| Suicide—the
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 change.
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” continued.
Naming Suicide and Confronting Mortality
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 Traumatic Stress
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.
Conclusion
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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