In this short paper, I condense an article that first appeared in the International Association of Suicide Prevention Postvention Taskforce Newsletter (Vol. 3. No. 5, Oct. 2008). Today analysts claim suicide stigma is subtle with blame being cast upon survivors and survivors being subjected to informal isolation and shunning. It is often noted that stigmatization promotes more grief difficulties and mental health problems for survivors. But, we were surprised to find no one has verified whether these assertions are supported with systematic evidence.
To investigate this, my co-investigators and I collected surveys from a sample of parents losing children to suicide (462 cases) and a contrast population of other parents who lost children to other traumatic deaths (e.g., auto accidents, drug overdoses, homicides, etc.) (89 cases) and natural deaths (24 cases). Our sample was drawn primarily from the ranks of members of suicide survivor support groups and from several chapters of The Compassionate Friends.
In addition to asking respondents various standardized diagnostic questions about their grief difficulties, depression and suicidality, we developed a new stigmatization measure consisting of 22 questions asking respondents whether, following the loss of their child, they experienced harmful (instead of helpful) responses from various kin and non-kin. Respondents were also asked whether relations with any of these groups had become more strained and to write onto their survey forms any hurtful things said and done to them following their loss.
Write-in questions yielded comments from over 80 % of respondents, the overwhelming majority (80%) giving either negative or mixed negative comments. We grouped the comments into one of seven types: a) Avoidance (expressed most frequently), e.g., “People avoided me,” “Friends or family didn’t call me afterwards.” b) Unhelpful advice (expressed by a majority), e.g., “It’s time to move on,” “Are you still going to that support group, now?” c) Absence of a caring interest (expressed by a majority), e.g., “No one asked me how I was feeling afterwards,” “If I started talking about my lost child, they quickly changed the subject.” d) Spiritual (expressed by a minority), e.g., “God called him,”;“He’s in a better place now,” “It was meant to be.” e) Blaming the victim (expressed by a minority), e.g., “That was a cowardly thing he did; ”He was selfish.” f) Blaming the parent (expressed by a minority), e.g., “Didn’t you see it coming?” “Why didn’t you get him into therapy?” g) Other negative (expressed by a minority), e.g., “Well at least he didn’t kill anyone else when he died,” or “At least you have other children.”
Our numeric measure of stigma showed 53% of survivors reported harmful responses
from one or more family member group following loss and 32% reported harmful responses from at least one non-kin group. Also, about half of the respondents (55%) reported one or more strained family relationships and 47% reported one or more strained social relationships. These frequencies attest to the pervasiveness of stigma.
When we examined whether those gaining higher scores on our stigma scale had more grief difficulties, depression and suicidal thinking (compared to low scorers), our findings confirmed this.
A somewhat surprising result emerged when we compared stigma exposures among our three survivor subgroups: suicide, other traumatic deaths and natural deaths. Results showed suicide survivors much like other traumatic death survivors in experiencing stigma and both showed more stigma exposures than parents of a child’s natural death. This suggests most sudden deaths, whether by suicide, a fatal automobile accident or drug overdoses evoke similar fear-based avoidance responses. People think “it could have happened to us,” and often evade survivors in terror and dread, rarely offering comfort to those on the front lines of grief.
Concluding, these findings suggest that stigma experiences are unfortunately part of the everyday lives of traumatic death survivors. What makes these stigmatizing experiences so irksome is the expectations survivors have of gaining support and solace from these close family and social intimates. Who else should be able to readily understand their personal devastating tragedies? Thus, survivors need to carefully take stock of their social supports after a loss, avoiding some significant others in the interests of promoting their own mental health, or imposing a moratorium on association with others and may need to teach some of their significant others how to be more supportive.
William Feigelman, Ph.D.
