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Surviving suicide: The day after

The loss of a loved one through an act of suicide is a terrible, painful and often a completely unexpected event. Such a loss can cause intense and lasting pain that will be different for each person. The family members and loved ones of a person who commits suicide are called 'survivors', and it is estimated that each suicide victim leaves behind about six people who suffer the moral and emotional effects of the suicide.

Suicide survivors often find that the people in their social network have attitudes or beliefs about suicide that are negative or that attribute blame. Taboos, religious beliefs and a tendency to avoid subjects related to death all contribute to the isolation and stigmatisation of survivors. If social support is also limited, there is a high risk that those affected by suicide will experience complicated grief responses or depression. Survivors may even be at risk of suicide themselves.

As well as a sense of loss, suicide tends to generate a wide range of emotional responses, including: distress, contempt, depression, sadness, rejection, a feeling of abandonment, denial, paralysis, shame, scepticism, stress, guilt, loneliness, anxiety, etc.While such feelings are normal reactions that reflect the pain experienced, those affected may at first feel overwhelmed by these emotions. Some suicide survivors may also experience a feeling of relief, particularly if the loved one suffered from a mental disorder.

Survivors often become obsessed with the reason for the suicide and with the doubt as to whether they could have done something to prevent the suicide or to help the loved one. In many cases this obsessive thinking can produce feelings of guilt. They often may feel that others blame them for the suicide, which leads them to deny what has happened or to hide their feelings. This attitude can complicate the grief process.

The best thing a friend can do in these circumstances is simply to listen to what the survivor has to say. Preconceived ideas should be put aside, and the listener should avoid criticising or making value judgments. The stigma surrounding suicide often makes survivors reticent to openly relate their own experience of the suicide and to show their feelings. To help them, we need to set aside any preconceptions about suicide and suicide victims that we may have. We can do this by learning more about the problem of suicide.

Some advice about how to help survivors

Ask if you can help and what you can do to help. Survivors may not     wish to share their pain and some time may pass before they are     ready to accept help.

Let survivors set the pace when it comes to talking about what has     happened. They'll share the experience with you when they're ready     to.

Be patient. Repetition is part of the process of overcoming what has     happened, so you may have to listen to the same story many times.

Use the name of the loved one rather than 'he' or 'she'. This     humanises the person who has died and is more comforting to     survivors.

You may not know what to say, but that doesn't matter. What the     survivor needs is your presence and your willingness to listen     unconditionally.

You shouldn't try to manage the survivor's grief. Every     individual responds differently, so don't tell the survivor     how he/she should act or feel.

Avoid saying things like 'I know how you feel'. Unless you're a     survivor yourself, you can only empathise with what the other     person is feeling.

After suicide. Steps to take