Qualitative inquiry into the experience of suicide loss, aftereffects and coping strategies of suicide-bereaved Greek-speaking parents in Cyprus

PURPOSE

Studies on suicide-bereaved parents are scarce in South European and Eastern Mediterranean countries. We explored the experiences of Greek-speaking suicide-bereaved parents in Cyprus, with emphasis on the interpretations of their child's suicide, its aftereffects and their coping strategies.

METHODS

A qualitative methodology based on inductive content analysis of the interviews of ten mothers and two fathers was applied.

RESULTS

The participants described their efforts to make sense of the senseless, reporting numerous interpretations of their child's suicide. Some participants had achieved to move on by trying to keep the remaining family together. Others felt detached from their social network. The different coping strategies and support systems described, reflected participants' efforts to escape from obsessive, enduring and deeply traumatizing thoughts about their child's suicide. The analysis mirrored participants' ultimate desire to find existential relief and serenity through the management of distressing reminders of their child's suicide, and alleviate the burden of their own negative self-judgement and the criticism of others. They sought physical and emotional comfort in the inner realm of their psyche, through spiritual and psychological coping processes.

CONCLUSION

Further exploration is suggested about intervention planning aiming to strengthen effective coping strategies and external supportive resources in mourning parents.

The impact of continuing bonds following bereavement: A systematic review

Following bereavement, continuing bonds (CBs) include engaging with memories, illusions, sensory and quasi-sensory perceptions, hallucinations, communication, actions, and belief that evoke an inner relationship with the deceased. To date, the literature has been unable to confirm whether retaining, rather than relinquishing, bonds is helpful. A mixed studies systematic literature search explored how CBs affect grief. Studies on the effect or experience of CBs on adjustment following bereavement were eligible for inclusion. Six computerized databases were searched. A total of 79 of 319 screened studies were included. Three themes were derived from the thematic analysis: (1) comfort and distress, (2) ongoing bonds and relational identity, and (3) uncertainty, conceptualizing, and spirituality. Themes describe the role of CBs for the accommodation of the death story, transformation of the relationship, meaning reconstruction, identity processes, and affirmation of spiritual belief. Results shed light on the adaptive potentials for CBs.

Trying to keep alive a non-traumatizing memory of the deceased: A meta-synthesis on the interpretation of loss in suicide-bereaved family members, their coping strategies and the effects on them

WHAT IS KNOWN ON THE SUBJECT?: Losing a family member due to suicide has been described as a traumatic experience, as suicide-bereaved relatives grapple to accept the particular character of death and the core elements of guilt, self-criticism and stigma it inflicts. There are long-term consequences for those who bereave due to the suicide of their beloved on, a high risk for mental and physical health problems included. Feelings of guilt and self-stigma influence help-seeking behaviour among suicide-bereaved individuals. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Coping mechanisms adopted by suicide-bereaved individuals mediate the impact of suicide on their family, and especially on the quality of relationships among them. Supporting others in need can help alleviate guilt and self-blame for the suicide while it enables the bereaved to fulfil their need to keep a non-traumatizing, or even positive bond with the deceased. WHAT THE IMPLICATIONS FOR PRACTICE ARE?: Nursing interventions to facilitate suicide-bereaved family members' participation in self-help support groups and promote their engagement in supporting others in need are important. Mental health nurses need to facilitate the replacement of dysfunctional coping strategies, such as substance use or self-blame with more adaptive ones focused on the personal needs of the bereaved, in order to help them embrace a non-traumatizing memory of the deceased while being in peace with the social environment. Screening for mental health problems and management of shame, self-stigma and guilt during the grieving period needs to be a priority in nursing interventions.

ABSTRACT

INTRODUCTION: Losing a family member to suicide is a traumatic experience which includes guilt and self-stigma. Yet, there is lack of data synthesis on the survivors' experience.

AIM

A meta-synthesis of qualitative data on the interpretation of loss in suicide-bereaved family members, their coping strategies and the effects on family.

METHOD

A meta-ethnographic synthesis following a systematic literature search and evaluation of the methodological quality of the selected studies was applied.

RESULTS

The narratives of 326 individuals (parents/siblings/children/spouses) reported in sixteen studies were analysed. Trying to achieve a balance between keeping alive a non-traumatizing memory of the deceased, destigmatizing and liberating themselves from self-blame, self-criticism and guilt while being able to transform this experience into support towards others in need, was identified as the essence of the experience of the bereaved.

DISCUSSION

Although suicide within a family is a traumatic experience, spiritual and existential implications among the bereaved have been reported; their coping mechanisms mediate the impact of suicide on family sustainability.

IMPLICATIONS FOR PRACTICE

Nursing interventions to facilitate adoption of coping strategies centred on keeping a non-traumatizing memory of the deceased among the bereaved and promote their participation in self-help groups and activities to support others in need are important.

Analyzing suicide life stories on Wikipedia with Highway_star and other textual visualization tools

Being responsible for a death every 40s, suicide is a major public health concern (Brunier et al. 2019). Even if many of its risk factors are social (Van Orden et al. 2010), there are surprisingly few qualitative sociological studies about the phenomenon. This study aim is to provide a life-story sociological analysis of suicidal trajectories. Two challenges are identified: gathering suicidal narrative and maintaining a quantitative foreground in order to deepen and rationalize the interpretation of data. They are both faced using a self-made, free to use, open access, algorithm: Highway_star (https://github.com/matheo-daly/highway_star). Two corpora of Wikipedia biographies of people who died by suicide in the 1920s (N = 82) and 2020s (N = 49) are gathered. Following an application of Fritze Schütze's methodology (Schütze, 2014), classical textual visualizations are produced. A Hierarchical Descending Classification, a Factorial Correspondence Analysis and a Similarity Analysis reveal five narration categories centered around different topics: cinema, death, family, poetry and politics. As none of those visualizations focuses on the developmental aspect of the biography, they offer limited interest for a life-story investigation. The second functionality of the Highway_star tool, which represents a narrative's unfolding with a Sankey Diagram, allows completing the analysis. It shows interesting differences between decades or gender. An example of the last being that men narratives tend to be more complex and achievement focused, while the women ones are more linear and family centered. The study's range has limitations. A major one is related to the corpus and the inability to identify clearly which parts of the narratives are associated to fame and which to suicide. Another one is linked to the Highway_star tool that sometimes lack of flexibility.

A Qualitative Study on Traumatic Experiences of Suicide Survivors

The suicide of a loved one can be a traumatic experience. The objective of this study was to investigate trauma-related experiences of suicide survivors. This is a qualitative study with people who had recently lost a family member or a close one to suicide, conducted at least two months after the event. Forty-one participants agreed to take part in the study and were interviewed. The interviewees' perception was that suicide brought harm, symptoms, and suffering. Traumatic experiences can begin immediately after the event, with many reporting symptoms lasting many months and persistent impact, both personal and to the family. Postvention models after suicide should incorporate such findings, and investigate trauma consistently.

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.