Interviews of Hope

Interview With
Dr Jack Jordan and Susan Whitmore

Susan: You have co-authored three books on the subject of suicide: After Suicide Loss: Coping with Your Grief; Grief After Suicide: Understanding the Consequences and Caring for the Survivors; and the latest book coming this Fall, Devastating Losses: How Parents Cope With the Death of a Child to Suicide or Drugs. Why did you begin doing bereavement work in the first place?

Dr. Jordon: I’ve been a grief counselor formost of myprofessional life and was then drawn to suicide survivors 15 years ago. I started as a family therapist and then got into grief and bereavement for several reasons. First, my father died of cancer when I was in my mid-20s, and that was a life changing experience. Also, when I was young, I thought of becoming a minister and was interested in spiritual issues. So that side of my personality was drawn to the type of work that was like a ministry. Also, I wanted to see people heal, and most people are able to integrate their losses and restore their functioning after a loss. I could see that I was actually helping people rebuild their lives.

I started working with suicide survivors either by accident or by karma, depending on how you look at these things. It started when I had a number of people in my practice who were suicide survivors, and at some point I realized these people should really be talking to each other, not just to me. So I started a support group for survivors, and that support group ended up running in various forms for 13 years. That was a professionally life changing experience for me. I then got involved with the American Foundation for Suicide Prevention (www.afsp.org), which is nationally one of the leading organizations for suicide prevention. I helped them devise a training program for people who run support groups for suicide survivors, and those trainings are now run throughout the United States. Devising that training program included creating a training manual, and I became the advisor for the Survivor Council of the AFSP. All of that is what drew me into suicide bereavement, and it is now the main focus of my work.

Susan: You talk about suicide survivors. What is the definition of a suicide survivor? And can suicide survivors include people who are not on close terms with the deceased?

Dr. Jordon:In general, a survivor is potentially anyone who felt responsible for the person who died by suicide or for preventing the death. It refers to anyone who was deeply and negatively impacted by the death.

Immediate kin are the most likely to be affected, but it’s not just them. It could be a next-door neighbor who saw the person every day. Or it could be a subway train driver who was traumatized after someone jumped in front of his train. Or a high-school student may have had no personal relationship with another student who died by suicide, but they still identified with that person and became more depressed and suicidal as a result of being exposed to the suicide in their school.

Susan: Do you know how many people in the United States end their lives each year and how many survivors there are?

Dr. Jordon:We do know that the official count is a total of about 36,000 a year who take their own lives—probably an underestimate. We do not have good researchbased estimates of how many survivors there are, and that is partially due to the fact that we have to first agree on a clear definition of a who a “survivor” is before we can “count” how many there are. The common estimate is that there are at least six survivors for each suicide, but that is based only on thinking of immediate family members as survivors, which is clearly not everyone who may be significantly impacted by a suicide.

Susan: So if we take that estimated number of six survivors, we end up with about 216,000 survivors every year—people who are left to deal with life now that the person is gone. Wow! That leaves a lot of people trying to figure out what to do with all that they are going through.

Have you found that suicide bereavement is different from other types of deaths? If so, what are some of those differences?

Dr. Jordon:To answer your question, the issue of whether there are differences has been debated for a number of years. Without getting into that debate, I can say that some of the prominent issues that most, but not necessarily all, survivors experience are:

1) The “Why?” issue - Why did this happen? Who is responsible for it? With diseases and other causes of death, there are many existential questions, but after suicide, people struggle with issues such as, What is depression? Is depression a real thing?Why do people get it?Was it depression that killed my loved one? In other words, people struggle with what ”causes” suicide; whereas, people don’t usually struggle with those questions when their loved one dies from more natural causes.

For suicide survivors, it is not clear whether the person did this of their own free will: Was it genetics that played a role? Did something stressful happen to them that caused it? Was it a result of a psychiatric disorder? Or, was it how they were raised? The answer to those questions is that suicide is usually a complex combination of all of the above contributing factors.

We can say that suicide is the perfect storm—a coming together of a group of factors all at once that create the conditions that make a suicide possible. And those factors can include everything from genetics, mental illness, early family environment, current life stressors, and sometimes decision-making processes in the individual. Survivors typically fixate on only one or two small pieces of this complex mix of factors involved. The problem in doing that is that they don’t take into account all of the other contributing factors. Survivors eventually have to construct the narrative as to why this person decided to do this. But to do so means they need all of the data, and some of the data they need is inherently missing with unanswered questions that only the deceased could have answered. These include questions such as, What were you thinking? Did you know how much this would hurt us? Why didn’t you let us help? But they can’t talk to the person to get those difficult questions answered.

2) Social stigma issues – Social stigma may affect the survivors, similar to people who have lost someone to AIDS or drug overdoses. Society puts a judgment on those whose loved ones die from any socially taboo cause of death. People can be very unempathic, which in turn produces additional isolation for survivors. It leaves them thinking, “I’m different from other grieving people because my son died by suicide.” Survivors feel more alone and may also actually self-stigmatize, meaning they think, “Well, I know what I would have thought and felt if a friend’s child took his own life. I would have thought, ‘What kind of parents were they that this happened?’” And so survivors can project that thought and believe that other people are now thinking that about them.

What often happens, then, is that survivors may start isolating themselves out of a sense of shame. Some survivors may also feel that they have no right to be sad the way that other mourners do. It is a sort of grief competition inside of them because of the judgments about suicide. They compare the worthiness of their grief to that of other people and may feel that their grief is not “worthy” enough to be recognized by others. We call that disenfranchised grief.

3) Overt stigma – An example of overt stigma would be when someone tells a survivor that their sibling or child is going to go to Hell because it is a sin to take one’s own life. Or someone will tell a sibling that taking one’s own life is a very selfish, immoral thing to do.

Susan: An 18-year-old once called our office after his brother had taken his own life. He was extremely distraught. People in his church had told him that his brother was in Hell. Of course this caused him and his parents additional pain with which they had to grapple. He wanted me to tell him if that was true. I talked with him for a long time and sent information to his family that he said helped a lot.

Dr. Jordon:Fortunately, we are seeing that this kind of response is slowly changing. But even when there is not that kind of overt social stigmatization, today many survivors struggle with what I would call social ambiguity. This is the situation where people are uncertain what the rules of interaction are when talking with suicide survivors. Friends may wonder, “Is it okay to use the word suicide? Is it okay to ask what caused this?” Saying that someone “committed” suicide can also be another implied judgment. It is better to say that someone “died by suicide” or “took their life,” rather than saying the person committed suicide.

My point is that with suicide comes a great deal of social awkwardness. I suggest that people who hear judgmental and hurtful comments respond by saying something like, “How do you think that makes me feel when you say that? Do you think that it is helpful when you say that?” Survivors need to give themselves permission to avoid or protect themselves from other people who may be well-meaning, but actually make the survivor feel worse, not better.

4) Potential for trauma – This is not just true with suicide, but also with any death that was violent or where a loved one suffered a lot at the end of their life. What the survivor saw, experienced or even just imagined can cause trauma, including the possibility of full-blown post traumatic stress disorder (PTSD).

Susan: In my work with parents and siblings, I address the various specifics that has caused them some degree of PTSD. As you said, sometimes it was what they actually witnessed, as it was with me, and other times it was what they were left to imagine. Our minds are one of the most powerful video cameras of all times, hitting play-back at any time, day or night. We don’t have the tools to know how to simply press the “stop” button…or even the “delete” button, which would be fantastic to be able to do. So we have to work with our level of PTSD.

Dr. Jordon: 5) Anger – Another one of the reactions to suicide are similar to those after a homicide. When a loved one is murdered, we feel rage against the perpetrator. But what if the “perpetrator” and the person who died are one in the same person? That is the case with suicide. This makes for a very confusing set of emotions. People may feel angry, yet also sorrowful for the person who took their life. They may feel very confused and wonder if it’s okay to feel angry with the person who took their life. They may also direct their anger at the therapist, at themselves (which we call guilt), or at someone in the family. Suicide often generates powerful feelings of anger, but no clear place where that anger can be directed.

Susan: How else is grief after suicide different from other kinds of grief?

Dr. Jordon: It depends on what aspects of grief you’re talking about. After any type of death, there is a yearning for the deceased. After sudden death, there is shock or disbelief; people have trouble accepting the reality of the death. After a sudden, unexpected, violent death (such as a homicide or suicide), people have to deal with the horror or trauma of the death. There is a preoccupation with, “What did my loved one go through during their final moments?” But with suicide, there can It depends on what aspects of grief you’re talking about. After any type of death, there is a yearning for the deceased. After sudden death, there is shock or disbelief; people have trouble accepting the reality of the death. After a sudden, unexpected, violent death (such as a homicide or suicide), people have to deal with the horror or trauma of the death. There is a preoccupation with, “What did my loved one go through during their final moments?” But with suicide, there can

Susan: How does the stigma of suicide affect siblings, and what can be done about that?

Dr. Jordon: Fundamentally, teens and children are affected the same way as adults. Yet there are some differences, and wise adults in the children’s lives can help. Here are suggestions for everyone:

1) Grieving parents and siblings, and grieving individuals in general, have a right and need to learn how to protect themselves from hurtful people. Most people say the wrong things because they are unaware of their impact on the grieving person, but there are also those who either think they know what is best for someone who is grieving or who deliberately say and do hurtful things. Unfortunately, grieving people need to learn how to manage those situations, which is a learned skill that people can acquire with good support. They learn them by educating themselves about suicide and grief after suicide, by receiving support from others, and through a process of trial and error. This is easier for some and harder for others. Some grievers (children and adults) in the beginning are so fragile and vulnerable that they are caught off guard and end up letting inappropriate comments slide, walking away feeling even more hurt. Others are able to let people know that what was said or done was either hurtful or not comforting. Once the child (or adult) becomes more confident, they can begin to choose to either avoid people who continually hurt them, or, if they stay engaged, let the other person know that their comment was hurtful. But children often need explicit permission and guidance to learn how to do this kind of thing with their peers.

2) Before a child returns to school, a teacher, counselor or caring adult needs to take the lead and educate the child’s peers about this situation. They need to prepare the way for the child and make it safe. For example, assuming that the family is open about the cause of death, the teacher could use this event as a way to educate the class about suicide and about how they can be helpful to someone who is grieving. The teacher might talk with the class and say, “I want to talk with you about what happened to Tim before he returns to class. Tim’s brother took his own life—he died by suicide. If that happened to you, what do you think you would be thinking or feeling? What would it be like for you if that were to happen to your brother or sister? What would you want your friends to do if that happened to you? How can we help Tim as a class? What should we be careful not to do?” We should also remember that we might not know what Tim actually wants: to talk about it or not. So part of the task in helping anyone who is grieving is figuring out what they need and then doing that. The teacher could talk with Tim and ask, “We want to help you. Does it help if we talk about this, or is it better if we don’t talk about it? Which do you prefer?” The teacher should let the child know that either preference is okay.

3) For parents and siblings, it is perfectly truthful for a parent to say that their child died from depression. About 90% of people who die from suicide had at least one diagnosable psychiatric disorder, most often depression. So it is a legitimate thing to say that your loved one died from bi-polar disease or depression. This gets the discussion away from the stigma and judgments surrounding suicide and from the idea that this is unacceptable, sinful behavior.

Susan: Your book discusses research suggesting that support groups for suicide survivors may be particularly helpful. Why do you think that is?

Dr. Jordon: I think that it is safe to say that, for many survivors, contact with other survivors can be very helpful. It counteracts a sense of stigma and isolation. Participants learn from each other about coping skills. And people may have a better chance of getting an empathic response than they would in their usual social networks. A mother who has lost a child to suicide may find that talking to another mother offers more comfort than talking to her own husband. There’s also a role-modeling effect: new survivors need some inspiration or hope that they can survive this tragedy, and the “veteran” survivors in a support group can offer that hope.

In the United States, most support groups are led by survivors. In Europe and Australia, they are usually professionally led. All involve bringing survivors together to share their experiences with each other. Many groups also provide information about psychiatric diseases, suicide, and grief. Another development is that cutting-edge programs are setting up teams that proactively reach out to new survivors, visiting with them in their homes. Survivors can also learn about resources from first responders, such as emergency medical technicians, firefighters, clergy, and funeral directors who may have brochures about support services.

Susan: And how would you suggest parents go about dealing with the surviving siblings and the kind of environment they should create for healthy grieving?

Dr. Jordon: I think that it is safe to say that, for many survivors, contact with other survivors can be very helpful. It counteracts a sense of stigma and isolation. Participants learn from each other about coping skills. And people may have a better chance of getting an empathic response than they would in their usual social networks. A mother who has lost a child to suicide may find that talking to another mother offers more comfort than talking to her own husband. There’s also a role-modeling effect: new survivors need some inspiration or hope that they can survive this tragedy, and the “veteran” survivors in a support group can offer that hope.

With openness about what happened and information that is developmentally appropriate for the child’s maturity level. Trying to keep it a secret or hide it is only going to make matters worse. Eventually, most children will hear about the suicide from someone else or figure it out themselves. They can also frequently sense when there is a secret going on. As I said, children need information that is age appropriate to their developmental age. A four-year-old doesn’t need to know details about how the person ended their life, but by eight, nine or ten years old, they may ask again and revisit the grief over and over again. They may have new questions about their sibling’s death as they grow and they become ready to understand more about what happened. What you want to establish is a relationship where your child knows she can ask anything she needs to ask and that she will always get the truth from her parents. That way, children of all ages can ask what they need to ask when they are ready. An additional suggestion is to stick to answering the questions that the child has asked. Adults tend to give long, detailed explanations when a child has only asked a simple question requiring a simple answer.

Susan: What can friends, family, and others do or say to help those whose child, sibling, friend, etc. has chosen to end his or her own life?

Dr. Jordon: Pretty much the same as they would say or do with any parent or sibling whose loved one died to any cause: “I’m so sorry.” Part of the problem is that people think it’s completely different because it’s suicide. But the kindness and sensitivity you would show to anyone who is bereaved applies just as much to the suicide bereaved. Also, one of the best gifts a person can give to parents and siblings is to communicate that you don’t know what their grief is like, but you want to understand. What hurts the bereaved is when a person projects their own feelings or thoughts onto someone else and says, “I know what you are going through” when they really don’t. For instance, if you were to say, “You must be furious!” to a survivor, you might be right, or then again, you might just be projecting how you would feel in that situation, not what your friend is feeling. Instead, ask openly, “What is this like for you?” and “What do you need that I can help with?” Be humble about the fact that you don’t know, and don’t try to pretend that you do.

Susan: Is there compassion for those left behind? Or do you find that society in general tends to blame the parents? And what about the siblings?

Dr. Jordon: Sometimes siblings are blamed, but usually less than the parents. However, siblings often feel they have failed their brother or sister, just as parents do. Did I do enough? Could or should I have done more? What did I miss? Why did she do this, and what was my role in the suicide?

This ties into the area of ”magical thinking.” The sibling might think that it was his fault because he wasn’t nice to his brother or because when he got mad at him he wished him dead.

Susan: What do you find are the best approaches to survivors that actually seem to work?

Dr. Jordon: It is important to remember that one size doesn’t fit all. This is really important because certain approaches might work for one person and not for another. For example, some survivors get a great deal out of attending a support group, while others do not find them helpful. Instead, they might do

better in one-on-one counseling with a skilled grief counselor. You can’t force someone into something that doesn’t feel right to them. There is no research evidence demonstrating that specific clinical approaches work better than others with all survivors. We need much more research to be able to answer the question, “What type of support works best for what kinds of survivors and at what stage of their grieving processes?”

Susan: Thank you for doing this, Dr. Jordan. Your wisdom is going to help so many people. I am grateful to you for how quickly you responded to my phone call and email and how willing you have been to sit down with me and do this interview. I know how much you have on your plate right now.

Dr. Jordon: You are very welcome. You are providing a valuable resource for bereaved parents and siblings, and I will start sending people to your website.

Dr. Jordan is a Ph.D. psychologist in private practice in Pawtucket, Rhode Island and Wellesley, Massachusetts, where he specializes in working with loss and bereavement. He is coauthor of After Suicide Loss: Coping with Your Grief and Grief After Suicide. His new book, co-authored with Dr. Bill Feigelman, John McIntosh, and Ms. Beverly Feigelman, entitled Devastating Losses, will be released later this year. Dr. Jordan is also the clinical consultant for Grief Support Services of the Samaritans of Boston (www.samaritanshope.org) and the professional advisor to the Survivor Council of the American Foundation for Suicide Prevention (www.afsp.org)

The Psychiatric Diagnostic Statistical Manual states that losing a child is a catastrophic stressor unlike any other
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The Erika Whitmore Godwin Foundation is a nonprofit 501(c)(3) and operates on a volunteer basis.
© 2003-2017 The Erika Whitmore Godwin Foundation


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