Loss Survivors

• A survivor of suicide is a family member or friend of a person who died by suicide.
• Survivors of suicide represent the largest mental health casualties related to suicide.
• It is estimated that for every suicide there are at least six survivors. Some suicidologists believe this to be a very conservative estimate.
• Based on this estimate, approximately 6 million Americans became survivors of suicide in the last 25 years.

Grief after suicide

The loss of a loved one by suicide is often shocking, painful and unexpected. The grief that ensues can be intense, complex, and long term. Grief work is an extremely individual and unique process; each person will experience it in their own way and at their own pace.

Grief does not follow a linear path. Furthermore, grief doesn’t always move in a forward direction. There is no time frame for grief. Survivors should not expect that their lives will return to their prior state. Survivors aim to adjust to life without their loved one.

Common emotions experienced in grief are:

• Shock
• Denial
• Pain
• Guilt
• Anger
• Shame
• Despair
• Disbelief
• Hopelessness
• Stress
• Sadness
• Numbness
• Rejection
• Loneliness
• Abandonment
• Confusion
• Self-blame anxiety
• Helplessness
• Depression

Children as survivors

These feelings are normal reactions and the expression of them is a natural part of grieving. At first, and periodically during the following days and months of grieving, survivors may feel overwhelmed by their emotions. It is important to take things one day at a time. Crying is the expression of sadness; it is therefore a natural reaction after the loss of a loved one.

Survivors often struggle with the reasons why the suicide occurred and whether they could have done something to prevent the suicide or help their loved one. Feelings of guilt typically ensue if the survivor believes their loved one’s suicide could have been prevented. At times, especially if the loved one had a mental disorder, the survivor may experience relief.

It is a myth that children don’t grieve. Children may experience the same range of feelings as do adults; the expression of that grief might be different as children have fewer tools for communicating their feelings.

Children are especially vulnerable to feelings of guilt and abandonment. It is important for them to know that the death was not their fault and that someone is there to take care of them.

Secrecy about the suicide in the hopes of protecting children may cause further complications. Explain the situation and answer children’s questions honestly and with age-appropriate responses.

Affects of stigma on suicide-loss survivors

There is a stigma attached to suicide, partly due to the misunderstanding surrounding it. As such, family members and friends of the survivor may not know what to say or how and when to provide assistance. They may rely on the survivor’s initiative to talk about the loved one or to ask for help.

Shame or embarrassment might prevent the survivor from reaching out for help. Stigma, ignorance and uncertainty might prevent others from giving the necessary support and understanding. Ongoing support remains important to maintain family and friendship relations during the grieving process.

Survivors sometimes feel that others are blaming them for the suicide. Survivors may feel the need to deny what happened or hide their feelings. This will most likely exacerbate and complicate the grieving process.

When the time is right, survivors will begin to enjoy life again. Healing does occur. Many survivors find that the best help comes from attending a support group for survivors of suicide where they can openly share their own story and their feelings with fellow survivors without pressure or fear of judgment and shame. Support groups can be a helpful source of guidance and understanding as well as a support in the healing process.

What to do when the worst has happened

When the worst has happened and you have lost a loved one to suicide there is little that can be said to comfort you. But remember:

• It is OK to grieve. The death of a loved one can feel like sudden, unexpected and drastic amputation of a limb without any anesthesia. The pain cannot be described and no scale can measure the loss. We want so much for our loved one to return so that we can do something, and we ache knowing that it just can’t happen. You need to know that it's OK to grieve.

• It is OK to cry. Tears release the flood of sorrow of missing the one you love. Tears relieve the brute force of hurting, enabling us to "level off" and continue our cruise along the stream of life. Shedding tears is not a sign of weakness-it is a sign of our human nature and emotions of deep despair and sorrow. It's OK to cry. It is OK to heal: We do not need to "prove" that we loved the person who has died. As the months pass we are slowly able to move around with less outward grieving each day. We need not feel "guilty," for this is not an indication that we love less. It only means that, although we don't like it, we are learning to accept death and its finality of the pain our loved one suffered. It's a healthy sign of healing. It's OK to heal.

• It is OK to laugh. Laughter is not a sign of "less" grief. Laughter is not a sign of "less" love. It's a sign that many of our thoughts and memories are happy ones and our dear one would have wanted us to laugh again. It's OK to laugh.

• Know that you can survive, even if you feel you can't.

• Intense feelings of grief can be overwhelming and frightening. This is normal. You are not going crazy; you're grieving.

• Feelings of guilt, confusion, anger, and fear are common responses to grief.

• You may experience thoughts of suicide. This is common. It doesn't mean you'll act on those thoughts. However, if you begin to feel like you may, ask for help or call 911.

• Forgetfulness is a common, but temporary side effect. Grieving takes so much energy that other things may fade in importance.

• Keep asking "why" until you no longer need to ask.

• Healing takes time. Allow yourself the time you need to grieve.

• Grief has no predictable pattern or timetable. Though there are elements of commonality in grief, each person and each situation is unique.

• Delay making major decisions if possible. Selling a home, car, cashing in on policies, moving, quitting a job, etc. are all things that should be avoided if possible.

• The path of grief is one of twists and turns and you may often feel you are getting nowhere. Remember even setbacks are a kind of progress.

• This is the hardest thing you will ever do. Be patient with yourself. Seek out people who are willing to listen when you need to talk and who understand your need to be silent.

• Give yourself permission to seek professional help.

• Avoid people who try to tell you what to feel and how to feel it and, in particular, those who think you should "be over it" by now.

• Find a support group for survivors that provides a safe place for you to express your feelings, or simply a place to go to be with other survivors who are experiencing some of the same things you're going through.

Responding to suicide survivors

Coping with death is never easy. When suicide is the cause of death, the situation can be even more uncomfortable.

• Understand that brain diseases such as clinical depression, anxiety disorders, bipolar illness, and schizophrenia underlay 90 percent of suicides.
• Express sympathy. Avoid statements like "You're you, you'll marry again" or "At least you have other children." Although well intentioned, these statements can be upsetting. A heartfelt "I'm sorry for your loss" is appropriate.
• Understand that the survivor may be experiencing a number of intense emotions. Shock, pain, anger, bewilderment, disbelief, yearning, anxiety, depression, and stress are emotions expressed by some suicide survivors.
• Remember that grief is an intensely individualistic journey. Although you may have experienced grief in your life, avoid statements like, "I know how you feel." Instead ask how the person is feeling.
• Listen. Listening can be the most helpful thing you can do for a suicide survivor. Acknowledge the difficulty of the situation and be available if the survivor wants to talk.
• Find out about suicide survivor grief support groups in your community. Many survivors have found it helpful to attend a suicide survivor support group. Encourage the survivor to attend at least three or four meetings.