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PARADOX REQUIRES CAREFUL SCRUTINY OF HELP FOR SUICIDE BEREAVED

5/18/2015

By Franklin Cook

A recent blog post on Grief After Suicide argues (convincingly, I hope) that suicide bereavement is unique because suicide itself is a unique way to die. Yet, at the same time, an abundance of research -- not to mention the universality of the human experience of grief -- points to a paradox, namely, that all bereavement over the death of a loved one shares a great deal in common. In other words, grief after suicide is, simultaneously, both different than and similar to bereavement following other means of death.

Understanding and accounting for this paradox is important because, as is stated in recently released national guidelines on responding to suicide, created by the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention:*

Suicide grief support is an emerging field of practice poised to gain strength from newer understandings of bereavement adaptation in thanatology [the study of death and bereavement].

This emerging field would benefit tremendously from looking more closely at -- and acting more collaboratively with -- the field of grief counseling (as well as other fields, such as traumatology, mental health crisis response, and disaster response). Doing so would enrich and strengthen suicide grief support through the application of evidence-based and promising practices that are already proving to be effective with a variety of bereaved people. Taking this multi-disciplinary approach would prevent responses to suicide grief from evolving based on narrow or monolithic ideas centered primarily around what is unique about suicide bereavement.

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SUICIDE GRIEF IS UNIQUE BECAUSE DEATH BY SUICIDE IS UNIQUE

4/26/2015

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By Franklin Cook

Perhaps the word unique is too restrictive in a discussion of universal phenomena such as death or grief, but according to new national guidelines* for responding to suicide, considering such a perspective ...

... opens the door to asking not only "What makes grief after suicide different?" but also "How does the distinctive nature of suicide itself affect the bereavement experience of survivors?"

Responding to Grief, Trauma, and Distress After a Suicide: U.S. National Guidelines suggests that death by suicide can raise questions about the deceased's volition and whether the death was preventable as well as about the role of stigma and of trauma in the death. The emotional reactions of loss survivors to a particular suicide, the argument goes, can be shaped by how each person experiences the death along the continua of it being willfull or not, preventable or not, stigmatized or not, and traumatic or not.

This idea is one of several fresh perspectives offered in the guidelines, which were created by the Survivors of Suicide Loss Task Force of the National Action Alliance for Suicide Prevention to advance a vision for reinventing postvention in America and creating ...

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FJC ON THE ROAD: NEW SUPPORT GROUP FACILITATION MODEL PROVES USEFUL

11/8/2013

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Until mid-December, I'll be writing "FJC On the Road" posts to keep readers up-to-date on my travels and on my reflections about suicide bereavement. FJC

There has been a two-week hiatus in posts on Grief after Suicide because I am on the road, having driven from my home in Watertown, Mass., to Colorado Springs, Colo., for last weekend's TAPS National Military Suicide Survivor Seminar. This is the second year I have attended the TAPS (Tragedy Assistance Program for Survivors) event as a trainer of peer helpers on suicide bereavement support group facilitation. I've used the opportunity to refine a facilitation model of my own creation,* called "Peer Sharing Circles."

Peer Sharing Circles are governed by fewer, simpler, and more generally stated "ground rules" (called "Protocols") than those in other mutual-help group approaches. Here are the Protocols:
• I agree to listen attentively and respectfully to the person who is speaking (only one person speaks at a time).
• I agree to talk only about my own experiences and to refer only to my own thoughts, feelings, and beliefs.
• I agree to speak to the whole group (not to just one individual).
• I agree not to judge others, correct others, or give advice to others.
• I agree to keep confidential what is said within the Circle.
• I agree to give the facilitator my attention when he or she asks me to.

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POWER OF SURVIVOR CIRCLE EXEMPLIFIED IN SIMPLE, PASSIONATE FILM

9/26/2013

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I encountered a fantastic film that tells the story of surviving suicide loss candidly and informally, covering the subject in-depth and completely, in a way that very few resources I know of accomplish. The film, "Survivors of Suicide Loss,"* offers a profound and intimate viewing experience, and I recommend it highly to anyone who has lost a loved one to suicide and to everyone who offers assistance to people bereaved by suicide.

The film is basically 90 minutes of five survivors sitting in a circle talking, and even though this approach gives it a homemade feel, the impact of what these survivors say collectively and individually is powerful. The participants, Erika, Andrea, Larry, and Chris, and the facilitator, Penny, demonstrate how enlightening and inspiring -- and hopeful -- it can be when survivors get together and speak from the heart.

I am keeping my recommendation brief because the film speaks for itself, but I do want to say one thing about it that is truly exceptional: Although all of the survivors share their story in a very courageous and helpful way, the one man in the circle, Larry, provides an extraordinary counterpoint to the stereotype that bereaved men are "unable to talk about it" or "unable to express their emotions." I mention this not to compare his story to any of the others (which are all superb) but rather to emphasize in my recommendation that viewing this film would be especially helpful to any man bereaved by suicide.

*Knapp, P. (2012). Survivors of suicide loss: Resource DVD. London, Ontario, Canada: MIKO Productions. Available for purchase here (for a donation plus shipping costs).

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'TAPS' MILITARY SURVIVOR OUTREACH IS A MODEL FOR SUICIDE GRIEF SUPPORT

9/14/2013

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Between 20 and 30 percent of the bereaved who receive support from the private organization best known for serving those who have lost a military loved one are, in fact, suicide survivors, according to Bonnie Carroll, founder of the Tragedy Assistance Program for Survivors (TAPS). In a Huffington Post article, Bonnie writes,

Every day, three to four people contact ... TAPS for the very first time seeking help and support in coping with the death by suicide of a loved one who served in our Armed Forces. They join the more than 4,000 people grieving a death by suicide who are already part of our community of care and support at TAPS.

In fact, TAPS annually conducts the most extensive healing conference in the world exclusively for survivors of suicide loss (this year's conference is Nov. 1-3 in Colorado Springs, Colo.).

Bonnie's husband died in a military aviation accident in 1992, and for two decades, she has been a tireless advocate for the bereaved families of those who serve or have served in the military. TAPS offers a variety of support and professional resources to the bereaved, and it is a pioneer in comprehensive peer support services, including a mentor program that matches a newly bereaved person with a trained peer helper.

We have found that people find healing and comfort in peer support and connecting with others who experience a similar loss.

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REPORTER DELIVERS POIGNANT STORIES OF FIVE BEREAVED TEENAGE BOYS

7/18/2013

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If you have any interest at all in teenage boys and grief, this is a must read: Reporter John Faherty takes a rare look at the grief journeys of five boys in "The Rules of Grieving: They Are Still Boys." The teens have all lost parents (none of them died by suicide), and over the span of a school year, Faherty attended the monthly grief group at their high school. His in-depth story highlights 17-year-old Phillip Bryant, whose mother died when he was four years old and whose father died in 2012, as well as:

The Smallwood brothers, Chuck and William, lost their dad to liver disease in 2011. Chuck keeps his hair long. William keeps his short. Both think it is important that people know their father's liver disease was genetic, not because of drinking.

Andrew Kraus lost his father and still doesn't like to hear his name called out over the school intercom because that's how he was summoned to the office in January 2012. His mother was there and the news was bad.

Zach Deck's mother, Jaimie, died in 2010 when she was 32. She died suddenly, at home, after a blood clot broke loose and entered her lungs. Zach woke that night to the sound of a panicked call from his stepfather to 911. He still cringes each time he hears a siren.

Faherty's moving story is accompanied by brief and poignant videos (less than a minute long) from each of the boys, which give voice to a profound truth each has found in his grief. Phillip is also interviewed in a longer video, in which he says,

"I looked at death as a greater thing. It comes and goes as it pleases, and there's no stopping that ... If death comes ... it's for a reason. You leave for an ultimate goal. You don't know what it is, and you question why. You kind of learn to accept it, I guess."

For more information on resources for bereaved teenagers, see the Grief after Suicide post "Teen Resource Focuses on Grief from Teen's Perspective."

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GUIDING PRINCIPLES ANNOUNCED FOR SUICIDE BEREAVEMENT SUPPORT GROUPS IN U.S.

4/30/2013

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I was on a panel at the American Association of Suicidology (AAS) national conference last week in Austin, Texas, that introduced new guiding principles for Suicide Bereavement Support Groups (SBSG) in the United States. The guiding principles were developed by an AAS work group last year, and have been approved by the AAS board of directors. These guiding principles provide a starting place for the development of best practices for support groups designed to help people who have lost a loved one to suicide cope with their grief.

Work group chairperson Doreen Marshall of Argosy University facilitated the presentation in Austin on Saturday, and she was joined by me and fellow work group member Susan Beaton of Australia's Beyond Blue.* According to Marshall, the work group intended for the principles ...

... to be less prescriptive, easy to implement, and require few resources ... We felt it was ... important to develop guiding principles by which survivors could ... evaluate the groups they were leading and attending in addition to providing some guidance toward best practices.

Beaton, who played a role in the development of Australia's support group standards -- on which the AAS guiding principles are based -- said many lessons are being learned as the field of suicide grief support increasingly focuses on strengthening the effectiveness of support groups and other services. Her aspirations include ...

... further research ... to determine types and modalities of suicide bereavement support related to better client outcomes, ... a national community of practice for SBSG facilitators, ... [and] funding ... for ongoing evaluation.

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FREE ONLINE TOOL POINTS TO TOP SUICIDE GRIEF RESOURCES

1/17/2013

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Expert information about grief after suicide -- plus links to nearly a hundred of the top resources for survivors of suicide loss and those who care for them -- are available from the Suicide Grief Support Quick Reference. The free online tool features content that is up-to-date and dependable, including:

• Introduction - Suicide Grief Support: Explains survivors' experiences and needs, describes reactions to trauma, and covers how to be helpful
• Resources for Survivors: Links to websites, booklets, and handouts designed for survivors, and offers information on support groups, school and community postvention, and special populations (such as the military and people of color)
• Resources for Children: Lists websites, materials, and information about how to help children after a suicide
• Online Support for Survivors: Provides links to discussion forums, listservs, chat rooms, and blogs especially for survivors of suicide
• Guidance for Caregivers: Points to information on key principles as well as to resources for survivors who are also caregivers

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'GRIEF AFTER SUICIDE' IS A 'MUST READ' FOR CAREGIVERS

8/31/2012

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Grief after Suicide: Understanding the Consequences and Caring for the Survivors, edited by John R. Jordan and John L. McIntosh, is a groundbreaking book featuring in-depth coverage of every aspect of suicide grief support. The book's goals, according to its editors,

are to establish not only what is known about suicide survivors and postvention efforts to assist them, but also to draw attention to vital information that is not known but would help us to better understand and assist survivors of suicide ... [including] recommendations for future research and postvention goals for the future.

The editors and more than 40 contributors to the book's chapters solidly accomplish those goals, covering in-depth and comprehensively the most up-to-date information about an impressive range of topics of interest to people working with the suicide bereaved. The editors begin by asking and attempting to answer several fundamental questions:

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GRIEVING PEOPLE'S GOALS DIFFER, BUT RECOVERY PRINCIPLES CAN SHOW THE WAY

5/7/2012

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Over the years, as I have worked with (and learned a great deal from) people who have lost a loved one to suicide, I have tried to understand what the goal of grief is. Is it to move on? To heal? To go on a journey? To integrate the loss? To make meaning of the death? All of these goals -- and many, many more -- have been named for me as different people's ideas of what the objectives of grief might be.

And the conclusion I have come to is that every bereaved person's goal is different.

However, as a grief support practitioner -- someone who tries to help bereaved people -- I have found it important to have goals for myself as I do my work, and it has been useful to me to view grief through the lens of recovery. If I am guided by the principles of recovery, I can focus on the process, and the bereaved person I am working with can determine his or her own goals.

The recovery model that I believe is the most broadly applicable to my work is from the National Consensus Statement on Mental Health Recovery, the elements of which I have outlined below (I've shortened them from the original, and altered some of the wording to focus on bereavement). These recovery principles guide my work:

Self-Direction: Grieving people ought to lead, control, make decisions about, and define their own recovery through autonomy, independence, and access to resources. Recovery must be self-directed by individuals determining their own life goals and designing a path to reach those goals.
Individualized and Person-Centered: The pathways to recovery are as multiple and various as the nature of individual bereaved people are. Recovery is at the same time an ongoing journey and an accomplishment, and it is a means for achieving optimal mental health and overall wellness.
Empowerment: Individually and collectively, bereaved people must be empowered to control their destiny in organizations and communities. They must be able to choose among a range of options, participate constructively in decisions that affect them, and efficiently remedy their grievances.

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