| 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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