How can you help when bereaved by suicide?

The keys to support for someone grieving the suicide of a loved one.

We know that mourning the expected (e.g., terminal illness) or unexpected (e.g., traffic accident) death of a loved one, partner or friend is a complex emotional response that can lead to periods of stress, sadness, isolation, depression, anxiety and even deterioration of the survivor's relationships and both physical and mental health.

We also know that bereavement by suicide is a very difficult situation that can generate many questions and few answers, doubts, confusion, guilt, guilt, reluctance and anxiety.We also know that suicide bereavement is a very difficult situation that can generate many questions and few answers, doubts, confusion, guilt, recrimination, concealment, shame, and even the stigma of being the survivor of a person who decided to die before his or her time but for different reasons.

The psychological impact of suicide

The news of a suicide has an impact, there is no doubt. If it does so in the case of a subject we do not know, how will it be in the case of one we do know, a person we have appreciated, loved, treated? It is a fact that shocks, impresses and hurts us. Then we close our eyes, take a deep breath and wish with all our Heart that it would not be like that... that such an event would not happen.... that such an event never happens or has never happened.

However, we also know that even if we don't see it and even if we don't talk so openly about this global public health problem, because it is still considered a taboo, it does exist, and more than we would like.

Suicide figures

According to the latest statistics from the World Health Organization (WHO), about 700,000 people commit suicide every year.Suicide is the fourth leading cause of death among young people aged 15 to 19 years, and the main risk factor is suicide attempts.

In fact, it is said that for every completed suicide, there are many other unfinished attempts. That is also why specialists indicate that the problem must be made visible, it must be tackled to prevent more deaths and ask for specialized help when needed.

For its part, Spain's National Statistics Institute (INE) published in its latest report "Deaths by cause of death", which was released in December 2020, that suicide continued to be the leading cause of external death during the first five months of 2020. Despite the fact that 1,343 people died for this reason, there was a decrease of 8.8% compared to the same period in 2019.

Likewise, the Chair Against Stigma, of the company Grupo 5 and the Complutense University of Madrid (UCM), reported that, based on data from the INE in 2019, suicide became the leading cause of death of young people in Spain and that it is ahead of traffic accident statistics.

Psychological support for bereavement due to suicide of loved ones

But let us delve a little into what to do in the face of grief for this cause; a route of protection and management of the situation in order to be able to move forward in the best possible way.

In this regard, in addition to, for example, the assistance of a psychologist, there are also mutual support groups, for example, also contribute through which one can share different experiences, empathize, drain and know that one is not alone.

As a clinical psychologist I can say that (based on my experience and on what I normally do in the consulting room) when someone seeks to be heard and asks for help for the pain that hurts him/her and that cannot be explained, the first helpful action is to to open a safe space in which the patient can drain the pain that is in his or her broken heart.. Before any elaboration, emotions must be allowed to be released, that is, catharsis must take place, but without any interruption and without judgment. My first step, then, is just to let it out.

Another priority task in helping to cope with grief is to propose a self-care program to avoid complications. To this end, I ask for rest as much as possible or the reduction of irrelevant tasks, I invite the mourner to think about himself, to visualize himself fractured in the deepest part of his being, so that he can carry out compassionate actions that allow him to take care of himself.

At the same time, there is the need to construct rituals that will lead to the lodging of the love that was maintained in the relationship with the person who has died.. We work on the idea that death does not mean the end of a love relationship, but the inevitable transformation of that relationship, but now on a spiritual plane.

In addition, in therapy I work on the acceptance of the spaces, the blank fragments that a suicide will always leave. It is necessary to support this emptiness, to suspend the questions that have no answer, to stop the imaginary ones with which the mourner tries to fill the blanks.... This is a difficult task, very difficult, but with accompaniment, those going through grief can succeed. It is a natural truth of our human condition that there are difficulties and pain in life, but not because we do something wrong. There are difficulties and pain in life, but not because we do something wrong..

Therefore, it is a great help to understand that the emotions we have, the negative and the positive ones, are precisely the ones we need to feel human, to be aware and to recognize that we are alive.

On the other hand, walking the path of grief, without thinking of a place of arrival, but being aware of the journey, will allow the mourner to withstand the pain.will allow the mourner to resist, process and elaborate the grief.

It will also help to be able to construct a narrative of the "death", including the word "suicide" and the phrase "I don't know" without burden or guilt, and to elaborate from there on everything that is happening.and to elaborate from there on everything that is presented, everything that happens.

During the elaboration, it is necessary to allow and work to make sense of the suffering, and later to become aware of or construct a purposeful meaning in life.

Going through a mourning process leads, finally, to to feel the truth of grief in the face of death. Through an active process we connect with grief and despair, but step by step we must achieve recognition and acceptance of the losses.

Author: Indira Ullauri, clinical psychologist and general manager of Superar Centro Integral de Psicología.