Suicide Bereavement and After Death Communications: Preliminary Findings from Our Research

By Sally Spencer-Thomas
AAS Survivor Division Director

At the International Association for Suicide Prevention Congress in 2009, Tony Gee, a suicidologist from Australia said, “…when we closely look at the bereavement literature we find that it tells us time and time again, that the ‘lived experience’ of the bereaved has a range of dimensions, some of which may in fact be quite different from what some of the traditional theories (really coming from that ‘objective’ realm) have been prepared to recognize….”

He went on to explain that the continuing bond between the deceased and the living seems to continue on two levels:

1) “an internal representation, living on in memory, being part of the internal self-structure, being a sort of constant internal companion,” and

2) “an actual sense of presence of the deceased as a separate individual identity who is still around in some way after death and this presence may be experienced in a number of different ways.”

He described the two as not mutually exclusive.

This past spring Danielle Jahn and I, with support from Texas Tech University, conducted a survey asking people bereaved by suicide about these types of experiences.

Our recruitment efforts stated “People bereaved by suicide needed for research on spiritual experiences subsequent to their loss,” and we sent requests for participation to members of or visitors to the following:

· American Association of Suicidology

· International Association for Suicide Prevention

· Survivor Support Networks

· Social Media (Facebook, Twitter)

We got a strong response: almost 700 people completed our questionnaire. While it will be months before we have a published report of our findings, I wanted to give the membership a sense of what we discovered initially:

· About 70% of our sample experienced some sort of“spiritual experience” with their loved one who died by suicide.

· The most common manifestation was dreaming of the deceased (72%), followed by feeling the presence of the deceased (51%) and experiencing profound coincidences (41%).

· About one third of our sample experienced their first “sign” immediately after death and another third experienced it within the first month.

· About 90% of our group told another person about their after-death communication, and most found that the person they told was supportive or intrigued, but a few felt discounted. People most often told included:

o Friends and family

o Support groups

o Faith leaders

o Mental health professionals

o Psychics

o The most common emotional reactions to these experiences were love (60%), peace (55%), and sadness (47%).

Some of the survey responses that people wrote were deeply moving:

·       “My son came to me in a dream about 2 weeks after he died. He said mom, ‘I'm sorry, I can't get back.’ I said, ‘It's okay, I will see you again.’ I felt his hug and then I woke up. A few weeks later I had another dream. I went to hug him and I knew he was gone. He has moved on to another place.”

·     “The dream was most profound. It seemed so real. My son, who I found after he shot himself, came to me in dream as a toddler. He was wearing a striped shirt that he wore as a child. The following day, an old friend, who lives I'm another state, sent a photo she found of him with my deceased father. He was wearing the same shirt as in the dream. My friend and I had not spoken since his death and she had no knowledge of the dream. I had cried all morning after and even described the shirt to my husband before we received the photo. My only son was 28 when he died.”

·      “Initially, I 'lost' my faith, not sure I really 'believed' anymore. The Spiritual experiences were gentle, if not shocking reminders that God wasn't going to abandon me because I was doubting my upbringing and teachings. In fact, it was expected, and I knew 'God' would wait and be patient as I struggled on my grief journey. I was approached by total strangers in moments of need…music with specific messages at crucial times…. I even had one 'visitation' by the Holy Trinity (Father, Son, Holy Ghost), unmistakable, and life-changing, in all places, in the Washington DC Metro. I am a physician, a scientist, and also an advocate social worker, with expertise in mental health and emotional conditions. My perspective on mental fitness is totally changed, with a new-found realization how much we avoid dealing with‘Spiritual Fitness.’”

Michelle Linn-Gust has often said, “The bond is not broken; the bond is changed. People really need to know that their loved one is still part of their life. There is so much fear that if we move forward we are letting them go.”

If you have experienced an after-death communication that you would like to share with me, I invite you to contact me atSally@CarsonJSpencer.org.

Reposted with permission from the American Association for Suicidology.

Tensions in Postvention: An International Dialogue Part I

By Sally Spencer-Thomas

In the aftermath of a suicide, several needs are evident —psychological first aid for those most directly affected, help for communities as they return to a level of functioning, and surveillance for vulnerable individuals who might be harmed by contagion. The strategies to achieve meeting these needs sometimes come into conflict with one another and create tension in our postvention efforts. Well-meaning and well-informed people can find themselves firmly standing on one side or another of these points of potential disagreement, complicating an already difficult process.

In September this year, I had the honor of facilitating an international discussion on the “Tensions in Postvention” at the International Association of Suicide Prevention’s (IASP) World Congress in Beijing. About two dozen people gathered to join some of the top suicidologists from around the globe as we explored the challenges of supporting individuals, families and communities in the aftermath of a suicide. Among the invited participants were:

· Karl Andriessen, M.Suicidology, (BELGIUM), Coordinator of the Suicide Prevention Program of the Flemish Mental Health Centres, and Co-Chair of the IASP Taskforce on Suicide Bereavement and Postvention. He is a tireless advocate for the needs of people bereaved by suicide.
· Prof. Onja Grad, PhD, (SLOVENIA), clinical psychologist who has worked with survivors on a daily basis for the past 22 years — with individuals, families, groups. She is also a teacher at the University of Ljubljana School of Medicine.
· Myfanwy Maple, PhD, BSW (Honours Degree), (AUSTRALIA), senior Lecturer, Social Work Course Coordinator, School of Health. He is a social work academic and researcher in suicide bereavement over the past decade, particularly examining the experiences of individual family members experience of loss.
· Sandra Palmer, Ph.D. (NEW ZEALAND), a registered psychologist and Clinical Manager Community Postvention Response Service, and provides support to communities experiencing suicide clusters or contagion. She continually faces the challenge of balancing the need for communities and families to honor the loss of loved ones with safe postvention practices to manage contagion to prevent further losses in the community.
· John Peters, M.Suicidology (UNITED KINGDOM), lost his son to suicide 19 years ago and has for many years been a volunteer with Survivors of Bereavement by Suicide including staffing their Helpline each week and running peer-led support groups and an annual support day.
· Diana Sands, PhD, (AUSTRALIA), Director, Bereaved by Suicide Service; has worked with families bereaved by suicide for over twenty years, produced a film and wrote a book for children bereaved by suicide. She will speak to the complex and sensitive issues regarding how to talk with children bereaved by suicide.

During this session we discussed the following questions:

1) How can we balance the need to prevent contagion with the need to honor loss?
2) How do we balance getting a familiar sense of normalcy with the acknowledgement of significance to a community that has been deeply affected by a suicide loss?
3) Do we tell children about suicide or not? When do we tell them? How much information?
4) What services do we provide – lay led, professionally facilitated or some combination? Knowing that the research indicates the benefits of peer led efforts, how do we manage quality control and sustainability?
5) How do we safely involve survivors or suicide loss and attempts in research? What are the best protocols for this?

In this column, I will review the discussion of the first two questions, and in the next issue of Newslink I will review the discussion of the last three questions.
How can we balance the need to prevent contagion with the need to honor loss? 

As we opened the discussion many participants shared examples of how communities have navigated the balance between what family and close friends want and what is safe for the community. Sandra Palmer talked about how t-shirts printed with pictures of lost loved ones are commonly seen at funerals and memorialization events. She went on to describe how families when told about the potential risk will also print a hotline number or other resource on the t-shirt. I talked about how candle lighting ceremonies are common and how we can help communities make these events safer by coaching the event planners on safe messaging and surrounding the attendees with helpful resources. Jill Fisher of Australia talked about framing a memorial event as a remembrance event celebrating life rather than over-emphasizing the circumstances of a death.

Sandra Palmer: “What we are getting to is about balance.”

Jill Fisher: “We try to do a number of activities to meet a number of needs of the bereaved.”

Onja Grad: “[The response] has to be right away.”

Diane Sands: “Schools are much more careful. Families are more thoughtful and respectful to the community. We can rely on folk to be more thoughtful.”
As in many provocative discussions attendees raised additional questions:

· How can we be proactive in our efforts with families and communities so they understand the risks?
· Knowing that it is never anyone’s intention to cause additional harm, how do we explain to families that there is a risk in doing things the way they planned?
· Many families, including my own, have a huge desire to do prevention work right away, and yet without proper time to grieve and heal sometimes these efforts crash and burn, causing additional hardship. How can we counsel people to heal first and engage in prevention activities later?
· How do we support people in bereavement when we are not of the grieving family’s culture?
· How do we promote young people’s safety while giving them the space to grieve in their own way, which often includes very public expressions through social media? For instance, youth sometimes post on their deceased friend’s Facebook page. Sometimes the outpouring reflects their grief at the loss like a public shrine of flowers and stuffed animials might. Others post comments like “you are now in a better place,” thereby romanticizing the death and minimizing the tragedy.

The general consensus of the group was that both honoring loss and preventing contagion are possible. With outreach to new survivors and supportive instruction about preventing contagion, we can allow a safe space for the bereaved to mourn and direct the grief energy so that risk factors for contagion are minimized.

[To watch this Part I of the discussion: http://www.youtube.com/watch?v=0kIoXoCvrz4 ]

How do we balance getting a familiar sense of normalcy with the acknowledgement of significance to a community that has been deeply affected by a suicide loss? 
This question revolves around a community response to suicide. We noted that returning to a previous routine can be grounding for many after a trauma; it offers structure and a sense of familiarity. Nevertheless, moving too quickly or too completely to “business as usual” can make those closest to the loss feel discounted.

We also acknowledged that in larger systems and communities there will often be many people who are not affected at all by the death, and if we go in “all guns blazing” we can do harm.

Many cited George Bonanno’s work (Bonanno, 2004) on resiliency after trauma and emphasized the potential strength of the human spirit and the power of communities pulling together after a loss like suicide. The key to finding the right balance revolved around framing the interventions as choices with the understanding that different survivors need different things at different points in their grief journey. Jill Fisher called her approach an invitation of the “lightest touch” so that what we offer won’t interfere with the natural resilience that exists.

As Jill noted, “After a suicide you find police, criminal investigators, medical rescue professionals, coroners — up to 10 people in your home — that you have no right to say ‘no’ to. You are invaded. We want to make sure that the bereavement support is a choice you’ve made.”

The group also explored the reality that not all suicide deaths impact communities in the same way. For instance a school that has been rocked by multiple deaths usually experiences heightened anxiety and fear as rumors escalate. For these communities, “returning to normal” might require more conversations of assurance.

One participant described this particular tension in postvention: “Grief is a natural process, and when you put shutters around it, damage can be done. The bereaved will let you know what they need; our role is to support them.”

While the cultures and languages of this diverse group of experts varied, the themes of the challenges were similar. By sharing lessons learned and stories of success, we forged a solidarity in our efforts to support people bereaved by suicide.

Reference:
Bonanno, G. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 20-28.

Sally Spencer-Thomas is CEO and co-founder, Carson J Spencer Foundation, founded after the suicide of her brother. The foundation is known for preventing suicide in the workplace, coaching youth social entrepreneurs to be the next generation of suicide prevention advocates, and supporting the bereaved. She is AAS Survivor Division Chair.

"Reposted with permission from the American Association for Suicidology" follow this link to see the article in Newslink.

 

Your Experience

Have you lost a co-worker or colleague to suicide? We would like to open the blog to discussing the topic of loss in the workplace. How has it affected you? Have you found the work environment to be supportive or unsupportive of you at this difficult time? Please share your stories, thoughts, and concerns here in this supportive environment.

Coping with Suicide Loss

Coping with Suicide Loss - Complex Healing Process

A. Beyond Surviving

No two people will grieve in the same way. Some will find support groups helpful; others may rely on friends' support. Some may turn to books; others may go to therapy. Some may take weeks to get back to "normal life"; others may find that life as they remember it no longer exists and they need to redefine themselves. Our response to the aftermath of suicide is shaped by a number of things - past experiences with death and loss, other current life stressors, our mental health, our family cultural traditions, our relationship with the deceased (e.g., strength of bond, presence of conflict, etc.), the circumstances surrounding the death, our support system, and our personality.

People feel a range of emotions in the aftermath of suicide - not everyone will go through all of these experiences and the length of each may differ, but these are common emotional reactions that often come like a tidal wave unexpectedly and repeatedly.

· Guilt and self-blame for not being able to prevent the suicide
· Anger at the person who died, at the world, at God, at yourself
· Experiencing suicidal thoughts yourself
· Depression and incredible sadness triggered by anything from major life milestones to a song on the radio

During the healing process, it is important to be patient with yourself and take each day as it comes. Surround yourself with caring people who do not try to fix things, but just listen without judgment. Set limits and postpone any major decisions if you can during this time. Basic self-care - eating, sleeping, hydration - are very important to feeling more stable and better able to handle the intense emotions. Avoid alcohol abuse and other mood altering substances - while they may alleviate the pain in the short-run, they tend to exacerbate depression and pain in the long run.

B. Coping with Holidays, Anniversaries and Birthdays: New Traditions and Healing Rituals

With an empty chair around the table, important celebrations can be particularly hard for suicide survivors. Before the holiday arrives, talk with the family about the expectations and consider creating some new traditions. For some, it may be better to be all together while others might prefer to be by themselves. Usually the anticipation of the holiday is worse than the actual day. There is not a right way to approach these days - find a way that works for you.

The death anniversary can also be a difficult time for survivors. Many find comfort in participating in some form of healing ritual of remembrance to honor the life of the loved one. Rituals serve many purposes for the suicide survivors. They make changes manageable and mark transitions. Rituals communicate values and beliefs while providing containment for strong emotions. The power of rituals comes from the fact that they often provoke deep emotional experiences that hold a level of meaning that words cannot capture. These practices may be done alone or with others: · Plant a memorial garden or tree. · Dove release or balloon release. · Candle lighting ceremony. · Write a poem or letter and release it to the universe by burning it.

For more information on surviving after suicide please visit The Carson J Spencer Foundation Website.