Grieving after a suicide

sunshine

Recently I found out that an ex-client from my old workplace had completed suicide, which really rattled me as a person and a psychologist. I immediately thought of the pain and despair they must have had to feel that it was impossible to continue living, pictured the grieving family and friends and then reflected on my past interactions with them. A week after I heard this awful news, I happened to have a supervision session which quickly turned somewhat into a therapy session. My supervisor gave me a space to grieve and reminded me to do what I often tell my grieving clients – try to find meaning in loss. This supervision/therapy session was exactly what I needed at that time to process my grief.

I was surprised when I heard the statistic from a recent episode of ABC documentary series called ‘You Can’t Ask That Question’ on suicide attempt survivors – 8 people died from suicide each day in Australia. This concerning statistic is double the number of Australians who died from road accidents! Most of the suicide attempt survivors interviewed in the program reported that they did not actually want to die instead they wanted a break from the painful feelings they had been experiencing.

What is grieving? Grieving is a healthy human reaction to a loss experienced, which typically involves acceptance of loss and learning to manage daily life without the person who died. Everyone grieves differently (even in the same family) because everyone has a different relationship with the person who died, carries varying past experiences of loss, and expresses their grief differently; for example, one person may prefer to share their feelings and thoughts while another may find it hard to show their emotions or verbalise their grief. Remember, there are no set rules on how to grief or what emotions one should be feeling.

When someone dies suddenly, it is not uncommon to feel overwhelming arrays of emotions and thoughts. Below is a list of feelings and thoughts that may be experienced:

  • Anger towards the person for taking their own life and leaving pain behind; or towards someone else who might have been perceived to cause or contribute to the suicide; or towards your God (if you have faith). It is also not uncommon to try and find someone to blame from the suicide.
  • Defensiveness as a protection against other people who may ask intrusive questions or say something upsetting.
  • Depression and anxiety from the intense grief.
  • Despair over prospect of life without the person who died.
  • Fear of how life will be like without the person who died.
  • Guilt over something that they believe they could have done differently to prevent suicide.
  • Numbness or feeling ‘nothing’ – for some people if may take a while before pain shows up.
  • Physical reactions – sometimes grief manifests in physical symptoms such as headaches, upset stomach, sleeping difficulty, change in appetite and/or poor immune system.
  • Intense longing to have the person return to life and experience their presence either physically (to see, touch, hold or smell) or emotionally.
  • Questioning “what if?’’ – It is not uncommon to question if suicide could have been prevented or if something could have been done differently.
  • Questioning “why?” – This is a common question that people who were left behind ask themselves and sometimes this question may never be answered completely. The reasons for suicide are often complicated and only the person who died could answer this question.
  • Rejection – sometimes people may feel that their love and care were rejected by the person who committed suicide; or sometimes people may feel rejected by others when they seemingly don’t offer appropriate support.
  • Relief – some people could not help but feel relief especially when the person who died had been experiencing distress and pain for a long time. This is a natural response from a long period of tension and stress and does not mean wishing the suicide to happen.
  • Sadness is the most frequent response reported after death of a loved one.
  • Searching for the person who died for instance by visiting places where the person used to go in case they will be there. It is also not uncommon for the grieving person to think that they have caught a glimpse of the person who died, to dream about that person or to call their name.
  • Sense of acceptance. It is possible to both accept the person’s death as a choice they made to end their pain and feel sadness over what has happened.
  • Shame maybe from regret that more could have been done to prevent death or maybe from stigma associated with suicide.
  • Shock and disbelief can manifest in different ways, such as losing ability to breathe normally or to complete daily tasks, or to feel detached from reality.
  • Stigma. Despite the concerning rate of suicide in Australia, suicide is still considered a taboo subject to discuss. People bereaved by suicide have reported feeling judged by others when death was by suicide.
  • Suicidal thoughts.

Can unresolved grief be problematic? The new Diagnostic and Statistical Manual for Mental Disorder (5th Ed., DSM-5) listed Prolonged grief disorder as a syndrome when a bereaved person experiences persistent yearning of the deceased for at least six months after the death. Criteria for prolonged grief disorder include preoccupation with the circumstances of death, difficulty of positive reminiscing about the person who died, and a desire to be together with that person. Prolonged grief disorder has been associated with 6 to 11 times greater risk of suicidality.

Regardless of how one chooses to grief, it is important for the grieving person to continue looking after themselves. It may be by doing things that they enjoy, spending time with other people or being alone by themselves. Looking after self is about identifying what is needed and getting those needs met. Many people also find talking about their grief helpful – it may be to a friend/s or family member/s, a professional who does not know them, and/or to a support group or other people who have been affected by similar experiences. Some people prefer to express their thoughts and feelings on paper instead of talking to others. Other things that can help include spending time outside, making opportunities to remember the person who died, and/or developing a personal ‘emotional first aid kit’ that can be used when feelings associated with grief get too much. Grief can feel crushing and relentless, but processing grief over time will give space for growth to occur and hope to return.

Below are telephone numbers for crisis help and support:
Mental Health Telephone Access Line 1800 011 511
Lifeline 131144
Suicide Call Back Service 1300 659 467
Kids Helpline 1800 55 1800
MensLine Australia 1300 78 99 78

References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Public Health England. (2015). Help is at hand: Support after someone may have died from suicide. doi: http://supportaftersuicide.org.uk/support-guides/help-is-at-hand/

Thinking there is perfection is your first imperfection (the first of many)

i-can-t-keep-calm-i-m-a-perfectionistHi, my name is Alison and I am a perfectionist. Actually, let me rephrase that. I’m a recovering perfectionist. Take it from me, the road to recovery from perfectionism is a long and difficult one. Why is perfectionism such a problem that warrants recovery and repair? Does this not mean that I’m a high achiever on the healthy pursuit of excellence, destined for greatness?

Well my friends I’m sorry to be the bearer of bad news, but perfectionism does not in any way resemble the healthy pursuit of anything. It is not healthy. Fullstop. It is actually quite harmful. Perfectionism can seem like a positive trait. It can make you seem smarter, more switched on or driven to succeed in life. Yes, often the perfectionist can present this way. But there is another side to perfectionism that is far less enticing, less rewarding and far more damaging.

Let me take you behind the scenes on some of the core beliefs behind this insidious trait. As a perfectionist:
1. You are motivated by the fear of failure or a sense of duty.
2. You feel driven to be number one, but your accomplishments, however great, never really satisfy you.
3. You feel you must earn your self-esteem. You think you must be very ‘special’ or intelligent or successful to be loved and accepted by others.
4. You are TERRIFIED by failure. If you do not achieve an important goal, you feel like a failure as a human being.
5. You think you must always be strong and in control of your emotions. You are reluctant to share vulnerable feelings like sadness, insecurity or anger with others. You believe they would think less of you.

Basically, perfectionism hampers success. It can lead you on a path towards depression, anxiety, addiction and life paralysis (defined as all the opportunities you have missed out on due to fear of putting anything out there that is imperfect).

These beliefs are incredibly negative and self-deprecating in nature and are inherently different to a healthy mental structure for screening and perceiving information. On the opposite end of the spectrum to perfectionism is the healthy pursuit of excellence, and this is where:
1. You are motivated by enthusiasm and you find the creative process exhilarating.
2. Your efforts give you feelings of satisfaction and a sense of accomplishment, even if you aren’t always ‘the greatest’.
3. You enjoy a sense of unconditional self-esteem. You do not feel you have to earn love and friendship by impressing people with your intelligence or your success.
4. You are not afraid to fail because you realise that no one can be successful all the time. Although failure is disappointing, you see it as an opportunity for growth and learning.
5. You’re not afraid of being vulnerable or sharing your feelings with people you care about. This makes you feel closer to them.

Brene Brown, a well known author of the bestseller, The Gifts of Imperfection, states that the journey towards letting go of who you think you’re supposed to be and embracing who you are starts with learning how to live a wholehearted life. Courage, compassion and connection, as the ‘gifts’ of imperfection, help you embrace your beautifully imperfect world and help you start to embrace worthiness. But don’t be fooled by these seemingly lofty ideas. The training in the use of these concepts involves practice. The art of repetition many times every single day. Not when you’ve gotten through your to-do list or when you have a spare few minutes (because let’s face it, you’re a perfectionist with a to-do list longer than you’re life span allows), but as a priority.

Here are some examples of how and what to practice.

1. Strive for a healthy outlook on life. Start and end each day with reading, watching or listening to something that inspires you.
2. Practice warmth and kindness towards yourself when you feel inadequate. Remember, imperfections are not inadequacies; they are reminders we are all in this together.
3. Tell yourself you are good enough just as you are. For example, at the start of your day say to yourself ‘Today, I’m going to believe that showing up is enough”.
4. Focus on forgiveness rather than bitterness. Be the ‘benefit’ finder rather than the ‘fault’ finder.
5. Work on stillness using mindfulness strategies at times when you feel vulnerable or fearful. By practicing mindfulness you will learn to roll with negative feelings so they stop having control over you. Your aim is not to be anxiety free, but to be anxiety aware.
6. Rather than being defensive, work on being open to suggestions. Embrace your flaws and learn to laugh at yourself by making your mistakes humorous and light-hearted.
7. When problems arise, focus on your sphere of influence. What is in your control to change? Move away from chronic worry that circles around in your head for days. Move into problem solving mode as quickly as you can.
8. Realise you can do one thing ‘perfect’ or many things well. Make a choice to let things go in order to increase your growth and learning.

It’s amazing how implementing such basic changes to your thinking and outlook can move you closer towards excellence from perfectionism. And if your perfectionistic brain thinks it’s not going to work so why bother, then I challenge you to challenge this faulty logic that keeps you stuck in ‘black and white’ or rigid thinking. For the richest, most beautiful and pleasing colour in the world my friends is ‘shades of grey’. That’s right. Shades of grey that go between the black and the white. This resembles flexibility and adaptability. By embracing flexibility, you have a chance to enjoy your life for what it is, in all its imperfect glory. In the words of Albert Einstein:

“Everybody is a genius. But if you judge a fish by its ability to climb a tree,
it will live its whole life believing that it is stupid”.

So, I will keep going on my journey and I wish you all the best of luck on yours. Remember, we cannot cross the sea merely by staring at the water. Positive change is no accident. It comes from hard work, perseverance and a little bit of love.

References:

The Gifts of Imperfection by Brene Brown. 2010.

The Feeling Good Handbook by David Burns. 1989.

The Pursuit of Perfect- How to Stop Chasing Perfection and Start Living a Richer, Happier Life by T. Ben-Shahar, 2009.

By: Alison Lenehan, Psychologist.

Choose life

CHOOSE LIFE

Posted by Joe Alberts, Clinical Psychologist.

You are urged to choose life so that you and your children will live. (Deuteronomy 30:19)

Even though living life is becoming more challenging and you may feel increasingly out of control, you still retain CHOICE as the most important aspect of being human.  You choose moment by moment and create your reality through choice.  Choose then to make life affirming choices, consciously and mindfully.

See what great thinkers have to say:

I am not what happened to me. I am what I choose to become.                                   Carl Jung  

You will either step forward into growth, or you will step back into safety.            Abraham Maslow    

“I worry about my age” Worry is self-attack. In truth, no one will hold your age against you if you don’t. Remember, you are never too old, to love, to smile, to give a compliment, to think positively. Be ageless today. Let your inner light shine today.                                                                                                                        Eckhart Tolle  

Whenever you fall, pick something up.                                                                     Oswald Avery

The pessimist sees difficulty in every opportunity. The optimist sees the opportunity in every difficulty.                                                                                                         Winston Churchill

You’ll seldom experience regret for anything that you’ve done. It is what you haven’t done that will torment you. The message, therefore, is clear. Do it! Develop an appreciation for the present moment. Seize every second of your life and savour it.                                                                                                                                       Dr Wayne Dyer

It’s not what happens to you that matters. It’s how you respond to what happens to you that makes a difference.                                                                                                  Zig Ziglar

If you have good thoughts they will shine out of your face like sunbeams and you will always look lovely.                                                                                                      Roald Dahl

Life is not about waiting for the storm to pass. It’s about learning to dance in the rain.                                                                                                                              Anon

Do just once what others say you can’t do, and you will never pay attention to their limitations again.                                                                                                       James Cook

In the depth of winter, I finally learned that within me there lay an invincible summer.                        .                                                                                             Albert Camus 

Choosing life, even when faced with severe adversity, brings life 

The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, sensitivity, and an understanding of life that fills them with compassion, gentleness, and a deep loving concern. Beautiful people do not just happen.                                                                                                                Elisabeth Kübler-Ross

 

 

Hope

by May Lim
Registered Psychologist
Alpha Psychology and The Resilience Centre

Hope.

HopeA reason for surviving. A reason for living. A reason to keep going despite facing adversity.

I really do feel encouraged and hungry to know more every time someone introduces me to Hope. This thing called Hope – it’s amazing and powerful. I’ve seen it when it’s full and generous; when it’s fragile and fading and also when it’s been lost and found.

When I encounter people who have experienced suffering in their lives, I like to be respectfully curious about what has encouraged them to persevere. My experiences supporting asylum seekers and refugees living and waiting in detention has further allowed me to witness the significance of hope in keeping life alive. I would invite them to consider, “If you are a candle and your hope is your flame, what would your flame look like now?” Many responses communicated that their flames were weak and faint. Despite the condition of their flames, one thing was for sure – though their flames were often flickering unsteadily, they certainly were not extinguished. Though their hope was not at its strongest and at grand heights, it was still alive and served a purpose.

Despite living through trauma and torture, witnessing atrocities and death, being displaced from their homes, enduring separation from family as well as facing an uncertain future for an unknown length of time, just how did Hope manage to stay alive and keep its job?

From my conversations with people I’ve met, it was love.

A strong and steadfast love for their family and all of its members – children, their spouse, parents, siblings and grandparents. A hope for a future filled with safety, promise and new beginnings for themselves and their loved ones. How powerful is love in its ability to protect and engineer hope? I witnessed how individuals can grow and strengthen their hope as a result of deriving meaning from suffering. It is truly encouraging to experience the positive changes that occur when one’s relationship with suffering shifts into a purposeful one.

Friedrich Nietzsche stated “He who has a why to live for can bear with almost any how”.

“A man who becomes conscious of the responsibility he bears towards a human being who affectionately waits for him, or to an unfinished work, will never be able to throw away his life. He knows the “why” for his existence, and will be able to bear almost any “how” ” , Viktor Frankl outlined in Man’s Search for Meaning (2006), detailing descriptions of life and spiritual survival in Nazi concentration camps.

Frankl continues to describe, “We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms- to choose one’s attitude in any given set of circumstances, to choose one’s own way. And there were always choices to make. Every day, every hour offered the opportunity to make a decision, a decision which would determine whether you would or would not submit to those powers which threatened to rob you of your very self, your inner freedom; which determined whether or not you would become the plaything of circumstance, renouncing freedom and dignity to become moulded into the form of the typical inmate”.

“The way in which a man accepts his fate and all the suffering it entails, the way in which he takes up his cross, gives him ample opportunity- even under the most difficult circumstances- to add a deeper meaning to his life” (Frankl, 2006).

I am inspired and encouraged by people who have met adversity and suffering with a deliberate attitude of hope. Moreover, it is of such value when experiences of suffering become much more than just a narrative – when there is meaning accompanying it. This distinction often makes the difference in the growth of hope for the person as well as others who later learn from this.

It is also noteworthy to highlight that suffering is not necessary to find meaning, only that “meaning is possible in spite of suffering” (Frankl, 2006).

Hope has a beautiful recipe of turning challenges into triumphs. It can propel us to choose how to cope with difficulties, draw meaning from it and coax us in a forward facing direction. Hope can be instrumental in the formation of helpful attitudes and can also be contagious.

When we reflect on the “why” and our purpose for travelling through hard times, this may be unique for every person. Perhaps it’s out of love and commitment to loved ones, a promise made to ourselves, a test of our spiritual faith, a relentless goal for the future, a need to experience positive changes, a lesson longing to be passed down to the next generation, a desire to acquaint ourselves with a stronger developed self, a hope for healing and restoration, a want for reconnection to others or maybe a search for a deeper meaning in life.

Whatever your reasons are for persisting through hardship, may they arm you and fuel you with Hope and more of it.

 

 

Reference:
Frankl, V. E. (2006). Man’s Search for Meaning. Massachusetts: Beacon Press.

May Lim is a Registered Psychologist at Alpha Psychology and The Resilience Centre.
Read more about her @maylim