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Intrusive Images in Children After Suicide
Thursday, October 01, 2015 by Cynthia Waderlow MSE, LCSW

When a parent is faced with the task of telling children that a sibling or a parent has died by suicide, there is usually a sense of dread and heartbreak.  The parent is overwhelmed with the loss and its circumstances.  How is it possible to expect a child or teen, in innocence, to make sense of a loved one’s suicide?  We must start with a compassionate explanation for this manner of death; one that flies in the face of the great stigma attached to suicide that blames the person who died.  Anger is a normal early grief response because the loss is painful and may feel frightening.  But it is problematic when young people stay stuck with angry feelings of blame or a sense of abandonment.  The assumptions that support these feelings need to be processed, and hopefully tempered by compassion and a new understanding of how suicide takes the lives of people who loved their families.   Our culture tends to condemn suicide as a failure on the part of the deceased to consider the impact of his or her death on children and other family members.  We can help children to use empathy in considering that at the time of the suicide, the loved one was not functioning in the way he or she was known in normal life. They can learn that all of the pieces of choice making were not operating for the loved one in this lethal state.  Suicidality is a sickness in the brain, however gradual, sudden or brief, that tragically overcomes the life force with which we are born.  Children can understand that even when they are sad, frustrated or upset they still want to live.  The normal sense of self-preservation that keeps us alive was no longer present for the person who ended his or her life.   When children and teens have a chance to think and talk about beliefs and feelings regarding the suicide, balanced with accurate information about suicidality, they can usually appreciate that something beyond the normal happened to their loved one when they died.  Through development and awareness, intelligent compassion bridges the void left by blame, judgment and a sense of abandonment associated with the loved one’s death.   Both adults and children can be empowered in their grief processes by learning that suicidality is powerful, mysterious and dangerous, the result of severe change involving brain chemistry and cognitive distortions.   Coming to terms with the profound, lethal mental state that took the life of someone we loved takes time and emotional safety to process. Language can be modified to fit any age, and while the grief journey is complex, it can be initiated even by children once they understand death’s permanence (age 6 or 7) and learn to engage in conversations about their loss.  They begin with a kernel understanding that “something happened to my loved one’s brain that caused him to stop his body from working.  His brain was not working right, and it changed his thoughts and behaviors, leading to his death.” This fundamental, compassionate perspective will support all later explorations and conversations as parents and children continue to grieve and make sense of the loss.

A way in which children and teens often struggle alone is more with the “how” regarding the suicide.  These thoughts and wonderings are usually considered dark, unwanted and not appropriate to share, but they are real, and they are the source of private suffering.  Imaginal ideas about the undertaking of the suicide, the thoughts experienced by the loved one before death, whether the loved one experienced pain or fear and how the loved one looked following the suicide can further complicate the grief process. This is a concern because children and teens frequently deal with these intrusive thoughts in shame and isolation.  Grief counselors assume that all children and teens bereaved by a violent loss or suicide are troubled with such thoughts and images at one time or another, whether they admit to them or not.  It is best to normalize these thoughts, to suggest that most grieving people, adults and children, experience such thoughts under the circumstances. It is healthy to admit and bring expression to them.

This is a delicate process that should be carried out with respectful witnessing.  Grief is sacred personal work, and no part of it should be dismissed.   One mother wanted to participate with her children to make art… paintings of bridges and sky, to help them sit with, tolerate and transcend the thoughts and feelings about their father jumping from a bridge.  Some children write.  A teen created a masterful drawing of the building from which her sister jumped to her death.  Two brothers painted an image of the shed where their mother hung herself. A very young child suspended a figure from a line as he drew on paper.  A seven year old boy drew a detailed floor plan of the house and garage where his father took his life, talking about the closing of windows and locking of doors.    These were brave efforts of children to make statements about what felt unspeakable. They were shared statements that helped them safely release troubling images, to master the scary, unsettling thoughts that could make a child feel insecure or guilty for having them.

We have coached parents about the importance of avoiding graphic detail about the death when they tell their children that their loved one died by suicide.  During that conversation, parents may be prepared to supply very basic information that “he used a rope,” or “she used a gun.” Most children will never come forward to a parent with questions that reflect the private imaginings about their loved one’s suicidal act. However, in an established grief counseling relationship, it may be possible to feel in to whether a child has been troubled with intrusive thoughts or images.  The child may agree, but may prefer not to divulge detail.  There is no need to.  Being together in the space where the images are admitted is enough.  Following this shared piece of grief, normalizing can take place, which can bring relief.  Later, they may be interested in giving expression to the images.  Symbols are a helpful means for this.  The more indirect and abstract the expression of the unspeakable, the more healing and encompassing the expression can be.  This must happen in a safe, developed relationship where the meaning and the effort can be recognized.  It does not involve a graphic, morbid narrative.     

There is a great deal of courage and emotional risk taking that characterizes deep grief work.  Children and teens might participate in the process by bringing a reference of what was experienced alone into the light and the presence of a safe witness. Suicide survivor grief can be a lengthy process.  What they share corresponds with each child’s personality and developmental capacity. We want to ensure that troubling, intrusive thoughts and images are addressed and normalized if the child desires to acknowledge this.

Someone said, “Grief is love.”  Allowing children’s hearts and minds to approach every thought about the death of the loved one through empathy and creativity may sound radical, but it appears to deepen the grief response, the love for the person who died, presence to the way he or she died and compassion for oneself as a survivor. 

The LOSS Program for Children and Youth offers a safe place for children and parents to come together or work individually on a loss that need not be experienced alone.                  



Archives:

Intrusive Images in Children After Suicide
Thursday, October 01, 2015 by Cynthia Waderlow MSE, LCSW

When a parent is faced with the task of telling children that a sibling or a parent has died by suicide, there is usually a sense of dread and heartbreak.  The parent is overwhelmed with the loss and its circumstances.  How is it possible to expect a child or teen, in innocence, to make sense of a loved one’s suicide?  We must start with a compassionate explanation for this manner of death; one that flies in the face of the great stigma attached to suicide that blames the person who died.  Anger is a normal early grief response because the loss is painful and may feel frightening.  But it is problematic when young people stay stuck with angry feelings of blame or a sense of abandonment.  The assumptions that support these feelings need to be processed, and hopefully tempered by compassion and a new understanding of how suicide takes the lives of people who loved their families.   Our culture tends to condemn suicide as a failure on the part of the deceased to consider the impact of his or her death on children and other family members.  We can help children to use empathy in considering that at the time of the suicide, the loved one was not functioning in the way he or she was known in normal life. They can learn that all of the pieces of choice making were not operating for the loved one in this lethal state.  Suicidality is a sickness in the brain, however gradual, sudden or brief, that tragically overcomes the life force with which we are born.  Children can understand that even when they are sad, frustrated or upset they still want to live.  The normal sense of self-preservation that keeps us alive was no longer present for the person who ended his or her life.   When children and teens have a chance to think and talk about beliefs and feelings regarding the suicide, balanced with accurate information about suicidality, they can usually appreciate that something beyond the normal happened to their loved one when they died.  Through development and awareness, intelligent compassion bridges the void left by blame, judgment and a sense of abandonment associated with the loved one’s death.   Both adults and children can be empowered in their grief processes by learning that suicidality is powerful, mysterious and dangerous, the result of severe change involving brain chemistry and cognitive distortions.   Coming to terms with the profound, lethal mental state that took the life of someone we loved takes time and emotional safety to process. Language can be modified to fit any age, and while the grief journey is complex, it can be initiated even by children once they understand death’s permanence (age 6 or 7) and learn to engage in conversations about their loss.  They begin with a kernel understanding that “something happened to my loved one’s brain that caused him to stop his body from working.  His brain was not working right, and it changed his thoughts and behaviors, leading to his death.” This fundamental, compassionate perspective will support all later explorations and conversations as parents and children continue to grieve and make sense of the loss.

A way in which children and teens often struggle alone is more with the “how” regarding the suicide.  These thoughts and wonderings are usually considered dark, unwanted and not appropriate to share, but they are real, and they are the source of private suffering.  Imaginal ideas about the undertaking of the suicide, the thoughts experienced by the loved one before death, whether the loved one experienced pain or fear and how the loved one looked following the suicide can further complicate the grief process. This is a concern because children and teens frequently deal with these intrusive thoughts in shame and isolation.  Grief counselors assume that all children and teens bereaved by a violent loss or suicide are troubled with such thoughts and images at one time or another, whether they admit to them or not.  It is best to normalize these thoughts, to suggest that most grieving people, adults and children, experience such thoughts under the circumstances. It is healthy to admit and bring expression to them.

This is a delicate process that should be carried out with respectful witnessing.  Grief is sacred personal work, and no part of it should be dismissed.   One mother wanted to participate with her children to make art… paintings of bridges and sky, to help them sit with, tolerate and transcend the thoughts and feelings about their father jumping from a bridge.  Some children write.  A teen created a masterful drawing of the building from which her sister jumped to her death.  Two brothers painted an image of the shed where their mother hung herself. A very young child suspended a figure from a line as he drew on paper.  A seven year old boy drew a detailed floor plan of the house and garage where his father took his life, talking about the closing of windows and locking of doors.    These were brave efforts of children to make statements about what felt unspeakable. They were shared statements that helped them safely release troubling images, to master the scary, unsettling thoughts that could make a child feel insecure or guilty for having them.

We have coached parents about the importance of avoiding graphic detail about the death when they tell their children that their loved one died by suicide.  During that conversation, parents may be prepared to supply very basic information that “he used a rope,” or “she used a gun.” Most children will never come forward to a parent with questions that reflect the private imaginings about their loved one’s suicidal act. However, in an established grief counseling relationship, it may be possible to feel in to whether a child has been troubled with intrusive thoughts or images.  The child may agree, but may prefer not to divulge detail.  There is no need to.  Being together in the space where the images are admitted is enough.  Following this shared piece of grief, normalizing can take place, which can bring relief.  Later, they may be interested in giving expression to the images.  Symbols are a helpful means for this.  The more indirect and abstract the expression of the unspeakable, the more healing and encompassing the expression can be.  This must happen in a safe, developed relationship where the meaning and the effort can be recognized.  It does not involve a graphic, morbid narrative.     

There is a great deal of courage and emotional risk taking that characterizes deep grief work.  Children and teens might participate in the process by bringing a reference of what was experienced alone into the light and the presence of a safe witness. Suicide survivor grief can be a lengthy process.  What they share corresponds with each child’s personality and developmental capacity. We want to ensure that troubling, intrusive thoughts and images are addressed and normalized if the child desires to acknowledge this.

Someone said, “Grief is love.”  Allowing children’s hearts and minds to approach every thought about the death of the loved one through empathy and creativity may sound radical, but it appears to deepen the grief response, the love for the person who died, presence to the way he or she died and compassion for oneself as a survivor. 

The LOSS Program for Children and Youth offers a safe place for children and parents to come together or work individually on a loss that need not be experienced alone.