Dr. Suzanne B. Phillips

Licensed Psychologist, Psychoanalyst, Diplomate in Group Psychology, Certified Group Therapist, Author, Radio Host and Media Consultant Covering a Wide Range of Psychological Topics

Post: Coping In The Aftermath of Suicide

On Friday 9/10/10, World Suicide Prevention Day, the federal government announced the National Action Alliance for Suicide Prevention aimed at promoting public awareness and prevention programs.

The need could not be more pressing. Every year in the U. S., suicide claims the life of 34,000 people. It is the second leading cause of death in college students,  the third leading cause of death in adolescents and young adults and the US military suicide rate is at an all time high.

Then There Are The Survivors.

For every suicide there is an estimated six or more “suicide survivors,” people who are left behind trying to cope with this traumatic loss.  They include spouses, parents, siblings, friends and relatives who need support but often have a difficult time getting it.

As recognized by professionals addressing this issue, suicide is a very difficult and complicated loss.  Often the survivors’ fears of stigma, feelings of confusion, grief, guilt or shock make them reluctant to confide in the usual networks of support.  The counterpart to this is the uncertainty and hesitation of neighbors, church friends and even relatives who don’t know what to say or how to support survivors. When survivors are left alone with this traumatic loss or decide to keep it secret or ask for secrecy from family members, everyone gets locked into the pain and out of life and recovery.

What Helps Survivors Cope and Go Forward?

The Need for a Reason – One of the haunting thoughts that survivors carry in the aftermath of suicide is “ WHY DID THIS HAPPEN?”   This can intensify the suffering of survivors as if is often underscored with self-blame, confusion and anger at the deceased.

Suicide as “ Psychache”

  • In my work with suicide survivors – be they family members, schoolmates or cops, the consideration of suicide as “ psychache” has been considered helpful.  Essentially it comes from the work of suicide expert, Edwin Shneidman who defined suicide as a misguided solution to unbearable psychic pain. In such pain, thinking becomes constricted, there is tunnel vision and the only compelling need is to end the pain.
  • Others as Dan Bilsker and Peter Forster (2003) who also define suicidal thinking in terms of a crisis of pain –describe it in terms of  “ The Three I’s” –  pain that is perceived as Intolerable, Interminable and Inescapable.
  • While some survivors need to pursue more details with the help of a professional or support group, others are able to use the definition of suicide as psychache as a way of talking about and thinking about an unthinkable event.

Connection with family and friends – It is physically and psychologically stabilizing for survivors to feel the support of family and friends who can offer compassion and help in some of these ways:

  • Make the contact and continue to check even if at first refused.
  • Actually help with practical needs – trauma and grief are disorganizing and exhausting.
  • Refrain from asking for explanations.
  • Validate the intensity of the grief.
  • Listen or bear witness to the telling and often re-telling of events.
  • Respect the faith or spirituality expressed.
  • Be aware of the needs of the children and teens to be comforted, to speak, to ask questions. It is ok to say “I don’t know” but “I’m here to be with you.”
  • Be willing to remember and speak about the deceased for everything he or she was beyond this tragic event.
  • Access on-line information from Groups like The American Association of Suicidology , the American Foundation for Suicide Prevention, Suicide Prevention in the Military, Life-lines School Programs to enhance support and guide survivors to important resources.

Connection to Suicide Survivor groups– Whether survivors make these connections on their own or are guided there by friends or professionals, the feeling of not being “ the only one,” the validation of the feelings by others who have experienced the suicide of a loved one and the opportunity to share and hear how others cope is invaluable.

Research suggests that suicide survivors find individual counseling and most especially suicide grief support groups more helpful than general grief groups. In a study reported in The journal, Suicide and Life-Threatening Behavior ( July 2008), every survivor who had the opportunity to speak with another suicide survivor found it beneficial.

Self-Care As A Survivor– As a suicide survivor you have been faced with a traumatic loss. Know that it makes sense that you like others who have suffered from unimaginable loss may feel  trauma symptoms like hyperarousal  (Can’t sleep, can’t relax), Intrusion (Intruding thoughts, dreams and images), Numbing and disconnect from all you thought you knew. Use your support networks to support you. Seek guidance from Suicide Survivor Groups and Professionals who can help. Feel entitled to take your time remembering, mourning and connecting. Pain shared is pain divided.

Survivor Mission – When you are ready, feel entitled to use your talents and strengths to remember your loved one in a special way – the care and sharing of memories in a memory book for your children, helping others who need to hear how you coped, a decision to work for a cause, a spiritual goal, a personal challenge. Give yourself permission to find a place and a way for your survival to matter.

Additional Reading:

Shneidman, E. (1993) Suicide as Psychache: A clinical Approach to Self-Destrictive Behavior. New Jersey: Jason Aronson

Bilsker, D. & Forster, P. (2003) ” Problem-Solving Intervention for Suicidal Crises in the Psychiatric Emergency Service.” The Juornal of Crisis Intervention and Suicide Prevention, Vol.24, No.3,134-136.