Understanding the Aftermath of Suicide Loss
continued from page 13
But after suicide , many factors make the loss — and its grieving — more complicated . One factor that stands out is our culture ’ s centuries-old view of suicide as a sin , or that “ suicide people ” go to hell . Experts in the field have held summit meetings sponsored by SAMHSA ( the Substance Abuse and Mental Health Services Administration , www . samhsa . gov ) with religious leaders and found that , while the varying world religions have unique perspectives on suicide , they generally agree that suicide is a result of human suffering , and that compassionate care is a core religious value to extend to both suicidal persons and to their loved ones .
Well-meaning friends and community members often extend their support framed in a critical response . What he did was so selfish and hostile ! How could she leave you to deal with all of this ? What was going on in that family that it came to this ? The list of non-helpful comments from these opinion-holders is endless . Many survivors of suicide loss understand that they are unintended targets of comments they overhear when they go out in public . However , even if the hurt is unintended , the survivor of suicide loss endures stigma when comments about suicide are tossed about at a dentist office , grocery store , or by a manicurist , for example . How would these conversations proceed differently if the public was educated that depression is a life-threatening illness , or that suicide is not considered a rational choice , or that suicide is caused by multiple factors ( and not one cause )?
Tips for Working With Clients Who Are Survivors of Suicide Loss
Any death arguably causes some strain and stress , even though we know that differential family grief is normal and expected . But differential family grief can be distinctive among suicidal grievers . An elevation in family conflict can occur after a family member ’ s suicide . For example , the adult stepchildren might blame the stepmother for the death . Members of a family may be disinvited from the funeral or even future family gatherings . Role strain within families can ensue . Family holidays and traditions are often discarded or significantly altered after suicide .
WE CLINICIANS CAN AID OUR CLIENTS ’ RECOVERY FROM SUICIDE LOSS
All of us Licensed Clinical Mental Health Counselors ( LCMHCs ) who treat clients affected by suicide are encouraged to embrace these following suggestions :
• Check your own beliefs , attitudes , and misinformation related to suicide loss .
• Normalize the additional stressors and distinctions that suicide loss can result in .
• Be patient with how vexing and how long-term the survivor of loss may grapple with the loss .
• Promote attendance at suicide bereavement groups .
• Suggest clients read websites and books by other survivors of suicide loss .
• Suggest clients set their internet bookmarks to a few of the many suicide websites , especially the American Foundation for Suicide Prevention , afsp . org , and the American Association of Suicidology , suicidology . org .
The DSM – 5 – TR recently approved a new diagnosis — Prolonged Grief Disorder ( PGD ). Survivors of suicide loss may or may not experience PGD , but if Cerberus had his way , we would naturally expect the course of grief to be lengthier and more challenging . The survivor of suicide loss may be brought to the low feelings largely related to sorrow and loss , only for those to be displaced with acute stress or symptoms related to trauma , which then yield to the feelings related to complicated bereavement .
As LCMHCs , while we recognize that PGD is a diagnosis , it is important to think about how not to pathologize the client , as if they are faulty , ineffective , or to be blamed for PGD . ( See some suggestions for working with clients affected by suicide loss in the adjacent box .)
• Think of postvention as prevention ; excellent postventive care might have helped Deborah ( see her case on page 12 ) to live her full life differently , and possibly avoid developing a Substance Use Disorder .
• After paying sustained attention to the client ’ s traumatic qualities of the loss , consider a timely introduction of posttraumatic growth or resiliency as a long-term goal for recovery .
• Think of “ recovery ” as accommodation or integration of the loss ; one never really “ recovers ” from the loss .
• Remember to practice self-care and trauma stewardship when counseling survivors of suicide loss .
From a rehabilitative counseling point of view , all those conditions ( experiences that result in traumatic stress , complicated grief , etc .) are like curbs or stairs over which a survivor is attempting to ambulate . Rehabilitation counselors would naturally help clients re-learn to navigate the curb or steps .
As with an elevator , cane , wheelchair ... we as mental health clinicians can metaphorically be the adaptive “ equipment ” our clients need to learn ways to recover from the illeffects of Cerberus ’ beastlike qualities .
14 The Advocate Magazine 2023 , Issue # 1 American Mental Health Counselors Association ( AMHCA ) www . amhca . org