The Lived Experience of Adults Bereaved by Suicide

Abstract

In recent years, a plethora of research studies have attempted to delineate the grief experiences associated with suicide from those of other sudden traumatic deaths. The emerging consensus suggests that bereavement through suicide is more similar than different to other bereavements, but is characterized by the reactions of shame, stigma, and self-blame. The causal nature of these reactions has yet to be fully understood. This study reports on the lived experiences of eight adults bereaved by suicides, which were obtained through in-depth interviews. Data were analyzed using interpretative phenomenological analysis. Four main themes dominated the relatives' grief experiences. First, the early months were checkered by attempts to "control the impact of the death." The second theme was the overwhelming need to "make sense of the death" and this was coupled with a third theme, a marked "social uneasiness." Finally, participants had an eventual realization of a sense of "purposefulness" in their lives following the suicide death. Overall, the findings suggest that suicide bereavement is molded and shaped by the bereaved individual's life experiences with the deceased and their perceptions following social interactions after the event. The findings from this study suggest that "meaning making" may be an important variable in furthering our understanding of the nuances in suicide bereavement.

Full text

M.Begley & E. Quayle: The Lived Experience of Adults Bereaved by SuicideCrisis2007; V ol. 28(1):26–34© 2007 Hogrefe & Huber Publishers
Research Trends
The Lived Experience of Adults
Bereaved by Suicide
A Phenomenological Study
Mary Begley
1
and Ethel Quayle
2
1
Assistant Director of Nursing, Limerick Mental Health Services
2
Department of Applied Psychology, National University of Ireland, Cork, both Ireland
Abstract. In recent years, a plethora of research studies have attempted to delineate the grief experiences associated with suicide from
those of other sudden traumatic deaths. The emerging consensus suggests that bereavement through suicide is more similar than different
to other bereavements, but is characterized by the reactions of shame, stigma, and self-blame. The causal nature of these reactions has
yet to be fully understood. This study reports on the lived experiences of eight adults bereaved by suicides, which were obtained through
in-depth interviews. Data were analyzed using interpretative phenomenological analysis. Four main themes dominated the relatives’ grief
experiences. First, the early months were checkered by attempts to “control the impact of the death.” The second theme was the over-
whelming need to “make sense of the death” and this was coupled with a third theme, a marked “social uneasiness.” Finally, participants
had an eventual realization of a sense of “purposefulness” in their lives following the suicide death. Overall, the findings suggest that
suicide bereavement is molded and shaped by the bereaved individual’s life experiences with the deceased and their perceptions following
social interactions after the event. The findings from this study suggest that “meaning making” may be an important variable in furthering
our understanding of the nuances in suicide bereavement.
Keywords: suicide bereavement, grief, social interactions, meaning making, and support networks
Introduction
Suicide is a serious problem in Ireland having grown
from a relatively low rate in the 1960s to a convergence
with European rates in the mid 1990s with the male sui-
cide rate having doubled in the past 20 years (National
Suicide Review Group, 2002). For example, in 1980 the
rate of suicide was 6.4 per 100,000 compared to 11.5 in
2002, which is now reflected in approximately 400 indi-
viduals, predominately young males dying by suicide
each year in Ireland (Central Statistics Office, 2003; Na-
tional Suicide Review Group 2003). It has been suggest-
ed that for every suicide death a minimum of six individ-
uals are deeply affected by this traumatic event (Shneid-
man, 1969). This means that, in Ireland, at least 2,400
parents and siblings face the task of making sense of a
sudden and premature loss of life each year. Our under-
standing of the grief process associated with suicide has
yet to be fully articulated and consensus in the interna-
tional research literature has yet to be reached as to
whether such bereavement is quantitatively different
from bereavement following other forms of traumatic
death (Jordan, 2001). Recent thinking suggests that sui-
cide bereavement is possibly more “similar than differ-
ent” to traumatic deaths such as those from sudden infant
death syndrome (SIDS), auto immune deficiency syn-
drome (AIDS), or accidental deaths (Bailley, Kral, &
Dunham, 1999; Dyregrov, Nordanger, & Dyregrov, 2003;
Jordan, 2001). There is however, agreement that psycho-
logical processes such as an ongoing search for meaning,
blame, guilt, rejection, and a perceived lack of social sup-
port are distinguishing factors in suicide bereavement
(Clarke & Wrigley, 2004; Ellenbogen & Gratton, 2001;
Knieper, 1999). International studies have indicated that
individuals bereaved by suicide continuously search for
meaning in the death (Allen, Calhoon, Cann, & Tedeschi,
1993) and feel embarrassed about it (Sequin, Lesage, &
Kiely, 1995). It has also been reported that for the sui-
cide-bereaved experience there is considerable within-
group variation in grief experiences and subtle compo-
nents such as shame need further investigation (Bailley
et al., 1999; Sequin, Lesage, & Kiely, 1995). However,
few studies have reported on how the bereaved have
described their experiences in the aftermath of a family
suicide.
DOI 10.1027/0227-5910.28.1.26
Crisis 2007; Vol. 28(1):26–34 © 2007 Hogrefe & Huber Publishers

Grief is a painful experience and making sense of a sui-
cide death is known to be a very difficult process for the
bereaved (Wertheimer, 1991). The trajectory and intensity
of grief will depend on a number of variables: whether the
predeath relationship with the deceased was conflictual
(Samy, 1995), if the act was anticipated (Bailley et al.,
1999), and whether the survivors perceived a sense of so-
cial support (Callahan, 2000). It is thought to be difficult
because the bereaved have to negotiate their own inner
world after the death and also because they have to nego-
tiate sociocultural norms (Dunne, 2000; Minois, 1999).
Findings from quantitative research suggest that many
factors may impact on the suicide-bereavement experi-
ence. The collective influences of prior medical, relation-
al, biological, and social factors on suicide all underscore
the individualized story in suicide bereavement (Beau-
trais, Joyce, & Mulder, 1997; Cullen & Connolly, 1997;
Makinen, 2002; Platt & Hawton, 2000; Williams & Pol-
lock, 2002). Yet, few qualitative studies have reported on
the lived experience of the bereaved, possibly reflecting
the fact that it is difficult to access this population (Dyre-
grov et al., 2003). Given that those bereaved by suicide
are a high risk population for completed suicide, the need
to provide appropriate and effective support networks has
been acknowledged (Clarke, 2001; Turecki, 2001). This
concern is aptly echoed in the often quoted dictum “post-
vention is prevention for future generations” (Shneidman,
1969).
In Ireland, a network of voluntary support groups called
Living Links has recently been established in order to pro-
vide practical assistance and social support to adults be-
reaved by suicide (Begley, 2003). The premise for such
networks is that adults bereaved by suicide require asser-
tive outreach support and access to other survivors in or-
der to cope with the deliberate self-inflicted death of a
relative. The aim of this study was to describe the bereave-
ment experiences of adults whose relative had died by sui-
cide and to explore challenges faced in coping after the
death. These stories of grief provide insight into the type
of issues that voluntary and statutory organizations may
consider when offering support to persons bereaved by
suicide.
Method
Participants
Recruitment to the study was through the Living Links vol-
untary support network that makes available practical
homecare support for up to 8 weeks to individuals or fam-
ilies bereaved by suicide. In addition, the Living Links net-
work provides an 8-week structured group program to sui-
cide-bereaved adults to facilitate healing through the shar-
ing of stories in small groups.
Individuals who had contacted or who were supported
by the Living Links voluntary support networks were pro-
vided with written details of the research initiative by the
organization’s coordinators. The network coordinator ad-
vised those that accessed their networks that family mem-
bers or other suicide-bereaved persons known to them, who
may not have accessed Living Links, were also invited to
participate. The coordinator obtained the name, telephone,
and details of persons willing to participate or who were
interested in further information. These were forwarded to
the researcher. Eight adult participants, three males and five
females, were recruited (see Table 1).
Of these, six had received support from the Living Links
support programs. Five had attended the healing program
and one had received six individual support sessions at their
home. Two adults had not accessed the support services and
had been advised by family members and by a neighbour
about the study. All but one resided in the rural environs
and all participants were bereaved between 3 and 5 years.
In-depth face-to-face interviews of 2 to 3 h duration were
held in the bereaved persons’ homes and included three
males and five females with an age range of between 27–72
years.
Interviews
To elicit the personal story of death a discussion guide was
developed following a review of the international research
literature on suicide bereavement and the findings of a re-
gional survey undertaken as part of this study. Aspects of
Table 1. Biographical details of participants
Participant Gender Age Occupation Relationship to deceased Gender of deceased Age of deceased at death Method of suicide
1 M 66 Manual worker Father Male 21 Hanging
2 F 27 Teacher Sister Male 21 Hanging
3 F 29 Psychologist Sister Male 21 Hanging
4 M 52 Clerical worker Father Male 18 Hanging
5 F 50 Nurse Mother Male 18 Hanging
6 F 72 Care asst./Ret Mother Male 23 Shooting
7 F 47 Care asst. Sister Female 47 Hanging
8 M 37 Businessman Brother Male 26 Shooting
M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide 27
© 2007 Hogrefe & Huber Publishers Crisis 2007; Vol. 28(1):26–34

grief experienced by the various individuals and the quality
of support received were explored. Questions also investi-
gated the meaning individuals had made of the death and
of their life after the death (see Table 2). The researcher
conducted six interviews: four individual, one joint inter-
view with parents, and a final interview was with a father
and his two daughters.
The interview schedule consisted of open-ended ques-
tions but encouraged a degree of flexibility according to
the different stories of loss. Permission was sought to re-
cord the interviews using 90 min cassettes so as to allow
for minimal disruption. All tapes were coded with a number
and no personal details (surname or address) were record-
ed. Each interview focused on the “story of the death” and
elicited information concerning the personality and life of
the deceased. It also probed relationships with family mem-
bers, the wider community, and why participants felt the
death had occurred. The second aspect of the interview en-
couraged the interviewee to elaborate on how the death im-
pacted on their lives and what helped them to cope. Ques-
tions also investigated how they responded to the suicide
and what meaning the person took from the untimely death.
The final aspect of the interview probed the person’s view
of life, of society, and what perspectives they had about
their own life since the death. The same process was used
for all six interviews. Ethical approval was obtained from
the Regions Ethics Committee to carry out the study within
a catchment area in Ireland comprised of a population of
approximately 350,000.
Data Analysis
Interpretative phenomenological analysis was utilized to
explore the “lived experience” as taped during the inter-
views (Smith, Jarman, & Osborn, 1999). As a study of peo-
ples’ experiences, phenomenology assumes that there is an
underlying structure and core meaning to shared experienc-
es and that these can be unearthed (Patton, 1990). Based on
the guidelines given by Smith et al. (1999) a thematic anal-
ysis was undertaken by listening to audiotapes and repeat-
edly reading individual transcripts noting the significant is-
sues communicated, the similarities, and differences. Each
taped transcript was typed verbatim and a pseudonym as-
signed to each participant interviewed. In each typed tran-
script every sentence was then given a number (using the
word processor) with individual lines within the sentence
given an alphabetical code (by hand). Thus, for each inter-
view the excerpt could be identified by the pseudonym
(e.g., Esther), the number of the sentence for example (24)
and the line (c). In order to ensure an audit trail, the key
points and themes noted were then given a title that best
represented its communication and these were noted in the
margins. When each series of interview files were complet-
ed all the themes that emerged from the eight interviews
were listed on a blank page and these were then listed under
three headings:
– “deceased’s life before the suicide”
– “the early months after,” and
– “adjusting to life without the deceased.”
The initial themes were then clustered together into five
subthemes that best described the lived experience of the
participants (Table 3). Validity checks were then undertak-
en where each subtheme was repeatedly examined against
the consistency of its appearance within the data set (Na-
deau, 2001).
Table 2. Discussion guide for participant interviews
Demographics
Participant’s age, marital status; level of education; occupation;
who living with?
The Deceased’s Story
1. Can you tell me about your loved one, what were they like?
2. What was their mental and physical health like?
3. Tell me about when the suicide happened?
4. Was there any event or something significant that you feel may
have happened to them before they took their life?
5. Who or what did you feel was responsible for the death?
Relationship with the Deceased
6. Can you tell me about your relationship with ______
7. Was there anything in ______ past that would have made you
understand the death?
The Impact of the Death
8. Grief affects individuals in different ways. How would you de-
scribe its impact on you personally?
9. How did it impact on your family?
10. How did people react to you after the suicide?
11. When you think about the death what is most in your mind
about yourself?
12. Have these views changed over time?
13. What way do you see your future now?
Table 3. Clustering of initial subthemes
Physical sequel – confusion, loss of sleep, numbness, panicky,
nightmares, attempt suicide.
Cognitive sequel – feelings of unreality, loss of control, fear, black
hole, blame, shattered, anger, reaching a crisis point, guilt, blame,
changed as a person, worrying about God.
Trying to understand – reviewing deceased’s childhood, checking
lifestyle & habits, influence of friends, reviewing suicide event, re-
viewing personality of deceased, checking for stressors, trying to
understand motive for suicide, questioning if depressed, ruminated
about personality flaw, denying the deliberateness of the suicide
Social interactions – protecting information, feeling different, loss
of social activity, let down, talking more, social groups, stigma, sup-
port groups, bonding, feeling marked, avoiding people, changes in
communication in family, sharing part of views
Attachment to deceased – talking to the deceased, sensing the de-
ceased, describing the deceased, motive for death, looking for signs
of depression, suicide not deliberate, not done to hurt survivor.
Living in the present – new interests, altruism, world different, spiri-
tual reason for suicide, new roles, attending other suicide funerals,
support groups, safe, understood, changed lives
28 M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide
Crisis 2007; Vol. 28(1):26–34 © 2007 Hogrefe & Huber Publishers

Results
The researcher then reviewed these six subthemes against
each of the eight main transcripts in order to reflect on what
the participants were saying and how they reflected their ex-
periences as told in their story. The subthemes were, thus,
regroupedinto four master themes that the researcherfeltbest
reflected the structure of the data set (see Table 4).
The first master theme “controlling the impact of the
suicide” describes the immediate reaction of participants
when they discovered that their relative had killed them-
selves. The early months were a time of intense pain, dis-
tress, fear, and turmoil, for both the individual and the fam-
ily as a whole. The impact of the suicide on the family
system was controlled in two ways. Participants assumed
the role of “protector,” watching for fear of more suicides
occurring in the family, while siblings became “peacekeep-
ers.” Parents said that they needed to engage in “safety be-
haviors” because they were so very frightened and worried
about further suicide occurring among surviving children.
“We walked on egg shells . . . it’s the fear that’s the worst . . .”
(Donal: 81a, b).
They managed this fear by adopting a watchfulness strate-
gy with their children. Donal kept up a nightly vigil
“for three months every night, at 1:00, 2:00, and 3:00 in the
morning and looking in to see was he (other son) alright”
(Donal: 81c, d,).
On the other hand, siblings avoided expressing their feel-
ings to parents, as they did not want to upset them. The
reluctance to share feelings freely within the family related
to the fact that participants grappled with a sense of per-
sonal blame for not having prevented the death and they
had felt guilty.
“Why he did it, is there something I should have noticed, some-
thing I should have done? I have talked about this to () and
she talks to her brothers and sisters but I can’t do that yet”
(Grainne: 82, c).
Closing ranks to “outsiders” for support and not freely
communicating within the family meant that individuals
felt stressed and found it difficult to cope with everyday
living. Siblings felt compelled to bring their “inner world”
of despair into the family system and this helped them.
Aine mentioned how her younger son expressed the impact
of his brother’s suicide on him:
“He arrived up . . . with these tackie laces around his neck and
he was absolutely hysterical” [long pause]. “I went over and
I caught that cord around his neck and stayed up all night . . .
but he began to get better after that.” (Aine: 163e, f, g, & h).
In the early months, participants also went through differ-
ent bereavement experiences at different times, and this had
been very difficult for them. The researcher interpreted that
the difficulty arose because these feelings were observed
rather than shared:
“I found it very hard myself, I would listen to the girls being
very bitter at times, their father saying nothing, and I felt like
screaming . . .” (Esther: 177, h).
Thus, the emotional reality that a loved one had deliberate-
ly left the family was not openly acknowledged at this
point. The eventual outcome was that younger participants
were unable to cope with their own turmoil. They subse-
quently had broken rank, engaged in self-harm behaviors,
or had sought professional support. Once the impact of the
suicide was eventually acknowledged participants seemed
to have moved from having to control overwhelming anx-
iety toward a more active searching mode.
The second master theme “making sense of the suicide”
described how participants tried to make sense of the sui-
cide. They achieved this by ruminating about the predeath
demeanor of the deceased and about the events that led up
to the actual act of suicide. The compelling factor that was
noted in the transcripts was that participants needed to
match the deliberateness of the suicide to what they be-
lieved about the world, about themselves, and their loved
one. This task was very difficult for them. The deliberate-
ness of the suicidal act was discrepant with their beliefs
about a predictable world. They tried to integrate the expe-
rience of suicide into their schemas about life by consider-
ing how the death fitted into what they already knew about
the cause of suicide:
Table 4. Master themes and their source
Master themes Arising from
Controlling the impact of
the suicide
Numbness, avoidance of sharing feelings, protective, watching other family members, fearful of further sui-
cides, responding to suicide attempts, changes in communication patterns, being careful of what is said and
avoiding former social activities.
Making sense of the suicide Searching for reasons why the suicide happened, questioning the prior relationship with deceased, feelings of
guilt and blame. Reviewing the deceased character, looking for external stressors, the motive for suicide, re-
viewing the suicide act.
Social uneasiness Needing support but felt let down by friends and community. Feeling marked by suicide, upset by people’s re-
sponses, self imposed social isolation. Protective about details of suicide when asked, feeling understood and
safer with others that are bereaved by suicide
Purposefulness The death had changed how life is viewed, a feeling that their lives are totally changed and that the deceased is
now helping them. Engaging in new activities, role in helping others.
M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide 29
© 2007 Hogrefe & Huber Publishers Crisis 2007; Vol. 28(1):26–34

“But I can accept there was something in [ ] for whatever
reason, depression or something out there that led him to do
that. Maybe something we didn’t know about, something in his
personality type, there was something in [ ]’s personality that
he went and did it” (Cathy: 94, b, c).
Participants had also tried to match their preestablished
beliefs about their relationship with their deceased relative
by reasoning that their relative would not intentionally hurt
them. They had met with as many people as possible who
may have known about the last moments of their relative’s
life in order to make some sense of the suicide. For exam-
ple, Martin had reflected on what he knew about his son’s
personality, what he believed about his son’s intention, and
what may have caused the death in order to accommodate
the experience of the suicide:
“you are thinking that [] did this because there was something
in there that caused him to do it. He could not have been in his
right mind, as we know him so I don’t think he betrayed our
trust by doing that, he was going through whatever pain and
wouldn’t set out to hurt us deliberately” (Martin: 46 e, f, g).
Irrespective of the how the suicide occurred, and how it
fitted into some participants’ frame of reference, the delib-
erateness of the act meant that some participants blamed
themselves for failing to prevent the death. This was be-
cause they believed they failed to notice signs of suicide
risk:
“I think the worst thing was not having prevented it, why didn’t
I see something, why didn’t I spot it.” (Grainne: 194, a).
It was not surprising that this self-blame was qualified. The
participant intimated that in reality it is very difficult to see
signs of risk:
“I didn’t understand at the time, I should have done some-
thing” (Rita: 67a).
Another strategy employed in making sense of the death
was the mental undoing of the events leading up to the
death. In this way, participants began a journey that pointed
to an incremental process of integrating the reality of the
suicide and the possible motivation for the act. Esther had
assimilated the reality of the death over time by thinking
of past situations and gradually taking in new information:
“you stop and you think of new things all the time” (Esther:
86a).
The majority of participants had formed the view that the
suicide was an impulsive act, where a single event became
overwhelming, putting the deceased in a “no choice” situ-
ation. They had searched for a trigger, an event that had
caused a relative to take their life even if a loved one had
a mental illness. Aine and Cathy had mulled over the mo-
tivation for their relatives’ deaths. These women had con-
cluded that it was not depression or a mental illness that
precipitated the death. They believed that some specific sit-
uation occurred that was just too much for them to bear at
the time:
“I don’t know why, we’ll never know why but with [ ], I’d say
somebody hurt his feelings that night and he wasn’t guilty of
anything and he just couldn’t take it cos that’s the type of per-
son he was, he wasn’t depressed or anything like that, no def-
initely not” (Aine: 136.b, c).
The sequel to participants engaging in this sense-making
activity was that they eventually, albeit at different times
and in different ways, began to personalize the situation.
Esther personalized her son’s self-killing and had felt that
the suicide was a breach of trust. She had felt both aban-
doned and guilty for failing in her role as a mother:
“All I wonder about is why didn’t my son trust me enough to
say, mam, look what I got that I will always say, why didn’t he
tell me, the whys, did he not trust me his mother enough . . .
that is my only regret” (Esther: 106, f).
Without doubt, making sense of the suicide was a complex
process and not necessarily undertaken in a linear fashion.
The picture that emerged from participants was that mean-
ing-making occurred in the context of seeking out the story
of death, then matching prior beliefs about the person to a
possible cause of death while protecting their sense of self
in the process. It was done slowly. Meaning-making oc-
curred in the context of putting the suicide aside and living
through daily routines of work. When unplanned events
such as funerals occurred, they were reminded about the
suicide. This meant that they found themselves having to
respond in some small way to questions about the suicide
and they had, for a period, returned their thoughts to the
death.
The third master theme represents participants’ experi-
ences in meeting people after the suicide. It emerged that
participants felt very uneasy in social interactions. Social
interactions resulted in much inner unease because the par-
ticipant’s had constantly ruminated over their own and oth-
ers’ reactions. Participants had responded differently when
they had met people. Grainne had controlled her conversa-
tions when she interacted with others outside the family.
This was because she felt it was the only way she could
manage overwhelming feelings. To her the suicide was a
private family matter:
“I am not at the end of my grieving process probably so I don’t
really want to start talking about it. I will, if brothers and sis-
ters ask” (Grainne: 182a, b).
Cathy also believed that access to her experience of the
suicide was privileged information. She felt that not every-
body had the right to know. She had not shared her story
as she felt she would be judged so she regulated other peo-
ple’s participation in her grief:
“I won’t tell others that he died by suicide. Its privileged in-
formation if you say he committed suicide. I suppose its fear
of people’s presumptions or what they would automatically as-
sume or judge, so I wont give that information for people to
do that” (Cathy: 83a,b).
Immediately following the suicide most participants had
30 M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide
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felt supported by their communities. However, once the
suicide mass was over they found that friends abandoned
them and acted uneasy around them. Esther’s experience
was that she had been treated with “kid gloves” (Esther:
67, a).
The suicide made participants so uneasy in social situa-
tions that they also avoided usual social activities. Peter
was so disabled by his brother’s suicide that he never actu-
ally returned to going to the pub or to the GAA matches,
usual activities before the suicide:
“My life is changed in the line of going out here and there, I
am not interested in any type of (social) things or matches or
anything like that” (Peter: 54a,b).
The impact of this loss of social support was somewhat
reduced when the bereaved were made aware in advance
that people could avoid them. Because of prior warning,
Martin was able to cope with the rejection he experienced
socially even when he detected that people were uneasy
when they met him:
“But I thought it was very important to be made aware of it.
There is this priest I know for years and a very holy, good priest
if he ever comes near me he goes away from us. But because
[a neighbour who was bereaved by suicide] had told us this
would happen, I understood . . .” (Martin: 86, a, b, c).
The consequences of the social uneasiness was that Peter
joined the Living Links suicide healing support group and
this resulted in him feeling less vulnerable as he could iden-
tify with people: “everybody understood the next because
it was all suicide people” (Peter: 102,a). Martin found he
was at ease in the support group. He was able to disclose
his private self because he felt safe and understood. This
was in contrast to the uneasiness he had felt in social inter-
actions with the wider community:
“I would not be able to talk to them people the same as I would
with someone who has been bereaved by suicide. So I think
suicide (suicide bereavement support) should be kept sepa-
rate” (Martin: 132d, e).
The fourth master theme reflects the participant’s personal
experiences about how the suicide had changed their lives.
This change was mostly positive and had resulted in a sense
of “purposefulness.” Seven of the participants, two males
and five females, all spoke about how much they had
changed. They shared how they eventually found meaning
in life after the death. For Martin this change was a perma-
nent one:
“it changed our whole family, our life, nothing ever will be the
same again” (Martin: 75a).
Many participants described a change in terms of life’s pri-
orities. After the suicide they developed a tendency toward
helping others who were vulnerable. The purpose and
meaning in life came from taking action as opposed to
philosophical questioning. Participants had resorted to do-
ing new things, which they believed only occurred because
they had experienced a suicide death of a relative. Rita said
she was a different person:
“I have done things that I never would have done.” (Rita, 48a)
Siblings in particular, noted positive changes among each
other over time. Before the death, Cathy would rarely have
“frank discussions” with her older brother but since the sui-
cide she describes him as:
“[] has changed so much since the suicide, he is much more
open now.” (Cathy: 151, a).
Of note, purposefulness was most often associated with a
continual “magical attachment” to the deceased. Events
such as house sales, acquiring new ideas, making important
decisions and getting general assistance with day-to-day
social tasks were attributed to the deceased person’s con-
tinual supportive involvement in their lives. The attach-
ment meant that participants had adapted to a life without
the physical presence of the deceased and it was achieved
by maintaining a “mental” bond with the deceased. Martin
made a distinct decision not to sever his relationship with
his son but decided to cherish it:
“But if you mean moving on, that I move on that some day I
won’t be relying on [] in my life, no or I never want to. I don’t
think I ever will and I have no goals set to do that and I
wouldn’t like to. I am happy, it’s a wonderful feeling for me,
and I am closer to []” (Martin: 123 d, e, f, g, h, I, j, and k).
Discussion and Conclusion
During the review of the transcripts it was seen that partic-
ipants did not necessarily move from one stage to another
through the four themes. The initial chaos, trying to control
the impact of the suicide, and fear of more suicide deaths
was the most clearly demarcated period. This period had
mainly occurred in the first 12 months of bereavement. All
the participants’ narratives attest to the experiences of
numbness, disbelief, physical sickness, fear, and panic, out-
comes that bear a striking resemblance to posttraumatic
stress responses. Of note, is that the physical and cognitive
reactions that occurred mirror other empirical evidence on
coping with traumatic experiences (Chung, Farmer, Wer-
rett, Easthope, & Chung, 2001; Foa & Herst-Ikeda, 1996;
Janoff-Bulman, 1992). Some researchers have suggested
that the presence of intense symptoms shortly after a loss
does not necessarily indicate disturbance or emotional
problems (Boelen, van de Bout, & van den Hout, 2003).
These findings imply that information about what emotions
the bereaved can expect, and provision of training in stress
management techniques and adaptive coping strategies
may be of real value to the bereaved in the immediate af-
termath of the suicide.
Once participants began to search for meaning, they ex-
perienced much difficulty both socially and interpersonal-
M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide 31
© 2007 Hogrefe & Huber Publishers Crisis 2007; Vol. 28(1):26–34

ly. Participants had expectations of others that they per-
ceived were not met. They sensed that friends, neighbors
and the wider community were uncomfortable around them
and failed to understand that they also had real difficulties
in communicating to others about the suicide death. A num-
ber of studies have reported this phenomena indicating that
the unease is associated with feelings of shame and guilt,
unique features in suicide grief compared with bereave-
ments by other traumatic deaths (Harwood, Hawton, Hope,
e& Jacoby, 2002; McIntosh, 1993; Reed, 1993; Van Don-
gen, 1993). However, participants in this study had, them-
selves, avoided social interactions as they needed to control
their own overwhelming emotions, which in turn rein-
forced their belief that other people had changed in their
behavior toward them. Although there were different de-
grees of social unease reported among the participants it
was the extent of the inner turmoil that modulated the level
of social interactions with the wider community. From this
perspective it seems likely that Sequin et al.’s, (1995) con-
tention was correct when they posited “ that there may be
a feedback loop between social and psychological dimen-
sions that is extremely important in suicide bereavement”
(p. 496).
Although participants reported that they were able to
find a purpose in the suicide death, they did not communi-
cate that they had moved on from the suicide. Instead, the
majority of the participants were deliberately living in the
shadow of the suicide 5 years after its occurrence. Howev-
er, unlike stage theories of grief, making sense of the sui-
cide and sensing some purpose in the death did not occur
in a linear fashion. Participants had engaged in what other
researchers have noted is a reappraisal back and forth be-
tween stories of the deceased and the suicide event in order
to make sense of and cope with the suicide (Davis, Noelen-
Hoeksema, & Larson, 1998; Stroebe & Schut, 1999). Many
of the participants explained how their lives had changed,
which resulted in them engaging in new behaviors. What
was striking was that the participants had chosen not to
relinquish their attachments to the deceased but believed
that their loved one continued to have a role in their fami-
lies’ lives. It could be interpreted that the bereaved had not
accepted the deliberateness of the death and were coping
by retaining their relatives in an altered life-purpose within
the family. Whether this behavior is indicative of a compli-
cated grief, as recently highlighted in the research litera-
ture, needs further illumination (Prigerson et al., 1999;
Mitchell, Kim, Prigerson, & Stephens, 2004).
The majority of participants in this study had attended
general bereavement support networks. However, they be-
lieved that they only understood their reactions to the sui-
cide death when they met with others who were also be-
reaved by suicide. They believed that suicide support
should be exclusive to those who had the lived experience
of suicide, as those who did not have a personal experience
of suicide could not fully appreciate its overwhelming im-
pact on a relative’s life. They also felt that the sharing of
stories in the suicide bereavement group helped them make
sense of their loved one’s death and they felt understood.
Neimeyer (2000) has argued that meaning-making occurs
in the context of “sense-making” and later “benefit-find-
ing.” It would be interesting to investigate the social con-
struction of grief and how meaning-making evolves in the
context of support groups. This is an area that is under-in-
vestigated in the suicide bereavement literature.
Finally, what relevance have these findings in terms of
understanding bereavement following suicide deaths? Un-
equivocally, suicide bereavement occurs within the context
of a combined interpersonal and social landscape that os-
cillates between appraisal of the suicide act and engaging
in the task of day-to-day living. The bereaved are chal-
lenged by their inner interpretation of the loss in the context
of their prior relationship with the deceased. In this study,
the willingness and ability to accept support or engage in
social interactions was modulated by the individual’s per-
ception about the death and cultural notions regarding sui-
cide deaths. The suicide death was a powerful social force
on participants, regulating their engagements in social
pathways and attachment to suicide bereavement groups.
The findings from this study indicate that a greater under-
standing of the meaning-making process in suicide be-
reavement is warranted, while the use of qualitative re-
search designs may be essential if researchers are to elicit
the important details in suicide bereavement.
Acknow ledgments
This article was made possible thanks to the Living Links
suicide bereavement support networks and adults bereaved
by suicide residing in the western region of Ireland. The
findings reported in this paper are from a larger study, of
which a further paper outlining the quantitative analysis
will be published.
This paper is based on research conducted for Mary Beg-
ley’s master’s thesis submitted to University College, Cork,
in fulfillment of the requirements for the degree of MPhil
in Applied Psychology.
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About the authors
Mary Begley, BSc (Hons), MPhil (National University of Ireland,
Cork), is an Assistant Director of Nursing with the Mid West HSE
Limerick Mental Health Services. As part of her former role as
Coordinator for Suicide Prevention in the western region of Ire-
land, she established the Living Links voluntary support network
for adults bereaved by suicide.
Ethel Quayle, MSc. (Queens University, Belfast), PsychD (Uni-
versity of Surrey), is lecturer in Clinical & Health Psychology at
the Department of Applied Psychology, National University of
Ireland, Cork, Ireland
Mary Begley
Assistant Director of Nursing
HSE-Mid West Region
St Joseph’s Hospital
Mulgrave Street
Limerick
Ireland
Tel. +353 61 416166
E-mail mary.begley@mailh.hse.ie
34 M. Begley & E. Quayle: The Lived Experience of Adults Bereaved by Suicide
Crisis 2007; Vol. 28(1):26–34 © 2007 Hogrefe & Huber Publishers