Advice From the Trenches

Advice from the Trenches: Trauma and Suicide

Dear B&C

Can you explain something to me? I read about the wave of suicides that comes one year after school shootings. I thought that the initial grief was the hardest, and then time began to heal the wounds. Why would suicides occur so much later on?

Time’s Up

Dr. B – Although there is no real timeline for grief, a year is a marker that is significant to survivors. A year after a trauma everyone seems to expect to them to be better, to have re-integrated and moved on. Unfortunately, that rarely, if ever, is the case. Trauma stops time for a person. After a trauma, there is no going back. Things are different. The expectations you had before, the casual way you thought about things, your automatic rule set and internalized definitions no longer apply. A person’s reality is what they choose to pay attention to. A year out, the rest of the world has certainly moved on. Your trauma is no longer front and center in their minds, but it is for you. You have a secret that no one else shares: the event. It’s like you live in a different dimension than everyone else, and it can be deadly isolating. In your world, horrific things CAN happen. In your world, no one is there to prevent those things. When you lose people in a trauma, you also have survivor’s guilt. You feel you do not have the right to be happy when the people you lost can’t be. You wonder, “What could I have done to have made a different outcome?” 

This is very similar to what veterans experience when they return from war. Life just can’t go back to the way it was. The rules before, during and after traumatic events are all completely different and they do not integrate. Humans like to have a cohesive story, one that is consistent and makes sense, but reality doesn’t work this way. Reality is ambiguous. It doesn’t make sense; inconsistency is the rule. Trauma often leads to “all or nothing, black/white” thinking, and traumatized people become allergic to ambiguity because it makes them anxious or fearful. Ambiguity becomes a thing to avoid, deny and disavow. This is a perfect set-up for codependent relationships, drug dependency or joining a religious cult. But at some point, all of these options fail and crash.

Immediately after a trauma, people often start playing the game and acting OK for others, but inside, they’ve lost all personal attachments to life. If they don’t share this isolation, a year later is the breaking point. People give up. A seemingly small disappointment or reminder can be the last straw, and feelings can go from numbness to intense pain. The end of that one year begins a series of firsts: first birthday since, first holiday since … these are all hard grief humps.

Grief is best not served alone. Isolation is deadly.  There are no medications specific for grief. Groups have the best record for success.   

C says – I remember going through this pattern of grief as a teenager, when a friend committed suicide by locking herself in a closet and setting herself on fire. At first, I was in a sort of shock – I couldn’t feel anything. She and I had shared so many similar feelings, we were both struggling with problems in our lives. Oddly, when she died, I felt like a fraud. I had thought my problems were so bad, but now I could see that hers were so deep, she just couldn’t go on. The horrific way she killed herself drove the point home – no one suffers through the agony of being burned alive without a complete loss of hope. Afterward, I felt like I had no right to feel bad about anything. I remembered talking with her and going on and on about the silly woes in my life. I was ashamed. I should have listened to her, I should have known how lost in her pain she was. I was a terrible person. It messed me up for a long time. I felt like I didn’t even have the right to grieve for her.

But we all need to remember that every sentient being in this world is suffering. It is not an exclusive club. Too many of us hold it in, hide it and bury it under substances, sex or a gallon of Hagen Daz. But Dr. B is right – isolation is deadly. The best thing we can do with our pain is admit to it and share it. Believing that we are alone, and that no one else could ever understand, is a big mistake. When I finally began talking about my feelings, I discovered that more people than I ever expected had compassion and sympathy, and they shared their own stories of pain and loss. Some of them had been through experiences I’d never imagined. The sharing was what finally turned things around.