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Grief After Suicide

Suicide. The very mention of the word conjures up uncomfortable feelings in us. While it may be comforting to believe that suicides do not occur very frequently, or that when they do occur it happens in “other families,” neither of these beliefs are necessarily true.

On an annual basis, suicide consistently ranks as one of the top 10 causes of death in this country, and in fact, there are more suicides than homicides on a yearly basis (1997 data documented suicide as the 8th leading cause of death, with homicide ranked 13th). On average, a suicide occurs about every 17 minutes. Roughly 30,000 Americans die by suicide on a yearly basis. During the years 1972 through 1997, there were roughly 765,000 reported suicides in America. Locally, vital statistics data document that there were 330 reported suicides in Harris County in 1995, representing 1.1% of all resident deaths. In 1996, there were 340 reported suicides in Harris County, representing 1.8% of all resident deaths. Individuals that die by suicide range in age from the young to the very old, they come from different ethnic backgrounds, and from all economic levels.

After the suicide of an important person in our lives, we feel shocked and shaken. Nothing in our past could have prepared us for this truly shattering event. How to cope with this terrible news? It couldn’t be… When it is true, when suicide touches our lives, we begin a grief process that many have described as torturous. Those who have lost a loved one to suicide are termed “survivors,” and we number into the millions in this country alone (number of survivors estimated at 4.5 million, or 1 of every 59 Americans). I say we, because I too am a survivor of suicide, having lost my mother when I was much younger. Since that moment in my life, I have traveled on a road toward survival, assisted greatly in my course by the loving presence of some very special people. I have also become keenly interested in suicide prevention and in tending to the needs of those who have suffered a similar loss. In my current practice, I have a special interest in providing grief counseling and support to those similarly touched. As I have walked down the road, and witnessed the courage that others’ have shown in the face of their losses, I know that this type of loss need not cripple us forever. The journey is hard, but not impossible. There may be times when the struggle of it all seems too much to bear, times when we doubt that we will ever make it. It takes a tremendous amount of courage to trudge onward, continually seeking to make sense of what is typically viewed as a senseless and wasteful loss of life. If you have touched by suicide, know that you are not alone. You are a member of a large community indeed.

I would like now to share some about what my experience and the professional literature suggest about the types of grief reactions that suicide survivors commonly report. The reactions that I will speak of are thought by some to be more prevalent after a death by suicide as opposed to a non-suicidal death. I have previously published a journal article on a study that revealed that suicide survivors, compared against those bereaved by other modes of death, reported heightened feelings of rejection, responsibility, stigmatization, and shame. There are many other studies in the literature that have sought to examine the potential “uniqueness” of grief after suicide. I will reference some published literature in the discussion that follows, and I invite you to contact me if you would like more information on these investigations.

Let me restrict my discussion to just a few particular grief reactions, staring with feelings of rejection. Suicide has been termed the “ultimate personal rejection,” and feelings of being abandoned or rejected by the deceased are frequently reported. These feelings can greatly affect the grief that we encounter and the mourning that we must face.

Survivors also typically engage in a painstaking “search for explanation.” Therese Rando (1993) noted that the initial process of mourning involves recognizing that a loss has occurred. This requires the newly bereaved individual to both (a) acknowledge that a death has in fact occurred and (b) understand the reason(s) for the death. Cleiren (1993) found that the questions typically asked by survivors during their grief centered on the thoughts of the deceased person prior to the act itself. Of note, Edwin Shneidman (1985) wrote that in the mind of the acutely suicidal individual, “the usual life-sustaining images of loved ones are not disregarded; worse, they are not even within the range of what is in the mind.” In the case of suicide, efforts to understand the many “Why?” questions can be both time consuming and emotionally draining. Such a search for explanation can also take the form of seeking to find some sort of meaning in the wake of such a tragedy.

Feelings of responsibility are also frequently reported. That is, survivors may feel themselves to be more or less responsible for the fact of the death. It is easily seen that holding the belief that one contributed (directly or indirectly) to the suicide of a loved one adds yet another unique burden to be dealt with. Sadly, survivors can all too easily recall times that they could have acted differently, especially around the actual time of the death. We also know that in about 80% of suicides, “clues” are (consciously or subconsciously) left by the tortured mind of the suicidal person. Unfortunately, these clues are all too often much too subtle to command our attention at the time, and in retrospect, may be much more easily recognized. Believing that we missed such clues, and therefore the opportunity to intervene to perhaps save a life, can then become a heavy burden to bear.

To lesser or greater degrees, feelings of guilt are likely to be experienced. Guilt is perhaps the grief reaction most mentioned in the literature as a reaction in the wake of a death by suicide. Therese Rando (1993) has stated that “in modest amounts, guilt characterizes most mourning experiences; however, in mourning after suicide, it is infinitely stronger and more persistent.” This assertion seems reasonable on an intuitive level, in that losing a loved one to suicide can be very easily imagined to induce thoughts and feelings of guilt over acts done or not done.

Feelings of shame and embarrassment about the manner of their loved one’s death are also reported by many survivors. For example, in a study by Range and Calhoun (1990), 44% of the survivors surveyed reported that they had lied to others about the cause of death.

Survivors may also feel stigmatized and unsupported by others after the death. It is not surprising that feeling stigmatized and simultaneously unsupported by members of one’s community are related. Suicide has a long history of negative associations (i.e., with insanity, criminality, etc.), and stigma still surrounds the act and those who mourn it.

As we see, the very nature of a loss due to suicide introduces a whole host of problematic issues and reactions that will color the experience of grief.

If you or someone you know is a “survivor,” you need not feel alone in your grief. Locally, Crisis Intervention of Houston (713 527-9864) holds support group meetings where survivors come together to give and receive support. The National Resource Center for Suicide Prevention and after care, a component of the Link Counseling Center in Atlanta, also has valuable resource materials available and can assist in directing persons to available local resources (404 256-9797; Doreen Schultz, Associate Director). Another very helpful resource is the American Association of Suicidology (AAS), a nonprofit organization dedicated to the understanding and prevention of suicide, including attention to the needs of survivors. AAS can be reached at (202) 237-2280. You may also consider individual counseling as a means to assist you in coming to terms with the painful grief you may feel. Whether the death was very recent, or more distant in time, this type of loss will challenge you in ways you could have never imagined. Seeking assistance, whether through support groups and/or individual counseling, can be one of the most courageous and life-altering (in a positive sense) decisions that you can make. If it is possible that I can be of help to you, please do not hesitate to contact me. In one way or another, this is a shared journey…

Grief Counselor, Dr. Steven Bailley
Grief Counselor
The purpose of these articles is to provide interested readers with information and thoughts about loss, grief, mourning, and grief counseling. A variety of grief-related topics have been covered. It is my sincerest hope that you will find the information presented here to be of interest and assistance to you. If there are specific topics of interest that you would like to see added in the future, I welcome you to email me with your suggestions. If you have a need to talk with me, please call me at my office at (713) 914-9944.
Collection of papers and articles on grief, and coping with grief
The need to express our grief… Grief is Different For Each of Us The emotions of grief: Guilt
Grief, Mourning and Grief Counseling The Experience of Grief The Emotions of Grief: Anger
Reactions from others… The Seasons of My Heart The emotions of grief: “I feel like I’ve lost control of myself.”
The Closeness of Mortality Ambivalence
A 'Grief Journal' Grief After Suicide
Research and clinical experience support the idea that many bereaved individuals gain benefit from grief counseling. Ideally, counseling can help people to cope as adaptively as possible during difficult times that follow a loss, and can also assist in bringing grief to a more adequate resolution. Should you decide to explore the possibility of seeking professional assistance, at any time following your loss, I welcome you to contact me to explore this option (appointments and fee schedule are available upon request). Every person is unique, and I will work with you to assist you in coping with your specific needs. At this most difficult time in your life, I wish to extend to you my sincerest condolences for your loss.

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