Suicide Bereavement and After Death Communications: Preliminary Findings from Our Research

By Sally Spencer-Thomas
AAS Survivor Division Director

At the International Association for Suicide Prevention Congress in 2009, Tony Gee, a suicidologist from Australia said, “…when we closely look at the bereavement literature we find that it tells us time and time again, that the ‘lived experience’ of the bereaved has a range of dimensions, some of which may in fact be quite different from what some of the traditional theories (really coming from that ‘objective’ realm) have been prepared to recognize….”

He went on to explain that the continuing bond between the deceased and the living seems to continue on two levels:

1) “an internal representation, living on in memory, being part of the internal self-structure, being a sort of constant internal companion,” and

2) “an actual sense of presence of the deceased as a separate individual identity who is still around in some way after death and this presence may be experienced in a number of different ways.”

He described the two as not mutually exclusive.

This past spring Danielle Jahn and I, with support from Texas Tech University, conducted a survey asking people bereaved by suicide about these types of experiences.

Our recruitment efforts stated “People bereaved by suicide needed for research on spiritual experiences subsequent to their loss,” and we sent requests for participation to members of or visitors to the following:

·         American Association of Suicidology

·         International Association for Suicide Prevention

·         Survivor Support Networks

·         Social Media (Facebook, Twitter)

We got a strong response: almost 700 people completed our questionnaire. While it will be months before we have a published report of our findings, I wanted to give the membership a sense of what we discovered initially:

·       About 70% of our sample experienced some sort of “spiritual experience” with their loved one who died by suicide.

·       The most common manifestation was dreaming of the deceased (72%), followed by feeling the presence of the deceased (51%) and experiencing profound coincidences (41%).

·       About one third of our sample experienced their first “sign” immediately after death and another third experienced it within the first month.

·      About 90% of our group told another person about their after-death communication, and most found that the person they told was supportive or intrigued, but a few felt discounted. People most often told included:

o   Friends and family

o   Support groups

o   Faith leaders

o   Mental health professionals

o   Psychics

o   The most common emotional reactions to these experiences were love (60%), peace (55%), and sadness (47%).

Some of the survey responses that people wrote were deeply moving:

·       “My son came to me in a dream about 2 weeks after he died. He said mom, ‘I'm sorry, I can't get back.’ I said, ‘It's okay, I will see you again.’ I felt his hug and then I woke up. A few weeks later I had another dream. I went to hug him and I knew he was gone. He has moved on to another place.”

·       “The dream was most profound. It seemed so real. My son, who I found after he shot himself, came to me in dream as a toddler. He was wearing a striped shirt that he wore as a child. The following day, an old friend, who lives I'm another state, sent a photo she found of him with my deceased father. He was wearing the same shirt as in the dream. My friend and I had not spoken since his death and she had no knowledge of the dream. I had cried all morning after and even described the shirt to my husband before we received the photo. My only son was 28 when he died.”

·       “Initially, I 'lost' my faith, not sure I really 'believed' anymore. The Spiritual experiences were gentle, if not shocking reminders that God wasn't going to abandon me because I was doubting my upbringing and teachings. In fact, it was expected, and I knew 'God' would wait and be patient as I struggled on my grief journey. I was approached by total strangers in moments of need…music with specific messages at crucial times…. I even had one 'visitation' by the Holy Trinity (Father, Son, Holy Ghost), unmistakable, and life-changing, in all places, in the Washington DC Metro. I am a physician, a scientist, and also an advocate social worker, with expertise in mental health and emotional conditions. My perspective on mental fitness is totally changed, with a new-found realization how much we avoid dealing with ‘Spiritual Fitness.’”

Michelle Linn-Gust has often said, “The bond is not broken; the bond is changed. People really need to know that their loved one is still part of their life. There is so much fear that if we move forward we are letting them go.”

If you have experienced an after-death communication that you would like to share with me, I invite you to contact me at Sally@CarsonJSpencer.org.

Reposted with permission from the American Association for Suicidology.

WORLD SUICIDE PREVENTION DAY: CHANGING THE CONVERSATION AMONG MEN OF WORKING AGE

Colorado has the 6th highest suicide rate in the nation.  Men between the ages of 25 and 54 account for 44% of the suicide deaths in the state, and in 2010 had the highest suicide rate among all age and gender groups. The high number of suicide deaths in this group, coupled with the limited prevention and intervention efforts, targeting this difficult to reach demographic, confirmed the urgent need to develop suicide prevention strategies to better serve this population. In 2006 the partnership between Cactus, The Office of Suicide Prevention (OSP) and the Carson J Spencer Foundation began and we made a commitment to address this growing public health crisis.  In 2011 the partnership received funding from the Anschutz Foundation to further these efforts and on July 9th 2012 launched the Man Therapy™ campaign with an article in the New York Times.

Dozens of Denver Metro Billboards with Man Therapy messages

 

The purpose of the Man Therapy™ campaign is to provide men with a place to learn more about men’s mental health, examine their own situation and consider a wide array of actions that will put them on the path to treatment and recovery. The universal message is that all men should be aware of their mental health status and treat it like they would any other ailment and strive to get better.

 

 

From the outset, Man Therapy was created to be shared with other states and mental health organizations around the U.S. that are working to prevent suicides in their communities.  It has been created so it can very easily be implemented in communities throughout the country.

 

Man Therapy reshapes the conversation, using humor to cut through stigma and tackle issues like depression, divorce and suicidal thoughts head on, the way a man would do it. The campaign features a mental health hero, the good Dr. Rich Mahogany. He’s a man’s man who is dedicated to cutting through the denial with a fresh approach using his rapier wit, odd sense of humor, no BS approach and practical advice for men. Dr. Rich Mahogany is dedicated to helping men take charge of their own mental health.

Posters and Bus Station Displays

 The centerpiece of the campaign is the mantherapy.org website, where men and their loved ones will find they have a virtual appointment with Dr. Mahogany.  Visitors can navigate through Dr. Mahogany’s office where they can find useful information about men’s mental health with Gentlemental Health™. Men can also take an 18-question quiz to evaluate their own mental health status.  Within the site you are able to access resources and explore a wide range of choices from do-it-yourself tips to professional therapist referrals. Additional resources include links to local support groups as well as a national suicide crisis line that is ever present on the site.

 

In addition to the engaging experience viewers can find at mantherapy.org, the integrated communications campaign includes a 30-second TV PSA, three viral videos, social media promotions, outdoor boards and outreach materials including posters, coasters and Dr. Mahogany’s business card. 

Results and Evaluation

Impressive results in just the first six weeks. After generating 5,000 hits in the first day, the mantherapy.org Web site has seen an average of 1,000 unique visitors per day and has had 40,000 total visitors averaging 7 minutes on the site.  A total of 8,000 people have taken the quiz and been given advice and recommendations to consider.  A thorough evaluation is being conducted currently to obtain more detailed feedback and analysis of the effectiveness of the campaign and Web site experience. The evaluation includes a one and three-month follow-up component designed to measure whether the website contributed to positive behavior change among men who have visited the site.  A survey on the website also captures users’ immediate impressions.

• 73% were satisfied with the quality of the Gentlemental Health™, video testimonials, and Man Therapies
• 86% said the Web site was useful to them
• 89% would recommend the Web site to a friend

The survey also revealed that the 34% of those who came to the website were looking for resources for themselves, and 14% were looking to help a friend or family member. The model user is a man aged 25-34. Some of the qualitative responses include:

• I have never regarded myself as a stereotypical macho male, but was struck by (i) how many of the macho-male myths I subscribed to and (ii) how fast they crumble when they are examined.
• I am a mental health clinician and I love the idea and the concept of using humor to get men the help they need. This is such an important area.
• Awesome way to reduce "stigma" for men seeking mental health assistance! This is what we need instead of the same old SAMHSA, DCOE, NIMH, etc. sites. This makes men want to use it as it delivers info in an easy to understand format! Love it!
• Extremely engaging use of humor, not only via the actor and faux therapist, but throughout. As a therapist and a man, I was pleased to see such a resource. Well done! Hopefully this will become the model for preventative campaigns within public health using modern media.
• Brilliantly uses a classic manly character to say that it's ok to be depressed and offer advice. The small jokes in the information booklets like Gentlemental Health 101, such as Ben Leizman ‎"The effects of substance abuse on your brain are as ugly as an 80-year old fat man in spandex," really make the argument more effective and appealing. A very well done website and an idea that will save hundreds of lives.
• Dr. Mahogany is hilarious, with just the right level of warmth to keep me feeling engaged. That's not easy!

 

###

About Cactus Marketing

Cactus is a full-service brand communications agency providing business solutions for companies and causes through brand strategy, advertising, design, interactive and media services. Cactus has been nationally recognized for its breakthrough creative executions by The One Show, Communication Arts, The Webby Awards, South by Southwest, Favourite Website Awards, Advertising Age, Creativity and Print’s Regional Design Annual. To learn more about Cactus, visit http://www.sharpideas.com.

About the Carson J Spencer Foundation - Sustaining a Passion for Life

The Carson J Spencer Foundation (www.CarsonJSpencer.org) is a Colorado nonprofit, established in 2005.  We envision a world where leaders and communities are committed to sustaining a passion for life. We sustain a passion for life by:

• Delivering innovative and effective suicide prevention programs for working-aged people
• Coaching young leaders to develop social enterprises for mental health promotion and suicide prevention
• Supporting people bereaved by suicide

About Colorado’s Office of Suicide Prevention

The Office of Suicide Prevention, a legislatively mandated entity of the Colorado Department of Public Health and Environment, serves as the lead entity for statewide suicide prevention and intervention efforts, collaborating with Colorado communities to reduce the number of suicide deaths and attempts in the state. To learn more about the Office, visit www.coosp.org.

 

Tensions in Postvention: An International Dialogue, Part II

By Sally Spencer-ThomasAAS Survivor Division Director

In the last issue of Newslink, I shared the first part of a historical discussion that took place at the International Association of Suicide Prevention’s World Congress in Beijing, China on September 15^th, 2011. In this issue I continue to share a summary of that dialogue among some of the world’s leading postvention experts:

·     Karl Andriessen, M.Suicidology, (BELGIUM), Coordinator of the Suicide Prevention Program of the Flemish Mental Health Centres, and Co-Chair of the IASP Taskforce on Suicide Bereavement and Postvention is a tireless advocate for the needs of people bereaved by suicide.

·     Prof. Onja Grad, PhD, (SLOVENIA), clinical psychologist who has worked with survivors on a daily basis for the past 22 years — with individuals, families, groups. She is also a teacher at the University of Ljubljana School of Medicine.

·     Tony Gee

·     Jill Fisher M.Suicidology, M. Health Studies (Loss and Grief) (AUSTRALIA), National Coordinator for the StandBy Response Service and was the recipient of the 2011 International Association for Suicide Prevention Norman Farberow Award.

·      Myfanwy Maple, PhD, BSW (Honours Degree), (AUSTRALIA). Senior Lecturer, Social Work Course Coordinator, School of Health, is a social work academic and researcher in suicide bereavement over the past decade, particularly examining the loss experiences of individual family members.

·     Sandra Palmer, Ph.D. (NEW ZEALAND), a registered psychologist and Clinical Manager Community Postvention Response Service, provides support to communities experiencing suicide clusters or contagion. She continually faces the challenge of balancing the need for communities and families to honor the loss of loved ones with safe postvention practices to manage contagion to prevent further losses in the community.

·      John Peters, M.Suicidology (UNITED KINGDOM), lost his son to suicide 19 years ago and has for many years been a volunteer with Survivors of Bereavement by Suicide including staffing their Helpline each week and running peer-led support groups and an annual support day.

·     Diana Sands, PhD, (AUSTRALIA),Director, Bereaved by Suicide Service has worked with families bereaved by suicide for over twenty years, produced a film and written a book for children bereaved by suicide will speak to the complex and sensitive issues in how to talk with children bereaved by suicide.

In the first article I reviewed the group’s responses to the first two questions:

1)      How can we balance the need to prevent contagion with the need to honor loss?

2)      How do we balance getting a familiar sense of normalcy with the acknowledgement of significance to a community that has been deeply affected by a suicide loss?

In this article I summarize the themes of the second set of questions:

3)      Do we tell children about suicide or not? When do we tell them? How much information?

4)      What services do we provide – lay led, professionally facilitated or some combination? Knowing that the research indicates the benefits of peer led efforts, how do we manage quality control and sustainability?

5)      How do we safely involve survivors of suicide loss and attempts in research? What are the best protocols for this?

Part II of the Dailogue on Tenstions in Postvention

Do we tell children about suicide or not? When do we tell them? How much information?

Another engaged conversation ensued around this anxiety provoking topic. As the mother of three young children and knowing that survivors of suicide loss are at higher risk for suicide, I noted, “We don’t have the evidence-based long-term answer on how to do this right [explain suicide to children], and the stakes are high.”

Nevertheless, several excellent suggestions came forward from the group. Some offered that we inoculate children before crisis occurs by letting kids know that when things go wrong there are resources to help them.

When a suicide tragedy strikes, we need to be honest in a way they understand. Parents often think the kids don’t know but they do. Sometimes we have to help the parents work through this more than the kids.

Diane Sands, author of a book about supporting children bereaved by suicide said, “It is important to support our children even in the awfulness. A lot of parents want to protect children from this tragic knowledge. We need to let parents know there are people who can help them navigate these decisions. Parents worry that they will have to explain everything; rather it is a process of coming to terms with this knowledge. Children are extraordinary in picking up on nonverbal.”

When children are lied to, the resulting complications can make things much worse. Children know when there is fabrication even if they don’t know what is made up. It can cause great anxiety in children when what they are told doesn’t match what they intuit. Lying closes down the conversation of the loss, and opportunities for supportive relationships and constructive processing don’t happen. When there are lies, there are trust issues. When children find out the truth, they often become angry that they have been lied to and find they have to grieve the loss all over again.

Several participants noted that children are resilient and can handle age-appropriate information. Just tell the children information related to the exact question they’ve asked and try understand the reasoning behind the question, so you can appreciate the need behind it.

Diane explained, when the person who has died by suicide isn’t talked about, problems emerge because at the center of the process is a secret. When the family doesn’t know how to talk about a person, the story of their life starts to disappear and mystery of their death causes problems as people are not sure what they can and cannot say. Diane explained that the multiple conversations caring adults have with children helps them process this experience over time and assimilate the experience into their lives in a healthy way.

What services do we provide – lay led, professionally facilitated, or some combination? Knowing that the research indicates the benefits of peer led efforts, how do we manage quality control and sustainability?

Myf Maple, a leader on suicide bereavement research commented that much of the research on support services for people bereaved by suicide are often done with people who have accessed peer led support services, so some of the outcomes might be biased because of this sampling.

John Peters responded by saying there are three types of survivors: those who want help and find it, those who want help and can’t find it, and those who don’t want help. It is reasonable to ask those who found help if it achieved a positive outcome.

Tony Gee, a mental health professional who is bereaved by suicide noted that peer support is sometimes undervalued by professionals, but can be very cost effective and accessible.

Jill Fisher observed that peer led groups sometimes are affected by challenges in succession planning. Bereaved people who start support groups and find they are ready to move on struggle with how they can leave the group without feeling like they are dishonoring the reason for their involvement or the people they have supported.

Many agreed that we need more research on a variety of support options for the bereaved as well as guidelines on how to sustain the work of the helpers so they don’t burn out or get compassion fatigue.

How do we safely involve survivors or suicide loss and attempts in research? What are the best protocols for this?

Finally, our time together was running out, but we briefly explored the topic of research with survivors and several commented that we need more research on long-term effects of support services and survivor-researcher partnerships.

Some of the frustrated researchers in the room shared their experiences of ethical review boards that made faulty assumptions about the implications of asking people about suicidal behavior. A research project might have all the safety protocols in place and still get rejected because the review committee did not understand that asking about suicide doesn’t put the idea in someone’s head.

John Peters closed our time together by sharing a quote from AAS President Michelle Linn-Gust, “Fear continues to guide research – this fear is no different than the stigma that surrounds suicide and keeps us from getting the answers we need.”

 Sally Spencer-Thomas, Ph.D., is CEO and co-founder of the Carson J Spencer Foundation, founded after the suicide of her brother. The foundation is known for preventing suicide in the workplace, coaching youth social entrepreneurs to be the next generation of suicide prevention advocates, and supporting the bereaved.

Reposted here with permission from The American Association for Suicidology

GUEST BLOG: Human Resources in the Pressure Hangover

Kate Burke and I met in cyberspace when she reached out to me to interview me for a class project on social entrepreneurship and suicide prevention. Six months later, she is interning for the Carson J Spencer Foundation remotely from Washington, D.C. and helping us build our Working Minds Program. Her blog speaks to the challenges HR professionals face when trying to promote mental health in the workplace.

Unless you’re a park ranger, this image is in stark contrast to the realities most of us face when we head into our days, in particular our workdays.  Instead of calming colors and soothing sounds, the concrete jungle and an impression that challenges loom as large as the buildings can surround us.  On such a day, I came across the following quote by Victor Frankl:

When we are no longer able to change a situation,

we are challenged to change ourselves.

This quote struck a cord with me.  There were quite a few things outside my control, which were consuming my energy and hopes.  I was a manager of 20 administrative staff, which included extensive performance management and employee relations duties, in one of the largest professional services firm in the US and globally.  The economic downturn had required a number of tough staff decisions as well as a restructuring of my team.  These stressors mirror situations faced by many Human Resources professionals noted in an HRCrossing article titled WorkplaceStress and the Human Resources Professional.  One of which is…

Dual allegiance: Trying to be of service both to the managers and blue-collar employees can put enormous stress on the consciences of human resources professionals. If, by chance, adversarial relationships exist between the two groups, then the human resources professionals may get scorned by both sides and viewed as inefficient meddlers.

I felt I was between this proverbial rock and a hard place. The National Institute for Occupational Safety and Health (NIOSH) has also noted in their report Stress at Work that “extensive literature links job characteristics (e.g., low levels of control and work overload) to job stress and stress-mediated health outcomes such as cardiovascular disease and psychological disorders”.  Their diagram included here shows how a mixture of work stress and factors from outside work can work for or against people with possible negative outcomes for health.  This stress trap was also termed a “pressure hangover” in an article titled “Creativity Under the Gun” in the Harvard Business Review.  The article notes that working under pressure situations can require a few days for recovery.  This idea supports further the idea that chronic stressful conditions increase risk of illness, by not allowing recuperation time between pressure intensive projects.

For me, the work stresses in addition to other life stressors were making it more difficult to keep my emotions in check.  The phrase “Let it go” was oft repeated by friends and colleagues, with an occasional “You care too much”.  So how does one manage if you want to care about life but have no framework on just how is it you, “Let it go”?  Even while “being proactive” is a catch phrase in corporate America, there is a gap in proactive work being done to create Healthy Workplaces as it relates specifically to mental health.  Seemingly ever-increasing stress levels in the workplace are compounded by evidence I observed that organizational leaders are not fully prepared to handle employees who are facing severe stress, depression or other mental illnesses, and even less those that are contemplating suicide.  I would say this is mostly due to lack of knowledge versus lack of caring.

As is mentioned later in the HRCrossing article, I followed the path of many HR professionals, and took my own advice in making a change.  I resigned after 10 years in an intense corporate environment to pursue a master’s degree in Social Enterprise at American University with the intention to find structural solutions for healthier workplaces and work lives.  This program is allowing me to bring together my experience from business, entrepreneurial practices for new business structures – whether for profit or non-profit – and a commitment to live and encourage more balanced living of integrity.  In the course of my studies, I researched whether there were people applying the methods and ideals of Social Entrepreneurship to the field of mental health in the workplace and came across the Carson J Spencer Foundation (CJSF).  In particular CJSF’s program, Working Minds, is an answer to what I had observed during my time in Human Resources and Management and was encouraged by how they are bringing the entrepreneurial spirit to this conundrum creating healthy workplaces nationally and internationally. 

Working Minds showcase workplaces that practice innovative and effective approaches in promoting mental health at work through contests.  They also open dialogue about mental health in the workplace by providing education and training in suicide prevention.  This approach not only works to help the individuals facing challenges, it also contributes to the organizations through a double bottom line of social/health benefit and financial benefit.  Instead of the costs associated with absenteeism and turnover, Working Minds equips leaders to create a working environment where staff can get assistance and continue to contribute to the organization.  The training normalizes the discussion of mental health, and provides intervention skills when needed.  There is also focus on re-integration after crisis situations, all of which helps create an environment where people can reach out for help as well as continue to contribute.

I am excited about what Carson J Spencer Foundation (CJSF) and Working Minds is accomplishing and being a part of expanding their work.  I encourage you to join in the effort by being a changemaker in your organization.  Open the dialogue with your leaders about creating a healthier workplace.  If you or any colleague you work with is at a crisis point, reach out for help through the National Suicide Prevention Lifeline.  This link can also provide more information about warning signs.  Become informed and ask for training from Working Minds.  

ABOUT THE AUTHOR: Kate Burke is a consultant with over 15 years of experience in business in the private and non-profit sectors.  Ms. Burke's most recent experience is in operational management and human resources with the professional services firm PricewaterhouseCoopers.  She focused on performance management, process improvement and change management projects in San Francisco Bay Area and Washington Metro Area.  Ms. Burke has also worked with a locally based management company, a national non-profit higher education association and national life insurance company.
Ms. Burke holds a B.A. from Westmont College in International Studies with an emphasis in Latin America, including studies in Costa Rica.  She is a Masters candidate in Social Enterprise with the School of International Service at American University in Washington, DC.

Celebrating Mentally Healthy Workplaces: Colorado Public Television Wins Working Minds Contest

Mental health isn’t something many workplaces consider when thinking about the health of their employees, and yet, distress impacts productivity, retention and morale significantly. We are delighted to honor workplaces in Colorado that take proactive steps to help promote mental health.

Colorado Public Television is 1st place winner of the Working Minds Contest

For more information about our Working Minds Contest and last year's winners, please visit http://www.carsonjspencer.org/sloh2010.html 

In these current economic times, the stress of work can be quite unbearable. With budgets being cut across numerous organizations and businesses, many are concerned about their employment. Colorado Public Television (CPT12, formerly KBDI) has found ways to promote mental health and resiliency during tough times:, shared sacrifice, team-based decision making, and an environment which enhances creativity. Colorado Public Television will be recognized with the grand prize “Working Minds Award” at the Carson J Spencer Foundation’s Shining Lights of Hope Gala on the evening of August 28th at Inifinity Park in Glendale, Colorado


CPT12 is a mission-focused organization with a product that is enjoyable and trusted. The culture of CPT12 fosters creativity, collaboration and risk-taking. Employees throughout the company feel a sense of pride in the quality of the product, and enjoy the intellectual stimulation associated with it.

“I would liken our staff meetings to a Sunday dinner that a family would have,” said Pam Osborne, Director of Marketing & Communications for CPT12. “As a cohesive team, we all feel that we are in this together.”

CPT12 makes it a point to include mental health days, telecommuting and flexible scheduling into its policies. Additionally, the mentally-healthy atmosphere includes pet- and children/family-friendly policies. The approach by management is to help employees feel safe and capable of high-performance. CPT12 welcomes perspectives of staff and viewers of all ethnicities, sexual orientations, genders and backgrounds.

“Our workforce is extremely loyal,” stated Osborne. “I attribute that to the fact that our organization is a creative, ever-evolving, fun place to work.”

CPT12 was awarded the grand prize in the Carson J Spencer Foundation’s Working Minds Contest. In order to win, contestants needed to be workplaces based in Colorado that demonstrated measurable success by implementing innovative and effective mental health policies and procedures.

About Colorado Public Television – CPT12

Every day Colorado Public Television (CPT12), formerly KBDI, sets itself apart with an unparalleled schedule of local, independent, “community voice” public affairs programming and invites its statewide audience to explore new issues, ideas, people and places in the state, nation, and world. CPT12 curates three digital channels including a flagship signal with a mix of local, national, and international programming and infused with quality PBS shows (12.1); CPT12+, the best of independently produced documentaries, music, travel, exercise, cooking, public affairs and more (12.2); and MHz Worldview, providing international news from five continents and diverse cultural perspectives for a globally minded audience (12.3).

Please join us in congratulating all of our winners (runners up were Tu Casa and Jefferson Center for Mental Health) at the Shining Lights of Hope Gala on August 28th at Infinity Park! For more information visit http://www.carsonjspencer.org/.

Lifting their Voices: Suicide Attempt Survivors Speak Out

[Reprinted from American Association of Suicidology's NEWSlink June 2011]

The roadmap of suicide prevention is filled with challenging terrain and blind spots around the curves. Just when we feel we have advanced to a new frontier, another uncharted land lies ahead. Last year at the annual conference for the American Association of Suicidology we heard the voices of the clinician survivors come to the forefront: clinician survivors built solidarity around unaddressed needs and created a forum to advance the work to address these needs. At this year’s conference another group got organized and found momentum for organized empowerment: survivors of suicide attempts.

AAS Panel about helping attempt-survivors and their families (photo by David Covington)

Most notably, the conference featured a plenary panel about suicide attempt survivors called “Silent Journey: Helping Suicide Attempters and their Families.” Stephanie Weber, the Executive Director of Suicide Prevention Services in Batavia, Illinois shared her experiences running a support group for suicide attempt survivors.

“At last year’s conference,” Stephanie said, “a woman asked me ‘This is for survivors, but I am a survivor of my own attempt, not of someone else’s death. What is here for me?’ I told her ‘Next year we will have a panel of attempt survivors who are no longer alone or ashamed.’” Stephanie continued, “This is the last stigma. Why is it when we lose a loved one to suicide, we grieve, but when we have a loved one who attempts suicide and survives we are angry and don’t know how to talk about it?”

CW Tillman, a suicide attempt survivor, talked about his experiences with first responders and family members. He said, “There are several ways to help suicide attempters. The first way is just to be honest. At first, after my suicide attempt they told me, ‘That was a stupid thing to do,’ and I know they meant ‘I love you’ and ‘I want you around.’” CW recommends not using the term “failed attempt.” He explains how he sees his suicide attempt as a success by virtue of its not resulting in his death.

Jason Padgett, Project Coordinator for Tennessee Lives Count, talked about his experiences with family members who had gone through suicidal crises. He said, “For all those out there who support those who struggle with suicide, you need support too.”

Finally, Dr. Kate Comtois, Associate Professor at University of Washington, shared findings from her research. After evaluating the similarities of effective psychotherapies for suicidal individuals, she concluded they have at least three qualities:

1) Suicide is treated directly, not just by treating the diagnosed mental illness or by observing or constraining the individual. She said these therapies focus tightly on what is making people suicidal and what can be done about it.

2) These therapies employ an overt, determined, and persistent collaborative stance. The therapist connects with the individual, not using the perspective “We, the experts will fix you, the patient,” but rather “Together, let’s see what we can figure out.”

3) Clinicians work as part of a staff team – they meet regularly to discuss cases and burnout.

Dr. Comtois also summarized what participants in her research said about their journeys after attempting suicide:

1) The pressures on individuals who have attempted suicide are tremendous. The response of our mental health system is to diagnose mental illness and prescribe medication, yet this will not solve their problems.

2) Individuals who had attempted suicide reflected that the researchers asked many more questions about their suicide attempt and their history of suicidal coping than the referring clinicians or team had.

3) Study participants engage in and appreciate the suicide-specific treatment that the researchers developed. This was not consistently the case for the treatment as usual group.

4) Study participants followed most of the recommendations from emergency departments, inpatient units, and the researchers.

Some of the conference attendees found the panel moving. Eduardo Vega, himself a survivor of a suicide attempt, said, “Suicide is not a problem that is fixed in a hospital. Bringing the voices here really touched me.” David Covington, Executive Committee member of the National Action Alliance for Suicide Prevention said, “The leaders of suicide attempt survivors are changing the way we think.”

I too am moved by their lived experience and believe their inner wisdom holds the keys to our ability to better understand suicide prevention.

Guest Blog: Why I Donated My Psyche to Science

I am delighted to introduce my guest blogger Amy (Cooper) Rodriguez. Her husband Dave was a good friend of my brother Carson's; they all attended Bowdoin College (class of '93). Last month she reached out to me to tell me they thought of Carson a lot and remembered his vitality. She also told me that she suffered from depression on a number of occasions (including while at Bowdoin) and did her best to hide it at all cost. Recently, she met with a group of medical students to let them interview her about her experiences with depression and anxiety and to let them know how good people can be at hiding it. Thank you, Amy for sharing your story. In her words...

Amy Cooper Rodriquez, Guest Blogger


As Robert Frost said, “I experience everything twice. Once when I experience it and once when I write about it.” Therein lies the reason I don’t like to talk-much less write- about depression.

But after successful treatment for post-partum depression, I was intrigued to get an email from my psychiatrist saying, “How would you feel about being interviewed by some second-year med students? You can tell them what you’ve gone through and help them understand a bit about depression and anxiety. You’d be great!”

Hmmm. What did this mean? I couldn’t figure out whether to be flattered or alarmed. Did this mean I was the epitome of anxiety…the most extreme case he’d ever seen? Or did it mean I was just high-functioning enough to put some answers together?

I had my first bout with depression when I was a sophomore at Bowdoin College. My boyfriend and I had broken up, and he was dating someone new. I watched them stroll hand in hand as I plodded across the quad to class. I felt as if I were wearing a lead vest from an x-ray. The campus still looked idyllic, like the brochure. The pine trees still reached into the brilliant blue sky while the sun shone on the students playing Frisbee, yet I could only observe: “The sky is very blue.” I had a hard time understanding people. When I think back, I picture cocking my head to the side while I listened to them, as if I were a dog, or squinting my eyes while I watched their mouths, as if I were hard of hearing. Worst of all, I didn’t tell anyone how I was feeling. Not only did I feel depressed, I felt ashamed.

When I recovered, I swore I’d never feel that shame again. But the next time, the shame was worse because this time my depression came with the birth of my first baby, my daughter. I remember how guilty I’d felt lying next to her thinking, what gives me the right to be sad when I have a beautiful, healthy baby? I wondered how many moms were out there now, lying next to their babies, crying. And I knew I had to contact my doctor and see what I could do.

I emailed my psychiatrist asking him what the meeting would involve. He left me an enthusiastic voicemail, “Oh, they need to learn how to listen to their patients. They’ll be more nervous than you! You’ll be wonderful!”

So, a week later I drove into Boston. Like everyone in hospital waiting rooms, I was nervous and fidgety. I sat up straight, slouched back into the chair, stood up, looked out the windows, and rummaged through my pocketbook.

At last, my doctor appeared, smiling warmly. He gestured behind him to a flock of eager young people in white coats. Beautiful people right out of Grey’s Anatomy.

“Amy,” my doctor said, “you’ll be coming with us. “Mike, here,” he pointed to the cutest one, “has agreed to do the interview.” Mike, with his dark hair and olive skin, smiled at me with piercing blue eyes. I found myself wishing he were less handsome.

My doctor led us to the hospital cafeteria where I scanned the room to see if I knew anybody. This seemed like a strange place for a confidential interview, but my doctor found a table tucked toward the back of the room. The students and I jockeyed awkwardly for seats. I didn’t want to be at the head of the table, like I was leading a boardroom meeting, nor did I want to be alone on one side of the table like an inmate at a parole board hearing. I was hoping for a we’re-all-in- this-together feeling.

I finally sat in the middle of one side, and hospitably waved for the students to sit. They looked nervous and, because of my habit of talking when I am nervous, I began to babble. “It’s so great that you guys are doing this. Wow. Med school. I went to PT school.” Smile. Smile. Babble. Babble. I was playing emcee for this group of medical students. I looked at my doctor as if to say please stop me.

He intervened. “Mike will ask you some questions, and you answer with whatever you are comfortable sharing.”

Mike smiled. He made excellent eye contact.

“So Amy, how’ve you been feeling?”

I reverted to the role of the happy patient. “Good. Good,” I answered, nodding my head and smiling.

Mike raised his eyebrows.

“Oh well, I used to be depressed,” I said, laughing nervously. “You know, back in college, when my boyfriend and I broke up. And then after I had my daughter. Sometimes I don’t feel so great, but then I see Dr. Sharp, and he helps me.”

Mike nodded and leaned toward me.

I leaned in, too, ready to be impressive and articulate. But then I thought, What am I doing? I am not here for a job interview. I am not trying to convince people of how capable I am. I took a deep breath and sat back. I remembered why I came. Why I paid a sitter to watch my kids. Why I drove through crazy Boston traffic. Not to chat with a handsome guy but to help doctors learn how to figure out their patients. To take time. To dig deeper. To really know them. Because they would all have patients like me who try to appear peppy and bright when they are dying inside.

I let my shoulders fall. “It’s been really, really hard,” I said. “I’ve been depressed a few times. I have to be careful to make sure my life is balanced. I take medicine, but I also have to talk about it and make time for myself.”

I scanned the table. They were all listening intently. So I held nothing back. “I’ve given birth twice, had surgeries, been hospitalized with infections, had migraines, and I would gladly take all of those experiences over being depressed. That’s how bad it feels.”

Suddenly I was acutely aware of my surroundings--not in anxious way--but in an empowered way. I had wanted to be honest, to try to help others, to reduce the stigma of mental illness. I had never been sure of how, but maybe this was it.

The students looked at me and nodded. I didn’t babble or fidget and neither did they. We sat in silence for a moment, and I knew they had heard me. After a pause, they began asking questions, and I answered them. It became less of an interview and more of a conversation. They asked me what made me tell the truth to Dr. Sharp and asked what they could do to get patients to talk. I told them, “I saw a lot of doctors who were fine but they never knew how much I struggled. Dr. Sharp took the time to chip away until I told him how bad things were. I think the doctor has to be open and caring, and I think the patient has to be ready.”

They thanked me graciously as we stood and shook hands. Then my doctor patted me on the back as he walked me to the door. “See?” he said. “I told you you’d do great. Thanks for helping us.”

Maybe it was the idealist in me, the romantic--the Grey’s Anatomy viewer, but I drove home feeling like those young people would understand more about their patients someday. Maybe someday a college girl like me would come in to their office- or a new mom ashamed to admit just how desperate she feels. Maybe it would be a middle-aged man-a CEO- or a new dad, and maybe these doctors-to-be would help. At least I hope so. And hope, so they say, is the best antidote to depression.