very nature of the word expresses negativity.
Suicide, according to Wikpedia comes from the
Lain sui caedere meaning “to kill oneself”
Thus the word “suicide” means “the
act of intentionally terminating one’s
life.” This negativity also comes with
an element of judgment. Just recently in a conversation
with a colleague, of suicide, they said, “it
is often an unspoken indictment.” The
negativity of meaning along with the element
of judgment often compromises survivors trauma
over what has happened and the traumatic stress
that accompanies them. This couple with the
“stigma” of suicide makes for an
abyss of darkness and the move to “get
on” with life.
While I had thought that we
had moved forward in the area of the stigma
surrounding suicide, I was quickly reminded
that we have not moved forward. I accompanied
a family to the morgue to see their loved one
who had died. As the coroner spoke to the family
and explained the reasons that could have led
to their loved one’s death, the family
begged the coroner to rule out suicide. The
coroner had explained that the deceased had
taken a number of “soma” a drug
that is a muscle relaxant, and the effect of
that drug alone could have led to her death.
This made me stop and think once again of the
stigma associated with suicide.
This article will detail a suicide
that occurred, the stigma involved, intervention
provided and the need for continued work in
dealing with survivors of death by suicide.
When a suicide occurs it not only affects family
and friends of the victim, but additionally
emergency personnel, hospital staff, funeral
directors, clergy and the surrounding community.
Survivors are not only left with a death and
unanswered questions, they are left with the
stigma and avoidance of dealing with the issue
at hand. In this article I will detail an experience,
the stigma and traumatic stress associated with
suicide. This experience highlights not only
the stigma that surrounds this subject, but
further, shows our avoidance in dealing with
suicide and not even wanting to give it a name.
I thought that the horrific events of September
11, 2001, with people falling from the Twin
Towers would break down some of these barriers,
yet I have not, in reality, experienced much
I had been working with a person
who had survived a suicide attempt. She had
cut her wrists, however, was discovered by her
spouse and lived. It was at this point that
I was asked to provide intervention. While never
feeling totally adequately prepared for the
“real thing” I began asking questions
and uncovering signs that led to the attempt.
As she progressed, she was willing to seek intervention,
however that became a smokescreen for what would
follow. As we began moving past the critical
stages, the diligence of family and friends
lessened. In what appeared to look like good
therapeutic intervention the fateful day came.
While family had not even remembered their was
a weapon in the house, the victim found a .22
caliber handgun and shot herself. This time
the suicide was completed.
While I had visited her regularly
on a weekly basis, I did not see the “tell-tale”
signs coming. I further was not exempted from
shock when I learned of her completed suicide.
I was in the hospital visiting a critically
ill patient, when I went to the nurses station
and was told, “Did you hear that Jane
(name changed) killed herself.” I reeled
at the news. I did not want to believe it. I
had just walked past her house. I wandered around
aimlessly. The shock rattled my being.
Again, I provided intervention
to the family and we attempted to make sense
out of the senseless. She did not leave a note.
The family groped for answers. In addition to
traumatic shock they dealt with their own feelings
of grief coupled with “what do we tell
people.” I tried to bring them an element
of normalcy and stability as they dealt with
a traumatic experience.
I encouraged the family to call
it was it what was, a suicide. The “why”
was an unknown. They were in an abyss of darkness.
Not only were they confronted with death, but
death by unnatural cause—death by one’s
own hand. In naming what had happened let them
know that her death had meaning. Yet, that was
not the feelings of people in the church community.
This victim’s father and
mother-in-law were members of the congregation
of which I was pastor. They were not just nominally
associated with the church, they were very active
members of the church. The event occurred on
Friday and I felt compelled to address it in
my sermon on Sunday. These people were sitting
in the congregation. They were looking for comfort
and healing at a very uncomfortable time in
their lives. Avoiding the use of the word suicide
would have been insensitive to the family and
an avoidance of the tragic occurrence in the
community. Yet, in the midst of all the trauma,
grief and crisis, I was confronted by congregants
and chided for my mention of the word suicide
from the pulpit of the church. In an attempt
to bring hope, comfort and healing to a hurting,
grieving family and community, I found myself
in the midst of conflict.
I myself felt abandoned. I could
only imagine what the family felt. The impact
of suicide was indeed in the headlines of the
people in our small, rural community.
The Impact of Suicide
As mentioned earlier, the impact
of suicide not only affects a family. The effects
of this incident rocked a community—a
community that involved emergency personal,
hospital staff, funeral director, pastor, church
community and the community-at-large. I was
not prepared to hear the news. Congregants would
have preferred not to hear the news or deal
with the matter before them. The news of this
event brought me to my knees. My first thought
was “how could this be?” Next came
questions. “Why did I not stop at her
house that day when on my way to the hospital?
What went wrong? What will her family think
of me? Did I do enough? What made her so desperate
to take her life?” The array of “whys”
Naming Suicide and Confronting
The chiding of the congregants
in response to my use of the word suicide in
my sermon left me in a quandary. If we as a
healing, spiritual community could not wrap
ourselves around a family in traumatic crisis,
how would we expect others to? When a suicide
occurs it does not merely affect a victim. It
affects a whole family and a community as well.
There is a lack of understanding and sympathy
in many arenas which only increase the pain,
suffering and grief of such a difficult occurrence.
Families are often “left alone”
as they struggle with the suddenness of their
loved one’s unexpected death. These feelings
of alone ness were recently expressed by a mother
whose seventeen-year old son hung himself. While
people attempt to be well-meaning it is often
seen in acts of “doing” and not
“presence.” People bring food to
the home and call at the funeral home, however,
they never really acknowledge the family’s
pain and grief. They are “afraid”
to mention the word suicide. It also appears
to bring home the reality of fear that this
could be me or a member of my family.
Confronting mortality is difficult.
This rocked my world and confronted me with
just how fragile life is. It further left me
helpless and without words. I realized that
before I could deal with the family and the
larger community, I had to address my own emotions,
needs and feelings. As I realized what I was
going through, I could then offer assistance
to a family and community that were experiencing
an array of emotions—from shock to peace.
As we were able to uncover some of the victim’s
feelings of “hopelessness” and “despair”
we were able to bring peace, comfort and hope
to the family. The depth of Jane’s emotional
pain, the act she committed all led to their
complicated grief and traumatic stress. By my
naming the act for what it was and helping them
to uncover questions that needed asked, I was
able to lead them to begin the healing process.
Grief of Suicide and
Death is the termination of
life and while we can explain this when death
comes through natural causes—heart attack,
stroke, infection, we have an easier time understanding.
Death by suicide leaves us with a void, emptiness
like traveling through an abyss. It is further
compounded by our desire to have answers. We
want to be in control and have a difficult time
making sense out of something we believe is
senseless. In our reluctance to understand the
nature of grief suicide brings, it is further
complicated by societal and religious stigma.
As an “unspoken indictment” judgmental
opinions are expressed in religious circles
regarding suicide. Some faith traditions refuse
to bury victims of suicide because of doctrine
and religious dogma.
In all of this we failed to
see the victim for who she really were. We cannot
understand the nature of their emotional pain,
their feelings of despair and their depth of
hopeless darkness. Theirs is a grief often held
in silence. Then we must turn to the grief of
survivors—family, spouse, children, grandchildren,
loved ones and friends. The depth of a family’s
grief is greater due to societal barriers and
avoidance in naming the act for what it is.
This circle of survivors are left to make sense
out of the senseless and are left with their
deepest grief unattended.
In order to help families of
suicide we must let them know “it’s
okay not to be okay,” as Mark Lerner,
PhD. outlines in his book, “It’s
Okay Not to Be Okay.” We must realize
that their may not be words to speak, but one’s
presence is vitally important. I attempted to
bring normalcy and stability into a situation
that was falling apart and unstable. In my presence,
I brought them a shoulder to lean on, encouraged
opportunities to talk and allowed them to cry
and express their grief as they felt. In my
presence I was able to help them with the “what
next” issues they would need to deal with.
Not only do the survivors have their own feelings
and emotions, grief and sorrow, there are also
the questions of “why” and the “guilt”
that often surrounds such a tragic act. There
is all this and we have not even considered
the method by which the victim used to take
their own life.
As professionals we must seek
to put aside our agenda—our opinions and
biases—and extend compassion in the form
of empathic care and support to the hurting
family and shocked community. We must be careful
not to express an “unspoken indictment”
and remember that we were not walking in the
shoes of the victim. We cannot feel their burdens,
their stress, or rationalize away their feelings
of despair and hopelessness. Standing along
side of survivors in their grief and trauma
is the most helpful assistance we can offer.
Suicide is as awful and tragic
as a terrorist event. For whatever reason such
a desperate act was committed, survivors are
going to remember that we entered their abyss
of grief and journeyed with them extending God’s
grace. They are going to remember that we listened
and allowed them to vent their feelings, express
their hurts and concerns, rant and rave, or
just sit down and cry. Extending care and compassion
is often remembered through the simple task
of being present.
While the stigma of suicide
continues, in our hospital and regional trauma
center, we are making strides to help people
deal with their traumatic stress and grief by
normalizing their shock, its horrific reality
and humanity’s own mortality. Through
addressing the issue we confront its reality
as well as to normalize peoples responses, emotions
and feelings. We help to bring stability into
a very unstable environment. Suicide will always
leave a void and emptiness, however, as we break
down the barriers of stigma and address in healthy
ways the traumatic stress they experience, we
will effect healing in survivors life journey.
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