Living Works Programs
By Richard Ramsay
Suicide leaves a painful legacy in the lives of people it touches. The pain is often deepened by the same stigma and taboo that stifles open talk about suicide. Everyone’s bereavement journey is different. Even people within a family or circle of friends will experience the suicide loss of the same loved on in their own way. Yet it may help to know about some commonly experienced feelings and thoughts. Some of these may be familiar to you or to someone you are caring for following suicide.
After a suicide, people may feel:
Alone Why do others avoid talking about the suicide and keeping their distance?
Sad I’ll miss him/her… a tragic end to a troubled life.
Devastated How could it have come to this?
Angry Why was so little support available?
Afraid Are these powerful feelings normal?
Ashamed How could this have happened in our family?
Guilty Did we do all we could?
Abandoned How could he/she have left me like this?
Relieved How could I be feeling like this?
Other feelings will likely be present. Everyone won’t experience all of the possible feelings. Feelings are not right or wrong. They locate where we hurt and it does help to share them and talk them through with people we trust.
Struggles after a suicide can include:
Disbelief Was it really a suicide? It is so hard to accept.
Ambivalence She/he’s no longer suffering, but I wish he/she found a reason to stay alive.
Coping How can I get on with life coming to terms with this suicide death?
Review I go over and over what happened---sifting events and conversations.
Searching How can I make sense of this and find meaning in the loss?
Renewal I’m seeking a way to carry on, perhaps reviewing values and priorities.
TALK that can be helpful:
Tell For yourself, you can Tell people you trust about your thoughts, feelings, and struggles including thoughts you may have about self-harm or suicide.
Ask To help someone else, you can Ask a person bereaved by a suicide about support they need and whether they have thoughts of suicide themselves.
Listen Caring for others, you can be open to Listen to the stories of the suicide bereaved--- hear the pain, attend to the distress, support the search for meaning in the loss.
KeepSafe For you and those you help, Keepsafe from suicide while creating a safe place for them to share their sorrow and struggles and experience healing support.
It is important to learn more about preventing suicide:
Suicide affects us all. Here are some ideas to help you prevent suicide in your family and community:
- Get suicide intervention training to learn how to TALK or ASIST.
- Get your workplace or community to do a presentation on the taboo and stigma of suicide.
- Learn what you and your family can do to protect against the risk of suicide.
You can learn more about preventing suicide at:
- LivingWorks Education www.livingworks.net
More about LivingWorks Education Programs
All programs are designed and developed with the aid of a tested social research and development (social R&D) method. LivingWorks has been guided by evidence-based research, rigorous curriculum development, and independent program evaluation results for close to thirty years.
suicideTALK: An exploration in suicide awareness
suicideTALK is a short community-oriented program exploring issues and attitudes in suicide prevention
This program is designed to play a role in mobilizing interested participants to engage in activities toward the creation of suicide-safer communities. As a first step toward greater community involvement, participants are invited to explore attitudes about suicide. It recognizes that, often, the first barrier to actual involvement may not be lack of knowledge or skills but anxiety and fear.
safeTALK: suicide alertness for everyone
safeTALK is a half-day training to increase suicide alertness.
This program is designed to alert community members to the signs that a person may be considering suicide. It acknowledges that while most people at risk of suicide signal their distress and invite help, these helping opportunities are often overlooked. They are missed, dismissed or avoided. Participants learn how to get past these barriers and respond in ways that link them with further suicide intervention help.
ASIST: Applied Suicide Intervention Skills Training
ASIST is a two-day interactive workshop in suicide first aid.
This program uses a variety of learning approaches to help participants develop specific intervention skills to recognize when someone may be at risk of suicide and respond in ways that help increase their immediate safety from suicide and link them to further help as needed.
suicideCare: Aiding life alliances
suicideCare is a one-day, practice-oriented seminar that addresses advanced clinical competencies beyond suicide first aid.
This specialized program is designed for mental health clinicians and other helping professionals. The program aims to enhance helper self-awareness knowledge about suicide and competence in working constructively with a person at risk beyond the immediate suicide crisis.
Some Keys to Healing
Acknowledge the death and the suicide.
The wounds are not only over the loss but how and why someone decided to suicide. This may initially evoke shock, disbelief, even denial. For some there is the additional trauma of discovering or identifying the body. And the endless questions which often remain unanswered, or unanswerable. Why did it happen? Could it have been prevented? Could I have done more to prevent it?
Acknowledging both the death and the suicide facilitates healthy grieving.
Attend to pain and distress.
Personal reactions to a suicide vary incredible amounts. Typically overwhelming, changeable, and even contradictory thoughts and feelings appear uninvited and won’t go away. Initially, many feel swept along by these reactions, but increasingly there are opportunities to examine, explore, and come to terms with them. People can be surprised by painful memories that resurface, particularly in response to anniversaries or personally significant events.
Taking time to experience, express, and explore the pain of the loss helps heal the wounds, even though the scars will remain.
Seek support and solitude.
There is usually a bond among those touched by the same suicide and emotional kinship in the presence of other suicide survivors. Many also gain perspective from seeking support outside the circle of the suicide bereaved. Social expectations about how one might respond to suicide deaths are poorly developed. Those grieving and their caregivers each need to play a role in shattering the stigma and journeying together into unknown territory. There are also times when it is necessary to be alone with one’s own thoughts and feelings--- bereavement is ultimately a personal journey.
Those inside and outside the circle of the suicide bereaved require sensitivity to the need for support and solitude--- and to be able to seek and ask for what is needed.
Give healing time.
There is no standard schedule or timetable for grief. And while time does not heal all wounds, most indicate that the intense pain associated with the suicide lessens, even though emotional scars remain. Coming to terms with a suicide can be affected by personal factors, the level of support received, and circumstances before, during, and after the death. What is recovered is not life as it was, but the ability to come to terms with life as it is and to create a meaningful future built around the loss, the bereavement experiences and the memorials in our minds.
Impatient advice from others (or from within) often says, “Get over it.” But suicide is something people learn to live with rather than put behind them. Grief, like all wounds, heals from the inside out– and this takes time and patience.
Take an active role in recovery.
Any death can be confronting and disempowering. Suicide adds to this feeling in that those affected must come to terms with another person’s choices. But the bereaved have choices too– about how to respond.
The challenge is to make choices which face the loss, seek support, strengthen positive relationships, build a new future and facilitate healing.
Suicide and Mental Health
There are common challenges in promoting a community climate which supports mental health and suicide-safety. With both suicide and mental disorders:
- Open TALK has been severely restricted by stigma;
- More accepting attitudes are increasingly seen as a key element in encouraging an informed, compassionate response;
- A community- or organization-wide approach is needed to achieve better outcomes.
People affected, and those in a position to help need to come together to nurture mental well-being, support suicide prevention and invite life-sustaining initiatives. While this vision needs to be realized on a community scale, changes typically begin on a personal level.
A community perspective
- The World Health Organization and several nations have developed strategies to enhance mental health and reduce suicide. In all of them, the promotion of attitudes and practices which support well-being and safety are emphasized as vital to effective prevention activities.
- At a personal level, these prevention activities rely on the willingness of individuals, families, communities and organizations to talk openly about mental heath and suicide. Concerns about mental health or suicide must be raised openly rather than marginalized or fearfully avoided. Part of this open, direct, and honest conversation can explore the common concerns and shared goals for mental well-being. Some elements which might feature in that conversation are discussed here.
Promoting mental well-being
- Since mental disorders have been clearly shown to increase vulnerability to suicide in some people, measures supportive of mental health will contribute to suicide safety. Finding informal support and professional treatment for those with mental disorders will enhance their well-being, strengthen life links, and help them deal with problems in living.
- Both mental health concerns and suicide safety need to be separately explored and specifically addressed. While the presence of mental disorders invites particular vigilance about suicide, the absence of mental disorder does not eliminate risk. Far from it. Indeed, as programs like safeTALK and ASIST emphasize, suicide touches a wide range of people in any community.
Strengthening life links
- Even when mental health problems are present, it is essential that suicide risk is explored openly and safety addressed directly. Promoting an organization, community, clinic or hospital climate supportive of open, honest TALK about suicide is a basic standard of care in any mental health setting.