How can you help a suicide survivor?

It is estimated that every person who commits suicide leaves behind six to eight people who will be severely affected by the death.  That means 180,000 to 240,000 people a year become “suicide survivors” in this country. The total number of Americans dealing with the aftereffects of suicide currently exceeds 4.5 million [22] .

The grief that accompanies any death is compounded by incomprehension, guilt and anger to a degree far beyond the experience of those who have lost loved ones to accidents or natural causes.  In most cases, it will take the suicide survivor much longer to come to terms with the loss.

Suicide is not a subject with which most people are comfortable.  But the reticence stemming from this discomfort is likely to be misjudged by the survivor as either disapproval or rejection stemming from the stigma that still attaches to suicide.  Never forget that you are dealing with someone trying to cope with what is almost certainly the worst experience of a lifetime.  If you are sincere in your commitment to help, be prepared for a significant investment in time and emotional energy.  Here are the fine points:

• Be very, very patient.  Suicide survivors, as the first step in the grieving process, must come to terms with a conscious, lethal act that took away a loved one.  The survivor is likely to become almost obsessive in talking about the event to a nonjudgmental listener.  Repetitive and unproductive as this may seem to the listener, it is a normal part of the grieving process for the suicide survivor.  By replaying the event, he or she is seeking – and will ultimately find – some accommodation with it.  Your role as a sounding board is much more important than it may seem, as you listen to what seems to be an unvarying recounting of the same event for the fourth – or 14^th – time.
• Don’t judge.  Remember that some people still consider suicide immoral. There is even a widely held, though erroneous, belief that suicide or attempted suicide is a criminal act.  So the bereaved is likely to feel that the death violated either a law or a taboo and that he or she is being judged by association.  The instinct to withdraw in the face of such judgment – real or imagined – compounds the sense of alienation.  You can reduce this sense of ostracism by not avoiding the subject of how the deceased died and, in fact, encouraging open discussion of it.
• Don’t hesitate to speak of the deceased.  Discouraging the survivor from thinking of the lost loved one is pointless.  His or her life is dominated by those memories during the grieving process.  Try to bring up pleasant memories of the deceased during such talks, so that he or she appears as a whole person, not just a single, tragic event.
• Encourage discussion of the survivor’s own suicidal thoughts.  Suicidal ideation is common among survivors, though actual suicide attempts are relatively rare.  Be assured that you are not risking “putting the idea in his (her) head” by raising the subject.  And talking about it will help put the matter in perspective
• Don’t challenge the survivor’s unrealistic defense mechanisms.  Denial, evasion and outright lying about the death may be part of the survivor’s approach to coping with it in the most painful early stages of the grieving process.  Understand that knowing what is true and being able to deal with it can be very different things.  Listen patiently, do everything in your power to win the mourner’s confidence and wait for this stage to pass.  If it appears that the denial is becoming a permanent delusion, find a way to supportively suggest that he seek professional help.
• Don’t preach.  Any sentence prefaced by the phrase “If I were in your shoes, I would…” will be resented.  It will also be foolish.  You don’t know how you would respond to such an event.  And guessing is presumptuous and condescending.  Don’t talk.  Listen.
• Don’t compare suffering.  This isn’t a contest. No one undergoing the agony of grieving draws any solace from hearing how much you’ve suffered. 
• Learn what community and professional resources are available.  Even the most well-meaning friends and relatives may not be able to provide all the support a suicide survivor needs.  Research the availability of competent clergy, lay counselors or medical professionals in your community.  Determine whether there is a local suicide survivor support organization.  Locate and bookmark respected Internet support groups for those able to make use of such organizations. [23] , [24] , [25]