Who is a suicide survivor?
By John R. Jordan, Ph.D., Private Practice, Pawtucket, Rhode Island, Co-Editor of Grief After Suicide: Coping with the Consequences and Caring for the Survivors
At first glance, the answer to the question “Who is a suicide survivor?” may seem obvious. Suicide survivors are the people who have lost a loved one to suicide, right? It seems to be one of those words that we all think we know what we’re talking about– until we try to actually define what the term means. Perhaps ironically, the field of Suicidology has never really defined or agreed upon what the term means, or who falls into the category of a suicide survivor.
First of all, the term suicide survivor itself is potentially a confusing one, since it might logically refer to people who have attempted suicide and survived the attempt. But in North America, the term suicide survivor has come to mean someone who is bereaved after the death by suicide of someone they know. In Europe and Australia, the more common language used to refer to this category of mourner is “the suicide bereaved” or “the bereaved by suicide."
Beyond the potential confusion about what we mean by the word survivor, there is the question of what are the “criteria” for deciding who is a survivor. Most research studies have focused on the immediate family members of the deceased as the survivors. But are these the only people who might be considered? Consider, for example, the suicide death of a young person in a high school, who takes his life by jumping in front of a subway train. Are this young person’s extended family members survivors (cousins, great-uncles, etc.)? Are his or her friends, teachers, and school counselor? What about another youngster in the school who had no relationship with the deceased, but is depressed and becomes suicidal himself after the death? Or what about the driver of the subway train? Are all of these people now suicide survivors? Should we be extending survivor outreach services to them, and developing research studies about all of these different populations of potential survivors?
The problem seems to lie in trying to define a survivor in terms of certain categories of connection to the deceased (parent, friend, counselor, etc.). In a new book just published by John McIntosh and myself (Jordan & McIntosh, 2011), we try to wrestle with this difficult question. We propose a new and we hope more useful definition of a suicide survivor:
“A suicide survivor is someone who experiences a high level of self-perceived psychological, physical, and/or social distress for a considerable length of time after exposure to the suicide of another person” (p. 7).
This definition identifies a survivor by the degree of impact on the person, not by their connection to the deceased. That is, anyone who is significantly negatively impacted by a suicide can be considered a suicide survivor, both for purposes of support and clinical services and for purposes of research. This means that the neighbor, the friend, the subway driver who never even knew the deceased might all be potential survivors. On the other hand, the definition does not presume that someone is automatically a survivor just because they were in a certain type of relationship with the deceased. This definition thus helps us recognize that not everyone, even people who are close to the deceased from a kinship perspective, will necessarily be wounded for a prolonged period of time after the death. And lastly, the definition requires that the individual themselves recognizes that they are having a difficult time. In this sense, a survivor is anyone who believes themselves to be deeply impacted, and thus a survivor.
Using this type of “operational definition” of a survivor may help us move forward in several ways. It could broaden the awareness of survivor support programs that there may be people beyond the immediate family who need support after a suicide. It could allow researchers to scientifically answer the question “how many survivors are there?” by specifying criteria for “high” levels of distress for a “considerable” period of time, and then doing carefully designed research to actually determine how many people really are significantly affected in a social network after a suicide occurs. This type of research has never really been done before, and it would help us to much better understand the scope of services that may be needed for suicide postvention. And lastly, it would allow individuals who have lost someone they know to suicide to recognize that suicide can cause a great deal of distress that can last a long time. This could help survivors to see that they are not alone in their reactions and that help is available, regardless of the type of relationship they had with the deceased.
Jordan, J., & McIntosh, J. L. (Eds.). (2011). Grief after suicide: Understanding the consequences and caring for the survivors. New York: Routledge.