BEHAVIOR

Arresting the suicide cycle

Support groups are helping the other victims of suicide contend with their bereavement

Penelope Jahn August 10 1981
BEHAVIOR

Arresting the suicide cycle

Support groups are helping the other victims of suicide contend with their bereavement

Penelope Jahn August 10 1981

Arresting the suicide cycle

BEHAVIOR

Support groups are helping the other victims of suicide contend with their bereavement

Penelope Jahn

I knew she’d do it,” a 33-year-old librarian remembers thinking when a long-distance call informed her of her mother’s suicide. Several previous attempts had warned of this final loss that left her an orphan at 20. “I didn’t grieve. I went home and in 13 days I’d cleaned up her life.” Three months later, the bereaved daughter cried for the first time and didn’t stop for almost 10 years. Only then —after drug and alcohol binges, confinements for psychiatric care and several suicide attempts of her own — could she accept the fact that her mother had chosen to die. “Before that, I was nothing but a living suicide.”

Mental health professionals have long recognized that a suicide is possibly the most difficult of all bereavements. Mourning the loss of a loved one by natural or accidental means has been described as a sequence: first shock, then emptiness that changes to anger at the abandonment, and finally future plans made in recognition of the death. By contrast, survivors of a suicide get “stuck,” as counsellors explain, in the earliest stage. Obsessed with the cause of death, they look for clues to their own responsibility. Although statistical data is scanty, case studies have identified survivors as a high-risk group for

suicide—which ranks a startling third among causes of death for people between the ages of 5 and 35. But only recently have support groups cropped up to meet the common needs of suicide’s other victims.

Toronto’s two-year-old Survivor Support Program (SSP), the first of its kind in this country, emphasizes sensitive counselling for individual families, followed by group sessions with other survivors. Thirty skilled volunteers expect to help 50 families in the coming year

“learn to live,” as one participant says, “with the presence of absence.” They will also be challenging a long-entrenched stigma. Although a suicide attempt is no longer a criminal offence, the shame still torments survivors. As one man puts it, “Nobody refers to me as a widower, but as the guy whose wife killed herself.”

The Toronto group signals an idea whose time has come. Last month the Greater Vancouver Mental Health Service planned a similar service developed by suicide attempt counsellors Linda Rosenfeld and Marilynne Prupas. Dr. Mark Solomon, provincial suicidologist for the Alberta government (the only post of its kind in Canada), begins a group for Edmonton survivors in September. And in Peterborough, Ont., crisis-centre organizer Barbara Moffat is arranging an open meeting for survivors and concerned professionals to take place in October. Interestingly, the prime indicator of a need unmet was not the callers on the 24-hour crisis lines, but the people who volunteered to man the phones. Says Moffat: “At least one or two in every training program seems to be a survivor.”

Overwhelmed by guilt, survivors tend to be passive. “It’s sometimes difficult for them to go out. But we care enough to come to them,” explains SSP Director Karen Letofsky of the eight sessions that a team of two, one a survivor, spends with the bereaved family. One team member provides empathy, the other assurance that the outside world can understand. This delicate balance,

the product of two years’ consultation between the Clarke Institute of Psychiatry and the community-based Distress Centre Inc., aims to avoid the flaws of the first self-help groups in the U.S., which memorialized the dead. One such group published a newsletter containing poems about suicides six years before. “We don’t want people to become professional survivors,” insists Letofsky.

The SSP’s approach focuses on family relationships, which can deteriorate after a suicide. Letofsky recounts a typical story: when her daughter died, one 45-year-old working mother found herself made the scapegoat by the other family members. Their innuendoes and even the way they sat during sessions telegraphed exclusion —until, at the end of eight weeks, they could sit beside her and touch her.

Anita Birt, one of SSP’s founding volunteers, has helped many bereaved parents, whom she describes as “normal people who have often worked desperately hard, really knocked themselves out for their kids, but they tend to deny this after the death. Our work involves surfacing that feeling.” Yet while survivor groups have proven effective in countering the “if only I had . . .” grief of parents, organizers admit that young children of suicides have special problems that leave counsellors stymied. All too frequently, it’s the children who find the body. Almost as often, telling a child the truth about daddy’s death confounds parents. Typically, the widowed parent first offers a supposedly comforting fiction, then becomes aloof to avoid the need for elaborate deceptions. Meanwhile, explains Marilynne Prupas, “the parent feels that everyone knows and is terrified that someone will tell his child.”

Putting the family pieces back together is like closing a wound. Often the final stage of mourning takes a concrete form, as Karen Letofsky can attest. One 32-year-old secretary turned to the SSP more than a year after her husband’s death, when she finally confronted the fact that the new men in her life had the same drug and alcohol problems as her dead spouse. After he killed himself, she still hoarded his belongings. But at her last therapy session she met her team at the door with all of his possessions packed in boxes, which the three of them dropped off with the Salvation Army.

Some survivors bring the recovery process full circle: the SSP encourages its graduates to volunteer as counsellors, providing that at least two years have passed since the suicide. Says the librarian, now a team member: “Working in this program is the last stage of my bereavement. I’m proof that suicide can be survived.”