Coping with the loss of someone you love is difficult and overwhelming. Losing someone to suicide can create a complicated myriad of emotions.
Suicide grief is often unpredictable and can therefore be challenging for counselors during sessions with clients. For example, a person’s grief may not correspond to the level of their relationship with the deceased. Some individuals may grieve intensely after losing someone with whom they had a strained relationship. On the contrary, others may cope quickly after losing someone with whom they had a strong relationship.
Furthermore, the New York State Office of Mental Health’s Suicide Prevention Center reports a wide range of suicide grief symptoms that can appear within counseling sessions. These include feelings of shock, disbelief, numbness, anxiety, fear, anger, and nihilism. Psychological, behavioral, and/or acute somatic components may be present. These symptoms may also ebb and flow over time, as there is no time frame for grief.
“When it comes to grieving a suicide loss, there is no protocol on ‘how’ you should grieve,” says Camila Pulgar Guzman, PhD, NCC, LMCHC, Academic Faculty Clinician in the Department of Family and Community Medicine at Wake Forest University School of Medicine. “As counselors, it’s important to allow our clients to navigate the grieving process how they feel most comfortable.”
Given this capriciousness and variability of suicide grief, how then can counselors be prepared to help clients cope?
Therapy should be grounded on an understanding of each individual and their personal needs, and there are techniques that have proven helpful to the array of clients facing suicide bereavement. These include speaking in direct language to help them face the reality of what transpired, providing space for them to draw pictures to facilitate their feelings and identify where they are in their mourning, and analyzing their thoughts for accuracy because how we think often influences how we feel.
Additional research suggests encouraging clients to keep a journal and to remember that their loved one’s life was greater than their suicide. Seeking support groups with others that have gone through similar grief is also beneficial, as is reminding them to practice self-care, which can include exercise, healthy eating, spending time in nature, listening to soothing music, and avoiding substance abuse. “It’s important to remind clients about safety and coping mechanisms that might be harmful,” says Dr. Pulgar Guzman.
The “empty chair technique,” the Gestalt psychotherapy practice influenced by theater and improvisation, might allow for a release of painful emotions as well.
Helping a client accept that their loved one’s suicide was not their fault is also strongly encouraged. Suicide is typically an escape from overwhelming feelings stemming from a variety of sources. Dr. Pulgar Guzman shares her expertise and insight: “Grieving is guided by our traditions, culture, and what we learned from our ancestors about grief, and that is beautiful and healing. Counselors can collaborate with clients to create a grieving experience that honors both self-care and tradition.”