Why “silence and secrecy” only increase the pain of bereavement by suicide.
Childhood is meant to be a happy time, a protected time, but for some children (especially those prematurely exposed to death as a result of a suicide in their family or community) childhood can become a particularly challenging time.
When there is a death by suicide we need to be able to talk to each other and to our children. Sometimes when adults are in pain and cannot find the right language we communicate with our presence, by our gestures and by our willingness to listen and to reassure to each other. Yet how should we speak to our children at these times?
There are no easy answers to the questions posed by our children at a time of death. Death by suicide occurs twice per day in Ireland with each day adding new dimensions to this essential painful conversation with our children.
Thankfully there is helpful guidance available and it comes from a variety of responsible sources. It is based upon a combination of experience, science and common sense and so this too needs to be shared. While no one should be considered ‘the expert’ in this field, professional help is available and seeking that help is worthwhile and for some essential.
That is why, in this piece, I will try to summarise some key points. I will finish with a list of useful resources. All these references are available through www.stpatricks.ie The intention is to be helpful and to be kind, by enabling each other to communicate at a time of extreme tragedy. Just as there is no right way to grieve, there is no right way to communicate that grief to each other or to our children. We can only do our best in these extremely difficult times. One thing is both certain and reassuring: talking about a death by suicide does not cause a death by suicide. In fact, such a conversation may prevent it.
So how should we have this conversation with our children?
There are some first principles. Firstly, children have a right to know about death. They have a right to ask questions and they have a right to a hearing. Secondly we adults have a duty to be as honest as possible and always to be appropriate whenever we talk to our children about suicide.
Remember that children at differing stages of development have different levels of comprehension depending upon their maturity. For example, pre-teens and teenagers are likely to have very different abilities to express or comprehend their loss. We need to take this individual variation into account when preparing what we are going to say. It is always better to prepare. After every death a conversation such as this may happen at any time. It is best to give this particular conversation some thought and some preparation. There is no harm in rehearsing what you are going to say whenever you have to talk about a suicide with your child.
So what are the first steps?
The first thing is to look after yourself and your own feelings. The shock and suddenness of loss through suicide is stunning. It’s best to remember that the causes of suicide are never straightforward. No one has all the answers. In your grief and confusion try to avoid gossip or speculation from others about the death. There is great value in a period of deep quiet before this conversation begins. Take your time. Give yourself space to cope emotionally. Whether the deceased is an adult or a child the mix of emotions is powerful. Give yourself latitude to cope with your own mixed feelings before you approach your child.
Next step is to care for your child-but how?
Remember your adult grief does not exist in a vacuum. Your concern for yourself will likely be quickly followed by intense concerns for your child. Your awareness of his or her grief is a good thing. As your child’s welfare becomes a priority be prepared for their different ways of handling their grief. Their sadness may be expressed in intense short bursts. Between these times nothing may be said by them. Be prepared to catch the moments when a conversation is possible and respond at that time.
Do your best to speak in a simple way. Avoid euphemisms. Use language that is easy to understand. Be as honest as you can be. This includes sharing your shock and bewilderment, your anger and your sadness. Try also to acknowledge the validity of your child’s feelings. Be ready to hear about their sadness, confusion, anger and lack of understanding. Listen to them. Sometimes a child will simply say ‘I don’t know what to think or say’. Acknowledge that too. Sometimes it’s hard for any of us to know what we feel or what we should feel. Remember it is OK to be distressed. Do not reproach yourself or your child for the way that you feel.
Next, it is best to acknowledge that rumours and questions abound about the suicide. Try to put these into context. Be particularly careful with social media in this regard. Inevitably the full facts will come out and in time the manner of death by suicide, its precipitants and its specific circumstances will be made clear. Soon these ‘facts’ will diminish in importance and be replaced with a deeper truth: the realisation of the finality of the loss. There will be need for much more communication along the way.
It is best to recognise the dangerous and often unintended consequences of self-harm behaviours. It’s important to remain non-judgemental, never to preach or lecture, but it is equally important to emphasise the dangerousness of risk-taking, especially around drugs or alcohol or firearms.
Suicidal behaviour is a learned behaviour. Obviously, it is not a model to be followed. Worryingly, at times, some children feel inclined to copy the behaviour of the deceased. This risk has been seen throughout history amongst siblings or cousins or school friends, leading rarely to groups of deaths known as ‘cluster suicides’. It is important for adults to avoid alarm about ‘clustering’ while remaining vigilant at the same time. Once again better communication is our best safe guard.
Children (like adults) will struggle to understand the reasons for suicide. Sadly, in the absence of any other explanations young people are more likely to blame themselves for the catastrophe. Some children even feel that a parent who died by suicide must not have loved them enough. In both situations it’s important to hear this distress and then to try to reassure the child. As far as possible nothing about the manner of a death should take away from the good of a life lived or diminish the love that was in that life for those who shared it.
Sometimes after a suicide the deceased can become ‘unspoken’ persons. As a result of this silence, those left behind, particularly the children, find themselves simultaneously bereaved of their loved one and prevented from grieving for them, without permission to give voice to their cherished memory. In time, talking with each other may make it possible to offer an alternative explanation, at first tentatively, ‘that the deceased must have felt so confused or so terrible that they came to a dreadful conclusion- that no other solution existed except their own death’. An opportunity to talk with a trusted adult on these lines can make all the difference.
Actually this ‘analysis’ is likely to be true. Suicide is most commonly associated with poor mental health through depression and substance misuse. It is not necessarily a mental health issue but in the vast number of instances mental health difficulty is the basis for suicide. It’s important for adults to affirm that nothing in life should ever be so terrible or so devastating that suicide becomes the best option. With the appropriate help a better option can become reality.
Ultimately we want to ensure that all our children have the confidence and freedom to reach out when they are hopeless, so that they seek more help when they feel depressed or despairing or in a crisis. Earlier intervention and more effective mental healthcare will only be accessed if we hear each other’s needs and respond with effective support.
For further information or support you can call The Information and Support Line at (01) 2493333 or on line at www.stpatricks.ie or check the references below.
-Parenting Positively: Helping teenagers to cope with death. Barnardos and The Family Support Agency (2009)
-The Irish Childhood Bereavement Network. The Care Pyramid: a guide to support for bereaved children and young people (2014). http://www.childhoodbereavement.ie/
When a child’s friend dies by suicide. Society for the Prevention of Teen Suicide http://www.sptsusa.org/
Prof Jim Lucey MD, PhD, FRCPI, FRCPsych
Medical Director of St. Patrick’s Mental Health Services
Clinical Professor of Psychiatry at Trinity College, Dublin