Suicide and Survival

Suicide is a topic I dreaded having to read about and a post I’ve been dreading having to write. There is no way I can write about this and not get more personal about this subject. In 2010 my oldest tadpole died by suicide at the age of 20. Although it’s been 6 years I am just now getting to the point that I can share her story. This is not to say I haven’t been dealing with her death in my own way. It’s just that I was more focused inwardly and now I’m able to begin to outwardly talk about the whole issue. I am actually writing a book which is our family’s testimony about the problems leading up to a senseless death that didn’t have to happen and how we believe God brought us through it all. Ironically I had already begun the book–most of which she read and ok’d as a story of her life–before this tragedy. I write now to keep a promise to her that I had made to somehow get her story heard. Her story is my story. It’s my family’s story. It’s a true story of dramatic twists and turns that none of us could have possibly made up. Although it’s a cliche, truth really is stranger than fiction.  Our story is one of betrayal, secrets, a double life, mental illness, corruption, prejudice, ignorance, survival and death and yet it is a story of faith, hope, love, loyalty, brutal honesty,compassion, integrity, acceptance, education, and forgiveness leading to life. Our lives are an enigma of oxymoron. Having said all of that, I found that when I reached the literature about suicide that I was actually ready to read it and much of it has been extremely helpful and even freeing for me, a suicide loss survivor.

Something amazing happens when we read and keep on reading. We not only learn about individual topics, but all of that knowledge begins to integrate in our minds. Our understanding is opened as if pieces of a jigsaw puzzle are joined together giving us a bigger picture. My previous post about Mental Health and now this one about Suicide and Survival have brought pieces of my own story together in a way that has been very therapeutic for me. Drafted into a club I never wanted to join, I feel uniquely qualified to discuss books and literature on the topic of suicide.

Until fairly recently all available literature pertaining to suicide dealt with statistics after the fact or with ways of trying to prevent it. While I believe this is valuable information, it did very little in helping survivors cope with a suicide. It’s also obviously not enough since suicide rates continue to climb. Some survivors have sought help from psychotherapists and have found that the therapist seemed more interested in the suicide than actually in helping the survivor cope. In many cases survivors are blamed and shamed for the death by the very people who should be able to help them cope. There are over 40,000 suicides in the US every year. Mental health professionals estimate that for every suicide there are at least 6 survivors who were very close to the deceased with many more people affected by the suicide. I’ve seen some figures that estimated that as many as 4 million people a year in the US are affected in some manner by suicide. For survivors closest to the suicide, the risk of suicide increases by 400%. Given that 4 million people can be a 400% higher suicide risk this is a huge problem. There is an enormous need for education and survivor support in this nation.

The first book on this topic that I read in my library read through was Words I Never Thought to Speak: Stories of Life in the Wake of Suicide by Victoria Alexander.

Victoria Alexander lost her mother by suicide. In trying to make sense of the tragedy, she began to collect suicide survivor stories. The stories are traced over the years after the suicide. In doing so, she discovered that suicide loss survivors have a unique need to grieve differently than people who have experienced loss due to causes other than suicide. There is an almost compulsive need to tell suicide stories over and over often for years. Often support isn’t as available to suicide survivors as it is for any other type of loss. This may be due as much to shock as it is to stigma and shame. Often there is secrecy surrounding the cause of death, making it difficult to mourn in traditional ways. Friends and even extended family members may not understand the need to grieve long after the death and to keep revisiting all of the details.. In many areas of the country survivors have banded together and can offer support to other survivors in ways the “uninitiated” can’t.

With suicide deaths often come stigma, speculation, and judgement. Survivors torture themselves with the “what if’s” and the “if only’s.” Self blame, feelings of abandonment, guilt, and rejection are also common. Families can either be brought together or torn apart by a suicide. Some families splinter between blame and support causing rifts in relationships that can last for years or a lifetime. Storytelling helps survivors to work out their thoughts and emotions. Victoria Alexander has arranged her book in such a manner that you can read survivor stories straight through or so you can read the stories in the stages of  “At the End/At the Beginning,” “In the Midland,” and “Then and Now.” The reader gets a better understanding of the stages of grief that suicide survivors go through–and how they waver between them. This book is appropriate to both survivors and therapists who work with survivors.

Victoria Alexander recommends the following groups [and I’ve tried to find the online versions] for those dealing with suicide related issues:

American Association of Suicidology  http://www.suicidology.org/

American  Foundation for Suicide Prevention https://afsp.org/

The Compassionate Friends https://www.compassionatefriends.org/home.aspx

The International THEOS Foundation http://accesshelp.org/resources/grief-support-orgs/

Children’s Grief Support Network http://www.griefsupportnetwork.org/index.php/community-links/general

Another result of suicide is that it creates unfinished business. Survivors are almost always caught off guard and must not only deal with the shock of an unexpected death, but they are forced to make very difficult decisions concerning everything from final services to legal and financial decisions. On top of this, in the midst of shock, survivors begin to realize that they will have to be responsible for dealing with the remnants of  a life left suddenly behind by the suicide which often involves discovering secret plans and personal facts about the loved one that the survivor would have preferred not to know.

In No Time to Say Goodbye, Carla Fine (a survivor herself) explores all of these unique aspects to dealing with a suicide death. Fine does a remarkable job of explaining why it is so difficult to talk openly about a suicide death. I found this book to be candid and affirming. I highly recommend No Time to Say Goodbye to any suicide survivor.

Because I felt it was a good summary, I have copied and pasted the summary of this book from the Fulton County Public Library card catalog below:

Suicide would appear to be the last taboo. Even incest is now discussed freely in popular media, but the suicide of a loved one is still an act most people are unable to talk about–or even admit to their closest family or friends. This is just one of the many painful and paralyzing truths author Carla Fine discovered when her husband, a successful young physician, took his own life December 1989. Being unable to speak openly and honestly about the cause of her pain made it all the more difficult for her to survive. With No Time To Say Goodbye, she brings suicide survival from the darkness into light, speaking frankly about the overwhelming feelings of confusion, guilt, shame, anger, and loneliness that are shared by all survivors. Fine draws on her own experience and conversations with many other survivors–as well as on the knowledge of counselors and mental health professionals. She offers a strong helping hand and invaluable guidance to the vast numbers of family and friends who are left behind by the more than thirty thousand* people who commit suicide each year, struggling to make sense of an act that seems to seem senseless, and to pick up the pieces of their own shattered lives. Perhaps, most important, for the first time in any book, she allows survivors to see that they are not alone in their feelings of grief and despair.

[*Discrepancy between this figure and the one stated previously is probably due to Carla Fine’s book being copyrighted in the late 90’s. Unfortunately suicide statistics have risen considerably.]

No Time to Say Goodbye is presented in six parts:

Part One: Introduction. This talks about the need to let go of the silence–something many survivors are hesitant to do because of all of the stigma, blame and shame associated with suicides.

Part Two: The Suicide. Very brave  survivors tell their actual stories.

Part Three: The Aftermath. This part of the book deals with a stage most survivors go through in which they search for answers, the helplessness they feel, tumultuous emotions, and dealing with legal and financial problems.

Part Four: The Survival. This is when survivors truly begin the mourning process and deal with the long term effects of the suicide on the family, how to get help for themselves, and forgiveness.

Part Five: Making Sense of the Chaos. This is about learning to live with the facts of the suicide and the life changes it brought while honoring the memory of the person lost.

Part Six: Resources. This one is self explanatory, but because it is so important, I will list some of the resources that weren’t previously mentioned. As above, I’ve tried to find and list the online versions of the groups I’ve listed.

Friends for Survival, Inc. http://www.friendsforsurvival.org/

Heartbeat http://heartbeatsurvivorsaftersuicide.org/

SPAN https://afsp.org/support_group/span-survivors-of-suicide-support-group/

The resource section also lists various material and pamphlets for survivors. There is also a state by state listing of already existing survivor support groups.

The following is an excerpt from “Understtanding Survivors of Suicide Loss”  Psychology Today  by Deborah Serani, Phys.D.

Ways to Help a Survivor of Suicide Loss

If you know someone who has lost a loved one to suicide, there are many things you can do. In addition, by reaching out, you also help take stigma out of the equation.

1. Don’t be afraid to acknowledge the death. Extend your condolences, express your feelings of sorrow. Make sure you use the loved one’s name. “My heart is so sad that John died.” Many who have lost someone to suicide have a broken heart, clinically called Stress Cardiomyopathy, and really need your empathy, compassion and understanding to heal.
2. Ask the survivor if and how you can help. Though they may not be ready to accept help, asking signifies that you are there—not avoiding or distancing during this tragic event. The notion of being there if needed is extremely comforting for survivors.
3. Encourage openness. Be accepting of however survivors need to express their feelings. It may be with silence, with sadness or even anger.
4. Be patient. Don’t set a time limit for a survivor’s grief. Complicated grief can take years to process. Moreover, don’t limit a survivor’s need to share and repeat stories, conversations or wishes. Repetition is a key factor in grief recovery.
5. Listen. Be a compassionate listener. This means don’t look to fix things. The greatest gift you can give someone you care about who has survived a suicide loss is your time, reassurance and love.

I think this is a decent list of things that anyone can do. Being a survivor myself, there are a few comments I would like to add. Definitely don’t be afraid to acknowledge the death. However, use a bit of common sense in this practice. In the beginning it is extremely important to acknowledge that there actually has been a death. Sometimes this seemingly obvious fact gets lost amidst police investigations and other legal and bureaucratic concerns. When my daughter died, someone brought up the fact of her suicide EVERY single time I saw that person for YEARS after the fact. This is where a little discretion could be used. While it’s perfectly fine to acknowledge the death, there is no reason for it to be brought up in every conversation. The person who was doing this was totally oblivious to the fact that it was upsetting me. Sometimes the name of the deceased will come up casually and normally in conversation and when this happens, it’s perfectly fine to comment and follow the conversation. Also, if those closest to the suicide like a mother (as in my case) bring it up, it’s ok to talk about it. Survivors have good days and bad days–and will for the rest of their lives so it is really important to follow the lead of those closest to the suicide. Some days survivors may have the strength to confront the facts and other days they won’t. Please do not try to force a survivor to talk about the suicide if they are clearly not ready to do so. They will open up when they are ready.

Listening–if the survivor(s) want to talk–is critical. I’m very fortunate that I had (and have) really great support in my life; wonderful people that I’m blessed to call my closest friends. Unfortunately there have also been a few people that just wanted to attack me. The people who wanted to attack me didn’t (and still don’t) have all of the facts and really do not know what they are talking about. They jumped to conclusions about the why of  my daughter’s death. Some blamed me. Some blamed her. A survivor is already blaming themself (although in the majority of situations the closest survivor couldn’t have stopped the death anyway) and the blaming and shaming that some want to do is not helpful at all. One of these people called my daughter a “coward.” One  attacked me at the memorial service basically saying I’m a lousy person who had a lousy kid. These are not exactly the type of people that a survivor is going to open up to. This type of behavior is extremely hurtful and harmful not to mention apalling and rude. It’s the exact opposite behavior of what should be happening. 

We have a very long way to go in our society in dealing with issues surrounding suicide. I am pleased that the silence is beginning to be addressed. I know there are many writers on this forum and this is a topic wide open. We need more materials to help survivors cope with suicide. Consider this post a challenge for you to bravely and openly talk about this issue.