Suicide: What about those left behind?
In some cultures it is viewed as a sin and the family of the deceased may be ostracised.
Henriette Lamprecht – Week after week crime bulletins compiled by the Namibian police have one thing in common: Somewhere someone ended their own life. With suicide rates annually and steadily rising in the country, much emphasis is placed on, among others, mental health as a contributing factor and rightly so. But what about those left behind – often without closure?
Grief associated with death by accident or illness is different to grief after suicide, says Abena Kwakwa, an intern clinical psychologist currently volunteering at Bel Esprit Mental Health Clinic in Windhoek.
“It could be argued that grief after suicide is more traumatic as it is always unexpected,” say KwaKwa.
She explains in some cultures suicide is viewed as a sin and the family of the deceased may be ostracised, which may lead to prolonged grief.
“There is also a stigma attached to suicide, which could hinder family and friends’ ability to grieve properly. It also invites self-blame as friends and family may struggle with not having been able to anticipate the suicide and being left behind.”
Counselling of family and friends should involve convincing the bereaved it is normal to be distressed, says KwaKwa.
“They should be made to understand that grief is a normal reaction. The main focus of therapy is to make sure they are able to accept the death and grieve properly.”
According to KwaKwa there is no time frame for grief, though it is clear that prolonged grief can lead to acute depression.
In the case of a parent who committed suicide, therapy or counselling involves having the children understand the parent was not trying to escape them or life, but rather pain, she explains.
“In the case of an adult or the surviving spouse, therapy/counselling is done to promote acceptance of emotions like fear, shame, anger and grief. Therapy should also ensure there is no suicidal ideation.”
Counselling a surviving spouse would include the acceptance of emotions, talking about the suicide, holding onto memories, expressing emotions, preparing for life without the spouse (i.e bills, insurance) as well as addressing the will if one exists.
KwaKwa explains factors influencing children’s adjustment after a parent’s suicide include the age of the child at the time, personal attributes and the child’s environment, the process and ability to accept the suicide, as well as the family support system.
“There have been studies showing that children dealing with suicide in childhood may develop substance abuse disorders in adulthood.
“Some may have the tendency to follow the deceased parent’s path – hence a higher likelihood of suicide attempts.”
According to KwaKwa, self-blame and fear of abandonment may result in unhealthy relationships in adulthood.
Families’ inability to grieve properly and accept or share emotions means they may not be able to effectively communicate with each other, which may cause rifting and feelings of isolation.
“This could result in long-term disenfranchised or complicated grief or depression.”
According to KwaKwa, the long-term psychological effects on those left behind may include the development of mental illnesses like chronic depression, anxiety, withdrawal, post-traumatic stress, as well as feelings of guilt, shame and rejection.
As an “outsider” one can positively contribute to a family’s healing process, KwaKwa explains.
This can be done by showing concern and availability, and at the same time allowing the bereaved to feel comfortable enough to seek support.
“One must resist the urge to weigh in with one’s own perspective of events. Listen and ask intelligent questions. Give the bereaved space, but ensure he or she knows you are available. Offer help in practical ways like grocery shopping, driving or everyday chores.”
There are, however, no specific dos and don'ts, says KwaKwa, as everyone's character and grieving processes differ.
Signs and behaviours family and friends can look out for to identify suicidal tendencies in a friend or a family member include:
Signs of despair – talking about unbearable pain or being a burden
Change in attitude or behaviour – speaking or moving with unusual speed or slowness
Becoming less concerned with physical appearance
Dangerous/Self-harming behaviour – reckless driving or unsafe sex
Recent trauma or life crisis – recent death, divorce or break-up
Preparing to end life – getting personal business in order, visiting family and friends, handing out personal belongings and drawing up a will
Threatening suicide – 50% to 75% of those considering suicide will give someone a warning sign
(www.belesprit.com.na; [email protected]; Facebook: Bel Esprit Clinic)
Grief associated with death by accident or illness is different to grief after suicide, says Abena Kwakwa, an intern clinical psychologist currently volunteering at Bel Esprit Mental Health Clinic in Windhoek.
“It could be argued that grief after suicide is more traumatic as it is always unexpected,” say KwaKwa.
She explains in some cultures suicide is viewed as a sin and the family of the deceased may be ostracised, which may lead to prolonged grief.
“There is also a stigma attached to suicide, which could hinder family and friends’ ability to grieve properly. It also invites self-blame as friends and family may struggle with not having been able to anticipate the suicide and being left behind.”
Counselling of family and friends should involve convincing the bereaved it is normal to be distressed, says KwaKwa.
“They should be made to understand that grief is a normal reaction. The main focus of therapy is to make sure they are able to accept the death and grieve properly.”
According to KwaKwa there is no time frame for grief, though it is clear that prolonged grief can lead to acute depression.
In the case of a parent who committed suicide, therapy or counselling involves having the children understand the parent was not trying to escape them or life, but rather pain, she explains.
“In the case of an adult or the surviving spouse, therapy/counselling is done to promote acceptance of emotions like fear, shame, anger and grief. Therapy should also ensure there is no suicidal ideation.”
Counselling a surviving spouse would include the acceptance of emotions, talking about the suicide, holding onto memories, expressing emotions, preparing for life without the spouse (i.e bills, insurance) as well as addressing the will if one exists.
KwaKwa explains factors influencing children’s adjustment after a parent’s suicide include the age of the child at the time, personal attributes and the child’s environment, the process and ability to accept the suicide, as well as the family support system.
“There have been studies showing that children dealing with suicide in childhood may develop substance abuse disorders in adulthood.
“Some may have the tendency to follow the deceased parent’s path – hence a higher likelihood of suicide attempts.”
According to KwaKwa, self-blame and fear of abandonment may result in unhealthy relationships in adulthood.
Families’ inability to grieve properly and accept or share emotions means they may not be able to effectively communicate with each other, which may cause rifting and feelings of isolation.
“This could result in long-term disenfranchised or complicated grief or depression.”
According to KwaKwa, the long-term psychological effects on those left behind may include the development of mental illnesses like chronic depression, anxiety, withdrawal, post-traumatic stress, as well as feelings of guilt, shame and rejection.
As an “outsider” one can positively contribute to a family’s healing process, KwaKwa explains.
This can be done by showing concern and availability, and at the same time allowing the bereaved to feel comfortable enough to seek support.
“One must resist the urge to weigh in with one’s own perspective of events. Listen and ask intelligent questions. Give the bereaved space, but ensure he or she knows you are available. Offer help in practical ways like grocery shopping, driving or everyday chores.”
There are, however, no specific dos and don'ts, says KwaKwa, as everyone's character and grieving processes differ.
Signs and behaviours family and friends can look out for to identify suicidal tendencies in a friend or a family member include:
Signs of despair – talking about unbearable pain or being a burden
Change in attitude or behaviour – speaking or moving with unusual speed or slowness
Becoming less concerned with physical appearance
Dangerous/Self-harming behaviour – reckless driving or unsafe sex
Recent trauma or life crisis – recent death, divorce or break-up
Preparing to end life – getting personal business in order, visiting family and friends, handing out personal belongings and drawing up a will
Threatening suicide – 50% to 75% of those considering suicide will give someone a warning sign
(www.belesprit.com.na; [email protected]; Facebook: Bel Esprit Clinic)
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