Suicide’s cruel toll on those left behind

The loved ones left behind after suicide often have more questions than answers, said Liane Lurie, a Johannesburg clinical psychologist and Carin Marcus, a clinical social worker and logotherapist, at a Chevrah Kadisha talk on 13 March about processing the pain of loss.

Using their combined more than 25 years of experience, Lurie and Marcus spoke to a community shattered by the losses from suicide in recent months, touching on elements of shame, grief, and anger.

For the family left behind, the innumerable number of conceptualisations of “whys” may do little to soothe their shattered hearts, said Lurie. “And they ask, ‘Why wasn’t I good enough for them to stick around?’ ‘Why didn’t they reach out to me and tell me what was wrong?’ ‘Why didn’t they allow me to pull them out of the deepest, darkest recesses of their mind?’ These are some of the thoughts, fixations, ruminations, and emotions that run recurrently through their mind,” Lurie said.

“The worst critic in this space of bereavement is the bereaved themselves,” Marcus said. “The game of ‘what if’ is the cruellest game you’re ever going to play, because you’re playing against yourself. You can ask, ‘What if I did this?’, ‘What if I did that?’, or ‘What if I had done this?’ There’s no answer to the ‘what ifs’. One has to journey through that space of asking ‘what if’ because it’s then you realise there isn’t an answer. Only then can one move into the ‘what now’. And very often, it’s a case of the person saying, ‘But, even if I had, I know I would still be sitting here because I’m not G-d, and I don’t have G-d’s direct number.’”

Lurie said the truth about suicide “may prove unsettling because people ultimately have autonomy, they have independence. And they are the only ones who know when life is no longer liveable”.

In the past, there was such a stigma attached to suicide that when someone took their own life, people would use euphemistic terms like “he had lead poisoning”, “he committed a hose pipe”, or “they fell down the stairs” to shield people from the truth, according to Lurie.

“In the same vein, families were often told to lie to friends and younger family members about the reality of what had happened. But when we were old enough to understand the true meaning of suicide, we were then conditioned to believe that it wasn’t a choice, that it was some form of manipulation. Thereby, we were unable to find the gating, the genuine pain, distress, chronic emptiness, and often invisible illness plaguing the individual before they died.”

The use of these euphemisms reinforces a family’s sense of shame, they said.

They delved into the emotional crises that families grieving death by suicide battle through, saying, “After somebody has lost someone to suicide, there are those who can offer compassion, empathy, and support without the intellectual need to understand why. Conversely, there are those for whom the intellectual need for ‘why’ short-circuits their capacity for compassion and empathy.

“Each person’s grief is like a fingerprint. No two people’s grief is ever the same. So, as much as people might share common features of loss, no two losses will ever be the same.”

Lurie told a story about her first experience of a completed suicide when she was doing her internship. She described a vivacious young girl in a psych ward on suicide watch who had spoken of hope and plans for her future. The next day, when she arrived for her shift, she was notified that this girl had died of suicide at 23:00 the night before. “I remember feeling sick and devastated, and I was debriefed and sent home. But as bewildered as I was, this wasn’t about me. This was about a family for whom this wasn’t an event they would just get over. Because it’s a loss that’s incurred repeatedly. And it’s felt acutely on a day-to-day basis, the trauma of which is beyond comprehension. Shock, grief, guilt, fear of blame, self-doubt, shame, anger, betrayal, and profound anguish are some of the emotions that therapists, family members, friends, and community members experience upon learning that somebody has taken their own life. It’s described as the single most significant event in a family’s life, in a professional’s life or career,” said Lurie.

Said Marcus, “Often we blame ourselves because it’s easier to feel we have control over something than to feel helpless. So, when we don’t have control, we say to ourselves, ‘If I had taken him sooner, if I had taken the gun out of his room, if I had taken the pills…’ It’s easier to blame ourselves than to leave it in a space of helplessness because it makes us feel more in control. But it’s such a cruel narrative. And that’s often what we’re working with. You couldn’t have known this. We don’t have crystal balls.”

“Our well-intentioned selves don’t want to see people suffer. So, we quickly look for the silver lining, try to answer the ‘why’ question, or give answers. People are quick to say, ‘But at least he’s not suffering’ or ‘Luckily, he lived to a good age’ and I often think we’d rather have him here sometimes suffering or at a ripe old age. We’re never at an age enough to let go of people that we love. And often in suicide, too, we tend to want to find a silver lining for people. It’s cruel. It’s almost implying that there’s a silver lining at that moment. That silver lining cannot be given to another person. It’s got to be found through the journey of grief by the person. And we’ve got to be able to walk alongside that person to find a way in which they can make meaning of their loss.”