Guestwords: The Stigma of Suicide

By William Feigelman

    People who study suicide scientifically, like me, have long recognized how society stigmatizes those who complete suicide and their remaining relatives. Historical records show that during the Middle Ages suicide corpses were regularly mutilated to prevent the unleashing of evil spirits. Suicides were denied burial in church cemeteries. Afterward, the property of their surviving kin was usually confiscated, and families were excommunicated for failing to pay the heavy tithes expected by the church.
    Today analysts claim suicide stigma is subtler, with blame being cast upon bereaved relatives, often called survivors, and survivors being subjected to informal isolation and shunning.
    As a survivor of my son’s suicide (he died tragically 10 years ago at age 31) and as a survey research sociologist, I wanted to further investigate contemporary suicide stigma. To do so I assembled a team to more thoroughly study this subject — my wife, Beverly Feigelman, who is a social worker, and two psychologists with great expertise in the bereavement field. We amassed a nationwide sample of 462 suicide-bereaved parents and 113 other bereaved parents who were kind enough to fill out our lengthy and exhaustive 27-page questionnaire. The findings from this massive data collection greatly illuminate the post-loss adaptations of bereaved parents and are summarized in our recent book, “Devastating Losses: How Parents Cope With the Death of a Child to Suicide or Drugs” (Springer Publishing, 2012).
    One of our most striking findings was that half of the suicide-bereaved parents and half those whose children died from drug-related causes heard comments from socially significant others blaming the child or the parent after the death. People heard remarks such as, “It’s just as well he died; he was tearing your life apart anyway and was only going further downhill.” “She was so selfish, only thinking about herself.” “That was such a cowardly thing he did.” “Didn’t you see it coming? Why didn’t you get him into therapy?”
    Almost none of the other parents whose children died from ordinary accidents or natural causes had heard blaming comments like these. Such comments produced a twofold vexation for bereaved parents. For one, they devalued the importance of their deceased child, essentially claiming that he or she was not worth grieving over. Grief experts call this disenfranchised grief. For another, they inspired even greater blame on the part of the bereaved parent, who unceasingly nags himself or herself afterward for not having averted the suicide or drug-death disaster. These parents usually feel they don’t need any extra help to examine themselves in their obsessive ruminations about what they could or should have done to prevent the death.
    Suicide-bereaved parents also faced other manifestations of stigma following their children’s deaths. Avoidance was very common, with close friends and family avoiding them, not mentioning the deceased child’s name after the death, quickly changing the subject at the mention of the deceased child, averting any discussions about the bereaved parent’s recovery, and making comments to the effect that, “Isn’t it time for you to move beyond your grief now?”
    We developed a 22-item scale of stigmatization, and the suicide survivors showed the highest scores on this scale, while natural-death survivors showed the least stigmatization. Many of our suicide-bereaved respondents stated that it was difficult for them to publicly mention their children’s cause of death. Some, even many years after the death, still remained unable to openly admit that their child died from a suicide or a drug overdose. These deaths were riddled with shame, embarrassment, and feelings of being shunned.
    With our scale it was noted that more than half of the suicide-bereaved parents reported that one or more close family member and more than one-third of close friends had reacted unhelpfully and unsympathetically after the death. Unfortunately for these more stigmatized bereaved parents, they experienced greater grief difficulties, more complicated grief, and more assorted psychological problems than their counterparts, who gained more compassion and support from friends and family after their children’s deaths.
    One of the important take-away points from this research appears to be that suicide and mental health difficulties are interwoven with secrecy, shame, and humiliation. Anyone alleged to harbor mental health problems or suicidal impulses is be likely to be demonized. With this as a likely possibility, most people will be especially reluctant to articulate their own suicidal impulses. Not very many will be able to handle the revelation of suicidality in other persons, as well. Therefore, no good friend will want to risk humiliating another by asking about suicidal impulses, fearing for the enduring scorn and condemnation that might be heaped upon that person.
    Two recent studies among family doctors suggested that even among these important health providers only a minority would be willing to broach the suicide subject with their patients. These two separate studies showed samples of U.S. doctors’ information on patients with unambiguous signs of clinical depression and great anxiety. Only a third of these sampled doctors said they would have asked the patients if they were contemplating suicide. For the most part, the doctors did not want to risk embarrassing these patients and did not feel sufficiently competent to ask them about their suicide risks.
    We live in a society where too many of us feel timidity and reticence to approach the suicidality within our midst. With this mind-set we only add to the suicide risks of those who are mentally vulnerable among us.
    For most of us, if we witness someone in great physical distress, someone coughing violently, in a convulsive state, or showing some other sign of a serious physical health abnormality, we would ask if that person is having difficulties and offer to take him or her to a hospital or a doctor’s office for immediate help. Yet we refrain from doing this with mental illnesses, and then sometimes suffer the consequences of enduring very tragic outcomes.

   William Feigelman, a longtime resident of Springs, is professor emeritus of sociology at Nassau Community College in Garden City.