “Could I have done something, said something to prevent it?” We may never know the answers and these unanswered questions compound with our grief.

It is very common for survivors of loss by suicide to wonder what they could have or should have done to prevent the loss. Suicide is the fault of mental illness, not the survivors and not the loved one who died. Their pain irrevocably clouded judgment. No one is blameworthy. This is difficult to understand in a world that needs someone or something at which to point. Suicide throws us into the “horrible mystery” of never knowing. Often, when we cannot make sense of a tragedy we will search for clues, even if it is to blame ourselves; “If I had called him that day, maybe he’d still be here”. Grief of this magnitude can play tricks on the mind.

We’re starting to get away from the language of “committing suicide” because the word “commit” sounds like a volitional, destructive, and vengeful act; a crime. Suicide is not a crime. It is the product of severe depression or other severe pain. Mental illness is not a crime. Addiction is not a crime. Pain is not a crime. We now say, “They died by suicide” which is not only accurate, it honours the life of the deceased by de-stigmatization. How someone died is not their identity.

In many cases, police notify the immediate family of the deceased because of discovering or receiving a report of the discovery of a body. Any investigation is meant to rule out foul play and is not personal.

Stigma dies a slow death. Just because stigma is often attached to loss by suicide does not mean stigma is truth. I am old enough to remember the day when persons of certain faiths who died by suicide would be buried in a sequestered cemetery spot and considered rejected by the god of their community’s understanding. In some places this still happens. Families today may still have difficulty speaking openly about the nature of their loss for fear of judgment and gossip. I recall attending the funeral of a young man who died by suicide. The officiant had obtained the family’s permission to speak openly of the cause of death. The truth proved to be the best thing for that family because then their community of relatives and friends were free to connect honestly and openly; no “elephant in the room”. I predicted that this family’s healing would be expedited because of this very thing. Having said that, survivors need to use their best judgment when speaking about the nature of their loss. The best source of assistance is usually with those who have some experience with loss of this kind.

There’s a saying that goes “People are down on what they are not up on”. Stigma is the product of a knowledge vacuum. When ignorance prevails, so does contempt. We don’t stigmatize those who die from pancreatic cancer, another grave illness, yet stigma prevails regarding grave mental illness.

As a therapist, I consider it a resource and a buffer against tragedy if someone’s religious beliefs impede the taking of their life. Yet, when someone dies by suicide and those same beliefs label them as selfish or sinful, it obscures the reality that severe illness was at play. This belief also casts the deceased into the realm of condemnation. Doing so perpetuates the problem of stigma and may contribute to reticence on the part of those experiencing suicidal ideation (a common symptom of depression) from seeking help within their faith communities if they feel that doing so will be met with castigation rather than concern. From a mental health perspective, to make sense of suicide is to say, “They were trying to escape unbearable pain.” This is very difficult for those of us who have not known such pain. It challenges every empathic capability we possess.

I appreciate David Kessler’s Disaster theory analogy of making sense of suicide. He recalls the sinking of the Titanic in 1912. There were many and complex reasons for this historic tragedy such that no one explanation would suffice. Closer to home, there is no one factor that ensures student success at University. For example, I have seen students who have done poorly in academics fare exponentially better when the proper supports are in place; perhaps even a change of program. So, just as many factors will determine outcomes, many factors will determine how and whether someone will recover from and/or manage depression and other pain. Society still has much to learn when it comes to mental illness and recovery.

Sufferers of suicidal thoughts, feelings, and impulses often struggle to openly disclose their pain with others, even with professionals. They may fear that they will be automatically institutionalized or perhaps judged. Such is the way stigma is internalized. To be fair, there are students who have disclosed suicidal thoughts to well-meaning persons who have, in some instances, reacted by calling the police so that a safe intervention could take place. It’s a tough call all around. Suffice it to say that most responders wish to err on the side of caution.

I have found that most people who disclose thoughts of suicide are actually saying that it’s not death they seek but pain relief. The best thing we can do for those who suffer this way is to listen, to ask about the pain, to stay calm and receptive, and to express empathy. Who of us has not known some kind of emotional pain? It’s always good to have crisis contact information available and a safety plan such as phone numbers of trusted people and alternative coping strategies such as taking time for enjoyable activities. A key sign of the need for urgent professional support is when a person’s mood is so low it impedes normal activities of daily living.

As earlier stated, guilt is a common feeling in the aftermath of a suicide loss. I recall someone saying that they and their loved one had been in an argument and had not been speaking for a few days prior to the death. They struggled with whether they were to blame for their loss. Taking into account Disaster Theory, the cause of suicide is far too complicated to be ascribed to the quality of one particular relationship. For example, occasional arguments and disconnects are normal in relationships. Death by suicide after an argument is not normal. What precedes suicide is not usually the cause of suicide.

“Why did they do it?” This is a natural question leading to no satisfying answers. There are better questions. “How will I/we move forward?” “How will we create a life that honours our deceased loved one?” “How will we create a future that honours our relationship with them; that honours their memory and shapes their legacy?”

It is common to relive the death story; that is, the details about how someone died. It is a traumatic event. The mind cannot make sense of it and may dwell on it. This is normal. One helpful strategy when preoccupied with the death story is to return to the present moment. One’s body, breath, and senses are all anchors to the present moment. To breathe, to notice our immediate surroundings, to move our body are a few ways to stabilize. Another helpful strategy is to retrieve good memories of the life story. In some Loss and Grief Support groups, participants might choose to create and share a Life Certificate of their loved one featuring photos, quotes, stories, and more.

David Kessler suggests that survivors might create a list of all the factors that contributed to a loved one’s suicide. Try to reserve judgment. Simply place each factor into one or more of three basic categories: Mine, Theirs, and The Universe. For example, “They didn’t take their medication” may be in the “Theirs” category. “I always reminded them” may be in the “Mine” category. “They were alone” could be in all categories. Then, examine the items using facts. Distinguish between what you know is true and what is speculation or assumption. For example, “Is it really true that my absence caused their death?” Then, apply compassion to the situation and ask, “Was it my re-sponsibility to be present 24/7? Did I have the power to stop the illness?”

Some survivors come to the conclusion that using the phrase “Even if…” might better fit their situation. For example, “Even if I had called more often, they still might have taken their life anyhow.” Survivors are really stating their love when expressing guilt. “If only I had said or done something different is another way to say, “I wish I could have stopped this tragedy from taking place”. Survivors need to give themselves permission, time, and space to grieve.

If you toured some of the best, most sophisticated medical facilities in the world, say those specifically designed by architects and others to prevent tragedy, you would be shocked to learn that even they have lost patients to suicide. If the most brilliant constructions and designs occasionally fail, who are we in thinking we can stem the tide of illness? All we can do is try our very best with what we know so far.

If ever there was a time to be kind it is in the wake of tragic loss. Survivors do well to take care of themselves and each other; to be kind and patient, to respect that everyone grieves differently, to do something nice for themselves, to let themselves grieve in whatever healthy way they can. Some people are very reserved in their grief expressions and others are more open. I remember visiting the home of an older couple who lost their adult son in a tragic accident. It had been many years since his death. His mother still needed to talk about it and express her tears. His father, a lovely and reserved man, would quietly excuse himself and go out for a solitary walk. This couple had learned to respect that each of them needed to grieve in their own time and in their own way.

For a variety of reasons, many people have a conflicted relationship with their emotions. Joy, gladness, and various other comfortable states may be judged as positive while other states such as anger, sadness, and fear may be judged as negative. If we took away all judgment and simply allowed emotions to exist, we would find ourselves actually taking care of them. Judgment is not helpful and nor is it necessary. For example, if I am angry, it’s just an emotion that states, “Something’s not right here”. It’s an internal state for which I assume responsibility. But if I lose control of my anger and hit someone, the aggression can be judged as bad. Many emotions get what I call “a bad rap” because people are actually judging behaviours.

So, how do we “make friends” with our emotions? There are a number of ways; one of which comes from psychologist Dr. Tara Brach. Brach uses the acronym RAIN. ‘R’ stands for Recognize what is happening. ‘A’ stands for Allow; allow the emotion to exist. ‘I’ stands for Investigate with curiosity. ‘N’ stands for Nurture with compassion. Notice that there is no judgment. Instead, there is a friendlier and more receptive relationship with the emotion. When this is allowed to take place, our emotions can inform us about our needs and then we can decide what to do to address them.

Here is a useful podcast where Dr. Brach explains further about putting RAIN into practice and how it can help us live more fully in our humanness. 

When learning to accept our emotional states, we may find ourselves better able to express ourselves with less judgment. I like David Kessler’s words, “If you have a thousand tears, don’t stop at five hundred”.

Catastrophic loss throws people into unimaginable pain. It also shakes beliefs whether religious or otherwise. A classic book penned by Rabbi Harold Kushner, “When Bad Things Happen to Good People” attempts to make sense of tragedy in light of belief in a loving god. He concludes that bad things do indeed happen to most people and that god is benevolent but not all-powerful. Some people make sense of their faith by choosing to believe that the god of their understanding suffers alongside them as do loved ones.

Beliefs will affect how we learn to live after loss. For example, one may struggle with survivor guilt; that sense that it ought to have been you that died and not the deceased. This is faulty thinking. Your life is no less precious than that of your loved one.

Catastrophic thinking may take hold; anxiety that manifests in situations where you presume the worst instead of the best. For example, a friend is late joining you for lunch and you wonder if they were killed in an auto accident while on route. Times like these call for the grounding and present-moment practices earlier mentioned.

One of many ways to live beyond loss is to choose a more appreciative way of life. For example, if the death of a loved one has activated guilt for having taken them for granted, this may be a prompt to live with more intentionality; taking no one or nothing for granted, expressing appreciation more frequently, sharing love in its many expressions, especially in moments of greeting and farewell. We honour our deceased loved ones in choosing to go on loving.

Grief and love have always been a package deal. The scope of our grief is closely connected to the depth and breadth of our love. This is why we can read about calamities in various parts of the world and feel sad but not destabilized. We are simply not as emotionally connected to strangers as we are to family and close friends.

Another way to conceptualize love is to see it as a living energy that persists even after death. In other words, just as we don’t stop loving our loved ones after their death, their love did not end when their life ended. As cliché as it may sound, love does go on.

“Grief Bursts” are common in all stages of the grief experience. Just when you think you’ve got this grief business taken care of, something will activate it again; perhaps a piece of music, the smell of after-shave, the sight of someone resembling the deceased.

We can cite the work of Martin Seligman who talked about antidotes to three things that interfere with the grief process. He cites personalization, pervasiveness, and permanence. To personalize, for example, is to interpret loss as something that happens to us alone. We may lose sight that loss by suicide happens to millions of people and that suffering is common to all humanity. It is a universal human experience. Everyone who loves, and that is most of us, will experience grief.

To regard grief as pervasive is to interpret loss as stopping one’s own life from continuing. It can be unfathomable that life can go on meaningfully after a loss. Yet, there is a continuity to life which can, if we allow it, foster hope and joy again, after time to grieve. For example, consider your fingernails. They are reminders that growth still happens even after loss.

To regard grief as permanent is to lose sight that all states of being are impermanent. Grief changes form over time as we develop a new relationship with deceased loved ones in memory.

David Kessler tells the story of his visit to Hamburg, Germany which, despite the city’s age, looks very new. Hamburg was bombed during WWII and eventually rebuilt, which explains the new appearance. One building, St. Nicholas Cathedral was not rebuilt after the bombing partially destroyed it. It still stands in the center of the city, the rubble removed, leaving the partial structure in place. Kessler states that the partly devastated church serves as a monument of the surrounding city’s loss. This is analogous to how our lives can be re-built after loss while the loss remains a part of our ongoing story.

Write down as many wonderful memories as you can recall. 

Grow the list over time. 

Let it be a comfort.

A ritual saying: “May their memory be a blessing. May these memories be a blessing.”