therapist survivor

Dear Suicide Loss Survivors

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I was recently asked if I wanted to contribute something to a book for survivors of suicide. With my client’s death by suicide anniversary being in March, of course I wanted to share my love letter to survivors here in a blog too. With abundant compassion and zero judgement, Khara

There’s nothing more painful that feeling like you’ve failed the person who has died by suicide. The shame. The self-doubt. The going over the last time you saw them or spoke to them, wondering what you missed. Believe me, I’ve been there. As a fellow loss survivor, I want you to know you are not alone. Each death by suicide impacts at minimum, 135 people, so of course you are feeling the loss of the person who has died. You may feel grief-stricken. Bewildered. Angry. This loss will forever change you, and that’s okay too. It’s to be expected. I hope you’ll consider this acronym as a compassionate guide through your heaviest moments of grief and despair, knowing that even the darkest nights have to move into dawn eventually.

L-Listen to your needs

Your needs after the loss of someone to suicide will change moment to moment. People will ask you what you need, and you may find yourself frozen, in shock, or mute, not knowing what you need. Try to find moments to slow things down, asking yourself what you need in that exact moment. Maybe you need to cry. Need a hug. Need to be left alone. Need to eat. Need to sleep. Let’s normalize that your needs change minute to minute and it’s okay to ask for what you need.

E-Embrace grief and loss work

No one is “fine” after losing someone to suicide. There isn’t a timeline for healing either. You will heal on your own time, in your own way. How do you want to engage in grief work? Do you want to work with a therapist? A coach? A mentor? A spiritual guide? This isn’t something that you wake up one day and feel okay about, so don’t discount the power of grief and loss work to help your healing journey.

A- Ask for help

For so many survivors, asking for help feels the hardest. Perhaps we don’t want to burden others. Perhaps we’ve received messages that hurt us further in the wake of losing someone to suicide. Please don’t let other people’s discomfort with suicide prevent you from asking for help from folks who are able and willing to hold space for you. There are places of support and community waiting with open arms to help you grieve and heal. You don’t have to do this alone.

N- Name meaning

This last idea oftentimes takes the longest. There is not a day when losing the person you did to suicide won’t matter. Survivors aren’t looking for acceptance as much as some form of neutrality or surrender that comes with time. After moving out of excruciating pain and sadness, there will come a time where you can discover meaning from this life-altering loss. Maybe meaning is holding dear the happy memories of this person. Maybe you write about your experience for other survivors. Maybe it’s participating in a suicide prevention event. Perhaps it’s honoring this person’s birthday or another day of significance. 

Making meaning is uniquely yours, and the experience of naming meaning can feel like you’re finally experiencing post-traumatic growth as your body learns to hold both pain and gratitude for the person you’ve lost. Talk about them. Think of them. Americans can be strange with grief, but I hope this sharing and so many others’ stories can lift you up amidst the grief and questioning that come with suicide loss. We are not okay, but we will be.

Breaking Free of Confidential Grief

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I first discovered the term confidential grief when researching for my latest book on helping clinicians heal from client suicide. In what felt like a sign from the universe, the September edition of the Counseling Today magazine arrived, and had an article titled Counselors Share What It’s Like to Lose a Client to Suicide. I felt compelled to reach out to Dr. Lena Salpietro, one of the quoted professionals who shared the importance of validation and empathy from mental health leadership to clinicians who’d lost a client to suicide. I couldn’t agree more with her statements and I was beyond excited that not only were people talking about the life-changing experience that is losing a client to suicide, but that there was a name for the behind-closed-doors experience of grieving a client loss.

According to the original research study published in July 2023, confidential grief describes the secrecy of our pain and grief when losing a client to suicide. Out of fear, shame, and perceived judgement from our peers, mental health professionals don’t feel safe to share that they are going through grief and loss, and thus attempt to grieve in private. It also feels confidential because client matters remain confidential, which means we can’t share our experience as openly as if it was a loss from a different part of our life. All of these things add up to an experience where clinicians are suppressing their emotions, attempting to compartmentalize their grief, and could result in them leaving the field due to the lack of support.

So here I am inviting colleagues to break free from confidential grief. How do we bring client suicide into the light? How do we prepare clinicians for this life-altering experience? For folks who’ve felt comfortable sharing with me thus far, I’ve often heard that nothing prepared them for this experience. With 1 in 4 therapists predicted to lose a client to suicide in their career, this is adding another layer of pain that could be easily addressed. How do we create safe spaces for this grief? Here are a few ideas for mental health leadership:

  1. Attend to the person first, professional second.

When a client dies by suicide, the first thing we focus on as mental health leaders should be the clinician standing in front of us in shock. How do we help them navigate this event with compassion? Do they want to talk about it? Do they want to sit here and experience the flood of emotions with someone they trust? Do they need us to cancel their appointments for the day so they can go home? We can offer various things that could support them in a time where they may feel frozen in place.

2. Talk about it!

Let’s normalize that clients die by suicide. Let’s talk about it in graduate school, in community mental health, in internships, and in private practice. Let’s explore it with supervisees as a possibility so they can feel more prepared. So much more healing can be accessed if we normalize the possibility of this happening within our field.

3. Create spaces for healing

Since suicide will happen for 25% of us, how do we create spaces for healing? Is it a one-on-one conversation? A support group? A journey to self-discovery? A healing retreat? The more healing spaces we can offer, the more clinicians can move towards post-traumatic growth. What spaces do you know of? What more can be added for colleagues experiencing client loss?

There are lots more ideas in my book Moving from ALERT to Acceptance: Helping Clinicians Heal from Client Suicide. This book captures ideas for clinicians wanting to heal, as well as ideas for the mental health leaders helping them with that healing. You don’t have to do this alone. I recently shared with a colleague that I identify as a Confidential Grief Specialist to therapists amidst other roles of consultant, trainer, and course creator. For years, colleagues have been sharing with me their hardships and challenges, everything from family abuse to trauma, to substance use, to client death. It’s one of the reasons I started surveying colleagues on their career experiences with Adverse Psychological Events (APEs) as mental health professionals. Although confidential grief exists because of the loss of clients to suicide, I believe this term can be expanded to cover all sorts of career-related stressors, which create the potential for burnout within our field. Adverse Psychological Events can include client suicide, client death, client violence, subpoena, and grievance. All are disruptive and painful for clinicians, all are not spoken about freely because of fear, shame, and judgement.

Let’s break free of confidential grief together. We have a name for the experience, now we can offer something different! I know there are many of us out there wanting to create a safe, empowered container for clinician healing. Let’s share what we are doing to combat confidential grief and connect soon in our efforts to support colleague healing!