Advice on "Open To Hope Radio" Interview: Give Yourself Time

The following is from a transcript of the Open to Hope Radio program on Aug. 22, 2013, featuring an interview by OTH hosts Dr. Gloria Horsley and Dr. Heidi Horsley with Franklin Cook, publisher of the Grief after Suicide blog (you can listen to the interview here):

Heidi Horsely: Franklin is our friend. He's also somebody that we work with, and our worlds just keep crossing, and we keep connecting. His father died by suicide in 1978. Franklin is a consultant, speaker, and trainer in peer grief support. After volunteering as a support group facilitator, he became an advisor to the Suicide Prevention Action Network and National Suicide Prevention Lifeline, and he is now developing suicide survivor services based on life coaching principles. He is also one of our Open to Hope authors. Welcome to the show Franklin.

Franklin Cook: Thanks so much for having me. It's so good to be with you both.

Gloria Horsely: Franklin, tell us about your journey. Tell us about your dad dying and how old you were, and that kind of thing, to start.

FC: My dad died a long time ago now, in 1978. He was 49 years old, and I was 24 years old. Unfortunately, he suffered a very, very severe depressive episode, which included psychotic features and suicidality, and he wound up finally being hospitalized. In fact, my dad died in a psychiatric hospital. So that's how our journey began. My mom, and I have three brothers, and it truly changed our lives -- shattered our lives at first -- and we can take that anywhere you'd like to go with it.

HH: He was actually in the hospital when he died, is that what you're saying?

FC: Yes, he was in a psychiatric hospital when he died.

GH: And how did he take his life there?

FC: Unfortunately, the protocols that were in place were not as strong and well implemented as they are today, and he was left alone with a sharp instrument. He was left alone with a very deadly instrument, and he wounded himself very badly. He lived 24 hours, but he never regained consciousness ... so it was a very horrible, horrible event.

GH: Were you able to see him at the hospital.

FC: After he did it, he never regained consciousness. He was mortally wounded.

GH: Were you with him? Did you see him?

FC: Absolutely. I saw him in the intensive care unit. He lived 24 hours. It was a very harrowing experience, very traumatic.

GH: It must have been incredible.

HH: I just wanted to say for everybody out there that is feeling guilty and bad about their loved one dying by suicide -- because they feel like they should have done more, they could have done more, etc. -- I think you need to rethink that. I mean, Franklin is telling us that his dad was in a very restrictive setting, in a psychiatric hospital, and he still found a way to take his life. So sometimes, at the end of the day, we do all we can, but people find ways to do these things, even when we've done everything we can.

FC: Yes. My dad was getting all the help that a person could possibly get. Unfortunately, there were some failures in the system that caused him not to be in as safe of a place as he should have been in.

I think you're absolutely right, Heidi. We don't have any control over what other people do, ultimately. And we're doing our best with people who are very sick sometimes -- and who sometimes, we don't realize even that they're in as much trouble as they're in.

Although I think it's also normal to feel guilty when somebody dies by suicide, I hope that everybody gives themselves a fair trial, let's say, and gives themselves a break in the end.

GH: I was just reading an aricle in the New York Times. The study [found] ... that 50 percent of the people ... who ultimately did kill themselves by suicide had been in treatment, and they still did [die by suicide]. And the point of this article was that we need to find better treatments. And I think that's kind of what you're doing too, right, is thinking about coaching principles for survivors. Do survivors have a higher risk of dying by suicide?

FC: Survivors do have a higher risk of dying by suicide, and the fallout for survivors not only includes higher suicide risk, but the course of grief for survivors of suicide loss can be very long. The incidence of complicated grief or of PTSD or of major depression [is higher].

GH: PTSD ... say what it is.

FC: Post Traumatic Stress Disorder.

GH: What does that look like?

FC: Postraumatic stress is actually from being traumatized by the other person's death. It's the kind of malady that a person has who comes back from war, and who's hypervigilant, who tries to avoid reminders of what happened, who is anxious, and who has flashbacks and that sort of thing. That's PTSD.

HH: Well, a couple of things come to mind. Number one, I'm really glad that Franklin normalized the guilt and said, Hey, this is a normal part of life. It's interesting because there's guilt that goes along with all sorts of death -- any kind of death. I felt terribly guilty that I lived and my brother died. He was the only ... brother, the only boy in the family.

[Next,] I'm a psychologist in private practice, and I currently have two clients that are suicidal -- and I do everything in my power to help them through this journey. But two weeks ago, the police called me at midnight and were taking one of my clietns away to the hospital because she had made a suicide attempt. Now I thought everything was in place, and I thought everything was good, and I did everything professionally that I knew to do. But like you said, Franklin, sometimes at the end of the day, we really don't know how much stress people are in. We just have to go by their words. We really don't know.

FC: That's absolutely right. I think the other thing is that we really focus -- and rightly so -- we focus on the people who die, and we don't know out there the thousands and thousands of people who go get help, who are rescued, who are battling with their demons however they're doing it -- and doing it over the long run successfully.

And really, in a way, that is the story of my family's survival.

My dad was an alcoholic. Three out of four of us boys were alcoholics or drug addicts. And we really were shattered by the suicide -- but over the long run, we are also a story of hope, a story of great healing ... great growth. Now that a person can look back 35 years almost and see that even though life could not have been darker -- and some of the fallout from my dad's suicide was absolutely horrible, for me emotionally, for all of us, for my mom, it really took her legs right out from under her -- we really recovered, and we really have gone on to live our lives and to "give back," and ... you always want to hear the rest of the story, I guess is what I'm saying.

GH: So here I am now, and I'm listening to you and I'm like, "OK, I don't have hope, but I'm open to hope. I'm seeing that maybe there is a light at the end of the tunnel that's not a train coming towards me." Talk about the guilt involved with this, and the shame I think that I might be feeling right now.

FC: Well, I think that when a person dies by suicide -- not always, but one of the most common things that we ask ourselves is, "Was it because of me?" "Was the person rejecting me, outright?" "Was the person abandoning me?" "Did I do something I shouldn't have done?" "Did I not do something I should have done?" These are relatively universal feelings that befall a suicide survivor, especially early on. So that's really the starting place I think for many of us ... And I think that is a very, very difficult feeling also in part because society judges suicide negatively, so there's this stigma or this negative judgment related to both people who die by suicide and people who are left behind. [People think,] "If you're the mother of someone who died by suicide, there must be something wrong with you." Or, "If you're the wife of somebody who died by suicide, you must not have been a good wife," etc. These kinds of things are very, very difficult for survivors early on. Or they can be.

GH: I do a Compassionate Friends group, and we have a family, that the boy died last year by hanging, and we never know for the family whether it was accidental or whether it was purposeful. But one of the things mom said, which I thought was interesting ... she said, "People will ask me about my family, and when I say -- if I really do go into it and say how he died -- they stop immediately and say, 'I'm sorry,' and turn away." They don't want to go there. How hurtful.

FC: Yeah. Well, I've heard similar stories more times than I can say. That judgmentalism not only affects the person who died, sadly, but also the family. So I've just heard that again and again -- and saw it in my own instance. At my dad's funeral, I thought there were judgmental things [said] from the pulpit. We could talk about those sorts of things forever, because they're a part of the experience, I think.

HH: I'm just trying to take in what Franklin just said about judging from the pulpit ... You're at your worst moment in your life, and you're grieving so heavily, and to have judgment -- I just can't even imagine. So often, when my mom and I talk with people that have had suicide in their family, they talk about how they need so much support. And we all know that people that are grieving in general don't get enough suppport ... but they [suicide survivors] even get less. Because -- like you said, Franklin -- of the judgment and the stigma that's still out there today.

FC: Truly, one of the research findings about losing a loved one to suicide is that social supports are weaker, comparitively, for peolpe who have survived the death of a loved one by suicide. And certainly the negative judgments go back centuries and millennia. There was a time when people who died by suicide were not buried in the cemetery ... in the Catholic cemetery, etc. We've come a long ways, and it's no longer like that in most instances, but it certainly still is part of the mix.

GH: OK now, Franklin, I'm out there, and I'm hearing what you guys are saying. You are normalizing many, many of the feelings I have. OK, I'm starting to see a little light. What can I do now? It's been three months, four months, maybe a year ... Where can I get help, Franklin? Where can I get more of what you're saying?

FC: First of all, I think that everybody is very different, but I would recommend that people at least try to identify whether there might be a suicide bereavement support group in their area, because that is a peer-led intervention, like Compassionate Friends support groups. It seems to me -- and there's a lot of support for this ... that being with someone else who has had a similar loss [can be helpful]. This is why I specialize in peer support. I'm not a clinician: I'm a survivor of suicide loss who helps other survivors of suicide loss. So I think one thing to do is to get with people who have lost someone to suicide and who can relate to the things that you're going through.

Beyond that, I think the other things that people normally do for grief, whether that's with a clergy person, or with other family, or with your community ... to remember your loved one and to memorialze your loved one and to learn how to cope with the pain of loss -- all those things are very much the same with suicide as they are with any other kinds of loss.

I think the real complicating thing for suicide is if you do have one of these maladies. If you have complicated grief, as they call it, or if you have PTSD, or if you have major depressive disorder, and it goes on and on, then that, I think, is what really separates out not just suicide but all traumatic loss. And then I think you really need to talk to a mental health professional, to get the specific kind of help. There are treatments for these things, so then you need to go beyond the normal ("normal," if you want to call it that) things that we do for grief.

I think another very important thing, though, is also to understand that -- give yourself time. [With] a loss, a traumatic loss (and that includes loss to suicide), you may have very, very serious challenges for six months or a year or even longer. Sometimes people go out several years and still struggle -- and that doesn't mean there's anything wrong with you. Give yourself some time, and really dig in to the kinds of solutions that you need in your life to get past this ...

GH: Franklin, where can [people] find you?

FC: I think the best thing to do if you're tyring to find me is just to go to my blog, which is personalgriefcoach.info.

GH: Franklin, thank you so much ... for being on the show today and for everything you're doing ...

FC: It's been a great pleasure to talk to you, as always.

HH: Thanks, Franklin.

GH: Thanks for listening to the show today ... You'll find us on our website at opentohope.com.

Reprinted with permission from "FJC's Journal" a feature on the Grief after Suicide blog, in which publisher Franklin Cook shares observations about suicide bereavement based on his personal experience as a survivor of suicide loss.