There are perhaps few human events which generate as many emotions and as intense a set of reactions as someone ending their own life. We can divide the reactions into two categories: those which tend to occur early in the grieving, and those which are ongoing. In this post we explore the early reactions of grief and mourning for the suicide-bereaved.

Shock

Suicide is a shocking event. Whatever assumptions the survivor holds about the world are suddenly shattered, and there is no defence against the horror of losing a loved one in this way. The suicide-bereaved in shock often feel shaky, numb, and like whatever is happening around them is surreal. The person may have difficulty breathing, dry mouth, nausea, tightness in the throat, and chest fatigue. There may be feelings of emptiness. Confusion reigns, and it is difficult to eat, sleep, or do routine tasks; people often have no memory of key aspects of events. Shock is exemplified by the comment of one person in the immediate aftermath of a suicide: “Is it normal to feel like you are just existing, no feelings at all, and kind of numb? I feel as though I’m still in shock. I don’t think it has really hit me yet” (Alliance of Hope for Suicide Survivors, 2011).

For some, shock is made worse by added traumas, such as from searches, rescue attempts, discovering the body, or witnessing the death. Shock is common in the days and weeks following a death, and may even go on for months for some people. It is a good time to be gentle on oneself and let others help out (Alliance of Hope for Suicide Survivors, 2011; Hawton & Simkin, 2010).

Numbness

As we noted above, nature’s anaesthetic — numbness — settles over us in the immediate aftermath of a suicide in order to protect us from feeling too much pain at once. By having the experience that one is “in a dream” or that things are “not really happening”, the bereaved person is able to let the loss in more slowly than if numbness did not occur. It serves us by keeping intense feelings somewhat at bay so that practical arrangements can be made. In fact, upon experiencing it, some people are in awe that it could so thoroughly affect their emotions, and yet leave their intellect intact. As one woman noted upon the suicide of her son, “Emotions can perform a lobotomy as effectively as any brain surgeon’s knife” (Dunne, E. & Wilbur, M., 2005). Numbness limits us in that some people may feel embarrassed, or doubtful that they truly loved the deceased if they cried very little at (for example) their own father’s funeral.

Disbelief, denial, and searching

As shock and numbness wear off, they give way to a sense of loss so powerful that it overwhelms the logical capability of the survivor to respond. Disbelief, denial, and searching occur, where, despite the awareness in one’s mind that the person has died, the bereaved survivor finds it hard to accept at a deeper level that the death has occurred. Confusion, panic, and fear are frequently experienced. The bereaved find themselves instinctively searching for the person they have lost: talking to their photo; being certain that they saw the deceased, say, getting into a car, or off in the distance walking away; or dreaming that they are back.

One woman said:

“After we came home from the hospital, I began making the foods she liked. I thought that somehow if I made what she always liked she would be all right. Then I put the food on the table and waited. . . ” (Dunne, E. & Wilbur, M., 2005)

Sometimes these experiences are so powerful that the survivor may question his or her sanity, yet such experiences are quite common at this stage of grieving. Because the thought of the death is so disturbing, some become convinced that it was really an accident or a homicide. Some families have even been known to entertain conspiracy theories. Denial and disbelief are the mind’s response to a threat of danger and to the fear of losing control. This is a good stage for you as professional to come into the picture. Eventually letting in the dreadful facts is a step towards realising that one does not have to, and in fact cannot, control everything.

Longing

Coming to grips with the fact that the deceased person is really dead plunges the survivor into even deeper sadness. To deal with this, the survivor begins to have overwhelming and desperate urges to see, touch, talk to, and be with the lost person. Survivors here have the need to talk about the person, and to replay things that happened over and over again in their heads. The intensity of the pining for the person can be devastating, yet it is part of the natural struggle to come to terms with the loss.

Physical and emotional stress

Dealing with the death of someone close is such a primary stressor, bringing on so many intense stress symptoms, that many newly-bereaved people are heard to say, “I feel like I’m going crazy”. If your client feels this way, you can assure him or her that both the physical and psychological reactions are normal responses to deep loss. Some of what the person may be experiencing is:

  • Restlessness
  • Sleeplessness
  • Fatigue
  • Vivid dreams
  • Difficulty concentrating
  • Difficulty remembering things
  • Dizziness
  • Palpitations
  • Shakes
  • Difficulty breathing
  • Loss of appetite
  • Nausea
  • Diarrhoea
  • Disturbance of menstrual cycle
  • Sexual interest may be affected
  • Choking in the throat and chest
  • Headaches, neck, and backache

The pain and discomfort of these symptoms may be so intense that the survivor doesn’t believe it is possible for a normal human being to experience these and not go out of their mind. Your role as mental health practitioner may be to simply reassure the bereaved that the intensity only means that they need to be very gentle with themselves. It’s not about mapping out a whole new future right now; it’s about taking things one day at a time. They need to allow themselves to receive help and just move through this period, trusting that things will improve over time.