“Beyond the aspects of grieving that apply to all bereavement situations, there are several aspects of a suicide death that can be considered to be either unique to suicide, or at least much more prominent after a suicide, and other traumatic deaths. By traumatic deaths, I mean a mode of death that is sudden, unexpected, and often times violent – and thus likely to leave the mourner in a state of shock and bewilderment.” – John R. Jordan
Grief is a universal human experience, but the nature and intensity of grief can vary significantly depending on the circumstances surrounding the loss. Suicide bereavement, in particular, presents unique challenges that differentiate it from other types of grief. This article explores the distinct aspects of suicide bereavement, the emotional and psychological impact on survivors, and the various therapeutic approaches that are effective in supporting those who have lost a loved one to suicide.
The Impact of Perceived Intentionality
One of the most distinguishing features of suicide bereavement is the perceived intentionality behind the death. Unlike other forms of death, such as illness or accidents, suicide is often seen as a deliberate act, which can lead survivors to wrestle with complex questions about why the suicide occurred. This sense of intentionality often brings about a range of difficult emotions, including guilt, shame, anger, and confusion. Survivors may find themselves questioning whether they could have done something to prevent the death, leading to intense feelings of responsibility and self-blame.
The Struggle with “Why” and “What If”
Survivors of suicide often experience an overwhelming need to make sense of the death, asking questions like “Why did this happen?” and “What could I have done differently?” Unlike other forms of bereavement, where the cause of death may be understood or accepted, the reasons behind a suicide can be elusive and shrouded in mystery. This struggle to find answers can prolong the grieving process and make it more complicated, as survivors may never fully understand the factors that led to their loved one’s decision to end their life.
Stigmatization and Social Isolation
Suicide carries a significant social stigma, which can exacerbate the grief experienced by survivors. Friends, family, and the broader community may be unsure of how to offer support or may avoid the subject altogether, leading to feelings of isolation for the bereaved. Survivors might also feel judged or blamed by others, even if these judgments are not explicitly expressed. This social isolation can deepen the sense of loneliness and alienation, making it harder for survivors to find the support they need during their grieving process.
The Risk of Complicated Grief
Due to the complex emotions and social dynamics involved, survivors of suicide are at a higher risk of experiencing complicated grief. Complicated grief is characterized by an extended and intense grieving period that interferes with a person’s ability to function in daily life. Symptoms may include persistent feelings of sadness, an inability to accept the death, intrusive thoughts about the deceased, and a preoccupation with the circumstances of the death. Complicated grief can significantly hinder the healing process, making it crucial for survivors to receive appropriate therapeutic support.
Trauma and PTSD Symptoms
In addition to grief, survivors of suicide often experience trauma, especially if they were present at the time of death, discovered the body, or were closely involved in the events leading up to the suicide. This trauma can manifest in symptoms similar to those of Post-Traumatic Stress Disorder (PTSD), including flashbacks, hyperarousal, avoidance behaviors, and intrusive thoughts. The combination of grief and trauma can be particularly challenging to navigate, requiring specialized therapeutic interventions to address both aspects of the survivor’s experience.
Effective Therapeutic Approaches for Suicide Bereavement
Given the unique and complex nature of suicide bereavement, it is essential to utilize therapeutic approaches that are specifically tailored to address the needs of survivors. Below are some of the most effective types of therapy for individuals who have lost a loved one to suicide.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is an evidence-based approach that helps individuals identify and challenge negative thought patterns that contribute to their emotional distress. For suicide loss survivors, CBT can be particularly effective in addressing feelings of guilt, self-blame, and hopelessness. Through CBT, survivors learn to reframe their thoughts in a more balanced and realistic way, which can alleviate some of the intense emotions associated with their loss. CBT also equips survivors with practical coping strategies for managing grief and stress, such as relaxation techniques and mindfulness practices.
Eye Movement Desensitization and Reprocessing (EMDR)
Eye Movement Desensitization and Reprocessing (EMDR) is a trauma-focused therapy that can be highly beneficial for survivors who are experiencing symptoms of trauma or PTSD. EMDR helps individuals process and reframe traumatic memories, reducing their emotional intensity and making them easier to integrate into the broader context of their lives. During EMDR sessions, the therapist guides the survivor through recalling distressing memories while engaging in bilateral stimulation, such as guided eye movements. This process is believed to help the brain reprocess the trauma in a way that promotes healing and reduces the impact of intrusive thoughts and flashbacks.
Complicated Grief Therapy (CGT)
Complicated Grief Therapy (CGT) is a specialized form of therapy designed to help individuals who are experiencing prolonged or complicated grief. CGT combines elements of cognitive-behavioral therapy, attachment theory, and grief-focused interventions to address the unique challenges faced by suicide loss survivors. The therapy focuses on helping individuals come to terms with the finality of the death, restore their sense of purpose and meaning in life, and develop strategies for managing grief triggers. CGT is particularly effective in helping survivors move through the stages of grief while addressing the specific emotions and challenges associated with suicide loss.
Narrative Therapy
Narrative Therapy is an approach that encourages individuals to explore and reshape the stories they tell about their lives and experiences. For suicide loss survivors, Narrative Therapy can be instrumental in reconstructing the narrative of their loved one’s death in a way that honors their memory while reducing feelings of guilt and shame. By working with a therapist to develop a new narrative, survivors can gain a sense of control over their story and find meaning and understanding in their loss. This process also helps survivors integrate the loss into their broader life narrative, allowing them to move forward while still acknowledging their loved one’s impact on their life.
Acceptance and Commitment Therapy (ACT)
Acceptance and Commitment Therapy (ACT) focuses on helping individuals accept their emotions and thoughts without judgment, rather than trying to avoid or control them. For those who have lost someone to suicide, ACT can be beneficial in helping them accept the painful emotions that come with grief while committing to actions that align with their values and life goals. ACT emphasizes mindfulness, acceptance, and living in the present moment, which can help survivors move forward while acknowledging their loss. This approach encourages individuals to live a meaningful life despite the pain of their loss, fostering resilience and emotional well-being.
Trauma-Informed Therapy
Trauma-Informed Therapy is an approach that recognizes the widespread impact of trauma and seeks to create a therapeutic environment that promotes safety, trust, and empowerment. This type of therapy is particularly relevant for suicide loss survivors who may experience trauma symptoms, such as flashbacks, hyperarousal, or avoidance. Trauma-Informed Therapy helps survivors understand the impact of trauma on their grief and develop strategies to manage trauma responses while working through their loss. By addressing both the trauma and grief aspects of suicide bereavement, this approach provides a comprehensive framework for healing.
Group Therapy
Group Therapy provides a supportive environment where suicide loss survivors can share their experiences with others who have faced similar losses. The sense of community and shared understanding in group therapy can reduce feelings of isolation and stigma often associated with suicide loss. Survivors can learn from the coping strategies of others and receive emotional support from peers who truly understand their experience. Group therapy can be conducted in various formats, including peer-led support groups or professionally facilitated sessions, offering a range of perspectives and resources for healing.
Suicide has a ripple effect that creates challenges for many different people. If you are in crisis, reach out for help. You can call 988. If you are seeking a therapist, contact us today or search our directory for the therapist who is right for you.