Dying to Be Free

A Healing Guide for Families after a Suicide

Beverly Cobain and Jean Larch

Who should read: If you’ve lost someone to suicide, or are trying to support those who have. 

Best quote: “At the moment an individual ends his life, he ends his pain. In that very same moment, the suffering of those left behind begins.” 

Why I feel it is important to veterinary medicine: We are a profession at high risk of suicide, which also means we have a high probability of encountering loss of someone to suicide. The emotional and mental ramifications of that are not improving our mental health as a profession. 

I very recently lost someone to suicide. It’s not my first time losing someone, but it is the first time as a result of suicide in a direct connection. It’s been a bumpy road. It’s been much more complex than normal grieving. There is the factor that I may have been the last person they spoke to, and specifically we spoke about actions and options to manage the biggest stressor they were facing (per their suicide note). There is the fact that it pulled the rug out from under me- nothing within our conversation clued me in to the state of their mind, and we had actually made plans to meet in person to pursue further action. It has left me second guessing my intuition and ability to connect with people. There is the fact that the act of suicide was so incongruent with their personality- this was an individual that normally was an enormous force of positive energy. To be in their presence was to feel energized, uplifted, noticed, and appreciated. There is the fact that this was an individual as vocal and protective of veterinarian’s mental well-being and prevention of suicide as I am.  There is the fact that I had created one tool to manage this person’s stressor, yet chose not to share it because it seemed too self-serving and redirecting the focus from them to me. Now, I will never have the opportunity to share that tool. There is the guilty relief that I didn’t share this tool and watch this person lose their battle with mental anguish with me more heavily involved in their struggles. And there is the fact of society’s impression of suicide. Initially their family was very open and honest about the cause of their loss, but then they retracted away from openly discussing suicide. Much of me wants to talk about how this is a striking example of how suicide can affect anyone, but much of me wants to respect the family’s wishes and experiences. So I don’t say much at all. I find myself at a loss. Lost in how to process this. Lost in understanding my responsibility and ownership of what happened. Lost in how to offer support for the others around me that were as deeply affected as I was. 

Loss of someone by suicide is a shocking experience, regardless of your relationship to that individual. Navigating those complex feelings in the midst of grief, and usually in the midst of normal life grinding on, is a different challenge than most of us are prepared for. It’s important to know that you are not alone in this experience, there is help available to navigate and overcome the experience, and many around you are in need of it also. This book gives good insight into the myths and factors surrounding suicide that are often missing in our culture’s awareness. 

Factors Associated with Grief Specific to Suicide

Any grief journey is challenging. There are some factors characteristic to loss by suicide that complicate the journey. The suddenness, societal stigma, possible feelings of guilt, and in some cases, PTSD created by the suicide, present added challenges. The knowledge that the victim of suicide suffered so deeply that they chose to purposefully end their life is an incredible burden to bear, and most of us aren’t equipped to navigate that without support. An added challenge is that many survivors report that continued support from the community starts to disappear long before the grieving has eased. It is not uncommon for those left behind to also begin to consider suicide. Most do not follow through, but navigating this journey can be so lonely, and we are already at high risk, so please do not keep those thoughts to yourself. Talking about scary things lessens their power upon us. Our risk factor in this profession is already too high, so I would urge you to seek professional support. 

Understanding the Person You Lost

 Most people that commit suicide are experiencing a severe psychache: pain in the mind. Unlike physical pain, medications and solutions don’t resolve the psychache as fully or rapidly as we can address physical pain. People that choose suicide have two factors that lead to their decision: 1. Intolerable mental pain, 2. An idea that death can provide escape from it. Once they have decided this is their best or only solution, they often exhibit relief and peace that has been absent from their behavior, leading those around them to believe they are improving. They may even appear happy or euphoric in the time leading towards their death. They can develop tunnel vision towards suicide, and become fully impenetrable to their loved one’s outreach and connection. It’s not that they don’t return your love or care what you have to say, but that their mind has become fixated on the idea of relief and cannot absorb anything further. At this stage, they will usually hide their intentions and plans from others, leaving those survivors stunned and doubting their intuition and connection with the deceased. It can create an unintentional experience of gaslighting. It is important to know that all cases of suicide were a choice made by someone else, exclusive of you and their relationship or interactions with you. 

Suicide is Non-discriminatory

A very common finding with people who commit suicide is that many left behind would never have expected the victim to choose suicide. They are frequently described as funny, happy, beloved and connected people. High achievers and highly accomplished, intelligent individuals are susceptible, right alongside those who have suffered childhood trauma, and those that have made prior suicide attempts. People in therapy commit suicide, as do people who have never had therapy. Underage people or people that appear to have everything that would make you happy. The take away here is that you cannot predict who may be contemplating suicide unless they communicate so. Another really important take-away is to not be afraid  to speak about suicide with someone you are worried is at risk. A myth they discuss about suicide is that speaking about it may give someone the idea. If they aren’t already in the place of considering suicide, openly talking about it isn’t going to change their state of mind towards it, and it can actually provide an opportunity for those who have considered it to speak about their feelings and struggles. 

Myths Regarding Suicide

The authors take some time to dispel some commonly held beliefs about suicide that don’t hold truth. Knowing the truth can be helpful in your journey, so I’ve added some of them below: 

Myth: Suicidal people want to die. They are craving peace. Freedom from pain. They see only one option left for them, but that doesn’t mean they have no value for life. 

Myth: People who talk about suicide won’t actually commit to the act. It is impossible to predict who will and who won’t. Anyone who speaks about suicide should be taken seriously and connected to support. 

Myth: Using the word suicide may cause someone to commit the act. Asking kindly and supportively gives the individual an opportunity to share their feelings and struggles, which can be very beneficial to drawing them towards other solutions. 

Myth: When a distressed person’s behavior suddenly improves dramatically, the danger of suicide is over. Abrupt mood changes can be a danger signal. Many suicidal individuals will hide their thoughts and plans from loved ones so successfully that no one guesses. 

Myth: Once suicidal, always suicidal. Many people have at least considered suicide at some point, but that doesn’t ensure they are always at risk. It truly is impossible to predict who is at risk and who is not. 

Myth: The arrival at a decision of suicide is always a gradual one. For some individuals, pshychache comes and goes abruptly. 

Myth: Each person that commits suicide has an underlying mental illness. All have mental distress, but not all have an underlying illness. 

Helpful strategies for Overcoming Loss by Suicide

Allowing yourself to mourn and grieve your loss is critical. Many times, those that are also affected by the loss are not the best source of support, as they will have a lot of processing and confusion of their own. Suicide may result in grief and trauma, and these factors may need to be processed separately. Support comes from others and from yourself. Look for people that will listen, are willing to talk about the person lost, will provide long-term support, and show you small acts of kindness. To support yourself, ask for what you need and want, get exercise, seek humor, find ways to honor your memory of the individual, and forgive where it is needed. Most people will find they need a combination of strategies, including a friend group, self-care, and formal counseling or therapy. There are numerous organizations and resources out there- I’ve included some below. 

My ultimate plea to you is to not let this loss create another loss- whether that be your life, your engagement with others, or your relationship with your career. This can be overcome. 

Practical Implementation Exercises: 

1. Write a letter to the individual you lost. Be frank about what you are thinking and feeling. You can keep the letter to look back on when you want to do more processing, or you can destroy it. 
2. Contemplate what would be most helpful and supportive to you right now. Find someone you are comfortable with and ask if they see a way they could help support you in this manner.

Additional resources: 

Support Groups and Resources for Survivors of Suicide

SAVE

Alliance of Hope

AVMA