In the following pages we hope to outline the emotions you may experience, but it is important to remember that:

•  The process is unique to you

•  The emotions experienced are a natural part of the journey you will make

•  Tightness in the chest

•  Hollow feelings in the stomach

•  Breathlessness

•  Lack of concentration

•  Exhaustion

•  Lethargy

•  Physical pain

These feelings act as a 'cushion', to enable the survivor to cope with this terrible situation in which they find themselves. Looking for a reason for the decision is inevitable.



Guilt
Guilt is often an overriding emotion, survivors feeling in some way responsible for the death, and that the death was somehow preventable. The “if only” and “what ifs” come to mind over and over again:

•  "‘Could we have pre-vented this?”

•  “Did we actually contribute towards it?”

•  "We should have seen the signs”

•  “We are to blame!”

But if help was not sought, or signs not shown, how could survivors have known?

As well as self-blame, there is often a tendency to blame others, frequently within the close family, leading to a breakdown in communications. Members of the medical profession, the police, God and church friends, work, social circumstances —these are all targets for blame. Blaming is often a way of dealing with grief, giving only temporary relief and causing damage to relationships within family and friends — just at a time when support is needed.

it is realistic and must not be suppressed out of a sense of loyalty to the deceased.

It is important to realise that the deceased can be loved, but the action they have taken can cause anger. The anger may be directed to others, leading to blame. Anger is sometimes unacknowledged because of its connection with the feelings of guilt. These swings of emotions —from anger to guilt, to blame, to anger — may give rise to feelings of a loss of control — “going mad” and being different, and noticeably so.


Rejection
An overwhelming emotion, since the loved one has chosen to go, can be rejection, that those left behind were not worth living for, and perhaps not even given the opportunity to be of help. Feelings of unworthiness may lead to feelings of being unloved, and hence unlovable. This sense of rejection, if not questioned, may lead to insecurity and a sense of failure.

Following bereavement by suicide, the survivor may be left feeling vulnerable, wondering what will happen next, distrusting everything and everybody. This may lead to a loss of self-esteem and confidence, a fear of being let down, and sensitivity to any rejection, however small.


Relief
It may be difficult to admit to relief, but when depression, despair and unsuccessful suicide attempts have been experienced by family and friends, there may be relief following the final successful attempt, coupled, of course, with sadness. The deceased is no longer in despair, and the constant threat of suicide is over.


Shame
A stigma attached to suicide is still present in our society, and may give rise to a feeling of being judged and found wanting. Also, the loved one may be judged as cowardly or selfish. Society in general has difficulty in dealing with suicide, and will take many and varied efforts to avoid it. This leads to isolation — survivors feel they are alone with no opportunity to speak of the loved one.


Depression
Depression is almost inevitable following a bereavement by suicide. The constant swings of emotions questioning, physical pain and lack of sleep — will have an effect. It may be necessary to consult a doctor.

Effects on the family
Communication may be difficult because of family members' fear of hurting one another by speaking of the suicide, or perhaps there may be blame within the family. Each member will be affected in a different way, since each bore a different relationship to the deceased.

The differences need to be discussed. accepted and respected, as each member will grieve in their own way and in their own time.

Be kind to yourself
It is so important to understand that all the feelings mentioned are normal and to be expected, in varying degrees and at different times. No one can give a pattern for grief — it is different for all of us. Let the emotions be felt and do not attempt to fight them. Allow yourself to be sad, angry, guilty — do not let anyone else tell you how you should, or ought to feel. You have experienced a traumatic and terrible shock.

Give yourself time to heal.

Events will trigger emotions unexpectedly, but allow for this and do not be ashamed. You will never ‘get over it', but, in time, will learn to live with it. Life will never be the same again, never back to ‘normal', but you can create a new normal.
It can be hard to talk to people about what has happened – you may not be sure about what to tell people, or may be upset by other people's reactions.

Regardless of the circumstances, you will probably need support, perhaps from friends or family, or maybe from an independent source e.g. a counsellor or support group.

While grief is a “normal” process for individuals to work their way through, the death of a loved one by suicide is generally not experienced as “normal” although suicide is a commonly recognized cause of death. The needs of people bereaved by suicide are many and can be quite complex. Assistance and support can be forthcoming from a variety of sources.

Each source or contact can play an important role in helping the individual experience the normal process of grieving. Seeking help should be seen by the bereaved as a strength, not as a weakness, and as a vital step to the integration of the deceased person into their resumption of a full life. A range or variety of supports and assistance will offer choices to the individual, taking into account individual preferences.

Families
Families are the major source of support and assistance. Families that are able to share their grief have found this to be a major factor in coming to terms with the loss. The sharing of grief will also serve to strengthen the family unit. Factors that may assist families in achieving this are the family's openness to expressing grief, the absence of secrecy surrounding the death, and the understanding of family members' right to grieve in their own way.

Problems that may inhibit families from grieving together are:

• destructive coping strategies;

• hiding the pain;

• denying the feelings the death has brought;

• avoiding, by pushing the death out of consciousness;

• secrecy and hiding the means of death;

• fleeing - escaping from contacts and the environment that are associated with the person who has taken his or her life;

• working, as a coping strategy, and keeping extremely busy;

• developing addictive behaviours, e.g. eating disorders, abuse of alcohol or drugs;

• blaming family members for the death.

Self-help support groups can assist group members by sharing situations and discussing problem-solving strategies as they arise in the family setting.


Friends and Colleagues
Friends and colleagues have a vital role to play in assisting the bereaved. The reactions of those in close contact with the bereaved are important, as their support, care and understanding can provide the opportunity for a safe haven and relief.

On the other hand, negative or judgemental reactions may increase the distress and isolation of the survivors. Avoidance behaviour is common amongst friends and colleagues and can also occur within the families of the bereaved. Such behaviour may indicate ignorance of the facts relating to suicide or an inability to cope with the feelings that the suicide has raised for that person. Common fears which can inhibit communication and lead to avoidance behaviour may include:

• “I don't know what to say.”

• “I don't want to make it worse for them.”

• “They have lots of family/friends around, they don't need me.”

• “They need the help of a professional, there is nothing I can do.”

• “This is a personal family matter they don't need outsiders.”

• “What if I say the wrong thing?”

The self-help support group can provide the bereaved with an understanding of the reasons for behaviour relating to avoidance or negativity, thus opening the door to discussion and understanding.

Suicide, like homicide and “accidental” death, is generally perceived as an unnatural death that can be horrific. As suicides occur frequently in the home setting, the survivor may also have found the loved one. The mental anguish and torment, flashbacks and visualizations, as a result of the method chosen to take the person's life, will often stay with the bereaved for extended periods. Professional help is often necessary. Consulting the doctor of the bereaved can be the first step, as referrals can then be made.

Professional Assistance
Professional assistance can provide the opportunity for objective support. One of the benefits of professional support is that the bereaved will not feel that they have “burdened” the individual. This is a real fear in contacts with family and friends.

 

Health professionals of different types can provide assistance in a variety of ways. If physical health problems are experienced as a result of the bereavement, the local doctor can provide the care needed. Advice on general health care and symptoms that may be of concern to the bereaved, either in themselves or in family members, can be discussed and addressed.

If there are mental health or other stressful issues relating to the death, professional counsellors may provide relief by helping survivors in integrating the reality of the deceased and seeking meaningful solutions. A counsellor who specializes in or who has an understanding of grief issues can help the bereaved by providing them with an understanding of the grief process itself, thereby “normalizing” the feelings they are experiencing and reducing the sense of isolation.

Psychologists can work with the bereaved in resolving specific problems that may have arisen since the death, e.g. anxiety or panic attacks.

Psychiatrists can also play a vital role, particularly if the bereaved are experiencing prolonged depression in which they feel trapped. If they express the thought that they are “losing their mind”, the support of a psychiatrist and medication may be needed for a period.

“Normalizing” the use of specialist services is of vital importance.

Social workers can help the bereaved in integrating the social relationship impact of cultural taboos, social supports, professional resources and their personal responses in going through the grieving process

Information and support are also available through many internet sites, which may be particularly useful to people who are geographically isolated or prefer anonymity.

Help and Support- When is it time to get help?
Grief is painful and exhausting. It is not always easy to decide when it might be time to get help. You might choose to seek help if you:

•  continue to feel numb and empty some months after the death

•  cannot sleep or suffer nightmares

•  feel you cannot handle intense feelings or physical sensations such as exhaustion, confusion, anxiety or panic, chronic tension

•  feel overwhelmed by the thoughts and feelings brought about by a loved one's death, e.g. anger, guilt, rejection

•  feel the need to share your grief but have no-one with whom to do so

•  keep constantly active in order not to feel (e.g. working all the time)

•  find you have been drinking or taking drugs to excess

•  find you are worrying and thinking about suicide yourself

•  feel afraid that those around you are vulnerable and not coping.

 

If you feel that professional help would help you through this terrible time contact your doctor in the first instance. G.P.'s are well equipped to help you and refer you to individuals or groups that will support and guide you through this terrible time. If you prefer you can get in touch with some of the groups on the internet who deal exclusively with bereavement from suicide.