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Bereavement due to suicide

Help and support from professionals

People bereaved by suicide face many problems and may feel guilt and anger (see ‘First reactions’ and ‘Changing emotions’), so often they need help. This may come from many different sources, including family and friends (also see ‘Self-help groups, conferences and helplines’ and ‘Help from Cruse Bereavement Care’).

General practitioners (GPs) can be an important source of care. Some people we talked to said that their GPs gave them plenty of time to talk about their feelings, though one man said that he had only a 10 minute appointment, which was not enough. GPs also prescribed antidepressants, sedatives or sleeping tablets. However, some people did not want to take such a medicine and refused it or threw the tablets away. As one bereaved parent said ‘I’m not depressed, I’m grieving’. Another was convinced that it was her daughter’s antidepressants that had caused her to kill herself, and couldn’t bear the thought of taking pills.

 
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Melanie's GP, who she has seen every fortnight, has been a 'tower of strength'. She did not ...

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Age at interview: 45
Sex: Female
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Did your own GP help you at all?


She has been wonderful. I continue to see her every fortnight, every three weeks for me to say the same things over and over again. I’m on antidepressants at the moment. I was on sleeping tablets. I’ve come off the sleeping tablets and I’m cutting down on the antidepressants. She has been a tower of strength.


Did you have any private counselling?


I had through my work and my work has been fantastic. I had listening counselling. I had 12 sessions of that. It should normally be 6 or did I have 10? I can’t remember. It was 10 or 12. It’s normally 6 but the lady who was doing it felt that because I was in such terrible state I needed more. And that really was just almost an unburdening of my soul, a sort of purging of everything. After that finished I went to see my GP and I was then referred to a counsellor, ironically at the mental health unit where Simon had been treated. And I found that, because I was at a different level then, it was the right sort of counselling then. It was more challenging. It was more questioning, it was more getting me to consider things.


So that was NHS?


NHS yeah. The first lot of counselling I had I went to one lady who was very nice but I didn’t really click with and I was allowed to have a second bite at the cherry and try a second lady and that, that was great. So I’d say, you know, if you don’t click with the first counsellor don’t be afraid of saying, ‘I’d like a change’.

 

All provided by the National Health Service, that was?


Yeah. That was through my work so that was. So I had a work counsellor first


Right.


And that was provided by work and they were fine about me saying, ‘Could I go and see someone else’. And then the second person I saw was through the National Health Service and I had 6 sessions.  And I’ve also gone back onto her waiting list because I just feel I need to be able to go and see someone and talk to them completely independent person still.


On a regular basis.


On a regular basis but again that probably is only going to be another 6 sessions.

 
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Jasvinder did not want to take antidepressants. She found counselling helpful because her...

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Age at interview: 42
Sex: Female
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What encouraged me to do it [have counselling] was the fact that she reassured me that it would be between me and her, and it wouldn’t go out of the room, what stays in the room stays in the room, and I’ve been told that, and it enabled me to start the process of speaking about my problems, of letting out what was inside me, and to be honest with you I, I spent most of the first few weeks just crying. And I learnt that crying wasn’t a bad thing.


Mm.


And I owned the concept of it being okay to seek support to talk about your problems and I went through my university degree, part of it with a counsellor again, and even today I would, if need be, speak to a counsellor in that environment if I felt the need to be, because nobody can carry all that pain on their own. I don’t believe they can.


Mm.


And I would encourage anybody to consider that because you start the process of releasing the things that are holding you prisoner in your mind and you start the process of letting go of the most important thing for me and that was guilt. And once you start doing that you actually start seeing the “you” in all of it.


Would you look for support anywhere else?


No I, I mean when I saw my GP and tried to talk about these things, I remember on a couple of occasions I was given antidepressants, and I just refused, and he thought I was taking them, but I’d go home and throw them away. Because I just didn’t want to take them. I was scared to take them, I’ve never taken drugs before and it just didn’t appeal to me to think that I was depressed either, so you know for me the talking was the therapy and even today it is, and I’ve learnt to structure myself, tap into the people, the very few people I can count on my hands that I would go to, for support and that is so important because ultimately I don’t have my family and even people who have families may not be able to turn to family members regardless of what ethnicity you are, you know there might be some guilt or shame attached to going to family members or you might not want to put your pain onto them ‘cos they’re grieving as well, so it’s important that you have others that you can talk to in confidence, that have the ability to be impartial, objective, and that can offer you that unconditional kind of love and support.

Many people need more specialised help, which may come through individual, group or family counselling or psychotherapy. Counsellors or psychotherapists work in different ways: some mainly listen, but will probably help people to explore and understand their feelings too. Others ask questions, suggest different ways of thinking about problems or challenge negative thought patterns. (For more information on different styles of counselling or psychotherapy see the British Association for Counselling and Psychotherapy)

People may seek counselling or psychotherapy immediately after the death has occurred or months later. During individual counselling the counsellor sees a client in a private and confidential setting and explores the distress or other difficulties they may be experiencing. Not everyone bereaved by suicide will want or even need counselling or psychotherapy: family or friends may provide enough support, but for those who do seek professional help, research suggests that it can have some benefits. Clients often use the terms counsellor and psychotherapist interchangeably. A trusting relationship with the counsellor or psychotherapist is very important.
 
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Kavita explains what happened when she had psychotherapy. She could talk about her feelings and...

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Age at interview: 41
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I had a very good counsellor actually, a psychotherapist I think he was. And I saw him for about twenty something weeks, something like that, sessions anyway. And we covered lots of different things. And it probably was helpful. But I think by this time my antidepressants had sort of kicked in. So I wasn’t, I wasn’t able to reach within, within you know, my emotions became more numb, if you like.


How long did you have to wait to see a counsellor?


Fairly long. I don’t remember how long. But it was …


Weeks or months?


It was weeks.


Hm.


It wasn’t months to fair, it was weeks. But by then the antidepressants had surely kicked in.


Yeah.


And I wasn’t crying an awful lot. The same thing was happening with my mum, she wasn’t crying. She wasn’t, you know, the antidepressants were doing their job really. We were functioning if you like.


Hm.


And not, not … yes we were … I think the antidepressants help you to function, carry on. Not reach in and not feel that raw pain and emotion as much as you would without them.

 

…I think initially it’s about speaking and about opening up and talking, you’re given the opportunity really to talk about how you feel (during counselling). I was asked how I felt and my relationship with my brother and how this has affected me. And, and from, from that other things emerge, you know, about your, I mean, my, my former life, before my brother, the way our childhood was. So it obviously can become in, intensive in that, and things do come to light, you know, come to the surface a bit. But it’s worth persevering really. For instance, it sort of dawned on me through psychotherapy about our childhood, whereas it hadn’t before.


Hmm. So this was psychotherapy rather than just counselling, wasn’t it?


Well both. I think counselling will do that as well.


Yes.


Psychotherapy is a bit more, it’s a bit more practical I would say. Counselling is sort of more about the patient or the client or whoever speaking, opening up. The counsellor, counsellor more, offering, steering the, the client in the right direction. Whereas psychotherapy is very focused on treatment and maybe sort of how to review your thinking and other things. Many aspects are covered in psychotherapy.


By treatment, do you mean to, to help the person reassess and think in a different way?


Yes. Yes.


Or did you have something else in mind?


Yes, that’s about it, to sort of change your thought processes and negative thinking and ...

 

Hmm.


... what you can actually do to, practical things, what you can actually write down things, you know, write down events and how they’ve affected you and, you know, just sort of very practical, so that you can actually see what’s happening there.


So were you encouraged to write about what had happened?


I was sort of made to write about things, and I remember having a lot of fears and worries about something happening to my younger brother mainly.


Hmm.


So I was, that was put more into perspective in that, you know, what are the like, what’s the likelihood? What would be the event? What would be the, you know, that sort of analysing.


Hmm.


And the risk factors and trying to sort of get it into perspective so you’re not overwhelmed and thinking, “My God, this is going to happen to him.”
 
Yes.
 
Tomorrow. You know. And also [sighs] also I sort of, when things come, come to, came to the surface a bit more, how to sort of practically create boundaries, say with my mum, trying to do that sort of stuff, because it’s been quite tough because she’s been left isolated.
 
Hmm.
 
And I became a bit entangled, you know.
 
So therapy helped you decide on how much you should help and when you should help?
 
Yes.
 
And that sort of thing.
 
Yes, and that’s been a very, very long and difficult, and it’s still going on…

 

When Marion was “at rock bottom” her GP arranged for her to see a counsellor. Counselling, once a...

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Age at interview: 58
Sex: Female
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I fell and broke my ankle out on the common, which was careless, and then of course I had to go and see my GP because I needed time off sick. And I went to her one day and she said, ‘How’s the ankle?’ And I just dissolved, I just fell apart completely and said, ‘My ankle’s fine’. Which it wasn’t. ‘My ankle’s fine it’s just me. I can’t do it anymore’. And.


You needed somebody to look after you.


Yes, yeah. And I mean that doesn’t mean that my children haven’t because they’ve been wonderful. They really have, well three of them and the fourth one we’re working on [laugh]. No he’s, he’s ok now. He’s fine. I have to say I’m very proud of him now. But he was very hard work, very hard work. And I just fell apart completely. I couldn’t. I couldn’t cope any more. And my GP said, oh you know, “Would you like to see somebody?” And I said, “I don’t know. I don’t know what to do” And she set it [counselling] up and I turned up at this day centre thinking I shouldn’t really be here. There are people who need it far more than I do. And actually that was a load of rubbish because I needed it tremendously and I needed somebody to say to me, “It’s ok to go on being alive”. Because I didn’t want to, I didn’t want to.


Mm.


I think I’d reached a point there where I was just at rock bottom. I really, really was so.


So this was a trained professional counsellor?


Yes, yeah, yeah, yeah.


How often did you go and see that person?


I saw that person once a fortnight for three years. He’s now retired but I think it enabled me to put my life back on track where I just literally; I think to an extent I had still been on autopilot. I do. I think I’d been on autopilot. I think after a shock like that it is so, so difficult to, to go on functioning as a human being. You function at a totally different level. What was normal is not normal anymore and the new normal isn’t normal. It’s not what you want it to be but you do it anyway because that’s what happens.

Counsellors or psychotherapists may be attached to a GP’s practice or a hospital or a bereavement counselling service, or they may have their own private practice. Counselling is sometimes provided free by the National Health Service, or the person’s employer or college may pay for it. There may be a waiting list for counselling. Some people do not want to wait for counselling. They may want to choose their own counsellor and decide to pay for it themselves.
 

Amanda said that she found regular meetings with a psychotherapist challenging and very helpful....

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Age at interview: 53
Sex: Female
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Everybody in the family has sought help except for the youngest who’s carried on, very kind of brightly and sprightly and I know maybe has shared it with other people but doesn’t with us. I would recommend people find somebody, my husband and I both found psychotherapists. I already knew mine because of some of the stuff Lori was going through I was already talking about and other matters, so I already had a relationship. I would say to people, you will not, if you find somebody like a counsellor therapist you’ve got to build a relationship with them and they will also challenge you, so it’s not somebody who’s just going be there for tea and sympathy type things that’s what your friends are for, a therapist will challenge you because you’ve got to make sense of this and carry on your life and it’s very easy just to sit there and to become the, the, the mother, the parent, the brother, whatever of a suicide rather than to be who you are.
 

Paula’s GP arranged counselling for her, paid for by the NHS. She preferred to be asked questions...

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Age at interview: 45
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What about you? You said the GP arranged counselling for you? Was that all paid for by the National Health Service?


I had three emergency sessions with somebody who was very helpful. And that was National Health paid. Then she said I had to go on a waiting list and that the emergency sessions there was limited to three. And I had to go on a waiting list [um] because there weren’t enough people basically. So I went onto her waiting list and I had the option of being with her or being with anyone from that particular clinic, the NHS clinic, and I put down to be with her, which meant that I would have to wait a bit longer. And in the meantime I tried to find others, outside. There are various charities around the place. I phoned Cruse whose waiting list was full and they were not taking anyone onto a waiting list.


When you went to her for counselling was it mainly her letting you talk about what you wanted to talk about or did she encourage you to talk about certain things?


…Probably a bit of both really.


Mm.


I mean I did have one who earlier among these charities that I tried, who just listened and I found that [laugh] very, very difficult you know. And there was one session I sat there and didn’t say a single thing and thought well come on say something [laugh]. It was very odd and I didn’t find that terribly helpful. I needed a bit of tweaking here and there at least. You know. But no the NHS one she did ask questions, not searching questions but I suppose to kind of kick start things.


Mmm.


…Anyway that finished and that was when I found the WAY Foundation.

Between Chloe’s death and her funeral, Linda and her husband found it really hard to sleep, and they hardly ate at all. Linda couldn’t stop thinking about the time when she found Chloe. One Sunday they decided to seek help so they went to the hospital and saw someone from the crisis management team. A member of the team gave them some tablets to help them sleep and someone else gave them useful advice to maintain their daily routines. Linda was also referred to a psychologist.

 
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A woman from the crisis management team gave Linda useful advice. Linda was also referred to a...

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Age at interview: 39
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Well I think the next [sighs] I don’t know how long it’d be, definitely the first few months were just hard to explain, just really difficult to get through. I had some tablets off the doctor, probably the first week because every time I went to bed I couldn’t sleep.


No.


And I’d get like these images in my head of her, that when I found her.

Hmm.


And we didn’t eat at all, me and my husband just weren’t eating. And I’d get up about 3 o’clock in the morning; I just couldn’t sleep at all. And I knew that the funeral was coming up and I wanted it to be the way we wanted it to be.


Hmm.


But I thought if I carry on with no sleep I won’t be able to get through it, so we phoned, I think we phoned the doctor and it was on the Sunday so we went up to the hospital and they said there was an, I think she was a crisis manager or something like that. And the man asked us if we’d like to speak to her and she was really good.


Did the doctor suggest that? Or, your GP. or did you just go over?


No, the, at the hospital.


You just went up there looking for help?


Well the doctor told us to go up there and they might be able to help. I think it was, must have been an emergency number…

 

Hmm.

 

… and …


They sometimes have a crisis management team, I think they’re called.


Yeah. I think it was something like that. So we went up and we were talking to the man up there and explained to him and he said he could give me some tablets just for a few days because they didn’t want you to get dependent on them. 


Were they to help you sleep?


Yeah.


Hmm.


And then there was this other lady, said would we like to go and talk to her. So we did. And she was really good because she said, “You’ve got to get into a routine, you’ve got to go through the process of making breakfast and dinner and your evening meal and to sit down.” And she said, “Even if you can’t eat it, you know, it’s just giving you some kind of pattern.” And then, you know, go to bed at the right time and things. And that really helped because all the days just seemed to blend into one another. And my other daughter was still at school …


And then he [the doctor at the hospital] talked to me and he said he thought that a psychologist might be able to help. And they referred me to somebody and that’s when I started going to the psychologist. And she was very good because she sort of did an assessment and then she said, “Oh there’s a waiting list of about six months”. And I just started to cry because I was really desperate then. So I thought I’ve tried all these other things and it’s not working and she must of obviously realised and she said, “Oh, I’ll find out, you know if we can see you any quicker.” And then she got back to me and said, “Because you’ve been waiting so long to talk to somebody then we can see you straight away.” So I’ve been going to see a psychologist. That was once a week until probably about three months ago and now I go every other week.


So when did that start? How long after your daughter’s death did that start?


Oh, probably about 18 months, something like that.


And then you say you saw a psychologist every week for how many weeks roughly?


Oh, since about, well, over a year now.


After one of Susan’s sons died by suicide she had counselling. The counsellor came from the hospital and went to Susan’s home once a fortnight for a year. The NHS paid for this.

 
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She could talk to the counsellor in confidence and found counselling helpful. It was hard to talk...

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Age at interview: 58
Sex: Female
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How did you find that counselling? Was it helpful?


It was very helpful, yeah, it was, I could talk to her, my counsellor, whereas I couldn’t always talk to family.


Did you have to go and see her? Or did she …?


She came to see me.


She came here?


Yes she came to my home for almost a year.


Was that every week or every month?


Every fortnight.


Mm.


Yeah, once a fortnight, which was a really good help.


How long did she stay with you?


Usually about an hour. Yeah, she was very very good.


She lets you talk as much as you want to, and it’s all in confidence which is nice, I could talk to her whereas I couldn’t really talk to my husband, because when somebody commits suicide, there’s a lot of guilt, you blame each other, which is awfully sad but you do, you’re looking to blame somebody, or you blame yourself. Could I have done more? Could I have done this? Could I have done that? You think about the things when you’ve had quarrels and the things that you said to them, which happened with both my sons, due to the drug taking, things could be quite heated at times, because we were angry with what they were doing with their lives. And you could see the problems it was causing.

Dave had Cognitive Behavioural Therapy (CBT) after his son died. CBT can help people to change how they think ("Cognitive") and what they do ("Behaviour)". These changes can help people feel better. Instead of focusing on the causes of distress or past events, it looks for ways to improve people’s state of mind now.
 
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After Ben died, Dave had cognitive behavioural therapy (CBT). He explains why he found it helpful.

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Age at interview: 56
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Did you have any individual counselling?


I’ve had loads of stuff, because I worked for the first year, but after a year, I could no longer do my job. I couldn’t think straight. My memory isn’t as good as it was. My organisational skills and thinking things through; it doesn’t work like that, so I had to stop doing my job, and when I stopped doing my job there was an insurance policy at work that would pay me a percentage of my salary if I couldn’t do my job through ill health.


Mm.


And I’ve claimed on that. And through the process of claiming through that, I’ve gone through on a private health scheme, seeing a psychiatrist, and I’ve, I’ve had counselling. I’ve had cognitive behavioural therapy sessions, which were very helpful.


Could you explain what that is?


It’s sitting talking to someone who can, …from what that person tells you, try and get you to think about things differently, not to assume things. There are, there are ways of thinking that aren’t helpful like, black and white thinking about, or mind-reading, thinking you know what someone’s thinking without questioning why they might be adopting an attitude towards you. So you might think that someone’s dealing with you [in a certain way] because you’re bereaved, when it might be the problem they’ve got that’s totally separate, you know. Someone might ignore you for what, for, for their own reason, you think it’s, so it’s not a good thing to mind-read. So there might be a dozen different ways that you can think unhelpfully to yourself.


Mm.


And CBT is about changing the way you, you approach people and think about things. So I found that very helpful. I’d often say that people should have CBT as part of their education in schools perhaps.

 

Just to, to teach people to deal with other people in different way. And you’d get, you’d have a lot less falling out if people could understand people a bit better. It’s all communication. And communication is a cause of lots of problems.

The NHS mental health team offered Stuart three or four sessions of bereavement counselling but he decided that that would not be adequate so he found a counsellor through the British Association for Counselling and Psychotherapy website. A scheme organised through his work paid for a number of sessions, and he paid for some himself.
 
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Stuart explains why he found his psychodynamic counselling useful.

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Age at interview: 40
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And how many sessions did you see a counsellor for or is that still going on?


I saw them for about twelve sessions and then I stopped it and then I carried on with another counsellor, for a while as well, because I’d changed location.


And what happens at a typical counselling session?


It depends on what sort of counselling you go for because there’s a number of different types that are available. So I wanted something that was reasonably structured, although I did in the end have, I think it’s called Psychodynamic Counselling and that’s where you just sit there and you talk about things yourself and at first it may seem really difficult to get, talking about issues and talking about things, but actually, what you can find is that after maybe a, sort of a short while of being there the counsellor can be very good at sort of, without actually having to ask you probing questions get you to think about things and sort of open up a bit really, and that’s what’s useful, I found it useful to dump issues on a counsellor in a nice way, you know, rather than having all these issues sort of around in my head I, I felt like you could go there and it’s like putting them in a little box, taking them away from yourself, putting them in a little box with the counsellor and that’s it, it’s, that little bit’s squared off and dealt with.


So that was really helpful?


That was really helpful yeah, and I think you just need to keep that going regularly though and not expect it to happen overnight, because it will take time, depending on.


And how many years was it since Anne died?


Two years.


Yeah.


that’s probably in about the September two thousand and five.


And are you still going sometimes?


Sometimes I do go and see a counsellor yes because I think that’s useful.


Can you just ring up and make an appointment?


It depends on the counsellor. Some of them like to see you on a regular basis and some them are happy for you to do that.


Mmm.


But at the moment I’m seeing someone who may also be able to help with children as well and I think that’s quite useful.

Some people had other types of therapy. Dolores still sees a psychotherapist, who offered her Eye Movement Desensitization and Reprocessing (EMDR). This is a therapy that uses eye movements and thoughts to resolve symptoms resulting from exposure to a traumatic or distressing event.
 

After Steve died Dolores felt guilty about what had happened. She has seen a psychologist every...

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Age at interview: 40
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So, but I’ve been very lucky, I’ve a very good bereavement counsellor and I broke down in the chapel, one day after Steve’s funeral mass, I broke down in the chapel, and we had been married in this chapel and our son had been christened in it just like thirteen weeks before, and I broke down one day in the chapel and I was very lucky that a person that came into the chapel while I was there, was in the field of psychology and, they said, “I’m going to ask somebody to give you a wee call, who I think’ll be really helpful for you.” And it was a psychologist who still sees me fortnightly two years on, and has made a big difference, and she has done EMDR, eye, eye densense, eye movement desensititation.


Can you say that again?


E, M,D, R, it’s Eye Movement Desensitization and I don’t know what the R stands for.


Mmm.


But it’s to help you, you have to be, excuse me, you have to be in a certain place with your grief, or with your situation, to be ready to do it and about April time of this year the psychologist asked if I would be willing to try it, and she basically gets you to relax, gets you to a place, you find a safe place where you feel you’re safe, and then you use a mode of transport, and you go on a journey, and they do this, get your eye follows their finger at different speeds and you’re kind of working through your grief or your, sorrow, whatever inside and your emotions. And she got me doing this with Steve, and she got me to a place where I could actually after it say, I couldn’t save Steve, because I was just another passenger on the train, but he was on the train as well and he was driving the train, and I couldn’t stop the train, and it was one of these therapies that I found very useful to, getting me to a place where, I will always carry guilt, I know I’ll always carry guilt but, but not the intensity, I was, a year ago, because I do feel I should’ve shouted more, and demanded a better service than what we got.

 

The counselling you’ve had.

 

Mmm, uh-huh.


Do you have to pay for that yourself or is that free?


I’ve been very lucky, I’ve been extremely lucky with the counselling that when my husband was missing the GP had referred me because I wasn’t coping very well and so I was in the system.


Mmm.


But if I wasn’t in the system prior to my husband dying I could’ve had up to a six months wait for an appointment, and again, the services are just so overstretched and under resourced that it’s really, really frustrating because you know there’s a lot more people than yourself out there that all need help with this.

Some people received help from various sources. After two of Kate’s children died by suicide she received help from her GP, from the local mental health crisis team, and from a mental health nurse, who called at the house every day for the first six weeks after Anna died. Kate also saw a psychiatrist, and has had five sessions of ‘family therapy’. Other members of the family are supposed to go to the family therapy but she is the only one who goes. When we talked she was about to start counselling for post-traumatic stress disorder. This is available for those who are experiencing thoughts and feelings associated with trauma, such as repeated vivid recall of events, flashbacks, intrusive images and thoughts, nightmares and anxiety.
 

Post-traumatic stress counselling is sometimes offered to people who have lost someone by suicide...

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Age at interview: 55
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You said you wanted to say something about this post-traumatic stress counselling.


I still have flashbacks to the time when I found Izzy and also when the, when the police came to tell me about Anna. You know, that, that was horrific. So I still have those, that is an, also a flashback of the time. And my therapy, therapist has suggested for me to go a post-traumatic stress clinic which is at a local hospital, which I shall be going to in a couple of months. It doesn’t take the images away, the images will always be there. But they soften them so they’re less, they’re not so overwhelming, because they, at, at his moment they’re just too overwhelming and, and they can just come. You know, I can be thinking about things and all of a sudden I’d, I’d see Izzy and I’m back to that time and I’m back to that time when the police came. So, hopefully, it will help.


You haven’t been yet?


No, I haven’t been yet. But it, it’s just, until this actually happens, a suicide in the family, people don’t realise the utter devastation that is left when a person commits suicide. I know the person that is thinking about it thinks, “Oh gosh, you know, I can’t go on. I can’t do this and nobody loves me and I’m not, I’m not worth, I’m not worth anything, nobody will miss me [airplane noise] and I’m so bad. I’m this and I’m that and I’ve caused my parents so much trouble and my girlfriend/boyfriend, you know, they, you know, it’s not fair and I’m going to teach them.” But it’s final, it’s, death is final.

 
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Jacqui had eight sessions of cognitive behavioural therapy to boost her confidence. She saw the...

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Age at interview: 45
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Did the GP say he could arrange any sort of counselling for you?

When I went off sick, the second time in the October, no, I’d sort of managed okay, just ticking along, but then really depression set in and I have been a sufferer of depression myself in the past, also those other things going on like my, my son wasn’t too great at that point in time, and I was worrying about him, and, and, you know, how we were going to get through this and, in the, yeah so I ended up, I ended up on anti-depressants again and then, then she arranged for me to have counselling, well cognitive behavioural therapy.

That was paid for by the National Health Service?

Yes, yeah.

Do you want to say a little bit about what that is? People might not know.

It’s really just [laughs], this is how much have I picked up on it, it’s really it’s just a way to challenge, challenge your thoughts and your thinking. My self-esteem had gone rock bottom, I had no confidence in myself, I had no confidence in my standing as the family, in the family because all the dynamics had changed, and I sort of even had lost, I hadn’t, I wouldn’t say I’d lost parental control but it was a case of, everything had changed and, because my son was going through his own problems, due to Mike’s suicide, it was just very-very, very-very fraught and, I’d felt very desperate, very, very desperate at times.

Mmm.

And they were able, they were able to help me look at thing, look at situations. I talked, I talked, you know, when I went, I used to go once a month and it would be, “Right what’s happened? What’s happened this month and what, what’s been going on and how did you handle that? And did you not think if, if we’d done it this way, you know, or you could look at some, look at a situation as so.” It just gave you different ways to think about how to handle a situation and also if I had handled a situation I was able to report back on it and they were able to say, “Yeah that was right, you did good there.” And, and, you know, that was, that was the right way to do it, or absolutely, or, “Well done you’ve got through this situation.” And, you know, it, so it was it was really just to help challenge the thoughts, the negative thoughts and, and, really boost, you know.

Your self-esteem.

boost my self-esteem and my, and my confidence and to be able to take my standing back in the family as that, I am the mother you know?

And did it help?

Yes, yeah it did definitely. Also I looked at my work as well what I wanted to do about my work at, ‘cause at the time I was still off sick And I didn’t know what I wanted to do. I couldn’t make decisions, and it’s a case of do you stick with the devil you know or the devil you, or do you go on the devil you don’t know, and I just didn’t know, just didn’t know what I wanted to do and eventually I got to that stage where I made the decision that I wanted to change, change what I was doing, and they supported me while I looked for other jobs and, and things like that and, you know, let them know when I had an interview and how I got support with that.

That’s good. Did you always go to the same therapist each time?

I had the same, yeah it was the CPN, Community Psychiatric Nurse, was assigned to m.

And you went to the hospital to see her or the clinic or?

It was at the, not my doctor’s surgery but it was at another doctor’s surgery in the community.

Not too far then?

Not too far, no.
 
Oh good.
 
Not too far at all.
 
That was a helpful thing to do?
 
Yeah, yeah, no it was, it was great, yeah that was very helpful.
 
How many months did that go on for?
 
I had, I had I think I had two initial sessions where it was, you know, circumstances were discussed. You know, obviously I had to be referred by my GP so oh that was just, and then we had six sessions of the actual therapy in which I was given things to do, I had to, you know you had to write a mood diary and, and that, you know, if you had situa, you know, you came across a situation you had to, it was homework really write you know, write, write down the situation, write your automatic thoughts of, of that situation and then you’re also asked to look at it objectively or, or what I was taught to do, to think about it was to say, “Well if that was your sister or your friend that that was happening to what would you say to them?.” And I know when I was put, you know, put this hypothetical other person in the same situation I was able to empathise with them and treat them in a completely different way to the way I was doing myself. I was treating myself so that was helping me understand that I was.
 
Mmm.
 
the thoughts, the way I looked at things myself was different for the, I expected, I would speak to others, does that make sense?
 
Yes it does. So that it helped you.
 
Yeah. You know, ‘cause like if, you know, if your friend was upset or something like that you would say, “But, you know, it’s not your fault.” Or you know, “Well what makes you think? Why, why d’you feel that, that’s the case?” And things like that, so you, so it was helping me challenge my thoughts, my automatic negative thoughts by just sorta, just going that little step further, as if to say well if that was your friend, or if that was your sister what would you have said to them? And of course I said, of course I would say something completely different to them.
 
Mmm.
 
so it was a case of well, well if that’s what you would say to your friend or your sister, if that’s what would you do why d’you do that to yourself?
 
Could you go back and see her again if you wanted to?
 
Yes I’ve had, I’ve had a follow-up session, I think it was maybe after three months and then I have another one in a month’s time if I want to.
 
Oh that’s good.
 
Just to re-cap, just to see how things are going.

Some of the people we talked to said that they did not want any counselling. Michael, who was living in Australia when he was bereaved, felt very depressed after his friend died. He could not work. After about five weeks his GP refused to sign the ‘sick notes’ unless he agreed to have some counselling. He had about six weeks of counselling but did not find it useful; perhaps partly because he did not think he needed it and did not want to attend. He also wonders if it was just the wrong kind of counselling for him.

 

Counselling did not help Michael but he did feel he needed time off work and to be able to use...

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Age at interview: 42
Sex: Male
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I also took about ten weeks off work actually, and I think I needed to, you know I was a wreck, and just was not capable of, I, I have work that requires thought and I was not capable of giving it that thought. And you know if I’d been forced to go into work and cope with that I’d just, I don’t know what I would have done but, taking time off work was definitely a good thing. My doctor was happy to write me sick notes for that. After about five weeks he actually became less happy just to write sick notes for time off work and he thought I needed to go and get some counselling. I actually didn’t think I needed counselling, I thought my reaction to what had happened was reasonable given the enormity of what had happened. However I thought, pragmatically, he was reluctant to continue to sign me off if I didn’t go to get counselling and so I thought well I would go and get counselling. And I still remain of the opinion that I didn’t really need counselling but that that was a good thing to do because it gave me the space to work through things in my own time. I actually found the counselling less than useful which is, looking back, surprising but you know, you know I guess it’s hard to find a good counsellor that you will necessarily interact with well, and I think some of the things we talked about were ridiculous. I mean one thing that sticks in my mind was this, several years later and it still sticks in my mind, after I’d been to see, after I’d been to the funeral I said to him, I was explaining I was describing it to him, and I said, “The coffin was very small.” And he said, “Oh why do you think the coffin, what do you think that means?” And I just think that it means that the fellow who died was quite a small fellow and he didn’t need a big coffin. And I still can remember thinking back at the time, you know, this is not doing me any good this conversation, however, never mind.


How did the counselling sessions go? And what happened at the beginning?


They tended to be very slow actually, because I, I think if you don’t want, I think that’s a general rule actually if you don’t want to be in a counselling session it’s going to be hard for the counselling session to do much good. And he would…, the counsellor tried to ask those kind of symbolic meaningful questions I think, and I actually don’t think that was the state of mind that I was in at the time, I just needed to go through I think the stages of grief. And you know take some time to come to terms with things and you know, I, to my mind my friend’s death wasn’t a symbol of anything, it didn’t mean anything. It meant he was unhappy in his life but it didn’t mean anything to me in a, in a, in that broader sense, and I, you know perhaps it was just the wrong kind of counselling. I think I, I think you know, the strategies I used to cope were, you know taking time and being with people and talking with other people about the issues, about you know my feelings and about my memories and that kind of stuff, and nothing more than that. So I think the counselling wasn’t just aimed correctly. And so what we would actually tend to do, is sit for long periods without, not saying much and that’s just, I, you know, was completely the wrong thing for me.


Did you have to pay for it?


No, it was all on, this all happened in Australia, and you can get a certain amount of counselling for free.

 

Steve had bereavement counselling through his NHS occupational health department, but he felt...

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Age at interview: 37
Sex: Male
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Did you ever get any help with your feelings? Did you have any counselling?

 

I did. I did have counselling. I had to go on a waiting list for it at my GP surgery that is. I had counselling through my NHS Trust occupational health department. And initially I suppose it was, it was good to talk to people who were not directly involved but it wasn’t helpful. It wasn’t helpful at all. It wasn’t. It didn’t meet my needs. It, it wasn’t just a death. This, a suicide death is so different from a natural death. It’s, you need to be able to share your experiences with people who know what you’re actually feeling and bereavement counsellors, unless they’ve experienced it themselves, don’t actually know how you are feeling. So although the bereavement advice they give you I suppose is pretty, pretty standard and generalised and it may be helpful I suppose but it didn’t help me at all.

Last reviewed July 2017.

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