Second Opinion: We need to be sensitive that suicide is a different kind of bereavement

The loss of someone you have been close to from any cause brings about intense grief and mourning. But the responses and emotions experienced by the suicide bereaved often differ from those felt after other types of death.

The fact that a loved one’s death appeared to involve an element of choice raises painful questions which deaths from natural or accidental causes do not, and can lead to a more protracted and complicated grief.

The sense of shock and disbelief following a death by suicide are very intense. A common aspect of grief after suicide is recurring images of the death, even if this was not witnessed.

Going over and over the very frightening and painful images of the death, and the feelings these create, is a natural need at such a time. The grieving process is characterised by agonising questioning and a search for some explanation for what has happened.

At Console, we find that many people bereaved by suicide eventually come to accept that they will never really know the reason why a loved one did what they did.

During this search for explanations, members of the same family may have very different ideas as to why a death happened.

Blame
Family relationships may become strained, particularly where an element of blame is involved.

Everything can seem painfully obvious in retrospect and the “what ifs” may seem endless.

However, rewinding events or conversations in one’s mind is a natural and necessary way of coping with what has happened.

Research suggests those who have lost someone through suicide tend to suffer greater guilt, self-blame and self-questioning during bereavement than those whose loved ones have died in some other way.

People bereaved by suicide may experience a sense of rejection and it is common to feel abandoned by someone who “chose” to die.

One sister whose brother took his life recalled: “I was upset that he hadn’t come to talk to us. I think we all went through anger at some point. You think, ‘how could you do this to us?’.”

People who have been bereaved by suicide may suffer more anxiety, and be more vulnerable to suicidal feelings of their own, than those bereaved in other ways.

Identifying with someone who has taken their life can be deeply threatening to one’s own sense of security, and is something that we at Console are acutely aware of from a therapeutic perspective.

Although attitudes to suicide are changing, there is often limited community support available to those bereaved by suicide.

If other people are embarrassed, uneasy and evasive about the way in which a loved one has died, the bereaved can be left feeling intensely isolated and opportunities to talk, remember and celebrate all aspects of their loved one's life and personality may be denied.

Need to protect
A strong need to protect their loved one, and themselves, from the judgment of others can also be felt by those bereaved by suicide.

Some things such as sadness at the death and missing the lost person probably never go away completely but the pain does lessen with time.

We find many people who come to us for bereavement counselling have not had their loved one’s death recorded as a suicide. Apart from giving an inaccurate picture of the national situation, this robs the family of the chance to reach an important level of acceptance during the grieving process.

Acceptance can take a long time but it helps people to put some of their very difficult feelings, such as anger and guilt, into perspective. With acceptance of loss, the things that were good about the person when they were alive can gradually start to be important.

Although life is never the same for many people, there does come a time when they can begin to enjoy living again. It tends to be small reminders and memories that bring feelings of grief flooding back, and anniversaries and birthdays can be particularly difficult times.

When things seem very bleak it is important to live from day to day with a knowledge that things will ease in the future and that organisations such as Console are available if needed to provide help and hope.

Paul Kelly is chief executive of Console (console.ie) which provides free counselling, support groups and helpline services (1800-201890) to those bereaved through suicide. It has centres in Dublin, Cork, Galway, Limerick, Kerry, Mayo, Wexford, Kildare, Athlone and London.