Cel de-al XXV-lea Congres SNPCAR

Vă invităm să participați la Cel de-al XXV-lea Congres SNPCAR şi a 47-a Conferinţă Naţională de Neurologie, Psihiatrie și Profesiuni Asociate Copii şi Adolescenți din România .

24-27 septembrie 2025 – Brașov Hotel Kronwell

Pentru a vă înscrie la congres, vă rugăm să apăsați aici.

Vă așteptăm cu drag!

Asist. Univ. Dr. Cojocaru Adriana – Președinte SNPCAR


SURVIVORS OF SUICIDE

Autor: Ruedi Zollinger
Distribuie pe:

ABSTRACT:

The suicide of a parent can be described under the aspect of „psychotrauma“. Many of the bereaved children show symptoms of posttraumatic stress disorder (8,9).

The suicide of a parent can also be described under the aspect of „grief and mourning“. How and to which extent trauma and mourning are connected or interfere is hardly described (18).

The concept of death develops during childhood and youth. A child’s actual concept of death is a mixture of his or her personal observations, his or her fantasies and the information he or she got (6).The capacity of accepting the irreversibility of the loss to a certain extend is a precondition of the mourning process and the psychological process following the loss of a beloved person. In such a moment (of loss) a child needs the support of a familiar person to share his or her fears, feelings and fantasies (6).And of course, the basic needs of the child should be guaranteed as well, so that the child has enough energy to mourn and to do the psychic work after the loss of a beloved person (6). Finding or reconstructing good and conciliatory inner pictures of the deceased person is a basis for a successful mourning process and is supported by a variety of cultural and religious rituals. Th e success of the mourning process is in danger, when it is difficult or impossible to find good enough reminiscences of the deceased person and when negative pictures and affects are predominant.

I would like to conclude with the history of the famous Belgian painter, René Magritte (36-38).

 


 

When we are talking here about survivors of suicide, we are not talking about people who survived an attempted suicide. We are talking of the bereaved people who have lost somebody by suicide. It is said that a suicide produces on average 6 or more survivors : family members, friends, colleagues, class mates,psychotherapists, copatients and so on (1-5).

Children can be survivors of suicide, too. They are particularly affected if they lose a parent or a sibling.Regardless of the cause of death, any child who loses father or mother suffers under severe emotional distress threatening his or her further development (6,7).Daily life and care may not be guaranteed any longer.

I remember a single mother (widow) who lived together with her three children aged 15 to 17. Th e mother was addicted to drugs and eventually committed suicide. The bereaved children had no closer relatives and continued living on their own in the family ‘s apartment, went to school and so on. Nobody took care of them until the day one of the siblings took an overdose of benzodiazepam and was brought to the emergency department of a nearby hospital. Only then the youth welfare office and a psychotherapist got involved. 
 

The suicide of a parent can be described under the aspect of „psychotrauma“. Many of the bereaved childrenshow symptoms of posttraumatic stress disorder (8,9).

The suicide of a parent can also be described under the aspect of „grief and mourning“. How and to which extent trauma and mourning are connected or interfere is hardly described (18).

Infants and young children have their own conception of death. They do not understand that death is irreversible, that it affects all human beings and that it cannot be avoided (10,11). The concept of death develops during childhood and youth. A child’s actual concept of death is a mixture of his or her personal observations, his or her fantasies and the information he or she got (6). The capacity of accepting the irreversibility of the loss to a certain extend is a precondition of the mourning process and the psychological process following the loss of a beloved person. In such a moment (of loss) a child needs the support of a familiar person to share his or her fears, feelings and fantasies (6). And of course, the basic needs of the child should be guaranteed as well, so that the child has enough energy to mourn and to do the psychic work after the loss of a beloved person (6).

Especially after the suicide of one parent, the carefor the child by the other parent is more diffi cult because this parent has to deal with his or her own sorrow. He or she may therefore not realise suffi ciently the child’s distress and needs, and may not be able to care enough for the child (13-16).

Finding or reconstructing good and conciliatory inner pictures of the deceased person is a basis for a successful mourning process and is supported by a variety of cultural and religious rituals. The success of the mourning process is in danger, when it is difficult or impossible to find good enough reminiscences of the deceased person and when negative pictures and affects are predominant. This can be the case, when the traumatic situation of a parent‘s death is dominated by severe feelings of guilt.

I remember a young man who lost his father by suicide in early childhood and who thought this had happened because he had stressed his father too much when he was a young child. 

The mourning process can also be blocked by horrible observations during the traumatic situation, for example mutilations, as they can occur in suicides.Even just hearing about suicide and mutilations can be traumatising.

I remember a boy, ten years old, who was the fi rst person to find his dead father in the garage. The father had shot himself in the head and therefore had a terribly disfi gured face. 

After the death of a parent, a child is confrontedwith consequences in every day life and has to mourn.These processes are made more diffi cult, when father or mother dies by suicide, that is on his or her own will. This makes the complexity of feelings bigger: grief, anger, disappointment, pity, guilt, helplessness or fantasiesabout how it could have been stopped (17).

After a suicide, a lot of painful questions arise :why had this to happen, what is the sense of all this? (19-21). On the other hand, there are reports stating that suicide may be seen as a relief (22,23).

I let it open if the aspect of relief is actually predominant in the beginning or if it is resulting throughout the mourning process.

Dealing with suicide is also made diffi cult for survivors by the fact that in many cultures this kind of coming to death is badly accepted.This fact infl uences relationships to relatives, friends and other people on several levels (21,24,25).

Children who lost somebody by suicide are predisposed to psychiatric symptoms and to a reduced social adaptation (9).They have higher risk of suicidal tendency (4, 32-34). Therefore prevention and earlydiagnosis are important.

I remember a 17 years old boy who lost his father by suicide. Three months later he had to be treated (in a clinic). He had a severe suicidal tendency. He missed his father and wanted to follow him. 

Mental health specialists play an important role in the field of suicide and suicide survivors (20,35).They can treat affected people and/or act as mediators between survivors and the society.

However, even if the consequences of trauma and loss are well handled: for the individuals affected, reality is no longer the same.They have to live on with a new reality and, to a certain extent, with scars.

I would like to conclude with the history of the famous Belgian painter, René Magritte (36-38). He was born in 1898 and died in 1967. René was the fi rst child of his parents and had two brothers, born in 1900 respectively in 1902.

René Magritte‘s mother was depressed and suffered from severe mood disturbances. She undertook several suicide attempts. Sometimes the mother slept in the same room with her younger son. One night in February 1912 this brother (of Magritte) noticed that the mother‘s bed was empty. He called the family.Th e family members searched for the mother and could not fi nd her in the house. They then discovered footprints outside the house.They followed the footprints.These led to a bridge over a nearby river. Th e mother had jumped into the river. When her dead body was found, her night dress was wrapped around her head.Magritte never cared for his biographical chronology.
Terr (39) wrote that René Magritte had had difficulties with the concept of time, as it is typical for traumatized children. It is also said that he was fascinated by coffins.
On the other hand it is said that René Magritte had denied that he was traumatized by his mother’s death. He told his biographer, Suzy Gablik, that he had forgotten all about it except the love and care he got by others at that time.
René Magritte avoided psychoanalysts all his life.He created pictures with the title „Therapist“: the one showing a person without head and a birdcage in the thorax, the other one with an empty thorax.
René Magritte‘s wife told that her husband had never been interested in the past nor in the future, but only in the present. She further told that there are no symbols in her husband‘s pictures, and that he would have got very upset, if anybody had claimed that he would paint symbols.

As specialists we know that projective tests or drawings can give us important hints about the inner world of a person and about his or her strategies to manage life (40,41).

The question is : are we, on the basis of this background, entitled to interpret Magritte‘s pictures? Wecan be pretty sure that Magritte would have rejected both: our impulse to interpret his pictures and the content of our interpretation.

Psychodynamic interpretations are then constructive and useful, if they can be discussed with the person concerned , so that they can be verified or not.In our situation this is not possible. Therefore and in order to respect Magritte‘s point of view, I propose that we suppress our impulse to make interpretations and try to concentrate on what feelings Magritte‘s pictures / provoke in ourselves.

 

Elective Affinities

 

Le thérapeute

 

The Lovers

 

Collective Invention

 

Golconde

 

The Meaning of Night

 

The Menaced Assassin 

 

La Voix Du Sang

 

Madame Récamier 

 

La Philosophie dans le Boudoir

The sources of the images displayed in this article: http://www.magritte.be/ http://slog.thestranger.com/slog/archives/2009/06/02/tintin-and-magritte-museums-both-opening-today; http://www.nga.gov.au/Interna- tional/Catalogue/Detail.cfm?IRN=148052&ViewID=2&GalID=ALL; http://southeasternartgallerynews.com/?p=84; http://arthistory.about.com/od/from_exhibitions/ig/Chirico_Ernst_Magritte_Balthus/CEMB_strozzi_10_09.htm; http://www.fotos.org/galeria/showphoto.php/photo/7367/size/big/cat/ ; http://riowang.blogspot. com/2009_07_01_archive.html ; http://forum.psychologies.com/psychologiescom/Developpement-personnel/trahison-images-sujet_750_2.htm .

BIBLIOGRAPHY

  1. Abadie D. (Herausgeber) (2003), „René Magritte“, Stuttgart: Belser Verlag
  2. Asarnow JR, et al. Coping strategies, selfperceptions, hopelessness, and perceived family environments in depressed and suicidal children. J Consult Clin Psychol 1987;55:3616
  3. Bland D., The experiences of suicide survivors 1989-June 1994. Baton Rouge, LA: Baton Rouge Crisis Intervention Center; 1994
  4. Bowlby J. The making and breaking of aff ectional bonds.London: Tavistock Publications; 1979/1980; Deutsche Ausgabe: Das Glück und die Trauer. 2. Aufl age. Stuttgart:Klett-Cotta; 2001
  5. Bürgin D. Das Kind, die lebensbedrohende Krankheit und der Tod. Bern: Huber Verlag; 1981
  6. Bürgin D.Trauer bei Kindern und Erwachsenen. Zeitschrift für Psychoanalytische Theorie und Praxis 1989; 4:55-78
  7. Cain AC, Fast I. Children’s disturbed reactions to parent suicide: Distortions of Guilt, Communication and Identifi cation. In: Cain AC (ed.). Survivors of Suicide. Springfield:C. C. Thomas; 1972. p. 93-111
  8. Calhoun LG, et al. Suicidal death: social reactions to bereaved survivors. J Consult Clin Psychol 1984;116:255-61
  9. Calhoun LG, et al. The psychological aftermath of suicide: an analysis of current evidence. Clin Psychol Rev 1982;2:409-20
  10. Calhoun LG, et al. The rules of bereavement: are suicidal deaths different? J Community Psychol 1986;14:213-8
  11. Castelli Dransart DA. Nachsorge nach einem Suizid: Unterstützung des engeren und weiteren sozialen Umfeldes von Suizidenten. In: Peter H-B, Mösli P (Hrsg.). Suizid …? Zürich: Theologischer Verlag, 2003. S. 149-60
  12. Cleiren M, et al. Mode of death and kinship bereavement:focussing on „who“ rather than „how“. Crisis 1994;15:2236
  13. Döpfner M. et al., Diagnostik psychischer Störungen im Kindes- und Jugendalter, Hofgrefe, Göttingen, 2000
  14. Fine C. No time to say good-bye. New York: Doubleday;1997
  15. Fischer G, Riedesser P. Lehrbuch der Psychotraumatologie.München, Basel: E. Reinhardt Verlag; 1999
  16. Fischer M. Schizophrenie und Suizid. Lizentiatsarbeit der Philosophischen Fakultät I der Universität Zürich; 1993
  17. Fonagy P. et al., Affect Regulation, Mentalization and the Development of the Self, 2002, Other Press, New York
  18. Gratton F. Secret, deuil et suicide: Recension d’écrits. Rapport pour le conseil de la recherche social. Ronéo; 1999
  19. Harder GM. Sterben und Tod eines Geschwisters. Herausgegeben von H. S. Herzka. 2. Auflage. Zürich: Verlag pro juventute; 1992
  20. Igreja V, Riedesser P.Traumatischer Elternverlust bei Kindernund Jugendlichen und ihre Behandlung durch traditionelleHeiler in Mosambik. Kinderanalyse 2002;10:253-62
  21. Knieper AJ. The suicide survivor’s grief and recovery. Suicide and life-threatening behaviour 1999;29:353-64
  22. Kuori R. Survivre au suicide d’un membre de sa famille. Une recension des écrits. Université de Laval, Sainte Foy,Ronéo; 1990
  23. „Magritte Kompakt“, Stuttgart: Belser Verlag, 2002
  24. McIntosh J. Preface. In: Dunne EJ, et al. (eds.) Suicide and its Aftermath: Understanding and Counseling the Survivors. New York: Norton; 1987. p. 19-30
  25. Michael K., Was brauchen suizidale Menschen? In: Peter H-B, Mösli P (Hrsg.). Suizid …? Zürich: Th eologischer Verlag; 2003. S. 13-20
  26. Nagy MH. The child’s theories concerning death. J Gen Psychol 1948;73:3-27
  27. Ness DE, Pfeffer CR., Sequelae of bereavement resulting from suicide. Am J Psychiatry 1990; 147:279-85
  28. Passeron R. (1986), „René Magritte“, Köln: Benedikt Taschen Verlag
  29. Pfeffer CR, et al. Child survivors of parental death from cancer or suicide: depressive and behavioral outcomes. Psycho-Oncology 2009;9:1-10
  30. Pfeffer CR, et al. Child survivors of suicide: psychosocial characteristics. J Am Acad Child Adolesc Psychiatry 1997;36(1):65-74
  31. Pfeffer CR, et al. Suicidal children grow up: suicidal behavior and psychiatric disorders among relatives. J Am Acad Child Adolesc Psychiatry 1994;33:1087-97
  32. Range LM, Thomson KE. Community responses following suicide, homicide, and other deaths: the perspective of potential comforters. J Psychol 1987;121:193-8
  33. Robinson R., Survivors of Suicide. Franclin Lakes: Career press; 2001
  34. Rudestam KE. Physical and psychological responses to suicide in the family. J Consult Clin Psychol 1977; 45:162-70
  35. Rutgers J. Le deuil à la suite d’un suicide. Dans: Dejardin D, et al. Le Suicide. Genève: Presses Bibliques Universitaires ; 1994. p. 63-93
  36. Steck B. Psychisches Trauma und Trauerprozess beim Kind.Schweiz. Arch Neurol Psychiatrie 2003; 154:37-41
  37. Séguin M, et al. History of early loss among a group of suicide survivors. Crisis 1995;16(3):121-5
  38. Terr L. (1990), Too scared to cry, New York: Basic Books
  39. Trolley B. Kaleidoscope of aid for parents whose child died by suicidal and sudden, non-suicidal means. Omega 1993;27:239-47
  40. Van Dongen C. Social context of postsuicide bereavement.Death Studies 1993;17:125-41
  41. Zollinger R. Survivors of suicide, Aspekte zum Th ema aus kinder- und jugendpsychiatrischer Sicht, Schweiz. Ärztezeitung, 2004, 1561-1564

 

Correspondence to:
Ruedi Zollinger, c/o KJPD, Brühlgasse 35/37, CH-9004 St. Gallen, Switzerlande-Mail: ruedi.zollinger@kjpd-sg.ch