Information for People Who Have Lost a Loved One to Suicide (PDF)

Suicide Bereavement Support Services WHY? Information for People Who Have Lost a Loved One to Suicide  2 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE Contents Because You Have Questions ����������������������������������������������������� 3 Why Did They Do It? ������������������������������������������������������������������� 4 What Should I Be Feeling? ���������������������������������������������������������� 4 How Do I Begin To Cope? ����������������������������������������������������������� 5 Will The Pain Ever Go Away? ������������������������������������������������������ 5 Is It Normal To Feel So Guilty? ��������������������������������������������������� 5 Am I Grieving Or Depressed? ����������������������������������������������������� 5 Why Am I So Tired? �������������������������������������������������������������������� 6 Is It Normal To Have Suicidal Thoughts Myself? ������������������������ 6 What Do I Tell The Children? ������������������������������������������������������� 6 Does Everyone Grieve A Suicide Loss The Same Way? ������������ 7 How Can I Tell Or Talk To Other People? ������������������������������������ 7 What Will Other People Think? ��������������������������������������������������� 8 How Do I Cope On Holidays And Anniversaries? ����������������������� 8 Will I Ever Get My Life Back? ������������������������������������������������������ 8 Where Can I Get Help? ��������������������������������������������������������������� 9 Voices Of People Who Have Participated In Our Bearevement Support Services ������������������������������������������������ 10 References And End Notes ��������������������������������������������������������11  3 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE Losing a loved one to suicide is different than losing someone to illness or even a sudden and tragic accident� Feelings of sadness and grief are often complicated by other feelings, like guilt, embarrassment, shame, despair, anger and denial� The endless search for answers can be overwhelming� Why did this happen? What could I have done? Will I ever be happy again? We know you have questions� And we want to help you find some answers� But more than that, we want to sup- port you in your journey of grief and healing� This package is intended to give you some basic information and assis- tance as you begin your journey� It is not a substitute for professional counselling or medical treatment and we encourage you to get the help you need� If you need immediate crisis support, call the 24-hour Distress Line at 780-482-4357� If you would like to explore ongoing individual or group support through our Suicide Bereavement Support Services, call us at 780-414-6300� If you require additional supports, we can refer you to other mental health service providers in the community� Because You Have Questions I bear witness to a mysterious truth that life has given me: that we are stronger, gentler, more resilient, and more beautiful than we imagine, and that the resource we call life is never far away. I know this because every time my heart has been broken or shattered, I have felt certain that it could never be put back together. And every time, without exception, not only has my heart mended but it has become larger, stronger, and more loving for the breaking. The mysterious and unfailing journey of how this happens is the ordinary art of staying awake and it involves the deep and continuous act of being present in all ways in all directions, which is the practice of holding nothing back. — MARK NEPO www.soundstrue.com/wakeup/authors/mark-nepo  4 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE No one can answer that question� There is no single cause of suicide� The many factors that can lead to suicide are complex and usually develop over time� People who survive a suicide attempt often describe an altered state of mind just before they take action to end their lives� But they usually can’t explain this state of mind or understand it rationally� Psychological science is still studying the question: Why do people consider suicide? People who consider suicide often feel a tremendous sense of loneliness, isolation, helplessness and hopelessness� Most believe they can no longer cope with their problems and that suicide is the only way out� Distress distorts their thinking and they might convince themselves that “everyone will be better off without me�” A desire to end the pain. The source of pain might be a sudden traumatic event, longstanding and unresolved personal problems, or the experience of a number of losses or changes over a short period of time� Whatever the source, the pain feels unbearable and the person can see no way through it� Suicide begins to look like the only way to end the pain� Helplessness. The person who considers suicide often feels powerless in the face of pain� They might think, “There’s nothing I can do to make a difference,” or, “I’ve already done all that I can�” Having lost a sense of control, the person might come to see suicide as the one last thing they can control� Hopelessness. Not only might the person believe there is nothing they can do, but that there is nothing anyone else can do to change the future or end the pain� There seems to be no reason to go on living� Isolation. The person might feel increasingly alone, even when others are nearby and want to help� They might believe that no one can understand their situation or that others have problems of their own� A person might attempt suicide because they can think of no other way to end the pain� You did not cause your loved one to die by suicide� And you may never have an answer to the question, “Why?” But with support you can find an answer to the question, “Where do I go from here?” Why Did They Do It? It is not a question of “what should I be feeling?” but rather of “what am I feeling?” Every person will react to a loved one’s suicide in their own way and experience the grief of loss differently� Some common responses to a loss by suicide include: • Numbness, shock, denial and disbelief� • Anxiety, panic and fear� • Anger or irritability� • Guilt and shame� • Persistent thoughts of “why�” • Impulse to blame� • Reviewing past conversations with the person who died� • Feeling rejected by the person who died� • Suicidal thoughts� • Relief, in some cases� • Physical symptoms such as fatigue, aches and pains, difficulty focussing, sleep disturbances and changes in appetite� • Trauma related responses such as real or intrusive images related to the death, nightmares and flashbacks� • Feeling embarrassed and judged by others (social stigma)� Many of these thoughts and feelings are part of the grieving process� Grief is the natural human response to loss� It is not something we choose or don’t choose� Grief is a necessary journey that we all must take when we lose someone or something we love and value�1 There is no right or wrong way to grieve� What Should I Be Feeling?  5 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE Be patient and gentle with yourself� The impact of losing a loved one by suicide can be devastating� Grief affects your emotions, thought processes, physical health, relationships with others and spiritual wellness�2 You may find yourself questioning basic assumptions and even doubting deeply held beliefs�3 This is normal� Grief after a loved one dies by suicide is often experienced as a circular path and has been described as an unpredictable and emotional “roller coaster ride�” The ride can be intense and upsetting� You might find yourself in deep sorrow one day and then feeling consoled or even relieved on another� These emotional ups and downs can come with little warning� The best thing to do is to let yourself feel these emotions in a safe way and accept support from others when it’s offered� Spend time with people you trust� Reach out – or reach back when they reach out – to supportive family members, friends, faith communities, spiritual advisors and community organizations� A support group of people who have survived the suicide of a loved one might help� These are people who can deeply understand what you are feeling, listen to your story and share the ways they are coping with their loss� Don’t be afraid to mourn� Mourning is part of the grieving process but it is different from grief�4 Grief is how you feel inside; mourning is the outward expression of your grief� When possible, mourn with others who can support and comfort each other; if you must mourn alone, be kind to yourself� Your life may never feel the same again but you can survive – and even thrive�5 How Do I Begin To Cope? Guilt is a natural response to a loss by suicide� Not only are your emotions like a roller coaster but your body is on high alert and responding as if it’s being threatened�6 This protective reaction can make it difficult to think clearly and process your feelings in a realistic manner� You may notice many thoughts during this time of intense grief: some may be accurate and some may not� Don’t believe everything you think� You might also be troubled by constantly asking the ever- present question: why? The only way you can stop asking this question is to find a way to be satisfied with partial answers�7 Remember, you are not responsible for another person’s life or decisions� Even if you and a full team of professionals did everything you could to keep your loved one safe, even with the perfect intervention and round- the-clock care, people still die by suicide� Is It Normal To Feel So Guilty? Will The Pain Ever Go Away? Grieving is a lifelong process with no time frame� During the first year you might feel numb – like you’re “in a fog” – and not begin to fully mourn until this numbness starts to go away� A year or more after your loss, you might find yourself surprised by the intensity of your grief� Give yourself time to work through your experience and receive support to find a new normal� By actively engaging in the grieving process, especially when supported by others, your pain can transform and diminish over time� Am I Grieving Or Depressed? Grief and depression are not the same thing� Major depres- sive disorder is a mental illness with many symptoms� Grief is a natural reaction to a loss of any kind� Sometimes peo- ple refer to sadness as “feeling depressed” but feelings of sadness and despair are different from a Major Depressive Disorder� Please talk to your doctor or health care prac- titioner if you were living with Major Depressive Disorder before your loss from suicide�  6 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE It is very common to have suicidal thoughts when you have lost a loved one to suicide� In the midst of your grief and suffering you may find yourself asking whether or not your own life is worth living� Get help immediately if you are having thoughts of not wanting to be alive or of ending your own life� Reach out to trusted friends, supportive family and mental health or other health care professionals� For immediate, 24-hour help, call the Distress Line at 780-482-4357� When a loved one dies by suicide, parents and caregivers usually ask two questions: “What do I tell my children about death?” and, “How do I tell my children that the death was by suicide?” Children need to know the truth� Tell your children the facts in a sensitive, caring and age appropriate way�9 This will foster trust and prevent children from overhearing half-truths or making up stories to “fill in the blanks�” Many children have told us that when they eventually learn the truth, they feel betrayed if this truth does not come from a caregiver� Keep the information simple and truthful� If children are very young, experts advise that you describe suicide as being “when someone made their body stop working�”10 Children are very literal� Be direct and avoid inaccurate descriptions like “he is sleeping�” Be sure to reassure your children that they are not responsible for the death� It is a common developmental trait for children to believe they are the centre of the universe and to take responsibility for events which are far beyond their control� They need to know that it is not their fault� “If children are old enough to love they are old enough to grieve”11 but the way they grieve can vary with age and change as they grow older� Older children may ask more questions and want more details� Answer their questions honestly� A professional can help you understand your children’s need for answers and find the right way to respond� Contact us for support� Why Am I So Tired? Grief is stressful� And stress is physically, emotionally, cognitively and spiritually exhausting� There is no getting around it� When you are grieving, your body produces a substance called cytokines, which can temporarily boost your immune system and then suppress it in the longer term� Cytokines can also make you feel tired, achy and lethargic – like you have cold, but without the congestion�8 Even if you don’t feel up to it, take the time to nurture yourself and engage in soothing activities that can help to relieve stress� Go for a walk� Watch a movie or favorite television show� Or take a soaking bath� Is It Normal To Have Suicidal Thoughts Myself? What Do I Tell The Children?  7 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE No� Grieving is a very personal experience� There is no right or wrong way to grieve� Even within the same family, people may grieve very differently�12 There are many factors that affect the way people grieve� These factors might include: • The age of the person who is grieving (adult or child)� • The kind of relationship they had with the person who died� • The way in which the person ended his or her life� • The way they responded to previous losses and death� • Personality differences� • Other problems or stresses the person might be experiencing� Does Everyone Grieve A Suicide Loss The Same Way? Telling others about your loved one’s suicide can be a challenge� It’s important to tell family and friends the truth, even if you find it difficult to talk openly about suicide� You might choose to say something as simple as, “His death was a suicide and I just can’t talk about it yet,” or “She was struggling with depression and died by suicide�” Simply acknowledging the suicide and saying it out loud can help you begin the grieving process� Talking about it will help others to cope with their own grief and help you to work through yours� When you talk openly about a loved one’s suicide, it reduces the stigma associated with suicide and can help end any rumours that surround a sudden death� You can’t control how others will respond to this news� Some friends and family may struggle to find the best way to support you� Co-workers may not know what to say� Some people may say unhelpful things that hurt or offend you� On the other hand, talking openly about suicide can give those who have experienced a similar loss an opportunity to become important supports to you and your family� Some friends, family and acquaintances may surprise you with their kindness, caring and support� How Can I Tell Or Talk To Other People?  8 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE Just as you can’t control how people respond to the news of your loved one’s suicide, you can’t control what others think and feel� People fear what they can’t understand� The stigma around suicide exists because of fear� In the same way, judgemental attitudes are common when we are afraid of or don’t understand something� Suicide is no longer considered a crime by society or a sin by most religions� We now recognize it for what it is: an inability to cope with emotional pain, a tragedy and a loss� You can help reduce the stigma by talking openly about suicide – when you are ready – and using appropriate language, like “died by suicide” or “ended their own life,” rather than “committed suicide�” How Do I Cope On Holidays And Anniversaries? When you survive a loved one’s suicide, it is common and understandable to feel anxious, sad and apprehensive before special days and anniversa- ries� Some grief survivors find it helpful to plan for these days and events ahead of time, in order to cope with the emotional challenges� Planned rituals, gatherings or engaging in your loved one’s favorite activities can support healing and provide comfort� But it’s also important to have alter- nate or flexible plans in case your feelings change as the day approaches� Ask for help if you find yourself panicking before special days or if your feelings become unbearable� Reach out to trusted friends, supportive family and mental health or other health care professionals� Connecting with others grieving a suicide loss can also be of great comfort� For immediate, 24-hour help, call the Distress Line at 780-482-4357� What Will Other People Think? Will I Ever Get My Life Back? People who have survived the loss of a loved one to sui- cide do get their lives back� Over time and with support you can begin to integrate your grief through active mourning, patience and self-compassion�13 Your sense of wellbe- ing and connection to others can return, even as the scars from your sorrow become part of who you are� As you pro- cess your loss, you can still honour and retain the bond you share with your loved one, while learning to embrace the present and have hope for the future�  9 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE This information is for people who live in the Edmonton area� If you live in another Province or Territory please contact the helpers in your community or look for resources at the Canadian Association for Suicide Prevention at www�suicideprevention�ca/grieving/ Immediate Crisis Support • 24-hour Distress Line 780-482-4357 (Edmonton and area) • Mental Health Help Line 1-877-303-2642 (toll free) • Health Link 811 Support and Counselling Canadian Mental Health Association – Edmonton Region • Support sessions for individuals • 12-week support group • Monthly drop-in support group for graduates of the 12-week program • Debriefing sessions for family, friends and colleagues Drop-in Single Session Counselling� Available free- of-charge at multiple locations throughout Edmonton, including CMHA-ER, with flexible days and times ready to serve you� For information, locations and times visit: www.dropinyeg.ca Ask us for information about other mental health professionals and health care providers� Print Resources Hope and Healing: A Practical Guide for Survivors of Suicide� Available from Alberta Health Services� To view or download, visit www.albertahealth.com and search “Hope and Healing” Where Can I Get Help? Willing to experience aloneness, I discover connection everywhere. Turning to face my fear I meet the warrior who lives within. Opening to my loss I gain the embrace of the Universe. Surrendering into emptiness, I find fullness without end. Each condition I flee from pursues me. Each condition I welcome transforms me. — JENNIFER WELWOOD jenniferwelwood.com/poetry/unconditional/  10 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE “Although it took a while I can safely say that coming here was one of my best decisions. Initially my thoughts were that no one could help me because my son simply wasn’t coming back. With time, understanding and compassion I have been able to see this tragedy from a number of viewpoints. A lot has been learned about Scott, my son, and about myself [sic]. A warm secure understanding is what greets me every time I arrive. One can only marvel at those who would put their hearts into a position where they are met with tragedy of others each day. Things are hard but good things are happening. Credit to all staff members and in particular to my wonderful suicide bereavement support worker.” “Having a program like this that is available at no cost to participants is extremely helpful! I am greatful [sic] to have a safe place to come and talk about what is going on in my life and my grieving process. They have knowledgeable support worker that provides insight and understanding that helps me make sense of my feelings of grief.” “I deal with not only a loss to suicide, but an urge to complete suicide myself. This support has quite literally kept me alive. I am beginning to function again with the ability to show myself self-compassion and understanding.” “Coming here has been the best thing I could have done. Every day I feel thankful that I can come here and talk about anything at all.” “Thank you so much for providing a safe comfortable environment for me to share my feelings, thought, and experiences. I feel more confident in my ability to find my way through this journey. Thank you for walking alongside with me.” “This program has helped with talking out my feelings without feeling like I have to be strong for my family.” “Thanks so much for helping me today. I feel safe and comfortable here.” “This service is incredibly important. It feels good to talk to someone who understands suicide but who I don’t feel I have to take care of or protect like I do with my friends when I talk about it with them.” “I have come to understand that my feelings are not abnormal!” “The tools, support, listening support worker and guidance have helped me cope over the past 6 or 7 months. I do not feel I would have made it through this journey without this amazing support and assistance.” Voices Of People Who Have Participated In Our Bearevement Support Services  11 CANADIAN MENTAL HEALTH ASSOCIATION – EDMONTON REGION | SUICIDE BEREAVEMENT SUPPORT SERVICES – INFORMATION PACKAGE REFERENCES The following books are key references used in writing this information package� Most of these books are available in bookstores, online and in many libraries� Bolton, Iris� 2005� My Son���My Son��� A Guide to Healing After Death, Loss or Suicide� Atlanta: Bolton� Doka, Kenneth J�, & Martin, Terry L� 2010� Grieving Beyond Gender: Understanding the Ways Men and Women Mourn� New York, NY: Routledge� Goldman, Linda� 2002� Breaking the Silence: A Guide to Help Children with Complicated Grief� London: Routledge� Kumar, Sameet M� 2003� Mindfulness for Prolonged Grief� A Guide to Healing after Loss When Depression, Anxiety, and Anger Won’t Go Away� Oakland, CA: New Harbinger� Levine, Peter� 2010� In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness� Berkeley, CA: North Atlantic Books� Neimeyer, Robert A� 2012� Techniques of Grief Therapy: Creative Practices for Counseling the Bereaved� New York, NY: Routledge� Thompson, Barbara E�, & Neimeyer, Robert A� 2014� Grief and the Expressive Arts: Practices for Creating Meaning� New York: NY: Routledge� Wolfelt, Alan� 2009� Understanding Your Suicide Grief: Ten Essential Touchstones for Finding Hope and Healing in Your Heart� Fort Collins, CO: Companion� Wolfelt, Alan� 2013� Finding the Words: How to Talk with Children and Teens about Death, Suicide, Funerals, Homicide, Cremation, and other End-of-Life Matters� Fort Collins, CO: Companion� Wolfelt, Alan� 2014� The Wilderness of Suicide Grief: Finding Your Way� Fort Collins, CO: Companion� END NOTES 1 Wolfelt, Alan 2 Wolfelt, Alan 3 Neimayer, Robert A� 4 Wolfelt, Alan 5 Bolton, Iris 6 Levine, Peter 7 Bolton, Iris 8 Kumar, Sameet M� 9 Goldman, Linda 10 Wolfelt, Alan 11 Doka, Kenneth J� & Martin, Terry L� 12 Neimayer, Robert A� 13 Thompson, Barbara E� & Neimeyer, Robert A�  Canadian Mental Health Association — Edmonton Region 300 – 10010 105 Street NW Edmonton, AB, Canada T5J 1C4 T: 780�414�6300 F: 780�482�7498 edmonton.cmha.ca @CMHAEdmonton Charitable # 118834316RR ACCREDITED BY MEMBER OF A PROGRAM FUNDED BY ALBERTA HEALTH SERVICES�