Dr Nandini Murali

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Navigating the grief of suicide loss - Dr Nandini Murali

Bereavement by suicide can be more intense and challenging than other forms of bereavement, and yet it does not elicit the same level of compassion and empathy

The death of a significant other by suicide is a stressor of unparalleled magnitude in most people’s lives and even the most psychologically mature individual may encounter difficulty in responding to it.

Edward Dunn, Suicide and its Aftermath: Understanding and Counseling the Survivors

Bereavement and grief are universal. Thomas Attig in How We Grieve: Relearning the Worlddifferentiates between grief and grieving. The latter, he says, is a constellation of emotions we experience when we are bereaved or lose someone dear to us. Grief is part of the bereavement process. While we have no choice over the bereavement, which is “choiceless”, we have every choice in how we respond to it.

Suicide shatters normative assumptions and stability in the suicide loss survivor’s world; it is an intensely confusing and profoundly isolating experience. Like people who have experienced other forms of bereavement, survivors of suicide loss also experience physical and emotional reactions to the loss experienced. Physical symptoms experienced can include headaches, stomach upsets, loss of appetite, trauma, heightened sensitivity to sound and light, fluctuations in blood pressure, insomnia and fatigue.

While suicide bereavement overlaps to some extent with non-suicidal bereavement, it is unique in several important ways. The self-inflicted manner of death is seen to violate fundamental norms of self-preservation – it induces very little social acceptance, barely having any space for validation. The stigma, shame, secrecy and silence that surrounds suicide tends to situate the act and the victim in a context of criminality or sin that perceives it as being indicative of a serious character flaw. The nature of this discourse effects survivors of the loss by spilling over to them, making it even harder for them to talk about it. More often than not, they choose to remain unseen, unheard and quiet when it comes to why their loved one died of suicide.

"Like grief with the volume turned on"

Whoever described suicide as a death like no other, knew what they were talking about. Bereavement in this context has been rather evocatively described as “grief with the volume turned on.” This simply means that emotions such as anger, fear, sadness and guilt that are common responses to loss are amplified and intensified in these cases. As a result, the grieving process is  longer and more complex, aptly termed as complicated grief.

A suicide death is sudden, violent and unexpected. Even if you have some inkling that it is a real possibility, nothing prepares you for the actuality of the loss. Whether you hear of it, discover the death or worse, witness it — it is very likely that you will feel overwhelmed with shock and an intense sense of disbelief that is disabling. Understandably, such an experience is often associated with a greater degree of trauma than other forms of bereavement (such as death caused b yhomicide, accidents or natural disasters).

Survivors of suicide loss are often confronted with two confounding and challenging questions: Why did my loved one chose to kill themselves? Could I have done something to anticipate and prevent it? These thoughts cause painful feelings of guilt and self-blame that are unique to this type of loss. In my case, my struggle to understand the motives behind why my spouse had taken this step were accompanied by feelings of rejection and abandonment. Going through these emotions isn’t something that is experienced in case of non-suicidal deaths.

The event of a suicide death does not elicit the same level of compassion and empathy in people to support the bereavement process as it does in case of other deaths. As a survivor of suicide loss myself, the huge empathy deficit I sensed in most people made me feel isolated, excluded and unloved. Most of my relatives seemed self-absorbed in their grief; to them they were  mourning the loss of someone who was incredibly precious to them. Their compassion and concern did not extend to and include me, except superficially so. Was it because people were so confused and stunned by the suicide that they didn’t know how to respond appropriately? Most friends’ responses were similar too. In such an atmosphere of ignorance and indifference, insensitivity and intrusiveness reign supreme.

Secondary victimization

A death by suicide is fodder for wild speculation and gossip  it is a public death, where the medico-legal implications of completed suicide are many. It leads to a high amount of insensitivity and intrusiveness by law enforcement authorities — interrogating the victim’s immediate relatives when they are most vulnerable because of the primary trauma results in secondary victimization that exacerbates what they are feeling.

The social processes surrounding suicide are mired in stigma, secrecy, shame and silence. Survivors of suicide loss, relatives and friends are unsure and confused about informed and sensitive responses. Its  social stigma acts as a mirror and as a result, survivors of suicide loss internalize the shame and negative societal attitudes towards it. They often tend to overemphasize their role in failing to prevent the suicide and tend to minimize the role of the risk factors that led to the act. There is also championing of the victim to highlight their acceptable parts, to reclaim a semblance of social acceptability and support.

Survivors often fear that they and the victim will be judged negatively and as a result,  isolate and withdraw themselves. In response to the stigma, they tend to gloss over the cause of the death or invent “acceptable” reasons. Such a loss of social networks and breakdown of interpersonal relationships both within the family and outside, delays or stunts the recovery and healing of survivors of suicide loss who remain unheard and unseen.

For the survivor, it would be very helpful if relatives and friends were to be sensitised to this issue. Where compassionate ways of responding and being there after such a big loss were thought of. This is a complicated matter that takes work to navigate but doing so will be much needed support for the survivor.

Dr Nandini Murali is a communications and gender and diversity professional. A recent survivor of suicide loss, she establishedSPEAK, an initiative of MS Chellamuthu Trust and Research Foundation, Madurai, to change conversations on suicide and promote mental health.

 

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