How to support a Friend Bereaved by Suicide

Support how to a

Friend Bereaved by

Suicide

Bereavement by suicide can be especially painful with extra layers of grief. We have put together some practical actions you can take to help support your friend in the short- and long-term.

When someone dies by suicide, the shock can be profound and widely felt by families, friends, colleagues, and professionals. There are many reasons behind what drives someone to suicide, leaving those left behind with a multitude of questions, a whole wealth of emotions, and many things left unsaid.

Focusing on the cause of this kind of loss can add to emotional isolation, as people turn to logical explanations for answers.

The problem is that suicide is an emotional choice, which could be related to issues that have brought grief into that person’s life or they could have had a mental illness. At the time of completing suicide, they are beyond thinking about the impact of their actions on those who are left behind. Emotions are rarely impacted by logic.

We have put together this ebook to help you to support your friend with their grief. Our focus is to help people deal with the aftermath of the act of suicide and highlight the emotional loss and grief suffered by them and give you some tools to help them. Many people shy away from talking about death, especially suicide. We hope we give you the confidence to reach out to your friend.

“To try and describe the impact on our lives is impossible. As well as grieving his loss, we were left with immense guilt. Over and over, we asked ourselves, ‘What did we miss? What could we have done differently?’ The torment was unbearable.

“In the weeks and months after Pete’s death, I felt as though I was in a glass jar being thrown around a choppy ocean, watching everybody else living life around me. I desperately wanted to get out, but just didn’t feel able to. I felt numb.”

– Rebecca Mapp, Sunflowers Suicide Support and Grief Recovery Specialist talking about her brother who died by suicide.

Your friend is not alone

According to World Health Organisation data, close to 800 000 people die globally due to suicide every year, which is one person every 40 seconds.

Suicide is a global phenomenon and occurs throughout the lifespan.

In 2019, the Office of National Statistics reported 5,691 registered deaths by suicide in England and Wales.

Suicide is the biggest killer of men under the age of 45 in the UK. The rate for females completing suicide under the age of 25 has increased by 93.8% since 2012 in England and Wales.

Men aged 45-49 in England and Wales are the most at risk of suicide.

Each suicide results in 135 people exposed (knew the person). Each suicide affects a large circle of people, who may need clinician services or support following exposure. (University of Kentucky).

Why bereavement for a suicide can be overwhelming

We will start by looking at what grief is: Grief is the normal and natural reaction to significant emotional loss of any kind.

Grief is the conflicting feelings caused by the end of, or change in, a familiar pattern of behaviour.

Grief is the feeling of reaching out for someone who has always been there, only to find when you need them one more time, they are no longer there.

Grief is normal and natural. It is not a pathological condition nor a personality disorder. Grief is often mislabelled as ADHD, depression, PTSD, and many other pathological conditions. If you misdiagnose grief, you will mistreat it. These mislabelled grievers are often incorrectly prescribed various medications, which will get in the way of recovering from loss.

On top of what we might call normal feelings of grief, emotionally unfinished business after a suicide death can leave behind a complex set of emotions, such as: Absolute shock – even if there are warning signs, suicide is still a huge shock. Your friend may be in a state of disbelief. The suicide might have been a total bombshell.

Shame/stigma – hey may feel ashamed that their loved one took their own life.

It’s not a natural way to die, it was a choice. They may also feel like they’ve done something wrong and are being judged.

Isolation – nobody understands what they’re going through, leaving them feeling unable to share their true feelings. They may physically hide themselves away, so they don’t have to face others, or because they don’t want to talk about it.

Guilt – could they have anticipated their loved one trying to take their life? Could they have done something? They will never know and may carry feelings of guilt.

Blame – they could blame themselves for not seeing the signs. They could blame others for not taking proper care of their loved one, e.g., mental health workers, or another loved one.

Relief – there may have been many failed suicide attempts in the lead-up to completing suicide. They may feel a sense of relief that it’s finally over, which also may come with a sense of guilt for feeling like that.

Conflicting feelings – the person who died may not have been nice or easy to live with. They may have had a gambling or drink addiction. Your friend might be feeling happy that they’ve gone and sad because they didn’t want their lives to end.

Rejection – they might feel rejected by the person who has died, and not feeling good enough for their loved one to live for. They may feel rejected by people they thought would show up but have stayed away.

Trauma – if your friend or their child found their loved one after the act of suicide, they could be dealing with extreme trauma.

Needing information – your friend might want to know all the details of the death but may also be scared about hearing them.

On top of these feelings, it is likely that additional information may come out about the person who died by suicide. They may feel a lack of privacy if the police and media are asking questions. They may also be looking for a note. Sometimes, people can spend years looking for a note to find some answers, but they don’t always exist.

It’s natural to not know how to help and your friend may need professional help. There are links at the end of this book to help you point them in the right direction.

Behaviours to be aware of Have you noticed a change of behaviour in your friend? Certain behaviours can become distractions to avoid grief and can be used to replace the loss or fill the void of the person who has died. Look out for destructive behaviours or unusual choices.

The activities used to “take your mind off of it” are what we call STERBs. STERB stands for Short Term Energy Relieving Behaviours. They are activities that can be used to distract from painful feelings that follow a major loss.

We’ve all heard about what people might do after a break-up: they eat chocolate, hit the bottle, go shopping, or find someone new to date. Those activities are short-term energy relieving behaviours. Most STERBs are not harmful in themselves. Let’s use shopping as an example. There’s nothing wrong with shopping. But if shopping is used to avoid feelings, not only do you avoid dealing with your emotions, but you could also end up with financial problems. It gets worse when shopping no longer gives you relief and stops working.

Here are some examples of behaviours which might be STERBS, remember this is not about judging your friend, it’s to give you an idea of the kinds of activities that people often turn to: Drinking Sleeping Eating Excessive exercise Sex Drugs Gambling Smoking Shopping Video games Workaholism Playing on the Internet Isolation Keeping Busy As a result of doing the STERB, your friend might feel different, but they don’t feel better.

Following a series of events like this, your friend will start to identify ‘different’ as ‘better.’

This can have lifelong negative consequences resulting in an unintentional and incorrect habit for dealing with grief and loss.

“If your back garden is full of weeds, you can cut the weeds as a temporary solution, but they will grow back. Or you can pull the weeds up and eliminate the problem.”

What to say and do What to Say: I can’t imagine how you feel.

I can’t imagine how painful/devastating/heart-breaking this has been for you.

There are no words, I don’t know what to say.

What to Do: Keep reaching out and keep in contact. Be consistent, even if you’re seemingly being ignored, perhaps every week at a certain time.

Let the griever lead the language that is used and the details of the story.

Be a ‘heart with ears’ and just listen. This means listening with your heart, not your head.

Allow them to express emotions with no judgment, criticism analysis or comparison.

Do ask “what happened?” to give them the chance to talk. Most people will avoid this question.

Don’t: Make assumptions about how they might be feeling.

Say things like: “Didn’t you see any signs?”“They’re no longer suffering,” or “It wasn’t your fault.” They are all unhelpful, even if it’s unintentional.

Say “committed” suicide. The term evokes associations with ‘committed a crime’ or ‘committed a sin’ and makes us think about something morally wrong or illegal. It also ignores the fact that suicide is often the consequence of an unaddressed illness (like depression, trauma, or another mental health issue). It should be regarded in the same way as any physical health condition.

Compare losses, or assume you know how they feel.

Try to fix your friend. They need to be heard.

Talk about the stages of grief. Grief can’t be neatly categorised. Elizabeth Kubler Ross’ book, On Death and Dying, which talked about the five stages of grief was for people in the last stages of life. They were never meant for people who are grieving. She is specific about this distinction in her books and yet the media and universities have attached her work to grief. This common misinformation has confused and hurt many grievers throughout the years.

There are no reactions so universal that all or even most people will experience them.

Offers of Help Offers of help often gets turned down or ignored, especially if you say, ‘let me know if there’s anything I can do.’ A grieving person doesn’t have the energy to work out how you can help, so make specific offers. This could be anything practical, such as offering to help with shopping, offering to look after the children so they can have a bit of peace, take over a meal, or buy them a takeaway… anything that gives them a break.

There is No Time Limit You may need to ‘hear’ them lots over the coming months and possibly years.

This is normal. Grief does not have a time limit. Bear this in mind and provide them with the same kindness, support, and consideration that you did in the first year after the death of their loved one.

Find ways to be there—even when you’re physically distant.

It can be agonising when we really want to be in the room and for whatever reason we simply can’t. While we know it isn’t the same there are lots of ways we can be there and offer our support.

Write an old-fashioned letter There is something special about receiving something pleasant through the post and it’s rare these days, making it extra special when it does happen.

Video Calls Technology gives you a chance to connect with people in ways that feel close and intimate, even if they’re on the other side of the world.

Make time zones work to your advantage One of the nice things about having friends in different time zones is that you might be awake and ready to talk right when they need you most. If your friend is dealing with worries that keep them up at night, tell them to give you a call.

Plan your next get-together If it’s possible, make plans to see each other in person. It’ll make you both happy to have a date on the calendar, even if it’s tentative. You can build excitement by making an itinerary of local sites to see, foods to try, or history to learn.

How to start a conversation Starting a conversation about grief may not feel like a natural thing to do. We’re not used to talking openly about sad emotions and this can feel even more difficult after a suicide loss. Here are some hints and tips that will hopefully reduce the number of verbal landmines you step on!

Listen, listen, listen!

While your desire might be always to help someone feel better, this simply isn’t possible. The real key is learning how to be a “heart with ears.”

Listening without interruption, or comparing it to your experiences, can be quite difficult but think of it as a one-way conversation where your job is to in the moment and really hear what is being said. Do not drift off thinking of what you are going to say or do next. Avoid reassuring them that things will be ok, or they will be fine in time, they won’t be. They’re adapting to their new normal and need to be heard.

They might cry, or say things that make you feel sad, too. Let that be ok. It’s hard seeing someone you care about hurting but allowing them to talk while you listen will help them enormously. When they’ve finished, offer them a hug, and thank them for sharing their feelings with you. Resist the temptation to offer advice, make comparisons or utter platitudes.

Say their name Most people who have been bereaved are terrified of the person who died being forgotten. Yet people around them are reluctant to mention their name for fear of causing hurt or upset. This feeds the fear that other people don’t care or have forgotten in a horrible negative cycle. Use the name of the person who died whenever you can. I promise you won’t make them feel worse. Yes, they may have an emotional reaction. That’s normal and let that be OK with you. We’ve used the name John here in this book, as it makes it a more natural read and we know you know not to say John, unless coincidentally your friend’s loved one was called John, too.

When to talk When you speak to your friend or meet them, you’re not going to know initially where their feelings are at in that moment. Grief is like the ocean – it is constantly moving, arrives in ways that range from a current tugging at your ankles, to giant waves that knock you off your feet and pull you under. Sometimes it is a relief to talk about it and sometimes it is anything but, and the topic should be avoided. So how can you know which it is right now? Ask. For example, ‘Would you like to talk about John right now, or something else? Remember those waves and the fact that sometimes no matter what you say you can’t win. Let it go – it’s not about you, it is their grief talking. Reassure them that you’ll be there when they do want to talk if that isn’t now. If they do want to talk, it’s sometimes handy to have some questions that can lead the conversation in a thoughtful way. Asking “how do you feel?” is often not helpful, as it seems such an impossible question to answer.

Your help might not be enough Seeing your friend in ongoing pain can be hard. If you feel like they need additional support, we would love you to tell them about the Grief Recovery Method.

Feeling better is not about forgetting or pretending the death didn’t happen. Feeling better is about easing the emotional pain they are carrying with them daily, so that they can start sleeping better, concentrating, eating, and even enjoying life again. Once they’ve learned the action steps for handling their grief, they can cherish the memories of their loved one without it turning painful.

The Grief Recovery Method is the only evidence-based grief programme in the world. It is proven to be effective at helping grievers with to move beyond their loss. Working with a Grief Recovery Specialist in person or online, individually or in a group, they will have a safe space to talk freely about their loss without the fear of judgment or analysis. This unique, structured programme is completed in seven or eight sessions and will teach them the correct actions, so they don’t have to wait for their grief to get better on its own.

Please visit our website to find out more and to find their nearest Grief Recovery Specialist.

THE ONLY

EVIDENCE BASED PROGRAMME

Useful links Our website: www.griefuk.org Find a Specialist: www.griefuk.org/nearest Download our ebook “ A Guide to loss – 61 hints and tips on the experience of grief and how to help people through it. www.griefuk.org/ebook Follow us on Facebook www.facebook.com/GriefRecoveryUK Follow us on Twitter www.twitter.com/griefuk Follow us on Instagram www.instagram.com/griefrecoveryuk Follow us on Linked In www.linkedin.com/company/griefuk Additional Support for those bereaved by suicide can be found here: Pete’s Dragons – www.petesdragons.org.uk Sunflowers Suicide Support - www.sunflowerssuicidesupport.org.uk SOBS – www.uksobs.org Papyrus (for young people) - www.papyrus-uk.org

About the Author Maria Bailey is an Advanced Grief Recovery Specialist based in Devon.