Continuing bonds after suicide bereavement in childhood

Construction of meaning in survivors of suicide loss: A Spanish translation and application of the Meaning in Loss Codebook

The increasing incidence of suicide loss in many nations makes an in-depth understanding of survivors' needs and responses a compelling priority. Accordingly, we conducted semi-structured individual interviews with 10 Spanish adult suicide loss survivors exploring their attempt to reaffirm or reconstruct a world of meaning that had been challenged by their loss. A qualitative analysis of the content of the interviews was carried out from both an inductive and deductive perspective drawing on a Spanish translation of the Meaning in Loss Codebook (MLC). Results documented the negative effects associated with the trauma and stigma surrounding suicide, the difficulty survivors had in finding a place to express their emotions, thoughts, and feelings related to their loss, but also their reports of personal growth during the grieving process in the form of greater strength, maturity, change in priorities, and a sense of responsibility for their lives. Moreover, the survivors reported feeling more altruistic, sensitive, empathetic, and willing to help others because of their loss, an outcome associated with their participation in organizations for suicide survivors. Methodologically, the study demonstrates the viability of studying meaning making in bereavement in Spanish speaking populations using the MLC, permitting both cross-cultural research and more attuned clinical assessment.

Initial-Stage Suicide Bereavement Experiences: A Case Study

This study aimed to shed light on the initial-stage bereavement experiences of an individual bereaved by suicide, at three months from the loss of his spouse to suicide. A semi-structured in-depth interview was conducted with the individual, a man in his thirties. The data were analyzed using qualitative assimilation analysis, based on the Assimilation Model and the Assimilation of Problematic Experiences Scale (APES). The APES ratings of the interview revealed that the individual's bereavement was associated with the earlier stages of APES (all scoring under 3.5). In addition, the swift and frequent fluctuations in the APES ratings gave indications that the bereavement was unstable and complicated. It is suggested that mental health professionals could use APES to evaluate suicide bereavement and take note of the APES evaluations in clinical interventions.

Consequences of Unexplained Experiences in the Context of Bereavement - Qualitative Analysis

Unexplained experiences are common among bereaved people and are a natural part of grieving, but their consequences may affect their coping with grief. However, professionals lack awareness of these unexplained experiences, which may lead to an unnecessary pathologising of the experiences and a lack of opportunity for the bereaved to process their experiences in a safe environment. The study involved an inductive content analysis of 408 narratives of the consequences of unexplained experiences shared by 181 bereaved individuals. The consequences of the unexplained experiences were: (1) Experiencing after-effects which may alleviate or aggravate wellbeing, as well as be life-affecting; (2) consequences related to sharing or concealing the experiences, and the reactions of others to recounting the experience; (3) documenting the experience through videography, photography and keeping mementos. In conclusion, these experiences have consequences to bereaved which needs to be taken account in support interventions aimed at bereaved individuals.

Unveiling studies on self-healing practices for suicide loss survivors: A scoping review

This scoping review aimed to examine how self-healing practices had been addressed in the empirical literature on suicide bereavement. Adhering to PRISMA-ScR guidelines, we searched five databases for peer-reviewed studies that reported using self-healing practices, either as a primary or secondary finding and 32 studies were included. The results highlight a substantial research gap in understanding self-healing practices' definition, implementation, and effectiveness in suicide bereavement. Further studies are necessary to clarify the definition, identify facilitators and barriers to implementation, and explore the applicability of these strategies in diverse contexts, particularly in non-Western and Low-and Middle-income countries.

Continuing Bonds after Loss by Suicide: A Systematic Review

The concept of continuing bonds as an alternative to detachment from the deceased person has gained traction in grief literature over the years. Those bereaved by suicide are likely to experience various grief reactions and may be at-risk for adverse grief and mental health outcomes. However, it remains unclear how those bereaved by suicide experience continuing bonds. To address this gap, we conducted a systematic review according to PRISMA guidelines. Searches of peer-reviewed literature in Medline, PsycINFO, Embase, Emcare, EBM Reviews, and Scopus identified 15 studies (2 quantitative and 13 qualitative) reporting on 12 samples, published between 2010 and 2021. The study quality of the quantitative studies was poor, but it was fair amongst the qualitative studies. People bereaved by suicide experienced continuing bonds across a variety of domains and reported mostly positive experiences. Factors that tended to have an impact on the expression of continuing bonds included time since bereavement, relationship to the deceased, social expectations, sex of the bereaved, and the ability of the bereaved to make meaning of the death. The review concludes that most participants reported positive experiences with continuing bonds. However, discrepancies between males and females and between those bereaved by suicide and those bereaved by other causes warrants further investigation. In addition, longitudinal community-based research involving representative samples is needed to understand the evolution and experience of continuing bonds over time in those bereaved by suicide and to inform future efforts in supporting them.

Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal?

Literature indicates laypeople hold strong opinions about how persons should grieve. This study examined how individuals perceive normal grief. Participants across two distinct samples (Study 1: N = 510 via MTurk; Study 2: N = 210 via Qualtrics panels) completed the Perception of Grief Scale and Grief Expectations Questionnaire. Findings indicated participants endorsed maladaptive grief responses as normal relative to other responses to loss. Endorsement of maladaptive grief responses as normal predicted endorsement of grief work beliefs. If social expectations deem maladaptive grief to be normal, as this study suggests, bereaved individuals might implicitly push themselves to grieve maladaptively.

Research-Based Theater and "Stigmatized Trauma": The Case of Suicide Bereavement

Background

Existing research shows that family members who suffer the loss of a loved one through suicide often experience self-blame and shame, and that this limits their grieving process. It can also lock them into stigmatized positions and the notion that either somebody or a dysfunctional family is to blame for the suicide.

Aim

This article investigates from a narrative perspective how a theater play might counteract the stigma that surrounds suicide bereavement by contributing destigmatizing understandings of suicide.

Methods

A theater play was performed in a churchyard theater in Stockholm, Sweden, in 2019. Audience members were asked to write down their free reflections on a form distributed at the theater. In particular, they were asked to assess whether they found the play related to their own lives and, if so, how; and to describe what they had learned. Their written reflections [N = 41] were analyzed from a narrative methodological perspective to investigate their responses to the play. Three categories of audience member were identified from their responses: people with their own suicide bereavement experiences; people with similar but different experiences of stigmatized trauma; and people who did not report any experiences of suicide or stigmatized trauma.

Results

The suicide-bereaved generally reported familiarity with the thematic performed, in particular the "why question," the blame and shame responses and the silenced family communication. Most of these aspects were also shared by those affected by other types of stigmatized trauma. Respondents from all categories emphasized how they had learned that suicide is a desperate rather than a deliberated act, caused by overwhelming emotional pain or depression. Ultimately, suicide was perceived as an involuntary death caused by complex interacting factors linked to both inner vulnerabilities and stressful life events, for which no one was to blame.

Conclusion

The results show that research-based theater isa time-limited and cost-effective method of introducing alternative meanings and identities to both individual mourners and the broader cultural context from which stigma originates, and how it can have destigmatizing effects on a stigmatized trauma such as suicide bereavement.

Survivors' perceptions of support following a parent's suicide

Children who experience a parent's suicide are vulnerable to an increased risk for mental health disorders and suicide attempts. In this study, 17 adults, each a child survivor of their parent's suicide, shared their perceptions of support following the suicide. Helpful experiences included opening communication about suicide and offering individualized support. Unhelpful experiences included judgment and blame, silence regarding suicide, and a heightened awareness of the surviving parent's challenges. Individuals most helpful in meeting the child's needs included those with preexisting relationships. In particular, our findings emphasize the critical need for honest, open, and age-appropriate communication about the parent's suicide.

Continuing Bonds With Children and Bereaved Young People: A Narrative Review

BACKGROUND

Finding alternative ways to reconnect with the deceased is a common feature of bereavement. However, it is currently unclear how bereaved children or young people establish and develop a "continuing bond" with deceased family members.

AIM

To investigate how bereaved young people continue bonds with deceased family members.

DESIGN

A systematically conducted narrative review was conducted using six electronic databases: CINAHL, Medline, EMBASE, PsycINFO, PubMed, and BNI. Limiters were applied to peer-reviewed articles published in English. Studies were assessed for methodological quality using the Joanna Briggs Institute Critical Appraisal Tools.

RESULTS

Twenty articles were included in the review. Three overarching themes were generated: unintended connections, intended connections, and internalized connections.

CONCLUSION

Bereaved young people establish a sense of connection with deceased family members through various means (e.g., unprovoked or spontaneous reminders, physical mementos, internalized memories). Some connections are unintended and occur spontaneously. However, other young people will specifically seek ways to remember the deceased to provide a sense of enduring connection.

Enfranchising grief following suicide: A case study of an Israeli social organization

Researchers have yet to explore suicide survivors activities in social organizations, which was the present purpose. I studied an Israeli organization, Path to Life, by interviewing 16 members, attending 11 events, and examining media, online, and print information. Although mainly comprised of activists whose loss occurred in civilian circumstances, frame analysis revealed that the organization emphasizes connections between suicide and esteemed military-related death. By relying on a legitimate model of dealing with death, the activists provided meaning to suicide and promoted a sociocultural change through drawing attention to a silenced death, upgrading the suicide victims' status, and enfranchising survivors' grief.

A Qualitative Examination of Continuing Bonds through Spiritual Experiences in Individuals Bereaved by Suicide

Introduction: Suicide is a public health problem worldwide, and spiritual experiences may be important positive experiences or coping mechanisms for difficulties associated with surviving a suicide loss. Studies have found that continuing bonds through spiritual experiences are common among individuals bereaved by suicide. However, the literature lacks depth in understanding these experiences, such as sense of presence. Aims: The aim of this study was to qualitatively examine descriptions of continuing bonds through spiritual experiences after death by suicide. Method: A total of 1301 individuals bereaved by suicide provided 2443 free responses about their spiritual experiences based on four different prompts, which were analyzed using an inductive approach. Results: Nine common themes were identified, selected for interest, and reported: (1) a helpful sense of comfort; (2) a helpful sense of connection with the deceased; (3) intense sadness evoked by the spiritual experiences; (4) confusion regarding the spiritual experiences; (5) negative reminders of the deceased or negative meanings of spiritual experiences; (6) evidence of an afterlife; (7) general importance of the spiritual experiences’ meaning; (8) impact of and on religious beliefs; and (9) others’ responses to disclosure of suicide or spiritual experiences. Conclusion: For the overwhelming majority of participants, spiritual experiences such as a sense of presence have deep meaning and are often regarded as a positive source of healing and transformation after a suicide death.

Understanding death, suicide and self-injury among adherents of the emo youth subculture: A qualitative study

Emo youth subculture bases its subcultural identification mostly on symbols of death, dying, suicide, and other kinds of morbid content. The main goal of the present study was to explore attitudes toward suicidal behavior and self-injury in emo adolescents. Semistructured in-depth qualitative interviews were conducted with 14 emo adherents, accompanied by the analysis of emo Web discussion forums. Participants reported attitudes including high acceptance for suicidal behavior and self-injury. The identification with the emo youth subculture is considered to be a factor strengthening vulnerability towards risky behaviors.

Predictors of Continuing Bonds Among Bereaved Adolescents

This study examined the relationship between continuing bonds (CBs) among 50 bereaved youth (ages 11–17) and their bereaved adult caregivers, and predictors of CBs among youth. Results indicated there was not a significant relationship between caregiver CB and youth CB. However, significant relationships were found between youth bereavement symptomatology, their relationship to the deceased, and youth CB. Specifically, youth with higher levels of symptomatology and those who lost an immediate family member were more likely to maintain CBs. Results suggest the need for practitioners to incorporate grief symptomatology and CBs in assessment and intervention with bereaved youth.

Meaning Reconstruction Process After Suicide

Although Japan has a high suicide rate, there is insufficient research on the experiences of suicide-bereaved individuals. We investigated the qualitative aspects of the meaning reconstruction process after a loss to suicide. We conducted a life-story interview using open-ended questions with one middle-aged Japanese woman who lost her son to suicide. We used a narrative approach to transcribe and code the participant’s narratives for analysis. The analysis revealed three meaning groups that structured the participant’s reactions to the suicide: making sense of her son’s death and life, relationships with other people, and reconstruction of a bond with the deceased. The belief that death is not an eternal split and that there is a connection between the living and the deceased reduced the pain felt by our participant. Furthermore, the narratives worked as scaffolds in the meaning reconstruction process. We discuss our results in the light of cross-cultural differences in the grieving process.

Internalized and externalized continuing bonds in bereaved parents: their relationship with grief intensity and personal growth

Continuing bonds (CBs) expression appears especially prevalent among bereaved parents. This study examined the relationship between CBs and grief outcomes for this population. A customized CB scale for use with bereaved parents was derived from the literature. Three hundred fifty-four participants (10 male) recruited from online support groups completed an internet questionnaire. A 3-factor dimensional structure of CB (internalized, externalized, and transference) was supported. Structural equation modeling showed clear links between internalized bonds and a more positive grief status; externalized bonds showing an opposite relationship. Weaker effects were found for child's age, time since death, and type of death.