Yossi Levi-Belz is the Chair of the Lior Tsfaty Center for Suicide and Mental Pain Studies at the Ruppin Academic Center in Israel. He serves as a scientific advisor for AFSP and has received two research grants – a Pilot Research Grant in 2015 and a Standard Research Grant in 2020 – to study post-traumatic growth in suicide loss survivors, as well as suicidal ideation among combat veterans.
Close to 700,000 people died by suicide globally, according to annual estimates by the World Health Organization. As shocking as this number is, it can't possibly convey the immeasurable grief that accompanies each of those deaths. Suicide deaths are tragic, premature losses that symbolize a complete breaking point. As a clinical psychologist whose research focuses on issues surrounding suicide, I have come to learn that suffering does not end with the suicide event.
In his research, the suicidologist Edwin Shneidman emphasized that suicide is not only the end of one life, but also the beginning of a very complex life for those left behind. Each suicide leaves behind a trail of mourners who grieve the loss of their loved one. Those who are left to mourn – not just family members, friends, and partners, but also co-workers and so many others in the surrounding community – deal with a wide range of painful emotions, such as guilt, shame, anger, and prolonged grief.
Recent studies show that over 60 people are profoundly affected by each suicide death. This means that every year, about 50 million people become part of a group known as suicide loss survivors. That is a staggering number of people. There is so much that needs to be done – and so much that can be done – to connect these loss survivors with support and understanding as they navigate the journey of coping with tragic loss.
It is important to know that in addition to experiencing immensely difficult emotions, many survivors of suicide loss may also experience positive psychological changes as a result of struggling with traumatic loss. In psychology, these changes are known as post-traumatic growth. The concept of post-traumatic growth does not merely refer to recovering from trauma, but rather to the development of a higher level of adaptive functioning. The developments that result from post-traumatic growth have been classified into three broad categories: changes in perceptions of self, changes in relationships with others, and changes in philosophy and apperception of life. Importantly, post-traumatic growth does not imply a lack of suffering from mental pain or distress – rather, it means that growth can, and often does, result from and take place alongside that suffering.
Scientific studies and clinical experience indicate that post-traumatic growth can occur after suicide loss. Suicide loss is a unique and devastating trauma, but many loss survivors report changes in their personal strength, bonds with their surroundings, and even philosophy of life in the years following suicide loss. In my clinic, I hear many survivors of suicide loss emphasize that they found meaning through the ways that loss changed their view of life, the world, and their role in the larger community around them. This process can take a while, and it may need to be facilitated by therapy – but it can and does happen!
Although post-traumatic growth can happen naturally in the years after a loss, it can also be actively facilitated in several ways. A series of studies conducted by my peers and me in the last decade show the significant contribution of interpersonal factors to the process of post-traumatic growth. One interpersonal factor found to be positively related to post-traumatic growth is self-disclosure, which is the ability to share complex and difficult information about oneself with others.
Self-disclosure is important because it allows those struggling to signal for help, relieve loneliness, communicate upsetting emotions, and receive support. Openly processing thoughts and feelings is an essential part of grief work that the bereaved need in order to confront their new reality. Moreover, interpersonal interactions can lead to a greater likelihood of modifying personal perceptions and cognitions that may facilitate positive self-acceptance and, as a result, a greater capacity for growth. In addition, sharing emotions with others can generate a cathartic effect, sometimes expressed as “getting it off my chest,” which is another key benefit of self-disclosure.
When we feel secure enough to share personal information with others, emotional aspects of trauma are likely to be revealed, leading to feelings of intimacy and togetherness. The knowledge that one can rely on the support of friends and family members, and that the individual is not compelled to face a lonely future, may help lessen the suffering that accompanies loss, and also help to avert the deleterious effects of bereavement, thus enhancing the likelihood of personal growth.
In addition to self-disclosure, my colleague Tal Gilo and I found in a 2020 study that self-forgiveness is also positively related to post-traumatic growth. Although many survivors of suicide loss struggle with intense feelings of guilt, research has shown that in most cases, no one is to blame for the suicide death. Not even suicidologists, who are experts in the psychology behind suicidal behavior, can predict who might die by suicide in the coming days or years. When loss survivors are unable to forgive themselves, it is much more difficult to communicate emotions, and thus to experience post-traumatic growth. On the other hand, when loss survivors treat themselves with compassion, they may be able to ease their shame and guilt, and facilitate the first steps toward positive change.
For those reading this article who may have been affected by suicide loss, the most important takeaway is that even amid feelings of shame, guilt, and fear of judgment, it is still possible to connect with others, open yourself up to social support, and find a sense of belonging. All of these steps can help you on the journey of learning how to cope with suicide loss. During that journey, you can even start to experience positive changes in your appreciation of life and in your perception of self and others. Throughout the grieving process, don’t hesitate to seek professional help. You may even find that on your healing journey, you become what clinical psychologists call an expert companion for others in your situation: encouraging introspection and curiosity, actively listening, and offering compassionate feedback.
Viktor Frankl, the author of the famous 1946 book Man's Search for Meaning, wrote, “Even the helpless victim of a hopeless situation, facing a fate he cannot change, may rise above himself, may grow beyond himself, and by doing so change himself. He may turn a personal tragedy into triumph.” I strongly believe that together, we can do just that.
If you’ve lost someone to suicide, help and support are available. Click here to learn more.