Paper One: Academia, Emotion and ‘Lived-Experience Research’

Paper One: Academia, Emotion and ‘Lived-Experience Research’

I had hoped to make life a little easier and just post a video of my recent conference presentation. Unfortunately, being out of practice at this style of public speaking, I misjudged content length and ran out of time resulting in this:

19143720_10154488565141954_4919221561333413096_o
When you get told to stop mid-point and prior to the big finish…

Argh. So, instead, I’m publishing the content below…..

The ‘Martin Effect’: reflections on ’emotional labor’ facets in qualitative suicide bereavement research.

Academia and ‘emotion’

The Academy has traditionally had a problem with emotion. The argument has been framed in a way that determines ‘visible emotion’ as causing lost legitimacy (of researcher and research) (Blackman 2007, cited in Jamieson, L., et.al. 2014: 2), primarily because “sharing personal stories can be seen as being self-centred and an act of ‘navel-gazing’” (Visser, 2016: 2). Essentially, in traditional circles (those adhering to the established notions of ‘scientific’ – or what constitutes ‘scientific’ – research), emotion has generally been perceived as not just problematic, but as something to be almost feared (and therefore avoided). As a result, researchers on the whole have learned (and to some extent still learn) to mould and manage feelings and associated actions to toe the non-emotion-line of academic preference.

The knock-on effect of “This holding of emotion” (Dickson-Swift et.al. 2009: 66) has been that researchers have often neglected the self. The implication that personal connection to research can instantly challenge the degree to which researchers can claim both themselves and their work are ‘professional’ (Kleinman and Copp in Dickson-Swift et al., 2009: 63) has in turn encouraged the moulding (if not outright suppression) of researcher emotion-work attached to projects academic in nature. Researchers, including social scientists, remain “‘trained [own emphasis] to suppress emotions’ (Bellas, 1999: 104)” (in Dickson-Swift et al., 2009: 66); and it is rare that such rules and ‘instructions’ of behaviour/attitude are questioned at the novice level. Yet, as Highet points out, these “Theoretical debates about ‘neutrality’ and ‘objectivity’, ‘engagement’ and ‘social action’ do not prepare you for how it feels [own emphasis]” (cited Jamieson, L., et.al. 2014: 86)

Emotion enters all research. Particularly within the social sciences, personal experiences have a role in shaping research in that we all do come to research with preconceptions, indeed biases. Thus, as Grant and Zeeman argue, accusing researchers of self-indulgence if the personal is visible in research is only to assume that the researcher is “autonomous and culturally, dialogically and relationally disconnected from other people” (2012: 2), which is not, and cannot be, the reality. As Barbalet (2002) has pointed out,

“A well-developed appreciation of emotions is absolutely essential…because no action can occur in a society without emotional involvement.” (Barbalet, 2002: 2)

The question should become, then, not about whether or not emotion should come into play, but about how emotion that is naturally there is to be managed.

‘Expert by Experience’ – ‘Lived-Experience Researchers’

I am conducting my research because of ‘lived experience’ – losing my brother and only sibling, Martin, to suicide, when I was 30 and he was 27, led me back into the world of academic research, to explore and record the experiences of other adult siblings after this form of loss. I came into the project with a proposal that followed the traditional focus on topic-content and the participants of the project. At the outset, I thought of only what I wanted to compile and write after talking to other people. I failed to appreciate my role and position in the research, as someone directly affected by the subject under examination.

Perhaps the assumption was ‘experience makes this research workable’ – essentially, I viewed my experience as an advantage, as crude as that sounds, in that it implied “ease of access to the field…expediency of building rapport; nuanced and responsible data collection, taking into consideration community norms and values; and richness in the interpretation of the data in light of deep knowledge” (Ross, 2017: 2). However, delving closer into other (though not bountiful) accounts of ‘lived-experience researchers’, and drawing on some of my initial emotions, it has become clear that multiple obstacles/potential trip-ups do have to be navigated.

Firstly, there is no such thing as a ‘Total Insider’ – there are only insiders of own experience. I remain an outsider to others’ grief experiences, no matter the common factor of suicidal death. Secondly, self-disclosure can also distance (Pezalla et al., 2012: 167) as well as unite – Finlay for instance describes this issue as being about a “threatening [own emphasis] path of personal disclosure”, whereby “the researcher treads a cliff edge where it is all too easy to fall into an infinite regress of excessive self-analysis at the expense of focusing on the research participants” (2002: 532). Recognition of this leads to, thirdly, the highlighting of other emotional elements: for instance, there is much guilt that brings forward questions – am I exploiting the death of my own brother? Am I exploiting others’ pain? Will I result in providing an example of how, to cite Kvale and Brinkmann (2009), a lived-experience researcher’s “knowledge of how to create rapport and get through a participant’s defences may serve as a ‘Trojan Horse’ to get inside areas of a person’s life where they were not invited”? (75) None of these are pleasant to think on, yet they inevitably arise, demanding consideration.

Other researchers in a similar position to mine have cited emotional tolls manifesting in regret, feeling powerless to aid their respondents (Highet cited in Jamieson, L., et.al. 2014: 87) and high-levels of “frustration, physical and emotional exhaustion” (Ryan cited in Silverman, 2016: 41), due to the cumulative nature of the emotional impact of the research (Jackson et al. cited in Jamieson, L., et.al. 2014: 139-40). Indeed, the analytical and dissemination stages of a research endeavour can be just as taxing as the data collection phase. For instance, there are accounts of (re)traumatisation developing during qualitative data analysis (Frambach, 2015: 957), and it has been described that researchers can find it hard to make decisions as to what to keep in and leave out – all can appear important, leaving the researcher anxious, not wanting to misrepresent or exclude. This can also filter down into spoken presentations, even to “needing to manage emotions while talking.” (Jackson et al. in Jamieson, L., et.al. 2014: 140). Overall, there is strong potential for researchers with lived-experience to reach “saturation point”, leaving them “feeling ‘emotionally drained’” (McKenzie et al., 2016: 6).

Strategies

Turning specifically, then, to my own project, realisation of the need to think about personal strategies to manage my emotional connectedness to the project began early on. Reflection and reflexivity are often put forward as crucial in an academic sense – as Finlay argues, “Ideally, the process of reflection and reflexive analysis should start from the moment the research is conceived.” (Finlay, 2002: 536) These aspects are certainly crucial to my study, but it also must be said that reflection and reflexion are not the be all and end all – indeed Pillow (2003) for instance, “problematizes the notion that self-reflexivity ‘provides a cure for the problem’” (cited in Ross, 2017: 3) – engaging in this R&R does not solve all the issues pertaining to lived-experience researchers, and clear articulation regarding specific decisions/strategies is also required.

Some of the key areas for my work are as thus follows:

1.My ‘Insider knowledge’ is to be recognised as useful for logistical decision-making, and is not something that always needs justifying through connection to already-published literature, particularly with regards to research questions. I will engage actively in “using emic understanding of the studied phenomenon to develop appropriate interview questions” (LaSala in Meezan and Martin 2003: 19). I know, for example, that loss by suicide can affect career choices, employment relationships etc.; I know that loss by suicide can encourage previously unconvinced people to seek out mediums and conversations with the dead – so why not use these insights to form questions? As LaSala points out,

“Qualitative researchers who are members of the groups or communities they study have a unique ability not only to elicit emic perspectives, but also to understand their importance…personal familiarity with issues affecting their respondents’ lives may enable them to formulate research questions” (LaSala in Meezan and Martin 2003: 17).

Furthermore, in terms of practicalities, I know the effect that ‘celebratory’ days (Christmas, Easter, even Hallowe’en and Mother’s/Father’s Days) (Omerov et al., 2014: 3412) can have on adult siblings specifically, so I will draw on that to plan interview timings. I know that restricting the length of time for an interview may be counter-productive, given that many siblings are in their lives often not afforded space to talk – I will therefore enter the interview scenario “prepared to listen for as long a time as…needed. (Dyregrov, 2004)” (Omerov et al., 2014: 3412). What will simply be important will be to explicitly outline and acknowledge where my ‘insider knowledge’ has been utilised, and how it has been incorporated.

2. ‘Researcher-participant’ friendships. As a suicide bereaved person, meeting those who ‘get it’ are worth their weight in gold. But then I am also a researcher. The usual academic advice is to ‘avoid dual relationships’ (LaSala in Meezan and Martin, 2003: 22) – they are often considered too blurry to be beneficial. Yet there is research to show that being open about the nature of the relationship with the interviewees can allow a form of friendship and research-relationship to co-exist relatively un-problematically. For instance, Ross has described how:

“I addressed them directly… ‘I feel the same way, about how great it is to be in touch with someone going through such a similar experience…Because of that I have to tell you I’m struggling a bit with figuring out what kind of relationship with you is ok considering I’m the principal researcher of a study you’re participating in, do you know what I mean? Just ethically in terms of making sure that you do not feel coerced to continue to participate, do not share information with the study you wouldn’t otherwise necessarily choose to share and so forth because of a relationship between us. Anyway, I just wanted to let you know that it’s on my mind, that I’m juggling these roles, so that if you feel any distance on my part, you will know that’s where it is coming from, and definitely not from a lack of interest or connection.’” (Ross, 2017: 6-7)

This to me emphasises that ‘mutual agreement’ here is more than helpful. Being emotionally honest and open, making the tensions visible is important and, I believe, a best way to demonstrate respect for participants, allowing successful handling of relationships when the research topic is entangled with the personal life of the researcher.

3. Closely linked to this aspect is the issue of self-disclosure (Visser, 2016: 3). As a person affected by suicide loss, I can say that what you reveal to whom can depend very much even upon the day of the week, never-mind anything else. And sometimes things are said on the spur of the moment, just because a pertinent memory pops up, for example. For research purposes then, extra concentration needs to be given to thinking about the questions: a) what would I want to share/feel comfortable in sharing? and b) under what circumstances would I speak my memories/experiences? The care I wish to take is to not speak my thoughts in a manner that can be taken as advice – I am not a therapist; I am merely a peer. Therefore, I have decided to stick to factually-based comments, rather than offering interpretations of my own experience. It may also be beneficial with regards to self-disclosure to be interviewed using my own research questions/interview schedule, as a means of thinking about what information I would share if I were a respondent, (to help reduce possible impulses to speak within actual interviews (when I should concentrate on asking questions), and also to perhaps determine a protocol of own-information open for disclosure, should respondents seek out such information). I will also not offer, but only respond, if asked. In this respect, I aim to entirely engage with Finlay’s suggestion that “the self is exploited only while to do so remains purposeful” (Finlay, 2002: 542).

4. It is also important to make explicit reference to the acceptance and appreciation of physical emotion as a feature of my decision-making. ‘Outward signs of emotion’ are largely overlooked in discussions regarding research interactions, although there are comments to be found where researchers have “reported holding on to emotion” (Dickson-Swift et al., 2009: 67) rather than displaying bodily reaction in interview contexts. This comes back to the idea that academic value rests on an idea of “being professional…involve[ing] not showing any outward signs of emotion.” (Dickson-Swift et al., 2009: 69) I highly anticipate that at some stage I will encounter a participant story that will prompt an emotional response – it would thus affect my professionalism and sense of stress as an interviewer to not allow crying, and therefore I will be explicitly mentioning crying as part of my methodological (and ethical) decision-making.

5. And lastly, self-care will be prioritised and built into my research design. Essentially, I “acknowledge[…] feelings as part of the research process” (Dickson-Swift et al., 2009: 62), as a means of self-empowerment. I have placed myself in the position of researching this topic; but I also have a duty to look after myself. The argument may be that “Universities (and research centres) have a duty of care to researchers” (Dickson-Swift et al., 2009: 74), but it is also the case that researchers should seek to care for themselves and express this so, without trepidation. As Highet comments, “We must be prepared to draw our own lines as we navigate our way through our work” (cited in Jamieson, L., et.al. 2014: 87). As this is a work in process, I’m not entirely sure what form this self-care will take, but I’m working on, and articulating the need for, it!

Conclusion

How then to sum up this very brief consideration of ‘emotion labor’ with regards to my researcher activity in examining that of which I have lived-experience? I would stress that emotional management is as much a research skill as any other, deserving of respect and recognition, especially when direct experience of the research topic is at the heart of an endeavour. In my (part time) case, I am currently a long way off fieldwork, yet focused consideration of the emotional connectedness and facets to my work have already come to the fore. I obviously do not know how I will react in interview situations, in relation to data analysis etc., but the point is to recognise, to anticipate possible impacts in as much detail as possible, in order to identify or design strategies to manage and combat should the need arise. Within academia the impression upon me is very much that “connections between…research and…private lives are not often publicly acknowledged because ‘the norms of scholarship do not require that researchers bare their souls, only their procedures’ (Lofland and Lofland, 1995)” (cited in Primeau, 2003: 11), so then my aim is to try and openly integrate the private life into the procedural process valued within academic communities. That, I hope, is a route to trust in me as a researcher, and in the work I produce.

 

Reference List:

Abell, J., Locke, A., Conder, S., Gibson, S. and Stevenson, C. (2006). ‘Trying similarity, doing difference: the role of interviewer self-disclosure in interview talk with young people’ in Qualitative Research, Vol. 6., No. 2., pp. 221-244.

Barbalet, J. (Ed). (2002). Emotions and Sociology. Blackwell Publishing.

Carmack, H.J. and DeGroot, J.M. (2014). ‘Exploiting Loss? ethical considerations, boundaries, and opportunities for the study of death and grief online’ in OMEGA, Vol. 68, No. 4, pp. 315-335.

Dickson-Swift, V., James, E.L., and Liamputtong, P. (2008). Undertaking Sensitive Research in the Health and Social Sciences: managing boundaries, emotions and risks. Cambridge.

Dickson-Swift, V., James, E.L., Kippen, S., and Liamputtong, P. (2009). ‘Researching sensitive topics: qualitative research as emotion work’ in Qualitative Research, Vol.9, No.1, pp.61-79.

Finlay, L. (2002). ‘ “Outing” the Researcher: The Provenance, Process and Practice of Reflexivity’ in Qualitative Health Research, Vol.12., No.2, pp.531-545.

Frambach, J.M. (2015). ‘Balancing Vulnerability and Narcissism: who dares to be an autoethnographer?’ in Medical Education, Vol. 49., pp. 952-958.

Grant, A.J., and Zeeman, L. (2012). ‘Whose Story Is It? An Autoethnography Concerning Narrative Identity’ in The Qualitative Report, Vol. 17., Article 72, pp.1-12.

Jamieson, L., Simpson, R., and Lewis, R. (2014). Researching Families and Relationships: Reflections on Process. Palgrave Macmillan.

Kvale, S. and Brinkmann, S. (2009). InterViews: Learning the Craft of Qualitative Research Interviewing. Sage.

McKenzie, S.K., Li, C., Jenkin, G. and Collings, S. (2016). ‘Ethical Considerations in Sensitive Suicide Research Reliant on Non-Clinical Researchers’ in Research Ethics, pp. 1-11.

Meezan, W. and Martin, J.I. (2003). Research Methods with Gay, Lesbian, Bisexual, and Transgender Populations. Routledge.

Omerov, P., Steineck, G., Dyregrov, K., Runeson, B. and Nyberg, V. (2014). ‘The Ethics of Doing Nothing. Suicide-bereavement and research: ethical and methodological considerations’ in Psychological Medicine, 44, pp.3409-3420.

Pezalla, A.E., Pettigrew, J. and Miller Day, M. (2012). ‘Researching the Researcher-as-Instrument: an exercise in interviewer self-reflexivity’ in Qualitative Research. Vol.12, No.2, pp.165-85.’

Primeau, L.A. (2003). ‘Reflections on Self in Qualitative Research: Stories of Family’ in The American Journal of Occupational Therapy, Vol.57., No.1. pp.9-16.

Ross, L.E. (2017). ‘An account from the inside: examining the emotional impact of qualitative research through the lens of ‘Insider’ research’ in Qualitative Psychology, pp.1-12.

Visser, R.C. (2016) ‘‘Doing Death’: reflecting on the researcher’s subjectivity and emotions’ in Death Studies, pp.1-8.

“He can’t have a birthday”: Motherhood after Sibling-Suicide Loss

“He can’t have a birthday”: Motherhood after Sibling-Suicide Loss

10443120_10152173639026954_6010579701438202277_o
My brother and my daughter – together.

Tomorrow is my brother’s birthday. Having mentioned this as a little reminder at the family dinner table, my four-year-old said “But Martin can’t have a birthday because he is died and lives in the sky”. Yes, but…. What followed was a discussion that connected her uncle ‘being died’ with Inky the nursery fish also going to ‘fishy Heaven’… Just the latest in a string of scenarios where my daughter has begun to show how she is making sense of death in general, but also a conversation that tells me she’s growing older and sooner or later questions about the nature of her uncle’s death will be asked. My daughter never met her uncle, but through me entered ‘suicide survivordom’ even before conception. And from my perspective this adds another facet to the suicide bereavement experience and process (as in many respects I must manage it for her AND me). Consequently, herein lies an issue that I believe is largely overlooked in bereavement by suicide considerations – how does losing a sibling to suicide in adult life, the time when many siblings branch out to head their own families, affect parenting relationships with their own children?

Given I’m primarily at this point interested in connecting my own experience with literature comments, my concern for this post is specifically exploring some ideas about mothering and motherhood after sibling suicide loss, particularly as there are, “specific issues for female survivors shaped by the sexual politics attached to women’s identity” (Cline, 1995: 246-7). This is obviously not to say fathering and fathers’ experiences after sibling loss are irrelevant, and I do think they also need close acknowledgement attention, but from here on my focus at this time is the female parenting experience.

Becoming a mother after a loss to suicide adds a very complicated facet to an already massively-life-altering experience. Both these life events necessitate a huge rethink in terms of identity. As Chidley et al. point out, “Motherhood alone is a challenging, paradoxical and poorly understood period of transition” (Chidley et. al., 2014: 19). Add to this the “excruciating experience” (Chidley et.al., 2014: 19) of a major (close) death and you are landed with a big question; ‘what on earth do I deal with first?’ It is interesting that Dyregrov and Dyregrov describe the experience of bereavement by suicide as leading “to increased insight and personal maturity, the changes required great energy expenditure…substantial social and relational adjustment” (2005: 720). This also entirely applies to the experience of becoming a mother for the first time. Thus, arguably, the loss of a sibling to suicide can be very much entangled with conceptions of self as ‘mother’ as well as ‘sibling’.

The question then becomes how to manage double the energy-spend needed for one of these events alone, how to navigate grief and the enormous learning curve that is parenthood at the same time. Some studies give weight to the idea that motherhood is a ‘distraction’ from grief, that the ‘mother-identity’ is stronger than anything, providing the ‘affectee’ with, “a sense of meaning and purpose in life. Motherhood seems to have helped them to be less susceptible to prolonged grief complications.” (Chidley et. al., 2014: 19). This may be the case for many experiences, however there is also acknowledgement that a family death during pregnancy leads to negative experiences and thought (Chidley et. al., 2014: 24). From experience, it would be my contention that there is an entire mix of these two ends of the spectrum following an adult-sibling suicide, the mother processing “the suicide of the sibling from a different vantage point when having a baby” (Petterson et.al., 2015: 329), whilst also being thrown into a self-conflict, with sensations akin to riding the waves up and down in a perfect storm, in a rubber dinghy, without a life-jacket, centred around whether to look back or move forward. One sister shows this most clearly through the following recollection of an experience after the suicide of her brother:

“‘So I have all these memories of walking through a cemetery, y’know picking out a good space for David, while I push my son in his stroller, or walking through the store of caskets and pushing a stroller through that store, or sitting in the funeral directors, nursing my son while I dictate David’s obituary to him'” (Four Sisters, 2012)

Chidley et al. describe this as mothers ‘oscillating’ “between their need to grieve and their responsibility to ‘be there’ for their children” (Chidley et.al., 2014: 25). Such is the pressure of the navigation of these peaks and troughs that actual grieving can get neglected. I know of myself that I tended to choose a focus, namely my immediate baby concern, to the detriment of the other elements that needed equal attention, simply because the energy expenditure of ‘managing it all’ was too much. Whilst some mothers affected by a death by suicide have spoken of how they did not “skip the grieving process, but were really mainly focused on the day to day needs of a small child” (Four Sisters, 2012), I recognise full-well that I did ‘jump over it’. Whilst I thought of my brother all the time, I did not engage in the actions of grieving throughout the whole of my pregnancy and the first year of my daughter’s life. Such suppression has implications. It is often spoken of in the tone of an old wives’ tale, but there appears to be much actual truth in the idea that grief always finds a way to show itself – as Dyregrov and Dyregrov describe one research respondent commenting that grief, “‘may come in different ways, for example, physically – I have been sick a lot, especially the last six months. So that’s the way it has manifested itself’.” (Dyregrov and Dyregrov, 2005: 718-9). Other examples of this also appear, such as the following: “Immune system response has been shown to be disrupted by the acute stresses of bereavement…The stress of repressing so much feeling had lowered my resistance and I was miserable with ‘flu.” (Gambotto-Burke, 2003). Mental health is a concern too – ‘is that postnatal depression/anxiety or are they mental health issues stemming from your bereavement?’ Women in the extraordinary situation of becoming/being mothers after losing a brother or sister to suicide should most certainly have access to support that would enable a clearer answer to this particular question.

When the flurry and overwhelmed-ness of the squirmy-blob baby-stage evolves into that of living with a little person of mega character, curiosity and voice, I would suggest that that is when the big regrets following suicide-loss can really begin to set in. It hurts me greatly that my brother will not know my daughter, and that she will only “have memories [I’ve] told [her] about” (Four Sisters, 2012). As other sisters in the same boat have said before me, “he would’ve been a great uncle to [her]” (Four Sisters, 2012). And further to this, the energy renewal that comes with nights slept through allows other thoughts to appear. A big concern for me, for instance, is ‘how do I tell her what happened?’ I am fortunate in that I do not feel shame or the need to hide my brother and his actions away as a secret; I want to talk about him and I want my daughter to know about him. And there are charities like Winston’s Wish to help…But the question still arises; ‘how do I explain his absence in such a way that does not cause harm?’ Others who have agonised over how to refer to the aunt or uncle’s death emphasise ‘illness’ as the cause: “She told her son that his uncle ‘had an illness in his brain’ and that was what caused him to die by suicide.” (Linn-Gust, 2010) And I found this particular explanation very moving:

“‘When Uncle Matt died he became all spirit. Our spirits are the parts of us that love and smile inside. Our spirits help us laugh and listen and care about each other. Living in his body was hard for Uncle Matt beacause he was sick. He wasn’t sick like with a cold or a stomach ache; he was sick in a way that the doctors were not able to make him well. That doesn’t happen very often but it happened to Matt. So he decided that to become a spirit would be a better way to live.’” (Four Sisters, 2012)

Importantly though, in reference to this issue, the broader discussion of mental illness as having parity with physical illness comes into play. Respect for mental health as being akin to physical illnesses, such as cancer, is unlikely (despite tremendous hope and effort) to be soon fully achieved (especially given unsupportive governmental policies and the lack of awareness in media reportage). Allowing a judgemental and stigmatised view of death by suicide to persist certainly makes telling my little one all about her uncle and how he died all the more difficult. An often overwhelming preoccupation with the need to protect is present, and this fosters in me a strong (perhaps even stronger than those not affected by suicide?) sense of duty and responsibility towards my daughter. In this I share affinity with Bialosky who describes how (after her sister’s suicide) “it wasn’t until just a few years ago, when my own son…reached the age at which Kim’s life began to falter, that I knew I had to try to understand what happened to my sister. My responsibility as a mother made it imperative.” (Bialosky, 2015). In effect, whilst I may never fully understand what a parent goes through in losing a child (at whatever age) to suicide, I have to approach my brother’s death as both a sibling and a parent. It is a complex notion to explain, but in effect my brother’s death could be seen as contributing to the formation and development of my parenting style. Bialosky similarly explains this, telling how she has approached mothering after her sister’s suicide by being wary of the question “What might go wrong if I [am] not paying close enough attention?”, describing herself as being “a vigilant mother, perhaps at times too overly conscious of the effects of the actions of my life and my husband’s life, the state of our marriage, on our child” (Bialosky, 2015). So, whilst motherhood following other forms of death is not as likely to be much defined by the loss (Chidley et.al., 2014: 22), for me (and others) it could be the opposite – my identity as a mother is inextricably linked to the suicide event, and therefore is (to quite a significant extent at least) defined by my sibling relationship.

Perhaps the principal element as to why this is the case relates to the idea of ‘legacy’. Many siblings bereaved by suicide suffer from “constant feelings of approaching disaster.” (Petterson et.al., 2015: 328). Such levels of concern, responsibility, anxiety have their roots in the ‘knowledge’ presented that seems to suggest “suicide runs in families”, and this “creates fear of another family suicide that complicates the grief process.” (Powell and Matthys, 2013: 322-3) In specific reference to new-motherhood, the mortality of both mother and child is thrown into the spotlight by a bereavement, meaning that “women…experience[d] specific anxiety related to future losses of their children and their own mortality.” (Chidley et.al., 2014: 26) Essentially what it comes down to is that there is an “unspoken fear” and anxiety “about which member of the [family] household will be the next to die.” (Cline, 1995: 267). One participant of a research study highlights this very clearly in their comment that,

“‘You worry so much about your children. Does depression run in families? What about suicide? Will this happen to my own children? You don’t even dare to talk about it but it is a constant question in the back of my mind.’” (in Petterson, 2015: 328).

Needless to say, this is a hideous thing to live with, especially as a new mother, when you are supposed to be revelling in the idea of new life, but the fact is a sudden and traumatic death throws the real insecurity of life into your face, highlighting the unfairness, torture and inescapable nature of loss as being an everyday reality.

This is certainly something that needs to be discussed with women affected in this way. Address the issue head on, quite frankly. Plenty of arguments relating to suicide and suicide bereavement state ‘post-vention is prevention for the next generation’; I have both read this (e.g. Schneidman, 1972), and heard it declared at academic conferences etc., but so far I fail to see concrete action when it comes to adult siblings, many of whom are or will be parents to the ‘next generation’. Following a suicide loss, adult siblings who became/are mothers in particular have demonstrated that they foster an “ongoing sense of responsibility for their children”, which Cline argues “gives ground for optimism.” (Cline, 1995: 277). Such women may “show our children how to celebrate existence in all its beauty, and how to get up after life has knocked us down, time and again.” (Gambotto-Burke, 2003), but they will need the support to do so. As Linn-Gust advocates, “By helping the bereaved through their losses, we support their efforts to find life sustaining hope again. By providing this support we are breaking the legacy of suicide in families.” (Linn-Gust, 2010). It seems to me there is a case to be made that such adult-sibling-young-family-mothers (parents) affected by a suicide loss should be given due attention and support in their bereavement, to aid both their own recovery and their ability to be positive in life in such a way as to enable a role as ‘preventors’ against future losses.

Bialosky, J. (2011). History of a Suicide: my sister’s unfinished life. Croydon: Granta.
Chidley, B., Khademi, M., Pilar Meany, K. and Doucett, M. (2014). ‘Bereavement during motherhood: a mixed method pilot study exploring bereavement while parenting’ in Bereavement Care, Vol.33., No.1, pp.19-27.
Cline, S. (1995). Lifting the Taboo: Women, Death and Dying. Little, Brown and Company.
Dyregrov, K. and Dyregrov, A. (2005). ‘Siblings after Suicide – the “Forgotten Bereaved’ in Suicide and Life-Threatening Behaviour, Vol.35.,No.6, pp.714-723.
Four Sisters, 2012. Available at https://vimeo.com/93890459 [accessed 5th November 2015]
Gambotto-Burke, A. (2003). The Eclipse: A Memoir of Suicide. [Kindle Edition]
Linn-Gust, M. (2010). Rocky Roads: The Journeys of Families through Suicide Grief. Albuquerque NM: Chellehead Works.
Pettersen, R., Omerov, P., Steinbeck, G., Dyregrov, A., Titelman, D., Dyregrov, K. and Nyberg., U. (2015) ‘Suicide-Bereaved Siblings’ Perception of Health Services’ in Death Studies, Vol.39., pp.323-331.
Powell, K.A. and Matthys, A. (2013). ‘Effects of Suicide on Siblings: Uncertainty and the Grief Process’ in Journal of Family Communication Vol.13., No.4., pp.321-339.
Three Years, Three Days: reconnecting with PhD origins.

Three Years, Three Days: reconnecting with PhD origins.

image2 A couple of months back, I connected with a woman organising an event for CALM (Campaign Against Living Miserably). She asked if I would write some words that could be spoken at a fundraising event (which is happening next week (15th July 2017), and I said yes.

The following is what came out.

Have to say that writing the words was also good opportunity to also remind myself of where my research came from and why I’ve taken it on (especially as general PhD stress and deadline-meeting can be things that take a hold, pushing your focus perhaps a little way from where you initially started)….Never a bad thing to reconnect with your own reality generally, but that is perhaps especially the case for researchers…

“On the 8th April 2011, my little brother, Martin, wrote the following to me:

“I haven’t moved a step forward in seven years. TIME for a CHANGE. What do you think?”

I replied saying that was a brilliant idea, and I would support him however needed. But later the same year, on 24th November, unbeknown to me at the time, he wrote this one and only blog post:

‘I don’t think I can live any longer in a vacuum; nor can I live with the unwavering paradox of desperately craving company and isolation at one and the same time. …

I have come to the point now whereby incessant commentary, self-criticism and constant fear have effectively annihilated whatever prior persona there may have been. I would renounce everything – everything – just to ‘be myself’ for 5 seconds. Just ‘to do’, not ‘think to do’.

I go to meet people as if they were the gallows. I have tried everything I can think of but cannot conceive of it being otherwise.

My only passions were music and history. But this whatever-it-is has jumped spheres and now infects my inner world: I am absolutely, distressingly indifferent.

Everything is subordinate to the problem, disease, whatever it’s called. Life, passion can only have meaning if you share it. I can’t talk to people. And from such little seeds do fuck-off massive weeds grow.’

Three weeks later, on 15th December 2011, he took his own life. He was 27.

Subsequent to the date of my brother’s passing, the fact of his death and the means by which it occurred have been omnipresent in my daily life. Amongst other aspects, I have experienced loss-of-limb nightmares, mirages on airplanes and in town-centres, immense guilt and situation re-livings all induced by the events of that winter. It is difficult to explain the sensation of carrying around such knowledge to someone, but I hope the following clarifies it a little. There is a scene in the 1992 film ‘Death Becomes Her’ in which Meryl Streep (her character, obviously) shoots a hole through (again, no recollection of character names) Goldie Hawn. The hole is big, round and airy, completely see-through with a black rim. And that is how I conceived of my physicality as I walked back into the classroom in Mexico where I worked at the time, about two months after Martin’s death. A huge gap of nothingness in my middle, like part of me had been shot out. That sense remains, though the hole-size is, 5.5 years on, much reduced.

It is perhaps classically the case that a ‘suicide story’ begins before the date of the actual death. Those left behind pick over the deceased’s life and try to fit together all the pieces in the hope that some sense can be made, some explanation can be found. The ‘why’ that bothers me is ‘why did he not talk to me?’ He had done so before; why not this time? I would be lying if I said I didn’t sense the depth of his problems. It sounds very cheesy but I just had a sense of the ‘wrongness’ of the situation in the months immediately prior to that December. I got more than upset hugging him goodbye in his dark and fairly cigarette-stinky pit of a bedroom, with the dog at his feet, as I again left for Mexico after a brief trip home in the summer of 2011. I even (don’t laugh) toyed with the idea of contacting Stephen Fry, just to ask if he had any thoughts on where I could find my brother help, because I simply couldn’t think of anywhere else to go or anyone else to ask; we had exhausted all options, and I had given all personal-experience advice I could give. It is so easy to obsess over this pre-death sense, to question ‘why didn’t I do something?’; ‘why did I carry on regardless?’ But that is utterly pointless. I’m not saying I haven’t questioned myself and my behaviours at various (numerous) points since, but the fact is it happened. I lost my baby brother in a manner I did not foresee, and which hurt(s) greatly.

It is unpleasant, but nonetheless true, to say that I spent a good part of the ensuing two and half years in a state of fury, specifically directed at my departed brother. I am not proud of this, but nonetheless my involuntary reaction to Martin’s death was pure ire at almost its most fire-in-the-belly severe. And because of this I lost Martin multiple times – everything became ‘my brother’, ‘depression’ and ‘suicide’ as inextricably linked entities. I eventually came to a realisation that I wanted Martin back. So I began “sifting my memories, the way men pan the dirt under a barroom floor for the bits of gold dust that fall between the cracks”(John Steinbeck, East of Eden, Ch24; p.296). And I began to rediscover ‘Martin’, and also my role of ‘sister’.

To begin the process of rediscovering my brother, I sat down and wrote the first things to come to mind: Books; Music (Guitar, Glasto, Radiohead, The Manics); Film; History; Football (Blackburn Rovers); Humour (Satire, Sarcasm); Smoking; Dog; Forgetfulness; Loyalty; The Great Outdoors; Impatient; Perfectionist; Often Infuriatingly Clever.

I then moved to prose, prompted by a writing course I took to ‘help get stuff out’:

You can see Martin through his bag. A navy-blue rucksack, not a new one. One that has been up and down a lot of hills and is starting to show signs of wear and tear. It has the beginnings of a hole in the base, and fraying on the straps. Inside is a book – something deep, academic, thought-provoking, philosophical, truly analytical (with words you’ve never seen before) or a classic fiction piece (a Brontë, or Steinbeck, or literature of purpose/social commentary). This book is dog-eared and the spine is broken as a result of multiple readings. The pages most likely show signs of having had coffee spilled on them, and there are loose tobacco strands in the page/spine creases. It follows that inside the bag there is his tobacco tin, a lighter and papers for roll ups. There are also to be found apparatus for cleaning up after the dog, because it is unlikely he would go walking or travelling anywhere without him (wherever doggily possible). A guitar plectrum. His laptop (on sleep), scratched and without a protective case – not for any writing, reading or internet surfing purposes, but for his music composition software, or perhaps for film viewing, having masses of downloads stored on it. There are his (latest set of) keys, which will likely fall out of the growing hole in the base of the bag for the upteenth time…and his passport, for entering a pub (i.e. spiritual home) often necessitates proof of age, due to his baby face. This passport will likely (subsequently) be left in said pub, and the process to replace it will begin yet again. He definitely isn’t carrying a camera – loathed the things – ‘you should be using your eyes properly to create memories, not experiencing the world through a tiny lens’….

These are such details insignificant to most, but part of Martin’s mid-20s essence to me.

Thinking about my brother meant that what often came first were not detailed thoughts about him as an individual. A memory of a person often starts with the thoughts of what was shared in the relationship, how the connection manifested itself. Thinking about the stories and situations that had us both as characters has largely been the route by which I have retrieved some of my strongest memories. So I recount to you the instance of my brother jumping headlong into a pond filled with frogspawn because he mistook it for grass – he was not best pleased and oh the laughter I fought to conceal as I ran to recruit parental assistance. The time when an unplanned fire alarm went off in our primary school, resulting in the infant school classes being pushed together with the juniors – I went around the playground with my brother, a protective arm around his shoulders, introducing him to everyone, which he seemed remarkably pleased about. Meandering and chatting through the Lancaster suburbs to our tennis club, and engaging in ‘matches’ that often ended in competitions to see who could lob the ball highest whilst still landing it in an ‘in’ location. Arrangements to meet and open our Christmas stockings together at 5am. Parascending in tandem over the Greek island of Skopelos. His staying with me, aged 15, in Aberystwyth during my first year at university, watching The Exorcist (!) and impressing my new friends with his ‘roll-up skills’ (I didn’t even know he smoked). Spending a summer’s day in Regent’s Park, culminating in a Seth Lakeman concert at the Open Air Theatre and a Chorizo burger at the Gourmet Burger Kitchen. His face when I handed him the Natasha Kaplinksy autograph I’d got for him the day after she won the first Strictly Come Dancing; he was a BIG FAN. Our ‘debates’ on smoking during the discussions pertaining to the introduction of the UK Smoking Ban – I, for; he, angrily against. Rising at 4am and travelling to our ‘local hill’ Clougha Pike (accompanied by our father) to climb it in time to see the sunrise from the summit on Midsummer’s day, before nodding off in the heather, followed by a descent that would include an obligatory stop (and dip) at a natural ‘plunge pool’, the location at which we were to later scatter some of his ashes.

Yet this is a brother we speak of, so I must state that Martin also loved to wind me up something chronic. Whether it was pinching the back of my neck, making me walk around with shoulders hoiked up and head tilted for his own amusement, or his pointing out of all examples of my ‘up-talking’ when home from university, or the changing of the ‘H’ in my name to an ‘F’, calling me ‘Feather’ much of the time, which I hated. One of Martin’s amusements was certainly getting a rise out of me. Exam revision times were ‘fun’ – I don’t care how well instruments are played, or what kind of wonderful creations are being constructed, you try learning the facts of some Tudor revolt whilst drum-machine thumping or multiple repetitions of Deep Purples’ Smoke on the Water‘s guitar-riff come pounding through the wall of your bedroom. ‘Shut ups’ were frequently exchanged. And I simply do not know anyone else who took longer to have a bath. Accompanied by a coffee and a book, Martin would enter the bathroom and we would know not to expect him to leave for near on two hours, even then necessitating ‘get a move on’ banging on the bathroom door. My brother could be demanding, often the grumpiest of human beings, seriously impatient, and I have no qualms in admitting I was more than a little jealous of his cleverness, his ability to exit an exam with the highest grades going without having done the slightest grain of revision. He could just do stuff.

When I think about it, we did fight a lot. Well, bickered. More niggly, nit-picking rather than outright arguments. But what siblings don’t do that? But to me, the arguments we had never meant we disliked one another. I was allowed to fight with him, but should anyone else have a go they would have me to answer to. I felt entirely loyal to Martin, and I believe he to me too, despite our squabbles. In my later teen years, after leaving for university whilst my brother remained, finishing school, this bond solidified. I really looked forward to heading back home for Christmas and catching up with him, and the common ground we had that led to the great experiences and conversations of an adult sibling relationship. A love of lounging in jacuzzis; a deep interest in Latin America and the Spanish language; simply going for a drink in the pub; a love of together taking the dog for his walkies; meandering around the local antiques centre at Lancaster Leisure Park (where he had been known to pick up random items, such as a useless gramophone just because ‘I found it interesting’). I believe we became even closer after he left for university himself, where and when it was that his illness really first took hold and then started to be visible to ‘outsiders’. He would call me in the early hours of the morn at times to vent. And I went along with that; it was standard practice for me to leave my mobile on in case of his needing a chat in the middle of the night, usually around 3am. Indeed, one of the toughest realisations after his death has been that my phone need not be on during the night; there is no call to receive.

Martin was not just my brother, he was my finest of friends. We could talk for ages about nothing in particular. He supported me, putting himself into situations to help me out, even though I now know they were so very difficult for him. He tried for me, did not judge, and whilst he may not have been a bruiser-type protector, he was brilliant at backing me up with quick fire wit. His understanding and use of words was enviable, and I admired his incredible intelligence and sharpness more than that of any other acquaintance. He was simply a wonderful, authentic human being that I am so very proud to have known.

I scattered my brothers ashes at Sycamore Gap on Hadrian’s Wall on 1st November 2015. I felt awkward after the scattering. I did not know what to do or what to say. I took some pictures of the tree, and walked around its base for a bit. My husband and I sat on the remains of Hadrian’s Wall at the base of the tree, eating cheese sandwiches, satsumas and cinnamon biscuits, saying very little of any consequence. We did not discuss what had taken place; we did not talk about Martin. We merely existed and focused attention on the landscape around us, particularly on a lone barn on the horizon ahead of us. I thought to myself how very much I missed my brother, and how much I wished he were there, as a living, breathing, talking being. He would have had something to say.

As with all other aspects of the grieving process, time is needed, as is personal, individual reflection. Scattering the ashes did not have all the effect I had hoped for – there was no immediate sense of release; there was no sense of setting him or myself free; there was no weight lifted or shoulders relaxing; and sadly, there was no sense of that much needed word, ‘goodbye’, being uttered or fulfilled. The world has not changed, things have not resolved and the existing multitude of mixed emotions persists. Given the nature of Martin’s death, I have realised this is what bereavement by suicide means – living, continuing, with the insolvable, unresolved. However, the ashes scattering was, for me, an important symbolic event to illustrate Martin and I as siblings, and what that connection meant – I am glad to have an idea of ‘knowing where he is’ so I can visit and remember on my own if I wish, glad to have spent moments in thinking about being brother and sister. That day reflected what I wanted to say about losing Martin in the way I did, as his sister – it allowed me to say ‘I am a sister; I have a brother’, and therein I am happy.

Why write this piece? Why lay essentially personal/private memories open? Because it is harder to remain silent on the subject, than it is to speak. I am not ashamed of Martin, of how he died, of having him as my brother. Martin knew all his faults and illness-induced problems himself, and eloquently explained himself in writings we have found since he died. He could, and managed to, help others with their conditions, (they have said so); he just couldn’t sort his own self out. I write also because I am not ashamed of myself – I know now I did all I possibly could to help my brother. Nor am I ashamed of my reaction to his death – it was and still is a trauma that has defined me and aspects of my future. Suicide is not a comfortable subject, and I have felt unease in talking about it with people, making judgments as to whether or not I should include my brother in a conversation. I never wish to put people on the spot, which sometimes makes conversing naturally difficult. But I do not wish to hide what happened, or indeed my relationship with Martin, which played such a role in defining who I am. And I also wish to make the point that behind facts, figures and fear of suicide deaths, there are people. People who had intricate lives and interests and specific, special relationships as individual characters. These people highlight issues that should be discussed in a public capacity, to aid others wherever that may be possible. Eradication of suicide may not be entirely achievable right now, but certainly a massive reduction in fatalities and the ensuing trauma of the loss experience could be.

I’d like to finish with two quotations:

‘I do not love my brother less for having killed himself. I was his sister, you understand; suicide makes no difference’ (Gambotto-Burke, 2003, 2013)

‘I had thought that your death

Was a waste and destruction,

A pain of grief hardly to be endured.

I am only beginning to learn

That your life was a gift, a growing

And a loving left with me.

The desperation of death

Destroyed the existence of love,

But the fact of death

Cannot destroy what has been given.

I am learning to look at your life again

Instead of your death and your departing.’

(Marjorie Pizer, ‘The Existence of Love’)

Thank you.”

 

 

Suicide Bereavement and 13 Reasons Why – Reflections

Suicide Bereavement and 13 Reasons Why – Reflections

*contains programme spoilers

 Pre-viewing background

I first became aware of 13 Reasons Why in 2014. I was in the midst of motherhood year one, and attempting to locate any story-book that portrayed sibling suicide loss that I could read during nap times. I ventured into my local bookstore and asked for advice on any fiction books that dealt with the subject, and 13 Reasons Why was the first to come up. I discounted it because a) it was a ‘young adult’ text (and I did not want to know about teen experiences being not one), b) it is set in America (suicide may be a global issue but cultural contexts and references do come into play and matter), and c) it appeared from the blurb that the bereavement focus was on friends, not the relationship I wanted to read about.

Fast forward to 2017, and the television adaptation has received a lot of coverage, reportage that someone personally touched by suicide would be hard pressed to avoid. But for all the focus on programme-associated suicide prevention concerns, the ‘glamorising’ of suicide, the ‘effects’ and potential for contagion etc., although entirely pertinent and crucial issues, they do not (for me) encompass the entire point. What about the already-suicide-bereaved? Might we not also need a viewing-warning regarding potential trigger elements, given it is near impossible to not recall our own experiences when the s-word is mentioned? Given that Hannah Baker is dead from the outset of the series, I would argue the story is as much about the immense sprawling and ripple after-effects of a suicide, and the variety of impacts experienced by people affected, as it is about examining the ‘reasons why’ someone would take their life (something which is impossible to generalise upon in the first place). Given also that one of Hannah’s friends goes on to attempt to take his life towards the end of the series, I put forward that paying attention to the handling of bereavement after suicide needs consideration.

Making the decision to watch

It is difficult to describe the draw to such a programme when you have lived experience – why would you even want to expose yourself to it? I am not the show’s intended audience at all, but my experience of suicide drew me to it – moth to flame. In many respects, I did fear this programme. I speak for myself, but I’m sure I’m not the only suicide-bereaved person to have thought ‘I was a reason for what they did’. I have distinct memories of sitting in a pub with two of my brother’s closest friends, not long after his death, asking and really wanting them to tell me if he had said anything that might indicate the extent to which I had been a cause. I doubt there is a suicide-bereaved person who has not expressed ‘if I hadn’t done this’, or ‘I should have done that’ at some point. The sense of responsibility, indeed culpability, can be immense, especially when there is no note (or tapes) to provide explanation. To have a programme (regardless of its fictional status) appearing to confirm that blame exists, and that a person has an ability to accuse after death, is a scary thing.

Nevertheless, I decided to watch the series, just to see how they showed the grief experiences, though not because I was seeking identification. I had (have) no wish to see my exact feelings and thoughts replicated in any dramatic text, televisual or otherwise. I think I’ve reached the point where it’s just about recognition of individuality of experience, and respect for that individuality. It’s more about just getting a sense of a validation of bereavement as generally important in suicide narratives. (Attached to the personal though, I can’t always escape the researcher hat – having also spent three years as a post-doctoral research fellow investigating actors’ constructions and performances of real lives, a part of me is simply interested in how the real is played in fictional and docudramatic representations, so this also fuelled my interest in watching this particular show.)

Post-viewing reflections

I have just finished a binge-watch of the series. I didn’t want to like it, and I’m still not sure ‘like’ is the right word, but it is undoubtedly compelling – once you’re into it, you need to watch it all. It works very well on that front, and it’s certainly impactful. The reports are in my view absolutely right in their concerns/comments referencing the graphic portrayals of rape and suicide – the latter of which is seriously distressing . It is by no means an easy watch, or one easily forgotten.

In reference to the depictions pertaining to suicide bereavement, there are a few things I’d say:

  1. I don’t know what research the actors did (or were even required to do) regarding bereavement after a suicide (I’d really like to know…), but the physicality of the grief experience does not come across at all. The tears, sadness etc. are played, but that’s just it, played (not lived) – the sense of the physical loss, especially in Hannah’s parents, felt quite inauthentic for much of the time. They are not, in my view, ‘embedded actors’ (Sutherland, 2010) – in reference to previous research I’ve conducted, I’ve argued that “Having that ability to understand entrenched emotions enables the actors to develop a convincing physical performance” (Sutherland, 2010: 277), and this is missing in 13 Reasons Why. Perhaps this could be attributed to it being a fictional piece (not docudrama, although dealing with a ‘real life’ issue), or to it requiring screen-acting techniques (Sutherland, 2010) rather than those necessary for live, theatre environments. Whatever the reason, in general this did hinder the level to which I was convinced by the roles.
  2. That said, the mechanics, as it were, of the bereavement experience worked well. The depictions of Clay’s episodes of distraction/daydreaming, disorientation, and experiences of (sometimes violent) mirages, nightmares and flashbacks induced by geographical locations were, I felt, pretty strong. Similarly, this character’s portrayal of anger was impressive, and his being seen to want to listen to the tapes, then not, then wanting to listen again was well portrayed. There are certainly times when you don’t want ‘The Suicide’ to be central, that you want to ‘forget it’ and ‘be normal’; then there are times when it demands total focus. That repeated ebbing and flowing is often not appreciated or shown; emphasis is usually on grieving then moving on, which I don’t believe is the nature of suicide bereavement.
  3. It sounds most odd to say, but I was pleased to see the stigma of suicide loss acknowledged. Other people’s (sometimes negative) reactions to the suicide bereaved themselves can be significant to the grieving process. Hannah’s parents’ experience of this, although brief, is a very important inclusion in the series. Yet at the same time, there remains a problem in that Hannah is her death – Hannah=Suicide throughout the whole series, which is something that anyone with lived experience also has to deal with. I have come to think that part of the grieving process is very much about trying to locate the person and the relationship held with them outside of the manner of their death, and it takes a huge amount of time, effort and energy to ‘remember the good parts’. In many respects, this programme seems to suggest this can’t be achieved.
  4. There are potent lines in the script that really resonate with the experience as I know it: “She had a face and a name”; “Everybody wants to talk. Nobody wants to do anything”; “I’d not thought about dying until this.”And there are little exchanges that have impact, ones which perhaps would not appear significant to someone who hasn’t experienced suicide loss. For instance, in conversation with a stranger, Olivia (Hannah’s mother) talks about Hannah in the present tense after her death: “I have a daughter. She is 17”. Her husband does not correct her and she later says, “I did not lie to that woman”. This was strikingly familiar – deciding what to tell and to whom, especially when meeting new people, is a core part of living with suicide loss.
  5. There is often an assumption that people bereaved by suicide must instantly be counselled by professionals. On many occasions this may be true, however I do think that what matters greatly is having the opportunity to talk to people who ‘just get it’, and who also don’t judge. Never underestimate the importance of an environment in which ‘normal conversation’ and talk of suicide can coexist, indeed are both equally welcome, the latter not shutting down the former. This is why peer support (Barlow et al,. 2010) can be so helpful in the process of navigating suicide bereavement, and this is something that is clearly shown, (and shown well), in 13 Reasons Why – Tony’s understanding, concern for and support of Clay is a wonderful feature of the show and the conversations between them are some of the most moving, (arguably real). We need more Tonys.
  6. The word ‘choice’ is used a great deal in reference to Hannah’s actions; she ‘made her decision’. To me, this simply does not adequately deal with the complexity of the issues, particularly in reference to the nature of mental ill health. From a bereavement perspective, this word is also problematic, as it reinforces the assumption that there are absolute reasons to be found to explain ‘the choice made’. It is interesting that the show presents obvious criticism of ‘the counsellor’, what he didn’t do, really pointing to a losing of faith in ‘mental health professionals’, which some suicide-bereaved people can experience (and have reported) (Pettersen et al. 2015).

In sum….

I would like to say I have a conclusion about the depictions of suicide bereavement in 13 Reasons Why. I’m still negotiating on that front. I wouldn’t label it helpful to those who have personal experience, and I think my initial thoughts on the book were correct – firstly, I found myself responding a little more to ‘the parents’ than to ‘the friends’ because of, principally, life stage. Age certainly matters, as do the priorities one has at different points in life. Secondly, the fiction-story (unreal) aspect of this production was certainly emphasised by the unfamiliar-to-me American context. Thirdly, I would have liked a bit more depth to the bereavement performances, but then again, as I say, it is a fictional show with different openly-expressed priorities, so what can you really expect? Bereavement is simply a facilitating aspect for the overall narrative, connected but not central, as per the outline provided by Netflix. But what the series does show well is the utter mess of the after-ward of a suicide for those left behind. That no-one is labelled a ‘survivor of suicide’ (the common term for those bereaved) at any point in the series worked well for me, emphasising just how big the impact of one person taking their own life can be.

 

If you have been affected by anything discussed here (or the television programme itself), please seek support. Suggested resources in the UK include: 

The Samaritans

Survivors of Bereavement By Suicide

If U Care Share Foundation

Papyrus

 

Bereavement as part of the ‘Mental Health Conversation’

Bereavement as part of the ‘Mental Health Conversation’

Whenever the London Marathon comes around, I always think how lovely it would be to participate. I’d love to run it. And then I remember I can’t run. My PE teacher at school pointed that out, and nothing has changed over the twenty-ish years since. Still, would be nice if…

I followed the build up to this year’s marathon with interest, given its billing as the inaugural ‘mental health marathon’. The coverage garnered by Princes William and Harry and Catherine via their Heads Together charity has really done a lot for the ‘mental health conversation’. The significance for me lies in the attention drawn specifically to bereavement. The references made to loss in the press coverage have highlighted the seriousness of bereavement within the mental health conversation – grief is not a ‘mental health problem’ but it can be a major precursor to difficulties. EVERYone can, and most likely will, be affected by a bereavement during their life time, and that is why it is so important to see loss as a significant part of the mental health conversation more broadly.

There is a myth regarding the effect of suicide, that it runs in families. Research points to the falsehood of this; however, research does show there is increased risk of suicide after exposure to this form of loss. A person bereaved by suicide experiences the pain of separation, the grief and sadness, but they also frequently endure additional facets such as guilt, questioning, anger, relief and/or rejection (Wertheimer, 2014). It is common for those affected by suicide to speak about a loss of identity and a sense of becoming numb, also presenting with symptoms of trauma – the flashbacks and re-livings associated with Post Traumatic Stress Disorder are common. Research shows how the multitude of emotional experiences after a suicide can contribute to a lack of self-worth, damaged self-esteem, a loss of trust in people and professionals. For instance, a study by Pettersen et al. (2015), very clearly outlined the ways in which siblings can perceive and relate to health services after a suicide:

“You get very scared….My brother tried to get help, there was none and he died. You don’t believe in them. Trust is necessary. I want to feel certain that when I call and say I need help, there will be somebody there that is willing to help me.” (2015: 326)

Fear and anxiety (Powell and Matthys, 2013: 322-3) can exist, with many “suffer[ing] from “constant feelings of approaching disaster” (Pettersen et al., 2015: 328). Significant are findings that suggest bereavement by suicide can lead to indifference to death, (“As Jennifer found out after her brother’s suicide, it was not that she actually wanted to die but more a sense that it really would not matter if she did.” (Wertheimer, 2014: 163)), and so it is not entirely surprising that suicidal feelings amongst persons bereaved by suicide are noted as being common. Thus, as Wertheimer points out, “Unravelling these complicated and sometimes conflicting feelings can be hard work for the survivor” (Wertheimer, 2014:161). The ‘legacy of suicide’ is a prevalent idea, illustrating why acknowledgement of bereavement (particularly by suicide) is so crucial as part of a more general conversation about mental health:

“one of the most striking features of suicide bereavement is the way in which [their] unbearable feelings are passed to the survivors. The ‘pyschache’ (Shneidman 1993), the shame, guilt, humiliation, anger, loneliness, angst and other emotions associated with suicidal states frequently become the survivor’s legacy….the suicide victim passes on his [her] psychological ‘skeletons’.” (Wertheimer, 2014: 218)

Thinking about all this from a personal perspective, I applaud the Princes for highlighting talking as important and normal (especially amongst men), for naming bereavement and loss as important, helping to gain increased acknowledgement for the significant life-changing experience that is losing a loved one. But what I wish more focus to fall on now is what can actively and practically be done to help bereaved people. Prince Harry didn’t want to talk and buried his emotions – I was willing and wanted to talk about my loss straight away, but there was no one to actually talk to, which also eventually led to emotion-burying. It was almost five years after the death of my brother before I met another sibling who had experienced the same and could ‘get it’. I wanted a face-to-face talking-support group, and in its place received anti-depressants – there are still no easily accessible support groups in my area of the UK. I didn’t want a telephone line or a website or counselling – I needed a physical ear, a place to vent without judgement. I specifically asked my doctor for advice on where to go, who I could talk to, and they could not help – ‘I don’t know’ was the response I received. I finally found a group (four and a half years after my loss), but still had to go through almost a ‘triage-eligibility’ phone call prior to confirmation of my place, (and, subsequently, the sessions ran for only ninety-minutes weekly over six weeks). I am lucky – I have a research personality that pushed me into seeking out, and demanding(!) help. I also have a very supportive family and network of friends. But for those who don’t, I can see the ease with which bereavement can entangle with mental health and spiral down into complicated grief, major depression, even suicide. Even if the intention and want to talk is there, the resources (charitable or otherwise) are simply not, and in many ways the bereaved are frequently left to ‘sort themselves out’. “Suicide postvention as suicide prevention” (Shneidman 1972) is a statement frequently declared as requiring attention. Linn-Gust has also argued that, “By helping the bereaved through their losses…we are breaking the legacy of suicide in families” (2010). But the actual means to act upon these ideas and the physical spaces available and accessible to allow their achievement are in reality severely limited.

I will watch with interest to see how Heads Together evolves – I hope the public consideration, acknowledgement and discussion of bereavement is not diminished (though obviously ‘mental health’ covers a myriad of conditions and situations that all require attention). I also continue to hope usable-resource-development for the bereaved, (especially, from my perspective, the bereaved by suicide), will become a priority.

 

Sources:

Pettersen, R., Omerov, P., Steineck, G., Dyregrov, A., Titelman, D., Dyregrov, K., and Nyberg, U. (2015). ‘Suicide-Bereaved Siblings’ Perception of Health Services’ in Death Studies. Vol.39, Iss.6.
Powell, K.A. and Matthys, A. (2013). ‘Effects of Suicide on Siblings Uncertainty and the Grief Process’ in Journal of Family Communication. Vol.13, Iss.4.

Wertheimer, A. (2014) A Special Scar: The Experiences of People Bereaved by Suicide. London:Routledge.