The Bereavement Of A Suicide.
MENTAL HEALTH VB
How suicide bereavement is different?
Bereavement by suicide shares characteristics with other bereavements and it is also different.
Understanding how and why it differs is helpful when you are supporting people who have been bereaved.
The grieving process is often complicated and typically lasts longer than other types of bereavement –
significant effects may still be felt for many years after the death. We are all individuals,
and each person will have had a unique relationship with the person who died –
there is no single or correct way to experience bereavement.
However, there are many common reactions and factors in bereavements by suicide.
Aspects of the experience of bereavement by suicide which make it different can include:
Circumstances of the loss
Emotional and physical reactions
The survivor’s questions – “why?” and “what could I have done?”
Stigma and isolation
Family and community tensions
Lack of privacy
Emotional and physical reactions
Bereavement by suicide can bring an intensity and range of emotions and physical reactions which may be
unfamiliar, frightening, and uncontrollable.
Emotional reactions are often complex, and people may find that they are experiencing a bewildering
range of feelings including guilt, anger, shame, rejection, sadness, and fear. People who have been bereaved by
suicide may become vulnerable to thoughts of suicide themselves.
Physical reactions may include tightness in various body parts, stomach pains, sleeplessness, and poor concentration.
Most people bereaved by suicide are haunted by two questions – “why did the person take their life?” and “could I have somehow prevented it?”. These are impossible questions to answer and eventually the person may have to either have to accept that they will never know or settle on an answer which they can live with.
It is natural that the bereaved person will take some considerable time in exploring these questions and it is an important part of the grieving process. However, it can also be damaging if they are unable to reach a stage
where the questions occupy less of their thoughts or if they cannot find an answer they can accept.
Self-esteem, confidence, and hope can be severely compromised.
Stigma and isolation
Death by suicide, even more than other types of bereavement, makes many people uncomfortable and unsure how to react. There is still a stigma attached to suicide, rooted in centuries of history and this generates misplaced associations of weakness, blame, shame or even sin or crime. This stigma can prevent people from seeking help when they need it and others from offering support when they want to.
There may be a desire to deny that the death was a suicide – this may be driven by cultural values or from a
sense of denial or of shame. This can create further confusion in an already complex situation.
Many people who have been bereaved by suicide find that they feel isolated. Others may avoid them, perhaps not knowing what to say or because they don’t want to upset the person. The sense of isolation may be especially acute if the bereaved person perceives other people to be uncaring or judgmental. Some people are unlucky enough to receive particularly thoughtless and malicious comments.
It may also be that the bereaved person avoids contact themselves – they may struggle to share their own feelings because they are fearful themselves of what they are experiencing, they don’t want to upset other people or they may worry about how to answer questions such as “how did he die?”
Family and community tensions
Whilst family and friends are often a great source of support, they can also be a source of tension and conflict. Sometimes families struggle to communicate, protective instincts kick in and they may be worried about causing more pain or about having a different view or feeling to others. Because the range of feelings and emotions experienced after a suicide can be so unfamiliar and frightening, people may be uncomfortable or scared to share.
Existing tensions and difficulties in family relationships can be surfaced as a result of the shock and trauma. Some people cope with their pain by blaming another person for the death – this may go as far as excluding them from the rest of the family, denying them the opportunity to attend the funeral and withholding information about the investigation. This can lead to huge rifts and a deep sense of hurt and isolation being added to the loss.
Losing a loved to suicide is one is one of life's most painful experiences.
The feelings of loss, sadness, and loneliness experienced after any death of a loved one are often magnified in suicide survivors by feelings of guilt,
confusion, rejection, shame, anger, and the effects of stigma and trauma.
Furthermore, survivors of suicide loss are at higher risk of developing major depression,
post-traumatic stress disorder, and suicidal behaviors, as well as a prolonged form of grief called complicated grief.
After the death of a loved one, regardless of the cause of death, bereaved individuals may experience intense and distressing emotions. Immediately following the death, bereaved individuals often experience feelings of numbness, shock, and denial. For some, this denial is adaptive as it provides a brief respite from the pain, allowing time and energy to accept the death and to deal with practical implications: interacting with the coroner's office, planning a funeral, doing what is necessary for children or others affected by the loss and settling the estate of the deceased. But, for most, the pain cannot be put off indefinably. It may not be until days, weeks, or even months following the death that the reality is fully comprehended, both cognitively and emotionally, and the intense feelings of sadness, longing, and emptiness may not peak until after that recognition sets in. Indeed, grief has been described as one of the most painful experiences an individual ever faces. Shock, anguish, loss, anger, guilt, regret, anxiety, fear, intrusive images, depersonalization, feeling overwhelmed, loneliness, unhappiness, and depression are just some of the feeling states often described.
Feelings of anguish and despair may initially seem ever present but soon they occur predominantly in waves or bursts—the so-called pangs of grief—brought on by concrete reminders of or discussions about the deceased. Once the reality of the loss begins to sink in, over time, the waves become less intense and less frequent. For most bereaved persons, these feelings gradually diminish in intensity, allowing the individual to accept the loss and re-establish emotional balance. The person knows what the loss has meant to them, but they begin to shift attention to the world around them.
Under most circumstances, acute grief instinctively transitions to integrated grief within several months. However, as described later, this period may be substantially extended for those who have lost a loved one to suicide. The hallmarks of “healing” from the death of a loved one are the ability of the bereaved to recognize that they have grieved, to be able to think of the deceased with equanimity, to return to work, to re-experience pleasure, and to be able to seek the companionship and love of others. For many, new capacities, wisdom, unrecognized strengths, new and meaningful relationships, and broader perspectives emerge in the aftermath of loss. However, a small percentage of individuals are not able to come to such a resolution and go on to develop a “complicated grief” reaction.
Complicated grief is a bereavement reaction in which acute grief is prolonged, causing distress and interfering with functioning. The bereaved may feel longing and yearning that does not substantially abate with time and may experience difficulty re-establishing a meaningful life without the person who died. The pain of the loss stays fresh and healing does not occur. The bereaved person feels stuck; time moves forward but the intense grief remains.
Symptoms include recurrent and intense pangs of grief and a preoccupation with the person who died mixed with avoidance of reminders of the loss. The bereaved may have recurrent intrusive images of the death, while positive memories may be blocked or interpreted as sad or experienced in prolonged states of reverie that interfere with daily activities. Life might feel so empty and the yearning may be so strong that the bereaved may also feel a strong desire to join their loved one, leading to suicidal thoughts and behaviors. Alternatively, the pain from the loss may be so intense that their own death may feel like the only possible outlet of relief.
Some reports suggest that as many as 10% to 20% of bereaved individuals develop complicated grief. Notably, survivors of suicide loss are at higher risk of developing this prolonged condition. Individuals can often have impairments in their daily functioning, occupational functioning, and social functioning.
Suicide survivors often face unique challenges that differ from those who have been bereaved by other types of death. In addition to the inevitable grief, sadness, and disbelief typical of all grief, overwhelming guilt, confusion, rejection, shame, and anger are also often prominent.11,35 These painful experiences may be further complicated by the effects of stigma36,37 and trauma.38 For these reasons, grief experienced by suicide survivors may be qualitatively different than grief after other causes of death.
Need to understand, guilt, and responsibility.
Most suicide survivors are plagued by the need to make sense of the death and to understand why the suicide completers made the decision to end their life. A message left by the deceased might help the survivors understand why their loved one decided to take his or her own life. Even with such explanations there are often still unanswered questions survivors feel they are left to untangle, including their own role in the sequence of events.
Another common response to a loved one's suicide is an overestimation of one's own responsibility, as well as guilt for not having been able to do more to prevent such an outcome. Survivors are often unaware of the many factors that contributed to the suicide, and in retrospect see things they may have not been aware of before the event. Survivors will often replay events up to the last moments of their loved ones' lives, digging for clues and warnings that they blame themselves for not noticing or taking seriously enough. They might recall past disagreements or arguments, plans not fulfilled, calls not returned, words not said, and ruminate on how if only they had done or said something differently, maybe the outcome would have been different.
Rejection, perceived abandonment, and anger.
Survivors of suicide may feel rejected or abandoned by the deceased because they see the deceased as choosing to give up and leave their loved ones behind. They are often left feeling bewildered, wondering why their relationship with the person was not enough to keep them from taking their lives.
Unlike other modes of death, suicide is stigmatized, despite recent valiant strides to destigmatize mental illness and suicide. Many bereaved individuals report that it can be difficult to talk to others about their loss because others often feel uncomfortable talking about the suicide. This can leave the bereaved feeling isolated.48 The feeling of being unable to talk about the death is often compounded by the perceived need to conceal the cause of death. At times, other people's belief systems, including that of the survivors themselves, can be a barrier to accepting the death and a deterrent to talking about it.
If you know someone who has lost a loved one to suicide,
there are many things you can do. In addition, by reaching out, you also help
take stigma out of the equation.
Don’t be afraid to acknowledge the death. Extend your condolences, express your feelings of sorrow. Make sure you use the loved one’s name. “My heart is so sad that John died.” Many who have lost someone to suicide have a broken heart, clinically called Stress Cardiomyopathy, and really need your empathy, compassion and understanding to heal.
Ask the survivor if and how you can help. Though they may not be ready to accept help, asking signifies that you are there—not avoiding or distancing during this tragic event. The notion of being there if needed is extremely comforting for survivors.
Encourage openness. Be accepting of however survivors need to express their feelings. It may be with silence, with sadness or even anger.
Be patient. Don’t set a time limit for a survivor’s grief. Complicated grief can take years to process. Moreover, don’t limit a survivor’s need to share and repeat stories, conversations or wishes. Repetition is a key factor in grief recovery.
Listen. Be a compassionate listener. This means don’t look to fix things. The greatest gift you can give someone you care about who has survived a suicide loss is your time, reassurance and love.
Ways to Help Yourself if You’re a Survivor of Suicide Loss
Ground yourself: It may be very painful, but you must learn to hold tightly to the truth that you are not responsible for your loved one’s suicide in any way, shape, or form.
Do not put a limit of your grief. Grieve in your own way, on your own time frame. It will take time to find a place for your sadness and loss. It may take even more time for you to feel hope again and envision possibilities.
Plan ahead. When you feel ready, assist your family in finding ways to mark your loved one's birthday, family holidays or other milestones. Understand that new moments, experiences or events will be met with sadness, even with emotional setbacks. Preparing for how you will move through these calendar dates will help minimize traumatic reactions.
Make connections. Consider joining a support group specifically designed for survivors of suicide loss. The environment can provide a mutually supportive, reassuring healing environment unlike anywhere else.
Give yourself permission. To cry. To laugh. To seek professional help if you need it. Remember that you are moving through the most difficult of losses—and you can take control of the path to healing.
THE MOB MENTALITY OF SOCIAL MEDIA
Jamie Spence MHVB
Cognitive Behavioral Therapist
Social media, with all the wonderful ways it allows us to connect to friends and family far and wide,
has also largely contributed to a new online mob mentality that can be truly disheartening at times.
An anonymous, negative, collective consciousness that greys and smudges the horizons
between actions and personal accountability.
Now, cowards sit behind illuminated screens. They’re spiteful as they clack at keyboards with numb finger tips.
They incite hate as they comment, troll, and bully through careless words and ignorant opinions.
They say things that they would never have the courage to say to another human in person. Hiding behind touch-screens, their anonymity inflates their egos and any sense of self or accountability slips away almost effortlessly.
The internet has created virtual mobs where all sense of social responsibility is absent.
It’s now so easy to comment on something, attack a person or group, or be influenced by mob ideals.
No longer do we need to leave our home and join an angry mob to get angry about something together.
Instead, we can troll with other anonymous, insecure, and angry people to attack and bring down others, to spread only hate.
When most people write comments, tweet, or post something that attacks another person online,
they actually don’t feel as though they’re talking to another human being.
The virtual nature of these communications weaken ones sense of self and their social responsibility which,
more often than not, greatly impacts their respect for others feelings.
It’s as if all sense of humanity gets lost between screens and servers.
It’s now easier than ever to get infected by negative thoughts or bullied by digital egos.
Why is it that when we take away personal responsibility, some people slip into a dark, moral-less
world where social norms crumble away and our perception and judgements shift out of focus?
Is it because suddenly the edges of good and bad become undefined and concepts
like social integrity become shapeless forms open to interpretation?
Social psychology describes how we adjust our behavior or thinking to follow the behavior or rules of the group we belong to.
Typically, people conform because a various social influences or desires. Some of these influences and desires are respect for authority,
a fear of being different, a fear of rejection, or a desire for approval. Once we join a group, we are likely to conform to or comply with whatever the group decides, in order to fuel our need to be liked or feel like we belong.
When mobs form, they create a powerful influential factor that shapes a the character ones identity.
“Mob/herd” mentality describes how people are influenced by their peers to adopt certain behaviors, follow trends, and/or
purchase specific items. The desire to join in on this group or, at the very least, be recognized by the group,
is an example of conformity.
Another lesson from social psychology is the influence others have on us. Research shows we do not have as much control over our thoughts and behavior as we think. We take cues from our environment and especially other people, on how to act.
We mostly rely on signals like popularity. A large reason that others influence us, to these extents, is that humans are social creatures.
We have survived because of our ability to band together. Early humans who formed groups were more likely
to live continuing the lineage of their blood line.
This highly affected the evolution of our psychology. In our evolutionary past, our ancestors were under constant threat. Keen awareness of others helped our ancestors survive in a dangerous and uncertain world. Modern humans have inherited
such adaptive behaviors as evolutionary “leftovers”. It’s innate and instinctual for us to regularly seek out and connect with others.
We also have a strong natural predilection to imitate one another’s behavior. We end up professing beliefs and acting out
in ways which we would have never otherwise done or considered independently.
Let’s consider the implications of this propensity for violence against others in the online world. We’ve already seen the mob effect on Twitter, where people’s lives have been ruined because others deemed that they had said the wrong thing. Twitter is often the ultimate example of dehumanizing someone—all you see is an avatar, which may or may not
be a picture of the person themselves, and their Twitter handle.
It’s often hypothesized that online trolling and harassment occurs because there is anonymity and a lack of
consequences for the perpetrator.
In most cases, one slogan or one propagandist phrase triggers such a strong reaction from participant in said movement.
The emotional bond becomes more important, and that’s what drives the whole group together.
When you’re having a conversation in person with someone and you disagree with them, you don’t just go nuclear in response,
even if their argument is stupid. Why? Because unless you’re a sociopath, people generally don’t like
hurting other people, physically or emotionally.
However, online your target is dehumanized. We can say horrible things and won’t see the effect it has on our victim.
We’re also not at risk of getting our ass kicked for pissing off the wrong person.
And that’s why, no matter who you are or what movement or group of people you identify with, you need to look thoroughly
within in yourself and confront this fact… you will do evil if the people around you are doing evil.
What we will not do as individuals we may do as part of a group. People may lose control of their usual inhibitions,
as their mentality becomes that of the category of masses . The larger the unit the greater the amplification of that group behavior.
However, some crowd behavior is peaceful, exemplified by Martin Luther King and Ghandi.
If the group behavior is violent, the larger the group the more magnified the violence.
All a riots are considered violent group behavior.
You have never heard of a peaceful riot because riots are, by definition, violent in nature.
The research findings show that as the number of people in a crowd increases,
the number of informed individuals DECREASES.
You are no longer completely responsible for what you are doing. In your head, you know you are one in maybe a 100.
If you burn a car alone, you will face consequences. But when you do it with so many others, you feel safe.
As a result, when many like-minded people get together, they reinforce each other’s ideologies and beliefs
regardless of reason and accuracy, and the end result is a more condensed, stronger, and fixed mindset about things.
Another reason why individuals have a tendency to align themselves with a certain group is to have a ‘sense of belonging’,
This sense of belonging plays a huge role in our self-identity. Also about fitting in and being accepted.
The fear of being an outcast alters people’s behavior.
It seems easier to be a part of a group than to stand alone.
Following others blindly or just ‘going with the flow’ may be beneficial, such as during emergency evacuations.
However, under many other circumstances like mob vigilantism or terrorism, it can rob people of their identities
and turn them into mere puppets.
While humans may be naturally inclined to conform (as various studies have proven time and again),
it is possible to maintain or stand by one’s own beliefs and ethics — even in difficult situations.
It’s time all of us examine ourselves and ask;
“Am I too caught up in everything to see reason?
Am I thinking for myself right now, or am I dismissing everything that doesn’t fit my narrative?”
‘Would I do the same if I was by myself?”
JAMIE C SPENCE, MHVB
PAIN PASSED ON..
The dark and brutal history of the U.S. is no secret.
It is common knowledge, in 2020, that throughout the 17th and 18th centuries,
African natives were kidnapped and forced into slavery in the still developing American colonies.
These individuals were mercilessly exploited to work as indentured servants and labor in the production of crops
such as tobacco and cotton.
The first documented slaves are thought to have been brought to Jamestown in the year 1619
(although some sources cite much earlier) and consisted of 20 men. By the mid-19th century,
America’s westward expansion and the abolition movement provoked a great debate over slavery
that would tear the nation apart in the bloody Civil War.
It wasn’t until the establishment of the 13th amendment in 1865, which abolished slavery in the United States of America,
freeing countless innocent lives that had been habitually dictated by severe and systematic oppression, trauma,
Though the Union victory freed the nation’s four million enslaved people,
the legacy of slavery continued to influence American history, from the Reconstruction era to the civil rights movement that
emerged a century after emancipation. However, that’s not quite where the story ends…
The word trauma in modern culture is defined as;
-A deeply distressing or disturbing experience.
-Emotional shock following a stressful event or a physical injury, which may be associated with physical shock
and sometimes leads to long-term neurosis (PTSD).
“Trauma” results from an event, series of events, or set of circumstances that is experienced by an individual
as physically or emotionally harmful or life threatening and that has lasting adverse effects on the individual’s functioning
and mental, physical, social, emotional, or spiritual well-being.
Trauma can occur throughout a person’s lifetime and there may be subsequent re-traumatizing experiences
that reinforce previous defenses but we will get to that later. We now know, through advances in neuroimaging, that experiencing trauma greatly alters and impairs the brain, as brain scans from a PTSD patients and a “neurotypical” brains have distinct differences which control how our brains function and therefor also control every other system of our body.
But the question we are answering today is;
Can traumatic experiences be passed down genetically??
And the answer seems to be yes!
Historical trauma is an event, or a set of events, that happen to a group of people who share a specific identity.
That identity could be based in nationality, tribal affiliation, ethnicity, race and/or religious affiliation.
The events are often done with genocidal or ethnocidal intent, and result in annihilation or disruption of traditional ways of life,
culture and/or identity.
Each individual event is profoundly traumatic and when you look at events as a whole, they represent a history of sustained cultural disruption and community destruction. I tend to define inter-generational trauma as a traumatic event that began years prior to the current generation and has impacted the ways in which individuals within a family understand, cope with, and heal from trauma.
The term “historical trauma” was coined by Native American social worker and mental health expert Maria Yellow Horse Braveheart in the 1980s. Braveheart's definition states that historical trauma “is cumulative emotional and psychological wounding, over the lifespan and across generations, emanating from massive group trauma.”
The effects of the traumas inflicted on groups of people because of their race, creed, and ethnicity linger on the souls of their descendants. As a result, many people in these same communities’ experience higher rates of mental and physical illness, substance abuse, and erosion in families and community structures.
The persistent cycle of trauma destroys family and communities and threatens the vibrancy of entire cultures.
Although few will ever make the link between these issues—our unexplained fear, anxiety, and depression
—and what happened to their family members in a previous generation.
Research exploring historical trauma looks at how the trauma of these events is “embodied” or held personally, chemically marked, and passed down over generations. Such that even family members who have not directly experienced the trauma can feel the effects of the events generations later. Individual trauma then becomes collective, as it affects a significant portion of the community and becomes compounded. Multiple historically traumatic events occur over generations and join an overarching legacy of assaults. The impact of these ongoing traumas has effects on a person’s brain and body, increasing their vulnerability to Post-Traumatic Stress Disorder (PTSD) and other mental health disorders.
Historical trauma occurs at all levels—individual, family, and community. Although each level is distinct, they are all interrelated. Individual responses to historical trauma are influenced by the experiences/responses of family members; individual and familial experiences coalesce to make up the collective community response. Thus, actions at the individual and familial levels reinforce the way the community responds
"Historical trauma is not just about what happened then. It's about what's still happening now."
Transmission of trauma across generations was first seen in 1966 by clinicians who were alarmed by the number of children of people who had survived the Nazi Holocaust who were seeking mental health treatment. The trauma experienced by the Jewish people
in the Holocaust was being seen in poor mental and physical health outcomes in their descendant generations (children and grandchildren) that were conceived AFTER the trauma occurred. The children of Holocaust survivors were presenting with symptoms of PTSD, survivor guilt, anxiety, anger, grief, symptoms of depression, impaired self-esteem, a preoccupation with death, impaired communication, substance abuse, and exaggerated personal attachments or interdependence.
Since these early studies with the children of Holocaust survivors, scientists have also been gathering evidence showing that historical trauma has an impact at the cellular level. This body of evidence shows the neurological toll of stress on the
health of like future generations.
A powerful stressful environmental conditions can leave an imprint or “mark” on the cellular material that can be carried
into future generations with devastating consequences.
Family systems theory has long understood that the relational, behavioral, and emotional patterns across generations provide a broader understanding of us as individuals and our children. Trans-generational trauma refers to the ways that trauma
gets transferred from one generation to another either directly or indirectly.
Unresolved trauma of one generation is a legacy that can be passed down to the next generation.
Children and grandchildren are shaped by the genes they inherit from their relatives before birth, but new research is revealing that experiences of hardship or violence can leave their mark too. ...
For those who survived, the harrowing experiences marked many of them for life.
Humans possess the remarkable ability to adapt to diverse environments in order to optimize our chances of survival.
If we find ourselves in a threatening or harmful context, we make both conscious and unconscious choices that are geared
to protect us. Even after the threat has dissipated, we may continue to hold the effects of the trauma in our bodies and minds. And so our survival strategies persist.
Knowing how the human body holds onto this stress reminds us that we cannot ignore the social, historical or cumulative
experiences of stress and their impact on wellness. There is growing evidence that biological and psychological expressions
of historical trauma may be partly responsible for producing health disparities in a wide spectrum
of health outcomes from diabetes to PTSD.
The transmission of multi-generational trauma effects are not only psychological, familial, social and cultural, but could be neurobiological and possibly even genetic as well.
The newest research in modern genetics tells us that you and I can inherit gene changes from traumas that our parents and grandparents experienced. This adaptive change can then be passed down to our children and grandchildren biologically preparing them to deal with similar trauma.
If our grandparents, for example, were traumatized from slavery, theoretically, they could pass on a survivor “skill set” to us.
This skill set would be helpful were we were also born into slavery. However, living in a safe environment where this inheritance isn't useful, the constant hypervigilance can create havoc in our bodies.
Many Native Americans also suffer from historical and transgenerational trauma. The horror they suffered, that they still suffer, has left entire communities scarred. We can see the results of this trauma when we look at mental health statistics for Native people.
This form of persistent and subconscious trauma can have varied effects on individuals and populations that may include: unsettled trauma or grief, depression, high mortality, increase of alcohol abuse, child abuse and domestic violence.
So we are left with the question, how do we heal centuries of suffering?
How do you repair trauma that spans generations?
Where do we begin such a monumental task?
The first step is recognizing historical/intergenerational trauma is real, that entire communities can be (and have been)
traumatized and that trauma can be passed from one generation to the next.
The next step is to have more discussions with communities who suffer from historical trauma and listen to how
they feel their mental health needs can be better met.
It is because of deep seated historical trauma that cultural variables need to be considered when
making a mental health treatment plan.
One of the barriers for some seeking treatment for mental health issues is a lack of culturally competent providers.
Native Americans, African Americans, and other marginalized groups of people who have suffered historical trauma,
will need to speak up about their experiences.
Mental health care providers should learn more about historical and intergenerational trauma and give those
who are suffering from it a safe space to talk about their struggles.