Although suicide usually is a solitary and secret act, it reaches deep into the lives of other people. What appears to be highly individual occurs within the immediate environment of family and friends, as well as the broader context of society as a whole. Suicide reflects collective attitudes and this impacts upon how we, as individuals and as a society, integrate with this phenomenon. Tensions between social behavior and moral values create suicide as a dilemma. It confronts ideologies such as the sanctity of life and the preferred order of cultural milestones. Control is thought to be required. Historically this occurred through the state and the church. Nowadays these structured shackles have been shed, however, suicide remains a cultural conundrum. So does suicide grief.
Losing someone you love to suicide can be a devastating experience. A legacy of torment is created where stigma, shame and secrecy reside. These are echoes of a world that does not know how to respond to what is now termed an epidemic. The baton of collective discomfort is passed from someone who has completed suicide to those intimately involved, making grieving suicide a lonely sentence of social disapproval.
I know. This happened to me. Just as my husband’s nightmare ended with his suicide, mine began. To ease my anxiety I needed to understand what underpinned his decision, to feel his pain and to wonder why his death was so difficult to grasp.
Death is part of life. We all will experience it one day. The unknowns are when and how. Suicide confronts these mysteries. It breaks the rules. It challenges social mores. It may be violent and gruesome, lacking middle-class Western sanitization of the human condition. It makes us feel uncomfortable and therefore we create rules around it.
What better way to enforce public concern than through institutionalized discrimination. While we no longer bury someone who has suicided outside the city limits or banish the bereaved, there are modern methods of exclusion that ensure segregation goes well beyond the grave. For instance life insurance policies made void, or houses that must be identified, if suicide has occurred in a dwelling that goes on the market.
Suicide, thus, is more than death. It is social judgment. Norms have been violated and in the absence of the dead, the living are found guilty. Those who complete suicide are said to be ‘victims of mental disorder,’ and those intimately involved ‘survivors of suicide.’ The acronym for this, S.O.S., shouts alarm that all is not well. Such unease can be witnessed through the voices of the marginalized, those who suffer loss through suicide.
I discovered this as I became aware that I was far from alone in my agonizing grief. Little by little people began opening up to me about their own experiences and I soon found myself collecting their stories. As a medical sociologist I was intrigued by what being intimately involved with someone who suicides means. A matrix began to unfold. Not only was my own unease being affirmed, these experiences were revealing commonalities that reflected negative constructions of suicide. I found that the lived experience of suicide grief replicates prejudicial attitudes to suicide and this detrimentally interferes with the grieving process.
While aspects of each person’s experience differed there were consistent similarities. At the core were difficulty in acknowledging and accepting suicide; guilt at not being able to prevent the suicide; and feeling rejected by the person who suicided. Confusion, shame and helplessness were in danger of being incorporated into a post-suicide identity and interfering with the grieving process.
Contradictory perceptions of suicide make it difficult to understand. It was certainly made apparent to me, by a so-called expert, that my husband was considered to have a mental illness and “should be locked up.” What I saw was a man in pain. A man so selfless, who, I believe, removed himself so as not to burden or ‘contaminate’ (his word) others. His view did not sit easily with the authoritative voice of condemnation. Rather his ultimate decision is understandable as an act of altruism. Yet, he, and other people who suicide, are constrained by lack of choice within an environment that sees complex issues through a single lens. No wonder those who care are equally confused.
Many of the people I spoke to had not opened up before about their connection with someone who had suicided. Embarrassment, shame and making others feel uncomfortable were cited as reasons for this. We each had found ourselves in an awkward void where we were not able to express our grief openly less we, too, were judged.
For some of us guilt crept in early. When a body is found the coroner needs to determine the cause of death. Or if a person goes missing the most likely scenario needs to be established by the police. Murder can sometimes be made to look like suicide and those closest are often scrutinized formally by the police and informally by spectators. The police questioned me at length when my husband went missing. The minds of curious onlookers fueled by speculation.
Scapegoats were not uncommon. A number of people spoke about being blamed for the suicide of someone they loved. Simple explanations were often favored over compassion and complex insights. Answers were sought and frequently someone, or something, became an easy target. If broken relationships, financial stress or embarrassing moments alone caused suicide many of us would have chosen that path already. These are everyday occurrences most people survive. They are not death sentences. They may be the last straw, the catalyst, but rarely are they the single identifiable reason for suicide. Sometimes suicide is a time bomb waiting to go off and a bystander merely stumbles over the trip wire. The cause of suicide involves more than a single life event gone wrong.
Feelings of rejection were high. A sense that someone who completed suicide had a choice over their action left loved-ones feeling abandoned and defenseless. A paradox when it is likely this is exactly how the person who completed suicide had felt. Even the well-intentioned suicide prevention programs can contribute to these insecurities. If suicide can be prevented why, ask the near and dear, could I not have saved my loved one? Or why could they not have saved themself? I was one who had difficulty with the underlying proposal of this program, which is based around being alert to ‘invitations’ for help. In my husband’s case there were many such clues that, despite intervention, did not alter the outcome. Without disclaimers it is easy to pile guilt on the shoulders of those who already assume some form of culpability. With all the good will in the world suicide still wears the misallocated cloak of wrongdoing, rather than alienation, dislocation and powerlessness.
Currently suicide is an enormous social problem with burgeoning numbers and groups identified who were previously not considered as being at risk. For instance it is now reported as the biggest killer of teenage girls. Attention must be drawn to the social milieu, as individual actions cannot be viewed in isolation. What the people I interviewed and I were experiencing was a social phenomenon being reduced to a form of existential angst. We can’t have one without the other. To be human is to be social. Yet suicide, and suicide grief, sit firmly in the separateness of a society focused on individualism.
I came to realize that the lived experience of suicide grief is inextricably bound to perceptions of suicide, and that those who grieve echo the displacement and isolation felt by the suicidal. Communal concerns are transacted at the level of the individual and when these create suicide as a form of transgression it limits choices for the suicidal and makes resolution difficult for the grieving. When attempts are made to control what suicidal people may feel they have no control over, an imbalance in perception arises. Embracing the suicidal within society rather than furthering isolation through social sanctions would provide a more supportive setting for those troubled by anxieties. Moreover it is only by reinventing suicide as death without penalty that the experience of suicide grief can be lived more easily. In an attempt to reach out to those bereaved by suicide and to open discussion on suicide grief, I have combined my own lived experiences with others in my recently published book, Suicide Tsunami.
Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.