“Be kind and have mercy dear friend. We are all strangers in a strange land and some of us fight dragons.” Those words left an indelible impression on me when I read them in a recent obituary.
This one was shattering to read. I discerned that the deceased was a relatively young woman, and was loved by many. She was a nurse, caring, compassionate and now she was gone forever, leaving behind a legacy of loss, shame, and guilt.
For those who loved her, their lives have been changed in unimaginable ways. Their grieving processes will be more complicated than normal, fraught with all the “should haves,” “could haves,” and “would haves” that one has when one loses a loved one to suicide.
Suicide is one of the leading causes of death in the United States. According to statistics from the American Association of Suicidology, roughly 32,000 suicides occur annually in the U.S.
More Americans die by suicide than by homicide. Suicide occurs across all ethnic, economic, social and age boundaries.
Many suicides are preventable. Most suicidal people desperately want to live, but are unable to see alternatives to their problems. More than 80 percent of people who die by suicide are suffering from a major psychiatric illness such as Major Depressive Disorder or Bipolar Disorder.
It is estimated that for every suicide there are six survivors. Approximately 5 million Americans became survivors of suicide in the last 25 years. Suicide is pandemic but its prevalence is underreported due to the stigma and shame associated with this type of death and loss.
For the past 15 years, I have counseled the bereaved. While each individual copes with loss in their own way, those that have lost a loved one to suicide suffer in more complicated ways.
Their grief is disenfranchised and their guilt is compounded by what actions they could have taken to change the tragic outcome. The shroud of secrecy and shame associated with suicide complicates the healing process.
Bereavement support groups specifically for those who have lost a loved one to suicide can be particularly helpful. Here members can receive support and share their grief amongst those who truly understand all the complexities of losing a loved one to suicide.
Elizabeth Kubler-Ross created a template for grief that consists of the stages of denial, shock, anger, bargaining, depression, and finally acceptance. The journey through the grieving process is not linear. Individuals have good days and bad days.
Initially, bereaved people are in a state of shock and disbelief; unable to accept they will never see their loved ones again. They replay how history could have been different, and a life saved. This questioning is a normal part of the bargain process as one tries to reconcile denial with the reality of the loss.
Many get stuck in feeling angry about the injustice of the loss and how their quality of life has now changed. Acceptance is elusive for many but comes with learning how to live and cope with the loss.
We are social beings who are hardwired to feel consoled when comforted by friends, family and strangers. However when a loved one dies by suicide, many may feel a lack of support, validation and acceptance of their grief and loss due to the stigma and shame.
For those left behind, their desire to do something to prevent this tragedy from happening to others is often a catalyst for them to become active in suicide prevention programs. Suicide prevention can be a helpful part of their healing process.
The QPR Institute is a national organization which trains lay people how to intervene if they believe someone is at risk for suicide. The acronym stands for Question, Persuade, and Refer. The ultimate goal of QPR is to prevent suicide attempts and completions.
QPR works to eliminate the stigma associated with suicide and to provide education on warning signs of suicidal behavior. These include co-occurring depression, moodiness and hopelessness, putting personal affairs in order, giving away prized possessions, sudden interest or disinterest in religion, drug or alcohol abuse, stockpiling pills or acquiring a gun, and any previous suicide attempt.
Obviously, this subject stirs up fears and strong emotions. Although few people are neutral about the subject, baseline knowledge about suicide and its causes is very low outside of the mental health field.
As a result, the subject of suicide is beset with dangerous myths and misconceptions. These not only isolate people considering suicide from their families and communities, but they also can lead to further isolation and hopelessness, two factors highly associated with suicide attempts and completions.
Through public education, QPR instructors correct these misperceptions and replace myth with fact, thereby creating a more understanding context and community for those at risk for self-destruction. For more information on coping with suicide and suicide prevention contact http:/www.preventsuicide.org
Melanie Wasserman, MSW, LCSW, is a psychotherapist in private practice in Milwaukee and is a QPR instructor.
