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.

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

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.

Feeling the Power of a Historical Moment and World Solidarity in Suicide Prevention

Photo by Alaskan Dude

Last week I found myself in an internet café near the Duomo in Florence, Italy weeping as I watched the press conference of the launch of the National Action Alliance for Suicide Prevention ("Action Alliance")steaming live on my computer. It was September 10th – World Suicide Prevention Day, and I was in Italy after just presenting at the European Symposium on Suicide and Suicidal Behaviour. As I sat there watching President Obama’s cabinet members – Secretary Sebelius of the Department of Health and Human Services and Secretary Gates of the Department of Defense – speak so passionately about the critical need for suicide prevention in our country, I could not help but feel I was watching a turning point in our field unfold.


Suicide prevention is a relatively new field. In the United States focused efforts in research, advocacy and clinical developments began as recently as the 1960s. We move forward slowly in small pockets around the country, often fueled by the dedication of a handful of committed people. For decades the suicide prevention field has suffered from a lack of funding for and coordination of these efforts, and these barriers have hampered our progress. Last week, when we launched the Action Alliance, the field now has hope that things will be different.

The Action Alliance is a public-private partnership whose mission it is to advance the National Strategy for Suicide Prevention (NSSP) by championing suicide prevention as a national priority, catalyzing efforts to implement high priority objectives of the NSSP, and cultivating the resources needed to sustain progress. On September 10th the 41 members of Action Alliance’s Executive Committee (“EXCOM”) came to the National Press Club to hear the Secretaries and others acknowledge the historical launch on World Suicide Prevention Day. (Click here for full video coverage of the press event).

Following the press event the EXCOM convened for their orientation to the work that lies ahead. Each of them will select objectives from the NSSP and find ways to leverage resources and political will at the highest levels to achieve these broad goals. With this strategy, all boats rise.

These Executive Committee members were selected because they are top leaders from the key governmental agencies -- like the Center for Disease Control, the Army and Veteran’s Affairs, the National Institute for Mental Health and more, and the from the private sector including major philanthropists, business leaders, faith leaders, researchers, and advocates. These are the people who make things happen. As I watched it all unfold on the other side of the world, I could not help but be in awe of the potential for what lies ahead. I am so honored to be playing a role in this effort.

This launch event came on the heels of another awe-inspiring experience – the European Symposium for Suicide and Suicidal Behavior had been held in Rome, Italy the previous week. I presented five times on issues like men and suicide, positioning suicide as a social justice issue, suicide prevention in the workplace, suicide and spirituality, and the Action Alliance. I love attending these international forums – there is something so humbling about the world coming together to solve this very tragic human problem. Through linguistic and cultural differences, we work together to learn from each other and find opportunities to collaborate.

Photo from NASA Goddard Photo and Video

And the world came together again on September 10th for commemorate World Suicide Prevention Day. Not only was this the launch day of the Action Alliance, but it was also the day when hundreds of countries participated in activities and awareness-raising efforts that acknowledged the impact of suicide and promoted efforts to prevent it. Because I was abroad as this was all happening, I could not help but feel the interconnectedness of our efforts and the intimacy of our planet. Together, we are better, and we have a chance at figuring this out. Our call to action?: “Take 5 to save lives.” Everyone can reach out to help. Join the movement.

What did you do on World Suicide Prevention Day?

Reflections on the Family of Suicidologists

When I arrived at my hotel on Tuesday evening, I was weary from a long flight from Denver to Orlando and looking forward to a quiet restful evening. No sooner did I drag my bags through the rotating doors when I was greeted by a half dozen other weary travelers with big smiles and warm hugs. I said, “I guess I am in the right place.”

Photo by edanley

You see, about 1,000 of us suicidologists traveled across the country, some as far away as Australia to come together for the annual American Association of Suicidologists’ conference. Even though most of us only see each other once a year, we are like a tightly knit extended family. In fact, it was difficult to get to all of our sessions in time because inevitably we would cross paths with at least two or three old friends every time we moved from room to room and the hugging and chatting would delay our arrival.

What makes this conference so special to me is that everyone works together. We have researchers working alongside clinicians. Families bereaved by suicide loss and suicide attempt survivors are working alongside those advocating for public policy change. People working for the military are listening to what is happening on our college campuses. We have support and compassion for people who have just recently lost a loved one to suicide, and we honor those who have dedicated their lives to the cause. Brilliant thinkers listen intently to understand so they can ask better research questions and understanding their findings. Passionate advocates and counselors soak up best practices to improve their efforts. And at the end of the day, we get together over a couple of beers and laugh.

Another reason this field inspires me is that we are a dedicated and scrappy group. With fire in our bellies we continue to try to figure out one of the most tragic human experiences. And we don’t give up. When funding gets cut, we get ultra-resourceful. When the media turn away from the good stories we have to tell, we keep knocking on the door. We are able to persist through hardship because of our unwavering commitment to saving lives and because of the support we get from one another. Even though we are in tough economic times, our association’s growth continues.

Highlights on the conference include:

• Asking two of my friends to sign books they had written that were just published within the last month (Thomas Joiner, The Myths of Suicide and Michelle Linn-Gust Rocky Roads: The Journeys of Families through Suicide Grief)

• Seeing the Clinician-Survivor task force take off – integrating the divisions of research, bereavement and clinical practice to open the conversation of how mental health service providers cope with the impact of suicide loss, personally and professionally

• Presenting with colleagues on topics we care about such as:

o Reaching men at risk for suicide who don’t seek help

o Assimilating the benefits of spirituality into suicide prevention, intervention and Postvention

o Looking at the challenges and opportunities of working in systems like college campuses, workplaces and the military

o Helping those bereaved by suicide become “survivors in action”

[Picture is of the memory quilt made in honor of my brother Carson Spencer (1969-2004)]

On our last evening of the conference, those who had lost loved ones to suicide gathered in a circle in reflection. Memory quilts lined the walls around us as we “lit” battery powered candles (the hotel was afraid of the fire hazard of lighting real ones) and Iris Bolton led us in a ritual where we said the names of our loved ones out loud. We cried, held hands and were witness to each other’s grief. Never forget. Never give up. See you next year.



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If you were at this conference with me over the last five days – please share your highlights in the comment box.

If you want to learn more about joining the American Association of Suicidology: CLICK HERE