Suicide complicates the grieving process for those left behind

09/01/2014 8:00 PM

09/02/2014 4:22 AM

Robin Williams’ suicide shined a media spotlight on mental health, depression and addiction – subjects that need to remain ongoing parts of the national dialogue if we’re ever to make progress in these areas.

But as the attention on Williams’ death inevitably subsides, the real emotional work – and suffering – for those closest to him will likely intensify.

That’s because the aftermath of suicide –“a death like no other,” as it’s often been described – creates myriad complications in the grieving process for those left behind.

“It’s a long, difficult path for suicide survivors because they’re going to experience such a wide array of emotions,” says bereavement specialist Jordana Perlman, founder of Psychotherapy of the Palm Beaches (psychpb.com). “And, unfortunately, there’s no ‘manual’ to follow.”

Conflicted feelings

How any of us deal with bereavement is determined by three factors, says Perlman: how we naturally cope with stress, our level of attachment to the deceased, the circumstances of the death.

“The sudden, often-violent action taken by the suicide victim will leave grievers in a state of confusion,” explains Perlman.

And with a host of conflicting emotions – some of which include:

• Shock (Perlman labels this “the emotional equivalent of your body producing adrenaline when injured. It prevents you from feeling.”)
• Guilt (Asking yourself: “Why wasn’t I there to save/protect my loved one?”)
• Anger (Justified rage at your loved one for “doing this to me”)
• Guilt over feeling anger (the quintessential conflicted emotion)
• Shame (Feeling you somehow caused this or did something wrong)
• Relief (Especially prevalent when your loved one was in extreme emotional distress; again, often accompanied by guilt over feeling relief)
• Helplessness (Being overwhelmed by the enormity of the tragedy)
• Frustration (Often caused by endlessly asking oneself the forever-unknowable: Why?)

“Everything one feels after the suicide of a loved one is legitimate,” says Perlman.“You have to honor where you are in the process – no matter how long you feel that way.”

Survivors will often overanalyze every last behavior that they – and the deceased – performed in the time leading up to the act.

If there was a suicide note, they’ll reread it countless times, parsing every last word.

Most grieving folks will, at some point, be introduced to the so-called “five stages of grief” – denial, anger, bargaining, depression and acceptance – that were formulated in 1969 by psychiatrist Elisabeth Kubler-Ross.

What most lay people don’t understand, though, says Florida therapist Debra Gross, is that these stages – even if the bereaved experiences them all – are not likely to happen in a linear or sequential fashion.

“You will bounce back and forth, especially when dealing with suicide,” says Gross.

Societal factors

Further complicating matters is the regrettable reality that suicide carries a social stigma – one that is often borne by the victim’s loved ones while at their most vulnerable.

“Many suicide survivors feel they’re being judged by people who know them,” explains Boca Raton, Fla., therapist Felicia Levine.

Then there’s the necessary, yet equally painful, intrusion by authorities.

No matter how obvious the circumstances, police initially treat a self-inflicted death as “an apparent suicide” until they can confirm it is so. Thus, loved ones – who are trying to process an emotional nuclear explosion – are also subjected to the prying questions of authorities.

“It’s like clawing at an open wound,” Perlman notes.

Coping with catastrophe

In his book “SOS: Survivors of Suicide,” Jeffrey Jackson notes that “the American Psychiatric Association ranks the trauma of losing a loved one to suicide as ‘catastrophic’ – on par with that of a concentration camp experience.”

Part of that, no doubt, is because one’s memories of the deceased – his or her “legacy,” if you will – will be forever shadowed by this dark cloud.

“You almost have to ‘rebuild’ your relationship with the person so you have positive, happy memories of your loved one,” Levine explains.

What Perlman has found is that in the grieving process many suicide survivors, filled with self-reproach, personalize their own sense of responsibility or culpability to the point that they believe that if they’d just done something different, then the outcome would have been different.

“They beat themselves up by placing unreasonable expectations on themselves. So eventually, we try to help them get to a place where they’re open to challenging those negative thoughts,” Perlman says.

The sad reality for suicide survivors is that, while they may never understand their loved one’s decision to end his or her life, the only way to move on with their own life is by eventually accepting it – and absolving themselves of all blame.

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