The grieving family
When a family member dies by suicide, the whole family is affected. Each person will grieve in their own way and in their own time. This is because they each have different ways of coping and their relationship with the deceased person is unique to them. These different paths in grief may sometimes be confusing or frustrating to other family members. It is important to understand that there is no right or wrong way to grieve, and to be patient with other family members when they react in a different way to you.
Sometimes the dynamics in a family affect what reactions are acceptable. For example, some families are very emotionally expressive and others do not encourage members to speak. Sometimes family members can try to protect others by not sharing certain information or by concealing their feelings. It is OK to grieve in your own way and to respect others’ right to do the same. If, however, you are worried that a family member is not coping at all or is a danger to themselves or others, it is important to discuss this with the person or with a trusted professional. The rituals around a death can provide an opportunity for a family to grieve together. Even if it is difficult to agree on funeral arrangements, you may find other special ways to share your grief as a family.
The loss of someone in the family may leave a void, as that person played a unique role in the family. Sometimes this loss can have knock-on effects on other family members’ roles, especially where the deceased person was the main earner or carer. There may be expectations that others in the family will step in-to these roles. If you feel pressured into stepping into such a role, it is important to be able to discuss this openly in order to come to a solution that works for you.
Children bereaved by suicide
Coping personally with the loss of a loved one to suicide is already difficult, but supporting a child through grief can be an added challenge for parents. When a child finds out about a death, they may deny the death or react with disbelief. They may react by crying, screaming or lashing out, or they may become quiet and withdrawn. They may be afraid that other people close to them will die. In contrast to adult’s grief, children’s grief tends to involve shorter periods of more intense emotion that come and go. Parallel to adults, the prevailing emotion is often sadness but they may also feel anger, irritability, guilt, fear, loneliness, and worry. If the person who died was violent or difficult, the child may feel a sense of relief. Sometimes, a child’s grief can involve physical signs, including stomach pains, headaches, shortness of breath, loss of appetite or the child may regress to bedwetting or thumb-sucking. When the child directly witnessed the death, this may impact on the child in terms of increased anxiety, recurrent disturbing intrusions or dreams. Symptoms of posttraumatic stress disorder including panic attacks, nightmares and sleep disturbance may be recurring. When these symptoms are present, it is advised to contact a qualified counsellor or your GP.
The nature of a child’s grief is likely to vary by age. Very young children have difficulty understanding the finality of death, and often expect the deceased person to come back. Slightly older children respond with many questions, including the specific details of how the person died. Young teenagers have increased emotionality with the onset of puberty, and may wish to discuss the concept of life and death. Older adolescents are striving to be independent, may act out angrily after a suicide, and may be more likely to confide in their friends than family.
Telling a child about a suicide
“With children, honesty about suicide is not only the best policy, it is the only policy. You must tell your children the truth in an age-appropriate manner from the beginning, no matter how young they are,”
(Myers & Fine, 2006; 2007)
Especially in cases of suicide, a parent’s instinct may be to withhold information to protect their child. However, this can lead to confusion and distrust, especially when the child is likely to hear details of the death elsewhere. There may be several stages of disclosure, spread over days, weeks, or months. When initially telling a child that the death has occurred, you may find it helpful to have someone else present, such as a family member, a friend or clergy. Keep the information simple and concrete (for example, use the word ‘died’, not ‘sleeping’). Allow your child to express their emotions and answer their questions honestly and simply, offering additional details only when the child asks for them. Another important part of this discussion is that the deceased person took their own life. Explaining that the death was due to suicide is difficult for parents. It may be helpful to explain suicide in the context of ‘emotional pain’ compared to physical pain, that the person’s mind was unwell and couldn’t think clearly, which caused them to act in a way that they would not have done otherwise. It should be made clear to the child that nobody is to blame, and that the deceased did not mean to cause hurt and pain to the child by taking their own life.
How to support the grieving child
Suicide bereavement can leave a child feeling helpless and out of control. You can help the child by giving them choices whenever possible. This may be in relation to whether or not they wish to participate in the funeral, to see the body in repose, or return to routines, including school soon after. Speaking about the deceased can give a child permission to remember their loved one and to speak about them. There may be some objects belonging to the deceased that the child might like to keep. It is important to bear in mind that your children may vary in grieving style and may be more or less expressive than other family members. Keep the lines of communication open by inviting discussion, listening without judgment, and answering questions honestly and simply. The funeral service and other rituals are a valuable opportunity for the child to say goodbye and to know that it is OK to grieve. In Ireland, funerals usually happen very quickly after a death, so the child might benefit from another chance to say goodbye later, through a grave visit, month’s mind, ash-scattering, or anniversary mass. Because children’s grief can happen in waves, there may be moments of fun and play too. These may seem inappropriate to adults at times, but it’s good to remember that the grieving child is still a child. Play and laughter is good for the child, and for the parent.
Professional supports for the grieving child
More often than not, a child who has lost a parent through suicide will benefit from professional help to process this traumatic loss. Professional support may be especially relevant when a child has ongoing outbursts, sleep disturbance or withdrawn behaviour. Also, as the surviving parent, accessing professional support of your own will be an invaluable gift to your child. You have the opportunity to share your feelings honestly in a safe and private space and to provide a model of healing for your child(ren). Taking care of yourself in this way will have positive effects on your child’s healing too.
You will find relevant resources and service information here
I am worried about someone
Following the death of a loved one by suicide, you may have a fear that others you care about may also take their own life. While this fear is a part of grieving, there is indeed an increased risk of suicide in families bereaved by suicide. If you are worried about someone in particular, it is OK to discuss your concerns openly with them – asking about suicide does not make a person more likely to harm themselves. As a person already bereaved by suicide, you may find it difficult to be calm and understanding in discussing your concerns with the person you are worried about. It may be best to involve another person or a trusted professional if you feel unable to cope with this conversation on your own.
You may feel uncomfortable talking about suicidal thoughts and acts. However, if you have the feeling that a person is seriously thinking about harming him/herself, it is best to speak about this in a direct way to establish if they need urgent medical assistance to keep them safe. If the person seems willing to disclose his or her thoughts, it is important that you create a warm and open atmosphere.
Sometimes, it is not easy to obtain a clear picture of the level of suicide or self-harm risk. Many people may think of the possibility of dying, regardless of their mental health. This is more common in older, religious people, and those who are recently bereaved. This does not necessarily mean that there is an immediate risk that they will act upon these thoughts. However, they are at-risk if their thoughts of suicide are very pressing and concrete plans are made. The following questions can help you to judge their risk (see below):
Source: Arensman et al, 2015
If the person discloses that they are thinking about self-harm or suicide, you can encourage them to discuss this with a professional, such as a GP or mental health professional, and perhaps offer to arrange the appointment and accompany them.
If the person discloses that they have a concrete plan or cannot distance themselves from their suicidal thoughts, you may need to seek urgent medical assistance. If the person is unwilling to go to hospital but you are worried they will harm themselves imminently, it may be necessary to have the person hospitalised against their will: this can help to keep them safe until the suicidal crisis passes.
Supporting grieving friends
When a friend is bereaved by suicide, you may not know what to do or say to help. The best support you can give is often the simplest. Take the time to listen to your friend and be respectful of their version of events – the story of their grief is unique and important to them. They may wish to speak at length about the deceased or about their grief. Offering a supportive listening ear will mean a lot.
Your bereaved friend may isolate him or herself in the aftermath of their traumatic loss – try to keep in touch even if it means that you are the one reaching out most of the time. If you are not sure what to say, try doing something practical for your friend like making a meal, buying groceries or doing some gardening. Your friend might not mention it at the time, but your emotional and practical support is appreciated. If you feel that your friend requires professional support, you can help to create a bridge to a relevant service, by making a phone call or looking at resources online. Finally, remember to mind yourself, as you are also likely to have been affected by this loss. Make time to do some nice activities and keep up contact with other friends. Keeping yourself well will allow you to be there for your friend too.